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Lapatinib in Treating Patients With Advanced or Metastatic Breast Cancer That Overexpresses HER2
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), December 2008
First Received: October 13, 2007   Last Updated: February 6, 2009   History of Changes
Sponsors and Collaborators: UCSF Helen Diller Family Comprehensive Cancer Center
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00544804
  Purpose

RATIONALE: 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 lapatinib in treating patients with advanced or metastatic breast cancer that overexpresses HER2.


Condition Intervention Phase
Breast Cancer
Metastatic Cancer
Drug: lapatinib ditosylate
Genetic: gene expression analysis
Other: laboratory biomarker analysis
Phase I

Genetics Home Reference related topics: breast cancer
MedlinePlus related topics: Breast Cancer Cancer
Drug Information available for: Lapatinib Lapatinib Ditosylate
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I Dose Escalation Study of 5-Day Intermittent Oral Lapatinib Therapy With Biomarker Analysis in Patients With HER2-Overexpressing Breast Cancer

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

Primary Outcome Measures:
  • Maximum tolerated dose [ Designated as safety issue: Yes ]

Estimated Enrollment: 15
Study Start Date: August 2007
Detailed Description:

OBJECTIVES:

Primary

  • To determine the maximum tolerated dose (MTD) of high-dose lapatinib ditosylate in patients with HER2-overexpressing advanced or metastatic breast cancer.
  • To determine the dose-limiting toxicity of this drug in these patients.

Secondary

  • To determine whether tumor HER2 can be completely inactivated by lapatinib ditosylate at its MTD in the 5-day schedule.
  • To determine whether the total inactivation of HER2 decreases cardiac ejection fraction.

OUTLINE: Patients are stratified according to dose level.

Patients receive escalating doses of oral lapatinib ditosylate twice daily on days 1-5 until the maximum tolerated dose is determined. Courses repeat every 2 weeks in the absence of disease progression or unacceptable toxicity.

Some patients undergo tumor tissue and blood sample collection periodically for biological and correlative studies. Samples are analyzed for evidence of cardiac injury, tumor target lysis effects, and to determine if the lapatinib serum levels result in the inactivation of tumor HER2 and HER3 kinase and oncogenic signaling.

After completion of study treatment, patients are followed every 2 months.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed breast cancer

    • Advanced or metastatic disease
    • No effective curative therapy available
  • Bone-only disease allowed
  • Tumor HER2 overexpression

    • HER2 3+ expression by immunohistochemistry OR > 2-fold (HER2 2+) gene amplification by fluorescence in situ hybridization
  • Evaluable disease

    • Measurable disease is not required
  • No progressive brain metastases
  • Hormone receptor status not specified

PATIENT CHARACTERISTICS:

Inclusion criteria:

  • ECOG performance status 0-2
  • Life expectancy > 3 months
  • Female
  • Menopausal status not specified
  • Absolute neutrophil count ≥ 1,000 cells/mm^3
  • Hemoglobin ≥ 9 g/dL
  • Platelet count ≥ 75,000 cells/mm^3
  • Total bilirubin normal
  • AST and ALT ≤ 3 x upper limits of normal (ULN) (≤ 5 x ULN with liver metastases)
  • Creatinine normal OR creatinine clearance ≥ 40 mL/min
  • INR ≤ 1.5
  • Potassium normal
  • Magnesium normal
  • Not pregnant
  • Negative pregnancy test
  • Fertile patients must use effective contraception prior to and during study therapy
  • Cardiac ejection fraction ≥ 50%
  • Consents to 2 tumor fine needle aspiration biopsies for biomarker analysis

    • Lung-only disease or sites otherwise deemed high-risk for biopsy, the requirement for biopsy will be waived

Exclusion criteria:

  • History of significant cardiac disease including any of the following:

    • Congestive heart failure
    • Symptomatic cardiac arrhythmias
    • Unstable angina
  • Uncontrolled prior lapatinib ditosylate therapy toxicity ≥ grade 2
  • Allergic reactions to IV contrast dye despite standard prophylaxis
  • History of malabsorption syndrome or disease significantly affecting gastrointestinal function or major resection of the stomach or small bowel that could affect absorption, distribution, metabolism, or excretion of study drug
  • Conditions that would impair the patient's ability to swallow and retain oral medication
  • Concurrent disease or condition that would make the patient inappropriate for study participation or would interfere with the patient's safety
  • Psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol

PRIOR CONCURRENT THERAPY:

  • Prior lapatinib ditosylate or trastuzumab allowed
  • At least 4 weeks since prior and no concurrent chemotherapy or investigational anticancer agents
  • At least 2 weeks since prior and no concurrent hormonal therapy
  • At least 2 weeks since prior and no concurrent lapatinib ditosylate prohibited medications, including CYP3A4 inhibitors or inducers, all herbal supplements, and gastric pH modifiers
  • More than 4 weeks since prior radiotherapy
  • No aspirin or plavix therapy within 7 days prior to tumor biopsy
  • No concurrent coumadin

    • Low molecular weight heparin allowed provided it can be held at least 24 hours prior to tumor biopsy
  • Concurrent gonadal suppression agents (i.e., Zoladex or Lupron) or palliative bisphosphonates (i.e., Zometa) allowed
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00544804

Locations
United States, California
UCSF Helen Diller Family Comprehensive Cancer Center Recruiting
San Francisco, California, United States, 94115
Contact: Clinical Trials Office - UCSF Helen Diller Family Comprehensi     877-827-3222        
Sponsors and Collaborators
UCSF Helen Diller Family Comprehensive Cancer Center
Investigators
Study Chair: Mark M. Moasser, MD UCSF Helen Diller Family Comprehensive Cancer Center
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000570532, UCSF-H47800-31139-01, UCSF-077518
Study First Received: October 13, 2007
Last Updated: February 6, 2009
ClinicalTrials.gov Identifier: NCT00544804     History of Changes
Health Authority: Unspecified

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

Study placed in the following topic categories:
Skin Diseases
Neoplasm Metastasis
Breast Neoplasms
Lapatinib
Protein Kinase Inhibitors
Breast Diseases
Recurrence

Additional relevant MeSH terms:
Skin Diseases
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Breast Neoplasms
Lapatinib
Enzyme Inhibitors
Protein Kinase Inhibitors
Pharmacologic Actions
Neoplasms
Neoplastic Processes
Neoplasms by Site
Pathologic Processes
Therapeutic Uses
Neoplasm Metastasis
Breast Diseases

ClinicalTrials.gov processed this record on May 06, 2009