Lapatinib and Topotecan in Treating Patients With Ovarian Epithelial Cancer or Primary Peritoneal Cancer That Did Not Respond to Cisplatin or Carboplatin
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.
調査の概要
詳細な説明
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.
研究の種類
入学 (実際)
段階
- フェーズ2
連絡先と場所
研究場所
-
-
Arizona
-
Scottsdale、Arizona、アメリカ、85254
- Mayo Clinic Arizona
-
-
Florida
-
Jacksonville、Florida、アメリカ、32224
- Mayo Clinic in Jacksonville
-
-
Minnesota
-
Rochester、Minnesota、アメリカ、55905
- Mayo Clinic 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 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
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
- 割り当て:非ランダム化
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的: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.
他の名前:
3.2 mg/m2 IV over 30 min in 100mL D5W (5% dextrose in water) or 0.9% NS at days 1, 8 & 15.
他の名前:
|
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 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Response Rate (Complete Response (CR) or Partial Response (PR))
時間枠: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
Non-measurable disease patients:
|
Two consecutive evaluations at least 4 weeks apart
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Time to Progression
時間枠: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
時間枠: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
時間枠: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)
|
協力者と研究者
スポンサー
捜査官
- スタディチェア:Paul Haluska, MD, PhD、Mayo Clinic
- 主任研究者:John K. Camoriano, M.D.、Mayo Clinic
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
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
追加の関連 MeSH 用語
その他の研究ID番号
- RC0661 (その他の識別子:Mayo Clinic Cancer Center & MCCRC)
- P30CA015083 (米国 NIH グラント/契約)
- 06-002426 (その他の識別子:Mayo Clinic IRB)
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
卵巣がんの臨床試験
-
Novartis Pharmaceuticals終了しましたメラノーマ | 高度なEGFR変異体非小さな細胞肺cancer(NSCLC) | KRAS G12変異NSCLC | 食道扁平上皮がん(SCC) | ヘッド/ネックSCC | 進行した胃腸間質腫瘍(GIST) | 進行したNRAS/BRAFT WT皮膚黒色腫アメリカ, 台湾, オランダ, カナダ, スペイン, シンガポール, イタリア, 日本, 韓国
-
Jonsson Comprehensive Cancer CenterNational Cancer Institute (NCI); Highlight Therapeutics積極的、募集していない平滑筋肉腫 | 悪性末梢神経鞘腫瘍 | 滑膜肉腫 | 未分化多形肉腫 | 骨の未分化高悪性度多形肉腫 | 粘液線維肉腫 | II期の体幹および四肢の軟部肉腫 AJCC v8 | III期の体幹および四肢の軟部肉腫 AJCC v8 | IIIA 期の体幹および四肢の軟部肉腫 AJCC v8 | IIIB 期の体幹および四肢の軟部肉腫 AJCC v8 | 切除可能な軟部肉腫 | 多形性横紋筋肉腫 | 切除可能な脱分化型脂肪肉腫 | 切除可能な未分化多形肉腫 | 軟部組織線維肉腫 | 紡錘細胞肉腫 | ステージ I 後腹膜肉腫 AJCC (American Joint Committee on Cancer) v8 | 体幹および四肢の I 期軟部肉腫 AJCC v8 | ステージ... およびその他の条件アメリカ