Study of Erlotinib in Combination With Bortezomib

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier:
NCT00895687
First received: May 6, 2009
Last updated: March 31, 2014
Last verified: March 2014
  Purpose

The goal of this clinical research study is to find the highest tolerable dose of Tarceva (erlotinib hydrochloride) that can safely be given in combination with Velcade (bortezomib). The safety of this drug combination will also be studied.


Condition Intervention Phase
Advanced Cancer
Drug: Erlotinib Hydrochloride
Drug: Bortezomib
Phase 1

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase I Dose-Escalation Study of Erlotinib in Combination With Bortezomib in Subjects With Advanced Cancer. Companion Study to Umbrella Protocol 2007-0638.

Resource links provided by NLM:


Further study details as provided by M.D. Anderson Cancer Center:

Primary Outcome Measures:
  • Tumor Response [ Time Frame: Evaluation of response after two 21-day cycles of treatment ] [ Designated as safety issue: Yes ]
  • Maximum Tolerated Dose (MTD) [ Time Frame: Continuous assessment of safety throughout entire study period and determination of dose-limiting toxicities during and at the end of 21 Day Cycle. ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 48
Study Start Date: April 2009
Estimated Primary Completion Date: April 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Erlotinib + Bortezomib
Up to 4 dose levels of study drug combination tested with 3-6 participants enrolled at each dose level. Erlotinib beginning dose of 150 mg taken by mouth daily for 21-day cycle. Bortezomib beginning dose of 1. mg/m^2 by vein over about 1-5 minutes on Days 1, 4, 8, and 11 of each 21-day cycle.
Drug: Erlotinib Hydrochloride
Beginning dose of 150 mg taken by mouth daily for 21-day cycle.
Other Names:
  • Erlotinib
  • Tarceva
Drug: Bortezomib
Beginning dose of 1. mg/m^2 by vein over about 1-5 minutes on Days 1, 4, 8, and 11 of each 21-day cycle.
Other Names:
  • Velcade
  • LDP-341
  • MLN341
  • PS-341

  Hide Detailed Description

Detailed Description:

The Study Drugs:

Erlotinib hydrochloride and bortezomib are both designed to block proteins that are thought to cause cancer cells to grow. These drugs may help slow the growth of tumors.

Study Drug Dose Level:

If you are found to be eligible to take part in this study, you will be assigned to a dose level of erlotinib hydrochloride and bortezomib based on when you join the study. Up to 4 dose levels of this study drug combination will be tested. There will be 3-6 participants enrolled at each dose level of the study drug combination.

The first group of participants will receive the lowest dose level of erlotinib hydrochloride (Group 1). If all of Group 1 tolerate that dose level, the next group (Group 2) will receive a higher dose. Each new group will receive a higher dose than the group before it, if no intolerable side effects were seen (Groups 2-4). This will continue until the highest tolerable dose of the study drug combination is found. However, if Group 1 did not tolerate the first dose level, the next group will receive a lower dose (called Dose Level -1). If that dose level is still intolerable, the third group will receive an even lower dose (called Dose Level -2).

The dose of bortezomib will be based in which group you in. Groups 1 and 2 will receive the same dose, Group 3 will receive a higher dose, and Group 4 will receive an even higher dose.

After the highest tolerable dose is found, up to an additional 10 participants, called the "expansion group," will receive the study drug combination at that dose.

Study Drug Administration:

Erlotinib hydrochloride will be taken by mouth 1 time every day for 21-days, called a study "cycle." You should take erlotinib hydrochloride on an empty stomach either 1 hour before eating or 2 hours after eating.

Depending on which dose level you are assigned to, you will receive bortezomib by vein over about 1-5 minutes on Days 1 and 8, or on Days 1, 4, 8, and 11 of each 21-day cycle.

Study Visits:

You will have a single study visit just before each cycle. At these visits, the following tests and procedures will be performed:

  • Your performance status will be recorded.
  • You will be asked to list any drugs you may be taking, including over-the-counter drugs.
  • You will be asked about any symptoms you may have.
  • You will have a physical exam, including measurement of your vital signs.
  • Blood (about 2 teaspoons) will be collected for routine tests.
  • Blood (about 2 teaspoons) will be collected for pharmacodynamic (PD) testing. PD testing is used to look at how the level of study drug in your body may affect the disease.

After every 2 cycles (Cycles 2, 4, 6, and so on), you will have a CT or MRI scan to check the status of the disease.

Length of Study:

You may continue taking the study drugs for as long as you are benefitting. You will be taken off study if the disease gets worse or intolerable side effects occur.

Follow-up Visit:

About 30 days after the last dose of study drugs, you will have a follow-up visit. You will be asked to return any unused study drug. At this visit, the following tests and procedures will be performed:

  • Your performance status will be recorded.
  • You will be asked to list any drugs you may be taking, including over-the-counter drugs.
  • You will be asked about any symptoms you may have.
  • You will have a physical exam, including measurement of your vital signs.
  • Blood (about 2 teaspoons) and urine will be collected for routine tests.

This is an investigational study. Bortezomib and erlotinib hydrochloride are both FDA approved and commercially available. Bortezomib is FDA approved for the treatment of multiple myeloma. Erlotinib hydrochloride is FDA approved for the treatment of lung cancer and pancreatic cancer. The use of these drugs together is investigational and authorized for use in research only.

Up to 48 participants will take part in this study. All will be enrolled at M. D. Anderson.

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Patients with pathologically confirmed advanced or metastatic cancer that is refractory to standard therapy, relapsed after standard therapy, or who have had no standard therapy that induces a CR rate of at least 10% or improves survival by at least three months.
  2. Measurable or non-measurable disease.
  3. Patients must be >/= 6 wks beyond treatment with a nitrosourea or mitomycin-C, >/= 4 wks beyond other chemotherapy or XRT, and must have recovered to </= Grade 1 toxicity for any treatment-limiting toxicity resulting from prior therapy. (Exception: patients may have received palliative low dose XRT one week before treatment provided it is not given to the only targeted lesions).
  4. (continued from above) Also, patients who have received non-chemotherapeutic biological agents will need to wait at least 5 half-lives or 4 wks, whichever is shorter, from the last day of treatment.
  5. ECOG performance status </= 2 (Karnofsky >/= 60%)
  6. Patients must have normal organ and marrow function defined as: absolute neutrophil count >/=1,000/mL; platelets >/=50,000/mL; creatinine </= 2 X ULN; total bilirubin </= 2.0; ALT(SGPT) </= 3 X ULN; Exception for patients with liver metastasis: total bilirubin </= 3 x ULN; ALT(SGPT) </= 5 X ULN.
  7. Women of childbearing 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.
  8. Ability to understand and the willingness to sign a written informed consent document
  9. For the MTD expansion cohort, patients will be eligible if they meet one of the following criteria: (I) Have an EGFR-sensitive mutation and have been previously treated with EGFR inhibitor therapy but have subsequently developed resistance, OR (II) Have an EGFR-resistant mutation, OR (III) Do not have an EGFR mutation, but have benefited from EGFR inhibitor therapy (including either >/=4 months of stable disease [SD] OR a >/= partial response [PR]).

Exclusion Criteria:

  1. Patients with uncontrolled concurrent illness, including but not limited to: ongoing or active infection; altered mental status or psychiatric illness/social situations that would limit compliance with study requirements and/or obscure study results.
  2. Uncontrolled systemic vascular hypertension (systolic blood pressure > 140 mm Hg, diastolic blood pressure > 90 mm Hg on medication).
  3. Patients with clinically significant cardiovascular disease: history of CVA within 6 months, myocardial infarction or unstable angina within 6 months, or unstable angina pectoris.
  4. Patients with colorectal carcinoma with tumors that demonstrate a KRAS mutation.
  5. Pregnant or lactating women.
  6. Patients with a history of bone marrow transplant within the previous two years.
  7. Patients with a known hypersensitivity to any of the components of the drug products.
  8. Patients unable to swallow oral medications or with pre-existing gastrointestinal disorders that might interfere with proper absorption of oral drugs.
  9. Patients with major surgery within 30 days prior to entering the study.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00895687

Locations
United States, Texas
UT MD Anderson Cancer Center
Houston, Texas, United States, 77030
Sponsors and Collaborators
M.D. Anderson Cancer Center
Investigators
Principal Investigator: Jennifer J. Wheler, MD UT MD Anderson Cancer Center
  More Information

Additional Information:
No publications provided

Responsible Party: M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier: NCT00895687     History of Changes
Other Study ID Numbers: 2008-0554, NCI-2012-01631
Study First Received: May 6, 2009
Last Updated: March 31, 2014
Health Authority: United States: Institutional Review Board

Keywords provided by M.D. Anderson Cancer Center:
Metastatic Cancer
Bortezomib
Velcade
Erlotinib
Erlotinib Hydrochloride
Tarceva
EGFR
EGFR mutations

Additional relevant MeSH terms:
Neoplasms
Bortezomib
Erlotinib
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Protease Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Protein Kinase Inhibitors

ClinicalTrials.gov processed this record on July 23, 2014