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Lapatinib With Sirolimus or Metformin
A Phase 1 Trial of Lapatinib in Combination With 1) Sirolimus or 2) Metformin in Advanced Cancer
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
The Study Drugs:
Lapatinib is designed to prevent or slow down the growth of cancer cells by blocking 2 proteins on the surface of the cancer cell, which are HER 1 and HER 2 receptors.
Sirolimus is designed to block a protein called mammalian target of rapamycin (mTOR) (a protein that is thought to cause cancer cells to grow) inside the cancer cell. This may interfere with the growth or spread of cancer cells or possibly kill the cancer cells.
Metformin was designed to treat patients with diabetes. It may be able to block mTOR and slow the growth of tumors.
Study Drug Groups:
If you are found to be eligible to take part in this study, your doctor will decide if you will receive lapatinib with metformin or lapatinib with sirolimus. Once it is decided which combination you will receive, you will be assigned to a dose level based on when you join the study.
Up to 7 dose levels of lapatinib with sirolimus will be tested. Up to 6 dose levels of lapatinib with metformin will be tested. Three (3) to 6 participants will be enrolled at each dose level. The first group of participants will receive the lowest dose level. Each new group will receive a higher dose than the group before it, if no intolerable side effects were seen. This will continue until the highest tolerable dose of the combination of lapatinib with either sirolimus or metformin is found.
Once the highest tolerated dose of the combination of lapatinib with either sirolimus or metformin is found, 14 participants with the tumor type that has responded to the study drug combination will receive the study drugs at that dose level.
Study Drug Administration:
Each study "cycle" is 28 days.
You will take lapatinib by mouth 1 time each day. You should take it at about the same time each day on an empty stomach with a cup (about 8 ounces) of water, 1 hour before and 2 hours after a meal.
If you are also taking metformin, you will take it by mouth 1 time every day. You should take it at about the same time each day with a meal and cup of water (about 8 ounces).
If you are also taking sirolimus, you will take it by mouth 1 time every day. You should take it at about the same time each day on an empty stomach with a cup of water, 1 hour before and 2 hours after a meal.
Study Visits:
At every study visit, you will be asked about any current health conditions you have, any other drugs you are taking, and if you have experienced any side effects.
On about Days 1, 8, and 15 of Cycle 1, blood (about 2 teaspoons) will be drawn for routine tests.
On about Day 1 Cycle 1, urine will be collected for routine tests.
On about Day 1 of Cycles 2 and beyond:
- You will have a physical exam.
- Blood (about 2 teaspoons) and urine will be collected for routine tests.
Every 6 weeks, you will have a blood (about 1 teaspoon) drawn or urine collected for pregnancy test if you are able to become pregnant.
Every 8 weeks for the first 4 cycles, you will have an x-ray, CT scan, MRI scan, and/or PET/CT scan to check the status of the disease. If the study doctor thinks it is needed, they will be performed more often. After 4 cycles you will have an x-ray, CT scan, MRI scan, and/or PET/CT scan every 8 - 12 weeks as your study if the study doctor feels it is appropriate.
Length of Study:
You may stay on study for as long as you are benefitting. You will be taken off study if you experience intolerable side effects, the study doctor thinks it is in your best interest, or the disease gets worse.
This is an investigational study. Sirolimus is FDA approved and commercially available as an anti-rejection drug for kidney transplant recipients. Lapatinib is FDA approved and commercially available for the treatment of advanced breast cancer. Metformin is FDA approved and commercially available for the treatment of diabetes mellitus. The combination of these drugs to treat advanced cancer is investigational.
Up to 106 patients will take part in this study. All will be enrolled at M. D. Anderson.
Studietype
Inschrijving (Werkelijk)
Fase
- Fase 1
Contacten en locaties
Studie Locaties
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Texas
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Houston, Texas, Verenigde Staten, 77030
- University of Texas MD Anderson Cancer Center
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Kind
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Patients with advanced or metastatic cancer that is refractory to standard therapy, relapsed after standard therapy, or who have no standard therapy available that improves survival by at least three months.
- Patients must be at least 3 weeks beyond their previous cytotoxic treatment. Patient must wait at least 5 half-lives or 3 weeks, whichever is shorter, from their previous targeted or biologic therapy; In addition, patients must be at least 3 weeks beyond the last session of radiation therapy or major surgery. Local palliative radiation therapy that is not delivered to all target lesions is allowed immediately before or during treatment.
- Eastern Cooperative Oncology Group (ECOG) performance status should be less or equal to 3
- Patients must have normal organ and marrow function defined as: absolute neutrophil count (ANC) >/= 750/mL; platelets >/= 50,000/mL; creatinine </= 2x upper limit of normal (ULN) for the Sirolimus Arm and creatinine < 1.5 mg/dl for the Metformin arm; total bilirubin </=2.0 (For patients with Gilbert syndrome, bilirubin level > 2 could will be allowed on study if the hyperbilirubinemia is believed to be secondary only to the Gilbert syndrome); ALT (SGPT) </= 5x ULN; Exception for patients with liver metastasis: total bilirubin </= 3x ULN; ALT (SGPT) </= 8x ULN.
- Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 30 days after the last dose
- Patients must be able to understand and be willing to sign a written informed consent document
- Patients with treated brain metastases are allowed in both arms of the study.
Exclusion Criteria:
- Uncontrolled intercurrent illness including, but not limited to, uncontrolled infection, uncontrolled asthma, need for hemodialysis, need for ventilatory support.
- Pregnant or lactating women.
- History of hypersensitivity to Lapatinib or any component of the formulation.
- Patients who have malabsorption syndrome
- Patients with class III or IV congestive heart failure as defined by New York Heart Association functional classification system
- Patients unwilling or unable to sign informed consent document
- History of hypersensitivity to Sirolimus or any component of the formulation (for Lapatinib and Sirolimus arm only)
- History of hypersensitivity to metformin or any component of the formulation (for Lapatinib and Metformin arm only)
Studie plan
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 |
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Experimenteel: Lapatinib + Sirolimus
Lapatinib starting oral dose of 500 mg daily for 21 day cycle.
Sirolimus starting oral dose 1 mg daily.
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Starting oral dose of 500 mg daily for 21 day cycle.
Andere namen:
Starting oral dose 1 mg daily.
Andere namen:
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Experimenteel: Lapatinib + Metformin
Lapatinib starting oral dose of 500 mg daily for 21 day cycle.
Metformin Starting oral dose 1000 mg daily.
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Starting oral dose of 500 mg daily for 21 day cycle.
Andere namen:
Starting oral dose 1000 mg daily.
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
---|---|---|
Maximum Tolerated Dose (MTD) of Lapatinib in Combination with Sirolimus or Metformin
Tijdsspanne: 21 day cycle
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MTD is defined as the highest dose studied in which the incidence of dose-limiting toxicity (DLT) is less than 33%.
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21 day cycle
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Filip Janku, MD, PHD, M.D. Anderson Cancer Center
Publicaties en nuttige links
Nuttige links
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Neoplasmata
- Hypoglycemische middelen
- Fysiologische effecten van medicijnen
- Moleculaire mechanismen van farmacologische werking
- Anti-infectieuze middelen
- Enzymremmers
- Antineoplastische middelen
- Immunosuppressieve middelen
- Immunologische factoren
- Antibacteriële middelen
- Proteïnekinaseremmers
- Antibiotica, antineoplastiek
- Antischimmelmiddelen
- Metformine
- Sirolimus
- Lapatinib
Andere studie-ID-nummers
- 2009-0743
- NCI-2011-00563 (Register-ID: NCI CTRP)
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 .
Klinische onderzoeken op Geavanceerde kankers
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M.D. Anderson Cancer CenterNational Cancer Institute (NCI)VoltooidAdenocarcinoom van de dunne darm | Stadium III Adenocarcinoom van de dunne darm AJCC v8 | Stadium IIIA Adenocarcinoom van de dunne darm AJCC v8 | Stadium IIIB dunne darm adenocarcinoom AJCC v8 | Stadium IV Adenocarcinoom van de dunne darm AJCC v8 | Ampulla van Vater Adenocarcinoom | Stadium III... en andere voorwaardenVerenigde Staten
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Extremity MedicalWervingArtrose | Inflammatoire artritis | Carpaal Tunnel Syndroom (CTS) | Posttraumatische artritis | Scapholunate geavanceerde instorting (SLAC) | Scapholunaat Crystalline Advanced Collapse (SCAC) | Scaphoid, Trapezium en Trapezoid Advanced Collapse (STTAC) | Ziekte van Kienbock bij volwassenen | Radiale... en andere voorwaardenVerenigde Staten
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University of UtahNational Cancer Institute (NCI)WervingVermoeidheid | Sedentaire levensstijl | Gemetastaseerd prostaatcarcinoom | Stadium IV prostaatkanker AJCC (American Joint Committee on Cancer) v8 | Stadium IVA prostaatkanker AJCC (American Joint Committee on Cancer) v8 | Stadium IVB prostaatkanker AJCC (American Joint Committee on Cancer) v8Verenigde Staten
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Georgetown UniversityNational Cancer Institute (NCI); American Cancer Society, Inc.; Susan G. Komen...VoltooidBestudeer Chinese vrouwen die zich niet hebben gehouden aan de richtlijnen voor screening op mammografie van de American Cancer SocietyVerenigde Staten
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BioNTech SESeventh Framework ProgrammeVoltooidBorstkanker (Triple Negative Breast Cancer (TNBC))Zweden, Duitsland
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Advanced BionicsVoltooidErnstig tot zeer ernstig gehoorverlies | bij volwassen gebruikers van Advanced Bionics HiResolution™ Bionic Ear SystemVerenigde Staten
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Novartis PharmaceuticalsVoltooidGeavanceerde Triple Negative Breast Cancer (TNBC) met hoge TAM'sFrankrijk, Italië, Oostenrijk, Taiwan, Verenigde Staten, Spanje, Australië, Korea, republiek van, België, Duitsland, Hongkong, Kalkoen
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Rashmi Verma, MDNational Cancer Institute (NCI)WervingCastratieresistent prostaatcarcinoom | Gemetastaseerd prostaatadenocarcinoom | Stadium IVB Prostaatkanker American Joint Committee on Cancer (AJCC) v8Verenigde Staten
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Jonsson Comprehensive Cancer CenterNog niet aan het wervenProstaatcarcinoom | Stadium IVB Prostaatkanker American Joint Committee on Cancer (AJCC) v8Verenigde Staten
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Jonsson Comprehensive Cancer CenterNational Cancer Institute (NCI); National Institutes of Health (NIH)WervingAnatomische fase II borstkanker AJCC v8 | Anatomische fase III borstkanker AJCC v8 | Borstcarcinoom in een vroeg stadium | Anatomische fase I Borstkanker American Joint Committee on Cancer (AJCC) v8Verenigde Staten
Klinische onderzoeken op Lapatinib
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GlaxoSmithKlineVoltooidKankerVerenigde Staten
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Institut Paoli-CalmettesGeschorst
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German Breast GroupBeëindigdUitgezaaide borstkankerDuitsland
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GlaxoSmithKlineIngetrokkenGezonde onderwerpenVerenigde Staten
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GlaxoSmithKlineVoltooidColorectale kankerVerenigde Staten, Canada
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University of Alabama at BirminghamGlaxoSmithKlineBeëindigdEierstokkankerVerenigde Staten
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GlaxoSmithKlineVoltooidNeoplasmata, borstVerenigde Staten, Israël
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Indiana UniversityGlaxoSmithKlineBeëindigdDuctaal carcinoom in situVerenigde Staten
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Arbeitsgemeinschaft medikamentoese TumortherapieGlaxoSmithKlineBeëindigdUitgezaaide borstkankerOostenrijk
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University Hospital, BordeauxBeëindigdBlaascarcinoom | Cystectomie | Infiltratief blaascarcinoomFrankrijk