Erlotinib Hydrochloride in Treating Patients With Pancreatic Cancer That Can Be Removed by Surgery

Stage III Pancreatic Cancer Clinical Trial

Official title:

Phase IIA Trial Testing Erlotinib as an Intervention Against Intraductal Pancreatic Mucinous Neoplasms

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT00482625
• Other study ID #: NCI-2009-00898
• Secondary ID: UCI 06-30N01CN35
• Status: Terminated
• Phase: Phase 2
• First received: June 4, 2007
• Last updated: October 7, 2014
• Start date: June 2007
• Est. completion date: September 2013

Study information

• Verified date: March 2014
• Source: National Cancer Institute (NCI)
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

Erlotinib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving erlotinib hydrochloride before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. This phase II trial is studying how well erlotinib hydrochloride works in treating patients with pancreatic cancer that can be removed by surgery

Description:

PRIMARY OBJECTIVES:

I. To test the hypothesis that the activated epidermal growth factor receptor (EGFR) signal transduction biomarker Mucin 5AC (MUC5AC) protein expression within intraductal pancreatic mucinous neoplasm (IPMN) lesions will have greater than zero absolute mean decrease from baseline comparing pre and post 21-42 days of Erlotinib (erlotinib hydrochloride) administration at 100mg orally (PO) once daily (QD).

SECONDARY OBJECTIVES:

I. To test the hypothesis that other correlative IPMN EGF inducible biomarkers will have greater than zero absolute mean decrease from baseline pre and post Erlotinib 100mg PO QD therapy.

II. Safety of Erlotinib treatment. III. To determine Erlotinib pharmacokinetic concentration in plasma and pancreatic tissue at the 100mg/day dose up to 42 days of therapy.

OUTLINE:

Patients receive erlotinib hydrochloride PO QD for 21-42 days in the absence of disease progression or unacceptable toxicity. Patients then undergo to pancreatectomy.

After completion of study treatment, patients are followed up at 4-20 weeks.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 6
• Est. completion date: September 2013
• Est. primary completion date: February 2010
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Confirmed IPMN histological diagnosis, endoscopic ultrasound fine needle aspiration (EUS-FNA) core biopsy tissue specimen with plan for pancreatic surgical resection; histological diagnosis should be within 6 months of entry into protocol

• Patients must have adequate bone marrow function at study entry

• White blood cell (WBC) > 3,000

• Platelets > 100,000/mm^3

• Hemoglobin > 10 g/dL

• Plasma creatinine of < 1.6 mg/dL

• Total bilirubin < 1.5

• Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 1.5 x upper limit of normal

• Patients with evidence of obstructive lung disease (forced expiratory volume in one second [FEV1] < 80% predicted and FEV1/forced vital capacity [FVC] ratio < 90% of predicted value) as the etiology of a low diffusing capacity will still be eligible as long as the chest radiograph or computed tomography (CT) does not demonstrate interstitial changes

• Eastern Cooperative Oncology Group (ECOG) performance status 0-1

• Women of child-bearing potential and men taking study drug 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

• Ability to understand, as well as sign the written informed consent document

• If a woman of child-bearing potential, must have a negative pregnancy test prior to study entry; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her study physician immediately

Exclusion Criteria:

• Intake of EGFR antagonist, Erbitux (cetuximab)

• Previous history of sensitivity to Tarceva (erlotinib hydrochloride), Iressa (gefitinib), or Erbitux, such as a rash that is uncontrollable by topical steroids and/or antibiotics

• Uncontrollable diarrhea of any cause

• Active keratoconjunctivitis, or corneal surgery in the past three weeks

• Participants taking a known cytochrome P450 3A4 (CYP 3A4) inducer (e.g., phenytoin, carbamazepine, St. John's wort, and rifampin) and medications known to be inhibitors or metabolized by CYP3A4; these inhibitors include erythromycin, clarithromycin and ketoconazole, and patients taking them will be excluded since these drugs may be expected to result in altered exposure of Erlotinib

• Hospitalization within the past 5 years for mania or for bipolar disease

• Participants may not be receiving any other investigational pharmaceutical agents

• Women who are breast-feeding should not receive Erlotinib

• Any medical or psychosocial condition that, in the opinion of the investigator, could jeopardize the subject's participation in and compliance to the study

Study Design

Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Intraductal Papillary Mucinous Neoplasm of the Pancreas
• Pancreatic Neoplasms
• Recurrent Pancreatic Cancer
• Stage IA Pancreatic Cancer
• Stage IB Pancreatic Cancer
• Stage IIA Pancreatic Cancer
• Stage IIB Pancreatic Cancer
• Stage III Pancreatic Cancer

Intervention

Drug:
• erlotinib hydrochloride
Given PO

Procedure:
• conventional surgery
Undergo pancreatectomy

Other:
• immunohistochemistry staining method
Correlative studies

Genetic:
• protein expression analysis
Correlative studies

Procedure:
• biopsy
Correlative studies

Other:
• pharmacological study
Correlative studies
• laboratory biomarker analysis
Correlative studies

Locations

Country	Name	City	State
United States	University of California Medical Center At Irvine-Orange Campus	Orange	California

Sponsors (1)

Lead Sponsor	Collaborator
National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

References & Publications (1)

Armstrong WB, Wan XS, Kennedy AR, Taylor TH, Meyskens FL Jr. Development of the Bowman-Birk inhibitor for oral cancer chemoprevention and analysis of Neu immunohistochemical staining intensity with Bowman-Birk inhibitor concentrate treatment. Laryngoscope — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Reduction in Number of Positive IPMN Celss and Staining Intensity After Treatment	Number of participants showed a reduction in number of positive IPMN cells and staining intensity after treatment	Pre-treatment and post-treatment	No
Secondary	Plasma Calculated Concentration - OSI-774 (ng/mL)	Plasma concentration levels of Erlotinib (OSI-774)	20 weeks	No
Secondary	Pancreas Calculated Concentration - OSI-774 (ng/g)	Pancreatic tissue concentration levels of Erlotinib (OSI-774)	20 weeks	No
Secondary	Plasma Calculated Concentration - OSI-420 (ng/mL)	Plasma concentration levels of Erlotinib (OSI-420)	20 weeks	No
Secondary	Pancreas Calculated Concentration - OSI-420 (ng/g)	Pancreatic tissue concentration levels of Erlotinib (OSI-420)	20 weeks	No
Secondary	Number of Participants Reported at Least 1 Adverse Event With a Grade of 3 and Above	The worst grade of pre-listed toxicity will be summarized by participant and by visit for each treatment group. Descriptive statistics (frequencies and percents) will be used to summarize data and hypotheses about group differences will be tested where appropriate.	Up to 20 weeks	Yes