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Tipifarnib and Fulvestrant as Second-Line Therapy in Treating Postmenopausal Women With Hormone Receptor-Positive Inoperable Locally Advanced or Metastatic Breast Cancer With Progressive Disease After Previous First-Line Endocrine Therapy
This study is ongoing, but not recruiting participants.
Sponsors and Collaborators: Albert Einstein College of Medicine of Yeshiva University
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00082810
  Purpose

RATIONALE: Tipifarnib may stop the growth of tumor cells by blocking the enzymes necessary for their growth. Estrogen can stimulate the growth of breast cancer cells. Hormone therapy using fulvestrant may fight breast cancer by blocking the use of estrogen. Combining tipifarnib with fulvestrant may kill tumor cells that did not respond to first-line therapy.

PURPOSE: This phase II trial is studying how well giving tipifarnib together with fulvestrant works as second-line therapy in treating postmenopausal women with hormone receptor-positive inoperable locally advanced or metastatic breast cancer that has progressed after previous first-line endocrine therapy.


Condition Intervention Phase
Breast Cancer
Drug: fulvestrant
Drug: tipifarnib
Phase II

Genetics Home Reference related topics: breast cancer
MedlinePlus related topics: Breast Cancer Cancer
Drug Information available for: Ici 182780 Tipifarnib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase II Trial of Tipifarnib (R115777, Zarnestra™) in Combination With Fulvestrant (Faslodex®) in Postmenopausal Hormone Receptor-Positive Breast Cancer Patients Who Have Progressive Disease After First-Line Endocrine Therapy

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Clinical benefit rate (complete, partial, and stable disease) for more than 24 weeks [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Median time to progression [ Designated as safety issue: No ]
  • Duration of response [ Designated as safety issue: No ]
  • Toxicity as measured by NCI CTCAE version 3.0 [ Designated as safety issue: Yes ]
  • Median overall survival [ Designated as safety issue: No ]

Estimated Enrollment: 45
Study Start Date: May 2004
Detailed Description:

OBJECTIVES:

Primary

  • Determine the efficacy of tipifarnib and fulvestrant as second-line therapy, in terms of clinical benefit rate (a combination of complete and partial response rates and stable disease for more than 24 weeks), in postmenopausal women with hormone receptor-positive inoperable locally advanced or metastatic breast cancer with progressive disease after prior first-line endocrine therapy.

Secondary

  • Determine the median time to progression and duration of response in patients treated with this regimen.
  • Determine the median overall survival of patients treated with this regimen.
  • Determine the toxicity profile of this regimen in these patients.

OUTLINE: This is a multicenter study.

Patients receive fulvestrant intramuscularly on day 1 and oral tipifarnib twice daily on days 1-21. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity*.

NOTE: *Fulvestrant continues even if tipifarnib is held for toxicity.

Patients are followed every 3 months.

PROJECTED ACCRUAL: A total of 45 patients will be accrued for this study within 1 year.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed adenocarcinoma of the breast of 1 of the following stages:

    • Metastatic disease (stage IV)
    • Inoperable locally advanced disease
  • At least 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques OR ≥ 10 mm by spiral CT scan
  • Progressive disease, defined by 1 of the following:

    • Progressive disease after 1 prior endocrine therapy for metastatic breast cancer, including a selective estrogen receptor modulator (SERM) (e.g., tamoxifen or toremifene) OR an aromatase inhibitor (AI) (e.g., anastrazole, letrozole or exemestane)
    • Relapsed while receiving adjuvant therapy with a SERM or an AI
    • Relapsed within 6 months of completing adjuvant therapy with a SERM or an AI
  • No rapidly progressive, life-threatening metastases, including any of the following:

    • Extensive hepatic involvement (> 50% involvement of the liver)
    • Symptomatic lymphangitic metastases
    • Brain or leptomeningeal involvement
  • Hormone receptor status:

    • Estrogen receptor- and/or progesterone receptor-positive disease

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Sex

  • Female

Menopausal status

  • Postmenopausal, defined as 1 of the following:

    • At least 12 months without spontaneous menstrual bleeding
    • Prior bilateral salpingo-oophorectomy with or without hysterectomy
    • At least 55 years of age with a prior hysterectomy with or without oophorectomy
    • Under 55 years of age with a prior hysterectomy without oophorectomy OR unknown status AND documented follicle-stimulating hormone levels consistent with postmenopausal range within the past 4 weeks
    • Receiving a GnRH analog to suppress ovarian function (e.g., goserelin 3.6 mg every 4 weeks)

Performance status

  • ECOG 0-2 OR
  • Karnofsky 60-100%

Life expectancy

  • More than 3 months

Hematopoietic

  • WBC ≥ 3,000/mm^3
  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3

Hepatic

  • See Disease Characteristics
  • Bilirubin ≤ 2 mg/dL
  • AST and ALT ≤ 2.5 times upper limit of normal (ULN)

Renal

  • Creatinine ≤ 1.5 times ULN

Cardiovascular

  • No symptomatic congestive heart failure
  • No unstable angina pectoris
  • No arrhythmia

Other

  • No prior allergic reaction attributed to compounds of similar chemical or biological composition to tipifarnib or other study agents (e.g., imidazoles or quinolones)
  • No peripheral neuropathy ≥ grade 2
  • No ongoing or active infection
  • No other invasive malignancy within the past 5 years except curatively treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
  • No psychiatric illness or social situation that would preclude study compliance
  • No other concurrent uncontrolled illness

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • Not specified

Chemotherapy

  • No prior chemotherapy for metastatic disease

    • Prior adjuvant or neoadjuvant chemotherapy is allowed

Endocrine therapy

  • See Disease Characteristics
  • At least 28 days since prior fulvestrant

    • Only 1 prior dose allowed
  • Concurrent gonadotropin-releasing hormone (GnRH) analog allowed provided progressive disease occurred while on a GnRH analog and a SERM or an AI
  • No concurrent SERM or AI

Radiotherapy

  • More than 4 weeks since prior radiotherapy

Surgery

  • Not specified

Other

  • Recovered from prior therapy
  • No prior farnesyltransferase inhibitors
  • No other concurrent anticancer treatment

    • Concurrent bisphosphonates for bone metastases allowed
  • No other concurrent investigational agents
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00082810

Locations
United States, New York
Albert Einstein Cancer Center at Albert Einstein College of Medicine
Bronx, New York, United States, 10461
Beth Israel Medical Center - Petrie Division
New York, New York, United States, 10003-3803
Mount Sinai Medical Center
New York, New York, United States, 10029
St. Luke's-Roosevelt Hospital Center - Roosevelt Division
New York, New York, United States, 10019
North Shore University Hospital
Manhasset, New York, United States, 11030
New York Weill Cornell Cancer Center at Cornell University
New York, New York, United States, 10021
Sponsors and Collaborators
Albert Einstein College of Medicine of Yeshiva University
Investigators
Study Chair: Linda T. Vahdat, MD Weill Medical College of Cornell University
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Publications of Results:
Li T, Christos P, Sparano JA, et al.: Phase II study of the farnesyl transferase inhibitor tipifarnib plus fulvestrant in postmenopausal patients with hormone receptor-positive breast cancer: New York Cancer Consortium trial P6205. [Abstract] J Clin Oncol 25 (Suppl 18): A-1037, 41s, 2007.

Study ID Numbers: CDR0000360837, AECM-0104-085, NCI-6205
Study First Received: May 14, 2004
Last Updated: July 23, 2008
ClinicalTrials.gov Identifier: NCT00082810  
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
recurrent breast cancer
stage IIIB breast cancer
stage IIIC breast cancer
stage IV breast cancer

Study placed in the following topic categories:
Skin Diseases
Fulvestrant
Breast Neoplasms
Breast Diseases
Recurrence
Tipifarnib

Additional relevant MeSH terms:
Estrogen Receptor Modulators
Estrogen Antagonists
Neoplasms
Neoplasms by Site
Antineoplastic Agents, Hormonal
Antineoplastic Agents
Hormone Antagonists
Therapeutic Uses
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 15, 2009