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Lapatinib and Topotecan in Treating Patients With Ovarian Epithelial Cancer or Primary Peritoneal Cancer That Did Not Respond to Cisplatin or Carboplatin

20 marzo 2014 aggiornato da: Mayo Clinic

A Phase II Trial of Lapatinib in Combination With Weekly Topotecan in Patients With Platinum-Refractory/Resistant Ovarian and Primary Peritoneal Carcinoma

RATIONALE: Lapatinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as topotecan, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving lapatinib together with topotecan may kill more tumor cells.

PURPOSE: This phase II trial is studying how well giving lapatinib together with topotecan works in treating patients with ovarian epithelial cancer or primary peritoneal cancer that did not respond to cisplatin or carboplatin.

Panoramica dello studio

Stato

Completato

Condizioni

Intervento / Trattamento

Descrizione dettagliata

OBJECTIVES:

Primary

  • Determine the efficacy of lapatinib ditosylate and topotecan hydrochloride, in terms of response, in patients with platinum-resistant or refractory ovarian epithelial or primary peritoneal cavity carcinoma.

Secondary

  • Determine the overall survival time in patients treated with this regimen.
  • Determine the time to progression in patients treated with this regimen.
  • Assess the toxicity profile of this regimen in these patients.

Translational

  • Determine the expression patterns of epidermal growth factor receptor, HER2/neu, hypoxia-induced factor 1 alpha, CD31, breast cancer resistance protein, and topoisomerase I by immunohistochemistry using tumor tissue from primary debulking surgery.
  • Determine the feasibility of monitoring circulating tumor cells with specific biological markers to determine or follow response in these patients.

OUTLINE: This is a multicenter study.

Patients receive oral lapatinib ditosylate once daily on days 1-28 and topotecan hydrochloride IV over 30 minutes on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Blood samples are collected at baseline and on day 8 of course 1 (immediately after the topotecan infusion) and are evaluated for pharmacological studies. Tumor tissue samples obtained at debulking surgery are examined by immunohistochemistry for epidermal growth factor receptor, HER1, ErbB1, HER2/neu, ErbB2, hypoxia-induced factor 1 alpha, CD31, platelet endothelial cell adhesion molecule 1, topoisomerase I, and breast cancer resistance protein.

After the completion of study treatment, patients are followed periodically for 2 years.

PROJECTED ACCRUAL: A total of 39 patients will be accrued for this study.

Tipo di studio

Interventistico

Iscrizione (Effettivo)

18

Fase

  • Fase 2

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

    • Arizona
      • Scottsdale, Arizona, Stati Uniti, 85254
        • Mayo Clinic Arizona
    • Florida
      • Jacksonville, Florida, Stati Uniti, 32224
        • Mayo Clinic in Jacksonville
    • Minnesota
      • Rochester, Minnesota, Stati Uniti, 55905
        • Mayo Clinic Cancer Center

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Femmina

Descrizione

DISEASE CHARACTERISTICS:

  • Histologically confirmed ovarian epithelial or primary peritoneal carcinoma
  • Must have one of the following:

    • Measurable disease
    • Evaluable disease AND a CA-125 value that has increased ≥ 2 times the nadir value established after debulking surgery and first-line chemotherapy, confirmed by a second measurement within the past 21 days

      • If a second measurement has not been done, it can be done ≥ 7 days but < 21 days prior to study treatment
  • Platinum-refractory and/or -resistant disease after first-line chemotherapy

    • Patients retreated with platinum agents (i.e., second relapse) are not eligible
    • Patients treated with first-line triplet therapy (e.g., on clinical trial GOG-182) are eligible
  • Must have had debulking surgery

    • Tissue blocks from this surgery must be available
  • No CNS metastases

PATIENT CHARACTERISTICS:

  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2
  • Life expectancy ≥ 12 weeks
  • Absolute neutrophil count ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • AST ≤ 3 times ULN (5 times ULN if there is liver involvement)
  • Creatinine ≤ 1.5 times ULN
  • Hemoglobin ≥ 9.0 g/dL
  • No uncontrolled infection
  • No New York Heart Association class III or IV heart failure
  • Left Ventricular Ejection Fraction (LVEF) ≥ 50% by echocardiogram
  • No seizure disorder
  • No other prior or concurrent malignancy in the past 5 years except nonmelanoma skin cancer or carcinoma in situ of the cervix
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No prior topotecan hydrochloride
  • More than 4 weeks since prior surgery or procedure involving the peritoneum or pleura

    • CA125 measurements used as basis for enrollment must be made outside of this 4-week window
  • More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C) and recovered
  • More than 4 weeks since prior immunotherapy
  • More than 4 weeks since prior biologic therapy
  • More than 4 weeks since prior radiotherapy
  • No prior radiotherapy to > 25 % of bone marrow
  • No prior therapy with an anti-epidermal growth factor receptor or anti-HER2 tyrosine kinase inhibitors
  • No prior agents targeting topoisomerase I
  • No prior or concurrent human anti-mouse antibodies (HAMA) in patients with non-measurable disease
  • At least 14 days since prior and no concurrent herbal or dietary supplements

    • Vitamin supplements are allowed unless they include herbal additives
  • At least 14 days since prior and no concurrent CYP3A4 inducers, including any of the following:

    • Rifampin
    • Rifabutin
    • Rifapentine
    • Phenytoin
    • Carbamazepine
    • Phenobarbital
    • Efavirenz
    • Nevirapine
    • Cortisone (> 50 mg)
    • Hydrocortisone (> 40 mg)
    • Prednisone (> 10 mg)
    • Methylprednisolone (> 8 mg)
    • Dexamethasone (> 1.5 mg)

      • Oral doses of ≤ 1.6 mg of dexamethasone allowed
    • Modafinil
    • Hypericum perforatum (St. John's wort)
  • At least 7 days since prior and no concurrent CYP3A4 inhibitors, including any of the following:

    • Clarithromycin
    • Erythromycin
    • Troleandomycin
    • Itraconazole
    • Ketoconazole
    • Fluconazole (> 150 mg daily)
    • Voriconazole
    • Delaviridine
    • Nelfinavir
    • Amprenavir
    • Ritonavir
    • Indinavir
    • Saquinavir
    • Lopinavir
    • Verapamil
    • Diltiazem
    • Nefazodone
    • Fluvoxamine
    • Cimetidine
    • Aprepitant
    • Grapefruit or grapefruit juice
  • At least 6 months since prior and no concurrent amiodarone
  • No concurrent participation in another study involving a pharmacologic agent (e.g., drugs, biologics, immunotherapy, gene therapy) for symptom control or therapeutic intent

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Non randomizzato
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Lapatinib + Topotecan
Assess biological effects of topotecan and lapatinib in patients with epithelial ovarian cancer and primary peritoneal carcinoma.
1250 mg orally days 1 -28.
Altri nomi:
  • Tykerb
3.2 mg/m2 IV over 30 min in 100mL D5W (5% dextrose in water) or 0.9% NS at days 1, 8 & 15.
Altri nomi:
  • Hycamptin

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Response Rate (Complete Response (CR) or Partial Response (PR))
Lasso di tempo: Two consecutive evaluations at least 4 weeks apart

Measurable disease patients: measureable disease is defined as at least one lesion whose longest diameter >= 2cm with conventional techniques or >=1cm with spiral CT

  • Confirmed tumor response (complete and partial) as measured by RECIST(Response Evaluation Criteria In Solid Tumors) criteria on 2 consecutive evaluations at least 4 weeks apart.
  • Confirmed tumor response is at least a 30% decrease in the sum of the longest diameter of target lesions and no new lesions.

Non-measurable disease patients:

  • Decrement in CA125 by > 50%
  • Improvement in other evaluable disease
Two consecutive evaluations at least 4 weeks apart

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Time to Progression
Lasso di tempo: Time from registration to progression (up to 2 years)
Time to progression was defined as the number of months from registration to the date of disease progression, with patients who are progression free being censored on the date of their last evaluation.
Time from registration to progression (up to 2 years)
Adverse Event Profile
Lasso di tempo: Every 4 weeks
Number of patients that experienced adverse events (grade 3 or more) as measured by NCI CTCAE (Common Terminology Criteria for Adverse Events) v3.0
Every 4 weeks
Overall Survival
Lasso di tempo: Time from Registration to Death or last follow-up (up to 3 years)
Overall survival time was defined as the number of months from registration to the date of death or last follow-up
Time from Registration to Death or last follow-up (up to 3 years)

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Collaboratori

Investigatori

  • Cattedra di studio: Paul Haluska, MD, PhD, Mayo Clinic
  • Investigatore principale: John K. Camoriano, M.D., Mayo Clinic

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 marzo 2007

Completamento primario (Effettivo)

1 marzo 2009

Completamento dello studio (Effettivo)

1 novembre 2012

Date di iscrizione allo studio

Primo inviato

15 febbraio 2007

Primo inviato che soddisfa i criteri di controllo qualità

15 febbraio 2007

Primo Inserito (Stima)

19 febbraio 2007

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Stima)

16 aprile 2014

Ultimo aggiornamento inviato che soddisfa i criteri QC

20 marzo 2014

Ultimo verificato

1 marzo 2014

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • RC0661 (Altro identificatore: Mayo Clinic Cancer Center & MCCRC)
  • P30CA015083 (Sovvenzione/contratto NIH degli Stati Uniti)
  • 06-002426 (Altro identificatore: Mayo Clinic IRB)

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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