Esophageal Cancer Clinical Trial
Official title:
Phase II Trial of Afatinib in Combination With Weekly Paclitaxel in the Second Line Treatment of HER2 Amplified Advanced Gastric, Gastroesophageal Junction and Esophageal Cancer
The investigators are doing this research program to find out if the investigational drug,
afatinib which is a medication known to block the function of the ErbB2 protein might help
standard chemotherapy, in particular paclitaxel, work better.
Afatinib (GILOTRIF) is a highly potent, irreversible inhibitor of the EGFR and HER2. On July
12, 2013 the United States Food and Drug Administration (US FDA) approved afatinib for the
first-line treatment of patients with metastatic non-small cell lung cancer whose tumors had
specific EGFR gene mutations (exon 19 deletions or exon 21 i.e. L858R substitution
mutations) as detected by an FDA approved test.
Paclitaxel is a standard, anti-cancer medicine that has been approved by the US Food and
Drug Administration (FDA) for the treatment of lung cancer.
The combination of Afatinib and Paclitaxel are considered investigational when used in this
research program. An investigational drug is a drug that is not approved by the FDA for its
indication.
Standard Procedures:
Subjects are offered second line chemotherapy with paclitaxel 80 mg/m2 intravenous infusion
over 60 minutes on days 1, 8, and 15 of a 28-day cycle until disease progression or
intolerable toxicity.
Experimental Procedures:
In addition to the standard chemotherapy, afatinib 40 mg orally once daily will be
administered starting on the first day of paclitaxel. Translational studies to assess
circulating tumor cells at the start of therapy and then at several later time points,
including at the time of progression. These studies will assess the correlation of
circulating tumor cell numbers with radiographic response and pilot studies will also be
conducted to assess HER2 expression, HER2 genomic amplification, HER2 pathway activation and
secondary genetic changes in the HER2 coding sequence as well as other pathway components.
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