- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT01208441
RO4929097 and Letrozole in Treating Post-Menopausal Women With Hormone Receptor-Positive Stage II or Stage III Breast Cancer
A Phase Ib Neoadjuvant Study of the Gamma Secretase Inhibitor (RO4929097) in Combination With the Aromatase Inhibitor Letrozole in Post-Menopausal Women With Stage II/III Hormone Receptor-Positive Breast Cancer
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
PRIMARY OBJECTIVES:
I. To establish the maximum-tolerated dose and the recommended phase II dose of gamma-secretase inhibitor RO4929097 (RO4929097) in combination with letrozole in post-menopausal women with hormone receptor-positive stage II or III breast cancer.
II. To assess the safety of this regimen in these patients.
SECONDARY OBJECTIVES:
I. To evaluate the pharmacokinetics of this regimen, taking into consideration the induction of CYP3A4, in these patients.
II. To characterize the pharmacodynamic effects of letrozole prior to and during administration of RO4929097 with attention to suppression of estradiol and estrone levels.
III. To describe the pharmacodynamic effects of letrozole with or without RO4929097 on the NOTCH pathway, proliferation, angiogenesis, stromal cell infiltration/pathways, and comprehensive genomic analysis in tumor tissue of these patients.
IV. To describe the response, including clinical complete or partial objective response, pathological complete response, and attainment of pathologic stage 0 or I status in these patients.
OUTLINE: This is a multicenter, dose-escalation study of gamma-secretase inhibitor RO4929097(RO4929097).
Patients receive oral letrozole once daily on days 1-21. Beginning in course 2, patients also receive oral RO4929097 on days 1-3, 8-10, and 15-18. Treatment repeats every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity.
Beginning 1 week after completion of neoadjuvant therapy, patients undergo surgery or tumor biopsy. Patients continue to receive oral letrozole once daily during surgery and for an additional 4 weeks.
Blood and tumor tissue samples are collected at baseline and periodically during study for pharmacokinetics, pharmacodynamics, and correlative studies.
After completion of study therapy, patients are followed up for 1 month and then every 6 months for 5 years.
Type d'étude
Inscription (Réel)
Phase
- La phase 1
Contacts et emplacements
Lieux d'étude
-
-
Alabama
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Birmingham, Alabama, États-Unis, 35294
- University of Alabama at Birmingham
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-
Pennsylvania
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Pittsburgh, Pennsylvania, États-Unis, 15213
- Magee-Womens Hospital of UPMC
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Pittsburgh, Pennsylvania, États-Unis, 15232
- University of Pittsburgh Cancer Institute
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
Pathologically confirmed invasive breast cancer
Stage II or III disease (T2-T3, N0-2)
- No N3, T4 disease
Estrogen receptor-positive (ER+) and/or progesterone receptor-positive (PR+)
- H score ≥ 10 or positivity ≥ 10%
- HER2 negative as determined by IHC (1 or 2+) or FISH (< 2.0+)
- Bilateral disease allowed as long as all tumors are ER+ and ≥ 1 is T2-T3
Patient must have disease that is palpable on physical exam and able to be imaged via breast ultrasound
- Defined as ≥ 1 T2 tumor > 2 cm
- Multifocal disease allowed provided that ≥ 1 of the tumors is > 2 cm
- No metastatic disease by CT scans of the chest, abdomen, and pelvis, a PET/CT bone scan, or nuclear medicine bone scan
- No inflammatory breast cancer or presence of breast tumor cells in the dermal lymphatics of the breast
Post-menopausal meeting 1 of the following criteria:
- Bilateral oophorectomy
- Age ≥ 50 years and amenorrheic for > 12 months in the absence of chemotherapy, tamoxifen, toremifene, or ovarian suppression (spontaneous amenorrhea)
- ECOG performance status (PS) 0-2 (Karnofsky PS 60-100%)
- Life expectancy > 3 months
- ANC ≥ 1,000/mm³
- Platelet count ≥ 100,000/mm³
- Hemoglobin ≥ 9 g/dL
- Total bilirubin normal
- AST and ALT ≤ 2.5 times upper limit of normal
- Creatinine normal OR creatinine clearance ≥ 60 mL/min
- Baseline QTcF ≤ 470 msec
- No history of allergic reactions attributed to compounds of similar chemical or biologic composition to gamma secretase inhibitor RO4929097 or other agents used in the study
- No malabsorption syndrome or other condition that would interfere with intestinal absorption
- Able to swallow tablets
- Not serologically positive for hepatitis A, B, or C, or have a history of liver disease, other forms of hepatitis, or cirrhosis
- No uncontrolled electrolyte abnormalities including hypocalcemia, hypomagnesemia, hyponatremia, hypophosphatemia, or hypokalemia despite adequate electrolyte supplementation
No uncontrolled intercurrent illness including, but not limited to, any of the following:
- Ongoing or active infection
- Symptomatic congestive heart failure
- Unstable angina pectoris
- History of torsades de pointes or other significant cardiac arrhythmia other than chronic, stable atrial fibrillation
- Psychiatric illness and/or social situations that would limit compliance with study requirements
- Recovered to < grade 2 CTCAE toxicities related to prior therapy
No prior chemotherapy, hormonal therapy, radiotherapy, or biological therapy for breast cancer
- Prior treatment for non-melanoma skin cancer or carcinoma in situ of the cervix allowed
- No prior hormone therapy for ductal carcinoma in situ (DCIS)
- No other concurrent investigational agents
- No concurrent medications with narrow therapeutic indices that are metabolized by cytochrome P450 (CYP450), including warfarin sodium (Coumadin®)
No concurrent medications that are strong inducers and/or inhibitors or substrates of CYP3A4
- Switching to alternative medications allowed
- No concurrent combination antiretroviral therapy for HIV-positive patients
- No concurrent antiarrhythmics or other medications known to prolong QTc
- No other concurrent anticancer agents or therapies
- No concurrent grapefruit juice
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
---|---|
Expérimental: Arm I
Patients receive oral letrozole once daily on days 1-21. Beginning in course 2, patients also receive oral RO4929097 on days 1-3, 8-10, and 15-18. Treatment repeats every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity. Beginning 1 week after completion of neoadjuvant therapy, patients undergo surgery or tumor biopsy. Patients continue to receive oral letrozole once daily during surgery and for an additional 4 weeks. |
Autres noms:
Autres noms:
Autres noms:
Autres noms:
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Délai |
---|---|
MTD defined as the dose level at which no more than 1 of 6 patients experience a DLT, and the dose below that at which at least 2/6 patients have DLT according to NCI CTCAE version 4.0
Délai: 21 days
|
21 days
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Measurement of NOTCH 1 and 4, activated NOTCH (ICN), Hey 1 and NOTCH ligands (DLL4 and Jagged 1)
Délai: Baseline
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
Baseline
|
Measurement of NOTCH 1 and 4, activated NOTCH (ICN), Hey 1 and NOTCH ligands (DLL4 and Jagged 1)
Délai: 21 days
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
21 days
|
Measurement of NOTCH 1 and 4, activated NOTCH (ICN), Hey 1 and NOTCH ligands (DLL4 and Jagged 1)
Délai: 42 days
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
42 days
|
Measurement of NOTCH 1 and 4, activated NOTCH (ICN), Hey 1 and NOTCH ligands (DLL4 and Jagged 1)
Délai: At time of surgery
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
At time of surgery
|
Genomic analysis of RNA transcriptome, mirco-RNA transcriptome, and DNA methylation
Délai: Baseline
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
For the analysis of the gene expression data, the overall false discovery rate (FDR), which is defined as the expected portion of false positives, will be controlled at 20% to generate a list of genes for further investigation.
|
Baseline
|
Genomic analysis of RNA transcriptome, mirco-RNA transcriptome, and DNA methylation
Délai: 21 days
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
For the analysis of the gene expression data, the overall FDR, which is defined as the expected portion of false positives, will be controlled at 20% to generate a list of genes for further investigation.
|
21 days
|
Genomic analysis of RNA transcriptome, mirco-RNA transcriptome, and DNA methylation
Délai: 42 days
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
For the analysis of the gene expression data, the overall FDR, which is defined as the expected portion of false positives, will be controlled at 20% to generate a list of genes for further investigation.
|
42 days
|
Genomic analysis of RNA transcriptome, mirco-RNA transcriptome, and DNA methylation
Délai: At time of surgery
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
For the analysis of the gene expression data, the overall FDR, which is defined as the expected portion of false positives, will be controlled at 20% to generate a list of genes for further investigation.
|
At time of surgery
|
Measurement of cell proliferation (Ki-67)
Délai: Baseline
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
Baseline
|
Measurement of cell proliferation (Ki-67)
Délai: 21 days
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
21 days
|
Measurement of cell proliferation (Ki-67)
Délai: 42 days
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
42 days
|
Measurement of cell proliferation (Ki-67)
Délai: At time of surgery
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
At time of surgery
|
Measurement of appoptosis (TUNEL and activated caspase)
Délai: Baseline
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
Baseline
|
Measurement of appoptosis (TUNEL and activated caspase)
Délai: 21 days
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
21 days
|
Measurement of appoptosis (TUNEL and activated caspase)
Délai: 42 days
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
42 days
|
Measurement of appoptosis (TUNEL and activated caspase)
Délai: At time of surgery
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
At time of surgery
|
Measurement of angiogenesis (VEGF and CD31)
Délai: Baseline
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
Baseline
|
Measurement of angiogenesis (VEGF and CD31)
Délai: 21 days
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
21 days
|
Measurement of angiogenesis (VEGF and CD31)
Délai: 42 days
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
42 days
|
Measurement of angiogenesis (VEGF and CD31)
Délai: At time of surgery
|
All measurements are continuous.
Descriptive statistics will be calculated to summarize change of each measurement from the baseline value.
A two-sided Wilcoxon signed rank test will be used to compare each measurement at a specific time to the baseline value.
|
At time of surgery
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Shannon Puhalla, University of Pittsburgh
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Maladies de la peau
- Tumeurs
- Tumeurs par site
- Maladies du sein
- Tumeurs mammaires
- Effets physiologiques des médicaments
- Mécanismes moléculaires de l'action pharmacologique
- Inhibiteurs d'enzymes
- Agents antinéoplasiques
- Hormones, substituts hormonaux et antagonistes hormonaux
- Antagonistes hormonaux
- Inhibiteurs de l'aromatase
- Inhibiteurs de la synthèse des stéroïdes
- Antagonistes des œstrogènes
- Létrozole
- R04929097
Autres numéros d'identification d'étude
- NCI-2011-02487 (Identificateur de registre: CTRP (Clinical Trial Reporting Program))
- U01CA099168 (Subvention/contrat des NIH des États-Unis)
- UPCI-09-080
- CDR0000683397
- UPCI 09-080 (Autre identifiant: University of Pittsburgh Cancer Institute)
- 8554 (Autre identifiant: CTEP)
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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