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A Study to Evaluate the Efficacy and Safety of Trastuzumab Emtansine in Combination With Atezolizumab or Atezolizumab-Placebo in Participants With Human Epidermal Growth Factor-2 (HER2) Positive Locally Advanced or Metastatic Breast Cancer (BC) Who Received Prior Trastuzumab and Taxane Based Therapy

NCT02924883

Description:

This Phase II, double-blind, randomized, placebo-controlled multicenter study will investigate the efficacy and safety of trastuzumab emtansine in combination with atezolizumab or atezolizumab-placebo in participants with HER2-positive locally advanced or metastatic BC who have received prior trastuzumab and taxane based therapy, either alone or in combination, and/or who have progressed within 6 months after completing adjuvant therapy.

Related Conditions:
  • Breast Carcinoma
Recruiting Status:

Completed

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: A Study to Evaluate the Efficacy and Safety of Trastuzumab Emtansine in Combination With Atezolizumab or Atezolizumab-Placebo in Participants With Human Epidermal Growth Factor-2 (HER2) Positive Locally Advanced or Metastatic Breast Cancer (BC) Who Received Prior Trastuzumab and Taxane Based Therapy
  • Official Title: A Randomized, Multicenter, Double-Blind, Placebo-Controlled Phase II Study of the Efficacy and Safety of Trastuzumab Emtansine in Combination With Atezolizumab or Atezolizumab-Placebo in Patients With HER2-Positive Locally Advanced or Metastatic Breast Cancer Who Have Received Prior Trastuzumab and Taxane Based Therapy

Clinical Trial IDs

  • ORG STUDY ID: WO30085
  • SECONDARY ID: 2015-004189-27
  • NCT ID: NCT02924883

Conditions

  • Metastatic Breast Cancer

Interventions

DrugSynonymsArms
AtezolizumabTecentriq, RO5541267, MPDL3280ATrastuzumab Emtansine + Atezolizumab
Trastuzumab emtansineKadcyla®, T-DM1, RO5304020Trastuzumab Emtansine + Atezolizumab

Purpose

This Phase II, double-blind, randomized, placebo-controlled multicenter study will investigate the efficacy and safety of trastuzumab emtansine in combination with atezolizumab or atezolizumab-placebo in participants with HER2-positive locally advanced or metastatic BC who have received prior trastuzumab and taxane based therapy, either alone or in combination, and/or who have progressed within 6 months after completing adjuvant therapy.

Trial Arms

NameTypeDescriptionInterventions
Trastuzumab Emtansine + AtezolizumabExperimentalAtezolizumab 1200 milligrams (mg) intravenous (IV) infusion or matching Placebo followed by trastuzumab emtansine 3.6 milligrams per kilogram (mg/kg) IV infusion on Day 1 Cycle 1 and thereafter on Day 1 of each 21-day cycle until disease progression, unmanageable toxicity, or study termination by the Sponsor (approximately 29 months)
  • Atezolizumab
  • Trastuzumab emtansine
Trastuzumab Emtansine + PlaceboActive ComparatorPlacebo matched to atezolizumab followed by trastuzumab emtansine 3.6 mg/kg IV infusion on Day 1 Cycle 1 and thereafter on Day 1 of each 21-day cycle until disease progression, unmanageable toxicity, or study termination by the sponsor (approximately 29 months)
  • Trastuzumab emtansine

Eligibility Criteria

        Inclusion Criteria:

          -  Archival tumor samples must be obtained from primary and/or metastatic sites

          -  Able to submit tumor tissue that is evaluable for programmed death- ligand 1 (PD-L1)
             expression

          -  HER-2 positive BC as defined by an immunohistochemistry score of 3 or gene amplified
             by in-situ hybridization as defined by a ratio of greater than or equal to (>=) 2.0
             for the number of HER2 gene copies to the number of chromosome 17 copies

          -  Histologically or cytologically confirmed invasive BC: incurable, unresectable,
             locally advanced BC previously treated with multimodality therapy or metastatic BC

          -  Prior treatment for BC in the: adjuvant; unresectable locally advanced; or metastatic
             settings; which must include both, a taxane and trastuzumab (alone or in combination
             with another agent)

          -  Progression must have occurred during or after most recent treatment for locally
             advanced/metastatic BC or within 6 months after completing adjuvant therapy

          -  Participants must have measurable disease that is evaluable as per RECIST v1.1

          -  Eastern Cooperative Oncology Group Performance Status of 0 or 1

          -  Negative serum pregnancy test within 7 days of enrollment for pre-menopausal women and
             for women less than 12 months after the onset of menopause

          -  Use of highly effective method of contraception as defined by the protocol

        Exclusion Criteria:

          -  Prior treatment with trastuzumab emtansine, cluster of differentiation 137 agonists,
             anti-programmed death-1, or anti-PD-L1 therapeutic antibody or pathway-targeting
             agents

          -  Receipt of any anti-cancer drug/biologic or investigational treatment within 21 days
             prior to Cycle 1 Day 1 except hormone therapy, which can be given up to 7 days prior
             to Cycle 1 Day 1; recovery of treatment related toxicity consistent with other
             eligibility criteria

          -  Radiation therapy within 2 weeks prior to Cycle 1, Day 1

          -  History of exposure to the cumulative doses of anthracyclines

          -  History of other malignancy within the previous 5 years, except for appropriately
             treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, Stage I uterine
             cancer, or participants who have undergone potentially curative therapy with no
             evidence of disease and are deemed by the treating physician to be at low risk for
             recurrence

          -  Cardiopulmonary dysfunction, symptomatic pleural effusion, pericardial effusion, or
             ascites

          -  Participants with severe infection within 4 weeks prior to randomization, including
             but not limited to hospitalization for complications of infection, bacteremia, or
             severe pneumonia

          -  Current severe, uncontrolled systemic disease

          -  Major surgical procedure or significant traumatic injury within 28 days prior to
             randomization or anticipation of the need for major surgery during the course of study
             treatment

          -  Clinically significant history of liver disease, including cirrhosis, current alcohol
             abuse, autoimmune hepatic disorders, sclerosis cholangitis or active infection with
             human immunodeficiency virus, hepatitis B virus, or hepatitis C virus

          -  Need for current chronic corticosteroid therapy (>=10 mg of prednisone per day or an
             equivalent dose of other anti-inflammatory corticosteroids)

          -  Spinal cord compression not definitively treated with surgery and/or radiation, or
             previously diagnosed and treated spinal cord compression without evidence that disease
             has been clinically stable for greater than (>) 2 weeks prior to randomization

          -  Participants with known central nervous system disease

          -  Leptomeningeal disease

          -  History of autoimmune disease

          -  Prior allogeneic stem cell or solid organ transplantation

          -  Active tuberculosis

          -  Receipt of a live, attenuated vaccine within 4 weeks prior to randomization or
             anticipation that such a live, attenuated vaccine will be required during the study

          -  Treatment with systemic immunostimulatory agents within 4 weeks or five half-lives of
             the drug (whichever is shorter) prior to randomization

          -  Treatment with systemic corticosteroids or other systemic immunosuppressive
             medications within 2 weeks prior to randomization, or anticipated requirement for
             systemic immunosuppressive medications during the trial

          -  Participants who are breastfeeding, or intending to become pregnant during the study
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Progression-Free Survival (PFS) as Determined by Investigator's Tumor Assessment Using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 (v1.1)
Time Frame:Baseline up to approximately 15 months
Safety Issue:
Description:PFS was defined as the time from randomization to the first occurrence of disease progression or death from any cause, whichever occurred first, on the basis of investigator assessments. Progression was defined as at least a 20% increase in the sum of diameters of target lesions with an absolute increase of at least 5 millimeter (mm) or the appearance of one or more new lesions.

Secondary Outcome Measures

Measure:Overall Survival (OS)
Time Frame:Baseline up to study completion or death, whichever occurs first, approximately 40 months
Safety Issue:
Description:OS was defined as the time from randomization to death from any cause.
Measure:Percentage of Participants With Objective Response (OR) as Determined by Investigator's Tumor Assessment Using RECIST v1.1
Time Frame:Baseline up to approximately 15 months
Safety Issue:
Description:An OR was defined as a complete or partial response determined on 2 consecutive occasions ≥ 4 weeks apart using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. Complete response was defined as the disappearance of all target and non-target lesions. Any pathological lymph nodes (whether target or non-target) must be < 10 mm on the short axis. Partial response was defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum. Participants who had no post-baseline tumor assessment were counted as non-responders.
Measure:Duration of OR as Determined by Investigator's Tumor Assessment Using RECIST v1.1
Time Frame:Baseline up to approximately 15 months
Safety Issue:
Description:Duration of OR was defined as the time from the first tumor assessment that was judged to indicate that the patient had an objective response to the time of first documented disease progression using RECIST v1.1 per investigator assessment or death from any cause, whichever occurred first.
Measure:Maximum Serum Concentration (Cmax) of Trastuzumab Emtansine
Time Frame:Pre-infusion (0 hour [h]), 30 minutes (min) after end of infusion (EOI) (over 90 min) on Day 1 Cycles 1 and 4; pre-infusion (0 h) on Day 1 Cycle 2 (each cycle = 21 days); at any time during study treatment/early discontinuation visit (approx. 40 months)
Safety Issue:
Description:Average post infusion Trastuzumab Emtansine concentration
Measure:Cmax of Deacetyl Mercapto 1-Oxopropyl Maytansine (DM1)
Time Frame:Pre-infusion (0 h) on Day 1 Cycle 1 and 30 min after EOI (over 90 min) on Day 1 Cycles 1 and 4 (each cycle = 21 days)
Safety Issue:
Description:Average post infusion Deacetyl Mercapto 1-Oxopropyl Maytansine concentration of trastuzumab emtansine infusion
Measure:Cmax of Total Trastuzumab
Time Frame:Pre-infusion (0 h), 30 min after EOI (over 90 min) on Day 1 Cycles 1 and 4; pre-infusion (0 h) on Day 1 Cycle 2 (each cycle = 21 days)
Safety Issue:
Description:
Measure:Cmax of Atezolizumab
Time Frame:Pre-infusion (0 h), 30 min after EOI (over 60 min) on Day 1 Cycles 1 and 4; pre-infusion (0 h) on Day 1 Cycles 2, 3, 8, and every 8 cycles thereafter (each cycle=21 days) up to 120 days after treatment completion/early discontinuation (approx. 40 months)
Safety Issue:
Description:Average post infusion atezolizumab concentration
Measure:Percentage of Participants With Anti-therapeutic Antibodies (ATAs) to Atezolizumab
Time Frame:Pre-infusion (0 h) on Day 1 Cycles 1, 2, 3, 4, 8, and every 8 cycles thereafter (each cycle = 21 days) up to 120 days after treatment completion or early discontinuation (approximately 40 months)
Safety Issue:
Description:ATAs are antibodies that inactivate the therapeutic effects of Atezolizumab. Patients are considered to be ATA positive if they are ATA negative at baseline but develop an ATA response following study drug administration (treatment-induced ATA response), or if they are ATA positive at baseline and the titer of one or more post-baseline samples is at least 4-fold greater (i.e., ≥ 0.60 titer units) than the titer of the baseline sample (treatment-enhanced ATA response).
Measure:Percentage of Participants With ATAs to Trastuzumab Emtansine
Time Frame:Pre-infusion (0 h) on Day 1 Cycles 1 and 4 (each cycle = 21 days); and at any time during study treatment/early discontinuation visit (approximately 40 months)
Safety Issue:
Description:ATAs are antibodies that inactivate the therapeutic effects of Trastuzumab Emtansine. Patients are considered to be ATA positive if they are ATA negative at baseline but develop an ATA response following study drug administration (treatment-induced ATA response), or if they are ATA positive at baseline and the titer of one or more post-baseline samples is at least 4-fold greater (i.e., ≥ 0.60 titer units) than the titer of the baseline sample (treatment-enhanced ATA response).

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Completed
Lead Sponsor:Hoffmann-La Roche

Last Updated

February 17, 2021