Clinical Trials /

A Study of Novel Anti-cancer Agents in Patients With Metastatic Triple Negative Breast Cancer

NCT03742102

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

Related Conditions:
  • Breast Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

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

DrugSynonymsArms
DurvalumabMEDI4736Arm 1
CapivasertibAZD5363Arm 2
OleclumabMEDI9447Arm 5
PaclitaxelArm 1
Trastuzumab deruxtecanDS-8201aArm 6
Datopotamab deruxtecanDato-DXd; DS-1062aArm 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

NameTypeDescriptionInterventions
Arm 1Experimentaldurvalumab + paclitaxel
  • Durvalumab
  • Paclitaxel
Arm 2Experimentaldurvalumab + paclitaxel + capivasertib
  • Durvalumab
  • Capivasertib
  • Paclitaxel
Arm 5Experimentaldurvalumab + paclitaxel + oleclumab
  • Durvalumab
  • Oleclumab
  • Paclitaxel
Arm 6Experimentaldurvalumab + trastuzumab deruxtecan
  • Durvalumab
  • Trastuzumab deruxtecan
Arm 7Experimentaldurvalumab + 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