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Lapatinib in Treating Young Patients With Recurrent or Refractory CNS Tumors
This study is ongoing, but not recruiting participants.
First Received: November 9, 2004   Last Updated: April 14, 2009   History of Changes
Sponsors and Collaborators: Pediatric Brain Tumor Consortium
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00095940
  Purpose

RATIONALE: Lapatinib may stop the growth of tumor cells by blocking the enzymes necessary for their growth.

PURPOSE: This phase II trial is studying lapatinib to see how well it works in treating young patients with recurrent or refractory CNS tumors.


Condition Intervention Phase
Brain and Central Nervous System Tumors
Drug: lapatinib ditosylate
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 Molecular Biology And Phase II Study Of Lapatinib (GW572016) In Pediatric Patients With Recurrent Or Refractory Medulloblastoma, Malignant Glioma Or Ependymoma

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

Primary Outcome Measures:
  • Inhibition of ERBB receptor signaling [ Designated as safety issue: No ]
  • Objective response rate (complete and partial response) [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Plasma and tissue pharmacokinetics [ Designated as safety issue: No ]
  • Effect of steroids on lapatinib pharmacokinetics [ Designated as safety issue: No ]

Estimated Enrollment: 84
Study Start Date: January 2005
Estimated Primary Completion Date: April 2011 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the inhibition of ERBB receptor signaling by lapatinib in pediatric patients with recurrent or refractory medulloblastoma, primitive neuroectodermal tumors, high-grade glioma, or ependymoma.
  • Determine the objective response rate (complete response and partial response) in patients treated with this drug.

Secondary

  • Determine the plasma pharmacokinetics and tumor tissue concentration of this drug in these patients.
  • Determine the effect of steroids on the pharmacokinetics of this drug in these patients.

OUTLINE: This is an open-label, multicenter study. Patients are stratified according to histology (medulloblastoma/primitive neuroectodermal tumor vs high-grade glioma vs ependymoma).

Patients receive oral lapatinib twice daily on days 1-28. Treatment repeats every 28 days for up to 26 courses (2 years) in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed for at least 30 days.

PROJECTED ACCRUAL: A total 84 patients will be accrued for this study.

  Eligibility

Ages Eligible for Study:   up to 21 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed diagnosis of 1 of the following:

    • Medulloblastoma/primitive neuroectodermal tumor
    • High-grade glioma (anaplastic astrocytoma, glioblastoma multiforme, gliosarcoma, or anaplastic oligodendroglioma)
    • Ependymoma
  • Recurrent or refractory disease
  • Measurable disease

PATIENT CHARACTERISTICS:

Age

  • 21 and under

Performance status

  • Karnofsky 50-100% (> 16 years of age) OR
  • Lansky 50-100% (≤ 16 years of age)

Life expectancy

  • Not specified

Hematopoietic

  • Absolute neutrophil count ≥ 1,000/mm^3*
  • Platelet count ≥ 100,000/mm^3*
  • Hemoglobin ≥ 8.0 g/dL* NOTE: *Transfusion independent

Hepatic

  • Bilirubin ≤ 1.5 times upper limit of normal (ULN) for age
  • ALT < 2.5 times ULN for age
  • Albumin ≥ 2 g/dL
  • No overt hepatic or biliary disease

Renal

  • Creatinine ≤ 1.5 times ULN for age OR
  • Glomerular filtration rate ≥ 70 mL/min
  • No overt renal disease

Cardiovascular

  • No overt cardiac disease
  • Shortening fraction ≥ 27% by echocardiogram OR
  • Ejection fraction ≥ 50% by gated radionuclide study

Pulmonary

  • Pulse oximetry > 94%
  • No dyspnea at rest
  • No exercise intolerance
  • No overt pulmonary disease

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Neurological deficits allowed provided they remain stable ≥ 1 week before study entry
  • Seizure disorders allowed provided symptoms are well controlled
  • No uncontrolled infection
  • No other significant medical illness not adequately controlled with appropriate therapy or that would preclude study participation
  • No other disease that would obscure toxicity or dangerously alter drug metabolism

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • More than 1 week since prior nonmyelosuppressive anticancer biologic therapy
  • At least 6 months since prior allogeneic bone marrow transplantation
  • At least 3 months since prior autologous bone marrow or stem cell transplantation
  • At least 2 weeks since prior hematopoietic growth factors (filgrastim [G-CSF], sargramostim [GM-CSF], or epoetin alfa)

Chemotherapy

  • More than 3 weeks since prior myelosuppressive anticancer chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered

Endocrine therapy

  • Concurrent corticosteroids allowed provided dose is stable or decreasing for ≥ 1 week before study entry

Radiotherapy

  • At least 3 months since prior craniospinal irradiation (≥ 18 Gy)
  • At least 4 weeks since prior local radiotherapy to primary tumor
  • At least 2 weeks since prior focal irradiation to symptomatic metastatic sites

Surgery

  • Not specified

Other

  • At least 2 weeks since prior enzyme-inducing anticonvulsant drugs (EIACDs)
  • At least 1 week since prior and no concurrent CYP3A4 inhibitors
  • At least 6 months since prior amiodarone
  • At least 2 weeks since prior and no concurrent CYP3A4 inducers
  • At least 2 weeks since prior herbal or dietary supplements
  • At least 2 days since prior and no concurrent cimetidine
  • Concurrent ranitidine or omeprazole allowed only in conjunction with corticosteroids given for increased intracranial pressure
  • Concurrent antacids allowed provided they are administered > 1 hour before and > 1 hour after lapatinib administration
  • No concurrent EIACDs
  • No other concurrent anticancer or experimental agents or therapy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00095940

Locations
United States, California
UCSF Helen Diller Family Comprehensive Cancer Center
San Francisco, California, United States, 94115
United States, District of Columbia
Children's National Medical Center
Washington, District of Columbia, United States, 20010-2970
United States, Illinois
Children's Memorial Hospital - Chicago
Chicago, Illinois, United States, 60614
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, North Carolina
Duke Comprehensive Cancer Center
Durham, North Carolina, United States, 27710
United States, Pennsylvania
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States, 19104-4318
Children's Hospital of Pittsburgh
Pittsburgh, Pennsylvania, United States, 15213
United States, Tennessee
St. Jude Children's Research Hospital
Memphis, Tennessee, United States, 38105
United States, Texas
Texas Children's Cancer Center and Hematology Service at Texas Children's Hospital
Houston, Texas, United States, 77030-2399
United States, Washington
Children's Hospital and Regional Medical Center - Seattle
Seattle, Washington, United States, 98105
Sponsors and Collaborators
Pediatric Brain Tumor Consortium
Investigators
Study Chair: Maryam Fouladi, MD Children's Hospital Medical Center, Cincinnati
Investigator: Richard J. Gilbertson, MD, PhD St. Jude Children's Research Hospital
  More Information

Additional Information:
No publications provided

Responsible Party: St. Jude Children's Research Hospital ( James M. Boyett )
Study ID Numbers: CDR0000393490, PBTC-016
Study First Received: November 9, 2004
Last Updated: April 14, 2009
ClinicalTrials.gov Identifier: NCT00095940     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
recurrent childhood medulloblastoma
recurrent childhood ependymoma
childhood central nervous system germ cell tumor
childhood choroid plexus tumor
childhood craniopharyngioma
childhood infratentorial ependymoma
childhood grade III meningioma
childhood oligodendroglioma
childhood spinal cord neoplasm
childhood supratentorial ependymoma
childhood high-grade cerebral astrocytoma
childhood low-grade cerebral astrocytoma
recurrent childhood brain stem glioma
recurrent childhood cerebellar astrocytoma
recurrent childhood cerebral astrocytoma
recurrent childhood supratentorial primitive neuroectodermal tumor
recurrent childhood visual pathway and hypothalamic glioma

Study placed in the following topic categories:
Choroid Plexus Neoplasms
Neuroectodermal Tumors, Primitive
Astrocytoma
Spinal Cord Neoplasm
Lapatinib
Central Nervous System Neoplasms
Protein Kinase Inhibitors
Recurrence
Ependymoma
Neuroectodermal Tumors
Brain Stem Glioma, Childhood
Neoplasms, Germ Cell and Embryonal
Medulloblastoma
Craniopharyngioma
Neuroepithelioma
Spinal Cord Neoplasms
Oligodendroglioma
Meningioma
Glioma
Nervous System Neoplasms
Neoplasms, Glandular and Epithelial

Additional relevant MeSH terms:
Neoplasms by Histologic Type
Neuroectodermal Tumors, Primitive
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Nervous System Diseases
Neoplasms, Nerve Tissue
Enzyme Inhibitors
Lapatinib
Central Nervous System Neoplasms
Protein Kinase Inhibitors
Pharmacologic Actions
Neuroectodermal Tumors
Neoplasms
Neoplasms by Site
Therapeutic Uses
Neoplasms, Germ Cell and Embryonal
Medulloblastoma
Glioma
Neoplasms, Neuroepithelial
Nervous System Neoplasms
Neoplasms, Glandular and Epithelial

ClinicalTrials.gov processed this record on May 07, 2009