Lapatinib and RAD-001 for HER2 Positive Metastatic Breast Cancer

This study is currently recruiting participants. (see Contacts and Locations)
Verified December 2013 by University of Kansas
Sponsor:
Collaborators:
Novartis
GlaxoSmithKline
Information provided by (Responsible Party):
University of Kansas
ClinicalTrials.gov Identifier:
NCT01283789
First received: January 10, 2011
Last updated: December 30, 2013
Last verified: December 2013
  Purpose

By doing this study, researchers hope to learn the effectiveness of the combination of Lapatinib and RAD-001 for treating patients who have progressed on previous therapies.


Condition Intervention Phase
Metastatic Breast Cancer
Drug: Lapatinib and RAD-001
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase II Trial of Lapatinib and RAD-001 for HER2 Positive Metastatic Breast Cancer

Resource links provided by NLM:


Further study details as provided by University of Kansas:

Primary Outcome Measures:
  • Assess the effectiveness of the combination of RAD-001 and lapatinib [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]
    To assess the effectiveness of the combination of RAD-001 and lapatinib as measured by the six-month Overall Response Rate in women with MBC who have progressed on trastuzumab and/or lapatinib based therapies.


Secondary Outcome Measures:
  • Overall benefit of combination [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]
    • Six-month Progression Free Survival.
    • Safety and Tolerability of the combination.
    • Six-month Objective CNS response rate in patients with CNS metastases.
    • Six-month Clinical benefit rate of systemic disease.
    • Six-month Clinical benefit rate in the CNS.
    • Rate of development of Brain Metastases on six months of therapy.


Estimated Enrollment: 45
Study Start Date: February 2011
Estimated Study Completion Date: May 2015
Estimated Primary Completion Date: November 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Lapatinib and RAD-001

RAD-001 will be administered orally as a once-daily dose of 5 mg (one 5 mg tablet) continuously from study day 1 until progression of disease or unacceptable toxicity. Patients will be instructed to take RAD-001 in the morning, at the same time each day.

Lapatinib will be administered orally as a once-daily dose of 1250 mg (five 250 mg tablets) continuously from study day 1 until progression of disease or unacceptable toxicity. Patients will be instructed to take lapatinib at bedtime, at the same time each day. Lapatinib should be taken by the patient in a fasting state.

Drug: Lapatinib and RAD-001

Lapatinib will be taken orally as a once-daily dose of 1250 mg (five 250 mg tablets) continuously from study day 1 until progression of disease. Patients will take the tablet at bedtime, at the same time each day, in a fasting state.

Everolimus will be taken orally as a once-daily dose of 5 mg (one 5 mg tablet) from study day 1 until progression of disease. Patients will take the tablet at the same time each morning.

Other Names:
  • everolimus
  • tykerb

  Show Detailed Description

  Eligibility

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

INCLUSION CRITERIA

  • Females > 18 years of age
  • Histologically proven adenocarcinoma of breast in primary or metastatic setting. Stage: Locally advanced (inoperable) or metastatic
  • HER2 positive breast cancer (IHC 3+ or FISH ratio of > 2.0)
  • ECOG Performance status 0-2
  • Up to four prior chemotherapy regimens and anti-HER2 agents in metastatic setting allowed. Must have progressed on at least one HER2 targeted therapy (lapatinib or Herceptin) for metastatic breast cancer.
  • Women of childbearing potential must have negative urine or serum pregnancy test within 7 days prior to administration of Everolimus. If barrier contraceptives are used, they must be continued throughout trial by both sexes. Hormonal contraceptives not acceptable as a sole method of contraception.
  • Adequate kidney function: serum creatinine of < 1.5 mg/dl and/or creatinine clearance of > 60 mL/min
  • Adequate hepatic function: transaminases < 2.5 x upper limit of normal (up to 5 x ULN in patients with liver metastases) and total bilirubin < 1.5 mg/dL. Adequate coagulation: INR ≤ 2.0 and PTT < 1.5 X the upper limit of institution normal range. Oral anticoagulants, eg, warfarin are CYP2C9 substrates and, as such, no interaction with Everolimus is expected. Anticoagulation with Coumadin is allowed if target INR is ≤ 2.0 and stable for > 2weeks. Anticoagulation with LMW is allowed.
  • Must be informed of investigational nature of study, and must sign an informed consent
  • Pretreatment lab values (must be performed within 14 days of patient registration unless otherwise specified. Other baseline studies must be performed within 30 days of registration.
  • Patients will have baseline CT chest, abdomen and pelvis within 30 days of registration.
  • Adequate cardiac function (LVEF ≥ 50% as measured by echocardiogram or MUGA scan).
  • Fasting serum cholesterol ≤ 300 mg/dL OR ≤ 7.75 mmol/L AND fasting triglycerides ≤ 2.5 x ULN. NOTE: In case one or both of these thresholds are exceeded, patient may be included after initiation of appropriate lipid lowering medication with approval from the principal investigator.
  • Must have measurable or non-measurable disease by RECIST criteria (version 1.1), with radiologic scans performed within 30 days of registration. Baseline scans can include:

    • CT Scan or MRI and Bone Scan OR
    • PET/CT provided it is performed with both IV and oral contrast and the CT is acquired with 5mm or less slice thickness. If IV contrast administration is contraindicated, patients should have CT scan without contrast and bone scan or MRI and bone scan.
    • MRI of brain will be used for baseline assessment and tumor response assessment for CNS lesions.
    • Baseline imaging method(s) should be used to determine tumor response throughout course of study.
    • Measurable disease: lesions with clearly defined margins that can be accurately measured in at least one diameter (longest diameter to be recorded) with a minimum size of:

      • 10mm by CT scan (CT scan slice thickness no greater than 5mm)
      • 10mm caliper measurement by clinical exam (lesions which cannot be accurately measured with calipers should be recorded as non-measurable)
      • 20mm by chest xray
      • Malignant lymph nodes: to be considered pathologically enlarged and measurable. Lymph node must be > 15mm in short axis when assessed by CT scan. At baseline and in follow-up, only short axis will be measured and followed.
    • Non-measurable disease: all other lesions including small lesions (longest diameter < 10mm or pathological lymph nodes with > to <15 mm (short axis), and masses with margins not clearly defined. Lesions that are considered non-measurable include:

      • Bone lesions
      • Leptomeningeal disease
      • Ascites
      • Pleural/pericardial effusion
      • Inflammatory breast disease
      • Abdominal masses that are not confirmed and followed by imaging techniques
      • Cystic lesion
      • Lymphangitic involvement of skin or lung
  • The following pre-study tests should be obtained within 14 days prior to registration in accordance with good medical practice. Results of these tests do not determine eligibility and minor deviations are acceptable if they do not impact patient safety in the judgment of the treating physician:

    • ANC > 1,000/mm3
    • platelet count > 100,000/mm3
    • hemoglobin > 9 g/dL

Exclusion Criteria:

  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection requiring parenteral antibiotics or psychiatric illness/social situations that would limit compliance with study requirements.
  • GI tract disease resulting in an inability to take oral medication, malabsorption syndrome, a requirement for IV alimentation, prior surgical procedures affecting absorption, uncontrolled inflammatory GI disease (eg, Crohn's, ulcerative colitis).
  • Current active hepatic or biliary disease (exception of patients with Gilbert's syndrome, asymptomatic gallstones, liver metastases or stable chronic liver disease per investigator assessment)
  • Pregnant and lactating women. Women of reproductive potential not using or unwilling to use effective birth control methods throughout the trial.
  • Severe and/or uncontrolled medical conditions or other conditions that could affect participation in the study such as:

    • Symptomatic congestive heart failure of NYHA Class III or IV
    • unstable angina pectoris, symptomatic congestive heart failure, myocardial infarction within 6 months of start of study drug, serious uncontrolled cardiac arrhythmia or any other clinically significant cardiac disease
    • liver disease such as cirrhosis or severe hepatic impairment (Child-Pugh class C). Note: A detailed assessment of Hepatitis B/C medical history and risk factors must be done at screening for all patients. HBV DNA and HCV RNA PCR testing required at screening for all patients with a positive medical history based on risk factors and/or confirmation of prior HBV/HCV infection.
  • Patients with symptomatic brain metastases who have not completed radiation therapy and/or are receiving systemic steroid therapy. Patients with leptomeningeal disease will be excluded.
  • Patients receiving chronic, systemic treatment with corticosteroids (of more than 4mg/day or equivalent of dexamethasone. Doses of dexamethasone of up to 8mg/day may be administered for less than 2 weeks) or another immunosuppressive agent. Topical or inhaled corticosteroids are allowed.
  • Patients should not receive immunization with attenuated live vaccines within one week of study entry or during study period.
  • Severely impaired lung function defined as spirometry and DLCO that is < 50% of the normal predicted value and/or 02 saturation that is 88% or less at rest on room air.
  • Uncontrolled diabetes as defined by fasting serum glucose >1.5 x ULN.
  • Active (acute or chronic) or uncontrolled severe infections.
  • Known history of HIV seropositivity.
  • Active, bleeding diathesis.
  • Patients who have received prior treatment with an mTOR inhibitor (eg, sirolimus, temsirolimus, everolimus).
  • Known hypersensitivity to Everolimus or other rapamycins (eg, sirolimus, temsirolimus) or to its excipients.
  • Active Hepatitis B or C infection.
  • Life expectancy of < 2 months.
  • Prior anti-cancer therapy (eg, biologic or other targeted therapy, chemotherapy, hormonal therapy) within 2 weeks prior to Day 1 if the patient has recovered from all AEs to grade 1 except for alopecia.
  • Prior investigational anti-cancer therapy within 4 weeks prior to Day 1.
  • Patients who have had a major surgery or significant traumatic injury within 4 weeks of start of study drug, have not recovered from side effects of any major surgery (defined as requiring general anesthesia) or may require major surgery during the course of study.
  • Other malignancies within past 3 years except for adequately treated carcinoma of cervix or basal or squamous cell carcinomas of the skin.
  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: NCT01283789

Contacts
Contact: Qamar Khan, MD 913-588-3659 qkhan@kumc.edu
Contact: Stella Baccaray, RN 913-588-2437 sbaccaray@kumc.edu

Locations
United States, Kansas
University of Kansas Medical Centner Recruiting
Kansas City, Kansas, United States, 66160
Contact: Stella Baccaray, RN    913-588-2437    sbaccaray@kumc.edu   
Sub-Investigator: Priyanka Sharma, MD         
Sub-Investigator: Bruce Kimler, PhD         
Sub-Investigator: Carol Fabian, MD         
Sub-Investigator: Henry Yeh, PhD         
Sponsors and Collaborators
University of Kansas
Novartis
GlaxoSmithKline
Investigators
Principal Investigator: Qamar Khan, MD University of Kansas
  More Information

No publications provided

Responsible Party: University of Kansas
ClinicalTrials.gov Identifier: NCT01283789     History of Changes
Other Study ID Numbers: 12418
Study First Received: January 10, 2011
Last Updated: December 30, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by University of Kansas:
breast
cancer
metastatic
metastasis

Additional relevant MeSH terms:
Breast Neoplasms
Breast Diseases
Neoplasms
Neoplasms by Site
Skin Diseases
Everolimus
Lapatinib
Sirolimus
Anti-Bacterial Agents
Anti-Infective Agents
Antibiotics, Antineoplastic
Antifungal Agents
Antineoplastic Agents
Enzyme Inhibitors
Immunologic Factors
Immunosuppressive Agents
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Physiological Effects of Drugs
Protein Kinase Inhibitors
Therapeutic Uses

ClinicalTrials.gov processed this record on October 23, 2014