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Trastuzumab and Gefitinib in Treating Patients With Metastatic Breast Cancer



Trastuzumab and Gefitinib in Treating Patients With Metastatic Breast Cancer

For Condition: stage 4 breast cancer,recurrent breast cancer,Male Breast Cancer
Status: Recruiting
Sponsor(s): Eastern Cooperative Oncology Group , National Cancer Institute (NCI)
Synopsis: RATIONALE: The monoclonal antibodytrastuzumab can locate breast cancer cells that have HER2 on their surface and either kill them or deliver tumor-killing substances to them without harming normal cells. Biological therapies such as gefitinib may also interfere with the growth of tumor cells and may enhance the effects of trastuzumab. Combining trastuzumab with gefitinib may be an effective treatment for metastatic breast cancers with high amounts of HER2. PURPOSE: Phase II trial to study the effectiveness of combining trastuzumab with gefitinib in treating patients who have HER2-positive breast cancer.
Details: OBJECTIVES: - Determine the response rate, duration of response, and time to progression in patients with metastatic breast cancer that overexpresses HER2-neu treated with trastuzumab (Herceptin) and gefitinib . - Determine the phase II dose of gefitinib when given in combination with trastuzumab in these patients. - Determine the toxicity of this regimen in these patients. - Determine the 3- and 6-month progression-free survival of patients treated with this regimen. - Correlate response rates with plasma levels of circulating HER2 and tumor levels of epidermal growth factor receptor, activated HER2, and HER2 receptors, as measured by immunohistochemistry and/or fluorescent in situ hybridization (FISH), in patients treated with this regimen. OUTLINE: This is a multicenter, dose-escalation study of gefitinib. The phase I portion of this study was open in only 5 ECOG institutions. The phase I portion has been completed, and the study is being opened in all ECOG-affiliated institutions. - Patients receive trastuzumab (Herceptin) IV over 30-90 minutes once weekly and oral gefitinib once daily beginning on day 1. Cohorts of 3-6 patients receive escalating doses of gefitinib 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. Once the MTD is established, additional patients are accrued to the phase II portion of the study and are treated at that dose. - Phase II: Patients receive oral gefitinib once daily (at the MTD established in phase I) and trastuzumab IV weekly until week 24, at which time trastuzumab is given every 3 weeks (with daily gefitinib) until disease progression or unacceptable toxicity. Patients are followed every 3 months for 2 years and then every 6 months for 1 year. PROJECTED ACCRUAL: A total of 3-12 patients will be accrued for the phase I portion of this study. The phase I portion of this study has been completed. A total of 34-132 patients (15-46 previously treated with chemotherapy but not trastuzumab [Herceptin] in the metastatic setting; 19-86 not previously treated with chemotherapy or trastuzumab in the metastatic setting) will be accrued for the phase II portion of this study.
Eligibility:
Study Type:
  Interventional, Treatment
Minimum Age/Maximum Age: 18 Years/
Genders: Both
Protocol Entry Criteria: DISEASE CHARACTERISTICS: - Histologically confirmed metastatic adenocarcinoma of the breast - Patients may have had or not had standard first-line chemotherapy for the treatment of metastatic disease - Overexpression of HER2-neu (HER2 3+ by immunohistochemistry or gene amplification as measured by fluorescent in situ hybridization) - Measurable disease - Patients with no prior adjuvant chemotherapy may have failed or not failed first-line chemotherapy for metastatic disease - No more than 2 prior systemic chemotherapy regimens for metastatic disease - Relapse while receiving or within 6 months of completion of adjuvant chemotherapy is considered failure of 1 regimen for metastatic disease - No untreated brain metastases or brain metastases undergoing radiotherapy - Previously treated brain metastasis that has responded to radiotherapy and/or surgery allowed if not sole site of measurable disease - Hormone receptor status: - Not specified PATIENT CHARACTERISTICS: Age: - 18 and over Sex: - Male or female Menopausal status: - Not specified Performance status: - ECOG 0-2 Life expectancy: - Not specified Hematopoietic: - Granulocyte count at least 1,500/mm^3 - Platelet count at least 100,000/mm^3 Hepatic: - Bilirubin no greater than 1.5 times upper limit of normal (ULN) - AST and ALT no greater than 3 times ULN (5 times ULN if liver metastases is present) - INR no greater than 1.5 times ULN - PT and PTT no greater than 1.5 times ULN Renal: - Creatinine no greater than 1.5 mg/dL - No more than trace blood or protein in urine Cardiovascular: - LVEF at least 50% by MUGA scan - No prior New York Heart Association class I-IV heart disease - No PR prolongation or atrioventricular block on ECG Other: - Not pregnant or nursing - Negative pregnancy test - Fertile patients must use effective contraception (preferably nonhormonal) - Random blood sugar less than 2.5 times ULN - No other malignancy within the past 5 years except curatively treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix - No other acute or chronic medical or psychiatric condition or laboratory abnormality that would preclude study participation PRIOR CONCURRENT THERAPY: Biologic therapy: - No prior trastuzumab (Herceptin) - No other concurrent immunologic therapy Chemotherapy: - See Disease Characteristics - No prior cumulative dose of doxorubicin more than 360 mg/m^2 - No concurrent chemotherapy Endocrine therapy: - At least 2 weeks since prior hormonal therapy - No concurrent hormonal therapy, including tamoxifen - No concurrent dexamethasone, progesterone, or glucocorticoids Radiotherapy: - See Disease Characteristics - At least 2 weeks since prior radiotherapy - No prior radiotherapy to target lesions or only site of measurable disease - No concurrent radiotherapy Surgery: - See Disease Characteristics - No prior organ allograft Other: - No prior gefitinib - No prior immunosuppressive therapy - At least 2 weeks since prior cytotoxic drugs - No concurrent carbamazepine, ethosuximide, griseofulvin, nafcillin, nelfinavir mesylate, nevirapine, oxcarbazepine, phenobarbital, phenylbutazone, phenytoin, primidone, rifabutin, rifampin, rofecoxib, Hypericum perforatum (St. John's Wort), sulfadimidine, sulfinpyrazone, or troglitazone - No other concurrent investigational agents - No concurrent topical eye agents - Concurrent bisphosphonates allowed for hypercalcemia and/or prophylaxis of bone metastases
Total Enrollment: 

Location and Contact Information:

Overall Study Official:
CarlosArteaga,  Study Chair,  Vanderbilt-Ingram Cancer Center

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins *Recruiting*
Baltimore,  Maryland,  21231
United States
Recruiting Antonio  Wolff 410-614-4192

Instituto de Enfermedades Neoplasicas *Recruiting*
Lima,  ,  34
Peru
Recruiting Carlos  Vallejos-Sologuren 51-14-499-137

CCOP - Oklahoma *Recruiting*
Tulsa,  Oklahoma,  74136
United States
Recruiting James  Lockhart 918-491-5878

H. Lee Moffitt Cancer Center and Research Institute *Recruiting*
Tampa,  Florida,  33612-9497
United States
Recruiting Cancer  Answers 800-456-7121

Tufts - New England Medical Center *Recruiting*
Boston,  Massachusetts,  02111
United States
Recruiting John  Erban 617-636-5147

CCOP - MainLine Health *Recruiting*
Wynnewood,  Pennsylvania,  19096
United States
Recruiting Paul  Gilman 610-645-2057

Albert Einstein Clinical Cancer Center *Recruiting*
Bronx,  New York,  10461
United States
Recruiting Joseph  Sparano 718-904-2555

CCOP - Scott and White Hospital *Recruiting*
Temple,  Texas,  76508
United States
Recruiting Lucas  Wong 254-724-7048

Vanderbilt-Ingram Cancer Center at Vanderbilt Medical Center *Recruiting*
Nashville,  Tennessee,  37232-6307
United States
Recruiting David  Johnson 615-343-9454

Fox Chase Cancer Center *Recruiting*
Philadelphia,  Pennsylvania,  19111-2497
United States
Recruiting Lori  Goldstein 215-728-2689

CCOP - Duluth *Recruiting*
Duluth,  Minnesota,  55805
United States
Recruiting Robert  Dalton 218-786-8364

NYU School of Medicine's Kaplan Comprehensive Cancer Center *Recruiting*
New York City,  New York,  10016
United States
Recruiting Howard  Hochster 212-652-1912

University of Alabama at Birmingham Comprehensive Cancer Center *Recruiting*
Birmingham,  Alabama,  35294-3300
United States
Recruiting Carla  Falkson 205-975-2691

CCOP - Metro-Minnesota *Recruiting*
St. Louis Park,  Minnesota,  55416
United States
Recruiting Patrick  Flynn 952-993-15175

MBCCOP-Our Lady of Mercy Cancer Center *Recruiting*
Bronx,  New York,  10466
United States
Recruiting Peter  Wiernik 718-920-1100

Indiana University Cancer Center *Recruiting*
Indianapolis,  Indiana,  46202-5289
United States
Recruiting Patrick  Loehrer 317-278-7418

MBCCOP - LSU Health Sciences Center *Recruiting*
New Orleans,  Louisiana,  70112
United States
Recruiting Jill  Gilbert 504-568-5136

CCOP - St. Vincent Hospital Cancer Center, Green Bay *Recruiting*
Green Bay,  Wisconsin,  54307-3453
United States
Recruiting Gerald  Bayer 920-433-8889

CCOP - Evanston *Recruiting*
Evanston,  Illinois,  60201
United States
Recruiting Gershon  Locker 847-570-2518

CCOP - Northern Indiana CR Consortium *Recruiting*
South Bend,  Indiana,  46601
United States
Recruiting Rafat  Ansari 574-284-7977

CCOP - Kalamazoo *Recruiting*
Kalamazoo,  Michigan,  49007-3731
United States
Recruiting Raymond  Lord 269-373-7488

CCOP - Carle Cancer Center *Recruiting*
Urbana,  Illinois,  61801
United States
Recruiting Kendrith  Rowland 217-383-4083

CCOP - Geisinger Clinic and Medical Center *Recruiting*
Danville,  Pennsylvania,  17822-2001
United States
Recruiting Suresh  Nair 570-271-6413

University of Wisconsin Comprehensive Cancer Center *Recruiting*
Madison,  Wisconsin,  53792-0001
United States
Recruiting James  Stewart 608-265-8131

CCOP - Ochsner *Recruiting*
New Orleans,  Louisiana,  70121
United States
Recruiting Carl  Kardinal 504-842-3910


Additional Information:
Study ID Numbers:
  CDR0000068896;  ECOG-1100
Study Start Date: 
Record last reviewed: June 2003
Additional information available at: clinicaltrials.gov
Clinicaltrials.gov Reference link: NCT00024154

Other Stage 4 Breast Cancer Studies:
1. Trastuzumab and Exemestane in Treating Postmenopausal Women With Metastatic or Locally Advanced Breast Cancer

2. Combination Chemotherapy With or Without Trastuzumab in Treating Women With Metastatic Breast Cancer

3. Vaccine Therapy in Treating Women With Metastatic Breast Cancer

4. Radiation Therapy in Treating Patients With Bone Metastases From Breast or Prostate Cancer

5. Diagnostic Procedures in Women With Locally Advanced Breast Cancer Who Are Receiving Chemotherapy Before Breast Cancer Surgery

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