A Study Inhibiting Telomerase to Reverse Trastuzumab Resistance in HER2+ Breast Cancer

Breast Neoplasms Clinical Trial

Official title:

A Phase I Study Inhibiting Telomerase to Reverse Trastuzumab Resistance in HER2+ Breast Cancer

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01265927
• Other study ID #: IUCRO-0314
• Secondary ID: 1010-05
• Status: Completed
• Phase: Phase 1
• First received: December 3, 2010
• Last updated: October 26, 2015
• Start date: January 2011
• Est. completion date: October 2015

Study information

• Verified date: October 2015
• Source: Indiana University
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

A study to evaluate safety and biologic effects of giving GRN163L in combination with trastuzumab in patients diagnosed with HER2+ metastatic breast cancer that is resistant to therapy with trastuzumab.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 10
• Est. completion date: October 2015
• Est. primary completion date: August 2012
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Males or females 18 years or older at the time of consent.

2. ECOG performance status of 0-2 within 21 days of study registration.

3. Histologically or cytologically confirmed adenocarcinoma of the breast with locally recurrent or metastatic disease. NOTE: locally recurrent disease must not be amenable to surgery or radiation with curative intent.

4. Measurable or evaluable disease according to RECIST v1.1 within 35 days prior to study registration.

5. Disease must be amenable to biopsy (image-guided or via direct visualization of superficial lesions) with minimal risk to the patient. NOTE: Patients with disease limited to the lung and/or pleura are excluded.

6. Disease must be HER2+ as defined by IHC 3+ or FISH ratio > 2.0.

7. Resistant to trastuzumab as defined as (1) progression within 12 months of completing adjuvant/neoadjuvant trastuzumab or (2) progression on trastuzumab administered for metastatic disease.

8. Prior treatment with lapatinib or investigational HER2 targeted therapies is allowed but not required. There are no limits on the number of regimens or other prior anti-HER2 therapies patients have received.

9. LVEF = Lower Limit of Normal based on MUGA or ECHO within 35 days prior to study registration

10. Females of childbearing potential and males must be willing to use an effective method of contraception from the time consent is signed until 6 months after treatment discontinuation. Methods of contraception include hormonal birth control (oral contraceptives, patch, injection, vaginal ring or implant), two barrier methods of birth control, abstinence and/or other methods as determined by the treating physician.

11. Females of childbearing potential must have a negative pregnancy test within 14 days prior to registration for protocol therapy.

NOTE: Females are considered of child bearing potential unless they are surgically sterile (they have undergone a hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or they are postmenopausal (> 12 months since last menses).

Laboratory values must be obtained within 21 days of study registration:

12. Absolute neutrophil count (ANC) = 1.5 K/mm3

13. Platelets = 100 K/mm3

14. Hemoglobin (Hgb) = 9.0 g/dL (may be transfused)

15. Serum creatinine < 3.0 mg/dL

16. Total Bilirubin = 1.5 x ULN

17. AST/SGOT = 2.5 x ULN. If liver metastases is present, AST = 5 x ULN

18. ALT, SGPT = 2.5 x ULN. If liver metastases is present, ALT = 5 x ULN

Exclusion Criteria:

19. No Investigational therapy within 4 weeks of study registration

20. No hormonal therapy within 2 weeks of study registration

21. No cytotoxic chemotherapy within 2 weeks of study registration.

22. No prior treatment with GRN163L

23. No prior history of severe reaction to trastuzumab, as determined by the treating physician.

24. No history of clinically significant cardiac dysfunction, including:

Current uncontrolled hypertension (systolic >150 mmHg and/or diastolic >100 mmHg), or unstable angina History of symptomatic CHF (Grade >3 by NCI CTCAE or Class >II by NYHA criteria [see Appendix IV]) or serious cardiac arrhythmia requiring treatment within 12 months of study registration, with the exceptions of atrial fibrillation and paroxysmal supraventricular tachycardia History of myocardial infarction within 6 months of study registration

25. No history of cerebrovascular accident within 12 months of study registration

26. No active CNS metastases. Patients with previously treated CNS metastases who do not require chronic steroids or anticonvulsants are eligible.

27. Prior radiation therapy must not have involved > 25% of bone marrow due to potential myelosuppression with GRN163L. See bone marrow chart in Appendix III

NOTE: Radiation therapy within 2 weeks of study registration is not allowed.

28. Females must not be breastfeeding.

29. No clinically significant active infection, as determined by the treating physician

Study Design

Allocation: Non-Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Breast Neoplasms

Intervention

Drug:
• GRN163L in combination with trastuzumab
GRN163L will be administered in escalating dose cohorts on Day 1 of each 21-day cycle prior to trastuzumab infusion. Trastuzumab will be a administered day 1 of each 21-day cycle after GRN163L. There will be a 30 minute observation period between the end of the GRN163L infusion and the beginning of the trastuzumab infusion.

Locations

Country	Name	City	State
United States	Indiana University Simon Cancer Center	Indianapolis	Indiana

Sponsors (3)

Lead Sponsor	Collaborator
Indiana University	Breast Cancer Research Foundation, Geron Corporation

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Determine the dose-limiting toxicity of GRN163L in combination with trastuzumab in patients with refractory HER2+ metastatic disease		End of Study	Yes
Secondary	Measure the concentration of trastuzumab and GRN163L from blood samples immediately before and after infusion on day 1, weekly during cycle 1, and immediately prior to cycle 2	PK data will be described using means, standard deviations, medians, minimums and maximums.	Until cycle 2	No
Secondary	Tumor biopsy and bone marrow aspirate assayed for telomerase activity prior to treatment and immediately prior to planned cycle 2	Telomerase activity data will be described using means, standard deviations, medians, minimums and maximums.	Until cycle 2	No
Secondary	Flow cytometry to compare cell cycle distribution in tumor and bone marrow prior to treatment and immediately prior to cycle 2.	Marrow (and tumor when sufficient sample is available) will be analyzed via flow cytometry to determine cell distribution. Percentage of cells at each cycle will be described using means, standard deviations, medians, minimums and maximums.	Until cycle 2	No
Secondary	Tumor samples analyzed for activation of HER2 family signaling protein activation (phosphorylation) status prior to treatment and immediately prior to cycle 2.	HER2 family signaling protein activation will be described using means, standard deviations, medians, minimums and maximums.	Until cycle 2	No
Secondary	Determine objective response rate (ORR) and progression free survival (PFS) of GRN163L in combination with trastuzumab in this patient population		End of Study	No