Intrathecal Trastuzumab for Leptomeningeal Metastases in HER2+ Breast Cancer

Completed · Phase 1/Phase 2

Conditions studied: Breast Cancer

In brief

The drug being studied is Trastuzumab, a medicine that is used to slow or stop the growth of cancerous tumors that are HER-2 positive. Patients are being asked to participate in this study because they have been diagnosed with having tumor cells in their spinal fluid. This study will investigate the safety and effects of this drug when given directly into the spinal fluid. Phase I/II Dose Escalation Trial to Assess Safety of Intrathecal Trastuzumab for the Treatment of Leptomeningeal Metastases in HER2 Positive Breast Cancer The purpose of this research study is to determine a safe dose of the drug Trastuzumab and then determine how effective this treatment is.

Key facts

Study ID

NCT01325207

Run by

Northwestern University

People needed

34

Starts

2011-08-01

Expected to finish

2019-01-20

Last updated by the study team

2019-09-26

Who can join

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

You may qualify if…

• ELIGIBILITY CRITERIA
• HER2 positive (IHC 3+ and/or FISH positive) breast cancer patients with leptomeningeal metastases by MRI or CSF (if MRI is negative).
• o Review will be performed for cases not reviewed at Northwestern for confirmation, but will not preclude patients from entering the trial (pathology report is sufficient for registration).
• Patients can have concomitant brain metastases as long as they do not require active treatment or have been treated.
• Patients with leptomeningeal disease from ependymomas, gliomas, and medulloblastoma will be eligible for phase I
• Life expectancy > 8 weeks
• Normal renal (creatinine < 1.5 ULN), liver (bilirubin < 1.5 x ULN, transaminases < 3.0 x ULN, except in known hepatic metastasis, wherein may be < 5 x ULN) and blood counts (WBC > 3.0, Neutrophils > 1500, platelets >100 000, Hemoglobin > 10).
• LVEF > 50%
• KPS > 50
• Age > 18 years
• Cannot be on systemic agents (chemotherapy) that have CNS penetration unless they develop leptomeningeal metastases while on these agent(s) and have controlled systemic disease. May continue on IV trastuzumab, lapatinib or hormonal agents if controlling systemic disease and developed LM while on therapy. Patients requiring systemic chemotherapy are eligible but will not be able to start treatment until after the first assessment by imaging and cytology.
• Patients may need a CSF flow study at the discretion of the treating principal investigator. If a spinal block is seen by CSF flow study or MRI, it will need local RT prior to treatment. Concurrent radiation is not allowed.
• Patients should be > 2 weeks from RT treatment and all effects of treatment should have resolved
• No limit on prior systemic or IT therapies.
• CSF sampling to document LM if not documented on MRI.
• Must be willing to have an Ommaya reservoir placed.
• NO history of any other cancer (except non-melanoma skin cancer or carcinoma in-situ of the cervix) unless in complete remission and off all therapy for the disease for a minimum of 3 years.
• Significant medical or psychiatric illness that would interfere with compliance and ability to tolerate treatment as outlined in the protocol.
• Women of childbearing potential and sexually active males must commit to the use of effective contraception while on study.
• Women may not be pregnant or breast-feeding.
• Ability to sign an informed consent; can be signed by family member or health care proxy. Informed consent must be done prior to registration on study.
• All patients must have given signed, informed consent prior to registration on study.
• No known hypersensitivity to trial medications Note: The eligibility criteria listed above are interpreted literally and cannot be waived.

You may not qualify if…

• Any deviations from the inclusion criteria

Where it is running

• University of California San Francisco (UCSF) — San Francisco, California, United States
• Northwestern University — Chicago, Illinois, United States
• Tufts Medical Center — Boston, Massachusetts, United States
• Dana Farber Cancer Institute — Boston, Massachusetts, United States
• Columbia University — New York, New York, United States
• Memorial Sloan-Kettering Cancer Center — New York, New York, United States
• Rhode Island Hospital — Providence, Rhode Island, United States
• Texas Oncology-Austin — Austin, Texas, United States

Full record on ClinicalTrials.gov

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