Lapatinib and Vinorelbine in Treating Patients With Advanced Solid Tumors

Exclusion Criteria

• •Measurable or evaluable disease. Disease in previously irradiated sites is considered measurable if there is clear disease progression following radiation therapy.
• •18 years of age or older.
• •Zubrod performance status of 0-2.
• •Estimated survival of at least 3 months.
• •Any prior chemotherapy must have been completed at least 4 weeks prior to start of this protocol and all side effects (except alopecia) resolved to grade 1 or less. Any prior radiation must have been completed at least 2 weeks prior to start of therapy. For prior mitomycin chemotherapy a 6-week interval is required. Patients must have completed prior trastuzumab at least 4 weeks prior to start of protocol therapy.
• •Adequate renal function
• •Adequate liver function
• •Pretreatment granulocyte count of \>1500/mm3 and platelet count of \>100 000/mm3.
• •Cardiac ejection fraction within the institutional range of normal as measured by 2-D echocardiogram or MUGA scan.
• •Asymptomatic treated brain metastasis may be included if they are neurologically stable and have been off steroids and anticonvulsants for at least 4 weeks.
• •All patients must give informed consent.
• •Able to take and retain oral medication.
• •Patients of reproductive potential must agree to use an effective contraceptive method
• •Patients may not have previously received lapatinib, vinorelbine or any other EGFR-1 targeted agent. Prior trastuzumab is allowed.
• •Females cannot be pregnant or breastfeeding
• •Symptomatic brain metastasis or still requiring steroids and anticonvulsants may not participate.
• •Pre-existing neuropathy \> grade 2 may not participate.
• •Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements, will be excluded.
• •History of other diseases, metabolic dysfunction, physical examination finding or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that might affect the interpretation of the results of the study or render the patient at high risk from treatment complications.
• •Gastrointestinal tract disease resulting in an inability to take oral medication or a requirement for IV alimentation, or prior surgical procedures affecting absorption.
• •HIV-positive patients receiving combination anti-retroviral therapy are excluded from the study because of possible pharmacokinetic interactions with lapatinib.
• •Patients requiring oral anticoagulants are eligible provided there is appropriate close INR monitoring is in place. If medically appropriate and treatment available, the investigator may also consider switching these patients to LMW heparin, where an interaction with lapatinib is not expected.
• •Adherence to the requirements for concomitant medications classified as CYP3A4 inducers or inhibitors, or gastric pH modifiers