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Study Of Lapatinib In Patients With Relapsed Or Refractory Inflammatory Breast Cancer

24. september 2015 oppdatert av: GlaxoSmithKline

A Phase II Study to Evaluate the Efficacy, Safety and Pharmacodynamics of Lapatinib in Patients With Relapsed or Refractory Inflammatory Breast Cancer

This study was designed to determine how effective and safe a new investigational drug, lapatinib, is in treating patients with treatment refractory or relapsed inflammatory breast cancer. Tumor tissue collected pre-treatment and at Day 28 will be examined for biologic activity by IHC (immunohistochemistry). Treatment will consist of daily oral therapy with lapatinib. A patient may continue treatment as long as they are receiving benefit. Blood samples for hematology and chemistry panels, MUGA/ECHO (multigated acquisition/echocardiogram) exams and physical exams will be performed throughout the study to monitor safety.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

This Phase II open label, multicenter study is designed to evaluate the efficacy, safety, and pharmacodynamic effects of oral lapatinib administered as a single agent therapy to patients with relapsed or refractory inflammatory breast cancer. Eligible patients must have a diagnosis of inflammatory breast cancer based on clinicopathologic criteria, tumor that is readily accessible for biopsy, and must have previously received treatment with an anthracycline and taxane-containing regimen (30 patients) plus trastuzumab (90 patients). Patients enrolled must have tumors that overexpress ErbB2, with or without co-expression of ErbB1. The primary objective for this study is to evaluate the objective response rate (defined as complete response plus partial response). Secondary objectives are to evaluate clinical benefit including quality of life parameters, progression-free survival, overall survival, time-to-response, response duration, safety and tolerability, pharmacodynamic effects on intracellular mediators that regulate tumor cell growth and survival, as well as effects on proteomic profile, and circulating levels of extracellular domains of ErbB1 and ErbB2 in peripheral blood.

Studietype

Intervensjonell

Registrering (Faktiske)

126

Fase

  • Fase 2

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Belgia
      • Bruxelles, Belgia, 1000
        • GSK Investigational Site
  • Canada
    • Ontario
      • Toronto, Ontario, Canada, M4N 3M5
        • GSK Investigational Site
  • Forente stater
    • Florida
      • Miami, Florida, Forente stater, 33136-1002
        • GSK Investigational Site
    • Illinois
      • Chicago, Illinois, Forente stater, 60637
        • GSK Investigational Site
      • Zion, Illinois, Forente stater, 60099
        • GSK Investigational Site
    • Maryland
      • Bethesda, Maryland, Forente stater, 20892-1201
        • GSK Investigational Site
    • Michigan
      • Detroit, Michigan, Forente stater, 48201
        • GSK Investigational Site
    • Missouri
      • St. Louis, Missouri, Forente stater, 63110
        • GSK Investigational Site
    • North Carolina
      • Durham, North Carolina, Forente stater, 27710
        • GSK Investigational Site
    • Washington
      • Seattle, Washington, Forente stater, 98109
        • GSK Investigational Site
  • Frankrike
      • Bayonne, Frankrike, 64100
        • GSK Investigational Site
      • Lyon Cedex 08, Frankrike, 69373
        • GSK Investigational Site
      • Marseille Cedex 09, Frankrike, 13273
        • GSK Investigational Site
      • Paris Cedex 20, Frankrike, 75970
        • GSK Investigational Site
      • Paris Cedex 5, Frankrike, 75248
        • GSK Investigational Site
      • Saint-Herblain, Frankrike, 44805
        • GSK Investigational Site
  • Israel
      • Ramat Gan, Israel, 52621
        • GSK Investigational Site
      • Zrifin, Israel, 70300
        • GSK Investigational Site
  • Spania
      • Barcelona, Spania, 08036
        • GSK Investigational Site
      • Barcelona, Spania, 08035
        • GSK Investigational Site
      • Girona, Spania, 17007
        • GSK Investigational Site
      • Madrid, Spania, 28041
        • GSK Investigational Site
  • Storbritannia
      • London, Storbritannia, SW3 6JJ
        • GSK Investigational Site
  • Tunisia
      • Sfax, Tunisia, 3000
        • GSK Investigational Site
      • Sfax, Tunisia, 3029
        • GSK Investigational Site
      • Tunis, Tunisia, 1007
        • GSK Investigational Site
      • Tunis, Tunisia, 1004
        • GSK Investigational Site

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion criteria:

  • Must have a life expectancy of at least 12 weeks.
  • Has a left ventricular ejection fraction (LVEF) ≥ 50%, or ≥ lower limit of normal for the institution, based on ECHO or MUGA.
  • Aspartate and alanine transaminase (AST or ALT) ≤ 3 times the upper limit of the reference range (patients with liver metastases may have AST and ALT ≤ 5 times the upper limit of the reference range and may be enrolled).
  • Total bilirubin ≤ 3.0 mg/dL.
  • Serum creatinine ≤ 2.0 mg/dL or calculated creatinine clearance (CrCl) ≥ 30 mL/min
  • Adequate bone marrow function. Hemoglobin ≥ 9 gm/dL. Absolute granulocyte count ≥ 1,500/mm³ (1.5 x 10^9/L). Platelets ≥ 75,000/mm³ (100 x 10^9/L).
  • Recovered or stabilized sufficiently from side effects associated with previous chemotherapy, surgery or radiotherapy.
  • Provided written informed consent.
  • ECOG (Eastern Cooperative Oncology Group) performance status 0 to 2.
  • Able to swallow and retain oral medication.
  • Male or female, if female:

A female is eligible to enter and participate in the study if she is of:

  1. Non-childbearing potential (i.e., women with functioning ovaries who have a current documented tubal ligation or hysterectomy, or women who are postmenopausal); or
  2. Childbearing potential (i.e., women with functioning ovaries and no documented impairment of oviductal or uterine function that would cause sterility. This category includes women with oligomenorrhoea (severe), women who are perimenopausal, and young women who have begun to menstruate), has a negative serum pregnancy test at screening, and agrees to one of the following where considered acceptable to the local IRB/IEC: Double-barrier contraception (condom with spermicidal jelly, foam suppository, or film; diaphragm with spermicide; or male condom and diaphragm).

Abstinence from sexual intercourse from 2 weeks prior to administration of the investigational product, throughout the active study treatment period, and through the post-treatment follow-up visit (to occur 28 days after last dose of investigational product).

Male partner who is sterile prior to the female subject's entry into the study and is the sole sexual partner for that female subject.

Implants of levonorgestrel. Injectable progestogen. Any intrauterine device (IUD) with a documented failure rate of less than 1% per year.

Oral contraceptives (either combined or progestogen only). Barrier methods including diaphragm or condom with a spermicide.

  • At least 18 years of age.
  • Has either measurable disease by Response Evaluation Criteria in Solid Tumors (RESIST) or clinically evaluable skin disease. Measurable lesions may be in the field of prior adjuvant irradiation; however, there must be at least an 8 week period between the last radiation treatment and the baseline scan documenting disease status for the lesion to be measurable.
  • Tumor that is accessible for biopsy.
  • Tumor that overexpresses ErbB2 defined as 3+ by IHC or FISH +. The ErbB 2 overexpression must be documented prior to dosing.
  • Documented disease progression or relapse following treatment, which must have contained a taxane and anthracycline-containing regimen in the adjuvant or metastatic setting (30 patients) plus trastuzumab (90 patients)
  • Histological diagnosis of breast carcinoma with a clinical diagnosis of IBC based on the presence of inflammatory changes in the involved breast, including diffuse erythema and edema (peau d'orange), with or without an underlying palpable mass involving the majority of the skin of the breast. Pathologic evidence of dermal lymphatic invasion should be noted but is not required for diagnosis.

Exclusion criteria:

  • Is clinically assessed to have inadequate venous access for protocol-related blood draws.
  • Has a clinically significant electrocardiogram (ECG) abnormality.
  • Has Class II to IV heart failure as defined by the New York Heart Association (NYHA) functional classification system.
  • Has physiological, familial, sociological, or geographical conditions that do not permit compliance with the protocol.
  • Is currently receiving oral steroid treatment (inhaled steroids are permitted), or any other medication on the prohibited medications list
  • Is currently receiving amiodarone or has received amiodarone in the 6 months prior to screening.
  • Has received chemotherapy, immunotherapy, biologic therapy or hormonal therapy within the past 14 days, with the exception of mitomycin C within the past 6 weeks.
  • Has received treatment with any investigational drug in the previous 4 weeks.
  • Has a known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to the investigational product. These include other anilinoquinazolines, such as gefitinib [Iressa], erlotinib [Tarceva], or other chemically related compounds.
  • Is considered medically unfit for the study by the investigator as a result of the medical interview, physical exam, or screening investigations.
  • Has evidence of symptomatic or uncontrolled brain metastases or leptomeningeal disease. Patients with brain metastases treated by surgery and/or radiotherapy are eligible if neurologically stable and do not require steroids or anticonvulsants.
  • Has malabsorption syndrome, a disease affecting gastrointestinal function, or resection of the stomach or small bowel.
  • Is a pregnant or lactating female.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Ikke-randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Lapatinib
Single arm study of lapatinib with no comparator arm.
Legemiddel: lapatinib
Tyrosine kinase inhibitor administered daily at 1500 mg/kg

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
Objective Response rate (complete response plus partial response)
Tidsramme: Week 84
Week 84

Sekundære resultatmål

Resultatmål
Tidsramme
Clinical benefit (progression free survival, time to progression, response duration)
Tidsramme: week 84
week 84
Assessment of clinical benefit, defined as CR or PR for at least 4 weeks, or SD for at least 6 months
Tidsramme: week 84
week 84
Calculation of progression-free survival, defined as the time between the first dose of investigational product and the first documented sign of disease progression or death.
Tidsramme: week 84
week 84
Calculation of time-to-response, defined as the time between the first dose of investigational product and the first documented CR or PR.
Tidsramme: week 84
week 84
Calculation of duration of response, defined as the time from initial documented CR or PR to the first documented sign of disease progression.
Tidsramme: week 84
week 84
Evaluation of changes in QoL and pain scale measurements collected on Day 1 and every 4 weeks while receiving study treatment.
Tidsramme: week 84
week 84
Evaluation of adverse events (AEs), changes in laboratory values and echocardiogram (ECHO) or multiple gated acquisition scan (MUGA) results from pre-dose, during dosing and post-dose assessments
Tidsramme: week 84
week 84
Comparison of the effects of lapatinib on biomarkers that are involved in regulating tumor cell proliferation and survival (e.g., phosphorylated forms of Erk1/2 and Akt, STAT3, S6 Kinase, Bad, truncated ErbB2 and potentially other downstream mediators of
Tidsramme: Day 28
Day 28
tumor cell growth and survival) by quantitative IHC and by direct and genome-wide methods (e.g., direct sequencing and DNA microarray) in tumor tissue collected prior to and following 28 days of lapatinib monotherapy.
Tidsramme: Day 28
Day 28
Examination of the effects of lapatinib therapy on the levels of circulating ErbB1 and ErbB2 ECD and the proteomic profile of peripheral blood. Investigation of the use of FDG-PET to predict early response to treatment with lapatinib.
Tidsramme: Day 28
Day 28

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

GlaxoSmithKline

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. mars 2005

Primær fullføring (Faktiske)

1. september 2007

Studiet fullført (Faktiske)

1. mai 2010

Datoer for studieregistrering

Først innsendt

18. mars 2005

Først innsendt som oppfylte QC-kriteriene

18. mars 2005

Først lagt ut (Anslag)

21. mars 2005

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

28. september 2015

Siste oppdatering sendt inn som oppfylte QC-kriteriene

24. september 2015

Sist bekreftet

1. mai 2015

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • EGF103009

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

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Forhold

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Legemiddelintervensjoner

Kosttilskudd

Sponsor / samarbeidspartnere

Steder

Abonnere