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Ph I Dasatinib + Erlotinib in Recurrent MG

Study Purpose

Primary: To determine maximum tolerated dose & dose limiting toxicity of dasatinib when combined w erlotinib among pts w recurrent MG.Secondary: To further evaluate safety & tolerability of dasatinib + erlotinib To evaluate pharmacokinetics of dasatinib when administered w erlotinib among recurrent MG pts who are on & not on CYP-3A enzyme inducing anti-epileptic drugs To evaluate for anti-tumor activity with this regimen in this patient population

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 18 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Diagnosis of recurrent/progressive WHO grade IV MG or WHO grade III MG.
Pts with prior low-grade glioma are eligible if histologic assessment demonstrates transformation to WHO grade III / IV MG.
  • - >18 yrs.
  • - Karnofsky Performance Status >70 percent.
  • - Pts presenting in 1st, 2nd / 3rd relapse.
Prior therapy must have included external beam XRT.
  • - Adequate bone marrow, liver & renal function as assessed by following: - Hemoglobin>9.0g/dl.
  • - ANC>1,500/mm3.
  • - Platelet count>100,000/mm3.
  • - Total bilirubin<1.5 x ULN.
  • - ALT & AST<2.5 x ULN.
  • - INR<1.5 or PT/PTT within normal limits.
Pts receiving anti-coagulation treatment w low-molecular weight heparin allowed to participate, oral warfarin is not permitted.
  • - Creatinine<1.5 x ULN.
  • - Serum Na, K+, Mg2+, Phosphate & Ca2+ >LLN.
  • - Interval<2 wks between prior surgical resection & initiation of study regimen.
  • - Interval <12 weeks from completion of standard, daily XRT, unless one of following occurs: new area of enhancement on MRI imaging that is outside XRT field; biopsy proven recurrent tumor; / radiographic evidence of progressive tumor on 2 consecutive scans >4 wks apart.
  • - Interval <4weeks from prior chemotherapy unless there is unequivocal evidence of tumor progression & pt has recovered from all anticipated toxicities from prior therapy.
  • - Interval <4weeks from prior investigational agent unless there is unequivocal evidence of tumor progression & pt has recovered from all anticipated toxicities from prior therapy.
  • - Signed written informed consent including HIPAA according to institutional guidelines.
Signed informed consent must be obtained prior to any study specific procedures.
  • - If sexually active, pts will take contraceptive measures for duration of treatments & for 4 weeks following discontinuation of dasatinib & Erlotinib.
  • - Women of childbearing potential must have negative serum or urine pregnancy test within 72 hrs prior to start of study drug administration.

Exclusion Criteria:

  • - No prior dasatinib / oral EGFR-inhibitor therapy.
  • - Pregnancy/breast feeding.
  • - History of significant concurrent illness.
->3 prior episodes of progressive disease.
  • - Significant cardiac disease.
  • - Excessive risk of bleeding as defined by stroke <6 months, history of CNS / intraocular bleed,/ septic endocarditis.
  • - Concurrent severe and/or uncontrolled medical disease that could compromise participation in study including any of following: pleural / pericardial effusion of any grade; uncontrolled diabetes; uncontrolled hypertension; active clinically serious infection >CTCAEv3 Gr2 requiring active intervention; history of clinically-significant bleeding diathesis or coagulopathy including platelet function disorder or acquired bleeding disorder within 1yr; impairment of GI function /GI disease that may significantly alter absorption of study regimen; ongoing or recent significant gastrointestinal bleeding.
  • - Thrombolic or embolic events such as cerebrovascular accident including transient ischemic attacks <6 months.
  • - Any hemorrhage/bleeding event >CTCAEv3AE Gr3 within 4wks of 1st dose of study drug.
  • - Serious non-healing wound, ulcer, /bone fracture.
  • - Major surgery, open biopsy /significant traumatic injury <4 weeks of 1st study drug.
  • - Known HIV infection/chronic Hepatitis B/C.
  • - Pt is <3yrs free of another primary malignancy except: if other primary malignancy is either not currently clinically significant/does not require active intervention.
Existence of any other malignant disease is not allowed.
  • - Pts unwilling to/unable to comply with protocol including ability to swallow whole pills/presence of any malabsorption syndrome.
  • - Concurrent administration of warfarin, rifampin/St. John's Wort.
  • - Subjects w hypokalemia/hypomagnesemia if it cannot be corrected.
- Prisoners/subjects who are compulsorily detained for treatment of either psychiatric/physical illness

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT00609999
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 1
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Duke University
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Annick Desjardins, MD, FRCPC
Principal Investigator Affiliation Duke Health
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Other, Industry
Overall Status Completed
Countries United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Glioblastoma, Gliosarcoma
Study Website: View Trial Website
Additional Details

Tarceva administered on continuous oral dosing schedule at 150 mg/day for pts not on EIAEDs & 450 mg/day for pts on EIAEDs. Starting dose level of dasatinib will be 100 mg once day via continuous oral daily dosing. Dasatinib will be increased in successive cohorts of enrolled pts. Pts will remain on treatment until excessive toxicity, progressive disease, withdrawal of consent/death. Pts have confirmed diagnosis of recurrent/progressive WHO gr IV MG / WHO grade III MG. Phase I 3+3 dose escalation design w 2 independently escalated stratum: stratum A-pts not on CYP3A-enzyme inducing anti-epileptic drugs; stratum B-pts on EIAEDs. Assessment of safety will be based mainly on frequency of adverse events, particularly adverse events leading to discontinuation of treatment & on number of significant lab abnormalities.

Arms & Interventions

Arms

Experimental: Stratum A

Pts not on EIAEDs

Experimental: Stratum B

Pts on EIAEDs

Interventions

Drug: - Erlotinib and Dasatinib

You will begin study drug regimen on day 1 of cycle 1 w Dasatinib. If you are undergoing Dasatinib pharmacokinetic blood analysis, Dasatinib will be taken alone until initial PK assessments are collected. Erlotinib will be begin after initial Dasatinib PK assessments are collected & will continue to be administered w Dasatinib on continuous daily dosing schedule. Initial Dasatinib PK assessments will be collected over 24hrs between days 3-7 of cycle 1 & at end of cycle 1. If you are not undergoing Dasatinib PK collections you will begin both Dasatinib & Erlotinib together on day 1 of cycle 1. Both drugs will be given in continuous daily oral manner. Cycle is defined as Dasatinib & Erlotinib given daily for 28 days for purpose of scheduling evaluations.

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

Duke University Health System, Durham, North Carolina

Status

Address

Duke University Health System

Durham, North Carolina, 27710