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Phase III Randomized Study of Capecitabine With Versus Without Lapatinib in Women With Refractory Locally Advanced or Metastatic Breast Cancer
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outcomes Outline Published Results Trial Contact Information Related Information Registry Information
Alternate Title
Capecitabine With or Without Lapatinib in Treating Women With Locally Advanced or Metastatic Breast Cancer That Has Not Responded to Previous Therapy
Basic Trial Information
Phase | Type | Status | Age | Protocol IDs |
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Phase III | Treatment | Closed | 18 and over | GSK-EGF100151 UCLA-0403074-01, NCT00078572 |
Objectives Primary - Compare time to disease progression in women with refractory locally advanced or metastatic breast cancer treated with capecitabine with vs without lapatinib.
Secondary - Compare overall response, clinical benefit, time to response, duration of response, 6-month progression-free survival, and overall survival in patients treated with these regimens.
- Compare the toxicity of these regimens in these patients.
- Compare quality of life of patients treated with these regimens.
- Compare serum concentration of ErbB2 with tumor response in patients treated with these regimens.
Entry Criteria Disease Characteristics:
- Histologically confirmed breast cancer
- Invasive disease
- Stage IIIB, IIIC (with T4 lesions), or IV
- Progressive advanced or metastatic disease, defined by 1 of the following:
- Any new lesion not previously identified
- Increase of ≥ 25% in existing lesions
- Refractory disease, defined as progression in the metastatic setting OR relapse within 6 months after completion of adjuvant therapy comprising (sequentially or concurrently) 4 courses of both a taxane and an anthracycline
- Patients who progressed while receiving 2 courses of adjuvant therapy are eligible
- Patients whose relapse is > 6 months after completion of adjuvant therapy AND further anthracycline therapy is not indicated are eligible
- Measurable disease, as defined by RECIST
- Measurable lesions in the field of prior adjuvant radiotherapy allowed provided ≥ 8 weeks since the last radiation treatment
- Archived tumor tissue available
- ErbB2 (HER-2) overexpression (+3 by immunohistochemistry [IHC] alone OR +2 by IHC with fluorescence in situ hybridization confirmation)
- Patients must have received trastuzumab (Herceptin®) alone or in combination with chemotherapy for at least 6 weeks at standard doses
- No known history or clinical evidence of CNS metastases
- No leptomeningeal carcinomatosis
- Hormone receptor status:
- Patients with hormone receptor-positive tumors must have had disease progression after hormonal therapy unless intolerant to hormonal therapy or hormonal therapy is not considered to be clinically appropriate
Prior/Concurrent Therapy:
Biologic therapy - See Disease Characteristics
- More than 2 weeks since prior and no concurrent anticancer biologic therapy
- No concurrent immunotherapy
Chemotherapy - See Disease Characteristics
- Recovered from prior chemotherapy
- No prior capecitabine
- No other concurrent anticancer chemotherapy
Endocrine therapy - See Disease Characteristics
- More than 2 weeks since prior and no concurrent hormonal therapy
- More than 2 weeks since prior and no concurrent glucocorticoids
- More than 2 weeks since prior and no concurrent oral or IV steroids
Radiotherapy - See Disease Characteristics
- Recovered from prior radiotherapy
- No concurrent anticancer radiotherapy
Surgery - No prior resection of the stomach or small bowel
- No concurrent tumor embolization
- No concurrent surgery for advanced or metastatic cancer
Other - More than 2 weeks since prior and no concurrent anticancer cytotoxic therapy
- More than 2 weeks since prior and no concurrent CYP3A4 inducers or inhibitors, including any of the following:
- Clarithromycin
- Erythromycin
- Troleandomycin
- Ciprofloxacin
- Rifampin
- Norfloxacin
- Rifabutin
- Delaviridine
- Indinavir
- Nelfinavir
- Ritonavir
- Saquinavir
- Efavirenz
- Nevirapine
- Amprenavir
- Lopinavir
- Sorivudine
- Brivudine
- Phenytoin
- Carbamazepine
- Phenobarbital
- Fluoxetine
- Nefazodone
- Fluvoxamine
- Intraconazole
- Ketoconazole
- Fluconazole
- Voriconazole
- Cimetidine
- More than 2 weeks since prior and no concurrent administration of any of the following:
- Amiodirone
- Diltiazem
- Pioglitazone
- Hypericum perforatum (St. John's wort)
- Grapefruit or grapefruit juice
- Rifabutin
- Mibefradil
- Diethyldithiocarbamate
- Gestodene
- Mifepristone
- Modafinil
- Allopurinol
- Dipyridamole
- Folinic acid
- Trimethoprim
- More than 30 days or 5 half-lives (whichever is longer) since prior and no concurrent systemic investigational drugs (7 days for topical investigational drugs)
- No limit to other prior therapies
- Concurrent antacids allowed provided they are not administered for 1 hour before, during, and 1 hour after administration of study drug
- No concurrent coumadin-derivative anticoagulants (e.g., warfarin, leucovorin, or phenprocouman)
- Concurrent bisphosphonates allowed provided they are started before study entry
- No concurrent prophylactic bisphosphonates
- No other concurrent investigational agents or participation in another investigational trial
Patient Characteristics:
Age Sex Menopausal status Performance status Life expectancy Hematopoietic - Absolute neutrophil count > 1,500/mm3
- Hemoglobin > 9.0 g/dL
- Platelet count > 100,000/mm3
Hepatic - Bilirubin ≤ 1.5 times upper limit of normal (ULN) (2.5 times ULN for Gilbert's syndrome)
- AST and ALT ≤ 3 times ULN (5 times ULN if liver metastases are present)
- Albumin ≥ 2.5 g/dL
Renal - Creatinine clearance ≥ 50 mL/min
Cardiovascular - Ejection fraction normal by echocardiogram or MUGA
- No prior uncontrolled or symptomatic angina
- No prior uncontrolled or symptomatic arrhythmia
- No prior uncontrolled or symptomatic congestive heart failure
Gastrointestinal - Able to swallow and retain oral medication
- No ulcerative colitis
- No disease siginificantly affecting gastrointestinal function
- No malabsorption syndrome
Other - Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 4 weeks after study participation
- No known dihydropyrimidine dehydrogenase deficiency
- No active or uncontrolled infection
- No unresolved or unstable serious toxicity from prior administration of another investigational drug
- No dementia or altered mental status
- No psychiatric condition that would preclude giving informed consent
- No disease or condition that would preclude study participation
- No serious medical disorder that would preclude patient safety
- No known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to GW572016, capecitabine, fluorouracil, or any of their excipients
- No other malignancy within the past 5 years except completely resected nonmelanoma skin cancer or successfully treated carcinoma in situ
Expected Enrollment A total of 528 patients (264 per treatment arm) will be accrued for this study. Outcomes Primary Outcome(s)Time to progression per RECIST every 6 weeks for 24 weeks and then every 12 weeks thereafter
Secondary Outcome(s)Overall survival measured by date of death Response rate per RECIST every 6 weeks for 24 weeks and then every 12 weeks thereafter Safety measured by adverse events every 6 weeks for 24 weeks and then every 12 weeks thereafter
Outline This is a randomized, open-label, multicenter study. Patients are stratified according to disease stage (IIIB vs IV) and site of disease (visceral vs nonvisceral). Patients are randomized to 1 of 2 treatment arms. - Arm I: Patients receive oral capecitabine twice daily on days 1-14 and oral lapatinib once daily (not at the same time of day as capecitabine administration) on days 1-21.
- Arm II: Patients receive capecitabine alone as in arm I.
In both arms, courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients are followed every 12 weeks. Published ResultsGeyer CE, Forster J, Lindquist D, et al.: Lapatinib plus capecitabine for HER2-positive advanced breast cancer. N Engl J Med 355 (26): 2733-43, 2006.[PUBMED Abstract]
Trial Contact Information
Trial Lead Organizations GlaxoSmithKline | | | Acurian Pre-Screening Evaluation Contact | | | |
Related Information Website for additional information.
Registry Information | | Official Title | | A Phase III, Randomized, Open-Label, Multicenter Study Comparing GW572016 and Capecitabine (Xeloda) Versus Capecitabine in Women with Refractory Advanced or Metastatic Breast Cancer | | Trial Start Date | | 2004-03-01 | | Registered in ClinicalTrials.gov | | NCT00078572 | | Date Submitted to PDQ | | 2004-05-11 | | Information Last Verified | | 2006-04-18 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |
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