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A Phase 1/2 Study of HKI-272 (Neratinib) in Combination With Paclitaxel (Taxol) in Subjects With Solid Tumors and Breast Cancer

Phase 1
Completed
Conditions
Advanced Breast Cancer
Advanced Malignant Solid Tumors
Breast Neoplasms
Interventions
Registration Number
NCT00445458
Lead Sponsor
Puma Biotechnology, Inc.
Brief Summary

The purpose of this study is to learn whether it is safe and effective to administer HKI-272 (neratinib) in combination with paclitaxel in patients with breast cancer.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
110
Inclusion Criteria

Inclusion criteria for both parts of clinical trial:

  • Good performance status
  • Normal ejection fraction
  • Adequate cardiac, kidney, and liver function
  • Adequate blood counts
  • At least one measurable target lesion
  • Negative pregnancy test for female subjects

Inclusion Criteria for Part 1 Only:

  • Pathologically confirmed solid tumor not curable with available standard therapy

Inclusion Criteria for Part 2 Only:

  • Pathologically confirmed breast cancer
  • HER2 positive tumor
  • Prior treatment with Herceptin
Exclusion Criteria

Exclusion criteria for both parts of clinical trial:

  • Major surgery, radiotherapy, chemotherapy or investigational agents within two weeks of treatment day 1
  • Subjects with bone or skin as the only site of disease
  • Active central nervous system metastases
  • Significant cardiac disease or dysfunction
  • Significant gastrointestinal disorder
  • Inability or unwillingness to swallow HKI-272 capsules
  • Prior exposure to HKI-272 or other HER2 targeted agents, except trastuzumab (Part 2 only). Prior lapatinib is permitted in arm B of part 2.
  • Treatment with a taxane within 3 months of treatment day 1
  • Grade 2 or greater motor or sensory neuropathy
  • Pregnant or breast feeding women
  • Known hypersensitivity to paclitaxel or Cremophor EL
  • Prior treatment with anthracyclines with cumulative dose of >400 mg/m^2
  • Any other cancer within 5 years with the exception of contralateral breast cancer, adequately treated cervical carcinoma in situ, or adequately treated basal or squamous cell carcinoma of the skin

Exclusion Criteria for Part 2 Only:

  • More than 1 (arm A) or 3 (arm B) prior cytotoxic chemotherapy regimen for metastatic disease

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
HKI-272 dose level 1PaclitaxelPart 1: Subjects with solid tumors receiving HKI-272 (neratinib) 160 mg daily by mouth in combination with paclitaxel 80 mg/m\^2 weekly IV.
HKI-272 dose level 1HKI-272Part 1: Subjects with solid tumors receiving HKI-272 (neratinib) 160 mg daily by mouth in combination with paclitaxel 80 mg/m\^2 weekly IV.
HKI-272 dose level 2HKI-272Part 1: Subjects with solid tumors receiving HKI-272 (neratinib) 240 mg daily by mouth in combination with paclitaxel 80 mg/m\^2 weekly IV.
HKI-272 expanded MTD cohort, arm AHKI-272Part 2: Subjects with metastatic breast cancer who have not received more than 1 prior cytotoxic chemotherapy treatment regimen for metastatic disease receiving HKI-272 (neratinib) 240 mg daily by mouth in combination with paclitaxel 80 mg/m\^2 weekly IV.
HKI-272 expanded MTD cohort, arm BHKI-272Part 2: Subjects with metastatic breast cancer who have not received more than 3 prior cytotoxic chemotherapy treatment regimen for metastatic disease receiving HKI-272 (neratinib) 240 mg daily by mouth in combination with paclitaxel 80 mg/m\^2 weekly IV.
HKI-272 expanded MTD cohort, arm BPaclitaxelPart 2: Subjects with metastatic breast cancer who have not received more than 3 prior cytotoxic chemotherapy treatment regimen for metastatic disease receiving HKI-272 (neratinib) 240 mg daily by mouth in combination with paclitaxel 80 mg/m\^2 weekly IV.
HKI-272 dose level 2PaclitaxelPart 1: Subjects with solid tumors receiving HKI-272 (neratinib) 240 mg daily by mouth in combination with paclitaxel 80 mg/m\^2 weekly IV.
HKI-272 expanded MTD cohort, arm APaclitaxelPart 2: Subjects with metastatic breast cancer who have not received more than 1 prior cytotoxic chemotherapy treatment regimen for metastatic disease receiving HKI-272 (neratinib) 240 mg daily by mouth in combination with paclitaxel 80 mg/m\^2 weekly IV.
Primary Outcome Measures
NameTimeMethod
Maximum Tolerated DoseFrom first dose date through day 28.

Maximum Tolerated Dose (MTD) of neratinib, daily, in combination with paclitaxel 80 mg/m², intravenous at days 1, 8, and 15, associated with the dose limiting toxicity data.

Objective Response RateFrom first dose date to progression or last tumor assessment, up to 140 weeks

Subjects with partial response (PR) or complete response (CR) with ERBB2 positive breast cancer treated at the maximum tolerated dose (MTD) of neratinib in combination with paclitaxel, per Response Evaluation Criteria In Solid Tumors Criteria (RECIST) v.1.0: CR, disappearance of all target lesions; PR, \>=30% decrease in the sum of the longest diameter of target lesions; and no progressive disease (PD) for non-target lesions, and no new lesions.

Dose Limiting Toxicity Incidence of Neratinib in Combination With PaclitaxelFrom first dose date through day 28

Dose Limiting Toxicity in subjects with solid tumors treated with neratinib, administered daily, in combination with paclitaxel 80 mg/m² IV on days 1, 8, and 15 of a 28 day cycle.

Secondary Outcome Measures
NameTimeMethod
Area Under the Concentration-time Curve 0-24Samples taken at 0 hour and at 1, 2, 4, 6, 8, and 24 hours postdose on Day 15 of Cycle 1, and 1 predose sample on Day 1 in Cycle 1.

Area under the concentration-time curve of neratinib; after each dosing of neratinib on Cycle 1 of Day 15, blood samples taken at regular time points.

Maximum Plasma Concentration of NeratinibSamples taken at 0 hour and at 1, 2, 4, 6, 8, and 24 hours postdose on Day 15 of Cycle 1, and 1 predose sample on Day 1 in Cycle 1.

Maximum plasma concentration of neratinib; after each dosing of neratinib on Cycle 1 of Day 15, blood samples taken at regular time points.

Trial Locations

Locations (32)

Boston University Medical Center

🇺🇸

Boston, Massachusetts, United States

Mid-Michigan Physicians-HOS Division

🇺🇸

Lansing, Michigan, United States

Princess Margaret Hospital University Health Network

🇨🇦

Toronto, Ontario, Canada

Birla Cancer Centre, S.M.S. Medical College & Hospital

🇮🇳

Jaipur, Rajasthan, India

Oncologisch Centrum GZA - Location St Augustinus

🇧🇪

Wilrijk, Belgium

AZ Groeninge Campus Maria's Voorzienigheid (MV)

🇧🇪

Kortrijk, Belgium

Oncology Care Associates

🇺🇸

Saint Joseph, Michigan, United States

Sharp Memorial Hospital

🇺🇸

San Diego, California, United States

Tata Memorial Hospital

🇮🇳

Mumbai, Parel, India

State Oncological Regional Treatment and Diagnostic Center Department of chemotherapy

🇺🇦

Lviv, Ukraine

Tianjin Cancer Hospital

🇨🇳

TianJin, Tianjin, China

Chinese People's Liberation Army General Hospital

🇨🇳

Beijing, Beijing, China

Tianjin Union Medicine Center Department of Oncology

🇨🇳

Tianjin, Tianjin, China

Cancer Hospital, Chinese Academy of Medical Sciences

🇨🇳

Beijing, China

Columbia University Medical Center

🇺🇸

New York, New York, United States

Scripps, Clinic General

🇺🇸

La Jolla, California, United States

Moores UC San Diego Cancer Center

🇺🇸

La Jolla, California, United States

The Hospital Affiliated Academy Military Medical Science, Chinese People's Liberation Army

🇨🇳

Beijing, Beijing, China

Institut Jules Bordet Unite du Chimiotherapie

🇧🇪

Brussels, Belgium

Peking Union Medical College Hospital of Chinese Academy of Medical Sciences

🇨🇳

Beijing, China

Asan Medical Center, Division of Oncology, Department of Internal Medicine

🇰🇷

Seoul, Korea, Republic of

Yonsei University Health System - Severance Hospital

🇰🇷

Seoul, Korea, Republic of

Oddzial Chemioterapii Centrum Onkologii Ziemii Lubelskiej

🇵🇱

Lublin, Poland

City Multifield Clinical Hospital #4 Department of chemotherapy, Dnipropetrovs'k State Medical Academy, Chair of Oncology and Medical Radiology

🇺🇦

Dnipropetrovsk, Ukraine

Jehangir Clinical Development Centre, Jehangir Hospital Premises

🇮🇳

Pune, Maharashtra, India

Wojewodzki Szpital Specjalistyczny im. Ludwika Rydygiera, Oddzial Onkologii

🇵🇱

Krakow, Poland

Universitair Ziekenhuis Gent

🇧🇪

Gent, Belgium

M.M.F. Joshi Hospital & Ratna Memorial Hospital

🇮🇳

Pune, Maharashtra, India

CTRC at The University of Texas Health Science Center

🇺🇸

San Antonio, Texas, United States

UNIMED Medical Institute

🇭🇰

Hong Kong, Hong Kong

Department of Medicine, Queen Mary Hospital

🇭🇰

Hong Kong, Hong Kong

Department of Surgery Queen Mary Hospital

🇭🇰

Hong Kong, Hong Kong

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