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A Phase 1 Trial of Lapatinib in Combination With 1) Sirolimus or 2) Metformin in Advanced Cancer


Phase 1
N/A
N/A
Open (Enrolling)
Both
Advanced Cancers

Thank you

Trial Information

A Phase 1 Trial of Lapatinib in Combination With 1) Sirolimus or 2) Metformin in Advanced Cancer


The Study Drugs:

Lapatinib is designed to prevent or slow down the growth of cancer cells by blocking 2
proteins on the surface of the cancer cell, which are HER 1 and HER 2 receptors.

Sirolimus is designed to block a protein called mTOR (a protein that is thought to cause
cancer cells to grow) inside the cancer cell. This may interfere with the growth or spread
of cancer cells or possibly kill the cancer cells.

Metformin was designed to treat patients with diabetes. It may be able to block mTOR and
slow the growth of tumors.

Study Drug Groups:

If you are found to be eligible to take part in this study, your doctor will decide if you
will receive lapatinib with metformin or lapatinib with sirolimus. Once it is decided which
combination you will receive, you will be assigned to a dose level based on when you join
the study.

Up to 7 dose levels of lapatinib with sirolimus will be tested. Up to 6 dose levels of
lapatinib with metformin will be tested. Three (3) to 6 participants will be enrolled at
each dose level. The first group of participants will receive the lowest dose level. Each
new group will receive a higher dose than the group before it, if no intolerable side
effects were seen. This will continue until the highest tolerable dose of the combination
of lapatinib with either sirolimus or metformin is found.

Once the highest tolerated dose of the combination of lapatinib with either sirolimus or
metformin is found, 14 participants with the tumor type that has responded to the study drug
combination will receive the study drugs at that dose level.

Study Drug Administration:

Each study "cycle" is 28 days.

You will take lapatinib by mouth 1 time each day. You should take it at about the same time
each day on an empty stomach with a cup (about 8 ounces) of water, 1 hour before and 2 hours
after a meal.

If you are also taking metformin, you will take it by mouth 1 time every day. You should
take it at about the same time each day with a meal and cup of water (about 8 ounces).

If you are also taking sirolimus, you will take it by mouth 1 time every day. You should
take it at about the same time each day on an empty stomach with a cup of water, 1 hour
before and 2 hours after a meal.

Study Visits:

At every study visit, you will be asked about any current health conditions you have, any
other drugs you are taking, and if you have experienced any side effects.

On about Days 1, 8, and 15 of Cycle 1, blood (about 2 teaspoons) will be drawn for routine
tests.

On about Day 1 Cycle 1, urine will be collected for routine tests.

On about Day 1 of Cycles 2 and beyond:

- You will have a physical exam.

- Blood (about 2 teaspoons) and urine will be collected for routine tests.

Every 6 weeks, you will have a blood (about 1 teaspoon) drawn or urine collected for
pregnancy test if you are able to become pregnant.

Every 8 weeks for the first 4 cycles, you will have an x-ray, CT scan, MRI scan, and/or
PET/CT scan to check the status of the disease. If the study doctor thinks it is needed,
they will be performed more often. After 4 cycles you will have an x-ray, CT scan, MRI scan,
and/or PET/CT scan every 8 - 12 weeks as your study if the study doctor feels it is
appropriate.

Length of Study:

You may stay on study for as long as you are benefitting. You will be taken off study if you
experience intolerable side effects, the study doctor thinks it is in your best interest, or
the disease gets worse.

This is an investigational study. Sirolimus is FDA approved and commercially available as
an anti-rejection drug for kidney transplant recipients. Lapatinib is FDA approved and
commercially available for the treatment of advanced breast cancer. Metformin is FDA
approved and commercially available for the treatment of diabetes mellitus. The combination
of these drugs to treat advanced cancer is investigational.

Up to 106 patients will take part in this study. All will be enrolled at M. D. Anderson.


Inclusion Criteria:



1. Patients with advanced or metastatic cancer that is refractory to standard therapy,
relapsed after standard therapy, or who have no standard therapy available that
improves survival by at least three months.

2. Patients must be at least 3 weeks beyond their previous cytotoxic treatment. Patient
must wait at least 5 half-lives or 3 weeks, whichever is shorter, from their previous
targeted or biologic therapy; In addition, patients must be at least 3 weeks beyond
the last session of radiation therapy or major surgery. Local palliative radiation
therapy that is not delivered to all target lesions is allowed immediately before or
during treatment.

3. ECOG performance status should be less or equal to 3

4. Patients must have normal organ and marrow function defined as: ANC >/= 750/mL;
platelets >/= 50,000/mL; creatinine 1.5 mg/dl for the Metformin arm; total bilirubin syndrome, bilirubin level > 2 could will be allowed on study if the
hyperbilirubinemia is believed to be secondary only to the Gilbert syndrome); ALT
(SGPT) 3x ULN; ALT (SGPT)
5. Women of child-bearing potential and men must agree to use adequate contraception
(hormonal or barrier method of birth control; abstinence) prior to study entry, for
the duration of study participation, and for 30 days after the last dose

6. Patients must be able to understand and be willing to sign a written informed consent
document

7. Patients with treated brain metastases are allowed in both arms of the study.

Exclusion Criteria:

1. Uncontrolled intercurrent illness including, but not limited to, uncontrolled
infection, uncontrolled asthma, need for hemodialysis, need for ventilatory support.

2. Pregnant or lactating women.

3. History of hypersensitivity to Lapatinib or any component of the formulation.

4. Patients who have malabsorption syndrome

5. Patients with class III or IV congestive heart failure as defined by New York Heart
Association functional classification system

6. Patients unwilling or unable to sign informed consent document

7. History of hypersensitivity to Sirolimus or any component of the formulation (for
Lapatinib and Sirolimus arm only)

8. History of hypersensitivity to metformin or any component of the formulation (for
Lapatinib and Metformin arm only)

Type of Study:

Interventional

Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Maximum Tolerated Dose (MTD) of Lapatinib

Outcome Time Frame:

21 day cycle

Safety Issue:

Yes

Principal Investigator

Filip Janku, MD, PHD

Investigator Role:

Principal Investigator

Investigator Affiliation:

UT MD Anderson Cancer Center

Authority:

United States: Institutional Review Board

Study ID:

2009-0743

NCT ID:

NCT01087983

Start Date:

March 2010

Completion Date:

Related Keywords:

  • Advanced Cancers
  • Metastatic cancer
  • Lapatinib
  • Tykerb
  • Metformin
  • Glucophage
  • Sirolimus
  • Rapamune
  • Neoplasms

Name

Location

UT MD Anderson Cancer CenterHouston, Texas  77030