Trastuzumab and Imatinib Mesylate in Treating Patients With Recurrent or Metastatic HER2/Neu-Expressing Cancer
Phase I of Trastuzumab and Imatinib Mesylate (Gleevec®, Formerly Known as STI-571) in Patients With Recurrent or Metastatic Her-2/Neu Expressing Cancer
RATIONALE: Monoclonal antibodies such as trastuzumab can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Imatinib mesylate may stop the growth of tumor cells by blocking the enzymes necessary for their growth and by stopping blood flow to the tumor. Giving trastuzumab together with imatinib mesylate may kill more tumor cells.
PURPOSE: This phase I trial is studying the side effects and best dose of imatinib mesylate when given together with trastuzumab in treating patients with recurrent or metastatic HER2/neu-expressing (producing) cancer.
研究概览
详细说明
OBJECTIVES:
Primary
- Determine the maximum tolerated dose of imatinib mesylate when administered with trastuzumab (Herceptin®) in patients with recurrent or metastatic HER2/neu-overexpressing cancer.
- Determine response in patients treated with this regimen.
Secondary
- Correlate the number of circulating tumor cells with radiographic imaging in patients treated with this regimen.
OUTLINE: This is a dose-escalation study of imatinib mesylate.
Patients receive trastuzumab (Herceptin®) IV over 90 minutes on day 1 and oral imatinib mesylate once or twice daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of imatinib mesylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.
PROJECTED ACCRUAL: Approximately 9-18 patients will be accrued for this study.
研究类型
注册 (预期的)
阶段
- 阶段1
联系人和位置
学习地点
-
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Pennsylvania
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Philadelphia、Pennsylvania、美国、19111-2497
- Fox Chase Cancer Center
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed cancer that overexpresses HER2/neu, measured 3+ by immunohistochemistry or positive by fluorescence in situ hybridization
- Recurrent or metastatic disease
Meets 1 of the following criteria for measurable or evaluable disease:
- Unidimensionally measurable disease at least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan
- Evaluable disease, defined as a lesion on physical examination or imaging study that can be assessed as to changes in size but cannot be clearly measured in 1 dimension (e.g., pleural effusions, ascites, or bone disease)
No carcinomatous meningitis or untreated/uncontrolled metastatic brain parenchymal disease
- Prior controlled brain parenchymal disease allowed provided at least 8 weeks since prior therapy AND no symptomatic progression off corticosteroids
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- ECOG 0-2
Life expectancy
- Not specified
Hematopoietic
- Absolute neutrophil count ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
Hepatic
- ALT and AST ≤ 2.0 times upper limit of normal (ULN)
- Alkaline phosphatase ≤ 2.0 times ULN
- Bilirubin ≤ 1.3 mg/dL
- No known chronic liver disease (i.e., chronic active hepatitis or cirrhosis)
Renal
- Creatinine ≤ 2.0 mg/dL
Cardiovascular
- Ejection fraction ≥ lower limit of normal by MUGA
- No uncontrolled or significant cardiovascular disease
- No myocardial infarction within the past 6 months
- No ischemic heart disease requiring medication
- No congestive heart failure
Pulmonary
- No uncontrolled or significant pulmonary disease
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective barrier contraception during and for 3 months after study participation
- No active unresolved infection
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Prior trastuzumab (Herceptin®) allowed
- No concurrent filgrastim (G-CSF) or sargramostim (GM-CSF) to support blood counts
- No other concurrent anticancer biologic agents
Chemotherapy
- Prior chemotherapy for metastatic disease allowed
- At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas) and recovered
- No concurrent anticancer chemotherapy
Endocrine therapy
- See Disease Characteristics
Radiotherapy
- At least 4 weeks since prior radiotherapy and recovered
Surgery
- More than 2 weeks since prior major surgery
Other
- At least 7 days since prior antibiotics
- No concurrent parenteral antibiotics
- No other concurrent anticancer agents
- No other concurrent investigational drugs
No concurrent therapeutic anticoagulation with warfarin
- Concurrent mini-dose warfarin (1 mg/day) for prophylaxis of central venous catheter thrombosis allowed
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
研究衡量的是什么?
主要结果指标
结果测量 |
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Maximum tolerated dose (MTD) of imatinib mesylate given concurrently with trastuzumab (Herceptin®) as measured by CTC v 3.0 at course 1
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Response as measured by RECIST criteria every 9 weeks
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次要结果测量
结果测量 |
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Circulating tumor cells in blood as measured by Immunicom Cell PrepTM at baseline, every 3 weeks until week 9, and then with each disease re-evaluation
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Phosphorylation status of AKT, extracellular signal-regulated kinase (ERK), and KIT as measured by western blot and/or immunohistochemistry at baseline and week 9
|
合作者和调查者
研究记录日期
研究主要日期
学习开始
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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