Study of Lapatinib in Breast Cancer Patients With HER-2 Non-amplified Primary Tumors and HER-2 Positive or EGFR Positive Circulating Tumor Cells
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| ClinicalTrials.gov Identifier: NCT00820924 |
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Recruitment Status :
Terminated
First Posted : January 12, 2009
Last Update Posted : March 28, 2012
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The underlying biology of the various patterns of metastasis observed in different tumour types remains unclear. The detection and characterization of circulating tumour cells in cancer patients has provided important new information about the progression of metastatic events. This information has important implications for cancer prognosis and therapy.
This multicenter open-label study is designed as a two-stage three-outcome phase II trial. The aim is to evaluate the efficacy and safety of daily dose of Lapatinib in advanced breast cancer patients with HER-2 non-amplified primary tumours and HER-2 or EGFR positive circulating tumour cells. Evaluation of HER-2 and EGFR status on circulating tumour cells will be performed by the means of the CellSearch equipment (Immunicon, Huntingdon Valley, PA, USA) and FISH method (PathVysion Kit -Abbott Laboratories).
| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Neoplasms, Breast | Drug: LAPATINIB | Phase 2 |
Rationale: Despite recent progress in gene-expression profiling studies, the underlying biology of the various patterns of metastasis observed in different tumour types remains unclear. The detection and characterization of circulating tumour cells in cancer patients has provided important new information about the progression of metastatic events. This information has important implications for cancer prognosis and therapy.
This open label, multicenter phase II study is designed to evaluate overall tumour response rate in advanced breast cancer patients with HER-2 non amplified primary tumours with positive HER-2 or EGFR circulating tumour cells treated with the dual tyrosine kinase inhibitor GW572016 (Lapatinib).
The patients will be allocated into one of the following two strata:
Stratum 1) Italian study group: Advanced breast cancer patients with HER-2 non-amplified primary tumours and HER-2 positive circulating tumour cells Stratum 2) UK study group: Advanced breast cancer patients with HER-2 non-amplified primary tumours and EGFR positive circulating tumour cells.
All of these patients will be treated with GW572016 (Lapatinib) which targets both HER-2 or EGFR receptors. A subgroup of patients enrolled into stratum 2 will be asked to participate in an additional sub-study using Positron Emission Tomography (PET) to quantify the potential early response to lapatinib treatment.
Study Design:
This study will be a multicenter open-label, phase II study to evaluate the efficacy and safety of daily dose of Lapatinib in advanced breast cancer patients with HER-2 non amplified primary tumours and positive HER-2 or EGFR circulating tumour cells.
Patients enrolled in this study will be treated with oral Lapatinib at the dose of 1,500 mg daily on day 1 to 28 every 4 weeks (q 4 weeks).
Patients will carefully be instructed on drug administration as far as Lapatinib oral intake is concerned. A daily dose of Lapatinib is six 250 mg tablets taken approximately at the same time each day. Lapatinib must be taken either at least 1 hour before or after meal.
Dose adjustment, modification and delays are permitted according to procedures described in the protocol. Initially 16 patients in each stratum will be treated; if 1 to 3 responses are observed, 15 additional patients will be treated, up to a total of 62 subjects with 31 subjects in each stratum.
| Study Type : | Interventional (Clinical Trial) |
| Actual Enrollment : | 23 participants |
| Allocation: | N/A |
| Intervention Model: | Single Group Assignment |
| Masking: | None (Open Label) |
| Primary Purpose: | Treatment |
| Official Title: | A Phase II Open Label, Multicenter Study to Evaluate the Efficacy and Safety of Daily Dose of Lapatinib in Advanced Breast Cancer Patients With HER-2 Non-amplified Primary Tumours and HER-2 Positive Circulating Tumour Cells or EGFR Positive Circulating Tumor Cells |
| Study Start Date : | June 2008 |
| Actual Primary Completion Date : | July 2011 |
| Actual Study Completion Date : | July 2011 |
| Arm | Intervention/treatment |
|---|---|
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Experimental: LAPATINIB
LAPATINIB 1500MG ORAL ONCE DAILY
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Drug: LAPATINIB
LAPATINIB 1500MG ORAL DOSE DAILY |
- The efficacy of lapatinib in advanced breast cancer patients with HER-2 non-amplified primary tumours with HER-2 or EGFR positive circulating tumour cells. [ Time Frame: approx. 6 mos ]
- Antitumour activity of lapatinib [ Time Frame: approx. 6 mos ]
- Safety of lapatinib as measured by number of AEs [ Time Frame: approx. 6 mos ]
- Early response of lapatinib on proliferation and the MAP kinase cascade by PET in a substudy in patients with EGFR positive CTCs only. [ Time Frame: approx. 6 mos ]
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| Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
| Sexes Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Female patients at least 18 years old with HER-2 negative breast cancer.
- Patients must have evidence of HER-2 or EGFR positive circulating tumour cells in a peripheral blood sample taken at screening visit.
- Patients must have measurable, metastatic disease and no brain metastasis requiring local therapy.
- Other criteria include ECOG score 0 to 2, life expectancy > 12 weeks, baseline organ function at screening visit,
- Previous treatment with anthracyclines and/or taxanes in the neo-adjuvant, adjuvant or advanced setting, and at least one line of treatment for metastatic disease.
Exclusion Criteria:
- Unstable medical conditions, pregnant or lactating women.
- Inability to provide informed consent.
- Lack of physical integrity of the upper gastrointestinal (GI) tract.
- Co-existing malignancy or malignancies within the last 5 years with the exception of basal cell carcinoma or in-situ carcinoma, concurrent anti-cancer therapies (chemo or hormonal therapy) or investigational drugs other than study drug.
- Concurrent radiotherapy to the only target lesion or concurrent bisphosphonates if bone metastases are the only target lesions.
- Previous treatment with anti HER-2 or anti-EGFR therapies.
- Protocol specified treatment regimens that would be inappropriate for the management of the subject.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00820924
| Italy | |
| GSK Investigational Site | |
| Rimini, Emilia-Romagna, Italy, 47900 | |
| GSK Investigational Site | |
| Udine, Friuli-Venezia-Giulia, Italy, 33100 | |
| GSK Investigational Site | |
| Bergamo, Lombardia, Italy, 24128 | |
| GSK Investigational Site | |
| Milano, Lombardia, Italy, 20121 | |
| GSK Investigational Site | |
| Rozzano (MI), Lombardia, Italy, 20089 | |
| GSK Investigational Site | |
| Livorno, Toscana, Italy, 57124 | |
| GSK Investigational Site | |
| Prato (PO), Toscana, Italy, 59100 | |
| GSK Investigational Site | |
| Perugia, Umbria, Italy, 06156 | |
| GSK Investigational Site | |
| Ancona, Italy, 60020 | |
| United Kingdom | |
| GSK Investigational Site | |
| London, United Kingdom, W6 8RF | |
| Study Director: | GSK Clinical Trials | GlaxoSmithKline |
| Responsible Party: | GlaxoSmithKline |
| ClinicalTrials.gov Identifier: | NCT00820924 |
| Other Study ID Numbers: |
105594 |
| First Posted: | January 12, 2009 Key Record Dates |
| Last Update Posted: | March 28, 2012 |
| Last Verified: | March 2012 |
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HER-2 Circulating Tumour Cell (CTC) EGFR Lapatinib (GW572016) Breast Cancer |
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Breast Neoplasms Neoplastic Cells, Circulating Neoplasms by Site Neoplasms Breast Diseases Skin Diseases Neoplasm Metastasis |
Neoplastic Processes Pathologic Processes Lapatinib Antineoplastic Agents Protein Kinase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |