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A phase I-II study of lapatinib and docetaxel as neoadjuvant treatment for HER-2 positive locally advanced/inflammatory or large operable breast cancer. - Lapatax

Conditions
ocally advanced/inflammatory or large operable brest cancer.
MedDRA version: 12.1Level: LLTClassification code 10006187Term: Breast cancer
Registration Number
EUCTR2006-000864-94-BE
Lead Sponsor
European Organisation for Research and Treatment of Cancer (EORTC)
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
Female
Target Recruitment
180
Inclusion Criteria

Breast cancer population for Phase I part
* Female patients with locally advanced or inflammatory, or specified subgroup of large operable (see below) breast cancer for whom neo-adjuvant chemotherapy is appropriate defined as:
- Clinical T4 a,b,c,d, any N (inflammatory breast carcinoma: tumor mass, breast enlargement, oedema and warmth of the skin are often present but not mandatory for the diagnosis)
- Or any clinical T, N2 or N3 (ipsilateral supraclavicular nodes)
- Or cT3cN0,1 any ER
- Or cT2cN1 any ER
- Or cT2cN0 ER neg
* Presence of bilateral breast cancer is allowed
* Patients with minimal lung, skin, or nodal metastatic disease shall be discussed case-by-case with the study co-ordinators. Patients with bone, liver or other extensive metastases are non eligible

Breast cancer population for Phase II part
* Female patients with any large operable T2 or T3 breast cancers, M0
* Or female patients with locally advanced or inflammatory breast cancer defined as:
- Clinical T4 a,b,c,d, any N (inflammatory breast carcinoma: tumor mass, breast enlargement, oedema and warmth of the skin are often present but not mandatory for the diagnosis)
- any clinical T, N2 or N3 (ipsilateral supraclavicular nodes)
- And M0
* Presence of bilateral breast cancer, provided only 1 side is HER2 positive

Eligibility criteria for both phase I and II
* Histologically confirmed diagnosis of invasive breast cancer
* Known hormone receptor status: ER/PR positive or negative.
* HER-2 positive (IHC 3+, or IHC 2+ and FISH/CISH +, or FISH, or CISH+ only)
* Two frozen trucuts with a 14 G needle are mandatory for every core biopsy indicated by the translational research study
* Age 18 to 70 years
* WHO performance status 0-2
* Adequate bone marrow function: hemoglobin > 10.0 g/dl or 6.2 mmol/L, neutrophils > 1.5 x 10exp9/L and platelets > 100 x 10exp9/L
* Adequate hepatic and renal function, defined as follows:
- Bilirubin < 1.5 x ULN,
- AST and/or ALT < 3 x ULN
- Serum creatinine < 1.5 x ULN
* Patients must be accessible for repeat dosing and follow-up
* Clinically normal cardiac function (LVEF assessed by MUGA or ECHO), normal 12 lead ECG, and in the past 6 months no serious cardiac illness or medical condition including but not confined to:
- History of documented congestive heart failure (CHF)
- High-risk uncontrolled arrhythmias
- Angina pectoris requiring antianginal medication
- Clinically significant valvular heart disease
- Evidence of transmural infarction on ECG
- Poorly controlled hypertension (e.g. systolic >180mm Hg or diastolic greater than
100mm Hg)
* Drugs and several HERBAL CONSTITUENTS (e.g. bergamottin and glabridin), which are inducers or inhibitors of CYP3A4 must not be taken within 10 days prior to initiation of treatment and are prohibited while the patient is being treated with lapatinib (a detailed list is provided in chapter 5 of the protocol)
* Women should either not be of childbearing potential (having had a hysterectomy, a bilateral oophorectomy or bilateral tubal ligation, or be post-menopausal with a total cessation of menses of > 1 year), or not be pregnant (negative serum pregnancy test at entry); should not be lactating; should agree to use contraceptive methods (with a documented failure rate < 1%, vasectomized partner sterile prior to trial entry and sole sexual partner or double-barrier contraception) from 2 weeks before your first study treatment until 4 weeks after

Exclusion Criteria

Exclusion criteria for Phase I part:
* Prior therapy for any cancer, including chemotherapy, radiotherapy, hormonal therapy for breast cancer, EGFR or HER-2 or antibody therapy

Exclusion criteria for Phase II part:
* Prior history of malignancies except:
- basal cell or squamous cell carcinoma of the skin
- carcinoma in situ of the cervix
- the patient has been free of any other malignancies for > 3 years.

Exclusion criteria for both phase I and II:
* Current active hepatic or biliary disease (with exception of patients with Gilbert's syndrome, asymptomatic gallstones or stable chronic liver disease not requiring therapy as per investigator assessment)
* Clinical signs of CNS involvement
* Patients with active or uncontrolled infections or with serious illnesses, malabsorption syndrome or medical conditions, including patients with a history of chronic alcohol abuse, hepatitis, HIV and/or cirrhosis

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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