RATIONALE: Abiraterone acetate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. PURPOSE: This phase I/II trial is studying the side effects and best dose of abiraterone acetate and to see how well it works in treating postmenopausal women with advanced or metastatic breast cancer.
OBJECTIVES: Primary * To evaluate the safety and tolerability of abiraterone acetate in postmenopausal women with estrogen receptor- or androgen receptor-positive advanced or metastatic breast cancer. (Phase I) * To determine the recommended phase II dose of this drug in these patients. (Phase I) * To evaluate the clinical benefit rate of this drug at 24 weeks in these patients. (Phase II) Secondary * To study the pharmacokinetics of this drug in these patients. (Phase I) * To determine the endocrine impact of this drug on the pituitary-adrenal-gonad endocrine axis. (Phase I) * To estimate the duration of objective tumor response in these patients. (Phase II) * To correlate response rates and duration of response with the endocrine profile in these patients. (Phase II) * To determine overall survival of these patients. (Phase II) Tertiary * To enumerate and molecularly characterize circulating tumor cells. * To identify normal genetic variations that predict resistance to this drug using pharmacogenomic analysis. OUTLINE: This is a multicenter, phase I study followed by a phase II study. Patients enrolled in the phase II portion of the study are stratified according to hormone receptor status (estrogen receptor \[ER\]-positive and any androgen receptor \[AR\] status vs AR-positive and ER-negative). Patients receive oral abiraterone acetate once daily on days 1-28. Treatment repeats every 28 days for 12 courses in the absence of disease progression or unacceptable toxicity. Blood samples are collected periodically and analyzed for pharmacokinetic assays (phase I only), pharmacodynamic assays, circulating tumor cells, and pharmacogenomic analysis. After completion of study treatment, patients are followed for 28 days. Peer Reviewed and Funded or Endorsed by Cancer Research UK.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
77
Velindre Cancer Centre
Whitchurch, Cardiff, United Kingdom
Guy's Hospital
London, England, United Kingdom
Royal Marsden - Surrey
Sutton, England, United Kingdom
University of Birmingham,
Birmingham, United Kingdom
Causality of each adverse event and grading severity as measured by NCI CTCAE v3.0 (Phase I)
Maximum tolerated dose (MTD) of abiraterone acetate (Phase I)
Proportion of patients with stable disease for ≥ 24 weeks or objective response as measured by RECIST criteria (Phase II)
Plasma levels of abiraterone acetate as measured by liquid chromatography/tandem mass spectrometry assay (Phase I)
Relationship between dose and endocrine response (Phase I)
Duration of objective tumor response as measured by RECIST criteria (Phase II)
Relationship between tumor response and endocrine response (Phase II)
Median overall survival (Phase II)
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Western General Hospital
Edinburgh, United Kingdom
The Beatson West of Scotland Cancer Centre
Glasgow, United Kingdom