Breast Cancer
Conditions
Keywords
Breast Cancer, Estrogen Receptor Negative Breast Cancer, Biomarker studies, Ki-67, Dasatinib, BMS-354825, Sprycel
Brief summary
The goal of this clinical research study is to learn if dasatinib can help prevent breast cancer from developing in the unaffected breast. Dasatinib is designed to decrease the activity of one or more proteins that are responsible for the uncontrolled growth of tumor cells. This is an investigational study. Dasatinib is FDA approved and commercially available for the treatment of leukemia. Its use in breast cancer patients in investigational. Up to 66 patients will take part in this multicenter study. Up to 60 will be enrolled at MD Anderson.
Detailed description
Study Drug Administration: If you are found to be eligible to take part in this study, you will be randomly assigned (as in the flip of a coin) to 1 of 3 study groups: * If you are in Group 1, you will take dasatinib 40mg once a day by mouth with water. * If you are in Group 2, you will take dasatinib 80mg once a day by mouth with water. * If you are in Group 3, you will not receive dasatinib. You will be given a study drug diary to complete. In the diary, you will record when you take the study drug. Study Visits: At Month 1: * You will be called by a nurse and asked about any drugs you are taking and side effects you may be having. * You will be asked about any drugs you may be taking and side effects you may be having. * Your drug diary will be reviewed. At Month 2 you will be called by a nurse and asked about any drugs you are taking and side effects you may be having. You will also be asked to review your drug diary. This call will take about 20 minutes At Month 3 (or if you leave the study early): * You will have a fine needle aspirate (FNA) of the breast for biomarker testing. Biomarkers are found in the blood/tissue and may be related to your reaction to the study drug. * Blood (about 2-3 tablespoons) will be drawn for biomarker testing. * You will be asked about any drugs you may be taking and side effects you may be having. * Your drug diary will be reviewed. Length of Study: You may remain on study for up to 3 months. You will no longer be able to take the study drug if the disease gets worse, if intolerable side effects occur, or if you are unable to follow study directions.
Interventions
DRUGDasatinib
Group 1: 40 mg by mouth once a day. Group 2: 80 mg by mouth once a day.
Sponsors
Susan G. Komen Breast Cancer Foundation
Bristol-Myers Squibb
M.D. Anderson Cancer Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Histological confirmation of ER negative breast carcinoma (defined as less than 10%), stage I, II, or III 2. Completed all adjuvant therapy including (if indicated) endocrine, trastuzumab, radiation therapy 3. At least 18 years of age. 4. Female: A female is eligible to enter and participate in the study if she is of: a. Non-childbearing potential (i.e., women with functioning ovaries who have a current documented tubal ligation, hysterectomy alone, hysterectomy and bilateral salpingo-oophorectomy, bilateral salpingo-oophorectomy alone or women who are post-menopausal); or b. Childbearing potential (i.e., women with functioning ovaries and no documented impairment of oviductal or uterine function that would cause sterility. This category includes women with oligomenorrhoea (severe), women who are perimenopausal, and young women who have begun to menstruate), has a negative serum pregnancy test at screening, and agrees to one of the following where considered acceptable to the local IRB/IEC: • Double-barrier contraception (condom with spermicidal jelly, foam suppository, or film; diaphragm with spermicide; or male condom and diaphragm). 5. (Continued from above) • Abstinence from sexual intercourse from 2 weeks prior to administration of the investigational product, throughout the active study treatment period. • Male partner who is sterile prior to the female subject's entry into the study and is the sole sexual partner for that female subject. • Any intrauterine device (IUD). • Barrier methods including diaphragm or condom with a spermicide. 6. Able to swallow and retain oral medication. 7. ECOG (Eastern Cooperative Oncology Group) performance status 0 to 2. 8. Provided written informed consent. 9. Adequate bone marrow function: Hemoglobin \>/= 9 gm/dL. • Absolute granulocyte count \>/= 1,500/mm\^3 (1.5 x 10\^9/L). • Platelets \>/= 75,000/mm\^3 (100 x 10\^9/L). 10. Serum creatinine \< 1.4 mg/dL or calculated creatinine clearance (CrCl) \>/= 30 mL/min 11. Total bilirubin \</= 1.5 times the upper limit of the reference range 12. Aspartate and alanine transaminase (AST or ALT) \</= 2 times the upper limit of the reference range. 13. Patients must have a baseline ECG with QTcF within the normal range within 28 days prior to registration. 14. Normal mammogram of unaffected breast within 12 months prior to study entry.
Exclusion criteria
1. Unwillingness to undergo RPFNA. 2. Contraindication to RPFNA including breast implant(s), bilateral radiation, anticoagulation (excluding those on 81mg aspirin). 3. Concurrent medical condition that would increase drug toxicity: Pleural or pericardial effusion, coagulation or platelet function disorder, ongoing or recent (less than 3 months gastrointestinal bleeding) 4. Uncontrolled angina, congestive heart failure, MI (within last 6 months), congenital long QT syndrome, history of clinically significant ventricular arrhythmia, prolonged QTcF interval on pre-entry EKG (greater than normal range) 5. Hypokalemia or hypomagnesemia if it cannot be corrected 6. Is a pregnant or lactating female. 7. Has evidence of recurrent or metastatic (Stage IV) breast cancer. 8. Is considered medically unfit for the study by the investigator as a result of the medical interview, physical exam, or screening investigations. 9. Has a known immediate or delayed hypersensitivity reaction or idiosyncrasy to dasatinib 10. Has received treatment with any investigational drug in the previous 4 weeks. 11. Has received chemotherapy, immunotherapy, biologic therapy or endocrine therapy within the past 12 weeks. 12. Is currently receiving oral steroid treatment (inhaled steroids are permitted) 13. Oral estrogen, progesterone, testosterone therapy within last 3 months. 14. Concomitant Medications: Drugs that are considered category D (Consider therapy modification) and X (Avoid combination) using the Lexicomp database are prohibited. Concomitant drugs that fall into categories A (No known interaction), B (no action needed) and C (monitor therapy) are allowed.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Ki-67 in Breast Tissue of High-Risk Women | up to 3 months | Change in Ki-67 measured in baseline and month 3 using contralateral breast Fine Needle Aspiration (FNA) samples. Samples evaluated by immunohistochemistry (IHC). Baseline and follow up Ki-67 values presented in percentage (%) of cell positive, change reflects difference in percentage. Ki-67 is measured as a continuous variable and a one-way ANOVA followed by Dunnett's multiple comparison test comparing the change of Ki-67 of each of the three treated groups with control. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | up to 3 months | Evaluation of serum utilizing ELISA kits for IGFBP1 |
Countries
United States
Participant flow
Recruitment details
26 patients were enrolled by 08/13/2018, of which were 24 randomized, 6 in No Treatment/Control, 12 in Dasatinib 40 mg, and 6 in Dasatinib 80 mg.
Participants by arm
| Arm | Count |
|---|---|
| Group 1: Dasatinib 40 mg Dasatinib 40 mg by mouth once a day for 3 months (+/- 7 days), At the end of the 3 months (+/- 7 days) participants undergo a repeat FNA and blood collection for the same marker analyses.
Dasatinib: Group 1: 40 mg by mouth once a day.
Dasatinib Group 2: 80 mg by mouth once a day. | 12 |
| Group 2: Dasatinib 80 mg Dasatinib 80 mg by mouth once a day for 3 months (+/- 7 days). At the end of the 3 months (+/- 7 days) participants undergo a repeat FNA and blood collection for the same marker analyses.
Dasatinib: Group 1: 40 mg by mouth once a day.
Dasatinib Group 2: 80 mg by mouth once a day. | 6 |
| Group 3: No Dasatinib No treatment control group. At the end of the 3 months (+/- 7 days) participants undergo a repeat FNA and blood collection for the same marker analyses. | 6 |
| Total | 24 |
Baseline characteristics
| Characteristic | Group 1: Dasatinib 40 mg | Group 2: Dasatinib 80 mg | Group 3: No Dasatinib | Total |
|---|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 1 Participants | 0 Participants | 0 Participants | 1 Participants |
| Age, Categorical Between 18 and 65 years | 11 Participants | 6 Participants | 6 Participants | 23 Participants |
| Age, Continuous | 62.4 Years | 50.8 Years | 54 Years | 56.8 Years |
| Ethnicity (NIH/OMB) Hispanic or Latino | 3 Participants | 1 Participants | 0 Participants | 4 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 9 Participants | 5 Participants | 6 Participants | 20 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Black or African American | 2 Participants | 1 Participants | 2 Participants | 5 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 10 Participants | 4 Participants | 4 Participants | 18 Participants |
| Region of Enrollment United States | 12 participants | 6 participants | 6 participants | 24 participants |
| Sex: Female, Male Female | 12 Participants | 6 Participants | 6 Participants | 24 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 12 | 0 / 6 | 0 / 6 |
| other Total, other adverse events | 11 / 12 | 5 / 6 | 0 / 6 |
| serious Total, serious adverse events | 0 / 12 | 0 / 6 | 0 / 6 |
Outcome results
Primary
Change in Ki-67 in Breast Tissue of High-Risk Women
Change in Ki-67 measured in baseline and month 3 using contralateral breast Fine Needle Aspiration (FNA) samples. Samples evaluated by immunohistochemistry (IHC). Baseline and follow up Ki-67 values presented in percentage (%) of cell positive, change reflects difference in percentage. Ki-67 is measured as a continuous variable and a one-way ANOVA followed by Dunnett's multiple comparison test comparing the change of Ki-67 of each of the three treated groups with control.
Time frame: up to 3 months
Population: FNA yield for matched pre-and-post treatment FNA samples was technically insufficient for Ki-67 immunohistochemitry analysis
Secondary
To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway
Evaluation of serum utilizing ELISA kits for IGFBP3
Time frame: up to 3 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Group 1: Dasatinib 40 mg | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | pretreatment | 2041 ng/ml | Standard Deviation 411.1 |
| Group 1: Dasatinib 40 mg | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | Post-treatment | 2027.6 ng/ml | Standard Deviation 348.9 |
| Group 2: Dasatinib 80 mg | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | pretreatment | 1999 ng/ml | Standard Deviation 136.7 |
| Group 2: Dasatinib 80 mg | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | Post-treatment | 2048.4 ng/ml | Standard Deviation 220.7 |
| Group 3: No Dasatinib | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | pretreatment | 2279.9 ng/ml | Standard Deviation 394.5 |
| Group 3: No Dasatinib | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | Post-treatment | 2080.2 ng/ml | Standard Deviation 514.4 |
Secondary
To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway
Evaluation of serum utilizing ELISA kits for IGFBP1
Time frame: up to 3 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Group 1: Dasatinib 40 mg | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | Pre-treatment | 6683 pg/ml | Standard Deviation 4086.6 |
| Group 1: Dasatinib 40 mg | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | Post-treatment | 8508.5 pg/ml | Standard Deviation 7992.3 |
| Group 2: Dasatinib 80 mg | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | Pre-treatment | 2320.9 pg/ml | Standard Deviation 797.1 |
| Group 2: Dasatinib 80 mg | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | Post-treatment | 4270.6 pg/ml | Standard Deviation 4405.3 |
| Group 3: No Dasatinib | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | Pre-treatment | 6524 pg/ml | Standard Deviation 3900.3 |
| Group 3: No Dasatinib | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | Post-treatment | 7270.1 pg/ml | Standard Deviation 4715.4 |
Secondary
To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway
Evaluation of serum utilizing ELISA kits for IGF1
Time frame: up to 3 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Group 1: Dasatinib 40 mg | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | Pre-treatment | 71.8 ng/ml | Standard Deviation 35.6 |
| Group 1: Dasatinib 40 mg | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | Post-treatment | 70.3 ng/ml | Standard Deviation 41 |
| Group 2: Dasatinib 80 mg | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | Pre-treatment | 79.8 ng/ml | Standard Deviation 22.3 |
| Group 2: Dasatinib 80 mg | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | Post-treatment | 68.2 ng/ml | Standard Deviation 24.4 |
| Group 3: No Dasatinib | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | Pre-treatment | 95.2 ng/ml | Standard Deviation 25.7 |
| Group 3: No Dasatinib | To Evaluate Dasatinib Induced Modulation of Biomarker in the Serum Including Insulin Like Growth Factor (IGF) Pathway | Post-treatment | 95.3 ng/ml | Standard Deviation 27.7 |