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Cisplatin, Paclitaxel, and Everolimus in Treating Patients With Metastatic Breast Cancer

7 mars 2013 uppdaterad av: Ingrid Mayer, MD, Vanderbilt-Ingram Cancer Center

A Phase I Study of Cisplatin, Paclitaxel, and RAD001 Patients With Metastatic Breast Cancer

RATIONALE: Drugs used in chemotherapy, such as cisplatin and paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Everolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving more than one drug (combination chemotherapy) together with everolimus may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of cisplatin, paclitaxel, and everolimus when given together for the treatment of patients with metastatic breast cancer.

Studieöversikt

Detaljerad beskrivning

OBJECTIVES:

Primary

  • To establish the safety profile and the maximum tolerated dose of the combination of cisplatin, paclitaxel, and everolimus in patients with metastatic breast cancer.

Secondary

  • To explore the antitumor activity of this regimen, in terms of response rate and time to progression in these patients.

OUTLINE: This is a multicenter study.

Patients receive cisplatin intravenously (IV) over 1 hour and paclitaxel IV over 1 hour on days 1, 8, and 15. Patients receive oral everolimus on days 1, 8, 15, and 21. Courses repeat every 4 weeks in the absence of disease progression and unaccepted toxicity.

After completion of study therapy, patients are followed at 4 weeks.

Studietyp

Interventionell

Inskrivning (Faktisk)

18

Fas

  • Fas 1

Kontakter och platser

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

Studieorter

    • Tennessee
      • Nashville, Tennessee, Förenta staterna, 37232-6838
        • Vanderbilt-Ingram Cancer Center
      • Nashville, Tennessee, Förenta staterna, 37064
        • Vanderbilt-Ingram Cancer Center - Cool Springs
      • Nashville, Tennessee, Förenta staterna, 37064
        • Vanderbilt-Ingram Cancer Center at Franklin
      • Nashville, Tennessee, Förenta staterna, 37203
        • Sarah Cannon Cancer Center at Centennial 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

Allt

Beskrivning

Inclusion Criteria:

DISEASE CHARACTERISTICS:

  • Histologically confirmed invasive mammary carcinoma

    • Stage IV disease
  • No locally recurrent breast cancer
  • Patients with HER2/neu overexpressing tumors must have received prior trastuzumab (Herceptin®) in first-line treatment of metastatic breast cancer
  • Patients with estrogen receptor- or progesterone receptor-expressing tumors must have received prior endocrine therapy (i.e., aromatase inhibitors, fulvestrant, tamoxifen, or ovarian ablation) in first-line treatment of metastatic breast cancer
  • No symptomatic brain metastases

    • Patients with a history of brain metastases must be clinically stable and not taking steroids or therapeutic anticonvulsants that are CYP3A4 modifiers
    • Patients with asymptomatic brain metastases on prophylactic convulsants that are CYP3A4 modifiers are not eligible
  • Hormone receptor status not specified

PATIENT CHARACTERISTICS:

  • Menopausal status not specified
  • ECOG performance status 0-1
  • Life expectancy ≥ 6 months
  • ANC ≥ 1000/mm^3
  • Platelet count ≥ 100,000/mm^3
  • Creatinine ≤ 1.5 times upper limit of normal (ULN)
  • Bilirubin ≤ 1.5 times ULN (3 times ULN if liver metastasis present)
  • SGOT and SGPT ≤ 1.5 times ULN (3 times ULN if liver metastasis present)
  • Alkaline phosphatase ≤ 3 times ULN if liver metastasis present
  • Able to swallow and retain oral medication
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 3 months after completion of study treatment
  • Must be disease-free from prior invasive cancers for > 5 years with the exception of completely resected basal cell or squamous cell carcinoma of the skin or successfully treated cervical carcinoma in situ
  • No malabsorption syndrome, disease significantly affecting gastrointestinal function, or ulcerative colitis
  • No uncontrolled intercurrent illness including, but not limited to:

    • Ongoing or active infection requiring parenteral antibiotics
    • Impairment of lung function (i.e., chronic obstructive pulmonary disease or lung conditions requiring oxygen therapy)
    • Symptomatic New York Heart Association class III-IV congestive heart failure
    • Unstable angina pectoris, angioplasty, stenting, or myocardial infarction within the past 6 months
    • Uncontrolled hypertension (systolic blood pressure [BP] > 180 mm Hg or diastolic BP > 100 mm Hg)
    • Clinically significant cardiac arrhythmia (i.e., multifocal premature ventricular contractions, bigeminy, trigeminy, or ventricular tachycardia that is symptomatic or requires treatment)
    • Uncontrolled diabetes
    • Psychiatric illness/social situations that would preclude compliance with study requirements
  • No known history of uncontrolled or symptomatic neuropathy ≥ grade 2
  • No hypersensitivity to paclitaxel, or drugs using the vehicle Cremophor, Chinese hamster ovary cell products, or other recombinant human antibodies

Exclusion Criteria:

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Recovered from all prior treatment
  • Must not have exceeded a total cumulative dose of life-time exposure of doxorubicin hydrochloride ≤ 360 mg/m² or epirubicin hydrochloride ≤ 640 mg/m²
  • At least 2 weeks since other prior investigational drugs
  • No prior resection of the stomach or small bowel
  • No more than 4 prior chemotherapy regimens in the metastatic setting

    • This restriction does not include endocrine therapies or single agent biologic therapies (i.e., trastuzumab)
  • Concurrent radiotherapy to painful bone metastases or areas of impending bone fracture allowed as long as radiotherapy is initiated prior to study entry
  • No concurrent trastuzumab
  • No concurrent endocrine therapy
  • No concurrent CYP3A4 modifiers
  • No concurrent herbal supplement
  • No other concurrent anticancer therapy (chemotherapy, radiotherapy, surgery, immunotherapy, hormonal therapy, or biological therapy)

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: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Terapeutisk intervention
  • Dose Level: -3 20mg/m2/week 3-6 patients
  • Dose Level: -2 20mg/m2/week 3-6 patients
  • Dose Level: -1 25mg/m2/week 3-6 patients
  • Dose Level: 1 25mg/m2/week 3-6 patients
  • Dose Level: 2 25mg/m2/week 3-6 patients
  • Dose Level: 3 25mg/m2/week 3-6 patients
Andra namn:
  • Platinol
  • Dose Level: -3 20mg/m2/week 3-6 patients
  • Dose Level: -2 20mg/m2/week 3-6 patients
  • Dose Level: -1 20mg/m2/week 3-6 patients
  • Dose Level: 1 20mg/m2/week 3-6 patients
  • Dose Level: 2 25mg/m2/week 3-6 patients
  • Dose Level: 3 30mg/m2/week 3-6 patients
Andra namn:
  • RAD001
  • Dose Level: -3 65mg/m2/week 3-6 patients
  • Dose Level: -2 70mg/m2/week 3-6 patients
  • Dose Level: -1 70mg/m2/week 3-6 patients
  • Dose Level: 1 80mg/m2/week 3-6 patients
  • Dose Level: 2 80mg/m2/week 3-6 patients
  • Dose Level: 3 80mg/m2/week 3-6 patients
Andra namn:
  • Taxol

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Safety profile and maximum tolerated dose
Tidsram: At 4 weeks
The Maximum Tolerated Dose (MTD) will be the dose level at which fewer than 2 of 6 (or 33% of) patients experience dose limiting toxicity (DLT).
At 4 weeks

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Antitumor activity
Tidsram: Date of study entry to date of progression of disease
Cisplatin + Paclitaxel + RAD001 combination by determining response rates (RR) and time to progression (TTP) achieved with treatment
Date of study entry to date of progression of disease
Response rate
Tidsram: at baseline and every 8 weeks to disease progression
at baseline and every 8 weeks to disease progression
Time to progression
Tidsram: date of study entry to date of disease progression
date of study entry to date of disease progression

Samarbetspartners och utredare

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

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 maj 2008

Primärt slutförande (Faktisk)

1 augusti 2009

Avslutad studie (Faktisk)

1 december 2010

Studieregistreringsdatum

Först inskickad

18 maj 2008

Först inskickad som uppfyllde QC-kriterierna

18 maj 2008

Första postat (Uppskatta)

20 maj 2008

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

8 mars 2013

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

7 mars 2013

Senast verifierad

1 mars 2013

Mer information

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