RO4929097 And Whole-Brain Radiation Therapy or Stereotactic Radiosurgery in Treating Patients With Brain Metastases From Breast Cancer
Status: Recruiting
Phase: Phase 1/Phase 2
Diagnosis:
NCT ID: NCT01217411
(View complete trial on ClinicalTrials.gov)
DFCI Protocol ID:
This randomized phase I/II trial is studying the side effects and the best dose of RO4929097 when given together with whole-brain radiation therapy or stereotactic radiosurgery and to see how well it works compared to whole-brain radiation therapy or stereotactic radiosurgery alone in treating patients with brain metastases from breast cancer or other cancers (such as lung cancer or melanoma). RO4929097 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Radiation therapy, such as whole-brain radiation therapy, uses high energy x-rays to kill tumor cells. Stereotactic radiosurgery may be able to deliver x-rays directly to the tumor and cause less damage to normal tissue. Giving RO4929097 together with whole-brain radiation therapy or stereotactic radiosurgery may kill more tumor cells
Conducting Institutions:
Dana-Farber Cancer Institute
Overall PI:
Site-responsible Investigators:
Contacts:
Eligibility Criteria
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed breast cancer meeting the following
criteria:
- Estrogen receptor-negative
- Newly diagnosed metastatic disease to the brain
- Patients with histologically or cytologically confirmed other cancers, such
as lung cancer, melanoma, etc., with newly diagnosed metastatic disease to
the brain allowed (phase I study only)
- Measurable disease in the brain, defined as ≥ 1 lesion that can be accurately
measured in ≥ 2 dimensions (longest diameter and its longest perpendicular diameter
to be recorded)
- Tumor HER2/neu status positive or negative
- No leptomeningeal metastases
- Up to 10 patients with leptomeningeal metastases may be enrolled in order to
test the feasibility of this therapy
PATIENT CHARACTERISTICS:
- Menopausal status not specified
- Karnofsky performance status (PS) 70-100%
- Recursive Partitioning Analysis (RPA) class I or II
- A small feasibility cohort of 10 RPA class III (Karnofsky PS < 70%) allowed,
however they will not be included in the efficacy analysis
- WBC ≥ 3,000/mm³
- ANC ≥ 1,000/mm³
- Platelet count ≥ 100,000/mm³
- Hemoglobin ≥ 9 g/dL
- Total bilirubin normal
- AST/ALT ≤ 2.5 times upper limit of normal
- Creatinine normal OR creatinine clearance ≥ 60 mL/min
- Fertile patients must use 2 forms of effective contraception (i.e., barrier
contraception and one other method of contraception) for the duration of study and
for ≥ 12 months after treatment
- Negative pregnancy test
- Not pregnant or nursing
- Able to swallow pills
- No history of allergic reactions attributed to compounds of similar chemical or
biologic composition to gamma-secretase inhibitor RO4929097
- No malabsorption syndrome or other condition that would interfere with intestinal
absorption
- Not known to be serologically positive for hepatitis A, B, or C, or have a history of
liver disease, other forms of hepatitis, or cirrhosis
- No uncontrolled hypocalcemia, hypomagnesemia, hyponatremia, hypophosphatemia, or
hypokalemia despite adequate electrolyte supplementation
- No uncontrolled intercurrent illness including, but not limited to, any of the
following:
- Ongoing or active infection
- NYHA class III or IV symptomatic congestive heart failure
- Unstable angina pectoris
- Cardiac arrhythmia other than chronic stable atrial fibrillation
- Psychiatric illness and/or social situations that would limit compliance with
study requirements
- Baseline QTcF > 450 msec (male) or QTcF > 470 msec (female)
PRIOR CONCURRENT THERAPY:
- Any type or number of prior therapies allowed
- No prior therapy with Notch inhibitors
- No prior cranial radiation
- Therapy-naive patients allowed
- At least 14 days since any prior experimental therapy, chemotherapy, or radiotherapy
and recovered to < grade 2 toxicities
- No other concurrent investigational agents
- No concurrent combination antiretroviral therapy in HIV-positive patients
- No concurrent medications with narrow therapeutic indices that are metabolized by
cytochrome P450 (CYP450), including warfarin sodium (Coumadin®)
- No concurrent medications that are generally accepted by the QTdrugs.org Advisory
Board to carry a risk for Torsades de Pointes, including antiemetics
- No concurrent medications that are strong inducers/inhibitors or substrates of CYP3A4
- No concurrent medications or food that may interfere with the metabolism of
gamma-secretase inhibitor RO4929097, including ketoconazole and grapefruit juice
- No other concurrent anticancer agents or therapies