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A clinical study to examine the occurrence and severity of diarrhea in breast cancer patients receiving Neratinib (an investigational medicine for cancer) and Loperamide (used to treat diarrhea)

Phase 1
Conditions
Early Stage HER2+ Breast Cancer
MedDRA version: 20.0Level: PTClassification code 10065430Term: HER-2 positive breast cancerSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Therapeutic area: Diseases [C] - Cancer [C04]
Registration Number
EUCTR2015-004374-15-ES
Lead Sponsor
Puma Biotechnology, Inc.
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
563
Inclusion Criteria

1. Aged =18 years at signing of informed consent.
2. Histologically confirmed stage 1 through stage 3c primary adenocarcinoma of the breast.
3.Documented HER2 overexpression or gene-amplified tumor by a validated approved method.
4.Patients must have completed a course of prior adjuvant trastuzumab or experienced side effects that resulted in early discontinuation of trastuzumab that have since resolved.
5. The last dose of trastuzumab must have been given >2 weeks and =1 year (365 days) from enrollment.
6. Clinical and radiologic assessments that are negative for local or regional recurrence of disease or metastatic disease at the time of study entry, including:
- Bone scan or positron emission tomography (PET) scan; required only if alkaline phosphatase (ALP) is =2 x upper limit of normal (ULN) and/or there are symptoms of metastatic bone disease. A confirmatory imaging study is required if the results from the bone scan are questionable.
- Computed tomography (CT), magnetic resonance imaging (MRI) or ultrasound of the abdomen and chest; required only if aspartate aminotransferase (AST)/alanine aminotransferase (ALT) or ALP is =2 x ULN.
- Chest radiograph.
7.Left ventricular ejection fraction (LVEF) =50% measured by multiple-gated acquisition scan (MUGA) or echocardiogram (ECHO).
8. Eastern Cooperative Oncology Group (ECOG) status of 0 to 1.
9. Negative ß-human chorionic gonadotropin (hCG) pregnancy test for premenopausal women of reproductive capacity (those who are biologically capable of having children) and for women less than 12 months after menopause. [Women are considered postmenopausal if they are =12 months without menses, in the absence of endocrine or anti-endocrine therapies.]
10. Women of childbearing potential must agree and commit to the use of a highly effective non-hormonal method of contraception, ie, intrauterine device, bilateral tubal ligation, vasectomized partner, or abstinence (only when it is the preferred lifestyle of the patient), from the time of informed consent until 28 days after the last dose of the investigational products. Men and their female partners of childbearing potential must agree and commit to use a highly effective method of contraception (ie, any of the above methods, or for females, hormonal contraception associated with inhibition of ovulation) while on treatment and for 3 months after last dose of investigational products.
11. Recovery (ie, to Grade 1 or baseline) from all clinically significant AEs related to prior therapies (excluding alopecia, neuropathy, and nail changes).
12. Provide written, informed consent to participate in the study and follow the study procedures.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 60
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 60

Exclusion Criteria

1.Clinical or radiologic evidence of local or regional recurrence of disease or metastatic disease prior to or at the time of study entry.
2.Currently receiving chemotherapy, radiation therapy, immunotherapy, or biotherapy for breast cancer.
3.Major surgery within <30 days of starting treatment or received chemotherapy, investigational agents, or other cancer therapy, except hormonal therapy (eg, tamoxifen, aromatase inhibitors), <14 days prior to the initiation of investigational products.
4.Active uncontrolled cardiac disease, including cardiomyopathy, congestive heart failure (New York Heart Association functional classification of =2; including individuals who currently use digitalis, beta-blockers, or calcium channel blockers specifically for congestive heart failure), unstable angina, myocardial infarction within 12 months of enrollment, or ventricular arrhythmia.
5.QTc interval >0.450 seconds (males) or >0.470 (females), or known history of QTc prolongation or Torsade de Pointes (TdP).
6.Screening laboratory assessments outside the following limits:
-Absolute neutrophil count (ANC); =1,000/µl (=1.0 x 109/L)
-Platelet count; =100,000/µl (=100 x 109/L)
-Hemoglobin = 9 g/dL
-Total bilirubin; >1.5 x institutional upper limit of normal (ULN) (in case of known Gilbert’s syndrome, <2 x ULN is allowed)
-Aspartate aminotransferase (AST) and/or Alanine aminotransferase (ALT); >2.5 x institutional ULN
-Creatinine; Creatinine clearance <30 mL/min (as calculated by Cockcroft-Gault formulaa or Modification of Diet in Renal Disease [MDRD] formula)
7.Active, unresolved infections.
8.Patients with a second malignancy, other than adequately treated non-melanoma skin cancers, in situ melanoma or in situ cervical cancer. Patients with other non-mammary malignancies must have been disease-free for at least 5 years.
9.Currently pregnant or breast-feeding.
10.Significant chronic gastrointestinal disorder with diarrhea as a major symptom (eg, Crohn’s disease, malabsorption, or Grade =2 National Cancer Institute [NCI] CTCAE v.4.0 diarrhea of any etiology at baseline).
11.Clinically active infection with hepatitis B or hepatitis C virus.
12.Evidence of significant medical illness, abnormal laboratory finding, or psychiatric illness/social situations that could, in the Investigator’s judgment, make the patient inappropriate for this study.
13.Known hypersensitivity to any component of the investigational products; known hypersensitivity to salicylates; known allergies to any of the medications or components of medications used in the trial.
14.Unable or unwilling to swallow tablets.

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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