Randomized RT +/- Lapatinib for Advanced Solid Tumor Cancer Patients Receiving Radiation Therapy for Metastatic Disease

NCT ID: NCT01427322

Last Updated: 2015-07-08

Basic Information

• Recruitment Status: TERMINATED
• Clinical Phase: EARLY_PHASE1
• Total Enrollment: 6 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2011-09-30
• Study Completion Date: 2015-07-31

Brief Summary

Lapatinib will prevent radiation-induced increase in Transforming Growth Factor alpha (TGFα), an important growth factor in cancer cell recovery after ionizing irradiation.

Detailed Description

Lapatinib is an orally bioavailable small molecule inhibitor of ERBB1 and ERBB2 (HER2). It is currently indicated for use in patients with HER2 over-expressing metastatic breast cancer. Serum increases in TGFα can have growth potentiating effects on distant sites of metastatic disease. Palliative irradiation paradoxically may promote distant tumor growth; blocking shedding of TGFα from irradiated tumors may prevent this effect and improve the therapeutic index of radiation therapy.

Conditions

Epithelial Cancer

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

lapatinib + radiation therapy

lapatinib given orally 2-4 hours prior to first fraction of radiation

Group Type: EXPERIMENTAL

Lapatinib

Intervention Type: DRUG

given orally 2-4 hours before first fraction of radiation therapy

Radiation therapy

Intervention Type: RADIATION

Standard radiation therapy

No therapy prior to radiation

Radiation therapy alone

Group Type: ACTIVE_COMPARATOR

Radiation therapy

Intervention Type: RADIATION

Standard radiation therapy

Interventions

Lapatinib

given orally 2-4 hours before first fraction of radiation therapy

Intervention Type: DRUG

Radiation therapy

Standard radiation therapy

Intervention Type: RADIATION

Other Intervention Names

GW572016; Tykerb

Eligibility Criteria

Inclusion Criteria

• History of stage IV epithelial-derived cancer requiring palliative radiation. Patients with sarcoma, lymphoma, myeloma or neuroendocrin cancers are not eligible.
• Evidence of metastatic disease
• Recommendation by patient's radiation oncologist to receive palliative external beam radiation for metastases -- minimum fraction size of 3 Gy.
• Age 18 years or older
• Patients may be undergoing concurrent therapy with GNRH agonists or combined androgen blockade or anti-estrogen hormonal therapy for breast cancer, as these are standard care for advanced prostate and some breast cancers respectively.
• Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria

• Any contraindication to lapatinib treatment.
• Prior radiation therapy within 30 days of the start of the planned course of treatment.
• Prior cytotoxic chemotherapy within 4-2 weeks of planned first dose of radiation. Persistent grade 2 or greater non-hematologic toxicity (other than neuropathy) from cytotoxic chemotherapy regardless of interval since last dose. Persistent grade 3 or greater hematologic toxicity (other than lymphopenia) reglardless of interval since last dose.
• Prior administration of an ERBB1 or ERK1/2 inhibitor within 30 days of the start of the planned course of treatment.
• Patients with a medical necessity to continue active therapy with CYP3A4 strong inhibitors or inducers. The concomitant use of strong CYP3A4 inhibitors should be avoided (e.g., ketoconazole, itraconazole, clarithromycin, atazanavir, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole, aprepitant). Grapefruit may also increase plasma concentrations of lapatinib and should be avoided. Once the strong inhibitor or inducer is discontinued, a washout period of approximately 1 week should be allowed before the lapatinib administration. If a patient is unable to discontinue these medications, they are not eligible for enrollment.
• Concurrent administration of any other investigational agents.
• Uncontrolled concurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, active hepatic or biliary disease with a Child-Pugh class of B or C, or psychiatric illness/social situations that would limit compliance with study requirements or that would interfere with accomplishing the study objectives.
• Pregnant or nursing. Women of childbearing potential must have a negative pregnancy test performed within 7 days prior to the start of treatment. Women of childbearing potential and men must agree to use a medically accepted form of birth control for the duration of study participation. Men must agree to use a medically accepted form of birth control for 4 months following completion of study treatment.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Virginia Commonwealth University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Andrew S. Poklepovic, MD

Role: PRINCIPAL_INVESTIGATOR

Massey Cancer Center

Locations

Hunter Holmes McGuire VA Medical Center

Richmond, Virginia, United States

Massey Cancer Center, Virginia Commonwealth University

Richmond, Virginia, United States

Countries

United States

Related Links

http://www.massey.vcu.edu/

Massey Cancer Center

Other Identifiers

NCI-2011-02734

Identifier Type: REGISTRY

Identifier Source: secondary_id

MCC-13711

Identifier Type: -

Identifier Source: org_study_id