Clinical Trials /

Ovarian Suppression Evaluating Subcutaneous Leuprolide Acetate in Breast Cancer

NCT04906395

Description:

This is a phase 3, single arm, open-label study evaluating the effectiveness of TOL2506 to suppress ovarian function in premenopausal women with HR+, HER2-negative breast cancer. The study will also aim to assess administration of TOL2506 in men with HR+ breast cancer. Study duration, for individual subjects, will be up to 57 weeks, including a Screening Period of up to 9 weeks, a Treatment Period of 48 weeks, and an End of Study Visit (Visit 8, Week 48). Eligible subjects will enter into the Treatment Period in 1 of 2 groups: those who will receive tamoxifen concurrently with TOL2506 or those who will initiate therapy with an AI (letrozole, anastrozole, or exemestane) beginning 6 weeks after the first administration of TOL2506, upon confirmation that estradiol (E2) levels of < 20 pg/mL have been achieved. After Week 12, subjects will be allowed to switch from receiving an AI to receiving tamoxifen or from tamoxifen to AI at the discretion of the Investigator. However, a switch is not permitted 28 days prior to a dosing visit. At the end of the Treatment Period, subjects will be eligible for compassionate use of TOL2506 (expanded access) until TOL2506 receives marketing approval and is commercially available.

Related Conditions:
  • Breast Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 3

Trial Eligibility

Document

Title

  • Brief Title: Ovarian Suppression Evaluating Subcutaneous Leuprolide Acetate in Breast Cancer
  • Official Title: Phase 3,Single Arm,Open-Label Study Evaluating Ovarian Suppression Following 3 Month Leuprolide Acetate For Injectable Suspension (TOL2506) in Combination With Endocrine Therapy in Premenopausal Subjects With Hormone-Receptor-Positive (HR+),Human Epidermal Growth Factor Receptor 2 (HER2)-Negative Breast Cancer

Clinical Trial IDs

  • ORG STUDY ID: TOL2506A
  • NCT ID: NCT04906395

Conditions

  • Breast Cancer

Interventions

DrugSynonymsArms
TOL2506Active Comparator: TOL2506
TamoxifenActive Comparator: TOL2506
Letrozole TabletsActive Comparator: TOL2506
Anastrozole TabletsActive Comparator: TOL2506
Exemestane TabletsActive Comparator: TOL2506

Purpose

This is a phase 3, single arm, open-label study evaluating the effectiveness of TOL2506 to suppress ovarian function in premenopausal women with HR+, HER2-negative breast cancer. The study will also aim to assess administration of TOL2506 in men with HR+ breast cancer. Study duration, for individual subjects, will be up to 57 weeks, including a Screening Period of up to 9 weeks, a Treatment Period of 48 weeks, and an End of Study Visit (Visit 8, Week 48). Eligible subjects will enter into the Treatment Period in 1 of 2 groups: those who will receive tamoxifen concurrently with TOL2506 or those who will initiate therapy with an AI (letrozole, anastrozole, or exemestane) beginning 6 weeks after the first administration of TOL2506, upon confirmation that estradiol (E2) levels of < 20 pg/mL have been achieved. After Week 12, subjects will be allowed to switch from receiving an AI to receiving tamoxifen or from tamoxifen to AI at the discretion of the Investigator. However, a switch is not permitted 28 days prior to a dosing visit. At the end of the Treatment Period, subjects will be eligible for compassionate use of TOL2506 (expanded access) until TOL2506 receives marketing approval and is commercially available.

Trial Arms

NameTypeDescriptionInterventions
Active Comparator: TOL2506ExperimentalTOL2506 in combinatination with standard endocrine therapy (Tamoxifen & Aromatase Inhibitors)
  • TOL2506
  • Tamoxifen
  • Letrozole Tablets
  • Anastrozole Tablets
  • Exemestane Tablets

Eligibility Criteria

        Inclusion Criteria:

          -  Females

               1. Able to understand the investigational nature of this study and provide written
                  informed consent prior to the participation in the trial

               2. Age 18 to 55, inclusive

               3. Diagnosis of Stage I, II, or III HR+, HER2-negative breast cancer (ER>1% and/or,
                  PR>1%, HER2-negative per ASCO CAP guidelines)

               4. Is a candidate for endocrine therapy + ovarian suppression

               5. Is premenopausal at the time of study entry.

                    -  E2 > 30 pg/mL

                    -  Follicle stimulating hormone (FSH) < 40 IU/L

                    -  Last menstrual period within the 3 months prior to first dose of TOL2506

                  Exclusion Criteria:

          -  Females

               1. Body mass index (BMI) < 18.00 kg/m2 or > 35.00 kg/m2

               2. Breastfeeding

               3. Life expectancy < 12 months

               4. Eastern Cooperative Oncology Group (ECOG) performance status ≥ 3

               5. Unacceptable hepatic function as determined by any of the following:

                    1. Alanine aminotransferase (ALT) ≥ 2X upper limit of normal (ULN)

                    2. Aspartate aminotransferase (AST) ≥ 2X ULN

                    3. Bilirubin ≥ 2X ULN

                    4. Alkaline phosphatase ≥ 2X ULN

                    5. Severe hepatic impairment (Child-Pugh Class C)

               6. Unacceptable renal function as determined by any of the following:

                    1. Creatinine ≥ 3X ULN

                    2. Creatinine clearance ≤ 30 mL/minute

                    3. Creatinine clearance ≤ 60 mL/minute in subjects with bone density 1.5
                       standard deviations below the young adult normal mean

               7. History of significantly abnormal ECG or screening 12-lead ECG demonstrating any
                  of the following:

                    1. HR > 100 BPM

                    2. QRS > 120 msec

                    3. QTc > 450 msec

                    4. PR > 220 msec

               8. Prior (within 28 days prior to Day 0) and/or concomitant use of medications known
                  to prolong the QT/QTc interval

               9. Prior use of tamoxifen, other SERMs (eg, raloxifene) or antagonists (eg,
                  fulvestrant), aromatase inhibitor, mammalian target of rapamycin (mTOR)
                  inhibitors, or hormone replacement therapy within 3 months before breast cancer
                  diagnosis

              10. Prior neoadjuvant or adjuvant endocrine therapy since diagnosis of breast cancer

              11. History of treatment for osteopenia/osteoporosis

              12. Prior or current use of drugs or supplements known to increase bone mineral
                  density (ie, bisphosphonates, denosumab, teriparatide, abaloparatide,
                  romosozumab, calcitonin, fluoride, strontium)

              13. Low trauma fracture(s) occurring within 12 months prior to Screening (defined as
                  a fracture that results from a fall from a standing height or less, excluding
                  fingers, toes, face and skull)

              14. Conditions that preclude bone mineral density measurement (lumbar spine/bilateral
                  hip surgery with hardware in place, abdominal clips, umbilical ring [not willing
                  to remove] or weight that exceeds the DEXA machine limitation)

              15. Any other medical condition or serious illness, presence of a second malignancy
                  under current treatment or follow-up, or the presence of clinically significant
                  findings on the physical exam, laboratory testing, medical history (including
                  conditions that may be associated with low bone mass), that in the opinion of the
                  Investigator may interfere with trial conduct, subject safety, or interpretation
                  of study results

              16. Already receiving and/or previously received GnRH analogs within 1 year before
                  breast cancer diagnosis

              17. Psychiatric, addictive, or other disorders that would preclude study compliance

              18. Use of medications that may impact subject safety and/or affect the PK of the
                  drug and hormonal assessments including but not limited to:

                    1. Oral or transdermal hormonal therapy within 30 days prior to Screening

                    2. Estrogen, progesterone, or androgens within 30 days prior to Screening

                    3. Hormonal contraceptives within 30 days prior to Screening

                    4. Medications known to result in clinically important decreases in bone mass
                       taken within 6 months prior to Screening

              19. Known hypersensitivity, idiosyncratic, or allergic reactions to GnRH, GnRH
                  agonist/analogs or to any of the components of the IP

              20. Sexually active with a male partner and not willing to use non-hormonal
                  contraceptive methods throughout the study

              21. Is of childbearing potential with a positive serum pregnancy test at Screening or
                  urine pregnancy test at Day 0

              22. Exposure to any investigational agent within 30 days prior to the first dose of
                  TOL2506

        See contact information to obtain inclusion/exclusion criteria for males
      
Maximum Eligible Age:55 Years
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Suppression of ovarian function (E2 levels and menses status)
Time Frame:6 weeks after the first administration of TOL2506
Safety Issue:
Description:E2 levels < 20 pg/mL at Week 6 and absence of menses after Week 5

Secondary Outcome Measures

Measure:Suppression of ovarian function overall (E2 and absence of menses; treatments pooled)
Time Frame:Week 6 to Week 48
Safety Issue:
Description:Percent of subjects with suppressed E2 and absence of menses in subjects treated with TOL2506 + endocrine therapy (tamoxifen or aromatase inhibitors) at every measurement from Week 6 to Week 48
Measure:Suppression of ovarian function overall (E2 and absence of menses; TOL2506 + tamoxifen)
Time Frame:Week 6 to Week 48
Safety Issue:
Description:Percent of subjects with suppressed E2 and absence of menses in subjects treated with TOL2506 + tamoxifen at every measurement from Week 6 to Week 48
Measure:Suppression of ovarian function overall (E2 and absence of menses; TOL2506 + aromatase inhibitor)
Time Frame:Week 6 to Week 48
Safety Issue:
Description:Percent of subjects with suppressed E2 and absence of menses in subjects treated with TOL2506 + aromatase inhibitor at every measurement from Week 6 to Week 48
Measure:Suppression of ovarian function at Weeks 12, 24, 36, and 48 (E2 and absence of menses + treatments pooled)
Time Frame:Weeks 12, 24, 36, and 48
Safety Issue:
Description:Percent of subjects with suppressed E2 < 20 pg/mL and absence of menses in subjects treated with TOL2506 + endocrine therapy (tamoxifen or aromatase inhibitors) assessed individually at weeks 12, 24, 36 and 48
Measure:Suppression of ovarian function at Weeks 12, 24, 36, and 48 (E2 and absence of menses; TOL2506 + tamoxifen)
Time Frame:Weeks 12, 24, 36, and 48
Safety Issue:
Description:Percent of subjects with suppressed E2 < 20 pg/mL and absence of menses in subjects treated with TOL2506 + tamoxifen assessed individually at weeks 12, 24, 36 and 48
Measure:Suppression of ovarian function at Weeks 12, 24, 36, and 48 (E2 and absence of menses; TOL2506 + aromatase inhibitor)
Time Frame:Weeks 12, 24, 36, and 48
Safety Issue:
Description:Percent of subjects with suppressed E2 < 20 pg/mL and absence of menses in subjects treated with TOL2506 + aromatase inhibitor assessed individually at weeks 12, 24, 36 and 48

Details

Phase:Phase 3
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Tolmar Inc.

Trial Keywords

  • Ovarian Suppression
  • HR+
  • HER2-
  • Oncology
  • Premenopausal

Last Updated

August 24, 2021