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Lapatinib Ditosylate in Treating Patients With Unresectable Liver or Biliary Tract Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00107536
Recruitment Status : Completed
First Posted : April 6, 2005
Results First Posted : April 29, 2015
Last Update Posted : April 29, 2015
Information provided by (Responsible Party):
National Cancer Institute (NCI)

Brief Summary:
Lapatinib ditosylate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. This phase II trial is studying how well lapatinib ditosylate works in treating patients with unresectable liver or biliary tract cancer

Condition or disease Intervention/treatment Phase
Adult Primary Hepatocellular Carcinoma Advanced Adult Primary Liver Cancer Localized Unresectable Adult Primary Liver Cancer Recurrent Adult Primary Liver Cancer Recurrent Extrahepatic Bile Duct Cancer Recurrent Gallbladder Cancer Unresectable Extrahepatic Bile Duct Cancer Unresectable Gallbladder Cancer Drug: lapatinib ditosylate Other: laboratory biomarker analysis Phase 2

Detailed Description:


I. To evaluate the objective response rate (complete response [CR] + partial response [PR]) as defined by the Response Evaluation Criteria in Solid Tumors (RECIST) criteria in each group of patients.


I. To evaluate the progression free survival at 6 months. II. To evaluate the toxicity profile of this treatment in each group of patients.

III. To evaluate median overall survival, 6 and 12 months survival rates. IV. To assess target-epidermal growth factor receptor (EGFR)/EGFR-P protein expression and the genes that regulate the cell cycle and apoptosis, which are either downstream of or cross-talk with the EGFR signaling pathway, to explore their association with clinical outcome.

V. To measure expression profile and mutations of genes critical for EGFR and (v-erb-b2 erythroblastic leukemia viral oncogene homolog 2 (ERBB2 signaling pathways with particular relevance to GW572016, and to explore new gene-drug relationships as relating to hepatocellular and biliary carcinomas.

OUTLINE: This is a multicenter study.

Patients receive oral lapatinib ditosylate once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

PROJECTED ACCRUAL: A total of 70 patients will be accrued for this study within 1 year.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 26 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase II Study of Efficacy and Tolerability of GW572016 in Patients With Advanced Hepatocellular and Biliary Carcinomas
Study Start Date : October 2005
Actual Primary Completion Date : May 2009
Actual Study Completion Date : May 2009

Arm Intervention/treatment
Experimental: Arm I
Patients receive oral lapatinib ditosylate once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Drug: lapatinib ditosylate
Other Names:
  • GSK572016
  • GW-572016
  • GW2016
  • Lapatinib
  • Tykerb

Other: laboratory biomarker analysis
Correlative studies

Primary Outcome Measures :
  1. Proportion of Patients Demonstrating Objective Response (PR+CR) as Defined by RECIST [ Time Frame: Up to 3 years ]
    PR (Partial Response) definded as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD. CR (Complete Response) is defined as the disappearance of all target lesions.

Secondary Outcome Measures :
  1. Progression-free Survival [ Time Frame: up to 6 months ]
  2. Toxicity Profile Assessed Using NCI CTCAE Version 3.0 [ Time Frame: Up to 3 years ]
    Percentage of patients with Adverse events accordng to NCI CTCAE version 3.0

  3. Median Overall Survival [ Time Frame: Up to 3 years ]
  4. Overall Survival [ Time Frame: up to 12.6 months ]
  5. Target-EGFR/EGFR-P Protein Expression [ Time Frame: Up to 3 years ]
    EGFR (exons 18-21)

  6. Expression Profile and Mutations of Genes Critical for EGFR and ERBB2 Signaling Pathways [ Time Frame: Up to 3 years ]

Information from the National Library of Medicine

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, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Histologically confirmed diagnosis of 1 of the following:

    • Hepatocellular carcinoma (hepatoma)

      • Child-Pugh classification score ≤ 7
    • Biliary tract carcinoma
  • Surgically unresectable disease
  • Measurable disease

    • At least 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques OR ≥ 10 mm by spiral CT scan
  • Fresh tissue or paraffin embedded tissue from tumor blocks available
  • No ampulla of Vater tumors
  • No known brain metastases
  • Performance status - ECOG 0-1
  • Performance status - Karnofsky 60-100%
  • More than 12 weeks
  • Absolute neutrophil count ≥ 1,500/mm^3
  • Platelet count ≥ 75,000/mm^3
  • Bilirubin ≤ 2 times upper limit of normal (ULN)
  • AST and ALT ≤ 3 times ULN
  • Albumin ≥ 2.5 mg/dL
  • INR ≤ 1.5 (for patients not receiving an anticoagulant)
  • Live metastases or stable chronic liver disease allowed
  • No current active hepatic or biliary disease except for Gilbert's syndrome or asymptomatic gallstone
  • Creatinine ≤ 2 mg/dL
  • Ejection fraction normal by echocardiogram or MUGA
  • No unstable angina pectoris
  • No cardiac arrhythmia
  • Able to swallow and retain oral medication
  • No gastrointestinal (GI) tract disease resulting in an inability to take oral medication
  • No malabsorption syndrome
  • No requirement for IV alimentation
  • No uncontrolled inflammatory GI disease (e.g., Crohn's disease or ulcerative colitis)
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No significant traumatic injury within the past 3 weeks
  • No active or ongoing infection
  • No history of allergic reaction attributed to compounds of similar chemical or biological composition to lapatinib
  • No psychiatric illness or social situation that would preclude study compliance
  • No other uncontrolled illness
  • No other malignancy within the past 3 years except adequately treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
  • More than 4 weeks since prior biologic therapy
  • More than 4 weeks since prior immunotherapy
  • See Radiotherapy
  • More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin)
  • No prior cumulative doxorubicin dose > 450 mg/m^2
  • At least 14 days since prior and no concurrent glucocorticoids (e.g., dexamethasone or equivalent [dose > 1.5 mg/day])
  • More than 4 weeks since prior radiotherapy
  • More than 12 weeks since prior radiotherapy with or without a fluoropyrimidine as a radiosensitizer (for patients with biliary carcinoma only)
  • No prior surgical procedure affecting absorption
  • More than 3 weeks since prior major surgery
  • Recovered from all prior therapy
  • No more than 1 prior systemic anticancer therapy, including chemoembolization
  • No prior epidermal growth factor receptor-targeting therapy
  • More than 6 weeks since prior cryotherapy, radiofrequency ablation, ethanol injection, transarterial chemoembolization, or photodynamic therapy AND meets both of the following criteria:

    • Indicator lesion is outside the area of prior treatment OR there is clear evidence of disease progression associated with the sole indicator lesion
    • Edges of indicator lesion are clearly distinct by CT scan
  • At least 7 days since prior and no concurrent H2 inhibitors or proton pump inhibitors

    • Concurrent antacids allowed provided they are administered > 1 hour before and > 1 hour after study drug administration
  • At least 7 days since prior and no concurrent CYP3A4 inhibitors, including any of the following:

    • Clarithromycin
    • Erythromycin
    • Troleandomycin
    • Delaviridine
    • Ritonavir
    • Indinavir
    • Saquinavir
    • Nelfinavir
    • Amprenavir
    • Lopinavir
    • Itraconazole
    • Ketoconazole
    • Voriconazole
    • Fluconazole (doses ≤ 150 mg/day are allowed)
    • Nefazodone
    • Fluvoxamine
    • Verapamil
    • Diltiazem
    • Cimetidine
    • Aprepitant
    • Grapefruit and grapefruit juice
    • Bitter orange
  • At least 6 months since prior and no concurrent amiodarone
  • At least 14 days since prior and no concurrent CYP3A4 inducers, including any of the following:

    • Phenytoin
    • Carbamazepine
    • Phenobarbital
    • Oxcarbazepine
    • Efavirenz
    • Nevirapine
    • Rifampin
    • Rifabutin
    • Rifapentine
    • Roxithromycin
    • Telithromycin
    • Hypericum perforatum (St. John's wort)
    • Modafinil
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No other concurrent investigational agents
  • No other concurrent anticancer therapy
  • Concurrent oral anticoagulants (e.g., coumadin or warfarin) allowed provided there is increased vigilance in monitoring INR

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00107536

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United States, Ohio
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center
Columbus, Ohio, United States, 43210
Sponsors and Collaborators
National Cancer Institute (NCI)
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Principal Investigator: Tanios Bekaii-Saab Ohio State University Comprehensive Cancer Center
Publications of Results:
Other Publications:
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Responsible Party: National Cancer Institute (NCI) Identifier: NCT00107536    
Other Study ID Numbers: NCI-2012-01464
OSU 0447
N01CM62207 ( U.S. NIH Grant/Contract )
N01CM62201 ( U.S. NIH Grant/Contract )
CDR0000420830 ( Registry Identifier: PDQ (Physician Data Query) )
First Posted: April 6, 2005    Key Record Dates
Results First Posted: April 29, 2015
Last Update Posted: April 29, 2015
Last Verified: March 2015
Additional relevant MeSH terms:
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Liver Neoplasms
Gallbladder Neoplasms
Bile Duct Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Liver Diseases
Biliary Tract Neoplasms
Biliary Tract Diseases
Gallbladder Diseases
Bile Duct Diseases
Antineoplastic Agents
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action