Trastuzumab and Imatinib Mesylate in Treating Patients With Recurrent or Metastatic HER2/Neu-Expressing Cancer
Phase I of Trastuzumab and Imatinib Mesylate (Gleevec®, Formerly Known as STI-571) in Patients With Recurrent or Metastatic Her-2/Neu Expressing Cancer
RATIONALE: Monoclonal antibodies such as trastuzumab can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Imatinib mesylate may stop the growth of tumor cells by blocking the enzymes necessary for their growth and by stopping blood flow to the tumor. Giving trastuzumab together with imatinib mesylate may kill more tumor cells.
PURPOSE: This phase I trial is studying the side effects and best dose of imatinib mesylate when given together with trastuzumab in treating patients with recurrent or metastatic HER2/neu-expressing (producing) cancer.
調査の概要
詳細な説明
OBJECTIVES:
Primary
- Determine the maximum tolerated dose of imatinib mesylate when administered with trastuzumab (Herceptin®) in patients with recurrent or metastatic HER2/neu-overexpressing cancer.
- Determine response in patients treated with this regimen.
Secondary
- Correlate the number of circulating tumor cells with radiographic imaging in patients treated with this regimen.
OUTLINE: This is a dose-escalation study of imatinib mesylate.
Patients receive trastuzumab (Herceptin®) IV over 90 minutes on day 1 and oral imatinib mesylate once or twice daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of imatinib mesylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.
PROJECTED ACCRUAL: Approximately 9-18 patients will be accrued for this study.
研究の種類
入学 (予想される)
段階
- フェーズ 1
連絡先と場所
研究場所
-
-
Pennsylvania
-
Philadelphia、Pennsylvania、アメリカ、19111-2497
- Fox Chase Cancer Center
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed cancer that overexpresses HER2/neu, measured 3+ by immunohistochemistry or positive by fluorescence in situ hybridization
- Recurrent or metastatic disease
Meets 1 of the following criteria for measurable or evaluable disease:
- Unidimensionally measurable disease at least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan
- Evaluable disease, defined as a lesion on physical examination or imaging study that can be assessed as to changes in size but cannot be clearly measured in 1 dimension (e.g., pleural effusions, ascites, or bone disease)
No carcinomatous meningitis or untreated/uncontrolled metastatic brain parenchymal disease
- Prior controlled brain parenchymal disease allowed provided at least 8 weeks since prior therapy AND no symptomatic progression off corticosteroids
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- ECOG 0-2
Life expectancy
- Not specified
Hematopoietic
- Absolute neutrophil count ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
Hepatic
- ALT and AST ≤ 2.0 times upper limit of normal (ULN)
- Alkaline phosphatase ≤ 2.0 times ULN
- Bilirubin ≤ 1.3 mg/dL
- No known chronic liver disease (i.e., chronic active hepatitis or cirrhosis)
Renal
- Creatinine ≤ 2.0 mg/dL
Cardiovascular
- Ejection fraction ≥ lower limit of normal by MUGA
- No uncontrolled or significant cardiovascular disease
- No myocardial infarction within the past 6 months
- No ischemic heart disease requiring medication
- No congestive heart failure
Pulmonary
- No uncontrolled or significant pulmonary disease
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective barrier contraception during and for 3 months after study participation
- No active unresolved infection
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Prior trastuzumab (Herceptin®) allowed
- No concurrent filgrastim (G-CSF) or sargramostim (GM-CSF) to support blood counts
- No other concurrent anticancer biologic agents
Chemotherapy
- Prior chemotherapy for metastatic disease allowed
- At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas) and recovered
- No concurrent anticancer chemotherapy
Endocrine therapy
- See Disease Characteristics
Radiotherapy
- At least 4 weeks since prior radiotherapy and recovered
Surgery
- More than 2 weeks since prior major surgery
Other
- At least 7 days since prior antibiotics
- No concurrent parenteral antibiotics
- No other concurrent anticancer agents
- No other concurrent investigational drugs
No concurrent therapeutic anticoagulation with warfarin
- Concurrent mini-dose warfarin (1 mg/day) for prophylaxis of central venous catheter thrombosis allowed
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
---|
Maximum tolerated dose (MTD) of imatinib mesylate given concurrently with trastuzumab (Herceptin®) as measured by CTC v 3.0 at course 1
|
Response as measured by RECIST criteria every 9 weeks
|
二次結果の測定
結果測定 |
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Circulating tumor cells in blood as measured by Immunicom Cell PrepTM at baseline, every 3 weeks until week 9, and then with each disease re-evaluation
|
Phosphorylation status of AKT, extracellular signal-regulated kinase (ERK), and KIT as measured by western blot and/or immunohistochemistry at baseline and week 9
|
協力者と研究者
研究記録日
主要日程の研究
研究開始
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- CDR0000365451
- P30CA006927 (米国 NIH グラント/契約)
- FCCC-03041
- NOVARTIS-FCCC-03041
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