Neoadjuvant Study With Chemotherapy, Lapatinib And Trastuzumab In Breast Cancer

NCT ID: NCT00429299

Last Updated: 2016-03-22

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

121 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-08-31

Study Completion Date

2012-06-30

Brief Summary

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Evaluate the activity of Trastuzumab, Lapatinib, and a combination of both agents with chemotherapy in the preoperative (neoadjuvant) treatment of early breast cancer.

Detailed Description

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Conditions

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Neoplasms, Breast

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm A

Chemotherapy plus trastuzumab

Group Type ACTIVE_COMPARATOR

trastuzumab

Intervention Type BIOLOGICAL

First dose 4mg/kg in 60mins, then weekly 2mg/kg in 30 mins

paclitaxel

Intervention Type DRUG

80mg/sqm 1 hour infusion for 12 weeks

fluorouracil

Intervention Type DRUG

600mg/sqm iv day 1 q21 days for four coursess

epidoxorubicin

Intervention Type DRUG

75mg/sqm iv day 1 q21 days for four courses

cyclophosphamide

Intervention Type DRUG

600mg/sqm day 1 q21 days for four courses

Arm B

Chemotherapy plus lapatinib

Group Type EXPERIMENTAL

lapatinib

Intervention Type DRUG

Arm B 1250mg/d PO Arm C 750mg/d PO

paclitaxel

Intervention Type DRUG

80mg/sqm 1 hour infusion for 12 weeks

fluorouracil

Intervention Type DRUG

600mg/sqm iv day 1 q21 days for four coursess

epidoxorubicin

Intervention Type DRUG

75mg/sqm iv day 1 q21 days for four courses

cyclophosphamide

Intervention Type DRUG

600mg/sqm day 1 q21 days for four courses

Arm C

Chemotherapy plus trastuzumab plus lapatinib

Group Type ACTIVE_COMPARATOR

lapatinib

Intervention Type DRUG

Arm B 1250mg/d PO Arm C 750mg/d PO

trastuzumab

Intervention Type BIOLOGICAL

First dose 4mg/kg in 60mins, then weekly 2mg/kg in 30 mins

paclitaxel

Intervention Type DRUG

80mg/sqm 1 hour infusion for 12 weeks

fluorouracil

Intervention Type DRUG

600mg/sqm iv day 1 q21 days for four coursess

epidoxorubicin

Intervention Type DRUG

75mg/sqm iv day 1 q21 days for four courses

cyclophosphamide

Intervention Type DRUG

600mg/sqm day 1 q21 days for four courses

Interventions

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lapatinib

Arm B 1250mg/d PO Arm C 750mg/d PO

Intervention Type DRUG

trastuzumab

First dose 4mg/kg in 60mins, then weekly 2mg/kg in 30 mins

Intervention Type BIOLOGICAL

paclitaxel

80mg/sqm 1 hour infusion for 12 weeks

Intervention Type DRUG

fluorouracil

600mg/sqm iv day 1 q21 days for four coursess

Intervention Type DRUG

epidoxorubicin

75mg/sqm iv day 1 q21 days for four courses

Intervention Type DRUG

cyclophosphamide

600mg/sqm day 1 q21 days for four courses

Intervention Type DRUG

Other Intervention Names

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Tyverb/Tykerb Herceptin Taxol

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed infiltrating primary breast cancer of \> 2.0 cm in largest clinical diameter

HER2 positive tumor (either IHC 3+ or FISH+)

* Availability of tumor tissue suitable for biological and molecular examination before starting primary treatment
* Age \>18, \< 65 years
* ECOG PS 0-1
* Normal organ and marrow function as defined below:

leukocytes ³ 3000/microL

absolute neutrophil count ³ 1,500/microL

platelets ³ 100,000/microL

total bilirubin \<= 1.5x ULN. In case of Gilbert's syndrome, \<2 x ULN is allowed

AST (SGOT)/ALT(SGPT)\<= 2.5 X institutional upper limit of normal

Alkaline phosphatase \<= 2.5 x ULN

Creatinine within normal institutional limits

* Cardiac ejection fraction within the institutional range of normal as measured by echocardiogram or MUGA scan
* Eligibility of patients receiving medications or substances known to affect, or with the potential to affect the activity or pharmacokinetics of lapatinib will be determined following review of their use by the Principal Investigator. A list of medications and substances known or with the potential to interact with CYP450 isoenzymes is provided
* The effects of lapatinib on the developing human fetus at the recommended therapeutic dose are unknown; women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control or abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately, the patient should be apprised of the potential hazard to the fetus and potential risk for loss of the pregnancy
* Ability to understand and the willingness to sign a written informed consent document
* Ability to swallow and retain oral medication

Exclusion Criteria

* Stage IIIB, IIIC, and inflammatory breast cancer
* Stage IV breast cancer
* Contraindication to the treatment with anthracycline, paclitaxel and/or trastuzumab
* Prior treatment with chemotherapy, endocrine therapy or radiotherapy. Prior treatment with EGFR targeting therapies
* Treatment with any other investigational agents, or with all herbal (alternative) medicines
* History of allergic reactions attributed to compounds of similar chemical or biologic composition to lapatinib
* Uncontrolled inter-current 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
* Pregnancy or breastfeeding; (breast feeding should be discontinued to be enrolled in the study)
* Women of childbearing potential that refusal to adopt adequate contraceptive measures
* HIV-positive patients receiving combination anti-retroviral therapy
* GI tract disease resulting in an inability to take oral medication, malabsorption syndrome, a requirement for IV alimentation, prior surgical procedures affecting absorption, uncontrolled inflammatory GI disease (e.g., Crohn's, ulcerative colitis)
* Concomitant requirement for medication classified as CYP3A4 inducers or inhibitors
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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GlaxoSmithKline

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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GSK Clinical Trials

Role: STUDY_DIRECTOR

GlaxoSmithKline

Locations

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GSK Investigational Site

Carpi (MO), Emilia-Romagna, Italy

Site Status

GSK Investigational Site

Berlin, State of Berlin, Germany

Site Status

GSK Investigational Site

Brindisi, Apulia, Italy

Site Status

GSK Investigational Site

Forlì, Emilia-Romagna, Italy

Site Status

GSK Investigational Site

Modena, Emilia-Romagna, Italy

Site Status

GSK Investigational Site

Parma, Emilia-Romagna, Italy

Site Status

GSK Investigational Site

Piacenza, Emilia-Romagna, Italy

Site Status

GSK Investigational Site

Rimini, Emilia-Romagna, Italy

Site Status

GSK Investigational Site

Treviglio (BG), Lombardy, Italy

Site Status

GSK Investigational Site

Candiolo (TO), Piedmont, Italy

Site Status

GSK Investigational Site

Pisa, Tuscany, Italy

Site Status

GSK Investigational Site

Cremona, , Italy

Site Status

GSK Investigational Site

Pavia, , Italy

Site Status

GSK Investigational Site

Perugia, , Italy

Site Status

GSK Investigational Site

Reggio Emilia, , Italy

Site Status

GSK Investigational Site

Varese, , Italy

Site Status

GSK Investigational Site

Warsaw, , Poland

Site Status

Countries

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Germany Italy Poland

References

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Guarneri V, Frassoldati A, Bottini A, Cagossi K, Bisagni G, Sarti S, Ravaioli A, Cavanna L, Giardina G, Musolino A, Untch M, Orlando L, Artioli F, Boni C, Generali DG, Serra P, Bagnalasta M, Marini L, Piacentini F, D'Amico R, Conte P. Preoperative chemotherapy plus trastuzumab, lapatinib, or both in human epidermal growth factor receptor 2-positive operable breast cancer: results of the randomized phase II CHER-LOB study. J Clin Oncol. 2012 Jun 1;30(16):1989-95. doi: 10.1200/JCO.2011.39.0823. Epub 2012 Apr 9.

Reference Type BACKGROUND
PMID: 22493419 (View on PubMed)

Guarneri V, Dieci MV, Griguolo G, Miglietta F, Girardi F, Bisagni G, Generali DG, Cagossi K, Sarti S, Frassoldati A, Gianni L, Cavanna L, Pinotti G, Musolino A, Piacentini F, Cinieri S, Prat A, Conte P; of the CHER-Lob study team. Trastuzumab-lapatinib as neoadjuvant therapy for HER2-positive early breast cancer: Survival analyses of the CHER-Lob trial. Eur J Cancer. 2021 Aug;153:133-141. doi: 10.1016/j.ejca.2021.05.018. Epub 2021 Jun 19.

Reference Type DERIVED
PMID: 34153715 (View on PubMed)

Guarneri V, Dieci MV, Frassoldati A, Maiorana A, Ficarra G, Bettelli S, Tagliafico E, Bicciato S, Generali DG, Cagossi K, Bisagni G, Sarti S, Musolino A, Ellis C, Crescenzo R, Conte P. Prospective Biomarker Analysis of the Randomized CHER-LOB Study Evaluating the Dual Anti-HER2 Treatment With Trastuzumab and Lapatinib Plus Chemotherapy as Neoadjuvant Therapy for HER2-Positive Breast Cancer. Oncologist. 2015 Sep;20(9):1001-10. doi: 10.1634/theoncologist.2015-0138. Epub 2015 Aug 5.

Reference Type DERIVED
PMID: 26245675 (View on PubMed)

Guarneri V, Generali DG, Frassoldati A, Artioli F, Boni C, Cavanna L, Tagliafico E, Maiorana A, Bottini A, Cagossi K, Bisagni G, Piacentini F, Ficarra G, Bettelli S, Roncaglia E, Nuzzo S, Swaby R, Ellis C, Holford C, Conte P. Double-blind, placebo-controlled, multicenter, randomized, phase IIb neoadjuvant study of letrozole-lapatinib in postmenopausal hormone receptor-positive, human epidermal growth factor receptor 2-negative, operable breast cancer. J Clin Oncol. 2014 Apr 1;32(10):1050-7. doi: 10.1200/JCO.2013.51.4737. Epub 2014 Mar 3.

Reference Type DERIVED
PMID: 24590635 (View on PubMed)

Other Identifiers

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EGF106988

Identifier Type: -

Identifier Source: org_study_id

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