RATIONALE: Lapatinib ditosylate may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving lapatinib ditosylate together with capecitabine may kill more tumor cells. PURPOSE: This phase II trial is studying how well giving lapatinib ditosylate together with capecitabine works in treating patients with metastatic pancreatic cancer.
OBJECTIVES: Primary * To evaluate the efficacy of lapatinib ditosylate and capecitabine as first-line therapy, in terms of overall survival, in patients with metastatic pancreatic cancer. Secondary * To evaluate the progression-free survival of patients treated with this regimen. * To evaluate the overall response rate (complete and partial responses) in patients treated with this regimen. * To evaluate the clinical benefit (complete response, partial response, or stable disease for ≥ 6 months) of this regimen in these patients. * To evaluate the qualitative and quantitative toxicity associated with this regimen in these patients. * To determine the intra-tumoral expression of ErbB1 (EGFR) and ErbB2 (HER2/neu) in these patients. * To seek pilot information on the intra-tumoral expression of markers of tumor resistance and sensitivity to treatment, including resistance drug pump expression and growth factor receptor expression. * To collect pre- and post-treatment serum samples from these patients for proteomic analyses to elucidate if any serum cancer marker profiles can be detected. OUTLINE: This is a multicenter study. Patients receive oral lapatinib ditosylate once daily on days 1-21 and oral capecitabine twice daily on days 1-14. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 6-12 weeks.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Cork University Hospital
Cork, Ireland
Mercy University Hospital
Cork, Ireland
Adelaide and Meath Hospital, Dublin Incorporating the National Children's Hospital
Dublin, Ireland
St. Vincent's University Hospital
Dublin, Ireland
6-month survival rate
Time frame: 6 months
Progression-free survival
Progression-free survival (PFS) will be measured as the number of days between patient's enrolment and his or her date of progression of disease. Patients who are still living six months after the last patient has been enrolled will be censored for the analyses, using the number of days between enrolment and the date of last follow-up. Disease progression will be determined according to definitions established in the modified response evaluation criteria in solid tumours (RECIST) (refer to Appendix G). For patients with non-measureable tumours disease progression will be determined by the treating physician in consultation with the Chief investigator for the study.
Time frame: 6 months
Overall response rate
The overall response rate will be an aggregation of the complete responses and partial responses. For patients to be given the status of complete response or partial response a confirmatory disease assessment should be performed no less than four weeks after the criteria for response are first met.
Time frame: up to 6 months
Clinical benefit
A patient will be regarded as' having experienced clinical benefit if they have shown a complete response, a partial response, or stable disease for at least six months.
Time frame: 6 months
Safety and tolerability
Time frame: Throughout course of study
Tumour biomarker analysis
Characterising the patient population by determination of intra-tumoural expression of ErbB1 (EGFR) and ErbB2 (Her2/neu).Seeking pilot information as to the intra-tumoural expression of markers of tumour resistance and sensitivity to treatment. Proteomic analysis of serum samples for potential markers.
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Enrollment
9
Mater Misericordiae University Hospital
Dublin, Ireland
Mater Private Hospital
Dublin, Ireland
St. James's Hospital
Dublin, Ireland
Beaumont Hospital
Dublin, Ireland
University College Hospital
Galway, Ireland
Time frame: Currently ongoing