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| Name | Class |
|---|---|
| GlaxoSmithKline | INDUSTRY |
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The purpose of this study is to determine if Lapatinib has any effect on tumors found in patients with Neurofibromatosis Type 2 (NF2). NF2 is a condition that mainly affects the skin and nervous system. It causes non-cancerous tumors (which are known as neuromas) to grow on the nerves around a person's body. Some signs of NF2 include a gradual loss of hearing and tumors growing on the skin, the brain and the spinal cord which can lead to complications.
Lapatinib is an oral drug that is approved by Food and Drug Administration (FDA) for other types of tumors, it is not approved by the FDA for treatment of NF2 related tumors. The investigators know a lot about how well it is tolerated, but the investigators do not know if it is effective in treating your condition, therefore it is considered to be an investigational medication. This study will test whether Lapatinib may shrink tumors commonly found in patients with NF2 or stop them from growing. This will help us to decide if Lapatinib should be used to treat NF2 patients in future. Lapatinib is a drug that has been used for over 10 years to treat various forms of cancer. It has not been studied for the treatment of tumors in NF2 patients.
In this trial, we propose to assess the objective response rates to Lapatinib in patients with NF2-related tumors. Lapatinib is a commercially available inhibitor of ErbB2 and EGF. Data suggests that abnormal signaling via EGFR and ErbB2 is a major contributor to tumor growth and progression in both sporadic and NF2-related VS and that inhibition of this signaling pathway can result in decreased tumor growth.
Demonstrating that Lapatinib produces an objective response to reduce tumor volume or stabilize disease will provide additional treatment options for NF patients with multiple tumor growth. For patients with VS we expect to see ≥ 10 dB improvement in PTA and/or improvement in SDS, compared to the audiogram at initiation of treatment. Currently there are no available treatment options for NF2 patients with multiple tumors. Depending on tumor cell type, lapatinib has cytostatic or cytotoxic antitumor effects, and in a recent study assessing the biological effects of Lapatinib on the associated molecular pathways and tumor growth in patients with solid tumors, a correlation was seen between tumor response and pre-treatment levels of (phosphor)-ErbB2 and (phosphor)-ERK1/2.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lapatinib | Experimental | Lapatinib PO dosed according to age: Children/adolescents (less than 18 years of age): 1,800 mg/m2/day PO divided into twice daily doses, to a maximum of 750 mg PO twice daily Adults (18 years of age or older): 1,500 mg PO once daily Lapatinib is available in 250 mg tablets only. For pediatric dosing, the total daily dose will be rounded up or down to the nearest 250 mg increment. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lapatinib | Drug | Lapatinib is dosed according to age. Lapatinib is available in 250 mg tablets only. For pediatric dosing, the total daily dose will be rounded up or down to the nearest 250 mg increment. Children/adolescents (<18 years of age): 1,800 mg/m2/day PO divided into twice daily doses, to a maximum of 750 mg PO (3 tablets twice daily) Adults (>=18 years of age): 1,500 mg PO (6 tablets once daily) Duration: Up to 12 months, depending on treatment response. |
| Measure | Description | Time Frame |
|---|---|---|
| Estimated Volumetric Progression Free Survival at 12 Months | Measurements were taken every three months, up to one year. Estimated volumetric progression free survival (PFS) was measured from date of enrollment to date of volumetric progression. PFS was analyzed using the Kaplan-Meier method in terms of overall PFS (volumetric or hearing progression), volumetric progression, and hearing progression. Point estimates for PFS with 95% confidence intervals (CIs) were calculated from Kaplan-Meier curves. | Every three months for one year |
| Measure | Description | Time Frame |
|---|---|---|
| Estimated Volumetric Progression Free Survival for Hearing at 12 Months | Measurements were taken every three months, up to one year. Estimated volumetric progression free survival (PFS) was measured from date of enrollment to date of hearing progression. PFS was analyzed using the Kaplan-Meier method in terms of overall PFS (volumetric or hearing progression), volumetric progression, and hearing progression. Point estimates for PFS with 95% confidence intervals (CIs) were calculated from Kaplan-Meier curves. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Matthias A Karajannis, MD, MS | NYU School of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| New York University School of Medicine | New York | New York | 10016 | United States |
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Twenty-one patients were enrolled between October 2009 and March 2011 at New York University Medical Center.
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| ID | Title | Description |
|---|---|---|
| FG000 | Lapatinib | Lapatinib will be administered |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Lapatinib | Lapatinib will be administered |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Estimated Volumetric Progression Free Survival at 12 Months | Measurements were taken every three months, up to one year. Estimated volumetric progression free survival (PFS) was measured from date of enrollment to date of volumetric progression. PFS was analyzed using the Kaplan-Meier method in terms of overall PFS (volumetric or hearing progression), volumetric progression, and hearing progression. Point estimates for PFS with 95% confidence intervals (CIs) were calculated from Kaplan-Meier curves. | This analysis is based on the 17 evaluable patients. | Posted | Mean | 95% Confidence Interval | Liklihood of PFS at 12 months | Every three months for one year |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Lapatinib | Lapatinib will be administered |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Vasovagal syncope | Nervous system disorders |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Matthias Karajannis, MD | New York University Langone Medical Center | 212-263-8400 | matthias.karajannis@nyumc.org |
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| ID | Term |
|---|---|
| D016518 | Neurofibromatosis 2 |
| D009464 | Neuroma, Acoustic |
| D009442 | Neurilemmoma |
| ID | Term |
|---|---|
| D018358 | Neuroendocrine Tumors |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
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| ID | Term |
|---|---|
| D000077341 | Lapatinib |
| ID | Term |
|---|---|
| D011799 | Quinazolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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|
|
| Every three months for one year |
| Participants Experiencing Grades 1 or 2 Toxicities (CTCAE) | Toxicity was assessed throughout the study, up to one year. | Baseline through one year |
| Participants Experiencing Grade 3 Toxicities (CTCAE) | Toxicity was assessed throughout the study, up to one year. | Baseline through one year |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
|
| Secondary | Estimated Volumetric Progression Free Survival for Hearing at 12 Months | Measurements were taken every three months, up to one year. Estimated volumetric progression free survival (PFS) was measured from date of enrollment to date of hearing progression. PFS was analyzed using the Kaplan-Meier method in terms of overall PFS (volumetric or hearing progression), volumetric progression, and hearing progression. Point estimates for PFS with 95% confidence intervals (CIs) were calculated from Kaplan-Meier curves. | This analysis is based on the 17 evaluable patients. | Posted | Mean | 95% Confidence Interval | Liklihood of PFS at 12 months | Every three months for one year |
|
|
|
| Secondary | Participants Experiencing Grades 1 or 2 Toxicities (CTCAE) | Toxicity was assessed throughout the study, up to one year. | Posted | Number | participants | Baseline through one year |
|
|
|
| Secondary | Participants Experiencing Grade 3 Toxicities (CTCAE) | Toxicity was assessed throughout the study, up to one year. | Posted | Number | participants | Baseline through one year |
|
|
|
| 0 |
| 21 |
| 21 |
| 21 |
| Anemia | Blood and lymphatic system disorders |
|
| Anorexia | Metabolism and nutrition disorders |
|
| Anxiety | Psychiatric disorders |
|
| Ataxia | Nervous system disorders |
|
| Constipation | Gastrointestinal disorders |
|
| Decreased bicarbonate | Metabolism and nutrition disorders |
|
| Dermatology/Skin (Other) | Skin and subcutaneous tissue disorders |
|
| Diarrhea | Gastrointestinal disorders |
|
| Dyspnea | Respiratory, thoracic and mediastinal disorders |
|
| Epistaxis | Respiratory, thoracic and mediastinal disorders |
|
| Fatigue | General disorders |
|
| Fever | General disorders |
|
| heartburn | Gastrointestinal disorders |
|
| Hemorrhage - rectum (stools) | Gastrointestinal disorders |
|
| Hyperbilirubinemia | Investigations |
|
| Hyperglycemia | Metabolism and nutrition disorders |
|
| Hyperkalemia | Metabolism and nutrition disorders |
|
| Hypernatremia | Metabolism and nutrition disorders |
|
| Hypertension | Vascular disorders |
|
| Hypocalcemia | Metabolism and nutrition disorders |
|
| Hypoglycemia | Metabolism and nutrition disorders |
|
| Hypokalemia | Metabolism and nutrition disorders |
|
| Hypophosphatemia | Metabolism and nutrition disorders |
|
| Increased ALT | Investigations |
|
| Increased AST | Investigations |
|
| Increased PTT | Investigations |
|
| Insomnia | Psychiatric disorders |
|
| Keratitis | Eye disorders |
|
| Lymphopenia | Blood and lymphatic system disorders |
|
| Memory Impairment | Nervous system disorders |
|
| Nausea | Gastrointestinal disorders |
|
| Numbness L-S area | Nervous system disorders |
|
| Pain-Other | General disorders |
|
| Pericardial effusion on echocardiogram | Cardiac disorders |
|
| Possible ectopic atrial bradycardia on EKG | Cardiac disorders |
|
| Premature supraventricular complexes on EKG | Cardiac disorders |
|
| Sinus Bradycardia | Cardiac disorders |
|
| Stomatitis (oral cavity ulceration) | Skin and subcutaneous tissue disorders |
|
| Vomiting | Gastrointestinal disorders |
|
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| D009369 | Neoplasms |
| D017253 | Neurofibromatoses |
| D009455 | Neurofibroma |
| D018317 | Nerve Sheath Neoplasms |
| D009380 | Neoplasms, Nerve Tissue |
| D009463 | Neuroma |
| D009386 | Neoplastic Syndromes, Hereditary |
| D000160 | Vestibulocochlear Nerve Diseases |
| D012181 | Retrocochlear Diseases |
| D004427 | Ear Diseases |
| D010038 | Otorhinolaryngologic Diseases |
| D010039 | Otorhinolaryngologic Neoplasms |
| D003390 | Cranial Nerve Neoplasms |
| D003389 | Cranial Nerve Diseases |
| D009422 | Nervous System Diseases |
| D020752 | Neurocutaneous Syndromes |
| D020271 | Heredodegenerative Disorders, Nervous System |
| D019636 | Neurodegenerative Diseases |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D009423 | Nervous System Neoplasms |
| D009371 | Neoplasms by Site |
| D010524 | Peripheral Nervous System Neoplasms |