A Phase II Evaluation of Afatinibin Patients With Persistent or Recurrent HER2-positive Uterine Serous Carcinoma



Status:Recruiting
Healthy:No
Age Range:18 - 100
Updated:1/6/2019
Start Date:June 2015
End Date:June 2028
Contact:Alessandro D. Santin, M.D.
Email:alessandro.santin@yale.edu
Phone:203-737-4450

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A Phase II Evaluation of Afatanib, an Irreversible Human Epidermal Growth Factor Receptor 2 (Her2/Neu) Tyrosine Kinase Inhibitor, in Patients With Persistent or Recurrent HER2-positive Uterine Serous Carcinoma

Primary Objective: To assess the activity of Afatinib in patients with persistent or
recurrent uterine serous carcinoma overexpressing HER2/neu with the frequency of patients who
survive progression-free for at least 6 months after initiating therapy. Secondary
Objectives: To assess objective response rate and durable disease control rate. To assess
overall survival. To assess the safety profile of Afatinib in uterine serous carcinoma
patients.

Exploratory/correlative objectives: To systematically evaluate HER2/neu
expression/amplification using standardized scoring criteria for both breast and gastric
cancer and correlate clinical response in uterine serous carcinoma patients with HER2/neu
scoring results. To correlate objective response rate, PFS and overall survival with the
presence/absence of phosphatidyl inositol 3-kinase catalytic subunit and F-box/WD
repeat-containing protein mutations by standard Sanger sequencing, and presence/absence of
Cyclin E2 overexpression by IHC in endometrial cancer patients overexpressing HER2/neu
treated with Afatinib. To study HER2/neu extracellular domain circulating levels in the
plasma of uterine serous carcinoma patients overexpressing HER2/neu before and during
Afatinib treatment to elucidate whether changes in HER2/neu extracellular domain would
predict response to Afatinib and to determine peripheral blood natural killer cell numbers
and activity in HER2/neu+ uterine serous carcinoma patients before and during Afatinib
treatment to assess the possible therapeutic contributions of immune mechanisms of action of
Afatinib.

Inclusion Criteria:

- Patients must have persistent or recurrent histologically confirmed uterine serous
carcinoma, harbor a tumor HER2/neu+ based upon IHC staining score of 3+ or 2+ with
confirmed gene amplification by FISH.

- Have measurable disease.

- Have at least one target lesion to be used to assess response as defined by RECIST
v1.1.

- After undergoing surgery may be optimally or sub optimally debulked, with measurable
recurrent disease of any previous substage.

- Diagnosis histologically confirmed by a gynecologic pathologist as containing >10%
uterine papillary serous adenocarcinoma in the specimen.

- Have adequate bone marrow function.

- WBC greater than or equal to 3,000/ul, platelets greater than or equal to 75,000/ul,
granulocytes greater than or equal to 1500/ul., creatinine less than or equal to 2.0
mg/kl, bilirubin < 1.5 X laboratory normal, SGOT/SGPT <3 X laboratory normal.

- Have an ECOG performance status of 0 or 1.

- Have signed an approved consent.

- Have recovered from effects of recent surgery, radiotherapy or chemotherapy. Should be
free of significant infection.

- Patients with recurrent disease may have received multiple prior chemotherapies for
treatment of their uterine cancer.

- May have received prior trastuzumab therapy alone or in combination with chemotherapy
with 2 week washout period required between trastuzumab treatment and first dose of
Afatanib.

- Patients of childbearing potential must have a negative serum pregnancy test within 7
days prior to the study entry and be practicing an effective form of contraception.

- Must be 18 years of age.

Exclusion Criteria:

- Patients with a history of other invasive malignancies, with the exception of
non-melanoma skin cancers are excluded if there is any evidence of other malignancy
being present within the last five years. Patients are also excluded if their previous
cancer treatment contraindicates this protocol.

- Patients who have a significant history of cardiac disease, uncontrolled hypertension,
unstable angina, uncontrolled congestive heart failure, or uncontrolled arrhythmias
within 6 months of registration. Patients with any unstable medical issue, active
treatment for symptomatic pulmonary embolism, CVA, renal or hepatic insufficiency,
active infection/sepsis requiring IV antibiotics, known brain/leptomengial involvement
of the disease, active neurological disease, dementia.

- Patients who have received prior therapy with any irreversible human epidermal growth
factor receptor tyrosine kinase inhibitor.

- Patients who have an uncontrolled seizure disorder or active neurological disease.
Patients known to be seropositive for HIV and active hepatitis, even if liver function
studies are in the eligible range. Known hemorrhagic diathesis or active bleeding
disorder.
We found this trial at
3
sites
185 Cambridge Street
Boston, Massachusetts 02114
617-724-5200
Principal Investigator: Whitfield Growdon, MD
Phone: 617-724-4800
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20 York St, N20 York St,
New Haven, Connecticut 06520
(203) 688-4242
Phone: 203-737-4450
Yale-New Haven Hospital Relying on the skill and expertise of more than 4,500 university and...
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Tucson, Arizona 85724
Phone: 520-626-0950
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