Lapatinib Study for Children and Adults With Neurofibromatosis Type 2 (NF2) and NF2-Related Tumors
Neurofibromatosis 2, Vestibular Schwannoma
About this trial
This is an interventional treatment trial for Neurofibromatosis 2 focused on measuring NF-2, NF-2 related tumors, Schwannoma, Acoustic, Bilateral, schwannomas, Neurilemmoma of other cranial and peripheral nerves, NF2 related benign intracranial tumors including, NF2 related meningiomas, NF2 related ependymomas, NF2 related spinal neurofibromas, NF2 related gliomas
Eligibility Criteria
Inclusion Criteria:
- Patients must be at least 4 years of age.
- Patients must meet diagnostic criteria for NF2 and at least one volumetrically measured NF2-related brain or spinal tumor with radiographic evidence of progression over the past 12 months, designated as the primary target OR volumetrically measurable VS with ipsilateral progressive hearing loss over the past 12 months, designated as the primary target tumor.
- Significant hearing loss criteria for enrollment.
- Karnofsky (PS) OR Lansky 50-100% (>16 years of age)
- Absolute neutrophil count ≥ 1,000/mm3 g/dL
- Hemoglobin ≥ 8 g/dL
- Creatinine ≤ 1.5 times upper limit of normal (ULN) OR corrected glomerular filtration rate ≥ 70 ml/min
- Bilirubin ≤ 1.5 times ULN
- ALT ≤ 2.5 times ULN
- Fully recovered from acute toxic effects of any prior chemotherapy, biological modifiers or radiotherapy.
- Steroids are allowed for progressive symptoms but patient must be on a stable dose for at least 1 week prior to study entry.
- Any neurologic deficits must be stable for ≥ 1 week.
- Patients with the potential for pregnancy or impregnating their partner must agree to follow acceptable birth control methods to avoid conception. Women of childbearing potential must have a negative pregnancy test. The anti-proliferative activity of this experimental drug may be harmful to the developing fetus.
- Normal cardiac left ventricular ejection fraction (LVEF) by transthoracic echocardiogram.
- Able to provide written informed consent (or consent by parent/legal guardian for minors)
Exclusion Criteria:
- Patients with serious concurrent infection or medical illness.
- Neurological deficits that are rapidly progressing.
- Patients who are pregnant or breast-feeding.
- Anti-tumor therapy within 4 weeks prior to enrollment.
- Radiation therapy within 2 months prior to enrollment.
- Prior therapy with agents targeting EGFR or ErbB2.
- Any surgery within 4 weeks prior to enrollment.
- Significant gastrointestinal disorder(s)
- Known cardiac disease
- Patients with a concurrent or prior malignancy are ineligible unless they are patients with curatively treated carcinoma-in-situ or basal cell carcinoma of the skin. Patients who have been free of disease (any prior malignancy) for more than five years are eligible for this study.
- Patients cannot have received cytochrome P450-inducing anticonvulsants (EIADs; e.g., phenytoin, carbamazepine, phenobarbital, primidone, oxcarbazepine) or similar agents (e.g., rifampin) or P450-inhibiting agents (Ketoconazole, Itraconazole, Clarithromycin, Atazanavir, Indinavir, Nefazodone, Nelfinavir, Ritonavir, Saquinavir, Telithromycin, Voriconazole)
Sites / Locations
- New York University School of Medicine
Arms of the Study
Arm 1
Experimental
Lapatinib
Lapatinib PO dosed according to age: Children/adolescents (less than 18 years of age): 1,800 mg/m2/day PO divided into twice daily doses, to a maximum of 750 mg PO twice daily Adults (18 years of age or older): 1,500 mg PO once daily Lapatinib is available in 250 mg tablets only. For pediatric dosing, the total daily dose will be rounded up or down to the nearest 250 mg increment.