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6 Weeks Treatment of Locally Advanced Breast Cancer With BIBW 2992 (Afatinib) or Lapatinib or Trastuzumab

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ClinicalTrials.gov Identifier: NCT00826267
Recruitment Status : Completed
First Posted : January 22, 2009
Results First Posted : October 17, 2013
Last Update Posted : December 31, 2013
Sponsor:
Information provided by (Responsible Party):
Boehringer Ingelheim

Study Description
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Brief Summary:
An open-label, randomized three-arm Phase II trial to explore the efficacy of BIBW 2992 as a single agent versus lapatinib versus trastuzumab in patients with HER2-positive treatment-naïve Stage IIIa locally advanced breast cancer. Additional information will be obtained on the safety profile and pharmacokinetics of BIBW 2992.

Condition or disease Intervention/treatment Phase
Breast Neoplasms Drug: lapatinib Drug: BIBW 2992 Drug: trastuzumab Phase 2

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 29 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Randomised Phase II Study of Neoadjuvant BIBW 2992 Versus Herceptin Versus Lapatinib in Her2 Positive Breast Cancer Patients
Study Start Date : January 2009
Actual Primary Completion Date : August 2011

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Breast Cancer

Arms and Interventions
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Arm Intervention/treatment
Experimental: BIBW 2992
BIBW 2992 high dose once daily (allowed dose reduction to medium or low once daily in case of AE)
 Drug: BIBW 2992
BIBW 2992 high dose once daily (allowed dose reduction to medium or low once daily in case of AE)
Active Comparator: Lapatinib
Lapatinib tablets 1500 mg daily.
 Drug: lapatinib
lapatinib tablets 1500 mg daily
Active Comparator: Trastuzumab
Trastuzumab 4mg/kg i.v. week 1, followed by 2mg/kg i.v. weekly.
 Drug: trastuzumab
trastuzumab 4mg/kg i.v. week 1, followed by 2mg/kg i.v. weekly


Outcome Measures
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Primary Outcome Measures :
  1. Objective Response (OR) [ Time Frame: Tumour assessments were performed at screening, day 22 and day 43. ]
    Objective response (complete or partial) was assessed according to RECIST 1.0 criteria.


Secondary Outcome Measures :
  1. Number of Participants Who Achieved Clinical Benefit (CB) [ Time Frame: Tumour assessments were performed at screening, day 22 and day 43. ]
    CB was defined as CR, PR or stable disease (SD) and was assessed according to RECIST criteria regardless of treatment status.

  2. Change From Baseline in the Diameter of the Primary Target Lesion. [ Time Frame: 3 weeks or 6 weeks ]
    Change was based on the primary lesion only rather that the sum of the target lesions as most patients had only one lesion.

  3. Plasma Concentration of Afatinib [ Time Frame: Day 7 ]
    Individual drug plasma concentrations of afatinib after multiple oral administrations at day 7

  4. Changes in Biomarker in Tumour Biopsies [ Time Frame: Screening, day 22, day 43 ]
    Changes in the biomarkers (Phospho-MAP-Kinase (MAPK), Total MAPK expression, EGFR, HER2, Phospho-EGFR and -HER2, Proliferation marker (Ki67 and p27), Apoptotic index (cleaved caspase 3), Phosphate and tensin homolog (PTEN), HER2 homodimerisation by HERmark assay and Phospho AKT) from biopsy tissue.


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

Inclusion criteria:

  1. Female, age 18 years or older.
  2. Histologically proven breast cancer who have not received any prior therapy.
  3. Locally advanced disease Stage IIIa with no evidence of distant metastatic disease other than anatomical site lymph nodes.
  4. HER2-positive.

Exclusion criteria:

  1. Absolute neutrophil count (ANC) less than 1500/mm3.
  2. Platelet count less than 100 000/ mm3.
  3. Hemoglobin level less than 9.0 g/dl.
  4. Bilirubin greater than 1.5 mg/dI.
  5. Aspartate amino transferase (AST) or alanine amino transferase (ALT) greater than twice the upper limit of normal.
  6. Serum creatinine greater than 1.5 times of the upper normal limit.
  7. Significant or recent acute gastrointestinal disorders with diarrhea
  8. Pregnancy or breast-feeding.
  9. Organ system dysfunction including cardiac (LVEF < 50%).
  10. Prior chemotherapy, radiotherapy or hormone therapy. Previous treatment with trastuzumab, EGFR, or EGFR/HER2-inhibitors.
  11. Other malignancies diagnosed within the past five years.
  12. Serious active infection. HIV, active hepatitis B or C.
Contacts and Locations
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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 ClinicalTrials.gov identifier (NCT number): NCT00826267


Locations
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Sponsors and Collaborators
Boehringer Ingelheim
Investigators
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Study Chair: Boehringer Ingelheim Boehringer Ingelheim
More Information
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Additional Information:

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Responsible Party: Boehringer Ingelheim
ClinicalTrials.gov Identifier: NCT00826267    
Other Study ID Numbers: 1200.44
First Posted: January 22, 2009    Key Record Dates
Results First Posted: October 17, 2013
Last Update Posted: December 31, 2013
Last Verified: August 2013
Additional relevant MeSH terms:
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Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Trastuzumab
Lapatinib
 Afatinib
Antineoplastic Agents, Immunological
Antineoplastic Agents
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action