Capecitabine and Lapatinib Ditosylate With or Without Cixutumumab in Treating Patients With Previously Treated HER2-Positive Stage IIIB-IV Breast Cancer

Completed · Phase 2

Conditions studied: HER2 Positive Breast Carcinoma, Recurrent Breast Carcinoma, Stage IIIB Breast Cancer AJCC v7, Stage IIIC Breast Cancer AJCC v7, Stage IV Breast Cancer AJCC v6 and v7

In brief

This phase II trial studies capecitabine and lapatinib ditosylate to see how well they work compared with capecitabine, lapatinib ditosylate, and cixutumumab in treating patients with previously treated HER2-positive stage IIIB-IV breast cancer. Drugs used in chemotherapy, such as capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Lapatinib ditosylate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Immunotherapy with cixutumumab, may induce changes in body's immune system and may interfere with the ability of tumor cells to grow and spread. It is not yet known whether capecitabine and lapatinib ditosylate are more effective when given with or without cixutumumab in treating breast cancer that has spread nearby or to other areas of the body.

Key facts

Study ID

NCT00684983

Run by

National Cancer Institute (NCI)

People needed

64

Starts

2008-07-30

Expected to finish

2019-10-15

Last updated by the study team

2020-03-24

Who can join

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

You may qualify if…

• Histologically confirmed, locally advanced: (a T4 primary tumor and stage IIIB or IIIC disease) or metastatic breast cancer that has progressed after treatment with regimens that included trastuzumab and either an anthracycline or a taxane or both
• NOTE: Agents need not have been given concurrently, nor in the same regimen
• NOTE: Prior treatment with trastuzumab is required unless there is a contraindication for trastuzumab treatment
• Pre-treatment requirements:
• Prior treatment with trastuzumab in the neo-adjuvant, adjuvant or metastatic setting is required
• NOTE: Prior treatment with trastuzumab is required unless there is a contraindication for trastuzumab treatment
• NOTE: Concomitant use of trastuzumab is not allowed in this study
• Prior chemotherapy allowed in the neo-adjuvant, adjuvant, or metastatic setting; unlimited prior chemotherapy is allowed
• Prior hormonal therapy allowed in the neo-adjuvant, adjuvant, or metastatic setting; unlimited prior hormonal therapy is allowed
• HER2 positive, defined as:
• Validated immunohistochemistry (IHC) assay score of 3+ (defined as uniform, intense staining of > 30% of invasive tumor cells)
• -OR- Average HER2 gene copy number of > 6
• -OR- Gene amplified (HER2:D17Z1 ratio > 2.20)
• Must have measurable disease according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria
• Negative pregnancy test done =< 7 days prior to registration, for women of childbearing potential only
• Hemoglobin > 9.0 g/dL (obtained =< 7 days prior to registration)
• White blood cells (WBC) >= 3,000/mL (obtained =< 7 days prior to registration)
• Absolute neutrophil count (ANC) >= 1500/mL (obtained =< 7 days prior to registration)
• Platelet count >= 75,000/mL (obtained =< 7 days prior to registration)
• Total bilirubin =< 1.5 x upper limit of normal (ULN) (obtained =< 7 days prior to registration)
• Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) and serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) =< 2.5 x ULN or SGOT (AST) and SGPT (ALT) =< 5 x ULN if elevations are due to liver metastases (obtained =< 7 days prior to registration)
• Serum creatinine =< 1.5 x ULN (obtained =< 7 days prior to registration)
• Creatinine clearance >= 30 mL/min (calculated according to Cockcroft and Gault) (obtained =< 7 days prior to registration)
• NOTE: In patients with moderate renal impairment (calculated creatinine clearance 30-50 mL/min) at baseline, a dose reduction of the capecitabine starting dose is required
• Fasting glucose < 120 mg/dL (obtained =< 7 days prior to registration)

You may not qualify if…

• Any of the following because this study involves an investigational agent whose genotoxic, mutagenic and teratogenic effects on the developing fetus and newborn are unknown:
• Pregnant women
• Nursing women
• Men or women of childbearing potential who are unwilling to employ adequate contraception (as determined by the treating physician)
• Stage III or IV invasive cancer, other than breast cancer, in =< 5 years prior to registration
• Actively being treated for other malignancy, excepting non-melanotic skin cancer or carcinoma-in-situ of the cervix; if there is a history of prior malignancy, patient must not be receiving other specific treatment for their cancer
• New York Heart Association class III or IV cardiovascular disease
• Current, active hepatic or biliary disease except Gilbert's syndrome or asymptomatic gallstones
• Evidence of active brain metastasis including leptomeningeal involvement; central nervous system (CNS) metastasis controlled by prior surgery and/or radiotherapy is allowed
• NOTE: To be considered controlled, there must be at least 2 months of no symptoms or evidence of progression prior to study entry and corticosteroid therapy must have been discontinued
• Major surgery, chemotherapy, or immunologic therapy =< 4 weeks prior to registration
• Radiotherapy =< 4 weeks prior to registration, except if to a non-target lesion only; prior radiation to a target lesion is permitted only if there has been clear progression of the lesion since radiation was completed; if patient receives single dose radiation for palliation or radiation to non-target lesion, they may immediately proceed to registration without waiting; acute adverse events from radiation must have resolved to =< Common Terminology Criteria for Adverse Events (CTCAE) version (v) 3.0 grade 1
• Prior treatment with any therapy targeting IGF-I, IGF-II or its receptors (either monoclonal antibody or tyrosine kinase inhibitor), including but not limited to any of the following (which would have been received on a previous clinical trial):
• IMC-A12 (cixutumumab)
• CP-751,871 (figitumumab)
• AMG-479
• INSM-18
• MK0646 (h7C10)
• SCH717454 (19D12, robatumumab)
• R1507
• OSI-906
• BMS-754807
• PPP
• NVP-AEW541
• AVE-1642

Where it is running

• Mayo Clinic in Arizona — Scottsdale, Arizona, United States
• Alta Bates Summit Medical Center-Herrick Campus — Berkeley, California, United States
• Mills-Peninsula Medical Center — Burlingame, California, United States
• East Bay Radiation Oncology Center — Castro Valley, California, United States
• Eden Hospital Medical Center — Castro Valley, California, United States
• Valley Medical Oncology Consultants-Castro Valley — Castro Valley, California, United States
• Bay Area Breast Surgeons Inc — Emeryville, California, United States
• Valley Medical Oncology Consultants-Fremont — Fremont, California, United States
• Glendale Memorial Hospital and Health Center — Glendale, California, United States
• Contra Costa Regional Medical Center — Martinez, California, United States
• El Camino Hospital — Mountain View, California, United States
• Palo Alto Medical Foundation-Camino Division — Mountain View, California, United States
• Sutter Cancer Research Consortium — Novato, California, United States
• Highland General Hospital — Oakland, California, United States
• Alta Bates Summit Medical Center - Summit Campus — Oakland, California, United States
• Bay Area Tumor Institute — Oakland, California, United States
• Hematology and Oncology Associates-Oakland — Oakland, California, United States
• Tom K Lee Inc — Oakland, California, United States
• Desert Regional Medical Center — Palm Springs, California, United States
• Palo Alto Medical Foundation Health Care — Palo Alto, California, United States
• Valley Care Health System - Pleasanton — Pleasanton, California, United States
• Valley Medical Oncology Consultants — Pleasanton, California, United States
• Salinas Valley Memorial — Salinas, California, United States
• California Pacific Medical Center-Pacific Campus — San Francisco, California, United States
• Providence Hospital — Mobile, Alabama, United States

Full record on ClinicalTrials.gov

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