Erlotinib in Combination With Docetaxel in Advanced Hepatocellular and Biliary Tract Carcinomas
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Purpose
An unmet medical need exists for the successful therapy of patients with advanced hepatocellular and biliary tract malignances, with few and short lived disease responses to chemotherapy for both advanced stage hepatic and biliary carcinomas. Pre-clinical data shows cooperative antitumor activity between an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor and taxanes. The efficacy of erlotinib in combination with docetaxel will be assessed in this trial.
| Condition | Intervention | Phase |
|---|---|---|
|
Hepatocellular Carcinoma |
Drug: Erlotinib Drug: Docetaxel |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase II Trial of Erlotinib in Combination With Docetaxel in Advanced Hepatocellular and Biliary Tract Carcinomas: Hoosier Oncology Group GI06-101 |
- To determine the rate of progression-free survival (PFS) at 16 weeks for the combination therapy of erlotinib and docetaxel. [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- To determine the response rate, duration of response, disease control and overall survival. [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- To evaluate the safety and toxicity of erlotinib in combination with docetaxel. [ Time Frame: 18 months ] [ Designated as safety issue: Yes ]
- To correlate responses with biologic tumor markers. [ Time Frame: 18 months ] [ Designated as safety issue: No ]
| Enrollment: | 25 |
| Study Start Date: | September 2007 |
| Study Completion Date: | August 2010 |
| Primary Completion Date: | August 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Erlotinib and Docetaxel
Erlotinib 150 mg p.o. daily, days 2-7, 9-14, 16-28 Docetaxel 30 mg/m2 IV over 30 min weekly x 3 weeks on days 1, 8 and 15 |
Drug: Erlotinib
Erlotinib 150 mg p.o. daily, days 2-7, 9-14, 16-28
Drug: Docetaxel
Docetaxel 30 mg/m2 IV over 30 min weekly x 3 weeks on days 1, 8 and 15
|
Detailed Description:
Outline: This is a multi-center study.
Patients who meet eligibility criteria will receive treatment as follows until disease progression or excessive toxicities:
- Erlotinib 150 mg p.o. daily on days 2-7, 9-14, 16-28
- Docetaxel 30 mg/m2 IV over 30 min weekly x 3 weeks on days 1, 8, 15
Treatment cycle = 28 days
Performance Status: ECOG performance status 0 to 2
Life expectancy: At least 12 weeks
Hematopoietic:
- Absolute neutrophil count (ANC) > 1000 mm3
- Platelet count > 75,000 mm3
- Hemoglobin > 8 g/dL
Hepatic:
- Bilirubin < 2.0 x upper limit of normal (ULN)
- Transaminases (AST, ALT) < 5.0 x ULN if alkaline phosphatase is < 2.5 x ULN, or alkaline phosphatase < 5 x ULN if transaminases are < 1.5 x ULN.
- If not on anticoagulation: PT < 4 seconds above ULN; INR < 1.5; PTT < 1.3 x ULN.
- If on therapeutic anticoagulation, patients may have an INR > 1.5 and PTT within therapeutic range; INR will be monitored weekly until stable.
- Serum Albumin > 3.0
Renal:
- Creatinine clearance of > 60 ml/ min (by Cockcroft-Gault)
Pulmonary:
- Not specified
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Histological or cytological proof of hepatocellular or biliary tract carcinomas, not amenable to curative resection or transplantation.
- Prior cancer treatment completed at least 30 days prior to being registered for protocol therapy and recovered from the acute toxicity effects of the regimen.
- Patients may have had radiofrequency ablation, cryosurgery or embolization, but must have documented progressive disease with the involved lesion, or at least one previously untreated lesion.
- Patients may have had ≤ 2 prior chemotherapy regimens.
- Prior radiation therapy allowed to < 25% of the bone marrow at least 30 days prior to being registered for protocol therapy.
- Patients with biliary obstruction must have percutaneous transhepatic drainage or endoscopic stent placement prior to starting study treatment.
- Patients with a history of malignancy are eligible provided they have been curatively treated and demonstrate no evidence for recurrence of that cancer.
- Peripheral neuropathy ≤ grade 1.
- Patients must agree to abstain from frozen or fresh grapefruit or grapefruit juice for 5 days prior to, and during treatment.
- Patients must be willing to use an effective method of contraception (hormonal or barrier method of birth control; abstinence) while on treatment and for a 12 week period thereafter.
- Females of childbearing potential must have a negative pregnancy test within 7 days prior to being registered for protocol therapy.
- Written informed consent and HIPAA authorization for release of personal health information.
- Age ≥ 18 years at time of consent.
Exclusion Criteria:
- No previous treatment with EGFR inhibitors.
- No treatment with any investigational agent within 30 days prior to being registered for protocol therapy.
- No symptomatic brain metastasis. A subject with prior brain metastasis may be considered if they have completed their treatment for brain metastasis, no longer require corticosteroids, and are asymptomatic.
- No Child-Pugh B or C liver cirrhosis.
- No active corneal erosions or history of abnormal corneal sensitivity test.
- No history of aneurysm or arteriovenous malformation.
- No hemorrhage/bleeding event > CTCAE Grade 3 within 30 days prior to begin registered for protocol therapy.
- No clinically significant infections as judged by the treating investigator.
- No condition that impairs patient's ability to swallow whole pills.
- No history of hypersensitivity to docetaxel or other drugs formulated with polysorbate 80.
- Females must not be breastfeeding.
- Patients who cannot avoid the following medications will be ineligible for the trial: midazolam, anti-mycotic agents (ketoconazole and related compounds), macrolide antibiotics (erythromycin and related compounds), nifedipine, phenobarbital, phenytoin, carbamazepine, and rifampin (induction) and anti-retrovirals (including ritonavir, saquinavir).
Contacts and Locations| United States, Delaware | |
| Helen F. Graham Cancer Center | |
| Newark, Delaware, United States, 19713 | |
| United States, Illinois | |
| Northwestern University Feinberg School of Medicine | |
| Chicago, Illinois, United States, 60611 | |
| Rush-Presbyterian St. Luke's Medical Center | |
| Chicago, Illinois, United States, 60612 | |
| United States, Indiana | |
| Cancer Care Center of Southern Indiana | |
| Bloomington, Indiana, United States, 47403 | |
| Fort Wayne Oncology & Hematology, Inc | |
| Fort Wayne, Indiana, United States, 46815 | |
| Indiana University Cancer Center | |
| Indianapolis, Indiana, United States, 46202 | |
| Quality Cancer Center (MCGOP) | |
| Indianapolis, Indiana, United States, 46202 | |
| IN Onc/Hem Associates | |
| Indianapolis, Indiana, United States, 46202 | |
| Medical Consultants, P.C. | |
| Muncie, Indiana, United States, 47303 | |
| Northern Indiana Cancer Research Consortium | |
| South Bend, Indiana, United States, 46601 | |
| United States, Missouri | |
| Siteman Cancer Center | |
| St. Louis, Missouri, United States, 63110 | |
| United States, Nebraska | |
| Methodist Cancer Center | |
| Omaha, Nebraska, United States, 68114 | |
| Study Chair: | Elena Gabriela Chiorean, M.D. | Hoosier Oncology Group, LLC |
More Information
Additional Information:
Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Hoosier Oncology Group |
| ClinicalTrials.gov Identifier: | NCT00532441 History of Changes |
| Other Study ID Numbers: | GI06-101 |
| Study First Received: | September 18, 2007 |
| Last Updated: | November 20, 2012 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Docetaxel Erlotinib Carcinoma Carcinoma, Hepatocellular Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Adenocarcinoma Liver Neoplasms Digestive System Neoplasms |
Neoplasms by Site Digestive System Diseases Liver Diseases Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Protein Kinase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on June 18, 2013