Description:
This study is designed to determine the efficacy and safety of durvalumab in combination with
novel oncology therapies with or without paclitaxel and durvalumab + paclitaxel for
first-line metastatic triple negative breast cancer
Title
- Brief Title: A Study of Novel Anti-cancer Agents in Patients With Metastatic Triple Negative Breast Cancer
- Official Title: A Phase IB/II, 2-stage, Open-label, Multicenter Study to Determine the Efficacy and Safety of Durvalumab (MEDI4736) + Paclitaxel and Durvalumab (MEDI4736) in Combination With Novel Oncology Therapies With or Without Paclitaxel for First-line Metastatic Triple Negative Breast Cancer
Clinical Trial IDs
- ORG STUDY ID:
D933LC00001
- SECONDARY ID:
2018-000764-29
- NCT ID:
NCT03742102
Conditions
- Triple Negative Breast Neoplasms
Interventions
Drug | Synonyms | Arms |
---|
Durvalumab | MEDI4736 | Arm 1 |
Capivasertib | AZD5363 | Arm 2 |
Oleclumab | MEDI9447 | Arm 5 |
Paclitaxel | | Arm 1 |
Trastuzumab deruxtecan | DS-8201a | Arm 6 |
Datopotamab deruxtecan | Dato-DXd; DS-1062a | Arm 7 |
Purpose
This study is designed to determine the efficacy and safety of durvalumab in combination with
novel oncology therapies with or without paclitaxel and durvalumab + paclitaxel for
first-line metastatic triple negative breast cancer
Detailed Description
This is a Phase IB/II, 2-stage, open-label, multicenter study to determine the efficacy and
safety of durvalumab in combination with novel oncology therapies (i.e. therapies designed
for immune modulation) with or without paclitaxel and durvalumab + paclitaxel as first-line
treatment in patients with metastatic triple negative breast cancer (TNBC). The study is
designed to concurrently evaluate potential novel treatment combinations with clinical
promise using a 2-stage approach. The study will use a Simon 2-Stage design to evaluate which
cohorts may proceed to expansion.
Part 1 is a Phase IB study of safety and initial efficacy, and Part 2 may expand patient
enrollment if adequate efficacy signal is observed in Part 1. The treatment regimens
evaluated in Part 2 will depend on the evaluation of safety and efficacy outcomes in Part 1.
Trial Arms
Name | Type | Description | Interventions |
---|
Arm 1 | Experimental | durvalumab + paclitaxel | |
Arm 2 | Experimental | durvalumab + paclitaxel + capivasertib | - Durvalumab
- Capivasertib
- Paclitaxel
|
Arm 5 | Experimental | durvalumab + paclitaxel + oleclumab | - Durvalumab
- Oleclumab
- Paclitaxel
|
Arm 6 | Experimental | durvalumab + trastuzumab deruxtecan | - Durvalumab
- Trastuzumab deruxtecan
|
Arm 7 | Experimental | durvalumab + datopotamab deruxtecan | - Durvalumab
- Datopotamab deruxtecan
|
Eligibility Criteria
Inclusion criteria
1. Female
2. At least 18 years of age at the time of screening
3. Patient must have locally confirmed advanced/unresectable or metastatic TNBC.
4. No prior treatment for metastatic (Stage IV) TNBC
5. Patient must have at least 1 lesion, not previously irradiated, that can be accurately
measured
6. WHO/ECOG status at 0 or 1 at enrollment
Patients enrolled to Arm 6 (durvalumab and DS-8201a) Must provide documentation of locally
determined advanced/unresectable or metastatic TNBC with HER2 low tumor expression (IHC
2+/ISH-, IHC 1+/ISH-, or IHC 1+/ISH untested)
Exclusion criteria
1. History of allogeneic organ transplantation
2. Active or prior documented autoimmune or inflammatory disorders
3. Active infection including tuberculosis, hepatitis B (known positive HBV surface
antigen [HBsAg] result), hepatitis C virus (HCV), or human immunodeficiency virus
(positive HIV 1/2 antibodies)
4. Untreated CNS metastases
5. Known allergy or hypersensitivity to any of the study drugs or any of the study drug
excipients
6. Any concurrent chemotherapy, IP, or biologic therapy for cancer treatment
7. Female patients who are pregnant, breastfeeding
8. Cardiac Ejection Fraction less than 50%
Patients enrolled in Arm 2 only:
1. Potent inhibitors or inducers or substrates of CYP3A4 or substrates of CYP2C9 or
CYP2D6 within 2 weeks before the first dose of study treatment (3 weeks for St John's
Wort)
2. Diagnosis of diabetes mellitus Type I or diabetes mellitus Type II requiring insulin
treatment.
3. Any factors that increase the risk of QTc prolongation or risk of arrhythmic events,
such as heart failure, hypokalemia, potential for torsades de pointes, congenital long
QT syndrome, family history of long QT syndrome or unexplained sudden death under 40
years of age, or any concomitant medication known to prolong the QT interval
4. Prior treatment with PI3K inhibitors, AKT inhibitors, or mammalian target of rapamycin
(mTOR) inhibitors.
Patients enrolled in Arm 5 only: History of venous thromboembolism in the past 3 months
Patients enrolled in Arm 7 only: Clinically significant corneal disease in the opinion of
the Investigator.
Patients enrolled in Arm 6 and 7 only:
1. History of or active interstitial lung disease/pneumonitis
2. Use of chloroquine or hydroxychloroquine in <14 days prior to Day 1 of DS-8201a (Arm
6) or Dato-DXd (DS-1062a; Arm 7) treatment
3. Patients enrolled in Arm 6 only: Previously been diagnosed as HER2+ or received
HER2-targeted therapy.
Maximum Eligible Age: | 130 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | Female |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Incidence of adverse events |
Time Frame: | Part1: From informed consent until the safety follow-up visit 3 months after the last dose of study drug. Part 2: From informed consent until the safety follow-up visit 6 months after the last dose of study drug. |
Safety Issue: | |
Description: | Part 1: Assessment of safety and tolerability of each treatment arm
Part 2:
Endpoints based on Investigator assessment according to RECIST 1.1: ORR (objective response rate): The percentage of evaluable patients with a confirmed Investigator-assessed visit response of CR (complete response) or PR (partial response). |
Secondary Outcome Measures
Measure: | Objective response rate (ORR) |
Time Frame: | Approx. 30 months |
Safety Issue: | |
Description: | Assessment of the efficacy of each treatment arm according to RECIST 1.1. ORR: The percentage of evaluable patients with a confirmed Investigator-assessed response of CR (complete response) or PR (partial response) Applicable for Part 1 and Part 2. |
Measure: | Progression-free survival (PFS). |
Time Frame: | On-study tumor assessments occur every 8 weeks (Arms 1-5),every 6 weeks (Arms 6-7) until week 48 and then every 12 weeks thereafter until radiological progression, death, withdrawal of consent or study completion up to approx. 30 months |
Safety Issue: | |
Description: | Assessment of the efficacy of each treatment arm according to RECIST 1.1. PFS: Time from date of first dose until the date of objective radiological disease progression or death (by any cause in the absence of progression)
Applicable for Part 1 and Part 2 |
Measure: | Duration of response (DoR) |
Time Frame: | On-study tumor assessments occur every 8 weeks (Arms 1-5), every 6 weeks (Arms 6-7) until week 48 and then every 12 weeks thereafter until radiological progression, death, withdrawal of consent or study completion up to approx. 30 months |
Safety Issue: | |
Description: | Assessment of the efficacy of each treatment arm according to RECIST 1.1. DoR: Time from date of first detection of objective response (which is subsequently confirmed) until the date of objective radiological disease progression Applicable for Part 1 and Part 2 |
Measure: | Overall survival (OS) |
Time Frame: | Approx. 30 months |
Safety Issue: | |
Description: | OS: Time from date of first dose until the date of death by any cause
Applicable for Part 1 and Part 2 |
Measure: | Serum concentration of durvalumab and serum or plasma concentration of novel oncology therapies |
Time Frame: | From cycle 1 day 1 until cycle 7 day 1 (Arms 1-5), from cycle 1 day 1 until cycle 8 day 1 (Arms 6-7) (each cycle is 28 days) and every 12 weeks thereafter until study completion approx. 30 months |
Safety Issue: | |
Description: | Assessment of pharmacokinetics (PK) Applicable for Part 1 (Arms 1-7) and for Part 2 (Arm 7) |
Measure: | Presence of anti-drug antibodies (ADAs) for durvalumab and applicable novel oncology therapies |
Time Frame: | From cycle 1 day 1 until cycle 7 day 1 (Arms 1-5), from cycle 1 day 1 until cycle 8 day 1 (Arms 6-7) (each cycle is 28 days) and every 12 weeks thereafter until study completion approx. 30 months |
Safety Issue: | |
Description: | Investigation of the immunogenicity of durvalumab and novel oncology therapies in all applicable treatment arms Applicable for Part 1 (Arms 1-7) and for Part 2 (Arm 7) |
Measure: | Progression-free survival (PFS 6) |
Time Frame: | On-study tumor assessments occur every 8 weeks until week 48 (Arms 1-5), every 6 weeks until week 48 (Arms 6-7) and then every 12 weeks thereafter until radiological progression, death, withdrawal of consent or study completion up to approx. 30 months |
Safety Issue: | |
Description: | PFS at 6 months following date of first dose Applicable for Part 2 |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | AstraZeneca |
Trial Keywords
- Breast Cancer
- TNBC
- Triple Negative
- Triple Negative Breast Cancer
- Triple-Negative Breast Cancer
- Triple-Negative Breast Neoplasm
- ER-Negative PR-Negative HER2-Negative Breast Cancer
- ER-Negative PR-Negative HER2-Negative Breast Neoplasms
Last Updated
August 24, 2021