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Lapatinib in Treating Patients Who Are Undergoing Surgery for Recurrent Progressive Glioblastoma Multiforme or Gliosarcoma
This study has been completed.
Sponsors and Collaborators: North American Brain Tumor Consortium
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00103129
  Purpose

RATIONALE: Lapatinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving lapatinib before surgery may shrink the tumor so it can be removed. Giving it after surgery may kill any remaining tumor cells.

PURPOSE: This phase II trial is studying how well lapatinib works in treating patients who are undergoing surgery for recurrent progressive glioblastoma multiforme or gliosarcoma.


Condition Intervention Phase
Brain and Central Nervous System Tumors
Drug: lapatinib ditosylate
Procedure: adjuvant therapy
Procedure: conventional surgery
Procedure: neoadjuvant therapy
Phase II

MedlinePlus related topics: Cancer
Drug Information available for: Lapatinib Lapatinib Ditosylate
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Biomarker and Phase II Study of GW572016 in Recurrent Malignant Glioma

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

Primary Outcome Measures:
  • Progression at 6 months [ Designated as safety issue: No ]

Estimated Enrollment: 44
Study Start Date: February 2005
Primary Completion Date: December 2008 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine 6-month progression-free survival of patients undergoing surgery for recurrent progressive glioblastoma multiforme or gliosarcoma treated with lapatinib.
  • Determine whether lapatinib inhibits the in vivo phosphorylation of epidermal growth factor receptor (EGFR) and HER2 and the downstream PI3K-AKT and RAS-ERK signaling pathways in these patients.
  • Determine concentrations of this drug in tumors of these patients.

Secondary

  • Determine progression-free and overall survival of patients treated with this drug.
  • Determine the safety of this drug in these patients.

OUTLINE: This is a multicenter study.

Patients receive oral lapatinib twice daily for 7-10 days. Patients then undergo surgical resection. Within 28 days after surgery, patients receive oral lapatinib twice daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed every 3-12 months.

PROJECTED ACCRUAL: A total of 44 patients will be accrued for this study within 15 months.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed glioblastoma multiforme (GBM) or gliosarcoma

    • Recurrent disease
    • Original histological diagnosis of low-grade glioma allowed provided a subsequent histological diagnosis of GBM is made
  • Evidence of tumor progression by MRI or CT scan

    • Patients who received prior interstitial brachytherapy or stereotactic radiosurgery must have confirmation of true progressive disease rather than radiation necrosis by 1 of the following:

      • Positron-emission tomography scanning
      • Thallium scanning
      • Magnetic resonance spectroscopy
      • Surgical documentation of disease
  • Failed prior radiotherapy
  • Patients may have been treated for no more than 2 prior relapses*

    • Surgical resection for relapsed disease and no anticancer therapy within 12 weeks after resection followed by a second resection is considered 1 relapse*
    • Surgical diagnosis of a high-grade glioma after prior therapy for a low-grade glioma is considered the first relapse* NOTE: *Defined as progression after initial therapy (e.g., radiotherapy with or without chemotherapy, including polifeprosan 20 with carmustine implant [Gliadel® wafers])
  • At least 5 unstained slides or 1 tissue block available
  • Must be a candidate for total or subtotal surgical re-resection

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • Karnofsky 60-100%

Life expectancy

  • More than 8 weeks

Hematopoietic

  • WBC ≥ 3,000/mm^3
  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3
  • Hemoglobin ≥ 10 g/dL (transfusions allowed)

Hepatic

  • SGOT < 2.5 times upper limit of normal (ULN)
  • Bilirubin < 2.5 times ULN

Renal

  • Creatinine < 1.5 mg/dL

Cardiovascular

  • Cardiac ejection fraction normal by echocardiogram or MUGA

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No active infection
  • No other serious medical illness
  • No disease that would obscure toxicity or dangerously alter metabolism of study drug
  • No other malignancy within the past 3 years except nonmelanoma skin cancer or carcinoma in situ of the cervix
  • No other uncontrolled significant medical illness that would preclude study participation

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • At least 7 days since prior thalidomide or interferon
  • No concurrent anticancer immunotherapy

Chemotherapy

  • See Disease Characteristics
  • At least 42 days since prior nitrosoureas
  • At least 21 days since prior procarbazine
  • At least 14 days since prior vincristine
  • No concurrent anticancer chemotherapy

Endocrine therapy

  • At least 7 days since prior tamoxifen
  • No concurrent anticancer hormonal therapy

Radiotherapy

  • See Disease Characteristics
  • At least 28 days since prior radiotherapy
  • No concurrent anticancer radiotherapy

Surgery

  • See Disease Characteristics

Other

  • Recovered from prior therapy
  • At least 28 days since prior investigational agents
  • At least 28 days since prior cytotoxic therapy
  • More than 2 weeks since prior and no concurrent enzyme-inducing anti-epileptic drugs (EIAEDs)

    • Concurrent non-EIAEDs allowed
  • At least 7 days since prior isotretinoin
  • At least 7 days since other prior non-cytotoxic agents (not including radiosensitizers)
  • At least 6 month since prior and no concurrent amiodarone
  • At least 14 days since prior and no concurrent inducers of CYP3A4, including any of the following:

    • Phenytoin
    • Carbamazepine
    • Phenobarbital
    • Oxcarbazepine
    • Rifampin
    • Rifabutin
    • Rifapentine
    • Hypericum perforatum (St. John's wort)
    • Modafinil
  • At least 7 days since prior and no concurrent inhibitors of CYP3A4, including any of the following:

    • Clarithromycin
    • Erythromycin
    • Troleandomycin
    • Itraconazole
    • Ketoconazole
    • Voriconazole
    • Fluconazole (doses ≤ 150 mg/day allowed)
    • Nefazodone
    • Fluvoxamine
    • Verapamil
    • Diltiazem
    • Aprepitant
    • Grapefruit or grapefruit juice
    • Bitter orange
  • No prior signal transduction inhibitors (e.g., gefitinib, erlotinib, or tipifarnib)
  • No use of gastric pH modifiers within 1 hour before or after study drug administration, including any of the following:

    • Cimetidine
    • Ranitidine
    • Nizatidine
    • Famotidine
    • Omeprazole
    • Esomeprazole
    • Rabeprazole
    • Pantoprazole
    • Lansoprazole
    • Antacids
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No other concurrent investigational drugs
  • No other concurrent anticancer therapy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00103129

Locations
United States, California
Jonsson Comprehensive Cancer Center at UCLA
Los Angeles, California, United States, 90095-1781
UCSF Helen Diller Family Comprehensive Cancer Center
San Francisco, California, United States, 94115
United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
Bethesda, Maryland, United States, 20892-1182
United States, Massachusetts
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
Boston, Massachusetts, United States, 02115
United States, New York
Memorial Sloan - Kettering Cancer Center
New York, New York, United States, 10021
United States, North Carolina
Duke Comprehensive Cancer Center
Durham, North Carolina, United States, 27710
United States, Pennsylvania
UPMC Cancer Centers
Pittsburgh, Pennsylvania, United States, 15232
United States, Texas
M. D. Anderson Cancer Center at University of Texas
Houston, Texas, United States, 77030-4009
University of Texas Health Science Center at San Antonio
San Antonio, Texas, United States, 78284-6220
United States, Wisconsin
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center
Madison, Wisconsin, United States, 53792
Sponsors and Collaborators
North American Brain Tumor Consortium
Investigators
Study Chair: H. I. Robins, MD, PhD University of Wisconsin, Madison
  More Information

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

Study ID Numbers: CDR0000409728, NABTC-0401, NCI-05-C-0134
Study First Received: February 7, 2005
Last Updated: December 23, 2008
ClinicalTrials.gov Identifier: NCT00103129  
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
adult giant cell glioblastoma
adult gliosarcoma
recurrent adult brain tumor

Study placed in the following topic categories:
Glioblastoma
Astrocytoma
Lapatinib
Central Nervous System Neoplasms
Recurrence
Brain Neoplasms
Neuroectodermal Tumors
Glioblastoma multiforme
Neoplasms, Germ Cell and Embryonal
Neuroepithelioma
Glioma
Gliosarcoma
Nervous System Neoplasms
Neoplasms, Glandular and Epithelial

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Histologic Type
Neoplasms by Site
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Therapeutic Uses
Neoplasms, Nerve Tissue
Nervous System Diseases
Enzyme Inhibitors
Neoplasms, Neuroepithelial
Protein Kinase Inhibitors
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 15, 2009