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Clinical Trial Summary

This phase II trial studies how well erlotinib hydrochloride works in Treating participants with muscle invasive urothelial cancer or urothelial cancer that has come back. Drugs used in chemotherapy, such as erlotinib hydrochloride, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading.


Clinical Trial Description

PRIMARY OBJECTIVES:

I. To estimate the response rate (ie: pT0 rate) of patients with urothelial cancer treated with erlotinib prior to cystectomy.

SECONDARY OBJECTIVES:

I. To estimate the 4-year disease-free survival of patients with urothelial cancer treated with erlotinib prior to cystectomy.

II. To measure epithelial-mesenchymal transition (EMT) markers (E-cadherin, HER4, PDGFR-beta, vimentin, fibronectin) in pre- and post-treatment biopsies and correlate expression patterns with the biological responses measured below.

III. To quantify target inhibition, antiproliferation (KI-67), and apoptosis (terminal deoxynucleotidyl transferase dUTP nick end labeling [TUNEL]) in biopsies obtained from patients before, during, and after therapy.

IV. Interrogate membrane (phosphorylated EGFR) and downstream receptor signaling pathways (ERKs, AKT/mTOR, GSK-3beta) to provide further insight into whether or not a given tumor displays a biological response.

V. To correlate the changes in Ki-67 expression with changes in angiogenesis and angiogenesis related gene expression utilizing fluorescent tissue staining techniques that we have developed in the laboratory (such as two-color TUNEL, phosphor-receptor, and microvessel density.) VI. To profile messenger ribonucleic acid (mRNA) expression in pre- and post-treatment biopsies using Affymetrix arrays and correlate the changes observed with EMT, growth arrest, and apoptosis.

VII. To quantify EGFR copy number and correlate with changes observed with EMT, growth arrest, and apoptosis.

OUTLINE:

Participants receive erlotinib hydrochloride orally (PO) once daily (QD) for 3-5 weeks in the absence of disease progression or unacceptable toxicity. Within 24 hours of the last dose, participants undergo cystectomy.

After completion of study treatment, participants are followed up every 6 months for 1 year, then annually for 4 years. ;


Study Design


Related Conditions & MeSH terms

  • Carcinoma
  • Carcinoma, Transitional Cell
  • Kidney Neoplasms
  • Pelvic Neoplasms
  • Recurrent Bladder Urothelial Carcinoma
  • Recurrent Renal Pelvis Urothelial Carcinoma
  • Recurrent Ureter Urothelial Carcinoma
  • Recurrent Urethral Urothelial Carcinoma
  • Stage 0a Bladder Cancer AJCC v8
  • Stage 0a Renal Pelvis Cancer AJCC v8
  • Stage 0a Ureter Cancer AJCC v8
  • Stage 0a Urethral Cancer AJCC v8
  • Stage 0is Bladder Cancer AJCC v8
  • Stage 0is Renal Pelvis Cancer AJCC v8
  • Stage 0is Ureter Cancer AJCC v8
  • Stage 0is Urethral Cancer AJCC v8
  • Stage II Bladder Cancer AJCC v8
  • Stage II Renal Pelvis Cancer AJCC v8
  • Stage II Ureter Cancer AJCC v8
  • Stage II Urethral Cancer AJCC v8
  • Stage III Renal Pelvis Cancer AJCC v8
  • Stage III Ureter Cancer AJCC v8
  • Stage III Urethral Cancer AJCC v8
  • Stage IIIA Bladder Cancer AJCC v8
  • Ureteral Neoplasms
  • Urethral Neoplasms
  • Urinary Bladder Neoplasms

NCT number NCT00749892
Study type Interventional
Source M.D. Anderson Cancer Center
Contact
Status Completed
Phase Phase 2
Start date June 10, 2008
Completion date November 26, 2019

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