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Sorafenib and Erlotinib in Treating Patients With Metastatic or Unresectable Solid Tumors

A Phase I Study of BAY 43-9006 (Sorafenib) in Combination With OSI-774 (Erlotinib; Tarceva) in Advanced Solid Tumors

Status
Completed
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00126620
Enrollment
17
Registered
2005-08-04
Start date
2005-09-30
Completion date
Unknown
Last updated
2015-07-23

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Unspecified Adult Solid Tumor, Protocol Specific

Keywords

unspecified adult solid tumor, protocol specific

Brief summary

RATIONALE: Sorafenib and erlotinib may stop the growth of tumor cells by blocking blood flow to the tumor and by blocking some of the enzymes needed for cell growth. PURPOSE: This phase I trial is studying the side effects and best dose of sorafenib and erlotinib in treating patients with metastatic or unresectable solid tumors.

Detailed description

OBJECTIVES: Primary * Determine the maximum tolerated dose and recommended phase II dose of sorafenib and erlotinib in patients with metastatic or unresectable solid tumors. Secondary * Determine the optimal biologically effective dose of this regimen that will lead to hypophosphorylation of epidermal growth factor receptor (EGFR), ERK, Akt, and vascular endothelial growth factor receptor (VEGFR), and inhibition of angiogenesis and apoptosis with tolerable toxicity in these patients. * Correlate the pharmacokinetic profiles of this regimen with toxicity and biological activity in these patients. * Determine, preliminarily, the antitumor activity of this regimen in these patients. * Correlate phosphorylation status of EGFR, ERK, Akt, and VEGFR with antitumor activity of this regimen in these patients. OUTLINE: This is a multicenter, open label, non-randomized, dose-escalation study. Patients receive oral sorafenib alone once or twice daily on days -6 to 0\*. Patients then receive oral sorafenib once or twice daily and oral erlotinib once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. NOTE: \*Not considered part of course 1; considered a run-in period only. Cohorts of 3-6 patients receive escalating doses of sorafenib and erlotinib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. An additional 10 patients are treated at the MTD. After completion of study treatment, patients are followed at 4 weeks and then at least annually thereafter. PROJECTED ACCRUAL: A total of 16-28 patients will be accrued for this study within 5-14 months.

Interventions

DRUGerlotinib hydrochloride
DRUGsorafenib tosylate

Sponsors

National Cancer Institute (NCI)
CollaboratorNIH
University Health Network, Toronto
Lead SponsorOTHER

Study design

Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

DISEASE CHARACTERISTICS: * Histologically confirmed solid tumor * Metastatic or unresectable disease * Standard curative or palliative measures do not exist OR are no longer effective * Measurable disease by radiography (for patients treated at the maximum tolerated dose \[MTD\] only) * Tumor accessible for serial biopsies (for patients treated at the MTD only) * No known brain metastases PATIENT CHARACTERISTICS: Age * 18 and over Performance status * ECOG 0-2 OR * Karnofsky 60-100% Life expectancy * More than 12 weeks Hematopoietic * WBC ≥ 3,000/mm\^3 * Absolute neutrophil count ≥ 1,500/mm\^3 * Platelet count ≥ 100,000/mm\^3 * No bleeding diathesis or coagulopathy Hepatic * Bilirubin normal * AST and ALT ≤ 2.5 times ULN * PT INR ≤ 1.5 unless on full-dose warfarin Renal * Creatinine normal OR * Creatinine clearance ≥ 60 mL/min Cardiovascular * No uncontrolled hypertension (i.e., systolic blood pressure \[BP\] \> 140 mm Hg or diastolic BP \> 90 mm Hg despite medication) * No symptomatic congestive heart failure * No unstable angina pectoris * No cardiac arrhythmia Ophthalmic * No abnormalities of the cornea, including any of the following: * Dry eye syndrome * Sjögren's syndrome * Congenital abnormalities (e.g., Fuch's dystrophy) * Abnormal slit-lamp examination using a vital dye (e.g., fluorescein or Bengal-Rose) * Abnormal corneal sensitivity test (e.g., Schirmer test or similar tear production test) Gastrointestinal * No active peptic ulcer disease that would impair the ability to swallow pills * No gastrointestinal tract disease resulting in an inability to take oral medication or a requirement for IV alimentation Other * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception * Willing to undergo serial biopsies, positron emission tomography, and CT scanning (for patients treated at the MTD only) * No ongoing or active infection * No significant traumatic injury within the past 3 weeks * No history of allergic reaction to drugs of similar chemical or biological composition to study drugs * No psychiatric illness or social situation that would preclude study compliance * No other condition that would impair the ability to swallow pills * No other uncontrolled illness PRIOR CONCURRENT THERAPY: Biologic therapy * No concurrent prophylactic hematopoietic colony-stimulating factors Chemotherapy * More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered Endocrine therapy * Not specified Radiotherapy * More than 4 weeks since prior radiotherapy (except for low dose, non-myelosuppressive radiotherapy) and recovered Surgery * More than 3 weeks since prior major surgery * No prior surgical procedure affecting absorption Other * No prior sorafenib or erlotinib * No other prior agents targeting Raf, vascular endothelial growth factor (VEGF), VEGF receptor, or epidermal growth factor receptor * No other concurrent investigational agents * No concurrent combination antiretroviral therapy for HIV-positive patients * No concurrent enzyme-inducing antiepileptic drugs (e.g., phenytoin, carbamazepine, or phenobarbital) * No concurrent CYP3A4 inducers (e.g., rifampin or Hypericum perforatum \[St. John's wort\]) * No other concurrent anticancer therapy * Concurrent prophylactic anticoagulation therapy (e.g., low-dose warfarin) allowed provided PT INR \< 1.1 times upper limit of normal (ULN) * Concurrent full-dose anticoagulants (e.g., warfarin) with PT INR \> 1.5 allowed provided both of the following criteria are met: * Patient has an in range INR (between 2-3) while on a stable-dose of oral anti-coagulant OR a stable-dose of low molecular weight heparin * No active bleeding OR pathological condition that would confer a high risk of bleeding (e.g., tumor involving a major vessel or known varices)

Design outcomes

Primary

MeasureTime frame
Maximum tolerated dose and recommended phase II dose28 days

Secondary

MeasureTime frame
Pharmacodynamic outcomesPre study and cycle 1
Pharmacokinetic outcomesPre-study, cycle 1 and cycle 2
Antitumor activityEvery 8 wks
Correlation of EGFR, AKT, ERK and VEGFR with antitumor activityIf responses or prolonged stable disease are observed
EGFR activating mutations, gene amplification status, EGFR intron 1 polymorphism if responses or prolonged disease stabilization are seenIf responses or prolonged stable disease are observed

Countries

Canada

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026