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临床试验/NCT00389922
NCT00389922已完成1 期

Phase I Study of Two Different Schedules of Lapatinib (GW572016) in Combination With Vinorelbine in Advanced Solid Tumors

University of California, Davis4 个研究点 分布在 1 个国家目标入组 22 人开始时间: 2005年12月最近更新:
适应症
干预措施
相关药物

试验速览

阶段
1 期
状态
已完成
入组人数
22
试验地点
4
主要终点
Toxicity as assessed by NCI CTCAE v3.0

研究概览

简要总结

RATIONALE: Lapatinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as vinorelbine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving lapatinib together with vinorelbine may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of lapatinib when given together with vinorelbine in treating patients with advanced solid tumors.

详细描述

OBJECTIVES:

Primary

  • Determine the safety and feasibility of 2 different schedules of lapatinib ditosylate when administered with vinorelbine ditartrate in patients with advanced solid tumors.

Secondary

  • Determine the maximum tolerated dose (MTD) of each of these regimens in these patients.
  • Determine, preliminarily, the efficacy of these regimens in these patients.
  • Examine tissue and blood specimens from these patients to investigate potential predictors of response.
  • Determine the pharmacokinetics of lapatinib ditosylate and vinorelbine ditartrate in patients treated at the MTD.

研究设计

研究类型
Interventional
分配方式
Non Randomized
干预模型
Parallel
主要目的
Treatment
盲法
None

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Cytologically or histologically proven advanced solid tumors for which there is no known standard therapy available or are not eligible for standard therapy because of their performance status, or have progressed after no more than 2 prior chemotherapy regimens for metastatic disease.
  • Measurable or evaluable disease. Disease in previously irradiated sites is considered measurable if there is clear disease progression following radiation therapy.
  • 18 years of age or older.
  • Zubrod performance status of 0-
  • Estimated survival of at least 3 months.
  • Any prior chemotherapy must have been completed at least 4 weeks prior to start of this protocol and all side effects (except alopecia) resolved to grade 1 or less. Any prior radiation must have been completed at least 2 weeks prior to start of therapy. For prior mitomycin chemotherapy a 6-week interval is required. Patients must have completed prior trastuzumab at least 4 weeks prior to start of protocol therapy.
  • Adequate renal function
  • Adequate liver function
  • Pretreatment granulocyte count of >1500/mm3 and platelet count of >100 000/mm
  • Cardiac ejection fraction within the institutional range of normal as measured by 2-D echocardiogram or MUGA scan.
  • Asymptomatic treated brain metastasis may be included if they are neurologically stable and have been off steroids and anticonvulsants for at least 4 weeks.
  • All patients must give informed consent.
  • Able to take and retain oral medication.
  • Patients of reproductive potential must agree to use an effective contraceptive method

排除标准

  • Patients may not have previously received lapatinib, vinorelbine or any other EGFR-1 targeted agent. Prior trastuzumab is allowed.
  • Females cannot be pregnant or breastfeeding
  • Symptomatic brain metastasis or still requiring steroids and anticonvulsants may not participate.
  • Pre-existing neuropathy > grade 2 may not participate.
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements, will be excluded.
  • History of other diseases, metabolic dysfunction, physical examination finding or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that might affect the interpretation of the results of the study or render the patient at high risk from treatment complications.
  • Gastrointestinal tract disease resulting in an inability to take oral medication or a requirement for IV alimentation, or prior surgical procedures affecting absorption.
  • HIV-positive patients receiving combination anti-retroviral therapy are excluded from the study because of possible pharmacokinetic interactions with lapatinib.
  • Patients requiring oral anticoagulants are eligible provided there is appropriate close INR monitoring is in place. If medically appropriate and treatment available, the investigator may also consider switching these patients to LMW heparin, where an interaction with lapatinib is not expected.
  • Adherence to the requirements for concomitant medications classified as CYP3A4 inducers or inhibitors, or gastric pH modifiers

研究组 & 干预措施

A (Daily Dosing)

Experimental

Oral lapatinib given daily for 28 days plus IV vinorelbine given weekly (3 out of 4 weeks)

Cohorts of 3-6 patients receive escalating doses of lapatinib ditosylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity during course 1. At least 6 patients are treated at the MTD. Once the MTD of lapatinib has been determined, patients may be accrued to group B or to a separate pharmacokinetics cohort in group A.

干预措施: lapatinib ditosylate (Drug)

A (Daily Dosing)

Experimental

Oral lapatinib given daily for 28 days plus IV vinorelbine given weekly (3 out of 4 weeks)

Cohorts of 3-6 patients receive escalating doses of lapatinib ditosylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity during course 1. At least 6 patients are treated at the MTD. Once the MTD of lapatinib has been determined, patients may be accrued to group B or to a separate pharmacokinetics cohort in group A.

干预措施: Vinorelbine ditartrate (Drug)

A (Daily Dosing)

Experimental

Oral lapatinib given daily for 28 days plus IV vinorelbine given weekly (3 out of 4 weeks)

Cohorts of 3-6 patients receive escalating doses of lapatinib ditosylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity during course 1. At least 6 patients are treated at the MTD. Once the MTD of lapatinib has been determined, patients may be accrued to group B or to a separate pharmacokinetics cohort in group A.

干预措施: comparative genomic hybridization (Genetic)

A (Daily Dosing)

Experimental

Oral lapatinib given daily for 28 days plus IV vinorelbine given weekly (3 out of 4 weeks)

Cohorts of 3-6 patients receive escalating doses of lapatinib ditosylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity during course 1. At least 6 patients are treated at the MTD. Once the MTD of lapatinib has been determined, patients may be accrued to group B or to a separate pharmacokinetics cohort in group A.

干预措施: cytogenetic analysis (Genetic)

A (Daily Dosing)

Experimental

Oral lapatinib given daily for 28 days plus IV vinorelbine given weekly (3 out of 4 weeks)

Cohorts of 3-6 patients receive escalating doses of lapatinib ditosylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity during course 1. At least 6 patients are treated at the MTD. Once the MTD of lapatinib has been determined, patients may be accrued to group B or to a separate pharmacokinetics cohort in group A.

干预措施: gene expression analysis (Genetic)

A (Daily Dosing)

Experimental

Oral lapatinib given daily for 28 days plus IV vinorelbine given weekly (3 out of 4 weeks)

Cohorts of 3-6 patients receive escalating doses of lapatinib ditosylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity during course 1. At least 6 patients are treated at the MTD. Once the MTD of lapatinib has been determined, patients may be accrued to group B or to a separate pharmacokinetics cohort in group A.

干预措施: mutation analysis (Genetic)

A (Daily Dosing)

Experimental

Oral lapatinib given daily for 28 days plus IV vinorelbine given weekly (3 out of 4 weeks)

Cohorts of 3-6 patients receive escalating doses of lapatinib ditosylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity during course 1. At least 6 patients are treated at the MTD. Once the MTD of lapatinib has been determined, patients may be accrued to group B or to a separate pharmacokinetics cohort in group A.

干预措施: polymerase chain reaction (Genetic)

A (Daily Dosing)

Experimental

Oral lapatinib given daily for 28 days plus IV vinorelbine given weekly (3 out of 4 weeks)

Cohorts of 3-6 patients receive escalating doses of lapatinib ditosylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity during course 1. At least 6 patients are treated at the MTD. Once the MTD of lapatinib has been determined, patients may be accrued to group B or to a separate pharmacokinetics cohort in group A.

干预措施: polymorphism analysis (Genetic)

A (Daily Dosing)

Experimental

Oral lapatinib given daily for 28 days plus IV vinorelbine given weekly (3 out of 4 weeks)

Cohorts of 3-6 patients receive escalating doses of lapatinib ditosylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity during course 1. At least 6 patients are treated at the MTD. Once the MTD of lapatinib has been determined, patients may be accrued to group B or to a separate pharmacokinetics cohort in group A.

干预措施: proteomic profiling (Genetic)

A (Daily Dosing)

Experimental

Oral lapatinib given daily for 28 days plus IV vinorelbine given weekly (3 out of 4 weeks)

Cohorts of 3-6 patients receive escalating doses of lapatinib ditosylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity during course 1. At least 6 patients are treated at the MTD. Once the MTD of lapatinib has been determined, patients may be accrued to group B or to a separate pharmacokinetics cohort in group A.

干预措施: reverse transcriptase-polymerase chain reaction (Genetic)

A (Daily Dosing)

Experimental

Oral lapatinib given daily for 28 days plus IV vinorelbine given weekly (3 out of 4 weeks)

Cohorts of 3-6 patients receive escalating doses of lapatinib ditosylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity during course 1. At least 6 patients are treated at the MTD. Once the MTD of lapatinib has been determined, patients may be accrued to group B or to a separate pharmacokinetics cohort in group A.

干预措施: immunohistochemistry staining method (Other)

A (Daily Dosing)

Experimental

Oral lapatinib given daily for 28 days plus IV vinorelbine given weekly (3 out of 4 weeks)

Cohorts of 3-6 patients receive escalating doses of lapatinib ditosylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity during course 1. At least 6 patients are treated at the MTD. Once the MTD of lapatinib has been determined, patients may be accrued to group B or to a separate pharmacokinetics cohort in group A.

干预措施: laboratory biomarker analysis (Other)

B (Intermittent Dosing)

Experimental

Oral lapatinib given days 2-5, 9-12 and 16-25 plus IV vinorelbine given weekly (3 out of 4 weeks)

Cohorts of 3-6 patients receive escalating doses of lapatinib ditosylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity during course 1. At least 6 patients are treated at the MTD. Once the MTD of lapatinib has been determined, patients may be accrued to group B or to a separate pharmacokinetics cohort in group A.

干预措施: lapatinib ditosylate (Drug)

B (Intermittent Dosing)

Experimental

Oral lapatinib given days 2-5, 9-12 and 16-25 plus IV vinorelbine given weekly (3 out of 4 weeks)

Cohorts of 3-6 patients receive escalating doses of lapatinib ditosylate until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity during course 1. At least 6 patients are treated at the MTD. Once the MTD of lapatinib has been determined, patients may be accrued to group B or to a separate pharmacokinetics cohort in group A.

干预措施: Vinorelbine ditartrate (Drug)

结局指标

主要结局

Toxicity as assessed by NCI CTCAE v3.0

时间窗: Completion of study

次要结局

  • Maximum tolerated dose of lapatinib ditosylate when administered with vinorelbine ditartrate as assessed by NCI CTCAE v3.0(Completion of study)
  • Best response(Completion of study)
  • Response rate (complete response, partial response, progressive disease, and stable disease) assessed at baseline and prior to courses 3 and 5(Completion of study)
  • Survival(Completion of study)
  • Progression-free survival(Completion of study)
  • Biological markers as predictors of response(Completion of study)

研究者

申办方类型
Other
责任方
Sponsor

研究点 (4)

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