Know Cancer

or
forgot password

A Phase II Trial of Endocrine Therapy in Combination With OSI-906 (an IGF-1R Inhibitor) With or Without Erlotinib (Tarceva, an EGFR Inhibitor) in Patients With Hormone-sensitive Metastatic Breast Cancer.


Phase 2
18 Years
N/A
Not Enrolling
Both
Breast Cancer

Thank you

Trial Information

A Phase II Trial of Endocrine Therapy in Combination With OSI-906 (an IGF-1R Inhibitor) With or Without Erlotinib (Tarceva, an EGFR Inhibitor) in Patients With Hormone-sensitive Metastatic Breast Cancer.


OBJECTIVES:

Primary

- To determine the antitumor activity of letrozole +/- goserelin (the latter for
pre-menopausal women only) in combination with IGF-1R inhibitor OSI-906 with or without
erlotinib hydrochloride, measured by time to progression, in patients with
hormone-sensitive metastatic breast cancer.

Secondary

- To determine the safety of these regimens in these patients.

- To determine the response rate in patients treated with these regimens.

- To measure circulating C-peptide, IGF-1, and IGFBP-3 levels in patients treated with
these regimens.

- To correlate the expression of IGF-IR, EGFR, HER2, Y1316 and Y1131 pIGF-1R, PTEN, S473
pAkt, pMAPK, S118 (MAPK site), and S167 (Akt and S6 site) pER in formalin-fixed
paraffin blocks (FFPB) with clinical outcome and luminal A vs. luminal B subtypes of
breast cancer.

- To correlate the mutational status of PI3K (E542K, E545K, H1047R) in DNA extracted from
FFPB or fresh biopsy with clinical outcome and luminal A vs. luminal B subtypes of
breast cancer

OUTLINE: This is a multicenter study. Stratification will be based on previous exposure to
endocrine therapy: (Arm I) no previous endocrine therapy or have completed adjuvant therapy
> 6 months prior to study enrollment; (Arm II) patients that had previous endocrine therapy
in the metastatic setting or had metastatic recurrence within 6 months of adjuvant endocrine
therapy.

- Arm I: Patients receive oral letrozole once daily on days 1-28 +/- subcutaneous
goserelin* on day 1 and oral IGF-1R inhibitor OSI-906 twice daily on days 1-28.
Treatment repeats every 28 days in the absence of disease progression or unacceptable
toxicity.

- Arm II: Patients receive oral letrozole +/- subcutaneous goserelin* and IGF-1R
inhibitor OSI-906 as in arm I. Patients also receive oral erlotinib hydrochloride once
daily on days 1-28. Treatment repeats every 28 days in the absence of disease
progression or unacceptable toxicity.

NOTE: *Goserelin will only be given to premenopausal patients.

Tumor tissue samples from original diagnosis or from fresh biopsy tissue are collected for
biomarker analysis and other studies.

After completion of study therapy, patients are followed periodically.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed invasive breast carcinoma

- Stage IV disease

- No locally recurrent resectable disease

- No symptomatic brain metastases

- History of brain metastases allowed provided the patient is clinically stable
for > 3 weeks after completion of radiotherapy AND is not taking steroids or
therapeutic anticonvulsants that are CYP3A4 modifiers

- Hormone receptor status:

- Estrogen receptor and/or progesterone receptor positive tumor by
immunohistochemistry (IHC)

PATIENT CHARACTERISTICS:

- Pre- or post-menopausal

- ECOG performance status 0-1

- Life expectancy ≥ 6 months

- ANC ≥ 1,250/mm^3

- Platelet count ≥ 100,000/mm^3

- Creatinine ≤ 1.5 times upper limit of normal (ULN)

- Bilirubin ≤ 1.5 times ULN (≤ 3 times ULN if liver metastasis is present)

- For patients with Gilbert syndrome, direct bilirubin will be measured instead of
total bilirubin

- SGOT and SGPT ≤ 1.5 times ULN (≤ 3 times ULN if liver metastasis is present)

- Alkaline phosphatase ≤ 1.5 times ULN (≤ 3 times ULN if liver metastasis is present)

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective barrier contraception during and for 3 months
after completion of study therapy

- Able to swallow and retain oral medication

- Baseline QTc ≤ 450 msec

- No other invasive cancer within the past 5 years except for completely resected basal
cell or squamous cell skin cancer or successfully treated cervical carcinoma in situ

- No malabsorption syndrome significantly affecting gastrointestinal function

- No diabetes, fasting glucose > 150mg/dL, or receiving ongoing anti-hyperglycemic
therapies

- No concurrent uncontrolled illness including, but not limited to, any of the
following:

- Ongoing or active infection requiring parenteral antibiotics

- Impaired lung function (i.e., COPD or lung conditions requiring oxygen therapy)

- Symptomatic congestive heart failure (NYHA class III or IV heart disease)

- Unstable angina pectoris, angioplasty, stenting, or myocardial infarction within
the past 6 months

- Uncontrolled hypertension, defined as systolic BP > 180 mm Hg or diastolic BP >
100 mm Hg on two consecutive measurements taken ≥ 1 week apart, despite adequate
medical support

- Clinically significant cardiac arrhythmia (multifocal premature ventricular
contractions, bigeminy, trigeminy, or ventricular tachycardia that is
symptomatic or requires treatment)

- Psychiatric illness and/or social situation that would compromise patient safety
or limit compliance with study requirements, including maintenance of a
compliance/pill diary

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- Recovered from prior therapy

- At least 2 weeks since prior investigational drugs

- No more than 4 prior chemotherapy treatments in the metastatic setting

- Does not include endocrine therapy or single-agent biologic therapy

- No concurrent CYP3A4 or CYP1A2 modifiers

- No other concurrent anticancer therapy, including chemotherapy, radiotherapy,
surgery, immunotherapy, hormonal therapy, or biologic therapy

- Concurrent radiotherapy to painful bone metastases or areas of impeding bone
fracture allowed provided radiotherapy is initiated before study therapy

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Time to progression

Outcome Description:

Duration from study enrollment to date of progressive disease (PD) as measured by Response Evaluation in Solid Tumors (RECIST) criteria v. 1.1: measurable lesions: PD is > 20% increase in the sum of the longest diameter of target lesions or appearance of new lesions

Outcome Time Frame:

from study entry to date of progressive disease

Safety Issue:

No

Principal Investigator

Ingrid Mayer, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Vanderbilt-Ingram Cancer Center

Authority:

United States: Vanderbilt University Human Research Protection Program

Study ID:

VICC BRE 0977

NCT ID:

NCT01013506

Start Date:

August 2009

Completion Date:

December 2009

Related Keywords:

  • Breast Cancer
  • estrogen receptor-positive breast cancer
  • progesterone receptor-positive breast cancer
  • stage IV breast cancer
  • recurrent breast cancer
  • Breast Neoplasms

Name

Location