Clinical Trials /

TKI258 for Metastatic Inflammatory Breast Cancer Patients

NCT01262027

Description:

The goal of this clinical research study is to learn if dovitinib can help to control inflammatory breast cancer. The safety of this drug will also be studied.

Related Conditions:
  • Breast Carcinoma
Recruiting Status:

Unknown status

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: TKI258 for Metastatic Inflammatory Breast Cancer Patients
  • Official Title: A Phase II Study of TKI258 (Dovitinib Lactate) as Salvage Therapy in Patients With Stage IV HER2-negative Inflammatory Breast Cancer (IBC) and Local or Distant Relapse

Clinical Trial IDs

  • ORG STUDY ID: 2010-0296
  • SECONDARY ID: NCI-2011-00299
  • NCT ID: NCT01262027

Conditions

  • Breast Cancer

Interventions

DrugSynonymsArms
DovitinibTKI258Dovitinib

Purpose

The goal of this clinical research study is to learn if dovitinib can help to control inflammatory breast cancer. The safety of this drug will also be studied.

Detailed Description

      The Study Drug:

      Dovitinib is designed bind to a protein on the surface of cancer cells called the FGF
      receptor. This may slow the growth of cancer cells or kill cancer cells.

      Study Drug Administration:

      If you are found to be eligible to take part in this study, you will take dovitinib by mouth
      each day for 5 days and have a 2-day rest period (5 days on/2 days off schedule). The first
      dose of each week is Day 1. You should take dovitinib in the morning with a glass (about 8
      ounces) of water at least 1 hour before or at least 2 hours after eating. It is important
      that you take the study drug at about the same time every day.

      If you forget to take a dose of the study drug as scheduled, or take a dose during your 2-day
      rest period, you should follow the guidelines below or call your study staff:

        -  If you take a dose on Day 6, then you will rest on Day 7 and start taking the drug on
           Day 1.

        -  If you take a dose on Day 7, then you will skip Day 1 the next schedule and start dosing
           on Day 2.

        -  If you take a dose on Day 6 and Day 7, then you will skip Days 1 and 2 of the next
           schedule and start dosing on Day 3.

        -  If you missed a dose on Days 1, 2, 3, or 4, you should restart the next dosing day and
           rest on Days 6 and 7.

        -  If you missed a dose on Day 5, you should rest on Days 6 and 7, and restart dosing on
           Day 1 of the next week.

      You should not take additional medications including over-the-counter products and
      herbal/alternative medications during the study without asking your doctor. It is important
      to avoid medications that are known to cause liver side effects.

      If you experience intolerable side effects, the study doctor may give you drugs to help
      control the side effects.

      You should store the study drug at room temperature and out of direct sunlight. The study
      drug should also be kept away from children.

      About every 4 weeks, you will need to bring back your empty or partially used bottles of
      study drug.

      During Treatment:

      At every visit, you will be asked if you have had any side effects.

      Before each Cycle:

        -  You will have a physical exam, including measurement of your vital signs.

        -  Your performance status will be recorded.

        -  Blood (about 2 tablespoons) will be drawn for routine tests.

      Cycle 1, around Days 8 and 22:

      ° Blood (about 1 tablespoon) will be drawn to check your liver function.

      Cycle 2 around Day 8:

      ° Blood (about 1 tablespoon) will be drawn to check your liver function.

      Every 2 cycles (before Cycles 3, 5, 7, and so on):

        -  If the doctor thinks it is needed, photographs will be taken of your skin and any areas
           affected by inflammatory breast cancer.

        -  If the doctor thinks it is needed, you will have x-rays, a CT scan of the chest and/or
           abdomen, and/or a bone scan.

      Before Cycle 3:

        -  If the doctor thinks it is needed, you will have a positron emission computed tomography
           (PET/CT) scan to check the status of the disease.

        -  Blood (about 2 tablespoons) will be drawn for biomarker testing.

      You will also have a one-time blood draw (about 1 tablespoon) to measure the level of the
      study drug in your blood. This sample may be drawn on Days 12 or 26 of Cycle 1, before Cycle
      2, or on Day 12 of Cycle 2.

      If the doctor thinks it is needed, any of these tests and procedures may be performed
      earlier. If the doctor thinks it is needed, you will have an ECG, ECHO, or MUGA scan to check
      your heart function.

      Length of Study:

      You may remain on study for as long as you are benefiting. You will be taken off study
      treatment if the disease gets worse or you experience intolerable side effects.

      Your participation on the study will be over once you have completed the end-of-treatment
      visit.

      End-of-Treatment Visit:

      After you are off study, you will have a end-of-treatment visit within 14 days after the last
      study visit.

        -  You will be asked if you have had any side effects.

        -  You will have a physical exam, including measurement of your vital signs.

        -  Your performance status will be recorded.

        -  Blood (about 1 tablespoon) will be drawn for routine tests.

        -  If the doctor thinks it is needed, photographs will be taken of your skin and any areas
           affected by inflammatory breast cancer.

        -  If the doctor thinks it is needed, you will have x-rays, a CT scan of the chest and/or
           abdomen, and/or a bone scan.

        -  If the doctor thinks it is needed, you will have an ECG and ECHO or MUGA scan to check
           your heart function.

        -  If the doctor thinks it is needed, you will have a PET/CT scan to check the status of
           the disease.

      Follow-up Visits:

      You will be called or e-mailed every 3 months for up to 1 year and asked how you are doing.

      This is an investigational study. Dovitinib is not FDA approved or commercially available. At
      this time, dovitinib is only being used in research.

      Up to 33 patients will take part in this study. All will be enrolled at MD Anderson.
    

Trial Arms

NameTypeDescriptionInterventions
DovitinibExperimentalA complete treatment cycle defined as 28 days or 4 weeks (+/- 2 days). Patients receive a single daily oral dose of 500 mg of dovitinib for 5 consecutive days, followed by a 2-day rest period (5 days on/2 days off schedule).
  • Dovitinib

Eligibility Criteria

        Inclusion Criteria:

          1. Patients have histological confirmation of breast carcinoma with a clinical diagnosis
             of IBC based on presence of inflammatory changes in the involved breast, including
             diffuse erythema and edema (peau d orange), with or without an underlying palpable
             mass involving the majority of the skin of the breast. Pathological evidence of dermal
             lymphatic invasion should be noted but is not required for diagnosis.

          2. Patients have stage IV disease with local or distant relapse

          3. Patients have negative HER2 expression by IHC (defined as 0 or1+), or fluorescence in
             situ hybridization (FISH). If HER2 is 2+, negative HER2 expression must be confirmed
             by FISH.

          4. Patients are able to swallow and retain oral medication.

          5. Patients have Eastern Cooperative Oncology Group (ECOG) performance status 0-2.

          6. Patients have received two or more standard chemotherapies for metastatic disease and
             have relapsed.

          7. Patients have ability and willingness to sign written informed consent.

          8. Patients are 18 years of age or older.

          9. Female patients of childbearing potential (A female not free from menses > 2 years or
             not surgically sterilized) must be willing to use highly effective contraception to
             prevent pregnancy or agree to abstain from heterosexual activity throughout the study.
             Highly effective contraception, defined as male condom with spermicide, diaphragm with
             spermicide, intra-uterine device. Highly effective contraception must be used by both
             sexes during the study and must be continued for 8 weeks after the end of study
             treatment. Oral, implantable, or injectable contraceptives may be affected by
             cytochrome P450 interactions, and are therefore not considered effective for this
             study.

         10. Female patients of childbearing potential must have negative serum pregnancy test
             </=14 days prior to starting study treatment.

         11. If Patients have been treated with anti-vascular endothelial growth factor (VEGF)
             agents, such as Bevacizumab, last dose must be > 4 weeks.

         12. Patients have biopsy tissue of the metastatic disease (including chest wall or
             regional nodes) available (paraffin blocks or up to 20 unstained slides), if no biopsy
             tissue available, a biopsy (or thoracentesis if patient has pleural effusion only) of
             the metastatic disease will be performed to confirm the diagnoses.

         13. Serum total bilirubin must be within Upper Limited Normal (T. Bilirubin upper limit of
             normal (ULN)=1.0 mg/dl)

         14. AST and ALT must be < 2.5 x ULN(with or without liver metastases).

        Exclusion Criteria:

          1. Patients are receiving concurrent anti-cancer therapy (chemotherapy, immunotherapy,
             radiation therapy and biological therapy) while taking study medication.

          2. Cirrhosis of liver, or known hepatitis B or C infection have hepatic impairment
             Child-Pugh Score of B or worse.

          3. Absolute neutrophil count (ANC) < 1.5

          4. Patients have an active infection and require IV or oral antibiotics.

          5. Impaired cardiac function or clinically significant cardiac diseases, including any of
             the following: a) History or presence of serious uncontrolled ventricular arrhythmias
             or presence of atrial fibrillation; b) Clinically significant resting bradycardia (<
             50 beats per minute); c) left ventricular ejection fraction (LVEF) assessed by 2-D
             echocardiogram (ECHO) < 50% or lower limit of normal (which ever is higher) or
             multiple gated acquisition scan (MUGA) < 45% or lower limit of normal (which ever is
             higher). d) Any of the following within 6 months prior to study entry: myocardial
             infarction (MI), severe/unstable angina, Coronary Artery Bypass Graft (CABG),
             Congestive Heart Failure (CHF), Cerebrovascular Accident (CVA), Transient Ischemic
             Attack (TIA), Pulmonary Embolism (PE); e) Uncontrolled hypertension defined by an
             SBP>150 and/or a diastolic blood pressure (DBP)>100 mm Hg with or without
             anti-hypertensive medication.

          6. History of gastrointestinal disorders (medical disorders or extensive surgery) which
             may interfere with the absorption of the study drug.

          7. Patients have a concurrent disease or condition that would make them inappropriate for
             study participation, or any serious medical disorder that would interfere with
             patients safety.

          8. Patients with only locally or regionally confined disease without evidence of
             metastatic disease.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:Female
Healthy Volunteers:No

Primary Outcome Measures

Measure:Overall Response (Complete Response [CR], Partial Response [PR] or Stable Disease [SD]) of Participants
Time Frame:6 months
Safety Issue:
Description:Number of participants experiencing CR, PR or SD as defined by Response Evaluation Criteria In Solid Tumors (RECIST). Response is anyone who experiences SD, CR or PR in first 6 months. CR: Disappearance clinical evidence active tumor by evaluation, mammogram & ultrasound. No symptoms or evidence of residual invasive tumor, including no residual tumor in axillary lymph nodes. PR: 50%/> decrease for minimum 4 weeks in measurable lesion determined by product of perpendicular diameters of lesion. Every lesion should not regress to qualify as PR; however, if lesion progresses or if new lesions appear, response cannot be classified as PR. Minor Response [MR]: Decreases in tumor masses insufficient to qualify as partial remission, i.e. <50%. SD: Between MR & PD. PD: Increase 25% measured lesion from baseline. New lesions constitutes increasing disease. Mixed responses consid

Secondary Outcome Measures

Measure:Safety Analysis of Dovitinib: Most Frequently Reported Treatment-related Adverse Event (AEs)
Time Frame:6 months
Safety Issue:
Description:Safety analysis evaluated by grading each adverse event according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 and reporting the type, frequency and severity in a summary format. Full AE reporting can be found in the Adverse Event Section.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Active, not recruiting
Lead Sponsor:M.D. Anderson Cancer Center

Trial Keywords

  • Metastatic inflammatory breast cancer
  • Stage IV disease
  • HER2-negative
  • Dovitinib
  • TKI258

Last Updated

May 23, 2017