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A Double Blind Randomised Study of Lapatinib and Placebo in Metastatic TCC of the Urothelium (LaMB)

14. april 2015 oppdatert av: Queen Mary University of London

A Phase II/III, Randomised, Two-Arm, Comparison of Maintenance Lapatinib Versus Placebo After First-Line Chemotherapy in Patients With HER1 and/or HER2 Overexpressing Locally Advanced or Metastatic Bladder Cancer [LaMB]

RATIONALE: Lapatinib ditosylate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known whether lapatinib ditosylate is more effective than a placebo in killing tumor cells.

PURPOSE: This randomized phase II/III trial is studying how well lapatinib ditosylate works compared to a placebo in treating patients with stage IV bladder cancer.

Studieoversikt

Status

Ukjent

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

OBJECTIVES:

Primary

  • Compare progression-free survival in patients with HER1- and/or HER2-overexpressing stage IV bladder cancer who have been randomized to maintenance therapy with lapatinib ditosylate or placebo following first-line chemotherapy.

Secondary

  • Compare overall survival between these patient groups.
  • Evaluate the safety and tolerability of the regimens in these patients.
  • Assess and compare quality of life between these patient groups.

OUTLINE: This is a multicenter study. Patients are stratified according to ECOG performance status and response to first line chemotherapy (complete or partial response vs stable disease). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive oral lapatinib ditosylate once daily in the absence of disease progression or unacceptable toxicity.
  • Arm II: Patients receive oral placebo once daily in the absence of disease progression or unacceptable toxicity.

Patients undergo quality of life assessment by EORTC QLQ-C30 at baseline and every 4 weeks during study treatment.

After completion of study treatment, patients are followed up periodically for up to 5 years.

Studietype

Intervensjonell

Registrering (Forventet)

204

Fase

  • Fase 2
  • Fase 3

Kontakter og plasseringer

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

Studiesteder

  • Storbritannia
      • Aberdeen, Storbritannia
        • NHS Grampian - Aberdeen Royal Infirmary
      • Basildon, Storbritannia
        • Basildon and Thurrock University Hospital NHS Trust - Basildon Hospital
      • Birmingham, Storbritannia
        • University Hospitals Birmingham NHS Foundation Trust - Birmingham University Hospital
      • Bournemouth, Storbritannia
        • Royal Bournemouth and Christchurch NHS Foundation Trust - Royal Bournemouth Hospital
      • Bristol, Storbritannia
        • University Hospitals Bristol NHS Trust - Bristol University Hospital
      • Cambridge, Storbritannia
        • Cambridge University Hospitals NHS Trust - Addenbrooke's Hospital
      • Chelmsford, Storbritannia
        • Mid Essex NHS Trust - Broomfield Hospital
      • Colchester, Storbritannia
        • Colchester University Hospitals NHS Trust
      • Coventry, Storbritannia
        • University Hospitals Coventry & Warwickshire NHS Trust
      • Derby, Storbritannia
        • Derby Hospitals NHS Trust - Royal Derby Hospital
      • Glasgow, Storbritannia
        • NHS Greater Glasgow and Clyde - The Beatson
      • Huddersfield, Storbritannia
        • Calderdale and Huddersfield NHS Trust - Huddersfield Royal Infirmary
      • Ipswich, Storbritannia
        • Ipswich Hospital NHS Trust
      • Leicester, Storbritannia
        • University Hospitals of Leicester Nhs Trust
      • Liverpool, Storbritannia
        • Clatterbridge Centre for Oncology NHS Trust
      • London, Storbritannia
        • Imperial Healthcare NHS Trust
      • London, Storbritannia
        • Guys & St Thomas' Hospital NHS Trust - Guys Hospital
      • London, Storbritannia
        • Royal Marsden NHS Trust
      • Middlesborough, Storbritannia
        • South Tees NHS Trust - James Cook University Hospital
      • Newcastle, Storbritannia
        • Newcastle Upon Tyne Hospitals NHS Trust
      • Northampton, Storbritannia
        • Northampton General Hospitals NHS Trust
      • Nottingham, Storbritannia
        • Nottingham University Hospitals NHS Trust
      • Nottingham, Storbritannia
        • Sherwood Forest Hospitals NHS Trust - Kings Mill Hospital
      • Portsmouth, Storbritannia
        • Portsmouth Hospitals NHS Trust - Queen Alexandra Hospital
      • Romford, Storbritannia
        • Barking, Havering and Redbridge NHS Trust - Queens Hospital
      • Taunton, Storbritannia
        • Taunton and Somerset NHS Trust - Musgrove Park Hospital
    • England
      • London, England, Storbritannia, EC1M 6BQ
        • Barts and the London NHS Trust

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed transitional cell carcinoma of the bladder

    • Stage IV disease
    • Metastatic or locally advanced disease

  • HER1- and/or HER2-positive disease, defined by the following criteria:

    • 2+ or 3+ intensity on IHC
  • Able to commence the study treatment within 10 weeks of completing chemotherapy

  • Must have achieved objective response or stable disease following 4-8 courses of first-line chemotherapy

    • No progression with first-line chemotherapy for metastatic disease
    • Any widely accepted chemotherapy regimen for bladder cancer allowed
    • Patients who did not receive cisplatin are eligible

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-3
  • ANC ≥ 1.0 x 10^9/L
  • Hemoglobin ≥ 8.0 g/dL
  • Platelet count ≥ 75 x 10^9/L
  • ALT/AST < 2 times upper limit of normal (ULN)
  • Bilirubin < 1.5 times ULN
  • Serum creatinine ≤ 3.0 ULN AND/OR creatinine clearance ≥ 30 mL/min
  • LVEF ≥ 50% (as assessed by quantitative echocardiogram or MUGA)
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

  • No current active hepatic or biliary disease, except for any of the following:

    • Gilbert's syndrome
    • Asymptomatic gallstones
    • Liver metastases
    • Stable chronic liver disease per investigator assessment
  • No known hypersensitivity to the study medication

  • No history of prior or concurrent other neoplasms, except for:

    • Any non life-threatening tumours that have been curatively treated.
    • Prostate cancer isolated to the prostate gland

  • No significant cardiac disease, including any of the following:

    • Angina pectoris
    • Severe cardiac arrhythmia requiring medication
    • Severe conduction abnormalities
    • Clinically significant valvular disease
    • Cardiomegaly
    • Prior myocardial infarction
    • Ventricular hypertrophy
    • Congestive heart failure
    • Poorly uncontrolled hypertension (resting diastolic blood pressure > 115 mm Hg)
    • Other cardiomyopathy
  • No serious intercurrent medical or psychiatric illness
  • No serious active infection

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No more than 1 line of prior chemotherapy for metastatic or locally advanced disease (neoadjuvant/adjuvant chemotherapy allowed)
  • No more than 10 weeks since first-line chemotherapy
  • No prior lapatinib ditosylate
  • No prior radiotherapy to the indicator lesion(s) (newly arising lesions in previously irradiated areas allowed)

  • At least 14 days since prior and no concurrent CYP3A4 inducers, including but not limited to, any of the following:

    • Antibiotics (all rifamycin class agents [e.g., rifampicin, rifabutin, rifapentine])
    • Anticonvulsants (phenytoin, carbamazepine, barbiturates [e.g., phenobarbital])
    • Oral glucocorticoids (cortisone [> 50 mg], hydrocortisone [> 40 mg], prednisone [> 10 mg], methylprednisolone [> 8 mg], dexamethasone [> 2 mg²])
    • St. John's wort or modafinil

  • At least 7 days since prior and no concurrent CYP3A4 inhibitors, including but not limited to, any of the following:

    • Antibiotics (clarithromycin, erythromycin, troleandomycin)
    • Antifungals (itraconazole, ketoconazole, fluconazole [>150 mg daily], voriconazole)
    • Antiretrovirals/protease inhibitors (delavirdine, nelfinavir, amprenavir, ritonavir, indinavir, saquinavir, lopinavir)
    • Calcium channel blockers (verapamil, diltiazem)
    • Antidepressants (nefazodone, fluvoxamine)
    • Gastrointestinal agents (cimetidine, aprepitant)
    • Grapefruit, grapefruit juice
  • At least 6 months since prior and no concurrent amiodarone
  • No concurrent radical or curative therapy (radiotherapy or surgery) at the end of first-line treatment (palliative radiotherapy allowed)
  • No other concurrent experimental or investigational drugs
  • No other concurrent anticancer treatment, including cytotoxic or specific immune therapy

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: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Dobbelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Arm I
Patients receive oral lapatinib ditosylate once daily in the absence of disease progression or unacceptable toxicity.
Legemiddel: lapatinib ditosylat
Gis muntlig
Andre navn:
  • Tykerb
  • Tyverb
Placebo komparator: Arm II
Patients receive oral placebo once daily in the absence of disease progression or unacceptable toxicity.
Annen: Placebo
Gis muntlig

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
Progression free survival
Tidsramme: Disease Progression - at least 20% increase in the sum of longest diameters of target lesions.
Disease Progression - at least 20% increase in the sum of longest diameters of target lesions.

Sekundære resultatmål

Resultatmål
Total overlevelse

Samarbeidspartnere og etterforskere

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

Sponsor

Queen Mary University of London

Samarbeidspartnere

GlaxoSmithKline

Etterforskere

  • Hovedetterforsker: Thomas Powles, MD, MRCP, Queen Mary University of London

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 2009

Primær fullføring (Forventet)

1. juli 2015

Datoer for studieregistrering

Først innsendt

29. juli 2009

Først innsendt som oppfylte QC-kriteriene

29. juli 2009

Først lagt ut (Anslag)

30. juli 2009

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

15. april 2015

Siste oppdatering sendt inn som oppfylte QC-kriteriene

14. april 2015

Sist bekreftet

1. april 2015

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • CDR0000640393
  • OCTG-LaMB
  • BL-2007-02
  • EUDRACT-2007-001826-28
  • EU-20929

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