Lapatinib Ditosylate and Akt Inhibitor MK2206 in Treating Women With Metastatic Breast Cancer
This phase I trial studies the side effects and the best dose of lapatinib ditosylate and Akt inhibitor MK2206 in treating women with metastatic breast cancer. Lapatinib ditosylate and Akt inhibitor MK2206 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.
Estrogen Receptor-negative Breast Cancer
Estrogen Receptor-positive Breast Cancer
HER2-positive Breast Cancer
Progesterone Receptor-negative Breast Cancer
Progesterone Receptor-positive Breast Cancer
Recurrent Breast Cancer
Stage IV Breast Cancer
Drug: Akt inhibitor MK2206
Drug: lapatinib ditosylate
Other: laboratory biomarker analysis
Other: pharmacogenomic studies
Other: pharmacological study
|Study Design:||Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||A Phase 1b Dose-Escalation Study of the AKT Inhibitor MK-2206 (NSC# 749607) Plus Lapatinib (NSC# 727989) Administered in Patients With HER2 Positive Metastatic Breast Cancer|
- Identification of maximum tolerated dose determined by dose-limiting toxicity and adverse events and the associated NCI CTCAE grade of continuous daily administration of lapatinib ditosylate in combination with weekly administration of MK-2206 [ Time Frame: 28 days ] [ Designated as safety issue: Yes ]
- Pharmacokinetics of MK-2206 in combination with lapatinib [ Time Frame: Days 1, 2, 8, 9, 10, 22, 23, 24 of course 1 and day 1 of course 2 ] [ Designated as safety issue: No ]Including, but not limited to, maximum observed plasma concentration (Cmax), time to maximum plasma concentration (tmax), plasma terminal half-life (t1/2), area under the plasma concentration-time curve from time 0 to infinity (AUC0-inf), AUC from time 0 to the next dose (AUCtlast), accumulation index (AI = AUCtlast/AUC0-inf), maximum observed plasma concentration at steady state (Css, max), and minimum observed plasma concentration at steady state (Css, min).
- Pharmacogenetic influence of the candidate drug-metabolizing enzymes and transporters on the PK of MK2206 and lapatinib [ Time Frame: Up to 30 days ] [ Designated as safety issue: No ]
- Tumor response assessed by RECIST [ Time Frame: Up to 30 days ] [ Designated as safety issue: No ]
- Percent change in BCSCs within the tumor [ Time Frame: Baseline to 2 weeks of treatment ] [ Designated as safety issue: No ]
|Study Start Date:||January 2011|
|Estimated Primary Completion Date:||December 2013 (Final data collection date for primary outcome measure)|
Experimental: Treatment (Akt inhibitor MK2206 and lapatinib ditosylate)
Patients receive lapatinib ditosylate PO QD on days 1 and 15-28 of course 1 and on days 1-28 of subsequent courses. Patients also receive AKT inhibitor MK2206 PO QD on days 8 and 15 of course 1 and on days 1, 8, 15, and 22 of subsequent courses. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Drug: Akt inhibitor MK2206
Other Name: MK2206Drug: lapatinib ditosylate
Other Names:Other: laboratory biomarker analysis
Correlative studiesOther: pharmacogenomic studies
Other Name: Pharmacogenomic StudyOther: pharmacological study
Other Name: pharmacological studies
I. To determine the safety and tolerability of continuous daily administration of lapatinib (lapatinib ditosylate) in combination with weekly administration of MK2206 (AKT inhibitor MK2206) in patients with human epidermal growth factor receptor (HER)2-positive advanced breast cancer.
II. To determine the dose-limiting toxicity (DLT) and identify the maximum-tolerated dose (MTD) and/or recommended phase II dose (RP2D) for this administration schedule.
I. To determine the pharmacokinetics (PK) of MK2206 and lapatinib, each given alone and in the combination.
II. To evaluate potential pharmacogenetic influence of the candidate drug metabolizing enzymes and transporters on the PK of MK2206 and lapatinib.
III. To evaluate the change in select breast cancer biomarkers in the phosphatase and tensin homolog (PTEN)/phosphatidylinositol 3-kinase (PI3K)/Akt-signaling pathways, (e.g., phosphorylated [p]PTEN, PTEN, pAkt, Akt, phosphorylated glycogen synthase kinase (pGSK)3-beta, GSK3-beta), Wnt/beta-catenin pathway (e.g., activated beta-catenin (ABC), beta-catenin), and pHER2.
IV. To evaluate the change in breast cancer stem cell (BCSC) biomarkers, aldehyde dehydrogenase (ALDH)1 and CD44+/CD24-, before and after 2 weeks of treatment with the combination of MK2206 and lapatinib at the MTD. The percent change in BCSCs in tumor biopsies will also be evaluated.
V. To determine tumor response in patients with measurable disease as assessed by the Response Evaluation Criteria in Solid Tumors (RECIST), and by percent change in BCSCs within the tumor before vs after 2 weeks of combination treatment.
VI. To perform genomic profiling of the tumor cell and BCSC populations before and after 2 weeks of treatment with the combination of MK2206 and lapatinib at the MTD.
OUTLINE: This is a phase I, dose-escalation study followed by an expansion cohort study.
Patients receive lapatinib ditosylate orally (PO) once daily (QD) on days 1 and 15-28 of course 1 and on days 1-28 of subsequent courses. Patients also receive AKT inhibitor MK2206 PO QD on days 8 and 15 of course 1 and on days 1, 8, 15, and 22 of subsequent courses. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
After completion of study therapy, patients are followed up for 30 days.
|United States, Connecticut|
|New Haven, Connecticut, United States, 06520-8032|
|Contact: Joseph P. Eder 203-737-6980 firstname.lastname@example.org|
|Principal Investigator: Joseph P. Eder|
|United States, Massachusetts|
|Dana-Farber Cancer Institute||Recruiting|
|Boston, Massachusetts, United States, 02115|
|Contact: Sara M. Tolaney 617-632-2335 email@example.com|
|Principal Investigator: Sara M. Tolaney|
|United States, Michigan|
|University of Michigan University Hospital||Recruiting|
|Ann Arbor, Michigan, United States, 48109|
|Contact: Max S. Wicha 734-936-1831 firstname.lastname@example.org|
|Principal Investigator: Max S. Wicha|
|Barbara Ann Karmanos Cancer Institute||Recruiting|
|Detroit, Michigan, United States, 48201|
|Contact: Patricia M. LoRusso 313-576-8716 email@example.com|
|Principal Investigator: Patricia M. LoRusso|
|United States, Tennessee|
|Vanderbilt-Ingram Cancer Center||Recruiting|
|Nashville, Tennessee, United States, 37232|
|Contact: Ingrid A. Mayer 615-322-4967 ingrid.mayer@Vanderbilt.Edu|
|Principal Investigator: Ingrid A. Mayer|
|Principal Investigator:||Patricia LoRusso||Barbara Ann Karmanos Cancer Institute|