LBH589 in Combination With Capecitabine Plus/Minus (±) Lapatinib in Breast Cancer Patients

Completed · Phase 1

Conditions studied: Breast Cancer

In brief

This single center Phase I dose escalation trial will evaluate the safety, tolerability and efficacy of LBH589 when combined with capecitabine and lapatinib in three parts. Part 1 will determine the maximum tolerated doses (MTD) of LBH589 when combined with capecitabine. Parts 2 and 3 will be limited to locally recurrent or metastatic breast cancer patients, ICH 3+ overexpression or FISH amplification documented locally. Part 2 will evaluate the safety of the MTD of LBH589 determined in Part 1 when paired with lapatinib 1000 mg by mouth (PO) daily. Parts 2 and 3 will be limited to locally recurrent or metastatic breast cancer patients, ICH 3+ overexpression or FISH amplification documented locally. Part 3 will evaluate the tolerability and effectiveness of the triplet combination, LBH589, capecitabine and lapatinib in breast cancer patients.

Key facts

Study ID

NCT00632489

Run by

SCRI Development Innovations, LLC

People needed

20

Starts

2008-05-01

Expected to finish

2011-07-01

Last updated by the study team

2015-06-08

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Histologically documented metastatic or locally unresectable, incurable malignancy for which capecitabine is clinically appropriate.
• Male or female patients aged ≥ 18 years old.
• Maximum of 3 prior regimens in a metastatic setting allowed and may include other targeted agents, immunotherapy and chemotherapy.
• Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) criteria.
• Eastern Cooperative Oncology Group performance status (ECOG PS) 0 or 1.
• Baseline MUGA or ECHO must demonstrate LVEF > than the lower limits of the institutional normal.
• Laboratory values as follows:
• ANC > 1500/μL
• Hgb > 9 g/dL
• Platelets > 100,000/uL
• Bilirubin < 1.5 mg/dL
• AST/SGOT < 2.5 x ULN or < 5.0 x ULN and ALT/SGPT in patients with liver metastases
• Creatinine < 1.5 mg/dL or calculated creatinine clearance > 50 ml/min
• Albumin > 3 g/dL
• Potassium > lower limit of normal (LLN)
• Phosphorous > LLN
• Calcium > LLN
• Magnesium > LLN
• Women of childbearing potential must have a negative serum or urine pregnancy test performed within 7 days prior to start of treatment and must commit to begin two acceptable methods of birth control, one highly effective method of birth control and one additional effective method at the same time before starting treatment.
• Life expectancy > 12 weeks.
• Accessible for treatment and follow-up.
• All patients must be able to understand the nature of the study and give written informed consent prior to study entry.
• Additional Breast Cancer Patient Subset (Part 2 and Part 3) Inclusion Criteria:
• Incurable carcinoma of the breast, with measurable locally recurrent or metastatic disease.
• ICH 3+ overexpression or FISH amplification documented by a local laboratory in primary or metastatic tumor tissue.

You may not qualify if…

• Prior treatment with an HDAC inhibitor or current treatment with valproic acid.
• Previous treatment with capecitabine.
• Impaired cardiac function including any of the following:
• Screening ECG with a QTc > 450 msec.
• Congenital long QT syndrome.
• History of sustained ventricular tachycardia.
• Any history of ventricular fibrillation or torsades de pointes.
• Bradycardia defined as heart rate < 50 beats per minute. Patients with a pacemaker and heart rate > 50 beats per minute are eligible.
• Myocardial infarction or unstable angina within 6 months of study entry.
• Congestive heart failure (NY Heart Association class III or IV).
• Right bundle branch block and left anterior hemiblock (bifascicular block).
• Atrial fibrillation or flutter.
• Ongoing therapy with antiarrhythmics or other medications associated with QTc prolongation.
• Uncorrected hypokalemia or hypomagnesaemia.
• Uncontrolled hypertension (systolic blood pressure [BP] 180 or diastolic BP > 100 mm Hg) or uncontrolled cardiac arrhythmias.
• Active CNS disease, including meningeal metastases.
• Known diagnosis of human immunodeficiency virus (HIV) infection.
• Unresolved diarrhea > CTCAE grade 1.
• Concomitant requirement for medication classified as CYP3A4 inducers or inhibitors.
• Patients with a history of allergic reactions attributed to compounds of similar chemical or biologic composition to lapatinib.
• Patients with known hypersensitivity to 5-fluorouracil chemotherapy, investigational drug therapy, major surgery < 4 weeks prior to starting study drug or patients that have not recovered from side effects of previous therapy.
• Patient is < 5 years free of another primary malignancy except if the other primary malignancy is not currently clinically significant or requiring active intervention, or if other primary malignancy is a basal cell skin cancer or a cervical carcinoma in situ. Existence of any other malignant disease is not allowed.
• Concomitant use of any anti-cancer therapy or radiation therapy.
• Pregnant or breast feeding or female of reproductive potential not using two effective methods of birth control.
• Male patients whose sexual partners are women of childbearing potential not using effective birth control.

Where it is running

• Tennessee Oncology, PLLC — Nashville, Tennessee, United States

Full record on ClinicalTrials.gov

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