Phase II trial to study the effectiveness of combining trastuzumab with combination chemotherapy in treating patients who have locally recurrent or metastatic urinary tract cancer. Monoclonal antibodies such as trastuzumab can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining monoclonal antibody therapy with combination chemotherapy may kill more tumor cells
PRIMARY OBJECTIVES: I. To assess the toxicity of the combination of Herceptin, paclitaxel, carboplatin, and gemcitabine in patients with metastatic or locally recurrent urothelial cancers who overexpress HER2. SECONDARY OBJECTIVES: I. The complete and partial response rates. II. The median and overall survival. III. To prospectively evaluate the percentage of patients with metastatic/recurrent bladder cancer who overexpress HER2 histologically (by immunohistochemistry and FISH) and serologically. IV. To generate preliminary data on response to other therapy and survival for Her2 negative patients. OUTLINE: Patients receive trastuzumab (Herceptin) IV over 30-90 minutes on days 1, 8, and 15; paclitaxel IV over 3 hours and carboplatin IV over 15 minutes on day 1; and gemcitabine IV over 30 minutes on days 1 and 8. Courses repeat every 3 weeks. Patients achieving a complete response (CR) receive 3 courses past CR. Patients achieving a partial response or stable disease continue on therapy until CR or disease progression or unacceptable toxicity. Patients are followed for disease progression and survival. Patients with HER2-negative disease are not eligible for treatment but are followed every 6 months for response and survival.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Given IV
Given IV
Given IV
Given IV
Correlative studies
University of Michigan University Hospital
Ann Arbor, Michigan, United States
Cardiac toxicity rate of this combination using MUGA or 2D ECHO
Time frame: Up to 7 years
Response rate
The response rate of this regimen will be estimated with a standard error no greater than 7.9%.
Time frame: Up to 7 years
Time to disease progression
Kaplan-Meier method will be used for the analysis and graphic presentation of this data.
Time frame: Up to 7 years
Survival duration
Kaplan-Meier method will be used for the analysis and graphic presentation of this data.
Time frame: Up to 7 years
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