Dasatinib and Crizotinib in Advanced Cancer
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Purpose
The goal of this clinical research study is to find the highest tolerable dose of the combination of dasatinib and crizotinib that can be given to patients with advanced cancer. The safety of this drug combination will also be studied.
Dasatinib is designed to block certain proteins from causing cancer cells to grow out of control. This may cause the cancer cells to die.
Crizotinib is designed to block certain abnormal genes found in cancer cells. This may cause the cancer cells to die.
| Condition | Intervention | Phase |
|---|---|---|
|
Advanced Cancers |
Drug: Crizotinib Drug: Dasatinib |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase I Trial of Dasatinib in Combination With Crizotinib in Patients With Advanced Malignancies |
- Maximum tolerated dose (MTD) of Dasatinib plus Crizotinib [ Time Frame: 4 weeks ] [ Designated as safety issue: Yes ]Maximum tolerated dose (MTD) defined by dose limiting toxicities (DLTs) that occur during the first cycle (first four weeks). MTD defined as the highest dose studied in which the incidence of DLT was less than 33%.
- Tumor Response [ Time Frame: After 2, 28 day cycles ] [ Designated as safety issue: Yes ]Tumor response defined as one or more of the following: (1) stable disease for more than or equal to 4 months, (2) decrease in measurable tumor (sentinel lesions) by more than or equal to 20% by Response Evaluation Criteria in Solid Tumors (RECIST) criteria, (3) decrease in tumor markers by more than or equal to 25% (for example, a >/= 25% decrease in cancer antigen 125 (CA125) for patients with ovarian cancer), or (4) a partial response according to the Choi criteria, i.e. decrease in size by 10% or more, or a decrease in the tumor density, as measured by Hounsfield units (HU), by more than or equal to 15%.
| Estimated Enrollment: | 176 |
| Study Start Date: | March 2013 |
| Estimated Primary Completion Date: | March 2018 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm A - Crizotinib + Dasatinib
Arm A: Patients receive dose of crizotinib plus an increasing dose of dasatinib. All participants take dasatinib by mouth 1 time each day. Patients take this drug alone on Day 1 of Cycle 1, before the first day they receive the study drug combination. Final dose level in both arms (dose level number 5) is identical. In the case that both arms define dose level 5 as the MTD, then the expansion cohort for safety will include 10 patients with that dose. If two different MTDs on both arms defined, then both MTDs cohorts expanded with 10 patients and 20 patients included on the safety expansion analysis. Crizotinib dose: 250 mg by mouth twice a day in a 28 day cycle. Dasatinib starting dose: 50 mg by mouth daily in a 28 day cycle. Crizotinib Expansion dose: 250 mg by mouth twice a day in a 28 day cycle. Dasatinib Expansion Dose: MTD from dose escalation group. |
Drug: Crizotinib
Arm A Crizotinib dose: 250 mg by mouth twice a day in a 28 day cycle. Crizotinib Expansion dose: 250 mg by mouth twice a day in a 28 day cycle. Arm B Crizotinib starting dose: 250 mg by mouth every other day in a 28 day cycle. Crizotinib Expansion Dose: MTD from dose escalation group. Other Names:
Drug: Dasatinib
Arm A Dasatinib starting dose: 50 mg by mouth daily in a 28 day cycle. Arm A Dasatinib Expansion Dose: MTD from dose escalation group. Arm B Dasatinib dose: 140 mg by mouth daily in a 28 day cycle. Arm B Dasatinib Expansion Dose: 140 mg by mouth daily in a 28 day cycle. Other Names:
|
|
Experimental: Arm B - Dasatinib + Crizotinib
Arm B: Patients receive dasatinib plus an increasing dose of crizotinib. All participants take dasatinib by mouth 1 time each day. Patients take this drug alone on Day 1 of Cycle 1, before the first day they receive the study drug combination. Final dose level in both arms (dose level number 5) is identical. In the case that both arms define dose level 5 as the MTD, then the expansion cohort for safety will include 10 patients with that dose. If two different MTDs on both arms defined, then both MTDs cohorts expanded with 10 patients and 20 patients included on the safety expansion analysis. Dasatinib 140 mg by mouth daily in a 28 day cycle. Crizotinib starting dose: 250 mg by mouth every other day in a 28 day cycle. Dasatinib Expansion Dose: 140 mg by mouth daily in a 28 day cycle. Crizotinib Expansion Dose: MTD from dose escalation group. |
Drug: Crizotinib
Arm A Crizotinib dose: 250 mg by mouth twice a day in a 28 day cycle. Crizotinib Expansion dose: 250 mg by mouth twice a day in a 28 day cycle. Arm B Crizotinib starting dose: 250 mg by mouth every other day in a 28 day cycle. Crizotinib Expansion Dose: MTD from dose escalation group. Other Names:
Drug: Dasatinib
Arm A Dasatinib starting dose: 50 mg by mouth daily in a 28 day cycle. Arm A Dasatinib Expansion Dose: MTD from dose escalation group. Arm B Dasatinib dose: 140 mg by mouth daily in a 28 day cycle. Arm B Dasatinib Expansion Dose: 140 mg by mouth daily in a 28 day cycle. Other Names:
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 16 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients must have histologically confirmed solid malignancy that is metastatic or unresectable or lymphoma, for which standard curative or palliative measures that improve survival by at least three months do not exist or are no longer effective. For the purpose of this study patients with leukemia are not eligible.
- Age >/= 16 years.
- Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status </= 2.
- Patients must have normal organ and marrow function as followed defined: ANC >/= 1,000/mcL; Plt >/=75,000/mcL; total bilirubin </=2.0 mg/dL; AST (TGO)/ALT (TGP) </=2.5x upper limit of normal; if liver metastasis are present, then </= 5.0x upper limit; estimated creatinine clearance by Cockcroft-Gault equation > 30 mL/min
- The effects of Dasatinib and Crizotinib on the developing human fetus are unknown. For this reason women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation.
- Patients receiving palliative radiation will be eligible after a wash-out period of 2 weeks between finishing radiation and initiation of study drugs. Palliative radiation will not be allowed during cycle 1 of treatment but is permitted in this study during following cycles as long as there are evaluable lesions that are not being irradiated
- Signed informed consent approved by the Institutional Review Board prior to patient entry.
- Expanded cohort only: Cohort 1: patients with predominant metastatic bone disease; Cohort 2: patients with primary squamous head and neck cancers; Cohort 3: patients presenting any molecular abnormality of interest, which can include an ALK translocation, ALK amplification, ALK mutation and overexpression as determined by FISH, IHC, qPCR, qRT-PCR, array Comparative Genomic Hybridization or direct sequencing (aCGH); a c-MET abnormality, either c-MET amplification by FISH, overexpression by IHC or c-MET mutation; BRAF, DDR2 and CDKN2A mutations; and, finally, TRIM 16 expression and CCN2 expression.
Exclusion Criteria:
- Patient receiving any concurrent chemotherapy.
- Concurrent severe and/or uncontrolled medical disease including, but not limited to, ongoing or active infection requiring intravenous antibiotics.
- Symptomatic congestive heart failure (NYHA Class III or IV), or unstable angina pectoris.
- Presence of symptomatic pleural and/or pericardial effusion not appropriated treated.
- Prolonged QTc interval (>/=500 msec), as calculated by Bazett`s formula.
- Psychiatric problems of sufficient severity to limit full compliance with the study or expose patients to undue risk.
- Known anaphylactic or severe hypersensitivity to Dasatinib or Crizotinib or their analogs.
- Patient has failed to recover from any prior surgery within 4 weeks of study entry.
- Patient is pregnant or lactating. Pregnant women are excluded from this study because dasatinib and crizotinib are agents with the potential for teratogenic or abortifacient effects (Pregnancy category D).
- Patient has had any treatment specific for tumor control within 3 weeks of dosing with investigational drugs and cytotoxic agents, or within 2 weeks of cytotoxic agent given weekly, or within 6 weeks of nitrosoureas or mitomycin C, or within 5 half-lives of biological targeted agents.
- Patient is not able to swallow oral medication.
- Patients receiving any medications or substances that are strong inhibitors or inducers of CYP3A4 complex are ineligible.
- Patients with known pulmonary hypertension.
Contacts and Locations| Contact: David S. Hong, MD | 713-763-1930 |
| United States, Texas | |
| UT MD Anderson Cancer Center | Recruiting |
| Houston, Texas, United States, 77030 | |
| Principal Investigator: | David S. Hong, MD | UT MD Anderson Cancer Center |
More Information
Additional Information:
No publications provided
| Responsible Party: | M.D. Anderson Cancer Center |
| ClinicalTrials.gov Identifier: | NCT01744652 History of Changes |
| Other Study ID Numbers: | 2012-0721 |
| Study First Received: | December 5, 2012 |
| Last Updated: | April 23, 2013 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by M.D. Anderson Cancer Center:
|
Advanced Cancers Advanced Malignancies Unresectable Metastatic Crizotinib |
PF-02341066 Xalkori Dasatinib BMS-354825 Sprycel |
Additional relevant MeSH terms:
|
Neoplasms Dasatinib Protein Kinase Inhibitors |
Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 19, 2013