Lapatinib Combined With Paclitaxel For Patients With First-Line ErbB2-Amplified Metastatic Breast Cancer

Inclusion Criteria

A subject will be eligible for inclusion in this study only if all of the following criteria apply:

• Signed informed consent.
• Only females ≥18 years of age will be recruited:
• Non-child-bearing potential (i.e., women with functioning ovaries who have a current documented tubal ligation or hysterectomy, or women who are postmenopausal); or
• Child-bearing potential (i.e., women with functioning ovaries and no documented impairment of oviductal or uterine function that would cause sterility). This category includes women with oligomenorrhoea (severe), women who are perimenopausal and young women who have begun to menstruate. These subjects must provide a negative serum pregnancy test at Screening and agree to one of the following:
• Complete abstinence from intercourse from 2 weeks prior to administration of the first dose of study medication until 28 days after the final dose of study medication; or
• Consistent and correct use of one of the following acceptable methods of birth control:
• Male partner who is sterile prior to the female subject's entry into the study and is the sole sexual partner for that female subject.
• Implants of levonorgestrel.
• Injectable progestogen.
• Any intrauterine device (IUD) with a documented failure rate of less than 1% per year.
• Oral contraceptives (either combined or progestogen only).
• Barrier methods, including diaphragm or condom with a spermicide.
• Subjects must have histologically confirmed invasive breast cancer with stage IVdisease;
• Where the disease is restricted to a solitary lesion, the neoplastic nature of the lesion should be confirmed by cytology or histology.
• Subjects whose disease is ER+ and/or PR+ or unknown status will only be included in the study if they meet the following criteria:
• They have symptomatic visceral disease that requires chemotherapy (e.g., patients with liver or lung metastases).
• The disease is considered by the Investigator to be progressing rapidly or lifethreatening.
• Subjects who have received endocrine therapy and who are no longer benefiting from this therapy.
• Documented amplification of ErbB2 defined by FISH in primary or metastatic tumor tissue. Results of FISH testing at local laboratories are acceptable, however, tissue sample must still be sent to Central laboratory where results will be repeated but not used for eligibility criterion.
• If a taxane had been administered in the neoadjuvant or adjuvant setting, progression must have occurred ≥12 months after completion of this treatment.
• Measurable lesion(s) according to RECIST (Response Evaluation Criteria in Solid Tumors) criteria [Stephens, 2004; Therasse, 2000].
• Radiotherapy prior to initiation of study medication is allowed to a limited area (e.g., palliative treatment for painful bone metastases), if it is not the sole site of disease. Subject must have completed radiation treatment and recovered from all acute radiation treatment-related toxicities, in particular bone marrow suppression.
• Bisphosphonate therapy for bone metastases is allowed however; treatment must be initiated prior to the first dose of study medication. Prophylactic use of bisphosphonates in subjects without bone disease, except for the treatment of osteoporosis, is not permitted.
• Subjects with stable central nervous system (CNS) metastases (stable for at least 3 months) as confirmed by computerized tomography (CT)/magnetic resonance imaging (MRI)) or leptomeningeal involvement are eligible only if they are not taking oral steroids or enzyme-inducing anticonvulsants.
• Subjects must have a cardiac ejection fraction within institutional range of normal as measured by echocardiogram (or multigated acquisition (MUGA) scan if an echocardiogram cannot be performed or is inconclusive). Subjects with known history of uncontrolled or symptomatic angina, arrhythmias, or congestive heart failure are not eligible.
• Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 -