Clinical Trials /

Window of Opportunity Trial of Dasatinib in Operable Triple Negative Breast Cancers With nEGFR

NCT02720185

Description:

Primary Objective: To determine if dasatinib, an inhibitor of the Src family kinases, can prevent the nuclear translocation of the epidermal growth factor receptor (EGFR) in Stage I-III, nuclear EGFR positive, triple negative breast cancers (TNBC). Secondary Objectives: 1. To examine the safety and tolerability of dasatinib in patients with operable TNBC 2. To explore potential intracellular mechanisms which impact dasatinib effect on cellular localization of EGFR in operable TNBC. 3. To examine the pathologic complete response (pCR) rates to standard neoadjuvant chemotherapy in nEGFR+ TNBC 4. To examine breast cancer recurrence rates and patterns of metastatic recurrent in nEGFR+ TNBC

Related Conditions:
  • Breast Carcinoma
Recruiting Status:

Active, not recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Window of Opportunity Trial of Dasatinib in Operable Triple Negative Breast Cancers With nEGFR
  • Official Title: Window of Opportunity Study of Dasatinib in Operable Triple Negative Breast Cancers With Nuclear Epidermal Growth Factor Receptor

Clinical Trial IDs

  • ORG STUDY ID: UW15114
  • SECONDARY ID: 1R01CA193004-01A1
  • SECONDARY ID: NCI-2016-00237
  • SECONDARY ID: 2015-1578
  • SECONDARY ID: A534260
  • SECONDARY ID: SMPH\MEDICINE\HEM-ONC
  • SECONDARY ID: Protocol Version 8/29/2019
  • NCT ID: NCT02720185

Conditions

  • Breast Neoplasms
  • Triple Negative Breast Neoplasms

Interventions

DrugSynonymsArms
Dasatinib732517, 863127-77-9, BMS-354825, SprycelDasatinib 100mg

Purpose

Primary Objective: To determine if dasatinib, an inhibitor of the Src family kinases, can prevent the nuclear translocation of the epidermal growth factor receptor (EGFR) in Stage I-III, nuclear EGFR positive, triple negative breast cancers (TNBC). Secondary Objectives: 1. To examine the safety and tolerability of dasatinib in patients with operable TNBC 2. To explore potential intracellular mechanisms which impact dasatinib effect on cellular localization of EGFR in operable TNBC. 3. To examine the pathologic complete response (pCR) rates to standard neoadjuvant chemotherapy in nEGFR+ TNBC 4. To examine breast cancer recurrence rates and patterns of metastatic recurrent in nEGFR+ TNBC

Trial Arms

NameTypeDescriptionInterventions
Dasatinib 100mgExperimentalDasatinib 100mg for 7-10 days until day prior to surgery
  • Dasatinib

Eligibility Criteria

        Inclusion Criteria for nEGFR testing:

          -  Patients must have histologically or cytologically confirmed Stage I-III triple
             negative breast cancer

               -  ER and PR must be <1% by standard assay methods

               -  HeR2 must be either 0, 1+ by immunohistochemistry (if 2+, in situ hybridization
                  method used to define HER2) OR have HER2: 17 centromere signal of <2.0 using a
                  standard in situ hybridization method

          -  No prior therapy for current breast cancer

          -  Meet criteria for neoadjuvant chemotherapy or primary breast surgery, as determined by
             primary oncologist and surgeon

        Inclusion Criteria for study therapy:

          -  nEGFR positive

          -  ECOG performance status ≤1

          -  Patients must have normal organ and marrow function as defined below:

          -  leukocytes ≥3,000/mcL

          -  absolute neutrophil count ≥1,500/mcL

          -  platelets ≥150,000/mcL

          -  total bilirubin <1.25x institutional upper limit of normal

          -  AST(SGOT)/ALT(SGPT) ≤2.5 × institutional upper limit of normal

          -  creatinine within normal institutional limits OR creatinine clearance ≥60 mL/min/1.73
             m2 for patients with creatinine levels above institutional normal.

          -  Women of child-bearing potential and men must agree to use adequate contraception
             (hormonal or barrier method of birth control; abstinence) prior to study entry and for
             the duration of study participation and for 30 days after the final dose. Should a
             woman become pregnant or suspect she is pregnant while she or her partner is
             participating in this study, she should inform her treating physician immediately

          -  Ability to understand and the willingness to sign a written informed consent document

        Exclusion Criteria:

          -  Patients who are receiving any other investigational agents

          -  Patients not able to swallow oral medications or with gastrointestinal conditions that
             may impact absorption of dasatinib.

          -  History of allergic reactions attributed to compounds of similar chemical or biologic
             composition to dasatinib.

          -  Patients receiving any medications or substances that are moderate or strong
             inhibitors or inducers of CYP3A4 are ineligible. Because the lists of these agents are
             constantly changing, medications should be reviewed by the UW Pharmacy Research Center
             for any contraindicated medications. As part of the enrollment/informed consent
             procedures, the patient will be counseled on the risk of interactions with other
             agents, and what to do if new medications need to be prescribed or if the patient is
             considering a new over-the-counter medicine or herbal product.

          -  H2 antagonists and proton pump inhibitors are not allowed

          -  Anticoagulants (ie. Coumadin, heparin, anti-Xa inhibitors) and anti-platelet agents
             (ie. aspirin) are not allowed. NSAIDS and acetaminophen are allowed on study.

          -  Medications known to prolong QTC are not allowed (See Appendix B)

          -  No history of prolonged QTC or cardiomyopathy unless normal QTC and ejection fraction
             confirmed within 1 month prior to study entry.

          -  Uncontrolled intercurrent illness including, but not limited to, ongoing or active
             infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
             arrhythmia, or psychiatric illness/social situations that would limit compliance with
             study requirements.

          -  Pregnant women are excluded from this study because dasatinib is a pregnancy category
             D agent with the potential for teratogenic or abortifacient effects. Because there is
             an unknown but potential risk for adverse events in nursing infants secondary to
             treatment of the mother with dasatinib, breastfeeding should be discontinued if the
             mother is treated with dasatinib and not resumed until at least 2 weeks after the
             final dose.

          -  HIV-positive patients on combination antiretroviral therapy are ineligible because of
             the potential for pharmacokinetic interactions with dasatinib. In addition, these
             patients are at increased risk of lethal infections when treated with
             marrow-suppressive therapy. Appropriate studies will be undertaken in patients
             receiving combination antiretroviral therapy when indicated.

          -  Contraindication to repeat breast biopsy (neoadjuvant chemotherapy group)
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:Female
Healthy Volunteers:No

Primary Outcome Measures

Measure:Increase in plasma membrane EGFR expression, measured by VECTRA
Time Frame:7-10 days
Safety Issue:
Description:An increase of at least 25% from baseline to post-dasatinib treatment will be considered significant.

Secondary Outcome Measures

Measure:Incidence of treatment-emergent adverse events [safety and tolerability]
Time Frame:Up to 4 weeks
Safety Issue:
Description:Safety and tolerability of dasatinib in participants with operable TNBC will be based on NCIC Adverse Events Version 4.0 and will be assessed by frequency tables.
Measure:Pathologic Complete Response (pCR)
Time Frame:Up to 4 weeks
Safety Issue:
Description:Examine pCR rates to standard neoadjuvant chemotherapy in nEGFR+ TNBC. pCR will be defined as ypT0 ypNO (absence of cancer in breast tissue and lymph nodes) an assessed by the investigator. The point estimate of pCR and it's exact 95% confidence intervals will be calculated.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Active, not recruiting
Lead Sponsor:University of Wisconsin, Madison

Last Updated

March 9, 2021