Phase II Dasatinib Study in Advanced Breast Cancer

This study has been completed.
Sponsor:
Collaborator:
Bristol-Myers Squibb
Information provided by (Responsible Party):
Duke University
ClinicalTrials.gov Identifier:
NCT00546104
First received: October 16, 2007
Last updated: July 15, 2013
Last verified: July 2013
  Purpose

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


Condition Intervention Phase
Advanced Breast Cancer
Drug: Dasatinib
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Trial of Dasatinib to Treat Women With Stage IV or Inoperable Stage III Advanced Breast Cancer

Resource links provided by NLM:


Further study details as provided by Duke University:

Primary Outcome Measures:
  • Estimation of the Proportion of Progression-free Patients at 16 Wks. [ Time Frame: 16 weeks ] [ Designated as safety issue: No ]

    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.



Secondary Outcome Measures:
  • To Measure Response to Protocol Therapy Per RECIST Criteria [ Time Frame: 16 weeks ] [ Designated as safety issue: No ]

    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


  • 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) [ Time Frame: 4 weeks ] [ Designated as safety issue: No ]
    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)

  • Correlate SRC Dysregulation Results With Response to Dasatinib Therapy [ Time Frame: 16 weeks ] [ Designated as safety issue: No ]
    Since all patients progressed there is no comparison to between responders and non-responders.

  • To Explore the Association Between Each Patient's SRC Signature and Their Time to Progression. [ Time Frame: Baseline Src measure to first progression ] [ Designated as safety issue: No ]
    Spearman's correlation between the change in SRC signature from baseline to 4 weeks and time to progression

  • To Explore the Association Between Dasatinib and Osteoclastic Bone Resorption [ Time Frame: not assessed ] [ Designated as safety issue: No ]
    Not assessed secondary to limited number of subjects.


Enrollment: 31
Study Start Date: October 2007
Study Completion Date: May 2011
Primary Completion Date: May 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Dasatinib
50- 100 mg PO BID
Drug: 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.
Other Names:
  • Sprycel
  • BMS-354825

Detailed Description:

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.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

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
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00546104

Locations
United States, Florida
Palm Beach Cancer Center Institute
West Palm Beach, Florida, United States, 33401
United States, North Carolina
Presbyterian Health Care
Charlotte, North Carolina, United States, 28204
Duke University Medical Center
Durham, North Carolina, United States, 27710
Sponsors and Collaborators
Duke University
Bristol-Myers Squibb
Investigators
Principal Investigator: Kimberly Blackwell, MD Duke University
  More Information

No publications provided

Responsible Party: Duke University
ClinicalTrials.gov Identifier: NCT00546104     History of Changes
Other Study ID Numbers: Pro00007578, BMS CA180089
Study First Received: October 16, 2007
Results First Received: January 22, 2013
Last Updated: July 15, 2013
Health Authority: United States: Institutional Review Board

Keywords provided by Duke University:
Advanced Breast Cancer
Breast cancer
Dasatinib
Inoperable Stage III Breast Cancer
Metastatic Breast Cancer
Stage IV Breast Cancer

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Dasatinib
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions

ClinicalTrials.gov processed this record on September 30, 2014