Trastuzumab in HER2-positive Biliary Tract Cancer

Overview

Trastuzumab is approved for the treatment of HER2-positive breast cancer and gastric cancer. The recent study showed that HER2 overexpression or amplification is noted about 5-15% of total biliary tract cancer patients. The aim of this study is to evaluate the efficacy and safety of trastuzumab in the combination of current standard gemcitabine plus cisplatin.

Full Title of Study: “The Pilot Study of Trastuzumab in Combination With Gemcitabine Plus Cisplatin for HER2-positive Biliary Tract Cancer”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: November 1, 2020

Interventions

  • Drug: Trastuzumab
    • Trastuzumab plus gemcitabine/cisplatin

Arms, Groups and Cohorts

  • Experimental: Trastuzumab plus Gem/Cis
    • Gemcitabine 1,000 mg/m2 Day 1 and Day 8, every 3 weeks Cisplatin 25 mg/m2 Day 1 and Day 8, every 3 weeks Trastuzumab, every 3 weeks, 8 mg/kg at first cycle then, 6 mg/kg

Clinical Trial Outcome Measures

Primary Measures

  • Response rate
    • Time Frame: 6 months
    • Best response according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1
  • Adverse events
    • Time Frame: 2 years
    • Adverse events graded by National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 4.03

Secondary Measures

  • Progression-free survival
    • Time Frame: 2 years
    • Time between the initiation of chemotherapy and disease progression or death
  • Overall survival
    • Time Frame: 2 years
    • Time between the initiation of chemotherapy and any cause of death

Participating in This Clinical Trial

Inclusion Criteria

1. The subject with disease that is not amendable to a curative treatment approach or locally advanced or metastatic or unresectable CCC with histological diagnosis 2. At least one measurable(per RECIST 1.1) lesion 3. Primary or metastatic tumor with HER2 positive defined on IHC2+, FISH+ or IHC3+ 4. ECOG Performance status 0 or 1 5. At least 3 months for life expectancy Common inclusion criteria 6. Men or women over 19 years at time of signing ICF 7. Signed Informed Consent Form Exclusion Criteria:

8. Received prior chemotherapy for advanced/metastatic disease (the adjuvant/neoadjuvant chemotherapy completed at least 6 months before enrolled will be accepted) 9. Not recovery from toxicities related to any prior treatments excluding alopecia (eg, neurological toxicity to ≥ Grade 2) 10. History of malignancy other than CCC within 5 years prior to screening, with the exception of malignancies with a negligible risk of metastasis or death, such as carcinoma in situ or thyroid papillary carcinoma Hematology, chemistry or organ function 11. ANC < 1.5 × 109/L, or Platelet < 100 × 109/L 12. Total bilirubin > 1.5 × ULN; or AST/ ALT > 2.5 × ULN (or if the tumor has expanded into the liver, > 5 × ULN); or, alkaline phosphatase > 2.5 × ULN (or > 5 × if the tumor has expanded into the liver, or > 10 × ULN if the tumor has expanded into the brain without liver,); or albumin < 2.5 g/dL 13. Creatinine clearance < 60 mL/min(calculated using the Cockcroft-Gault formula) Other exclusion criteria related to IP 14. History of proved congestive heart failure; angina with medication; evidence of transmural myocardial infarction on ECG; uncontrolled hypertension(systolic> 180 mmHg or diastolic> 100 mmHg); clinically significant heart valve disease; uncontrolled arrhythmia 15. LVEF < 50% (calculated by cardiac sonography or MUGA) 16. Subject with rest dyspnea due to metastatic tumor or other disease or who needs oxygen therapy 17. Chronic or high-dose corticosteroid treatment 18. Clinically significant Hearing impairment Common exclusion criteria 19. History or evidence of CNS metastases 20. Interstitial pneumonia or pulmonary fibrosis with symptom and exact lesion on chest X-ray 21. Hearing loss 22. Uncontrolled significant systemic disease (eg, infection or uncontrolled DM) 23. Pregnant or lactating females 24. Sexually active fertile subjects without contraception 25. Treatment with other investigational therapy within 4 weeks prior to initiation of study treatment 26. Radiotherapy within 4 weeks prior to initiation of study treatment (the rest at least 2 weeks after palliative radiotherapy for bone metastasis and recovery from the effects of radiation will be accepted.) 27. Major surgery within 4 weeks prior to initiation of study treatment 28. History of HIV and active HBV or HCV 29. Previously identified allergy or hypersensitivity to components of the study treatment formulations

Gender Eligibility: All

Minimum Age: 19 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Changhoon Yoo
  • Provider of Information About this Clinical Study
    • Sponsor-Investigator: Changhoon Yoo, Assistant professor – Asan Medical Center
  • Overall Official(s)
    • Changhoon Yoo, MD, Principal Investigator, Asan Medical Center

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