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Antimetabolite
Neratinib + Capecitabine for Breast Cancer
Phase 2
Recruiting
Led By Ajay Dhakal
Research Sponsored by University of Rochester
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial Must have
At least 18 years of age
Prior treatment-related major organ toxicities recovered to ≤grade 1
Must not have
Whole-brain radiotherapy in the prior three months for Step 1
Serious cardiac illness or condition for Step 1
Timeline
Screening 3 weeks
Treatment Varies
Follow Up 24 months
Awards & highlights
No Placebo-Only Group
Summary
This trial is testing a combination of neratinib and capecitabine for breast cancer patients with brain metastases. These patients' tumors did not show HER2 activity with usual tests but did with a special test, suggesting they might benefit from this treatment. Neratinib blocks growth proteins in cancer cells, while capecitabine kills them. Neratinib is approved for use in combination with capecitabine for advanced HER2-positive breast cancer.
Who is the study for?
This trial is for adults with HER2-negative breast cancer that has spread to the brain, showing abnormal HER2 activity. Candidates must have measurable disease, be fit for a biopsy, and not have had certain treatments recently. They should not be pregnant or breastfeeding and must use reliable contraception.
What is being tested?
The study tests the combination of Neratinib (a targeted therapy) and Capecitabine (chemotherapy) in patients whose tumors are HER2-negative but show unusual HER2 activity. It aims to assess safety and effectiveness specifically for brain metastases from breast cancer.
What are the potential side effects?
Potential side effects include diarrhea, liver issues, hand-foot syndrome (redness/swelling/pain on palms/soles), nausea, vomiting, fatigue, mouth sores. Heart problems could also occur due to Neratinib.
Eligibility Criteria
Inclusion Criteria
You may be eligible if you check “Yes” for the criteria belowSelect...
I am 18 years old or older.
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My side effects from previous treatments have mostly gone away.
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I understand this study is experimental and I can sign the consent form.
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My breast cancer is confirmed to be HER2 negative.
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I have a tumor outside my brain that can be biopsied.
Select...
I am able to get out of my bed or chair and move around.
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It has been over 30 days since my last experimental cancer treatment or immunotherapy.
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My cancer has spread to my brain recently or is getting worse.
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My tumor shows abnormal HER2 activity based on the CELsignia test.
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I am willing to have a biopsy for research purposes.
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I have a new or growing brain tumor larger than 5 mm.
Exclusion Criteria
You may be eligible for the trial if you check “No” for criteria below:Select...
I have not had whole-brain radiotherapy in the last 3 months.
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I have a serious heart condition.
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I have been treated with capecitabine for my breast cancer that has spread.
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I cannot absorb pills due to my stomach or intestine condition.
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My blood pressure is often above 160/110 mmHg, or I struggle to control it with medication.
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I am not taking any strong or moderate drugs that affect enzyme CYP3A4.
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My HER2 test results were unclear.
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I have or might have cancer spread to the lining of my brain and spinal cord.
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My tumor shows normal HER2 activity.
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I have inflammatory bowel disease with significant diarrhea.
Select...
I have bleeding problems or take blood thinners that could make a biopsy risky.
Timeline
Screening ~ 3 weeks3 visits
Treatment ~ Varies
Follow Up ~ 24 months
Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~24 months
Treatment Details
Study Objectives
Study objectives can provide a clearer picture of what you can expect from a treatment.Primary study objectives
CNS progression free survival
overall survival
Awards & Highlights
No Placebo-Only Group
All patients enrolled in this study will receive some form of active treatment.
Trial Design
1Treatment groups
Experimental Treatment
Group I: Experimental: Capecitabine and Neratinib.Experimental Treatment1 Intervention
Neratinib 240 mg PO QD Daily On-going
Capecitabine 750 mg/m2 PO bid Days 1-14, 7 days off On-going
Research Highlights
Information in this section is not a recommendation. We encourage patients to speak with their healthcare team when evaluating any treatment decision.Mechanism Of Action
Side Effect Profile
Prior Approvals
Other Research
HER2-targeted therapies, like Neratinib, inhibit the HER2 receptor, which is often overexpressed in certain breast cancers, thereby slowing or stopping tumor growth. Capecitabine, a chemotherapy drug, is converted into 5-fluorouracil (5-FU) in the body, disrupting DNA synthesis and preventing cancer cell proliferation.
These mechanisms are vital for tailoring treatment to the specific cancer type, enhancing effectiveness, and minimizing adverse effects for breast cancer patients.
Breast Cancer Resistance to Cyclin-Dependent Kinases 4/6 Inhibitors: Intricacy of the Molecular Mechanisms.New drugs for breast cancer.
Breast Cancer Resistance to Cyclin-Dependent Kinases 4/6 Inhibitors: Intricacy of the Molecular Mechanisms.New drugs for breast cancer.
Find a Location
Who is running the clinical trial?
University of RochesterLead Sponsor
872 Previous Clinical Trials
550,069 Total Patients Enrolled
11 Trials studying Breast Cancer
1,691 Patients Enrolled for Breast Cancer
Ajay DhakalPrincipal InvestigatorUniversity of Rochester
Media Library
Eligibility Criteria:
This trial includes the following eligibility criteria:- I am 18 years old or older.It has been at least 28 days since my last fulvestrant dose.My side effects from previous treatments have mostly gone away.I have not had whole-brain radiotherapy in the last 3 months.I understand this study is experimental and I can sign the consent form.My breast cancer is confirmed to be HER2 negative.I am post-menopausal, surgically sterile, or will use birth control during and for 6 months after the study.My doctor thinks I might need treatment that affects my whole body now or later.I have a serious heart condition.It has been over 21 days since my last targeted cancer treatment.I have a tumor outside my brain that can be biopsied.I am able to get out of my bed or chair and move around.It has been over 30 days since my last experimental cancer treatment or immunotherapy.I am either male or female.My cancer has spread to my brain recently or is getting worse.My tumor shows abnormal HER2 activity based on the CELsignia test.I have triple negative breast cancer and haven't had specific cancer treatments.I have ER+ breast cancer and was treated with CDK4/6 inhibitors and hormone therapy for advanced disease.I have been treated with capecitabine for my breast cancer that has spread.I cannot absorb pills due to my stomach or intestine condition.It's been over 14 days since my last chemotherapy dose, except for capecitabine.My blood, liver, kidneys, and clotting functions are all within normal ranges.I am willing to have a biopsy for research purposes.I have a new or growing brain tumor larger than 5 mm.I am healthy enough to have a biopsy.It's been over a week since my last hormone therapy, except for fulvestrant.My blood pressure is often above 160/110 mmHg, or I struggle to control it with medication.It's been over a week since my last radiation treatment and I've recovered from any immediate side effects.I am not taking any strong or moderate drugs that affect enzyme CYP3A4.My HER2 test results were unclear.I have or might have cancer spread to the lining of my brain and spinal cord.My tumor shows normal HER2 activity.I have had a blood clot in my lung or leg in the last 3 months.I understand this study is experimental and I can sign the consent form.I have not had major surgery in the last 10 days.I have inflammatory bowel disease with significant diarrhea.You have visible signs of cancer that has spread to the brain in imaging tests.I have no cancer recurrence in the last 2 years, except for certain skin cancers or treated cervical cancer.I have bleeding problems or take blood thinners that could make a biopsy risky.Your heart's pumping ability is normal.
Research Study Groups:
This trial has the following groups:- Group 1: Experimental: Capecitabine and Neratinib.
Awards:
This trial has 1 awards, including:- No Placebo-Only Group - All patients enrolled in this study will receive some form of active treatment.
Timeline:
This trial has the following timeline:- Screening: It may take up to 3 Weeks to process to see if you qualify in this trial.
- Treatment: The duration you will receive the treatment varies.
- Follow Ups: You may be asked to continue sharing information regarding the trial for 6 Months after you stop receiving the treatment.