A Phase 0 of Neoadjuvant Lapatinib in Infiltrative Bladder Carcinoma Before Cystectomy

Inclusion Criteria:

• Patients must sign and date IRB/EC-approved informed consent,

• Age ≥ 18

• Patients must have a life expectancy of at least 6 months,

• Patients must have a Karnofsky performance status ≥ 80%,

• Clinical stage T2NxM0 to T4aNxM0 bladder cancer

• Muscle-invasive transitional cell carcinoma by histology (focal squamous and/oradenocarcinoma differentiation defined as ≤ 10% of tumor volume allowed, sarcomatoidand small-cell components not allowed)

• Considered to have a macroscopic residue in the bladder to allow comparison of tissuesamples at cystectomy to initial biopsies

• Candidates for radical cystectomy

• Patient with normal cardiac function, LVEF ≥ 50% measured by echocardiography or MUGAscan

• Able to swallow and retain oral medication

• A female is eligible to enter and participate in this study if she is of :Non-child-bearing potential (i.e., a woman with functioning ovaries who have a currentdocumented tubal ligation or hysterectomy or a woman who is menopausal), orChild-bearing potential (i.e. a woman with functioning ovaries and no documentedimpairment of oviductal or uterine function that would cause sterility. This categoryincludes women with oligomenorrhoea (even severe), women who are perimenopausal andyoung women who have begun to menstruate), who have a negative serum pregnancy test atscreening, and agree to one of the following consistent and correct use of oneacceptable methods of birth control : Any intrauterine device (IUD) with a documentedfailure rate of less than 1% per year, or combined oral contraception

• care must be taken to avoid pregnancy in partners of male patients.

• Willingness and ability to comply with scheduled visits, treatment plans, laboratorytests, and other study procedures.

• Affiliated or profit patient of a social security system

Exclusion Criteria:

• Prior pelvic radiation or neoadjuvant chemotherapy.

• Pregnancy or breastfeeding.

• Other severe acute or chronic medical or psychiatric condition that would impart, inthe judgment of the investigator, excess risk associated with study participation orstudy drug administration, or which, in the judgment of the investigator, would makethe patient inappropriate for entry into this study.

• Patients with significantly reduced LVEF or LVEF < 50%.

• Patient with any of the following liver abnormal laboratory test :

• Serum bilirubin > 1,5 x upper limit of normal (ULN) (in case of Gilbert syndrome, ahigher serum total bilirubin (< 2 ULN) is allowed

• Alanine amino transferase (ALAT) or aspartate amino transferase (ASAT) > 2,5 ULN

• Platelets <100 x 109/L, hemoglobin < 9 g/dl, absolute neutrophil count (ANC) <1.5 x 109/L

• Have current active hepatic or biliary disease (with exception of patients withGilbert's syndrome, asymptomatic gallstones, liver metastases or stable chronic liverdisease per investigator assessment)

• Serum creatinine > 1.5 x ULN.

• Previous therapy targeting EGFR or HER-2.

• Predominantly non transitional cell histology.

• Diagnosis of any second malignancy within the last 3 years, except basal cellcarcinoma, squamous cell skin cancer, or in situ carcinoma of the cervix uteri thathas been adequately treated with no evidence of recurrent disease for 12 months.

• Malabsorption syndrome, disease significantly affecting gastrointestinal function, ormajor resection of the stomach or bowel, that could affect absorption of lapatinib.

• History of allergic reactions attributed to compounds of similar chemical or biologiccomposition to lapatinib

• Uncontrolled inter-current illness including, but not limited to, ongoing or activeinfection, symptomatic congestive heart failure, unstable angina pectoris, cardiacarrhythmia, that would limit compliance with study requirements.

• History of uncontrolled or symptomatic angina

• History of arrhythmias requiring medications, or clinically significant, with theexception of asymptomatic atrial fibrillation requiring anticoagulation

• Myocardial infarction < 6 months from study entry

• Uncontrolled or symptomatic congestive heart failure

• Ejection fraction below the institutional normal limit

• Any other cardiac condition, which in the opinion of the treating physician, wouldmake this protocol unreasonably hazardous for the patient

• Use of an investigational agent within 30 days or 5 half-lives, whichever is thelonger, preceding the first dose of investigational product.

• Concurrent treatment with an investigational agent

• Concurrent treatment with cytotoxic chemotherapy, immunotherapy, biologic therapy,hormonal therapy or curative radiotherapy for locally advanced or metastatic TCC ofthe urothelial tract.

• Concomitant requirement for medication classified as CYP3A4 inducers or inhibitors.

• Patient under safeguard of justice