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Lapatinib and Capecitabine

Phase 3

Neoplasms, Gastrointestinal Tract | Small molecule | Oncology |GSK plc|Last Updated: Jan 29, 2016

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedACTIVE_CONTROLLEDBiomarker
Total Trials2
Total Enrollment341
FDA Designations
No designations recorded
Clinical Trials (2)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT00486954Lapatinib in Combination With Weekly Paclitaxel in Patients With ErbB2 Amplified Advanced Gastric CancerPHASE3 COMPLETED 273Jul 1, 2007Oct 1, 2012Jun 20, 201317 China, Japan +2
NCT00526669Study For Patients With Untreated Gastric Cancer Who Will Receive Capecitabine And LapatinibPHASE2 COMPLETED 68Mar 1, 2008Jan 1, 2015Jan 29, 201622 United States, Canada +4
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Study Endpoints
Primary Endpoints
Number of Participants With Dose Limiting Toxicities (DLTs) in the Pilot Part of the Study
28 days

DLTs consisted of only drug-related toxicities (neurologic and non-neurologic DLTs). A neurologic DLT was defined as grade 3/4 clinically significant peripheral motor and/or sensitive neuropathy. Non-neurologic DLTs mainly included the following: grade 3/4 clinically significant non-hematological toxicity (except nausea), grade 4 neutropenia lasting \>=7 days, thrombocytopenia (\<=25000 cells per cubic millimeter), inability to begin next treatment within 2 weeks of scheduled dosing due to unresolved toxicity, treatment delay (due to toxicity) of \>5 days, for Days 8 or 15 of weekly paclitaxel.

Overall Survival (OS) in the Randomized Part of the Study
From randomization until death due to any cause (up to 42.58 months)

OS was defined as the time from randomization until death due to any cause. For participants who did not die, time to death was censored at the time of last contact. For censored participants, time to death was defined as the time from randomization to the time of last contact.

Change From Start of Run-in Period in Biomarker Expression Levels at Day 0
evaluated at baseline and after 7 days of study treatment

Participants were analyzed for intratumoral expression levels of genes involved in the 5-fluorouracil (FU) pathway and lapatinib-targeted genes. Change in biomarker expression levels was calculated as the levels measured after the lapatinib Run-in Period (Baseline) of the study minus the levels measured at the start of monotherapy (Day -7). EGFR, epidermal growth factor receptor; HER, human epidermal growth factor receptor. Data are presented as ratios of the normalized gene expression of the target gene to that of beta actin.

Response Rate (Measured as the Percentage of Participants With Response [Complete Response or Partial Response])
From Baseline (Day 0) until disease progression or death due to any cause evaluated every 6 or 12 weeks (up to approximately 85 weeks)

Response is defined as documented evidence of complete response (CR) or partial response (PR). The investigator evaluated response based on Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Complete response is defined as the disappearance of all target lesions (TLs) and non-TLs and the appearance of no new lesions (NLs). Partial response for TLs is defined as \>= a 30% decrease in the sum of the longest diameter (LD) of TLs, taking as a reference the Baseline sum LD. For non-TLs it is defined as the persistence of 1 or more non-TL and no new TLs or non-TLs.

Percentage of Participants (Par.) With 5-month Progression-free Survival (PFS)
From initial treatment up to 24 weeks (next available assessment after the 5-month assessment for progressive disease)

5-month (mo.) PFS was defined as the percentage of par. who were alive/progression free for 5 months from the time of initial treatment. PFS is defined as the time from the initial treatment until the first observation of disease progression (DP)/death due to any cause; the percentage of par. whose follow-up ended or was ongoing was reported. DP is defined as symptomatic progression or the appearance of \>=1 NL and/or unequivocal progression of existing non-TLs, and a \>=20% increase in the sum of the LD of TLs, taking as a reference the smallest sum LD recorded since treatment started.

Secondary Endpoints
Maximum Plasma Concentration (Cmax) of Lapatinib in the Pilot Part of the Study
Days 8 and 14
Time to Cmax (Tmax) of Lapatinib in the Pilot Part of the Study
Days 8 and 14
Area Under the Concentration-time Curve From Time Zero to 24 Hours (AUC[0-24]) of Lapatinib in the Pilot Part of the Study
Days 8 and 14
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Study Design & Arms
AllocationRANDOMIZED
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Paclitaxel plus LapatinibEXPERIMENTAL6 pills of lapatinib at 250 mg each once daily and infusion of paclitaxel at 80 mglm2 weekly
Paclitaxel aloneACTIVE_COMPARATORInfusion of paclitaxel at 80 mglm2 weekly
Interventions
NameTypeDescription
LapatinibDRUG6 pills at 250 mg each once daily
PaclitaxelDRUGInfusion at 80 mg/m2 weekly
Lapatinib and CapecitabineDRUGoral lapatinib (1250mg) administered as a monotherapy run-in followed by its combination with capecitabine
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Eligibility Criteria
Age Range20 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites17

Inclusion criteria: Specific Information regarding warnings, precautions, contraindications, adverse events, and other pertinent information on the investigational product that may impact subject eligibility is provided in the Investigator's Brochure (IB) Pilot Part Subjects eligible for enrollmen...

Countries:ChinaJapanSouth KoreaTaiwanUnited StatesCanadaMexicoRussia
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