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Study Assessing the Efficacy and Safety of Treatment With Alpelisib Plus Fulvestrant in Japanese Men and Postmenopausal Women With Advanced Breast Cancer

NCT04524000

Description:

The purpose of this study is to assess the safety and efficacy of alpelisib plus fulvestrant in men and postmenopausal women with hormone receptor (HR) positive, human epidermal growth factor 2 (HER2)-negative, advanced breast cancer harboring a PIK3CA mutation in Japan, whose disease has progressed on or after aromatase inhibitor (AI) treatment regardless of prior CDK4/6 inhibitor use.

Related Conditions:
  • Breast Carcinoma
Recruiting Status:

Not yet recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Study Assessing the Efficacy and Safety of Treatment With Alpelisib Plus Fulvestrant in Japanese Men and Postmenopausal Women With Advanced Breast Cancer
  • Official Title: A Phase II Open-label, 2-Part, Multi-center Study of BYL719 (Alpelisib) in Combination With Fulvestrant for Men and Postmenopausal Women With PIK3CA Mutation Hormone Receptor (HR) Positive, HER2-negative, Advanced Breast Cancer Which Progressed on or After Aromatase Inhibitor (AI) Treatment in Japan

Clinical Trial IDs

  • ORG STUDY ID: CBYL719C1201
  • NCT ID: NCT04524000

Conditions

  • Advanced Breast Cancer

Interventions

DrugSynonymsArms
AlpelisibBYL719Cohort 1:CDK4/6 inhibitor naive or pre-treated (Part 1)
FulvestrantFaslodexCohort 1:CDK4/6 inhibitor naive or pre-treated (Part 1)

Purpose

The purpose of this study is to assess the safety and efficacy of alpelisib plus fulvestrant in men and postmenopausal women with hormone receptor (HR) positive, human epidermal growth factor 2 (HER2)-negative, advanced breast cancer harboring a PIK3CA mutation in Japan, whose disease has progressed on or after aromatase inhibitor (AI) treatment regardless of prior CDK4/6 inhibitor use.

Detailed Description

      This is a Phase II open-label, 2-Part, multi-center study in Japan. The study will be
      conducted in two parts: Part 1 (Cohort 1) includes participants regardless of prior CDK4/6
      inhibitor use and is designed to determine the recommended dose (RD), evaluate the
      tolerability and safety of alpelisib in combination with fulvestrant. Part 2 consists of 2
      cohorts (the CDK4/6 inhibitor naive participants are in Cohort 2 and the CDK4/6 inhibitor
      pre-treated participants are in Cohort 3) which are designed to assess the efficacy and
      safety of alpelisib in combination with fulvestrant, will start once the RD of alpelisib is
      established.

      Participants will be treated until disease progression, unacceptable toxicity, death or
      discontinuation from the study treatment for any other reason and will be followed for
      survival regardless of treatment discontinuation reason (except if consent is withdrawn or
      participant is lost to follow up).
    

Trial Arms

NameTypeDescriptionInterventions
Cohort 1:CDK4/6 inhibitor naive or pre-treated (Part 1)ExperimentalParticipants regardless of prior CDK4/6 inhibitor will be treated at escalating doses (200 mg, 250 mg and 300 mg, orally) of BYL719 in combination with Fulvestrant (500 mg, intramuscular).
  • Alpelisib
  • Fulvestrant
Cohort 2: CDK4/6 inhibitor naive (Part 2)ExperimentalParticipants who are CDK4/6 inhibitor naive will be treated with BYL719 at the recommended dose identified in Part 1 in combination with Fulvestrant (500 mg, intramuscular).
  • Alpelisib
  • Fulvestrant
Cohort 3: CDK4/6 inhibitor pre-treated (Part 2)ExperimentalParticipants who are CDK4/6 inhibitor pre-treated will be treated with BYL719 at the recommended dose identified in Part 1 in combination with Fulvestrant (500 mg, intramuscular).
  • Alpelisib
  • Fulvestrant

Eligibility Criteria

        Inclusion Criteria:

          -  Japanese man or postmenopausal woman

          -  Participant has adequate tumor tissue for the analysis of PIK3CA mutational status by
             a Novartis designated laboratory.

          -  Participant has identified PIK3CA mutation (as determined by a Novartis designated
             laboratory)

          -  Participant has a histologically and/or cytologically confirmed diagnosis of ER+
             and/or PgR+ breast cancer by local laboratory

          -  Participant has HER2-negative breast cancer defined as a negative in situ
             hybridization test or an IHC status of 0, 1+ or 2+. If IHC is 2+, a negative in situ
             hybridization (FISH, CISH or SISH) test is required by local laboratory testing

          -  Participant has measurable disease, i.e., at least one measurable lesion as per RECIST
             1.1

          -  Participant has advanced breast cancer

          -  Participant has ECOG performance status 0 or 1

        Exclusion Criteria:

          -  Participant with symptomatic visceral disease or any disease burden that makes the
             participant ineligible for endocrine therapy per the investigator's best judgment

          -  Participant has received prior treatment;

          -  with chemotherapy (except for neoadjuvant/ adjuvant chemotherapy), fulvestrant, any
             PI3K, mTOR or AKT inhibitor for Cohort 1 and 3

          -  with chemotherapy (except for neoadjuvant/ adjuvant chemotherapy), fulvestrant, any
             PI3K, mTOR, AKT inhibitor or CDK 4/6 inhibitor for Cohort 2

          -  Participant has a known hypersensitivity to alpelisib or fulvestrant, or to any of the
             excipients of alpelisib or fulvestrant

          -  Participant with inflammatory breast cancer at screening

          -  Participant is concurrently using other anti-cancer therapy

          -  Participant has had surgery within 14 days prior to starting study drug or has not
             recovered from major side effects

          -  Participant with an established diagnosis at screening of diabetes mellitus type I or
             not controlled type II (based on FPG and HbA1c)

          -  Participant has currently documented pneumonitis /interstitial lung disease

          -  History of acute pancreatitis within 1 year of screening or past medical history of
             chronic pancreatitis

          -  Participant with unresolved osteonecrosis of the jaw

          -  Participant has a history of severe cutaneous reactions

        Other protocol-defined inclusion/exclusion criteria may apply
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:[Part 1] The incidence of Dose Limiting Toxicities (DLTs) of alpelisib in combination with fulvestrant
Time Frame:From Cycle 1 Day 1 to Cycle 2 Day 28 (Cycle = 28 days)
Safety Issue:
Description:A DLT is defined as an AE or abnormal laboratory value assessed as unrelated to disease, disease progression, inter-current illness, or concomitant medications that occurs within the first 2 cycles (the first 56 days) of treatment with alpelisib in combination with fulvestrant and meets any of the criteria specified in the protocol .

Secondary Outcome Measures

Measure:[Part 1] Number of participants with Adverse Events (AEs) and Serious Adverse Events (SAEs)
Time Frame:Up to approximately 37 months
Safety Issue:
Description:Safety is determined by incidence, type, and severity of adverse events per CTCAE v4.03 criteria including changes in laboratory values, vital signs, liver assessments, renal and cardiac assessments.
Measure:[Part 1] Number of participants with dose adjustments
Time Frame:Up to approximately 37 months
Safety Issue:
Description:The number of participants with dose adjustments (reductions, interruption, or permanent discontinuation) and the reasons
Measure:[Part 1] Dose intensity for alpelisib and fulvestrant
Time Frame:Up to approximately 37 months
Safety Issue:
Description:The dose intensity (computed as the ratio of actual cumulative dose received and actual duration of exposure) and the relative dose intensity (computed as the ratio of dose intensity and planned dose intensity)
Measure:[Part 1] Duration of exposure for alpelisib and fulvestrant
Time Frame:Up to approximately 37 months
Safety Issue:
Description:The duration of exposure (in months) to alpelisib and fulvestrant
Measure:[Part 1] Plasma concentrations of alpelisib in combination with fulvestrant
Time Frame:Cycle 1 Day 8 (pre-dose), 15 (pre-dose, post-dose 1 hour, 3 hours) and Day 1 of Cycles 2, 4, 6, 8 (pre-dose) (Cycle = 28 days)
Safety Issue:
Description:Summary statistics of alpelisib plasma concentrations by time point and dose level
Measure:[Part 2] Overall Response Rate (ORR) for CDK4/6 inhibitor pre-treated participants
Time Frame:Up to approximately 36 months
Safety Issue:
Description:ORR is defined as the proportion of participants with best overall response (BOR) of confirmed complete response (CR) or confirmed partial response (PR) based on local investigator assessment per RECIST 1.1.
Measure:[Part 2] Progression Free Survival (PFS)
Time Frame:Up to approximately 36 months
Safety Issue:
Description:PFS is defined as the time from the date of first administration of study treatment until the date of the first documented progression or death due to any cause. PFS will be assessed based on local investigator assessment per RECIST 1.1.
Measure:[Part 2] Overall Survival (OS)
Time Frame:Up to approximately 60 months
Safety Issue:
Description:OS is defined as the time from date of first administration of study treatment until date of death due to any cause.
Measure:[Part 2] Clinical Benefit Rate (CBR)
Time Frame:Up to approximately 36 months
Safety Issue:
Description:CBR is defined as the proportion of participants with a best overall response of confirmed CR, or confirmed PR, or an overall response of confirmed stable disease (SD), lasting for a duration of at least 24 weeks. CR, PR, and SD are defined based on local investigator assessment per RECIST 1.1.
Measure:[Part 2] Duration of Response (DOR)
Time Frame:Up to approximately 36 months
Safety Issue:
Description:DOR only applies to participants whose best overall response is CR or PR based on local investigator assessment per RECIST 1.1. The start date is the date of first documented response of CR or PR (i.e. the start date of response, not the date when response was confirmed), and the end date is defined as the date of the first documented progression or death due to underlying cancer.
Measure:[Part 2] Time to Response (TTR)
Time Frame:Up to approximately 36 months
Safety Issue:
Description:TTR is defined as the time from the date of first administration of study treatment until the date of the first documented response of either CR or PR, which must be subsequently confirmed (although date of initial response is used, not date of confirmation).
Measure:[Part 2] Time to definitive deterioration of Eastern Cooperative Oncology Group (ECOG) performance status
Time Frame:Up to approximately 36 months
Safety Issue:
Description:Time to definitive deterioration in ECOG performance status is defined as the time from the date of first administration to the date when ECOG performance status has definitively deteriorated by at least one category compared with baseline. Deterioration is considered definitive if there is no subsequent improvement in ECOG performance status back to the baseline category or above.
Measure:[Part 2] Number of participants with Adverse Events (AEs) and Serious Adverse Events (SAEs)
Time Frame:Up to approximately 37 months
Safety Issue:
Description:Incidence, type, and severity of adverse events per CTCAE v4.03 criteria including changes in laboratory values, vital signs, liver assessments, renal and cardiac assessments
Measure:[Part 2] Number of participants with dose adjustments
Time Frame:Up to approximately 37 months
Safety Issue:
Description:The number and percentage of participants with dose interruptions and dose reductions
Measure:[Part 2] Dose intensity for alpelisib and fulvestrant
Time Frame:Up to approximately 37 months
Safety Issue:
Description:The dose intensity (computed as the ratio of actual cumulative dose received and actual duration of exposure) and the relative dose intensity (computed as the ratio of dose intensity and planned dose intensity)
Measure:[Part 2] Duration of exposure for alpelisib and fulvestrant
Time Frame:Up to approximately 37 months
Safety Issue:
Description:The duration of exposure (in months) to alpelisib and fulvestrant
Measure:[Part 2] Plasma concentrations of alpelisib in combination with fulvestrant
Time Frame:Cycle 1 Day 8 (pre-dose), 15 (pre-dose, post-dose 1 hour, 3 hours) and Day 1 of Cycles 2, 4, 6, 8 (pre-dose) (Cycle= 28 days)
Safety Issue:
Description:Summary statistics of alpelisib plasma concentrations by time point and dose level

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Not yet recruiting
Lead Sponsor:Novartis Pharmaceuticals

Trial Keywords

  • HR+
  • HER2-negative
  • PIK3CA mutation
  • Advanced breast cancer
  • Breast carcinoma
  • Alpelisib
  • Fulvestrant
  • open-label
  • Part 1
  • Part 2
  • Japanese population

Last Updated

August 19, 2020