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CompletedNCT00101036Updated Apr 20, 2018Results posted

Lapatinib in Treating Patients With Locally Advanced or Metastatic Biliary Tract or Liver Cancer That Cannot Be Removed By Surgery

A Phase 2 interventional study of lapatinib ditosylate and laboratory biomarker analysis in Adult Primary Hepatocellular Carcinoma, Advanced Adult Primary Liver Cancer and Localized Unresectable Adult Primary Liver Cancer, sponsored by National Cancer Institute (NCI). Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2018-04-20.

Sponsored by National Cancer Institute (NCI) · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
57
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This phase II trial is studying how well lapatinib works in treating patients with locally advanced or metastatic biliary tract or liver cancer that cannot be removed by surgery. Lapatinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

Read the detailed description

PRIMARY OBJECTIVES:

I. The goal of this study is to determine the objective response rate of GW572016 in patients with biliary cancer and hepatocellular cancer (HCC).

SECONDARY OBJECTIVES:

I. Determine the overall survival of patients entered onto study. II. Quantitative and qualitative toxicities of the patient population treated with GW572016.

III. Determine the progression free survival of patients. IV. To perform molecular and pharmacogenomic correlative studies that will identify specific patient subsets that benefit from GW572016 therapy.

OUTLINE: This is a multicenter study. Patients are stratified according to tumor site (biliary tree cancer [includes ampullary, bile duct, and gall bladder cancer] vs hepatocellular cancer).

Patients receive oral lapatinib once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Patients are followed for survival.

02

Conditions studied

  • Adult Primary Hepatocellular Carcinoma
  • Advanced Adult Primary Liver Cancer
  • Localized Unresectable Adult Primary Liver Cancer
  • Recurrent Adult Primary Liver Cancer
  • Recurrent Extrahepatic Bile Duct Cancer
  • Recurrent Gallbladder Cancer
  • Unresectable Extrahepatic Bile Duct Cancer
  • Unresectable Gallbladder Cancer
03

In context

Carcinoma, Hepatocellular

3,182 studies on the registry are indexed under Carcinoma, Hepatocellular; 954 are open to participants now.

This study's enrollment of 57 is close to the median of 55 across 2,298 interventional studies indexed under Carcinoma, Hepatocellular.

Browse Carcinoma, Hepatocellular studies →

Lead sponsor

National Cancer Institute (NCI) is the lead sponsor of 3,506 studies on the registry; 334 are open to participants now.

Of its 402 completed or terminated interventional studies of FDA-regulated products, 365 (91%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria:

  • Patients must have histologically or cytologically confirmed, surgically unresectable biliary cancer (gallbladder, ampullary, intra or extrahepatic bile duct) OR patients must have surgically unresectable HCC and who are not candidates for percutaneous ethanol injection or radio frequency ablation (RFA); patients must have histological or cytological confirmation of HCC
  • Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as >= 20 mm with conventional techniques or as >= 10 mm with spiral CT scan; if a patient has undergone TACE, ethanol or RFA ablation then new lesions need to be present in the liver, if there are no other sites of disease
  • Patients may have received prior therapy as follows:

    • No more than one prior chemotherapy regimen for metastatic or recurrent disease will be allowed; prior chemotherapy for earlier stage disease (neoadjuvant, adjuvant, or concurrent with radiation therapy) will be allowed in addition to prior chemotherapy for recurrent metastatic disease; TACE is considered one regimen; at least 3 weeks must have elapsed since prior therapy, and toxicities of therapy should have resolved to =\< Grade 1
    • Patients may have received prior radiation therapy; three weeks must have elapsed since the completion of prior radiation therapy and patients must have recovered from all toxicities; measurable disease must either be outside the previous radiation field, or progressing within a radiated field, or a new lesion must be present
    • There must be no plans for the patient to receive concurrent hormonal, biologic, or radiation therapy to measurable lesions
    • Patients who have had prior treatment with EGFR targeting therapies are ineligible
    • Patients may not be receiving any other investigational agents or receiving concurrent anticancer therapy
  • Life expectancy of greater than 12 weeks
  • ECOG performance status less than or equal to 2 (Karnofsky >= 60%)
  • Patients who have scores that fall into Childs B or C groups are excluded
  • Patients must have organ and marrow function as defined below:
  • Leukocytes >= 3000/mcL
  • Absolute neutrophil count >= 1,500/mcL
  • Platelets >= 75,000/mcL
  • Total bilirubin \< 2 mg/dl
  • AST(SGOT)/ALT(SGPT) =\< 5.0 X upper limit of institutional normal (ULN)
  • PT prolongation \< 4 secs above ULN (unless taking warfarin)
  • Creatinine =\< ULN OR creatinine clearance >= 50 mL/min/1.73 m\^2 for patients with creatinine levels above institutional normal
  • Cardiac ejection fraction above the lower limit of normal as measured by echocardiogram or MUGA scan; note that baseline and on- treatment scans should be performed using the same modality and preferably at the same institution
  • Adherence to the requirements for concomitant medications classified as CYP3A4 inducers or inhibitors
  • HIV-positive patients receiving combination anti-retroviral therapy are excluded from the study because of possible pharmacokinetic interactions with GW572016; appropriate studies will be undertaken in patients receiving combination anti-retroviral therapy when indicated
  • Patients requiring oral anticoagulants (coumadin, warfarin) are eligible provided there is appropriate close INR monitoring is in place; if medically appropriate and treatment available, the investigator may also consider switching these patients to low molecular weight (LMW) heparin, where an interaction with GW572016 is not expected
  • The effects of GW572016 on the developing human fetus at the recommended therapeutic dose are unknown; for this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control or abstinence) prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
  • Pregnant women are excluded from this study because GW572016 is member of the 4-anilinoquinazoline class of kinase inhibitors 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 GW572016, breastfeeding should be discontinued if the mother is treated with GW572016
  • Ability to understand and the willingness to sign a written informed consent document
  • Able to swallow and retain oral medication
  • Patients with known brain metastases (Scans are not necessary to exclude brain metastasis) should be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events
  • Patients with 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, will be excluded
  • Patients with GI tract disease resulting in an inability to take oral medication, malabsorption syndrome, a requirement for IV alimentation, prior surgical procedures affecting absorption, uncontrolled inflammatory GI disease (e.g., Crohn's, ulcerative colitis) are also ineligible
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to GW572016 (i.e inhibitors of EGF and HER2- /neu) will render patients ineligible
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
57 participants (actual)

Study arms

  • Experimental
    Treatment (lapatinib ditosylate)

    Patients receive oral lapatinib once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

    Drug: lapatinib ditosylate · Other: laboratory biomarker analysis

Interventions

  • Druglapatinib ditosylate

    Given PO

    Also known as: GSK572016, GW-572016, GW2016, Lapatinib, Tykerb

  • Otherlaboratory biomarker analysis

    Correlative studies

06

What researchers measure

Primary outcomes

  1. Response Rate

    Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by CT, MRI or X-Ray: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR

    Time frame: Up to 5 years

Secondary outcomes

  1. Overall Survival

    Estimated by the Kaplan-Meier method.

    Time frame: Up to 5 years

  2. Progression-free Survival

    Estimated using the Kaplan-Meier method. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started, or the appearance of one or more new lesions.

    Time frame: Up to 5 years

  3. Disease Control Rate.

    The mathematical sum of percentages of complete response, partial response and stable disease. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI and/or CT: Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Stable Disease (SD), neither sufficient shrinkage to qualify for a Partial Response nor sufficient increase to qualify for Progression of Disease (POD); POD, 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions; Complete Response (CR), Disappearance of all target lesions

    Time frame: Up to 5 years

07

Results

Posted Jan 5, 2015

Participant flow

Participant flow — Overall Study
MilestoneArm 1Arm 2
Started1740
Completed1740
Not completed00

Outcome measures

PrimaryResponse Rate

Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by CT, MRI or X-Ray: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR

Time frame:
Up to 5 years
Reported as:
Number · percentage of responding patients
Response Rate
percentage of responding patientsArm 1Arm 2
Response Rate05
SecondaryOverall Survival

Estimated by the Kaplan-Meier method.

Time frame:
Up to 5 years
Reported as:
Median · Months
Overall Survival
MonthsArm 1Arm 2
Overall Survival5.2 (3.3 to NA)6.2 (5.1 to NA)
SecondaryProgression-free Survival

Estimated using the Kaplan-Meier method. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started, or the appearance of one or more new lesions.

Time frame:
Up to 5 years
Reported as:
Median · Months
Progression-free Survival
MonthsArm 1Arm 2
Progression-free Survival1.8 (1.7 to 5.2)2.3 (1.7 to 5.6)
SecondaryDisease Control Rate.

The mathematical sum of percentages of complete response, partial response and stable disease. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI and/or CT: Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Stable Disease (SD), neither sufficient shrinkage to qualify for a Partial Response nor sufficient increase to qualify for Progression of Disease (POD); POD, 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions; Complete Response (CR), Disappearance of all target lesions

Time frame:
Up to 5 years
Reported as:
Number · percentage of participants
Disease Control Rate.
percentage of participantsArm 1Arm 2
Disease Control Rate.265

Adverse events

Collected over Adverse events were collected over a period of 2 years, 3 months.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Arm 1—6/17 (35.3%)17/17 (100%)
Arm 2—13/40 (32.5%)39/40 (97.5%)
Most frequent serious events
Showing 10 of 21
Most frequent serious events
EventArm 1Arm 2
ThrombosisVascular disorders2/171/40
Disease progressionGeneral disorders1/174/40
Abdominal painGastrointestinal disorders1/171/40
NauseaGastrointestinal disorders1/170/40
VomitingGastrointestinal disorders1/170/40
DeathGeneral disorders1/170/40
FeverGeneral disorders1/170/40
PainGeneral disorders1/170/40
Bone infectionInfections and infestations1/170/40
InfectionInfections and infestations1/170/40
Most frequent other events
Showing 10 of 114
Most frequent other events
EventArm 1Arm 2
Disease progressionGeneral disorders14/1722/40
FatigueGeneral disorders12/1727/40
DiarrheaGastrointestinal disorders10/1726/40
Aspartate aminotransferase increasedInvestigations5/1726/40
NauseaGastrointestinal disorders9/1720/40
Alkaline phosphatase increasedInvestigations9/1718/40
Hemoglobin decreasedBlood and lymphatic system disorders6/1720/40
HyperglycemiaMetabolism and nutrition disorders8/1720/40
Alanine aminotransferase increasedInvestigations4/1718/40
HyperbilirubinemiaInvestigations7/1715/40

Baseline characteristics

Age, Continuous
Age, Continuous(years)Arm 1Arm 2Total
Median58 (44 to 76)62 (19 to 82)62 (19 to 82)
Sex: Female, Male
Sex: Female, Male(Participants)Arm 1Arm 2Total
Female13821
Male43236
Region of Enrollment
Region of Enrollment(participants)Arm 1Arm 2Total
United States174057
08

Study locations

1 site
  • UC Davis Comprehensive Cancer Center
    Sacramento, California 95817, United States
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 20, 2018, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00101036
Lead sponsor
National Cancer Institute (NCI)
Responsible party
Sponsor
First posted
Jan 10, 2005
Start date
Nov 2004
Primary completion
Jan 2009
Completion
Jan 2009
Results posted
Jan 5, 2015
Last update
Apr 20, 2018

Study contacts

Ramesh Ramanathan
principal investigator · UC Davis Comprehensive Cancer Center
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Mar 2018. You cannot join it, but the record below documents what was studied.

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