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Ph II Letrozole + OSI-774 (Tarceva) in Post-menopausal, w/ ER and/or PR-positive Met Breast Cancer.

3 août 2012 mis à jour par: Ingrid Mayer, MD, Vanderbilt-Ingram Cancer Center

A Phase II Trial of Letrozole Plus OSI-774 (Tarceva) in Post-menopausal Women With ER and/or PR-Positive Metastatic Breast Cancer

RATIONALE: Estrogen can cause the growth of breast cancer cells. Hormone therapy using letrozole may fight breast cancer by blocking the use of estrogen by the tumor cells. Erlotinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving letrozole together with erlotinib may kill more tumor cells.

PURPOSE: This phase II clinical trial is studying how well giving letrozole together with erlotinib works in treating postmenopausal women with estrogen receptor-positive and/or progesterone receptor-positive locally recurrent or metastatic breast cancer.

Aperçu de l'étude

Statut

Résilié

Les conditions

Intervention / Traitement

Description détaillée

OBJECTIVES:

Primary

  • To determine the rate of clinical benefit (complete response [CR], partial response [PR], and stable disease [SD] in patients with hormone-dependent locally recurrent or metastatic breast cancer treated with letrozole in combination with erlotinib hydrochloride.

Secondary

  • To determine the time to progression (TTP) in patients treated with this regimen.
  • To evaluate the anti-tumor activity, as determined by CR and PR rates, of this regimen in these patients.
  • To evaluate the safety of this regimen in these patients.
  • To determine if tumors that are positive for epidermal growth factor receptor (EGFR) or Ser118 ER, or that overexpress human epidermal receptor (HER2) exhibit a longer TTP from the combination compared to tumors that do not express or overexpress these molecules.

OUTLINE: This is a multicenter study. Patients are stratified according to prior hormone therapy (hormone-therapy naive/first-line therapy vs prior hormonal therapy with either tamoxifen or an aromatase inhibitor in the adjuvant or metastatic setting/second-line therapy)

Patients receive oral letrozole and oral erlotinib hydrochloride once daily in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed every 3 months for 2 years, every 6 months for 3 years, and then yearly thereafter.

Type d'étude

Interventionnel

Inscription (Réel)

48

Phase

  • Phase 2

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • États-Unis
    • Georgia
      • Macon, Georgia, États-Unis, 31201
        • Central Georgia Hematology/Oncology Associates, P.C.
    • Kentucky
      • Hopkinsville, Kentucky, États-Unis, 42240
        • Jennie Stuart Medical Center
      • Paducah, Kentucky, États-Unis, 42002
        • Purchase Cancer Group
    • Tennessee
      • Chattanooga, Tennessee, États-Unis, 37404
        • Memorial Health Care System
      • Germantown, Tennessee, États-Unis, 38138
        • The Jones Clinic - Germantown
      • Jackson, Tennessee, États-Unis, 38301
        • Jackson-Madison County Hospital
      • Knoxville, Tennessee, États-Unis, 37909
        • Tennessee Cancer Specialists
      • Nashville, Tennessee, États-Unis, 37232-6838
        • Vanderbilt-Ingram Cancer Center
      • Nashville, Tennessee, États-Unis, 37067
        • Vanderbilt-Ingram Cancer Center - Cool Springs

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Femelle

La description

  • Patients must have estrogen (ER) and/or progesterone receptor (PgR)-positive, histologically confirmed adenocarcinoma of the breast with measurable (but not operable) locally recurrent disease, or measurable and/or evaluable metastatic disease (see protocol section 10.3), including isolated bone metastases.
  • Patients with available paraffin tissue blocks from either the primary or the metastatic site must submit tissue blocks for retrospective EGFR and HER2 analysis. If tissue blocks cannot be submitted, 20 unstained slides from each paraffin block must be submitted.

  • All patients must be post-menopausal females as defined by one of the following:

    • Prior bilateral oophorectomy
    • Prior bilateral ovarian irradiation
    • No menstrual period for 12 months or longer
    • If age 55 years or less and < 12 months from last menstrual period, patient must have a serum estradiol < or equal to 30 and an FSH level > 40.
  • Patients must not have had more than 1 prior chemotherapy regimen for metastatic disease and have fully recovered from any grade 2-4 toxicities related to chemotherapy. No concurrent chemotherapy is allowed while on protocol therapy.
  • Patients may have had 1 prior hormonal therapy for metastatic disease. This includes: tamoxifen, fulvestrant, anastrozole, exemestane, aminoglutethimide, megace, and letrozole. Patients may have received tamoxifen or aromatase inhibitors in the adjuvant setting.
  • Patients must not have had prior therapy with EGF receptor inhibitors.
  • Previous but not concomitant therapy with trastuzumab (Herceptin) is allowed. Patients must not have received Herceptin within 4 weeks of initiation of protocol therapy.
  • Patients must have an ECOG performance status of 0, 1, or 2.

  • Patients must have adequate hematologic, hepatic, and renal function as defined by the following within 2 weeks of initiation of therapy:

    • Absolute neutrophils > or equal to 1,500/mm3 and platelets > or equal to 100,000/mm3.
    • Bilirubin < than or equal to 1.5 upper limit of normal.
    • SGOT and SGPT < or equal to 2.5 upper limit of normal.
    • Creatinine < or equal to 1.5 upper limit of normal.
    • INR, PTT and PT in the normal range.
    • Must be 18 years of age or older.
  • Patients must not have a history of central nervous system metastases or unevaluated CNS symptoms suggestive of possible brain metastases.
  • Patients may receive concurrent radiation therapy to painful bone metastases or areas of impending bone fracture as long as radiation therapy is initiated prior to study entry and sites of evaluable disease outside the radiation port(s) are available for follow-up. Patients who have received prior radiotherapy must have recovered from toxicity induced by this treatment.
  • Patients < 55 years of age must not have received Luteinizing hormone releasing hormone (LHRH) antagonists within 3 months prior to protocol therapy.
  • Patients must not suffer from medical or psychiatric conditions that would interfere with ability to provide informed consent, communicate side effects, or comply with protocol requirements including maintenance of a compliance/pill diary.
  • Patients must be disease-free of prior invasive cancers for > 5 years with the exception of basal or squamous cancer of the skin or cervical carcinoma in situ.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Non randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: First line/hormone-therapy naive
Médicament: erlotinib hydrochloride
OSI-774 150 mg/day
Autres noms:
  • Tarceva, OSI-774
Médicament: letrozole
Letrozole 2.5 mg/day
Autres noms:
  • Fémara
Génétique: fluorescence in situ hybridization
To determine HER2 gene amplification or excess copies of the HER2 gene
Autres noms:
  • Aucun spécifié
Autre: immunohistochemistry staining method
to measure the epidermal growth factor receptors (EGFR)
Autres noms:
  • Aucun spécifié
Autre: laboratory biomarker analysis
To determine if specific biomarkers exhibit a longer time to tumor progression after treatment with the study drugs
Autres noms:
  • aucun spécifié
Expérimental: Second-line/prev hormone-therapy tx
Médicament: erlotinib hydrochloride
OSI-774 150 mg/day
Autres noms:
  • Tarceva, OSI-774
Médicament: letrozole
Letrozole 2.5 mg/day
Autres noms:
  • Fémara
Génétique: fluorescence in situ hybridization
To determine HER2 gene amplification or excess copies of the HER2 gene
Autres noms:
  • Aucun spécifié
Autre: immunohistochemistry staining method
to measure the epidermal growth factor receptors (EGFR)
Autres noms:
  • Aucun spécifié
Autre: laboratory biomarker analysis
To determine if specific biomarkers exhibit a longer time to tumor progression after treatment with the study drugs
Autres noms:
  • aucun spécifié

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Number of Patients With Pathological Complete Response.
Délai: at 24 weeks
Per RECIST criteria v. 1.0: measurable lesions: complete response (CR) disappearance of target lesions, partial response (PR) > 30% decrease in the sum of the longest diameter (LD) of target lesions, stable disease (SD) neither sufficient decrease nor increase of the sum of smallest sum of the LD of target lesions
at 24 weeks

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Median Time to Progression of Target Lesions
Délai: Every 12 weeks from on-study to disease progression
Time frame from study entry till discontinuation of treatment due to disease progression. Progression of target lesions is measured by RECIST criteria v. 1.0: measurable lesions: complete response (CR) disappearance of target lesions, partial response (PR) > 30% decrease in the sum of the longest diameter (LD) of target lesions, progressive disease (PD) > 20% increase in the sum of the LD of target lesions or appearance of new lesions, stable disease (SD) neither sufficient decrease nor increase of the sum of smallest sum of the LD of target lesions.
Every 12 weeks from on-study to disease progression
Number of Patients With Anti-tumor Activity: Complete Response (CR) and Partial Response (PR)
Délai: at 24 weeks
Per RECIST criteria v. 1.0: measurable lesions: complete response (CR) disappearance of target lesions and partial response (PR) > 30% decrease in the sum of the longest diameter (LD) of target lesions.
at 24 weeks
Number of Patients With Worst-grade Toxicities Per Grade
Délai: at 24 weeks
Number of patients with worst-grade toxicities following NCI Common Toxicity Criteria: 1 = mild, 2 = moderate, 3 = severe, 4 = life-threatening, disabling, 5 = death
at 24 weeks

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Vanderbilt-Ingram Cancer Center

Collaborateurs

National Cancer Institute (NCI)

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 novembre 2003

Achèvement primaire (Réel)

1 décembre 2008

Achèvement de l'étude (Réel)

1 décembre 2008

Dates d'inscription aux études

Première soumission

8 février 2008

Première soumission répondant aux critères de contrôle qualité

8 février 2008

Première publication (Estimation)

11 février 2008

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Estimation)

9 août 2012

Dernière mise à jour soumise répondant aux critères de contrôle qualité

3 août 2012

Dernière vérification

1 août 2012

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • VICC BRE 0303
  • VU-VICC-BRE-0303
  • VU-VICC-030592
  • GENENTECH-VU-VICC-BRE-0303
  • NOVARTIS-VU-VICC-BRE-0303

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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