Breast Cancer Clinical Trial
Lapatinib and Paclitaxel in Treating Patients With Advanced Solid Tumors
Summary
RATIONALE: Drugs used in chemotherapy, such as paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Lapatinib may help paclitaxel work better by making tumor cells more sensitive to the drug. Lapatinib may also stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving lapatinib together with paclitaxel may kill more tumor cells.
PURPOSE: This phase I trial is studying the side effects and best dose of lapatinib when given together with paclitaxel in treating patients with advanced solid tumors.
Full Description
OBJECTIVES:
Primary
Determine the maximum tolerated dose (MTD) of a 2-day pulse of lapatinib that can be given prior to paclitaxel (albumin-stabilized nanoparticle formulation ) (ABI-007; Abraxaneâ„¢) in patients with advanced solid tumor malignancies.
Secondary
Define the toxicity of this regimen.
Determine, preliminarily, the antitumor efficacy and safety of ABI-007 when preceded by a 2-day pulse of lapatinib.
Characterize the potential of the molecular markers within circulating tumor cells as markers of response (e.g., HER2 and AKT) or apoptotic markers.
Determine whether lapatinib given at MTD prior to ABI-007 alters the pharmacokinetic properties of the paclitaxel component of ABI-007.
OUTLINE: This is a does-escalation study of lapatinib. Patients are stratified according to dose level.
Patients receive oral lapatinib on days 1, 2, 8, 9, 15, and 16 and paclitaxel (albumin-stabilized nanoparticle formulation) (ABI-007; Abraxaneâ„¢) IV over 30 minutes on days 3, 10, and 17. Treatment repeats every 4 weeks in the absence of disease progression or unacceptable toxicity.
Cohorts of 1-6 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 6 patients experience dose-limiting toxicities.
PROJECTED ACCRUAL: A total of 15 patients will be accrued for this study.
Eligibility Criteria
DISEASE CHARACTERISTICS:
Histologically confirmed solid tumor, including the following tumor types:
Breast cancer
Non-small cell lung cancer
Prostate cancer
Bladder cancer
Gastroesophageal junction cancer
Ovarian cancer
Germ cell tumor
Advanced or metastatic disease
No effective curative therapy exists
Evaluable disease
Measurable disease not required
Bone-only disease allowed
No progressing brain metastases
PATIENT CHARACTERISTICS:
ECOG performance status 0-2
Life expectancy > 3 months
Absolute neutrophil count ≥ 1,500/mm^3
Hemoglobin ≥ 9.0 g/dL
Platelet count ≥ 100,000/mm^3
Bilirubin normal
AST/ALT ≤ 2.5 times upper limit of normal
Creatinine normal
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No serious intercurrent medical or psychiatric illness
No serious active infection
No gastrointestinal tract disease that would impair a patient's ability to take oral medication
No history of significant cardiac disease, including any of the following:
Congestive heart failure
Symptomatic cardiac arrhythmias
Unstable angina
No pre-existing peripheral neuropathy ≥ 2
PRIOR CONCURRENT THERAPY:
Any number of prior therapies allowed
Prior paclitaxel, tyrosine kinase inhibitor therapy, or endothelial growth factor inhibitors allowed
At least 14 days since prior and no concurrent CYP3A4 inducers or herbal or dietary supplements
At least 7 days since prior and no concurrent CYP3A4 inhibitors
At least 6 months since prior and no concurrent amiodarone
More than 1 month since prior chemotherapy, radiotherapy, hormonal therapy, or investigational anticancer agents
Concurrent continued use of gonadal suppression agents (i.e., goserelin acetate or leuprolide acetate) allowed
No antacids 1 hour before and after study drug administration
No concurrent retinoids
No concurrent hormonal anticancer agent
No other concurrent anticancer chemotherapy or investigational anticancer agents
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There is 1 Location for this study
San Francisco California, 94115, United States
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