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Phase I Trial Evaluating the Epidermal Growth Factor Receptor Inhibitor Erlotinib in Combination With the SRC Kinase Inhibitor Dasatinib for Patients With Recurrent Non-small Cell Lung Cancer (NSCLC)


Phase 1
18 Years
N/A
Not Enrolling
Both
Non-Small-Cell Lung Carcinoma

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Trial Information

Phase I Trial Evaluating the Epidermal Growth Factor Receptor Inhibitor Erlotinib in Combination With the SRC Kinase Inhibitor Dasatinib for Patients With Recurrent Non-small Cell Lung Cancer (NSCLC)


This is a single site Phase I dose escalation trial of the epidermal growth factor receptor
inhibitor Erlotinib with the SRC tyrosine kinase inhibitor Dasatinib in patients with
previously treated advanced stage (Stage IIIB/IV disease) Non-Small Cell Lung Cancer
(NSCLC). The screening evaluation will consist of a medical history including
dates/description of your initial NSCLC diagnosis and documentation of any previous
treatment. There will also be a physical examination including vital signs, height, weight,
Eastern Cooperative Oncology Group (ECOG)performance status, blood draws for Complete Blood
Count (CBC) and Complete Metabolic Panel (CMP) tests, neurological examination, a pregnancy
test for female patients of childbearing potential, and (if applicable) any observable tumor
measurements all within 14 days before study enrollment. A screening Electrocardiogram (EKG)
as well as clinical testing to evaluate all known sites of malignant lesions, including
Computed Tomography (CTs) of the chest and upper abdomen, the adrenal glands; ultrasound; or
radionuclide scans of the bones; and/or other radiographic studies should be performed
within 30 days prior to enrollment.

The treatment regimen consists of Erlotinib tablets starting Day 1 and Dasatinib tablets
starting Day 9 for a 28-day cycle. If there are no DLTs, dose escalation continues. Patients
continuing on therapy past two cycles will be seen by the treating physician every 4 weeks
and will have complete History and Physical (H&P), CBC, and CMP. Tumor measurement and
response assessment will occur every 6-8 weeks. Dasatinib and Erlotinib will be continued
until progression of disease, unacceptable toxicity, or patient request.

The recommended phase II dose for this combined treatment will be defined and patients will
be treated at the recommended phase II dose to confirm tolerability.


Inclusion Criteria:



- Histologically or cytologically documented diagnosis of NSCLC that is
advanced/metastatic (Stage IIIB/IV).

- Written informed consent.

- The presence of progressive and measurable disease as defined by the -Response
Evaluation Criteria in Solid Tumors (RECIST)

- Performance status of 0 to 1 on the Eastern Cooperative Oncology Group (ECOG) Scale

- Have discontinued all previous systemic therapies for cancer, for at least 14 days
prior to study entry and have had previous first line chemotherapy, have recovered
from all acute effects of the therapies, and are considered for further chemotherapy,
radiotherapy, or other investigational therapy after they have relapsed or progressed
on previous treatment.

- Exhibit patient compliance and geographic proximity that allow for adequate
follow-up.

- Adequate bone marrow reserve and organ function as follows:

- Neutrophil count >1.5 x 10 to the 9th power/L and platelets > 100 x 10 to the
9th power/L.

- Hepatic: total bilirubin less than or equal to 1.5 times upper limit of normal
(ULN)

- Alanine transaminase (ALT) and aspartate transaminase (AST) less than or equal
to 2.5 times ULN (or less than or equal to 5 times ULN in case of known liver
involvement

- Renal: Serum Creatinine less than or equal to 1.5 times upper limit of normal
(ULN)

- Reproductive potential must be either terminated (by surgery, radiation, or
menopause) or attenuated by the use of an approved contraceptive method during and
for 3 to 6 months following the study.

- At least 18 years of age.

- Agrees to discontinue St. Johns Wort while receiving dasatinib therapy

- Agrees that IV bisphosphonates will be withheld for the first 8 weeks of dasatinib
therapy due to risk of hypocalcemia.

Exclusion Criteria:

- Prior treatment with EGFR tyrosine kinase inhibitors or EGFR targeting agent

- Have received treatment within the last 28 days with a drug that has not received
regulatory approval for any indication at the time of study entry.

- Have previously completed or withdrawn from this study or any other study
investigating Dasatinib.

- Pregnant or breastfeeding.

- Documented central nervous system or leptomeningeal metastasis (brain metastasis) at
the time of study entry. Patients with prior brain metastasis may be considered if
they have completed their treatment for brain metastasis, no longer require
corticosteroids, and are asymptomatic.

- Serious concomitant disorder, including active bacterial, fungal, or viral infection,
incompatible with the study (at the discretion of the investigator).

- Uncorrected electrolyte disorder, including potassium <3.0 mEq/L).

- Gastrointestinal disorder that in the opinion of the study physician may affect
absorption of either erlotinib or dasatinib. This also includes the inability to
swallow tablets.

- Prior major surgery or radiation therapy within 14 days of initiation of treatment

- Electrocardiogram (ECG) abnormalities indicative of cardiac disease (at the
discretion of the investigator).

- Uncontrolled angina, congestive heart failure or MI within six (6) months

- Diagnosed or suspected congenital long QT syndrome

- History of clinically significant ventricular arrhythmias (such as ventricular
tachycardia, ventricular fibrillation, or Torsades de pointes)

- Prolonged QTc interval on pre-entry electrocardiogram (> 450 msec)

- Uncontrolled hypertension.

- History of significant bleeding disorder unrelated to cancer, including:

- Diagnosed congenital bleeding disorders (e.g., von Willebrand's disease)

- Diagnosed acquired bleeding disorder within one year (e.g., acquired anti-factor
VIII antibodies)

- Patients currently taking drugs that are generally accepted to have a risk of causing
Torsades de Pointes including:

- quinidine,

- procainamide,

- disopyramide,

- amiodarone,

- sotalol,

- ibutilide,

- dofetilide erythromycins,

- clarithromycin,

- chlorpromazine,

- haloperidol,

- mesoridazine,

- thioridazine,

- pimozide,

- cisapride,

- bepridil,

- droperidol,

- methadone,

- arsenic,

- chloroquine,

- domperidone,

- halofantrine,

- levomethadyl,

- pentamidine,

- sparfloxacin; and

- lidoflazine.

- Patients with chronic obstructive pulmonary disease or pleural effusions (malignant
or benign) requiring chronic oxygen therapy.

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:

Number of Serious Adverse Events (SAEs) Reported

Outcome Description:

Determine the safety and tolerability of erlotinib in combination with dasatinib in patients with advanced NSCLC

Outcome Time Frame:

3 months per patient

Safety Issue:

Yes

Principal Investigator

Eric B. Haura, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

H. Lee Moffitt Cancer Center and Research Institute

Authority:

United States: Institutional Review Board

Study ID:

MCC-14984

NCT ID:

NCT00444015

Start Date:

March 2007

Completion Date:

August 2010

Related Keywords:

  • Non-Small-Cell Lung Carcinoma
  • Erlotinib
  • Dasatinib
  • Epidermal growth factor receptor (EGFR)
  • Tyrosine kinase
  • NSCLC
  • Pharmacokinetics (PK)
  • Lung
  • Carcinoma
  • Carcinoma, Non-Small-Cell Lung
  • Lung Neoplasms

Name

Location

H. Lee Moffitt Cancer Center & Research Institute Tampa, Florida  33612