Phase II Study of Bevacizumab Plus Erlotinib in Patients With Advanced Hepatocellular Cancer (HCC)
OBJECTIVES:
Primary
- Evaluate the objective response rate in patients with advanced hepatocellular carcinoma
treated with bevacizumab and erlotinib hydrochloride.
Secondary
- Evaluate the time to progression in patients treated with this regimen.
- Evaluate the overall and progression-free survival of patients treated with this
regimen.
- Evaluate the adverse events in patients treated with this regimen.
Tertiary
- Determine the presence of epidermal growth factor receptor (EGFR) mutations in tumor
tissue and correlate this with response rate, progression, and survival in patients
treated with this regimen.
- Evaluate the expression of molecules involved in EGFR signal transduction, including
EGFR, phosphorylated-EGFR, Akt, phosphorylated-Akt, mitogen-activated protein kinase
(MAPK), phosphorylated-MAPK, and HER2/neu by immunohistochemistry (from tumor tissue)
and correlate these with patient outcome measures.
- Determine the levels of vascular endothelial growth factor (VEGF) and VEGF receptors in
tumor tissue as well as baseline plasma VEGF levels and correlate these with patient
outcome measures.
OUTLINE: This is a multicenter study
Patients receive bevacizumab IV over 30-90 minutes on days 1 and 15 and oral erlotinib
hydrochloride once daily on days 1-28. Treatment repeats every 28 days in the absence of
disease progression or unacceptable toxicity.
Patients undergo laboratory studies to determine epidermal growth factor receptor (EGFR) and
phosphorylated-EGFR protein levels using initial diagnostic biopsy specimens by
immunohistochemistry (IHC) for correlation with clinical outcome. Levels of proteins through
which EGFR signals, including Akt, phosphorylated-Akt, mitogen-activated protein kinase
(MAPK), and phosphorylated-MAPK, are also determined using initial diagnostic biopsy
specimens by IHC and correlated with clinical outcome. Total and free serum vascular
endothelial growth factor levels are determined at the start of study and prior to course 3
by enzyme-linked immunosorbent assays (ELISA).
After completion of study treatment, patients are followed periodically for up to 3 years.
PROJECTED ACCRUAL: A total of 55 patients will be accrued for this study.
Interventional
Masking: Open Label, Primary Purpose: Treatment
Tumor response (compete and partial response) as measured by 2 consecutive evaluations at least 4 weeks apart
No
Philip A. Philip, MD, PhD, FRCP
Study Chair
Barbara Ann Karmanos Cancer Institute
United States: Food and Drug Administration
CDR0000492765
NCT01649076
August 2006
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