None listed
Conditions
Brief summary
Patients who have been diagnosed with non-small cell lung cancer may receive, or already be receiving treatment with a drug called Erlotinib or Gefitinib. Erlotinib and Gefitinib are similar drugs that belong to a class of drugs that inhibit a specific biological receptor, called the Epidermal Growth Factor Receptor (EGFR), which is over expressed in a number of different cancers. One of the potential side effects of Erlotinib and Gefitinib is skin rash, which occurs in up to 75% of patients. In this study, we will investigate whether treatment with a new drug, BN83495, can reduce the severity and/or frequency with which this rash occurs. BN83495 is an experimental drug, which is taken as a tablet, and is being tested as a possible anti-cancer treatment. The drug inhibits steroid production and is being developed by Ipsen Pty Ltd. Excess steroid production in the skin has also been linked to the development of acne and skin rashes. Therefore, it is our hypothesis that BN83495 pre-treatment may complement the use of erlotinib or gefitinib and reduce the severity of rash. This project will be performed at the Peter MacCallum Cancer Centre and will involve approximately 10 to 20 patients. The aim of this project is to measure the frequency and severity of skin rash, and other side-effects, for patients treated with Erlotinib or Gefitinib and BN83495. Changes in the drugs and hormones bllod levels will also be measured. Patients will be assessed at Peter MacCallum Cancer Centre weekly for a period of 12 weeks from the first day of treatment with BN83495.
Interventions
BN83495 Dosage and Administration
BN83495 (also known as STX64 and 667-coumate) is a first in class inhibitor of steroid sulphatase (STS), currently in clinical development to target steroid dependent cancers. STS converts oestrone sulphate to oestrone, a precursor of oestradiol and dehydroepiandrosterone sulphate (DHEA-S) to dehydroepiandrosterone (DHEA), a precursor of adrenal testosterone.
The oral dose of BN83495 is 40 mg daily, fasted (30 minutes before breakfast), given in the morning. BN8
BN83495 Dosage and Administration BN83495 (also known as STX64 and 667-coumate) is a first in class inhibitor of steroid sulphatase (STS), currently in clinical development to target steroid dependent cancers. STS converts oestrone sulphate to oestrone, a precursor of oestradiol and dehydroepiandrosterone sulphate (DHEA-S) to dehydroepiandrosterone (DHEA), a precursor of adrenal testosterone. The oral dose of BN83495 is 40 mg daily, fasted (30 minutes before breakfast), given in the morning. BN83495 will be taken for 12 weeks. BN83495 will be supplied by Ipsen Pty Ltd as tablets packed into conventional blister strips (10 tablets/blister). EGFR-TKI Dosage and Administration The EGFR-TKI used in this study will be either Erlotinib or Gefitinib which will be taken for 12 weeks. The oral dose of erlotinib is 150 mg daily, taken at least one hour before or two hours after the ingestion of food. The oral dose of gefitinib is 250mg daily, taken at least one hour before or two hours after the ingestion of food. In stratum A, patients with NSCLC requiring treatment with an EGFR-TKI will be pre-treated with BN83495 for 3 days prior to starting the EGFR-TKI. In stratum B, patients already on an EGFR-TKIwill receive BN83495. All patients will continue to receive BN83495 for a period of 12 weeks, and be followed for these 12 weeks to determine the impact of treatment on existing skin condition.
Sponsors
Professor John Zalcberg
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patients with histologically documented, unresectable, locally advanced, recurrent or metastatic (Stage IIIB or Stage IV) NSCLC who are otherwise eligible for treatment with an EGFR-TKI (erlotinib or gefitinib), or who are already receiving an EGFR-TKI. 2. Patients who are scheduled to receive, or are already receiving a standard dose EGFR-TKI. 3. The presence of any EGFR-TKI -related rash in patients already on treatment must be grade 2 or less. 4. Male or female patients aged 18 years or over who weigh 40kg or more. 5. ECOG performance status of 0 – 2, inclusive. 6. Granulocyte count =1.5 x 109/L and platelet count >100 x 109/L. 7. Serum bilirubin must be =1.5 x upper limit of normal (ULN). ALT must be = 2 x ULN. 8. Serum creatinine =1.5 ULN or creatinine clearance =60 ml/min. 9. Able to comply with study and follow-up procedures. Patients must be willing to be photographed. 10. a) Female patient of childbearing potential must have a negative pregnanacy test within one week prior to study entry OR have been amenorrhoeic for at least two years. b) All patients of reproductive potential must agree to use birth control for the duration of the study. This is only required for as long as the patient has reproductive potential. The type of birth control is a decision which should be made between the treating physician and the patient. 11. Patient has given written, informed consent to participate in the study.
Exclusion criteria
1. Patients who cannot take oral medication. 2. Patients with prior prostate, breast or endometrial cancer unless in remission for = 5 years. 3. Patients receiving other hormonally active agents. 4. Pregnancy or lactation. 5. Concurrent or recent history (within the last 3 months) of significant skin disease, not related to EGFR-TKI therapy. 6. Concurrent use of systemic or topical glucocorticoids (apart from intranasal and inhaled corticosteroids to treat rhinitis and asthma, respectively), for patients starting both an EGFR-TKI and BN83495. Patients already receiving an EGFR-TKI and topical glucocorticoids as part of their management are allowed. 7. Concurrent use of systemic carbonic anhydrase II inhibitors (e.g.acetazolamide, dichlorphenamide,methazolamide) 8. Serious illness or medical condition that precludes the safe administration of the trial treatment including, but not limited to, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. 9. Patients unwilling or unable to comply with protocol and patients with a history of non-compliance or inability to grant informed consent. 10. Current participation in another clinical trial using an investigational agent.
Outcome results
None listed