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| ID | Type | Description | Link |
|---|---|---|---|
| P30CA068485 | U.S. NIH Grant/Contract | View source | |
| VU-VICC-BRE-0977 |
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Study was abandoned before opening to accrual. Replaced by another study.
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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RATIONALE: Estrogen can cause the growth of breast cancer cells. Hormone therapy using letrozole +/- goserelin (the latter for pre-menopausal women only) may fight breast cancer by lowering the amount of estrogen the body makes. OSI-906 and erlotinib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known whether hormone therapy and OSI-906 are more effective when given with or without erlotinib hydrochloride in treating hormone-sensitive metastatic breast cancer.
PURPOSE: This phase II trial is studying how well giving hormone therapy together with OSI-906 with or without erlotinib hydrochloride works in treating hormone-sensitive patients with metastatic breast cancer.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is a multicenter study. Stratification will be based on previous exposure to endocrine therapy: (Arm I) no previous endocrine therapy or have completed adjuvant therapy > 6 months prior to study enrollment; (Arm II) patients that had previous endocrine therapy in the metastatic setting or had metastatic recurrence within 6 months of adjuvant endocrine therapy.
NOTE: *Goserelin will only be given to premenopausal patients.
Tumor tissue samples from original diagnosis or from fresh biopsy tissue are collected for biomarker analysis and other studies.
After completion of study therapy, patients are followed periodically.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Letrozole +/-goserelin, OSI-906 (Arm I ) | Experimental | Patients receive oral letrozole once daily on days 1-28 plus subcutaneous goserelin (the latter for pre-menopausal women only) on day 1 and oral IGF-1R inhibitor OSI-906 twice daily on days 1-28. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. |
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| Letrozole +/- goserelin, OSI-906, erlotinib (Arm II) | Experimental | Patients receive oral letrozole and subcutaneous goserelin (the latter for pre-menopausal women only) and oral IGF-1R inhibitor OSI-906 as in arm I. Patients also receive oral erlotinib hydrochloride once daily on days 1-28. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| IGF-1R inhibitor OSI-906 | Drug | Given orally |
|
| Measure | Description | Time Frame |
|---|---|---|
| Time to progression | Duration from study enrollment to date of progressive disease (PD) as measured by Response Evaluation in Solid Tumors (RECIST) criteria v. 1.1: measurable lesions: PD is > 20% increase in the sum of the longest diameter of target lesions or appearance of new lesions | from study entry to date of progressive disease |
| Measure | Description | Time Frame |
|---|---|---|
| Safety profile of OSI-906 and letrozole +/ goserelin, with and without erlotinib | The number of patients with worst-grade toxicity at each of five grades following NCI Common Toxicity Criteria: 1 = mild, 2 = moderate, 3 = severe, 4 = life-threatening, disabling, 5 = death | at 4 weeks |
| Response |
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DISEASE CHARACTERISTICS:
Histologically confirmed invasive breast carcinoma
No locally recurrent resectable disease
No symptomatic brain metastases
Hormone receptor status:
PATIENT CHARACTERISTICS:
Pre- or post-menopausal
ECOG performance status 0-1
Life expectancy ≥ 6 months
ANC ≥ 1,250/mm^3
Platelet count ≥ 100,000/mm^3
Creatinine ≤ 1.5 times upper limit of normal (ULN)
Bilirubin ≤ 1.5 times ULN (≤ 3 times ULN if liver metastasis is present)
SGOT and SGPT ≤ 1.5 times ULN (≤ 3 times ULN if liver metastasis is present)
Alkaline phosphatase ≤ 1.5 times ULN (≤ 3 times ULN if liver metastasis is present)
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective barrier contraception during and for 3 months after completion of study therapy
Able to swallow and retain oral medication
Baseline QTc ≤ 450 msec
No other invasive cancer within the past 5 years except for completely resected basal cell or squamous cell skin cancer or successfully treated cervical carcinoma in situ
No malabsorption syndrome significantly affecting gastrointestinal function
No diabetes, fasting glucose > 150mg/dL, or receiving ongoing anti-hyperglycemic therapies
No concurrent uncontrolled illness including, but not limited to, any of the following:
PRIOR CONCURRENT THERAPY:
See Disease Characteristics
Recovered from prior therapy
At least 2 weeks since prior investigational drugs
No more than 4 prior chemotherapy treatments in the metastatic setting
No concurrent CYP3A4 or CYP1A2 modifiers
No other concurrent anticancer therapy, including chemotherapy, radiotherapy, surgery, immunotherapy, hormonal therapy, or biologic therapy
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| Name | Affiliation | Role |
|---|---|---|
| Ingrid Mayer, MD | Vanderbilt-Ingram Cancer Center | Principal Investigator |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
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| ID | Term |
|---|---|
| C551528 | 3-(8-amino-1-(2-phenylquinolin-7-yl)imidazo(1,5-a)pyrazin-3-yl)-1-methylcyclobutanol |
| D000069347 | Erlotinib Hydrochloride |
| D017273 | Goserelin |
| D000077289 | Letrozole |
| ID | Term |
|---|---|
| D011799 | Quinazolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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| erlotinib hydrochloride | Drug | Given orally |
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| goserelin | Drug | Given subcutaneously |
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| letrozole | Drug | Given orally |
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Per RECIST criteria v. 1.1: measurable lesions: complete response (CR) disappearance of target lesions, partial response (PR) > 30% decrease in the sum of the longest diameter (LD) of target lesions, progressive disease (PD) > 20% increase in the sum of the LD of target lesions or appearance of new lesions, stable disease (SD) neither sufficient decrease nor increase of the sum of smallest sum of the LD of target lesions |
| every 12 weeks to progression |
| Circulating C-peptide, IGF-1 | Levels of the protein C-peptide and the hormone IGF-1 in the blood | At baseline and on day 1 of each 28-day cycle |
| Correlation of IGF-IR, EGFR, HER2, Y1316 and Y1131 pIGF-1R, PTEN, S473 pAkt, pMAPK, S118 (MAPK site), and S167 (Akt and S6 site) pER expression with time to progression and molecular classification | The levels of these biomarkers will be measured in breast tumor tissue and compared and contrasted with patient's time to progression and molecular classification (luminal A vs. luminal B) | On receipt of breast tissue: tissue block from prevous surgery or fresh tissue from current surgery |
| Mutation analysis of PI3K (E542K, E545K, H1047R) | Breast tumor tissue will be examined for mutations in these genes. | On receipt of breast tissue: tissue block from prevous surgery or fresh tissue from current surgery |
| D017437 |
| Skin and Connective Tissue Diseases |
| D007987 | Gonadotropin-Releasing Hormone |
| D010906 | Pituitary Hormone-Releasing Hormones |
| D007028 | Hypothalamic Hormones |
| D036361 | Peptide Hormones |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D009479 | Neuropeptides |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D009842 | Oligopeptides |
| D009419 | Nerve Tissue Proteins |
| D011506 | Proteins |
| D009570 | Nitriles |
| D009930 | Organic Chemicals |
| D014230 | Triazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |