Phase 1 of this study will evaluate the maximum tolerated dose (MTD) of XL147 when given in combination with trastuzumab (Herceptin) and in combination with trastuzumab and paclitaxel. After the MTD is established for each combination (Phase 2), subjects will be enrolled to evaluate the preliminary efficacy and safety of these combinations in metastatic HER2 positive breast cancer. Both trastuzumab and paclitaxel are used in the treatment of metastatic breast cancer (MBC), but patients can develop resistance. The link between PI3K mutations and trastuzumab resistance has been seen in breast cancer patients. This suggests that inhibitors of the PI3K/PTEN pathway may have the potential to restore sensitivity to trastuzumab. Similarly, introduction of activated mutant forms of PI3K has been shown to transform and confer paclitaxel resistance to immortalized breast epithelial cells. XL147 is a potent and selective inhibitor of PI3K and inhibits phosphorylation of multiple downstream components of PI3K/PTEN signaling. Therefore, XL147 may have utility in the treatment of trastuzumab resistant/refractory and HER2-positive MBC when administered in combination with trastuzumab alone or with trastuzumab and paclitaxel.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
42
administered orally once daily as tablet(s)
administered by IV once every 3 weeks
administered by IV once every week
Investigational Site Number 1537
Los Angeles, California, United States
Investigational Site Number 1238
Fort Meyers, Florida, United States
Investigational Site Number 1138
Boston, Massachusetts, United States
Investigational Site Number 1330
Detroit, Michigan, United States
Investigational Site Number 1150
New York, New York, United States
Investigational Site Number 1151
The Bronx, New York, United States
Investigational Site Number 1214
Nashville, Tennessee, United States
Investigational Site Number 1246
Nashville, Tennessee, United States
Investigational Site Number 3413
Madrid, Spain
Safety and tolerability of XL147 in combination with trastuzumab and in combination with trastuzumab and paclitaxel
Time frame: safety assessments at weekly study visits
In Phase 1, the maximum tolerated dose (MTD) of XL147 when administered in combination with trastuzumab and in combination with trastuzumab and paclitaxel
Time frame: assessed by weekly study visits
In Phase 2, objective tumor response
Time frame: every 6 weeks
Duration of response and progression-free survival (Phase 2)
Time frame: every 6 weeks
Pharmacokinetics and pharmacodynamics of XL147 and trastuzumab when given in combination, and of XL147, trastuzumab, and paclitaxel when given in combination
Time frame: assessed weekly, then every 3 weeks
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