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Phase II Dasatinib Study in Advanced Breast Cancer

15 juli 2013 bijgewerkt door: Duke University

A Phase II Trial of Dasatinib to Treat Women With Stage IV or Inoperable Stage III Advanced Breast Cancer

The purpose of this study is to find out if dasatinib will safely reduce the size or spread of your tumor.

Studie Overzicht

Toestand

Voltooid

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

The introduction of biologics with specific molecular targets has initiated a trend toward improved survival in women with metastatic breast cancer.

The tyrosine kinase SRC (pp60src) is a member of a family of proteins that contribute to cellular signal transduction activities such as cell growth, differentiation, survival, adhesion and migration. Abnormal signaling has been linked to cancer metastases; thus, identification of molecular regulators or inhibitors of SRC present therapeutic opportunity for cancer patients. Src kinases consist of eight non-receptor tyrosine kinases (Src, Fyn, Yes, Lck, Lyn, Hck, Fgr and Blk) that interact with the intracellular domains of growth factor/cytokine receptors, (G-protein-coupled receptor)GPCRs and integrins.

Inhibition of SRC has also been associated with reversal of chemoresistance and restored sensitivity to drug-resistant ovarian cancer cells, suggesting potential as second- line treatment for previously treated populations. Dasatinib is a potent, broad spectrum inhibitor of 5 critical oncogenic tyrosine kinases, including SRC.

Patients will receive dasatinib, a Src inhibitor, at an initial dose of 50 mg PO BID, with real-time PharmacoDynamic dose adjustment following 4 weeks of therapy based on inhibition of phosphorylation of SRC, focal adhesion kinase (FAK) and paxillin, until progression. The primary objective is to assess tolerability and estimate the proportion of patients who are progression-free at 16 weeks from the date of study enrollment.

A minimum of 2 (maximum of 3) tumor biopsies will be analyzed and compared for SRC signature: one at baseline (study enrollment, all patients); the second after 4 weeks of dasatinib therapy (all patients); and the third at progression (only patients who progress after a documented response).

Patients will receive continuous daily administration until documented disease progression, and will be followed until death.

The results of this study may be useful in designing future studies using dasatinib alone or in combination with chemotherapy, thus having the potential to alter the current standard of care in this incurable population.

Additional correlative studies will be conducted. Tumor biopsies will be analyzed and compared for SRC, pSRC, Ki67, and related genomic signatures.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

31

Fase

  • Fase 2

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

  • Verenigde Staten
    • Florida
      • West Palm Beach, Florida, Verenigde Staten, 33401
        • Palm Beach Cancer Center Institute
    • North Carolina
      • Charlotte, North Carolina, Verenigde Staten, 28204
        • Presbyterian Health Care
      • Durham, North Carolina, Verenigde Staten, 27710
        • Duke University Medical Center

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Vrouw

Beschrijving

Inclusion Criteria:

  • Measurable Stage IV or inoperable Stage III advanced breast cancer.
  • There is no limit on the number of prior therapies.
  • At least 3 weeks since prior chemotherapy, biological or hormonal therapy.
  • At least 2 weeks since surgical biopsy.
  • At least 3 weeks since major (open thoracic/abdominal/cardiac) surgery.
  • No central nervous system (CNS) metastases except solitary brain metastasis
  • No cardiac dysfunction
  • left ventricular ejection fraction (LVEF) ≥ 50% as determined by multiple gated acquisition scan (MUGA)/echocardiogram
  • Adequate blood counts
  • Normal liver and kidney function
  • Negative serum pregnancy test.
  • Able to provide informed consent

Exclusion Criteria:

  • Pregnant or breast feeding.
  • Prior treatment with dasatinib.
  • Bone as the only site of disease.
  • Significant gastrointestinal bleeding
  • Septicemia, infection, acute hepatitis, hypokalemia, or hypomagnesemia

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Niet-gerandomiseerd
  • Interventioneel model: Opdracht voor een enkele groep
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Dasatinib
50- 100 mg PO BID
Geneesmiddel: Dasatinib
An initial dose of 50 mg PO BID; following 4 weeks of treatment, dose adjustment will be based on inhibition of phosphorylation of FAK and paxillin per biopsy assessment, as well as toxicity assessment.
Andere namen:
  • BMS-354825
  • Sprycel

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Estimation of the Proportion of Progression-free Patients at 16 Wks.
Tijdsspanne: 16 weeks

Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or measurable increase in a non-target lesion, or the appearance of new lesions, or similar definition as appropriate.

Proportion progression-free at 16 weeks.From first day of study related treatment with Dasatinib until the date of first documented progression or date of death from any cause, whichever came first.
16 weeks

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
To Measure Response to Protocol Therapy Per RECIST Criteria
Tijdsspanne: 16 weeks

Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by CT: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Progression At least a 20% increase in the sum of the longest diameter (LD) of target lesions taking as a reference the smallest sum longest diameter recorded since treatment started, or the appearance of one or more new lesions.

RECIST 1.0 Overall response:

Complete Response (CR) Partial Response (PR) Stable Disease (SD) Progressive Disease (PD)

CR= CR+CR and No new lesions PR= CR+SD; PR+SD and no new lesions SD= SD+SD and no new lesions PD= PD+any new lesions
16 weeks
Characterization and Comparison of SRC (A Protein Tyrosine Kinase)Dysregulation at Baseline (All Patients), After 4 Weeks of Dasatinib Treatment (All Patients), and at Progression (Only Patients Who Progress After Documented Response)
Tijdsspanne: 4 weeks
For the 20 patients with evaluable biopsies at baseline and week 4, the median relative change from baseline in tissue biomarker levels of phospho-Src (p-Src)
4 weeks
Correlate SRC Dysregulation Results With Response to Dasatinib Therapy
Tijdsspanne: 16 weeks
Since all patients progressed there is no comparison to between responders and non-responders.
16 weeks
To Explore the Association Between Each Patient's SRC Signature and Their Time to Progression.
Tijdsspanne: Baseline Src measure to first progression
Spearman's correlation between the change in SRC signature from baseline to 4 weeks and time to progression
Baseline Src measure to first progression
To Explore the Association Between Dasatinib and Osteoclastic Bone Resorption
Tijdsspanne: not assessed
Not assessed secondary to limited number of subjects.
not assessed

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Duke University

Medewerkers

Bristol-Myers Squibb

Onderzoekers

  • Hoofdonderzoeker: Kimberly Blackwell, MD, Duke University

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 oktober 2007

Primaire voltooiing (Werkelijk)

1 mei 2011

Studie voltooiing (Werkelijk)

1 mei 2011

Studieregistratiedata

Eerst ingediend

16 oktober 2007

Eerst ingediend dat voldeed aan de QC-criteria

16 oktober 2007

Eerst geplaatst (Schatting)

18 oktober 2007

Updates van studierecords

Laatste update geplaatst (Schatting)

17 juli 2013

Laatste update ingediend die voldeed aan QC-criteria

15 juli 2013

Laatst geverifieerd

1 juli 2013

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • Pro00007578
  • BMS CA180089

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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