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An Umbrella, Modular Study Based on Epidermal Growth Factor Receptor (EGFR) Mutation Status
This study is currently recruiting participants.
Verified by M.D. Anderson Cancer Center, May 2009
First Received: May 14, 2009   Last Updated: May 15, 2009   History of Changes
Sponsored by: M.D. Anderson Cancer Center
Information provided by: M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier: NCT00903734
  Purpose

The goal of this screening portion of this clinical research study is to learn if you are eligible to take part in a clinical research study using Tarceva (erlotinib hydrochloride) and either Erbitux (cetuximab), Velcade (bortezomib), or Sprycel (dasatinib).

If the results of the screening portion of this clinical research study show that you are eligible to take part in one of the studies described above, the study drug that you will be assigned to take will depend on the results of biomarker analysis performed as a part of the screening tests described below. Biomarkers are chemical "markers" in the blood/tissue that may be related to how your body might react to the study drug.

Primary Objectives:

I. Determine reasonable dose of combination treatments, including Maximum Tolerated Dose (MTD) and toxicity profiles, via a brief initial "run-in"/dose escalation.

II. Evaluate response in patients with tumors that demonstrate EGFR-sensitive mutations, to treatment with single-agent erlotinib

III. Evaluate response in patients with tumors that demonstrate EGFR-resistant mutations, or patients who have previously demonstrated a response to EGFR inhibitors with subsequent resistance, to treatment with erlotinib combinations.


Condition Intervention Phase
Advanced Cancers
Drug: Erlotinib Hydrochloride (Tarceva)
Phase I

Study Type: Interventional
Study Design: Treatment, Open Label, Single Group Assignment, Safety/Efficacy Study
Official Title: An Umbrella Protocol for Histology-Independent, Phase I Modular Study Based on Epidermal Growth Factor Receptor (EGFR) Mutation Status: Using Erlotinib Alone or in Combination With Cetuximab, Bortezomib, or Dasatinib to Overcome Resistance

Resource links provided by NLM:


Further study details as provided by M.D. Anderson Cancer Center:

Primary Outcome Measures:
  • Determine reasonable dose of combination treatments, including Maximum Tolerated Dose (MTD) and toxicity profiles, via a brief initial "run-in"/dose escalation. [ Time Frame: 3 Years ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 102
Study Start Date: May 2009
Estimated Primary Completion Date: May 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Erlotinib Hydrochloride: Experimental
If found to be eligible for umbrella of studies and have not received Erlotinib hydrochloride in the past, will first receive Erlotinib hydrochloride alone.
Drug: Erlotinib Hydrochloride (Tarceva)
Dose of 150 mg daily by mouth.

  Show Detailed Description

  Eligibility

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

Inclusion Criteria:

  1. Patients with pathologically confirmed advanced or metastatic cancer that is refractory to standard therapy, relapsed after standard therapy, or who have had no standard therapy that induces a CR rate of at least 10% or improves survival by at least three months.
  2. Patients must have tumor tissue available, either from an archival specimen, or from a recent biopsy, to be analyzed for EGFR mutation. Patients must sign consent for the umbrella protocol prior testing for EGFR mutation. Patients will be eligible if they have an EGFR-sensitive mutation, OR if they have an EGFR-resistant mutation, OR if they do not have an EGFR mutation, but have benefited from EGFR inhibitor therapy (including either >/= 4 months of stable disease [SD] OR a >/= partial response [PR]).
  3. Measurable or non-measurable disease at baseline for patients to be enrolled during the dose-escalation phase; measurable disease for patients to be enrolled at the dose-expansion phase.
  4. Patients enrolled in the MTD cohorts must be willing to undergo tissue biopsy (and an accessible biopsy site). Pleural effusions and ascites will be acceptable in lieu of tissue biopsies, if available.
  5. Patients must be >/= 6 wks beyond treatment with a nitrosourea or mitomycin-C, >/= 4 wks beyond other chemotherapy or radiation therapy, and must have recovered to </= Grade 1 toxicity for any treatment-limiting toxicity resulting from prior therapy. (Exception: patients may have received palliative low dose XRT to the limbs 1-4 wks before this therapy provided pelvis, ribs, sternum, scapulae, vertebrae or skull were not included in the XRT field).
  6. (continued from above) Also, patients who have received non-chemotherapeutic biological agents will need to wait at least 5 half-lives or 4 wks, whichever is shorter, from the last day of treatment.
  7. ECOG performance status </= 2 (Karnofsky >/= 60%)
  8. Patients must have normal organ and marrow function defined as: absolute neutrophil count >/=1,000/mL; platelets >/=75,000/mL; creatinine </= 2 X ULN; total bilirubin </= 2.0; AST(SGOT)/ALT(SGPT) </= 3 X ULN; Exception for patients with liver metastasis: total bilirubin </= 3 x ULN; AST(SGOT)/ALT(SGPT) </= 5 X ULN.
  9. Women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 30 days after the last dose.
  10. Ability to understand and the willingness to sign a written informed consent document.
  11. Age >/= 18 years, male or female patients

Exclusion Criteria:

  1. Patients with uncontrolled concurrent illness, including but not limited to: ongoing or active infection; uncontrolled endocrine diseases [e.g., diabetes mellitus (Hba1C > 8), hypothyroidism (serum TSH >10) or hyperthyroidism (serum TSH <0.1), adrenal disorder); altered mental status or psychiatric illness/social situations that would limit compliance with study requirements and/or obscure study results.
  2. Uncontrolled systemic vascular hypertension (systolic blood pressure > 140 mm Hg, diastolic blood pressure > 90 mm Hg on medication).
  3. Patients with clinically significant cardiovascular disease: history of CVA within 6 months, myocardial infarction or unstable angina within 6 months, or unstable angina pectoris.
  4. Patients with colorectal carcinoma with tumors that demonstrate a KRAS mutation.
  5. Pregnant or lactating women
  6. Patients with a history of bone marrow transplant within the previous two years
  7. Patients with a known hypersensitivity to any of the components of the drug products.
  8. Patients who will be on treatment arm consisting of erlotinib and dasatinib should not be taking any drugs that are potent inhibitors or inducers of CYP34A
  9. Patients with active or untreated brain metastases, or patients with leptomeningeal disease.
  10. Patients unable to swallow oral medications or with pre-existing gastrointestinal disorders that might interfere with proper absorption of oral drugs.
  11. Patients with major surgery within 30 days prior to entering the study.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00903734

Contacts
Contact: Jennifer Wheler, MD 713-563-1930

Locations
United States, Texas
UT MD Anderson Cancer Center Recruiting
Houston, Texas, United States, 77030
Principal Investigator: Jennifer Wheler, MD            
Sponsors and Collaborators
M.D. Anderson Cancer Center
Investigators
Study Chair: Jennifer Wheler, MD UT MD Anderson Cancer Center
  More Information

Additional Information:
No publications provided

Responsible Party: UT MD Anderson Cancer Center ( Jennifer J. Wheler, MD / Assistant Professor )
Study ID Numbers: 2007-0638
Study First Received: May 14, 2009
Last Updated: May 15, 2009
ClinicalTrials.gov Identifier: NCT00903734     History of Changes
Health Authority: United States: Institutional Review Board

Keywords provided by M.D. Anderson Cancer Center:
Metastatic Cancer
Histology-independent
EGFR Mutation
EGFR inhibitor-sensitive mutation
Erlotinib Hydrochloride
Tarceva
OSI-774
Cetuximab
Bortezomib
Dasatinib

Study placed in the following topic categories:
Erlotinib
Dasatinib
Bortezomib
Cetuximab
Neoplasm Metastasis
Mitogens
Protein Kinase Inhibitors

Additional relevant MeSH terms:
Erlotinib
Molecular Mechanisms of Pharmacological Action
Mitosis Modulators
Mitogens
Enzyme Inhibitors
Protein Kinase Inhibitors
Pharmacologic Actions

ClinicalTrials.gov processed this record on September 10, 2009