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Lapatinib and Epirubicin in Treating Patients With Metastatic Breast Cancer. ICORG 06-30

This study has been completed.
Information provided by (Responsible Party):
Cancer Trials Ireland Identifier:
First received: September 13, 2008
Last updated: February 12, 2016
Last verified: January 2014

RATIONALE: Lapatinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as epirubicin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving lapatinib together with epirubicin may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of epirubicin when given together with lapatinib in treating patients with metastatic breast cancer.

Condition Intervention Phase
Breast Cancer
Drug: epirubicin hydrochloride
Drug: lapatinib ditosylate
Other: biomarker analysis
Other: immunohistochemistry staining method
Other: liquid chromatography
Other: mass spectrometry
Phase 1

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: An Open-Label Phase I Study of Fixed Dose Lapatinib in Combination With an Escalating Dose of Epirubicin in Metastatic Breast Cancer

Resource links provided by NLM:

Further study details as provided by Cancer Trials Ireland:

Primary Outcome Measures:
  • Optimally-tolerated regimen of lapatinib ditosylate in combination with epirubicin hydrochloride [ Time Frame: 2012 ]

Secondary Outcome Measures:
  • Efficacy of this regimen in terms of objective tumor response rate and disease progression as assessed by standard RECIST criteria [ Time Frame: 2012 ]
  • Pharmacokinetics [ Time Frame: 2012 ]
  • Correlation between baseline expression of intra-tumoral biomarkers (e.g., ErbB1, ErbB2, insulin-like growth factor-1 receptor, p-AKT, and ERK) and clinical response or benefit to lapatinib ditosylate by IHC [ Time Frame: 2012 ]
  • Correlation between expression pattern of drug resistance proteins (e.g., p-glycoprotein, MRP1, BCRP, and MDR-3) and clinical response or benefit to lapatinib ditosylate by IHC [ Time Frame: 2012 ]

Enrollment: 10
Study Start Date: October 2007
Study Completion Date: March 2012
Primary Completion Date: November 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Lapatinib and Epirubicin
Fixed dose of lapatinib in combination with escalating dose of epirubicin.
Drug: epirubicin hydrochloride Drug: lapatinib ditosylate Other: biomarker analysis Other: immunohistochemistry staining method Other: liquid chromatography Other: mass spectrometry

Detailed Description:



  • To assess the safety and tolerability of fixed-dose lapatinib ditosylate in combination with epirubicin hydrochloride in patients with metastatic breast cancer.
  • To determine the optimally-tolerated regimen in these patients.


  • To determine the clinical efficacy of this regimen in these patients.
  • To analyze pharmacokinetic data of this regimen.
  • To determine biomarkers that correlate with clinical benefit or response to lapatinib ditosylate in these patients.


  • To identify tumor-derived or blood-derived biomarkers that correlate with or are predictive of clinical response or benefit to lapatinib ditosylate in these patients.
  • To determine the levels of IGF-IR and phosphorylated IGF-IR in tumor tissue.
  • To determine the expression pattern of the proteins associated with drug resistance that may be clinically active in these patients.

OUTLINE: This is a multicenter, dose-escalation study of epirubicin hydrochloride.

Patients receive oral lapatinib ditosylate followed by epirubicin hydrochloride IV over 15-30 minutes on day 1. Treatment repeats every 3 weeks for up to 7 courses in the absence of disease progression or unacceptable toxicity.

Blood samples are collected periodically for pharmacokinetic analysis via liquid chromatography-mass spectometry (LC-MS).

After completion of study therapy, patients are followed at 28 days and then every 3 months thereafter.


Ages Eligible for Study:   18 Years to 120 Years   (Adult, Senior)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No


  • Confirmed diagnosis of breast cancer

    • Metastatic disease
  • No de novo metastasis
  • Hormone receptor status not specified


  • ECOG performance status 0-1
  • Life expectancy > 3 months
  • Menopausal status not specified
  • ANC ≥ 1,500/μL
  • Platelet count ≥ 100,000/μL
  • Hemoglobin ≥ 9 g/dL
  • Creatinine clearance ≥ 50 mL/min
  • AST/ALT < 3 times upper limit of the normal (ULN)
  • Total bilirubin normal (unless documented history of congenital hypobilirubinemia)
  • LVEF normal by ECHO or MUGA scan
  • Not pregnant or breastfeeding
  • Negative pregnancy test
  • Fertile patients must use effective contraception from the time of their negative pregnancy test before treatment, during treatment, and 28 days following treatment
  • Able to swallow and retain oral medication
  • History of other malignancies (e.g., cervical carcinoma in situ, melanoma in situ, or basal cell or squamous cell carcinoma of the skin) allowed provided patient has been treated and disease free ≥ 5 years and deemed by the investigator to be at low risk for recurrence
  • No known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to lapatinib ditosylate or excipients
  • No malabsorption syndrome, disease significantly affecting gastrointestinal function, resection of the stomach or small bowel, or ulcerative colitis
  • No active or uncontrolled infection
  • No known history of uncontrolled or symptomatic angina, arrhythmias, congestive heart failure, or other cardiac disorders
  • No history of prolonged QT interval
  • No active hepatic or biliary disease (except for Gilbert's syndrome, asymptomatic gallstones, liver metastases or stable chronic liver disease per investigator assessment)
  • No concurrent disease or condition that would render the patient inappropriate for study participation, or serious medical disorder that would interfere with the patient's safety
  • No dementia, altered mental status, or psychiatric condition that would prohibit the understanding or rendering of informed consent


  • Prior radiotherapy for treatment of primary tumor allowed
  • Prior non-anthracycline based regimens in neoadjuvant, adjuvant, or metastatic setting allowed
  • Prior adjuvant Herceptin® or ErbB inhibitors allowed provided disease progression was > 6 months after completion of treatment
  • More than 3 months since prior Herceptin®, ErbB1, or ErbB2
  • No prior chemotherapy in the adjuvant or neoadjuvant setting with anthracycline or anthracenedione-containing regimens
  • More than 3 weeks since prior and no concurrent medications that would prolong QT interval
  • More than 1 month or 5 half-lives (whichever is longer) since prior, no concurrent investigational drugs
  • No unresolved or unstable, serious toxicity from prior investigational drug and/or cancer treatment
  • At least 3 weeks since prior and no concurrent prohibited medications (i.e., CYP3A4 inducers or inhibitors)
  • No concurrent non-study anticancer therapy (i.e., chemotherapy, immunotherapy, or biologic therapy)
  • No concurrent participation in another clinical trial
  • No concurrent grapefruit or grapefruit juice
  • Concurrent bisphosphonates allowed
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Please refer to this study by its identifier: NCT00753207

The Adelaide and Meath Hospital, Dublin Incorporating the National Childresn's Hospital
Dublin, Ireland, 24
St Vincent's University Hospital
Dublin, Ireland, 4
St James's Hospital
Dublin, Ireland, 8
Sponsors and Collaborators
Cancer Trials Ireland
Principal Investigator: John Crown, MD St. Vincent's University Hospital
  More Information

Responsible Party: Cancer Trials Ireland Identifier: NCT00753207     History of Changes
Obsolete Identifiers: NCT00566748
Other Study ID Numbers: 06-30 ICORG
Study First Received: September 13, 2008
Last Updated: February 12, 2016

Keywords provided by Cancer Trials Ireland:
stage IV breast cancer
recurrent breast cancer

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Breast Diseases
Skin Diseases
Antineoplastic Agents
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antibiotics, Antineoplastic
Topoisomerase II Inhibitors
Topoisomerase Inhibitors processed this record on April 21, 2017