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Lapatinib and Ixabepilone in Treating Patients With Advanced Solid Tumors
This study is not yet open for participant recruitment.
Verified by National Cancer Institute (NCI), December 2008
First Received: December 5, 2008   Last Updated: February 6, 2009   History of Changes
Sponsors and Collaborators: University of California, Davis
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00804310
  Purpose

RATIONALE: Lapatinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as ixabepilone, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving lapatinib together with ixabepilone may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of lapatinib given together with ixabepilone in treating patients with advanced solid tumors.


Condition Intervention Phase
Unspecified Adult Solid Tumor, Protocol Specific
Drug: ixabepilone
Drug: lapatinib ditosylate
Genetic: DNA analysis
Genetic: gene expression analysis
Genetic: mutation analysis
Genetic: nucleic acid sequencing
Genetic: polymerase chain reaction
Genetic: proteomic profiling
Genetic: reverse transcriptase-polymerase chain reaction
Other: immunohistochemistry staining method
Other: laboratory biomarker analysis
Other: pharmacogenomic studies
Phase I

MedlinePlus related topics: Cancer
Drug Information available for: Ixabepilone Lapatinib Lapatinib Ditosylate
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment
Official Title: Phase I Study of Lapatinib (GW572016) in Combination With Weekly Ixabepilone (BMS 247550) in Advanced Solid Tumors

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

Primary Outcome Measures:
  • Toxicity as assessed by NCI CTCAE v 3.0 on days 1, 8, and 15 of each course [ Designated as safety issue: Yes ]
  • Tumor response rate according to RECIST assessed at baseline and prior to courses 3 and 5 [ Designated as safety issue: No ]
  • Objective status [ Designated as safety issue: No ]
  • Best response [ Designated as safety issue: No ]
  • Survival [ Designated as safety issue: No ]
  • Progression-free survival [ Designated as safety issue: No ]
  • Time to treatment failure [ Designated as safety issue: No ]

Estimated Enrollment: 34
Study Start Date: March 2009
Estimated Primary Completion Date: March 2010 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To evaluate the safety and feasibility of lapatinib ditosylate in combination with ixabepilone in patients with advanced solid tumors.

Secondary

  • To determine the maximum-tolerated dose of this regimen in these patients.
  • To assess, preliminarily, the efficacy of this regimen in these patients.
  • To perform laboratory correlative studies on tissue and blood specimens from these patients to investigate potential predictors of response.

OUTLINE: This is a multicenter, dose-escalation study.

Patients receive oral lapatinib ditosylate once daily on days 1-28 and ixabepilone IV on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Archival tumor tissue samples are collected for EGFR/HER2 pathway analyses via immunohistochemistry, mRNA analysis via RT-PCR, EGFR mutation analyses, Kras and braf mutation analysis via sequencing, and RAS mutations via PCR and sequencing. Blood samples are also collected periodically for tumor DNA and proteomics, acetylated alpha-tubulin analysis, EGFR-HER2 pathway genotypes, and pharmacogenomics.

After completion of study therapy, patients are followed for 30 days.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed advanced solid tumors meeting one of the following criteria:

    • No known standard curative therapy available
    • Considered ineligible for standard therapy due to performance status
    • Disease progression observed after standard therapy
  • Measurable or evaluable disease

    • Disease in previously irradiated sites is considered measurable if there is clear disease progression after radiotherapy
  • Patients with asymptomatic previously treated (e.g., surgical resection or radiotherapy) brain metastasis are eligible provided they are neurologically stable and have been off steroids for at least 2 weeks

    • No symptomatic brain metastasis still requiring steroids or anticonvulsants

PATIENT CHARACTERISTICS:

  • Zubrod performance status 0-2
  • Life expectancy ≥ 3 months
  • Serum creatinine ≤ 1.5 mg/dL or creatinine clearance ≥ 40 mL/min
  • Serum bilirubin ≤ 1.5mg/dL
  • ALT and AST ≤ 2.5 times upper limit of normal
  • Granulocyte count ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Cardiac ejection fraction normal by 2-D ECHO or MUGA scan
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Able to take and retain oral medication
  • No pre-existing neuropathy ≥ grade 2
  • No uncontrolled intercurrent illness including, but not limited to, the following:

    • Ongoing or active infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Cardiac arrhythmia
    • Psychiatric illness or social situations that would preclude study compliance
  • No history of other diseases, metabolic dysfunction, or physical examination or clinical laboratory finding that contraindicates the use of an investigational drug, affects the interpretation of the results of the study, or renders the patient at high-risk for treatment complications
  • No gastrointestinal tract disease resulting in an inability to take oral medication, requires IV alimentation, or prior surgical procedures affecting absorption
  • No severe (NCI CTC Grade 3- 4) history of hypersensitivity reaction to a drug formulated in Cremophor®EL (polyoxyethylated castor oil)

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Medications classified as CYP3A4 inducers or inhibitors must meet the following criteria:

    • At least 7 days since prior and no concurrent:

      • Antibiotics (i.e., clarithromycin, erythromycin, troleandomycin)
      • HIV antiretrovirals (i.e., delavirdine) or protease inhibitors (i.e., ritonavir, indinavir, saquinavir, nelfinavir, amprenavir, lopinavir)
      • Antifungals (i.e., itraconazole, ketoconazole, voriconazole, fluconazole [doses up to 150 mg/day allowed])
      • Antidepressants (i.e., nefazodone, fluvoxamine)
      • Calcium channel blockers (i.e., verapamil, diltiazem)
      • Gastrointestinal (i.e., cimetidine, aprepitant)

        • Gastric pH modifiers (i.e., H2 blockers and proton pump inhibitors) allowed
      • Miscellaneous (i.e., grapefruit or its juice, bitter orange, all herbal or alternative medications)
    • At least 14 days since prior and no concurrent:

      • Glucocorticoids (i.e., dexamethasone or dexamethasone-equivalent dose > 1.5 mg/day) with the exception of the steroid pre-medication required for ixabepilone administration
      • Anticonvulsants (i.e., phenytoin, carbamazepine, phenobarbital)
      • HIV antiretrovirals (i.e., efavirenz, nevirapine)
      • Antibiotics (i.e., rifampin [rifampicin], rifabutin, rifapentine)
      • Miscellaneous (i.e., St. Johns wort, modafinil)
    • At least 6 months since prior and no concurrent amiodarone
  • At least 3 weeks since prior chemotherapy and all side effects (except alopecia) resolved to grade 1 or less
  • At least 2 weeks since prior radiotherapy
  • No prior radiation to > 30% of bone marrow-containing areas (i.e., pelvis, lumbar spine)
  • At least 4 weeks since prior trastuzumab (Herceptin®)
  • No prior lapatinib, ixabepilone, or any other EGFR-TKI targeted agent
  • No concurrent combination antiretroviral therapy in HIV-positive patients
  • Concurrent oral anticoagulants (coumadin, warfarin) allowed provided INR is appropriately monitored
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00804310

Sponsors and Collaborators
University of California, Davis
Investigators
Principal Investigator: Helen K. Chew, MD University of California, Davis
  More Information

Additional Information:
No publications provided

Responsible Party: University of California Davis Cancer Center ( Helen K. Chew )
Study ID Numbers: CDR0000626165, UCD-207, UCDCC-207, 200816384-1
Study First Received: December 5, 2008
Last Updated: February 6, 2009
ClinicalTrials.gov Identifier: NCT00804310     History of Changes
Health Authority: Unspecified

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

Study placed in the following topic categories:
Epothilones
Tubulin Modulators
Lapatinib
Antimitotic Agents
Protein Kinase Inhibitors

Additional relevant MeSH terms:
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Therapeutic Uses
Epothilones
Mitosis Modulators
Tubulin Modulators
Enzyme Inhibitors
Lapatinib
Antimitotic Agents
Protein Kinase Inhibitors
Pharmacologic Actions

ClinicalTrials.gov processed this record on May 07, 2009