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Understanding Mechanisms of Acquired Resistance to BIBW2992

5 de março de 2018 atualizado por: Lecia V. Sequist, Massachusetts General Hospital
In this research study we are looking to see how effective BIBW 2992 is at suppressing the development of the T790M mutation in non-small cell lung cancer (NSCLC) patients. Epidermal growth factor receptors (EGFR) are proteins found on the surface of some cancer cells that promote a growth signal. Some cancer drugs for NSCLC work to block this signal from reaching its target on the cancer cells which in turn may slow or stop the cancer from growing. However, many times patients with EGFR mutations will stop responding to these cancer drugs and develop drug-resistance because they have developed a specific EGFR mutation called T790M. BIBW 2992 may prevent the T790M mutation from becoming active and therefore slow disease progression.

Visão geral do estudo

Status

Concluído

Intervenção / Tratamento

Descrição detalhada

  • Participants will take tablets of BIBW 2992 once a day during each cycle. Each cycle is 28 days (4 weeks).
  • Participants will come to the clinic on Day 1, 8 and 15 of Cycle 1. For Cycle 2 through 8, they will need to come to the clinic on Day 1. After Cycle 8, they will have study visits every 2 months.
  • The following tests and procedures will be performed at these clinic visits: physical examination, routine blood tests, research blood samples, EKG (every fourth cycle starting cycle 5), ECHO or MUGA (every fourth cycle starting cycle 5), an assessment of the tumor by CT or MRI scan (every 8 weeks).
  • Participants may continue to participate in this research study as long as their tumor does not grow and their disease does not worsen and they do not have any severe side effects.
  • Participants will have a tumor biopsy performed at the end of their participation in this study if their tumor is growing or if they have a new tumor. The purpose of this biopsy is to assess for the presence or the absence of the mutation T790M.

Tipo de estudo

Intervencional

Inscrição (Real)

24

Estágio

  • Não aplicável

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

    • Massachusetts
      • Boston, Massachusetts, Estados Unidos, 02114
        • Massachusetts General Hospital

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

Tudo

Descrição

Inclusion Criteria:

  • Participants must have histologically or cytologically confirmed stage IIIB, IV or recurrent non-small cell lung cancer
  • A somatic mutation in epidermal growth factor receptor (EGFR) must be present as documented by a CLIA-certified laboratory
  • There must be radiographic measurable or evaluable disease
  • Participants must be willing, at the time of signing consent, to agree to a future biopsy of their tumor tissue at the time of disease progression, provided such a biopsy is safe and feasible at that time.
  • Performance status must be 0, 1 or 2 on the Eastern Cooperative Oncology Group scale
  • 18 years of age or older
  • Normal organ and marrow function as outlined in the protocol
  • Women of child-bearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation

Exclusion Criteria:

  • Prior EGFR tyrosine kinase inhibitor therapy (including gefitinib, erlotinib, or any experimental EGFR TKI agents)
  • Known brain metastases, unless they have undergone definitive therapy and are neurologically stable at the time of study entry
  • Standard chemotherapy or radiation less than 2 weeks of starting BIBW 2992, or experimental systemic cancer therapy less then 4 weeks of starting BIBW 2992. Note that prior palliative radiation to bony disease, CNS disease, or a limited thoracic area is allowed if there is measurable or progressive disease outside the field of radiation.
  • Another malignancy within the last 3 years (except for non-melanoma skin cancer or a non-invasive/in situ cancer)
  • Known pre-existing and clinically active interstitial lung disease
  • Significant gastrointestinal disorders with diarrhea as a major symptom
  • History of clinically relevant cardiovascular abnormalities such as uncontrolled hypertension, congestive heart failure NYHA classification of 3, unstable angina or poorly controlled arrhythmia, or myocardial infarction within 6 months
  • Cardiac left ventricular function with resting ejection fraction <50%
  • Any other concomitant serious illness or organ system dysfunction which in the opinion of the investigator would either compromise patient safety or interfere with the evaluation of the safety of the study drug
  • Pregnancy or breast feeding
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition of BIBW 2992
  • Life expectancy of < 12 weeks

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: N / D
  • Modelo Intervencional: Atribuição de grupo único
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: BIBW 2992
BIBW 2992 Taken orally once a day
Taken orally once a day
Outros nomes:
  • Afatinibe

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Prazo
Number of Participants That Have a T790M Mutation on Their Progression Biopsy.
Prazo: At the time of disease progression (median duration of 11.4 months from start of treatment)
At the time of disease progression (median duration of 11.4 months from start of treatment)

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Response Rate
Prazo: Baseline and then after the end of every two 28 day cycles until treatment is discontinued; median duration of followup of 19.3 months

The number of participants with either a complete response (CR) or partial response (PR) as assessed by Response Evaluation Criteria in Solid Tumors (RECIST v1.1)

  • CR: Disappearance of all target lesions. Any pathological lymph node must have reduction in short axis to < 10 mm
  • PR: At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters.
Baseline and then after the end of every two 28 day cycles until treatment is discontinued; median duration of followup of 19.3 months
Median Progression-free and Overall Survival
Prazo: start of treatment, at the time of disease progression, time of death
The progression-free and overall survival times. Overall survival is measured from the start of treatment until the time of death or until the participant is lost to follow-up. Progression free survival is measured from the start of treatment until the time of progression, death, or until the participant is lost to follow-up (whichever occurs first). Progression is defined as having at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study with at least a 5 mm absolute increase in the sum of all lesions. The appearance of one or more new lesions denotes disease progression.
start of treatment, at the time of disease progression, time of death
Number of Participants With Biopsy Complications From Repeat Tumor Biopsies
Prazo: 7 days post biopsy and ≥ 30 days post-biopsy
The number of participants with biopsy complications from repeat tumor biopsies taken following disease progression. Biopsy complications are any adverse events considered to be potentially related to the biopsy.
7 days post biopsy and ≥ 30 days post-biopsy

Colaboradores e Investigadores

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

Investigadores

  • Investigador principal: Lecia V. Sequist, MD, PhD, Massachusetts General Hospital

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 fevereiro de 2011

Conclusão Primária (Real)

1 de março de 2017

Conclusão do estudo (Real)

1 de março de 2017

Datas de inscrição no estudo

Enviado pela primeira vez

22 de fevereiro de 2010

Enviado pela primeira vez que atendeu aos critérios de CQ

22 de fevereiro de 2010

Primeira postagem (Estimativa)

24 de fevereiro de 2010

Atualizações de registro de estudo

Última Atualização Postada (Real)

9 de março de 2018

Última atualização enviada que atendeu aos critérios de controle de qualidade

5 de março de 2018

Última verificação

1 de março de 2018

Mais Informações

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 .

Ensaios clínicos em BIBW 2992

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