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Lapatinib and Topotecan in Treating Patients With Ovarian Epithelial Cancer or Primary Peritoneal Cancer That Did Not Respond to Cisplatin or Carboplatin

20 de março de 2014 atualizado por: Mayo Clinic

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.

Visão geral do estudo

Descrição detalhada

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.

Tipo de estudo

Intervencional

Inscrição (Real)

18

Estágio

  • Fase 2

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

    • Arizona
      • Scottsdale, Arizona, Estados Unidos, 85254
        • Mayo Clinic Arizona
    • Florida
      • Jacksonville, Florida, Estados Unidos, 32224
        • Mayo Clinic in Jacksonville
    • Minnesota
      • Rochester, Minnesota, Estados Unidos, 55905
        • Mayo Clinic Cancer Center

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Fêmea

Descrição

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

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Não randomizado
  • Modelo Intervencional: Atribuição de grupo único
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: 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.
Outros nomes:
  • Tykerb
3.2 mg/m2 IV over 30 min in 100mL D5W (5% dextrose in water) or 0.9% NS at days 1, 8 & 15.
Outros nomes:
  • Hycamptin

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Response Rate (Complete Response (CR) or Partial Response (PR))
Prazo: 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

  • Confirmed tumor response (complete and partial) as measured by RECIST(Response Evaluation Criteria In Solid Tumors) criteria on 2 consecutive evaluations at least 4 weeks apart.
  • Confirmed tumor response is at least a 30% decrease in the sum of the longest diameter of target lesions and no new lesions.

Non-measurable disease patients:

  • Decrement in CA125 by > 50%
  • Improvement in other evaluable disease
Two consecutive evaluations at least 4 weeks apart

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Time to Progression
Prazo: 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
Prazo: 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
Prazo: 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)

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Investigadores

  • Cadeira de estudo: Paul Haluska, MD, PhD, Mayo Clinic
  • Investigador principal: John K. Camoriano, M.D., Mayo Clinic

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo

1 de março de 2007

Conclusão Primária (Real)

1 de março de 2009

Conclusão do estudo (Real)

1 de novembro de 2012

Datas de inscrição no estudo

Enviado pela primeira vez

15 de fevereiro de 2007

Enviado pela primeira vez que atendeu aos critérios de CQ

15 de fevereiro de 2007

Primeira postagem (Estimativa)

19 de fevereiro de 2007

Atualizações de registro de estudo

Última Atualização Postada (Estimativa)

16 de abril de 2014

Última atualização enviada que atendeu aos critérios de controle de qualidade

20 de março de 2014

Última verificação

1 de março de 2014

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • RC0661 (Outro identificador: Mayo Clinic Cancer Center & MCCRC)
  • P30CA015083 (Concessão/Contrato do NIH dos EUA)
  • 06-002426 (Outro identificador: Mayo Clinic IRB)

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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