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Dasatinib and Lapatinib in Treating Patients With Advanced Solid Tumors That Cannot Be Removed By Surgery
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), December 2008
Sponsors and Collaborators: Mayo Clinic
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00662636
  Purpose

RATIONALE: Dasatinib and lapatinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

PURPOSE: This phase I trial is studying the side effects and best dose of dasatinib and lapatinib when given together in treating patients with advanced solid tumors that cannot be removed by surgery.


Condition Intervention Phase
Unspecified Adult Solid Tumor, Protocol Specific
Drug: dasatinib
Drug: lapatinib ditosylate
Phase I

MedlinePlus related topics: Cancer
Drug Information available for: Lapatinib Lapatinib Ditosylate Dasatinib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment
Official Title: Phase I Trial of the Combination of Dasatinib and Lapatinib

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

Primary Outcome Measures:
  • Maximum tolerated dose [ Designated as safety issue: Yes ]
  • Adverse events profile [ Designated as safety issue: Yes ]
  • Toxicity profile [ Designated as safety issue: Yes ]
  • Response profile [ Designated as safety issue: No ]
  • Time to progression [ Designated as safety issue: No ]
  • Time to treatment failure [ Designated as safety issue: No ]

Estimated Enrollment: 50
Study Start Date: June 2008
Estimated Primary Completion Date: June 2010 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

  • Determine the maximum tolerated dose of dasatinib combined with lapatinib ditosylate.
  • Describe the toxicities associated with this treatment combination.
  • Assess the pharmacokinetic interaction of lapatinib ditosylate and dasatinib.
  • Assess the effect of the lapatinib ditosylate and dasatinib combination on circulating tumor cells and on osteoclast precursor activation.
  • Study the association of clinical (toxicity and/or tumor response or activity) with the pharmacokinetic parameters, and/or biologic (pharmacodynamic) results.
  • Describe the responses of this treatment combination.

OUTLINE: This is a multicenter study.

  • Cohort I (determination of maximum tolerated dose [MTD]): Patients receive oral dasatinib and oral lapatinib ditosylate once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
  • Cohort II (treatment at the MTD): Patients receive oral dasatinib once daily on days 1 and 9-28, and oral lapatinib ditosylate once daily on days 2-28 of course 1. For all subsequent courses, patients receive oral dasatinib and oral lapatinib ditosylate once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Tissue and blood samples are collected periodically for pharmacokinetic and correlative studies. Samples are analyzed for biomarkers, circulating tumor cells, tyrosine phosphorylated or total MAP-K, EGFR, Her2, and FAK, among other potential markers of activity and/or response by immunofluorescence. Circulating osteoclasts are also assessed by flow cytometry.

After completion of treatment study, patients are followed for 3 months.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed advanced solid tumor

    • Unresectable disease
  • Must be refractory to or have refused all standard treatment for the disease
  • Willing to provide the biologic specimens (cohort II only)
  • No known standard therapy for disease that is not refractory to treatment that is potentially curative or definitely capable of extending life expectancy
  • No CNS metastases that are not stable for at least 4 weeks prior to registration based on imaging, clinical assessment, and use of steroids
  • No uncontrolled pleural or pericardial effusion of any grade

PATIENT CHARACTERISTICS:

Inclusion criteria:

  • ECOG performance status 0-2
  • Life expectancy ≥ 12 weeks.
  • Absolute neutrophil count ≥ 1,500/μL
  • Platelet count ≥ 100,000/μL
  • Total bilirubin ≤ upper limit of normal (ULN)
  • AST ≤ 3 times ULN (5 times ULN if liver involvement)
  • Creatinine ≤ 1.5 times ULN
  • Hemoglobin ≥ 9.0 g/dL
  • Potassium and magnesium must be within normal limits
  • LVEF > 50% by ECHO
  • Able to swallow pills
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for at least 4 weeks after completion of study therapy

Exclusion criteria:

  • Uncontrolled infection
  • New York Heart Association classification III or IV
  • Seizure disorder
  • Uncontrolled angina, congestive heart failure, or myocardial infarction within the past 6 months
  • Diagnosed congenital long-QT syndrome
  • History of clinically significant ventricular arrhythmias (such as ventricular tachycardia, ventricular fibrillation, or torsades de pointes)
  • Prolonged QTc interval on pre-entry electrocardiogram (> 450 msec)
  • Hypokalemia or hypomagnesemia that cannot be corrected
  • Diagnosed congenital bleeding disorders (e.g., von Willebrand disease)
  • Diagnosed acquired bleeding disorder within one year (e.g., acquired anti-factor VIII antibodies)
  • Ongoing or recent (≤ 3 months prior to registration) significant gastrointestinal bleeding
  • Gastrointestinal conditions that may interfere with drug absorption such as ulcerative colitis, Crohn disease, and short bowel syndrome

PRIOR CONCURRENT THERAPY:

  • More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas and mitomycin C) and recovered
  • More than 4 weeks since prior immunotherapy, or biologic therapy (i.e., bevacizumab, trastuzumab [Herceptin®], or cetuximab)
  • More than 4 weeks since prior molecular target agents (i.e., erlotinib hydrochloride, sunitinib malate, sorafenib tosylate, gefitinib, imatinib mesylate)
  • More than 4 weeks since prior radiotherapy

    • No prior radiotherapy to > 25% of bone marrow
  • No other concurrent chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy considered investigational
  • No concurrent therapy with a CYP3A4 inhibitor or inducer
  • No concurrent prophylactic colony-stimulating factors
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00662636

Locations
United States, Arizona
Mayo Clinic Scottsdale Recruiting
Scottsdale, Arizona, United States, 85259-5499
Contact: Clinical Trials Office - All Mayo Clinic Locations     507-538-7623        
United States, Florida
Mayo Clinic - Jacksonville Recruiting
Jacksonville, Florida, United States, 32224
Contact: Clinical Trials Office - All Mayo Clinic Locations     507-538-7623        
United States, Minnesota
Mayo Clinic Cancer Center Recruiting
Rochester, Minnesota, United States, 55905
Contact: Clinical Trials Office - All Mayo Clinic Locations     507-538-7623        
Sponsors and Collaborators
Mayo Clinic
Investigators
Study Chair: Charles Erlichman, MD Mayo Clinic
  More Information

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

Study ID Numbers: CDR0000593527, MAYO-MC0616
Study First Received: April 18, 2008
Last Updated: December 16, 2008
ClinicalTrials.gov Identifier: NCT00662636  
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
unspecified adult solid tumor, protocol specific

Study placed in the following topic categories:
Dasatinib
Lapatinib

Additional relevant MeSH terms:
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Therapeutic Uses
Enzyme Inhibitors
Protein Kinase Inhibitors
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009