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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00741260
Registration number
NCT00741260
Ethics application status
Date submitted
22/08/2008
Date registered
26/08/2008
Date last updated
5/09/2018
Titles & IDs
Public title
Study Evaluating The Combination Of Neratinib And Capecitabine In Solid Tumors And Breast Cancer
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Scientific title
A Phase 1/2, Open-Label Study Of Neratinib (HKI-272) In Combination With Capecitabine In Subjects With Solid Tumors And ErbB-2 Positive Metastatic Or Locally Advanced Breast Cancer
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Secondary ID [1]
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3144A1-2206 / B1891017
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Breast Cancer
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Condition category
Condition code
Cancer
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Breast
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Neratinib
Treatment: Drugs - Capecitabine
Experimental: Neratinib and Capecitabine (Dose Level 1) - Neratinib 160 mg and Capecitabine 1500 mg/m\^2
Experimental: Neratinib and Capecitabine (Dose Group 2) - Neratinib 240 mg and Capecitabine 1500 mg/m\^2
Experimental: Neratinib and Capecitabine (Dose Group 3) - Neratinib 240 mg and Capecitabine 2000 mg/m\^2
Experimental: Neratinib and Capecitabine (Dose Group 4) - Neratinib 200 mg and Capecitabine 2000 mg/m\^2
Experimental: Neratinib and Capecitabine (Dose Group 5) - Neratinib 160 mg and Capecitabine 2000 mg/m\^2
Experimental: Neratinib and Capecitabine MTD (Dose Group 6) - Neratinib and Capecitabine Maximum Tolerated Dose without prior lapatinib
Experimental: Neratinib and Capecitabine MTD (Dose Group 7) - Neratinib and Capecitabine Maximum Tolerated Dose with prior lapatinib
Treatment: Drugs: Neratinib
Neratinib orally once daily continually
Treatment: Drugs: Capecitabine
Capecitabine orally on days 1-14 of each 21 day cycle
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Number of Participants With Dose Limiting Toxicities
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Assessment method [1]
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Number of participants reporting Adverse Events Causing Dose Limiting Toxicities (DLT).
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Timepoint [1]
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From first dose date to day 21
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Primary outcome [2]
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Maximum Tolerated Dose (MTD) of Neratinib
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Assessment method [2]
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MTD reflects the highest dose of neratinib plus capeciteabine that did not cause a selected Grade 3 toxicity in \>= 2 participants, which is any of 1) Grade 3 or 4 non-hematologic toxicity (Grade 3 asthenia was not considered a DLT unless lasting \>3 days, 2) Grade 3 diarrhea lasting \>2 days on optimal medical therapy or associated with fever or dehydration. 3) Grade 4 neutropenia lasting = 3 days or Grade 4 febrile neutropenia, 4) Grade 4 thrombocytopenia lasting =3 days or associated with bleeding or requiring platelet transfusion, 5) Delayed recovery \[to = National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) Grade 1 or baseline\] from one of the above listed toxicities that were related to neratinib and/or capecitabine that delayed the initiation of the next dose by more than 3 weeks.
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Timepoint [2]
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From first dose date to day 21.
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Primary outcome [3]
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Maximum Tolerated Dose (MTD) of Capecitabine
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Assessment method [3]
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MTD reflects the highest dose of capecitabine in combination with neratinib that did not cause a selected Grade 3 toxicity in \>= 2 participants, which is any of 1) Grade 3 or 4 non-hematologic toxicity (Grade 3 asthenia was not considered a DLT unless lasting \>3 days, 2) Grade 3 diarrhea lasting \>2 days on optimal medical therapy or associated with fever or dehydration. 3) Grade 4 neutropenia lasting = 3 days or Grade 4 febrile neutropenia, 4) Grade 4 thrombocytopenia lasting =3 days or associated with bleeding or requiring platelet transfusion, 5) Delayed recovery \[to = National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) Grade 1 or baseline\] from one of the above listed toxicities that were related to neratinib and/or capecitabine that delayed the initiation of the next dose by more than 3 weeks.
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Timepoint [3]
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From first dose date to day 21.
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Secondary outcome [1]
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Overall Response Rate
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Assessment method [1]
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Number of Subjects with Complete or Partial Response per Response Evaluation Criteria In Solid Tumors Criteria (RECIST) v.1.0: Complete Response (CR), disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; and Non-PD for non-target lesions, and no new lesions.
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Timepoint [1]
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From first dose date to progression or last tumor assessment, up to three years.
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Secondary outcome [2]
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Clinical Benefit Rate
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Assessment method [2]
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The percentage of subjects with Complete Response, Partial Response, or Stable Disease at least 24 weeks per Response Evaluation Criteria In Solid Tumors Criteria (RECIST) v1.0: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Stable Disease (SD), Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
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Timepoint [2]
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From first dose date to progression or last tumor assessment, up to three years.
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Secondary outcome [3]
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Duration of Response
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Assessment method [3]
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Duration of response was measured from the time at which response criteria were met for complete response (CR) or partial response (PR) (whichever status was recorded first) until the first date of recurrence or progressive disease (PD) or death per Response Evaluation Criteria In Solid Tumors Criteria (RECIST) v1.0: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions.
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Timepoint [3]
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From start date of response to first PD/death, up to three years.
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Eligibility
Key inclusion criteria
INCLUSION CRITERIA
PART 1:
* confirmed pathologic diagnosis of a solid tumor not curable with available therapies for which neratinib plus capecitabine is a reasonable treatment option.
PART 2:
* confirmed histologically and/or cytologically confirmed diagnosis of breast cancer, metastatic or locally advanced.
* erbB-2 gene amplified tumor (FISH or CISH) or erbB-2 overexpression (IHC 3+, or IHC2+ with FISH or CISH confirmation), based on local testing, or based on centralized FISH testing prior to day 1.
* disease progression on or following at least 1 prior trastuzumab containing treatment regimen (at least 6 weeks) for metastatic or locally advanced disease. (Prior adjuvant trastuzumab is allowed but not required). A 2 week period is required between the last dose of trastuzumab treatment and first dose of the test article.
* Prior treatment with a taxane in the neoadjuvant, adjuvant, locally advanced, and/or metastatic disease treatment setting.
PARTS 1 and 2:
* At least 1 measurable lesion as defined by RECIST criteria.
* LVEF within institutional range of normal as measured by multi-gated acquisition (MUGA) or echocardiogram (ECHO).
EXCLUSION CRITERIA
PART 2:
* prior treatment with capecitabine, lapatinib (20 subjects with prior lapatinib exposure will be enrolled) or any erbB-2 targeted agents except trastuzumab. Treatment with erbB-2 targeted therapy must exceed 2 weeks (14 days) in order to be exclusionary.
* prior treatment with anthracyclines with a cumulative dose of doxorubicin of greater than 400 mg/m², epirubicin dose of greater than 800 mg/m², or the equivalent dose for other anthracyclines.
PARTS 1 and 2:
* Subjects with bone as the only site of disease.
* Active uncontrolled or symptomatic central nervous system (CNS) metastases, as indicated by clinical symptoms, cerebral edema, and/or progressive growth. Subjects with a history of CNS metastases or cord compression are allowable if they have been considered definitively treated and are off anticonvulsants and steroids for at least 4 weeks before the first dose of test article.
* Any other cancer within 5 years prior to screening with the exception of adequately treated cervical carcinoma in situ, or adequately treated basal or squamous cell carcinoma of the skin.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
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Phase
Phase 1
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
9/12/2008
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/06/2018
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Sample size
Target
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Accrual to date
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Final
105
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Recruitment in Australia
Recruitment state(s)
QLD,VIC
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Recruitment hospital [1]
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Mater Private Centre for HOCA - South Brisbane
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Recruitment hospital [2]
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Border Medical Oncology - Wodonga
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Recruitment postcode(s) [1]
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4101 - South Brisbane
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Recruitment postcode(s) [2]
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3690 - Wodonga
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Recruitment outside Australia
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United States of America
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State/province [1]
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Alabama
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United States of America
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California
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United States of America
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Florida
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United States of America
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Idaho
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United States of America
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Indiana
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United States of America
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Missouri
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New York
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United States of America
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Ohio
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Pennsylvania
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United States of America
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Texas
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Brazil
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RS - Brazil
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Brazil
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RS
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China
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Beijing
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China
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Jiangsu
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Croatia
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Zagreb
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Hong Kong
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Hong Kong
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Hungary
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Budapest
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Hungary
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Nyiregyhaza
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Korea, Republic of
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Seoul
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Russian Federation
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Kazan
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Russian Federation
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Perm
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Russian Federation
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Saint Petersburg
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Singapore
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Singapore
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Spain
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Barcelona
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Spain
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Madrid
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Spain
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Valencia
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Puma Biotechnology, Inc.
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
This is a world wide phase 1/2, open-label, study of neratinib in combination with capecitabine, conducted in 2 parts. In Part 1, 3 to 9 subjects with solid tumors will be enrolled in each dose group of the combination of neratinib and capecitabine. Each subject will participate in only 1 dose group. Additional subjects may be included at any dose level to further assess the safety and tolerability at that dose level. In Part 2, up to 60 subjects with erbB-2 positive metastatic breast cancer will receive treatment with the combination of neratinib and capecitabine at the maximum tolerated dose level, as determined in Part 1. In addition 20 subjects with prior lapatinib exposure will be enrolled in Part 2. Depending on the safety and activity profile observed during the dose escalation phase, the dose selected for Part 2 may be adjusted, if appropriate. In case one test article of the combination is discontinued due to intolerance the other test article can be administered alone. The primary objectives of Part 1 are to assess the safety and tolerability, and to define the maximum tolerated dose (MTD) of neratinib in combination with capecitabine in subjects with advanced solid tumors. The primary objective of Part 2 of this study is to confirm the MTD determined in Part 1. The secondary objective of Part 1 is to collect information on preliminary anti-tumor activity of the combination of neratinib and capecitabine. Secondary objectives for Part 2 are to collect pharmacokinetic information and to obtain additional efficacy data, such as Objective Response Rate, for subjects with erbB-2 positive breast cancer treated at the MTD of neratinib + capecitabine.
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Trial website
https://clinicaltrials.gov/study/NCT00741260
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Trial related presentations / publications
Saura C, Garcia-Saenz JA, Xu B, Harb W, Moroose R, Pluard T, Cortes J, Kiger C, Germa C, Wang K, Martin M, Baselga J, Kim SB. Safety and efficacy of neratinib in combination with capecitabine in patients with metastatic human epidermal growth factor receptor 2-positive breast cancer. J Clin Oncol. 2014 Nov 10;32(32):3626-33. doi: 10.1200/JCO.2014.56.3809. Epub 2014 Oct 6.
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Public notes
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Contacts
Principal investigator
Name
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Puma
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Address
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Biotechnology
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Contact person for public queries
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT00741260
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