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Phase II Dasatinib Study in Advanced Breast Cancer

15 juli 2013 uppdaterad av: Duke University

A Phase II Trial of Dasatinib to Treat Women With Stage IV or Inoperable Stage III Advanced Breast Cancer

The purpose of this study is to find out if dasatinib will safely reduce the size or spread of your tumor.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

The introduction of biologics with specific molecular targets has initiated a trend toward improved survival in women with metastatic breast cancer.

The tyrosine kinase SRC (pp60src) is a member of a family of proteins that contribute to cellular signal transduction activities such as cell growth, differentiation, survival, adhesion and migration. Abnormal signaling has been linked to cancer metastases; thus, identification of molecular regulators or inhibitors of SRC present therapeutic opportunity for cancer patients. Src kinases consist of eight non-receptor tyrosine kinases (Src, Fyn, Yes, Lck, Lyn, Hck, Fgr and Blk) that interact with the intracellular domains of growth factor/cytokine receptors, (G-protein-coupled receptor)GPCRs and integrins.

Inhibition of SRC has also been associated with reversal of chemoresistance and restored sensitivity to drug-resistant ovarian cancer cells, suggesting potential as second- line treatment for previously treated populations. Dasatinib is a potent, broad spectrum inhibitor of 5 critical oncogenic tyrosine kinases, including SRC.

Patients will receive dasatinib, a Src inhibitor, at an initial dose of 50 mg PO BID, with real-time PharmacoDynamic dose adjustment following 4 weeks of therapy based on inhibition of phosphorylation of SRC, focal adhesion kinase (FAK) and paxillin, until progression. The primary objective is to assess tolerability and estimate the proportion of patients who are progression-free at 16 weeks from the date of study enrollment.

A minimum of 2 (maximum of 3) tumor biopsies will be analyzed and compared for SRC signature: one at baseline (study enrollment, all patients); the second after 4 weeks of dasatinib therapy (all patients); and the third at progression (only patients who progress after a documented response).

Patients will receive continuous daily administration until documented disease progression, and will be followed until death.

The results of this study may be useful in designing future studies using dasatinib alone or in combination with chemotherapy, thus having the potential to alter the current standard of care in this incurable population.

Additional correlative studies will be conducted. Tumor biopsies will be analyzed and compared for SRC, pSRC, Ki67, and related genomic signatures.

Studietyp

Interventionell

Inskrivning (Faktisk)

31

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Förenta staterna
    • Florida
      • West Palm Beach, Florida, Förenta staterna, 33401
        • Palm Beach Cancer Center Institute
    • North Carolina
      • Charlotte, North Carolina, Förenta staterna, 28204
        • Presbyterian Health Care
      • Durham, North Carolina, Förenta staterna, 27710
        • Duke University Medical Center

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Kvinna

Beskrivning

Inclusion Criteria:

  • Measurable Stage IV or inoperable Stage III advanced breast cancer.
  • There is no limit on the number of prior therapies.
  • At least 3 weeks since prior chemotherapy, biological or hormonal therapy.
  • At least 2 weeks since surgical biopsy.
  • At least 3 weeks since major (open thoracic/abdominal/cardiac) surgery.
  • No central nervous system (CNS) metastases except solitary brain metastasis
  • No cardiac dysfunction
  • left ventricular ejection fraction (LVEF) ≥ 50% as determined by multiple gated acquisition scan (MUGA)/echocardiogram
  • Adequate blood counts
  • Normal liver and kidney function
  • Negative serum pregnancy test.
  • Able to provide informed consent

Exclusion Criteria:

  • Pregnant or breast feeding.
  • Prior treatment with dasatinib.
  • Bone as the only site of disease.
  • Significant gastrointestinal bleeding
  • Septicemia, infection, acute hepatitis, hypokalemia, or hypomagnesemia

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Icke-randomiserad
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Dasatinib
50- 100 mg PO BID
Läkemedel: Dasatinib
An initial dose of 50 mg PO BID; following 4 weeks of treatment, dose adjustment will be based on inhibition of phosphorylation of FAK and paxillin per biopsy assessment, as well as toxicity assessment.
Andra namn:
  • BMS-354825
  • Sprycel

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Estimation of the Proportion of Progression-free Patients at 16 Wks.
Tidsram: 16 weeks

Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or measurable increase in a non-target lesion, or the appearance of new lesions, or similar definition as appropriate.

Proportion progression-free at 16 weeks.From first day of study related treatment with Dasatinib until the date of first documented progression or date of death from any cause, whichever came first.
16 weeks

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
To Measure Response to Protocol Therapy Per RECIST Criteria
Tidsram: 16 weeks

Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by CT: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Progression At least a 20% increase in the sum of the longest diameter (LD) of target lesions taking as a reference the smallest sum longest diameter recorded since treatment started, or the appearance of one or more new lesions.

RECIST 1.0 Overall response:

Complete Response (CR) Partial Response (PR) Stable Disease (SD) Progressive Disease (PD)

CR= CR+CR and No new lesions PR= CR+SD; PR+SD and no new lesions SD= SD+SD and no new lesions PD= PD+any new lesions
16 weeks
Characterization and Comparison of SRC (A Protein Tyrosine Kinase)Dysregulation at Baseline (All Patients), After 4 Weeks of Dasatinib Treatment (All Patients), and at Progression (Only Patients Who Progress After Documented Response)
Tidsram: 4 weeks
For the 20 patients with evaluable biopsies at baseline and week 4, the median relative change from baseline in tissue biomarker levels of phospho-Src (p-Src)
4 weeks
Correlate SRC Dysregulation Results With Response to Dasatinib Therapy
Tidsram: 16 weeks
Since all patients progressed there is no comparison to between responders and non-responders.
16 weeks
To Explore the Association Between Each Patient's SRC Signature and Their Time to Progression.
Tidsram: Baseline Src measure to first progression
Spearman's correlation between the change in SRC signature from baseline to 4 weeks and time to progression
Baseline Src measure to first progression
To Explore the Association Between Dasatinib and Osteoclastic Bone Resorption
Tidsram: not assessed
Not assessed secondary to limited number of subjects.
not assessed

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Duke University

Samarbetspartners

Bristol-Myers Squibb

Utredare

  • Huvudutredare: Kimberly Blackwell, MD, Duke University

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 oktober 2007

Primärt slutförande (Faktisk)

1 maj 2011

Avslutad studie (Faktisk)

1 maj 2011

Studieregistreringsdatum

Först inskickad

16 oktober 2007

Först inskickad som uppfyllde QC-kriterierna

16 oktober 2007

Första postat (Uppskatta)

18 oktober 2007

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

17 juli 2013

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

15 juli 2013

Senast verifierad

1 juli 2013

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • Pro00007578
  • BMS CA180089

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