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Lapatinib in Treating Patients With Recurrent Glioblastoma Multiforme

Primary Purpose

Brain and Central Nervous System Tumors

Status
Completed
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
lapatinib ditosylate
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Brain and Central Nervous System Tumors focused on measuring adult giant cell glioblastoma, adult gliosarcoma, recurrent adult brain tumor

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically confirmed malignant glioblastoma multiforme Recurrent or progressive disease after prior primary treatment with radiotherapy with or without adjuvant chemotherapy Bidimensionally measurable disease on CT scan or MRI with at least one lesion ≥ 1 cm x 1 cm Paraffin embedded tumor sample available Concurrent enzyme-inducing anti-epileptic drugs (EIAEDs) required for phase I of the study Patients in phase II of the study may or may not be receiving EIAEDs PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 Life expectancy Not specified Hematopoietic Absolute granulocyte count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hepatic Bilirubin ≤ upper limit of normal (ULN) AST and ALT ≤ 2.5 times ULN Renal Creatinine ≤ 1.5 times ULN Cardiovascular LVEF ≥ 50% by echocardiogram or MUGA No myocardial infarction within the past 6 months No congestive heart failure No unstable angina No active cardiomyopathy No cardiac arrhythmia No uncontrolled hypertension Pulmonary No pulmonary disease requiring oxygen Neurologic No preexisting peripheral neuropathy ≥ grade 3 No history of significant neurologic disorder that would preclude study compliance or ability to give informed consent Gastrointestinal No upper gastrointestinal or other conditions that would preclude compliance with oral medication No active peptic ulcer disease Other No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, curatively treated carcinoma in situ of the cervix, or other curatively treated solid tumor No immune deficiency No history of significant psychiatric disorder (e.g., uncontrolled psychotic disorders) that would preclude study compliance or ability to give informed consent No other serious illness or medical condition that would preclude study participation No known hypersensitivity to compounds of similar chemical or biological composition to lapatinib No active uncontrolled or serious infection HIV negative Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy No concurrent prophylactic filgrastim (G-CSF), sargramostim (GM-CSF), or other hematopoietic growth factors Concurrent hematopoietic growth factors allowed for treatment of acute toxicity (e.g., febrile neutropenia) Chemotherapy See Disease Characteristics No prior chemotherapy for recurrent disease No more than one prior chemotherapy regimen in the adjuvant setting At least 6 months since prior adjuvant chemotherapy Endocrine therapy Concurrent steroids allowed provided the dose is stable for at least 14 days before study entry Radiotherapy See Disease Characteristics At least 6 weeks since prior radiotherapy Surgery At least 2 weeks since prior major surgery Other H2 blockers and proton pump inhibitors allowed, unless they are CYP3A4 inducers or inhibitors At least 7 days since prior and no concurrent administration of any of the following CYP3A4 inhibitors: Clarithromycin Erythromycin Troleandomycin Telithromycin Ciprofloxacin Norfloxacin Itraconazole Ketoconazole Voriconazole Fluconazole (≤150 mg/day allowed) Nefazodone Fluovoxamine Delavirdine Nelfinavir Amprenavir Ritonavir Indinavir Saquinavir Lopinavir Verapamil Diltiazem Aprepitant Grapefruit or grapefruit juice Bitter orange At least 14 days since prior and no concurrent administration of any of the following CYP3A4 inducers: Rifampin Rifabutin Rifapentine Efavirenz Nevirapine Hypericum perforatum (St. John's wort) Modafinil At least 6 months since prior and no concurrent administration of amiodarone Antacids (e.g., mylanta, maalox, tums, rennies) must be administered ≥ 1 hour before and ≥ 1 hour after study drug At least 2 days since prior and no concurrent cimetidine No other concurrent anti-cancer agents No other concurrent investigational therapy

Sites / Locations

  • Tom Baker Cancer Centre - Calgary
  • British Columbia Cancer Agency - Centre for the Southern Interior
  • British Columbia Cancer Agency - Vancouver Cancer Centre
  • Margaret and Charles Juravinski Cancer Centre
  • Princess Margaret Hospital
  • Centre Hospitalier de l'Universite de Montreal

Outcomes

Primary Outcome Measures

Toxicity for phase I assessed by CTCAE v.3.0 MacDonald criteria
Response for phase II

Secondary Outcome Measures

Correlative studies on archival tissue
Pharmacokinetics

Full Information

First Posted
December 8, 2004
Last Updated
January 24, 2014
Sponsor
National Cancer Institute (NCI)
Collaborators
NCIC Clinical Trials Group
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1. Study Identification

Unique Protocol Identification Number
NCT00099060
Brief Title
Lapatinib in Treating Patients With Recurrent Glioblastoma Multiforme
Official Title
A Phase I/II Study of GW572016 in Patients With Recurrent Malignant Glioma
Study Type
Interventional

2. Study Status

Record Verification Date
April 2012
Overall Recruitment Status
Completed
Study Start Date
December 2004 (undefined)
Primary Completion Date
November 2007 (Actual)
Study Completion Date
November 2007 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)
Collaborators
NCIC Clinical Trials Group

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
RATIONALE: Lapatinib may stop the growth of tumor cells by blocking the enzymes necessary for their growth. PURPOSE: This phase I/II trial is studying the side effects and best dose of lapatinib and to see how well it works in treating patients with recurrent glioblastoma multiforme.
Detailed Description
OBJECTIVES: Phase I Determine the maximum tolerated dose and recommended phase II dose of lapatinib in patients with recurrent malignant glioblastoma multiforme who are taking CYP3A4 enzyme-inducing anti-epileptic drugs (EIAEDs). Determine the toxic effects of this drug in these patients. Determine the pharmacokinetics of this drug in these patients. Phase II Determine the efficacy of this drug, in terms of objective tumor response rate, in patients who are taking EIAEDs and in those who are not taking EIAEDs. Correlate immunohistochemical measures of cellular proteins and receptors from tumor samples with anti-tumor activity of this drug in these patients. Determine the pharmacokinetics of this drug in these patients. OUTLINE: This is a multicenter, open-label, phase I, dose-escalation study followed by a phase II study. Phase I: Patients receive oral lapatinib twice daily on days 1-28. Courses repeat every 28 days in the absence of unacceptable toxicity or disease progression. Cohorts of 3-6 patients receive escalating doses of lapatinib 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. Phase II: Patients receive lapatinib as in phase I at the MTD. Patients are followed at 1 month and then periodically for survival. Patients with stable or responding disease who go off therapy are followed every 3 months for up to one year and then periodically thereafter for survival. PROJECTED ACCRUAL: A total of 3-24 patients will be accrued for the phase I portion of this study within 18 months. A total of 15-30 patients will be accrued for the phase II portion of this study within 18 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Brain and Central Nervous System Tumors
Keywords
adult giant cell glioblastoma, adult gliosarcoma, recurrent adult brain tumor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
lapatinib ditosylate
Intervention Description
For patients receiving enzyme inducing anti-epileptic drugs (EIAEDs): Phase I: starting dose for first cohort: 1000 mg GW572016 po b.i.d.; actual dose assigned at registration; intra patient dose escalation permitted ONCE in phase I patients ONLY if specified criteria met (see section 8.6). Phase II: Recommended phase II dose from phase I portion of the study, given po b.i.d. For patients NOT receiving enzyme inducing anti-epileptic drugs (NON-EIAEDs): • Phase II: 750 mg GW572016 po b.i.d. For all patients: • Dose reductions as required based on adverse events.
Primary Outcome Measure Information:
Title
Toxicity for phase I assessed by CTCAE v.3.0 MacDonald criteria
Time Frame
7 years
Title
Response for phase II
Time Frame
7 years
Secondary Outcome Measure Information:
Title
Correlative studies on archival tissue
Time Frame
7 years
Title
Pharmacokinetics
Time Frame
7 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed malignant glioblastoma multiforme Recurrent or progressive disease after prior primary treatment with radiotherapy with or without adjuvant chemotherapy Bidimensionally measurable disease on CT scan or MRI with at least one lesion ≥ 1 cm x 1 cm Paraffin embedded tumor sample available Concurrent enzyme-inducing anti-epileptic drugs (EIAEDs) required for phase I of the study Patients in phase II of the study may or may not be receiving EIAEDs PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 Life expectancy Not specified Hematopoietic Absolute granulocyte count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hepatic Bilirubin ≤ upper limit of normal (ULN) AST and ALT ≤ 2.5 times ULN Renal Creatinine ≤ 1.5 times ULN Cardiovascular LVEF ≥ 50% by echocardiogram or MUGA No myocardial infarction within the past 6 months No congestive heart failure No unstable angina No active cardiomyopathy No cardiac arrhythmia No uncontrolled hypertension Pulmonary No pulmonary disease requiring oxygen Neurologic No preexisting peripheral neuropathy ≥ grade 3 No history of significant neurologic disorder that would preclude study compliance or ability to give informed consent Gastrointestinal No upper gastrointestinal or other conditions that would preclude compliance with oral medication No active peptic ulcer disease Other No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, curatively treated carcinoma in situ of the cervix, or other curatively treated solid tumor No immune deficiency No history of significant psychiatric disorder (e.g., uncontrolled psychotic disorders) that would preclude study compliance or ability to give informed consent No other serious illness or medical condition that would preclude study participation No known hypersensitivity to compounds of similar chemical or biological composition to lapatinib No active uncontrolled or serious infection HIV negative Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy No concurrent prophylactic filgrastim (G-CSF), sargramostim (GM-CSF), or other hematopoietic growth factors Concurrent hematopoietic growth factors allowed for treatment of acute toxicity (e.g., febrile neutropenia) Chemotherapy See Disease Characteristics No prior chemotherapy for recurrent disease No more than one prior chemotherapy regimen in the adjuvant setting At least 6 months since prior adjuvant chemotherapy Endocrine therapy Concurrent steroids allowed provided the dose is stable for at least 14 days before study entry Radiotherapy See Disease Characteristics At least 6 weeks since prior radiotherapy Surgery At least 2 weeks since prior major surgery Other H2 blockers and proton pump inhibitors allowed, unless they are CYP3A4 inducers or inhibitors At least 7 days since prior and no concurrent administration of any of the following CYP3A4 inhibitors: Clarithromycin Erythromycin Troleandomycin Telithromycin Ciprofloxacin Norfloxacin Itraconazole Ketoconazole Voriconazole Fluconazole (≤150 mg/day allowed) Nefazodone Fluovoxamine Delavirdine Nelfinavir Amprenavir Ritonavir Indinavir Saquinavir Lopinavir Verapamil Diltiazem Aprepitant Grapefruit or grapefruit juice Bitter orange At least 14 days since prior and no concurrent administration of any of the following CYP3A4 inducers: Rifampin Rifabutin Rifapentine Efavirenz Nevirapine Hypericum perforatum (St. John's wort) Modafinil At least 6 months since prior and no concurrent administration of amiodarone Antacids (e.g., mylanta, maalox, tums, rennies) must be administered ≥ 1 hour before and ≥ 1 hour after study drug At least 2 days since prior and no concurrent cimetidine No other concurrent anti-cancer agents No other concurrent investigational therapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Brian A. Thiessen, MD
Organizational Affiliation
British Columbia Cancer Agency
Official's Role
Study Chair
Facility Information:
Facility Name
Tom Baker Cancer Centre - Calgary
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T2N 4N2
Country
Canada
Facility Name
British Columbia Cancer Agency - Centre for the Southern Interior
City
Kelowna
State/Province
British Columbia
ZIP/Postal Code
V1Y 5L3
Country
Canada
Facility Name
British Columbia Cancer Agency - Vancouver Cancer Centre
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V5Z 4E6
Country
Canada
Facility Name
Margaret and Charles Juravinski Cancer Centre
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8V 5C2
Country
Canada
Facility Name
Princess Margaret Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada
Facility Name
Centre Hospitalier de l'Universite de Montreal
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H2L-4M1
Country
Canada

12. IPD Sharing Statement

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Lapatinib in Treating Patients With Recurrent Glioblastoma Multiforme

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