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Phase I Dasatinib/Erlotinib in Recurrent NSCLC
This study is currently recruiting participants.
Verified by H. Lee Moffitt Cancer Center and Research Institute, January 2009
First Received: March 5, 2007   Last Updated: January 30, 2009   History of Changes
Sponsors and Collaborators: H. Lee Moffitt Cancer Center and Research Institute
Bristol-Myers Squibb
Information provided by: H. Lee Moffitt Cancer Center and Research Institute
ClinicalTrials.gov Identifier: NCT00444015
  Purpose

This is a single site phase I dose escalation trial of the epidermal growth factor receptor inhibitor Erlotinib with the SRC tyrosine kinase inhibitor Dasatinib in patients with previously treated advanced stage (Stage IIIB/IV disease) Non-Small Cell Lung Cancer (NSCLC). The treatment regimen consists of Erlotinib tablets starting Day 1 and Dasatinib tablets starting Day 9 for a 28-day cycle. If there are no DLTs, dose escalation continues. The recommended phase II dose for this combined treatment will be defined and patients will be treated at the recommended phase II dose to confirm tolerability.


Condition Intervention Phase
Non-Small-Cell Lung Carcinoma
Drug: Erlotinib in combination with Dasatinib
Phase I

MedlinePlus related topics: Cancer Lung Cancer
Drug Information available for: Epidermal Growth Factor Erlotinib hydrochloride Erlotinib Dasatinib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study
Official Title: Phase I Trial Evaluating the Epidermal Growth Factor Receptor Inhibitor Erlotinib in Combination With the SRC Kinase Inhibitor Dasatinib for Patients With Recurrent Non-Small Cell Lung Cancer (NSCLC)

Further study details as provided by H. Lee Moffitt Cancer Center and Research Institute:

Primary Outcome Measures:
  • Determine the safety and tolerability of erlotinib in combination with dasatinib in patients with advanced NSCLC [ Time Frame: 3 months per patient ] [ Designated as safety issue: Yes ]
  • Determine the MTD of erlotinib in combination with dasatinib and the phase II dose [ Time Frame: 3 months per patient ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Characterize the pharmacokinetics (PK) of the erlotinib/dasatinib combination [ Time Frame: 3 months per patient ] [ Designated as safety issue: Yes ]
  • Assess serum angiogenic markers as pharmacodynamic markers of treatment [ Time Frame: 3 months per patient ] [ Designated as safety issue: Yes ]
  • Estimate the objective response rate (complete response [CR] and partial response [PR]) [ Time Frame: dependent upon results ] [ Designated as safety issue: Yes ]
  • Estimate the 6-month progression free survival rate [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 20
Study Start Date: March 2007
Estimated Study Completion Date: November 2009
Estimated Primary Completion Date: November 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
A: Experimental Drug: Erlotinib in combination with Dasatinib
6 Cycles @ 28 Days

Detailed Description:

This is a single site Phase I dose escalation trial of the epidermal growth factor receptor inhibitor Erlotinib with the SRC tyrosine kinase inhibitor Dasatinib in patients with previously treated advanced stage (Stage IIIB/IV disease) Non-Small Cell Lung Cancer (NSCLC). The screening evaluation will consist of a medical history including dates/description of your initial NSCLC diagnosis and documentation of any previous treatment. There will also be a physical examination including vital signs, height, weight, ECOG performance status, blood draws for CBC and CMP tests, neurological examination, a pregnancy test for female patients of childbearing potential, and (if applicable) any observable tumor measurements all within 14 days before study enrollment. A screening EKG as well as clinical testing to evaluate all known sites of malignant lesions, including CTs of the chest and upper abdomen, the adrenal glands; ultrasound; or radionuclide scans of the bones; and/or other radiographic studies should be performed within 30 days prior to enrollment.

The treatment regimen consists of Erlotinib tablets starting Day 1 and Dasatinib tablets starting Day 9 for a 28-day cycle. If there are no DLTs, dose escalation continues. Patients continuing on therapy past two cycles will be seen by the treating physician every 4 weeks and will have complete H&P, CBC, and CMP. Tumor measurement and response assessment will occur every 6-8 weeks. Dasatinib and Erlotinib will be continued until progression of disease, unacceptable toxicity, or patient request.

The recommended phase II dose for this combined treatment will be defined and patients will be treated at the recommended phase II dose to confirm tolerability.

  Eligibility

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

Inclusion Criteria:

  • Histologically or cytologically documented diagnosis of NSCLC that is advanced/metastatic (Stage IIIB/IV).
  • Written informed consent.
  • The presence of progressive and measurable disease as defined by the -Response Evaluation Criteria in Solid Tumors (RECIST)
  • Performance status of 0 to 1 on the Eastern Cooperative Oncology Group (ECOG) Scale
  • Have discontinued all previous systemic therapies for cancer, for at least 14 days prior to study entry and have had previous first line chemotherapy, have recovered from all acute effects of the therapies, and are considered for further chemotherapy, radiotherapy, or other investigational therapy after they have relapsed or progressed on previous treatment.
  • Exhibit patient compliance and geographic proximity that allow for adequate follow-up.
  • Adequate bone marrow reserve and organ function as follows:

    • Neutrophil count >1.5 x 10 to the 9th power/L and platelets > 100 x 10 to the 9th power/L.
    • Hepatic: total bilirubin less than or equal to 1.5 times upper limit of normal (ULN)
    • Alanine transaminase (ALT) and aspartate transaminase (AST) less than or equal to 2.5 times ULN (or less than or equal to 5 times ULN in case of known liver involvement
    • Renal: Serum Creatinine less than or equal to 1.5 times upper limit of normal (ULN)
  • Reproductive potential must be either terminated (by surgery, radiation, or menopause) or attenuated by the use of an approved contraceptive method during and for 3 to 6 months following the study.
  • At least 18 years of age.
  • Agrees to discontinue St. Johns Wort while receiving dasatinib therapy
  • Agrees that IV bisphosphonates will be withheld for the first 8 weeks of dasatinib therapy due to risk of hypocalcemia.

Exclusion Criteria:

  • Prior treatment with EGFR tyrosine kinase inhibitors or EGFR targeting agent
  • Have received treatment within the last 28 days with a drug that has not received regulatory approval for any indication at the time of study entry.
  • Have previously completed or withdrawn from this study or any other study investigating Dasatinib.
  • Pregnant or breastfeeding.
  • Documented central nervous system or leptomeningeal metastasis (brain metastasis) at the time of study entry. Patients with prior brain metastasis may be considered if they have completed their treatment for brain metastasis, no longer require corticosteroids, and are asymptomatic.
  • Serious concomitant disorder, including active bacterial, fungal, or viral infection, incompatible with the study (at the discretion of the investigator).
  • Uncorrected electrolyte disorder, including potassium <3.0 mEq/L).
  • Gastrointestinal disorder that in the opinion of the study physician may affect absorption of either erlotinib or dasatinib. This also includes the inability to swallow tablets.
  • Prior major surgery or radiation therapy within 14 days of initiation of treatment
  • Electrocardiogram (ECG) abnormalities indicative of cardiac disease (at the discretion of the investigator).
  • Uncontrolled angina, congestive heart failure or MI within six (6) months
  • Diagnosed or suspected congenital long QT syndrome
  • History of clinically significant ventricular arrhythmias (such as ventricular tachycardia, ventricular fibrillation, or Torsades de pointes)
  • Prolonged QTc interval on pre-entry electrocardiogram (> 450 msec)
  • Uncontrolled hypertension.
  • History of significant bleeding disorder unrelated to cancer, including:

    • Diagnosed congenital bleeding disorders (e.g., von Willebrand's disease)
    • Diagnosed acquired bleeding disorder within one year (e.g., acquired anti-factor VIII antibodies)
  • Patients currently taking drugs that are generally accepted to have a risk of causing Torsades de Pointes including:

    • quinidine,
    • procainamide,
    • disopyramide,
    • amiodarone,
    • sotalol,
    • ibutilide,
    • dofetilide erythromycins,
    • clarithromycin,
    • chlorpromazine,
    • haloperidol,
    • mesoridazine,
    • thioridazine,
    • pimozide,
    • cisapride,
    • bepridil,
    • droperidol,
    • methadone,
    • arsenic,
    • chloroquine,
    • domperidone,
    • halofantrine,
    • levomethadyl,
    • pentamidine,
    • sparfloxacin; and
    • lidoflazine.
  • Patients with chronic obstructive pulmonary disease or pleural effusions (malignant or benign) requiring chronic oxygen therapy.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00444015

Contacts
Contact: Eric B. Haura, MD 813-745-6826 ERIC.HAURA@MOFFITT.ORG
Contact: Leticia Tetteh, RN 813-745-4617 leticia.tetteh@moffitt.org

Locations
United States, Florida
H. Lee Moffitt Cancer Center & Research Institute Recruiting
Tampa, Florida, United States, 33612
Contact: Leticia Tetteh     813-745-4617     leticia.tetteh@moffitt.org    
Sub-Investigator: Scott Antonia, MD            
Sub-Investigator: Gerold Bepler, M.D. PhD            
Sub-Investigator: Alberto Chiappori, MD            
Sub-Investigator: George Simon, MD            
Sub-Investigator: Tawee Tanvetyanon, MD            
Sub-Investigator: Charles Williams, MD            
Sub-Investigator: Richard Lush, PhD            
H. Lee Moffitt Cancer Center & Research Institute Recruiting
Tampa, Florida, United States, 33612
Contact: Jill McHale, RN     813-745-8384     jill.mchale@moffitt.org    
Sponsors and Collaborators
H. Lee Moffitt Cancer Center and Research Institute
Bristol-Myers Squibb
Investigators
Principal Investigator: Eric B. Haura, MD H. Lee Moffitt Cancer Center and Research Institute
  More Information

Additional Information:
No publications provided

Responsible Party: H. Lee Moffitt Cancer Center & Research Institute ( Eric Haura, M.D. )
Study ID Numbers: MCC-14984, BMS Protocol Number: CA180080, 105285b
Study First Received: March 5, 2007
Last Updated: January 30, 2009
ClinicalTrials.gov Identifier: NCT00444015     History of Changes
Health Authority: United States: Institutional Review Board

Keywords provided by H. Lee Moffitt Cancer Center and Research Institute:
Erlotinib
Dasatinib
Epidermal growth factor receptor (EGFR)
Tyrosine kinase
NSCLC
Pharmacokinetics (PK)
Lung

Study placed in the following topic categories:
Thoracic Neoplasms
Erlotinib
Protein Kinase Inhibitors
Recurrence
Carcinoma
Respiratory Tract Diseases
Lung Neoplasms
Lung Diseases
Dasatinib
Non-small Cell Lung Cancer
Mitogens
Carcinoma, Non-Small-Cell Lung
Neoplasms, Glandular and Epithelial

Additional relevant MeSH terms:
Thoracic Neoplasms
Erlotinib
Respiratory Tract Neoplasms
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Enzyme Inhibitors
Protein Kinase Inhibitors
Pharmacologic Actions
Carcinoma
Neoplasms
Neoplasms by Site
Respiratory Tract Diseases
Lung Neoplasms
Lung Diseases
Dasatinib
Carcinoma, Non-Small-Cell Lung
Neoplasms, Glandular and Epithelial

ClinicalTrials.gov processed this record on May 06, 2009