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Breast NeoplasmsPhase 2NCT02229149

Phase 2 Study of Standard Chemotherapy With Trastuzumab, Plus or Minus Pertuzumab, for Pre-treated Metastatic Breast Cancer

A Phase 2 study testing Trastuzumab, Pertuzumab and Vinorelbine, Paclitaxel, Nab-Paclitaxel , Docetaxel, Capecitabine in people with Breast Neoplasms and Malignant Tumor of the Breast, run by US Oncology Research at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This randomized phase 2 study will seek to determine the effectiveness of chemotherapy (physician's choice of vinorelbine, taxane [paclitaxel, docetaxel or nab paclitaxel] or capecitabine) plus trastuzumab vs chemotherapy (physician's choice) plus trastuzumab plus pertuzumab in women with HER2-overexpressing… Read more about this study

Who is it for?
Ages 18 years and older, women only
What is being tested?
Trastuzumab, Pertuzumab and Vinorelbine, Paclitaxel, Nab-Paclitaxel , Docetaxel, Capecitabine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
33 participants
Where
1 siteUnited States
Study dates
Dec 2014to Jan 2022
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Female, Age ≥ 18 years
  • Histologic or cytologic confirmation of human epidermal growth factor receptor 2 (HER2)-positive breast cancer according to most recent biopsy (local testing permitted)
  • Measurable or evaluable metastatic disease by Response Evaluation Criteria in Solid Tumors (RECIST) (v1.1)
  • Previous treatment with ado-trastuzumab emtansine (T-DM1) for metastatic disease
  • Prior therapy with pertuzumab is allowed but not required
  • At least 1 but no more than 3 prior chemotherapy regimens for metastatic breast cancer (MBC)
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  • Life expectancy > 6 months
  • Eastern Cooperative Group (ECOG) performance status ≤ 2
  • Left Ventricular Ejection Fraction (LVEF) ≥ 50% at baseline as determined by either echocardiogram (ECHO) or Multi Gated Acquisition Scan (MUGA) and within normal limits per institutional guidelines
  • Adequate bone marrow function as indicated by the following:
  • Absolute Neutrophil Count (ANC) ≥1500/uL (or 1500 per microliter)
  • Platelets ≥100,000/uL
  • Hemoglobin >9 g/dL
  • Adequate renal function, as indicated by creatinine <1.5 times upper limit of normal (ULN)
  • Adequate liver function, as indicated by bilirubin <1.5 times ULN
  • Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) <2 x ULN unless liver metastases are present in which case AST and ALT up to 5.x ULN are allowed
  • Negative serum pregnancy test within 72 hours before starting study medications for women of childbearing potential
  • Women of childbearing potential must be willing to use an acceptable form of birth control (ie, intra-uterine device, diaphragm with spermicide, condom with spermicide, or abstinence) for the duration of the study Note: Women are considered postmenopausal and not of childbearing potential if they have had 12 months of natural (spontaneous) amenorrhea with an appropriate clinical profile (e.g. age appropriate, history of vasomotor symptoms), or if they have undergone surgical sterilization.
  • Signed informed consent obtained prior to any screening procedures.

Who cannot join

  • Patients will be excluded from the study based on the following criteria:
  • Prior treatment in the metastatic setting with the agent chosen as physician's choice of chemotherapy
  • Active infection
  • Uncontrolled central nervous system metastases, defined as clinical or radiologic evidence of progression of brain metastases or clinical signs of leptomeningeal disease
  • Patients with treated brain metastases are eligible provided they do not have clinical or radiologic evidence of disease progression and have been off of dexamethasone for at least 3 weeks
  • Patient is pregnant or lactating
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  • Prior chemotherapy within the last 3 weeks (last 6 weeks for nitrosureas/mitomycin)
  • Prior radiation therapy within the last 2 weeks; prior radiation therapy to indicator lesion (unless objective disease recurrence or progression within the radiation portal has been documented since completion of radiation).
  • Requirement for chronic steroid therapy with a requirement for > 5mg/day of prednisone or the equivalent.
  • Treatment with physiologic doses of hydrocortisone up to 20 mg daily (QD) is allowed.
  • Requirement for immunosuppressive therapy, such as those used to treat autoimmune disease.
  • Concomitant malignancies or previous malignancies within the last 3 years, with the exception of adequately treated basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix.
  • History of significant cardiac disease, cardiac risk factors or uncontrolled arrhythmias
  • Ejection fraction <50% or below the lower limit of the institutional normal range, whichever is lower
  • Known hypersensitivity to trastuzumab or pertuzumab
  • Serious medical or psychiatric limitations likely to interfere with participation in this study.
  • Symptomatic intrinsic lung disease or extensive tumor involvement of the lungs, resulting in dyspnea at rest or requiring supplemental oxygen
  • Patient is currently part of or has participated in any clinical trial of an investigational agent within 1 month prior to enrollment in this study.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • 19 Sites

    Multiple Locations, Texas

Other trials in United States

About this study

Official title: Randomized Phase II Trial of Chemotherapy of Physician's Choice Plus Trastuzumab Versus Chemotherapy of Physician's Choice Plus Trastuzumab Plus Pertuzumab In Women With Pretreated, HER2-Overexpressing Metastatic Breast Cancer (MBC)

This randomized phase 2 study will seek to determine the effectiveness of chemotherapy (physician's choice of vinorelbine, taxane [paclitaxel, docetaxel or nab paclitaxel] or capecitabine) plus trastuzumab vs chemotherapy (physician's choice) plus trastuzumab plus pertuzumab in women with HER2-overexpressing metastatic breast (MBC) that has been previously treated with ado-trastuzumab emtansine (T-DM1) in the metastatic setting.

Read the detailed description

The current preferred first-line therapy for patients with HER2-overexpressing metastatic breast cancer (MBC) is a taxane plus trastuzumab plus pertuzumab, based on results from the CLEOPATRA trial. For patients with disease that has progressed on trastuzumab and a taxane, ado-trastuzumab emtansine (T-DM1) was recently approved based on results from the EMILIA trial showing superiority in this setting compared with capecitabine plus lapatinib. However, the standard for first-line therapy may change again in the near future, when results become available from the MARIANNE trial, which is evaluating T-DM1 alone or in combination with pertuzumab as upfront therapy. Two important questions that may be raised by the findings of this study are whether pertuzumab is effective as second- or later-line therapy following single-agent T-DM1, and whether pertuzumab administered beyond progression on prior pertuzumab therapy is of clinical benefit as trastuzumab has been proven to be.

The study will seek to determine the efficacy of chemotherapy (physician's choice of vinorelbine, taxane [paclitaxel, docetaxel or nab paclitaxel] or capecitabine) plus trastuzumab vs chemotherapy (physician's choice) plus trastuzumab plus pertuzumab in women with HER2-overexpressing MBC that has been previously treated with T-DM1 in the metastatic setting.

We hypothesize that the addition of pertuzumab to trastuzumab plus chemotherapy will improve median progression-free survival (PFS), compared to trastuzumab plus chemotherapy alone, as second- or later-line therapy in patients who have received prior T-DM1. Patients will be stratified according to whether they have received prior pertuzumab versus not. We will also explore whether continuing treatment with pertuzumab in patients who have been previously treated with pertuzumab improves PFS.

Being tested
Trastuzumab, Pertuzumab, Vinorelbine, Paclitaxel, Nab-Paclitaxel , Docetaxel, Capecitabine
Keywords
breast cancer, metastatic breast cancer, HER2+ breast cancer
Medical subject headings
Breast Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TrastuzumabDrug

    Also called Herclon, Herceptin

    Treatment for all patients will consist of trastuzumab, given as a loading dose of 8 mg/kg IV on Day 1 followed by 6 mg/kg IV every 3 weeks thereafter.

    Patients randomized to the chemotherapy plus trastuzumab arm (without pertuzumab) can receive trastuzumab 6 mg/kg IV every 3 weeks if they are receiving docetaxel or capecitabine on a 3-week cycle, or 4 mg/kg IV every 2 weeks if they are receiving vinorelbine, paclitaxel, or nab-paclitaxel on a 4-week cycle. The loading dose for all patients remains 8 mg/kg.

    For patients randomized to the chemotherapy plus trastuzumab plus pertuzumab arm, both trastuzumab and pertuzumab need to be administered every 3 weeks regardless of which chemotherapy agent they are receiving.

  • PertuzumabDrug

    Also called 2C4, Perjeta, Omnitarg

    pertuzumab given as a loading dose of 840 mg IV on Day 1 followed by 420 mg IV every 3 weeks.

  • Vinorelbine, Paclitaxel, Nab-Paclitaxel , Docetaxel, CapecitabineDrug

    Also called Navelbine, Abraxane, Taxol, Taxotere

    physician's choice of chemotherapy:

    • Vinorelbine 25 mg/m2 IV weekly times 3 with 1 week off; OR
    • Paclitaxel 80 mg/m2 IV weekly times 3 with 1 week off; OR
    • Nab-Paclitaxel 100 mg/m2 IV weekly times 3 with 1 week off; OR
    • Docetaxel 75 mg/m2 IV every 3 weeks; OR
    • Capecitabine 1500 mg by mouth twice a day (PO BID) 14 days on and then 7 days off.
Study groups in NCT02229149
Study groupRoleWhat they receive
Triple TherapyExperimentalPhysician's choice of chemotherapy plus trastuzumab plus pertuzumab * trastuzumab, given as a loading dose of 8 mg/kg intravenously (IV, or through the vein) on Day 1 followed by 6 mg/kg IV every 3 weeks thereafter, AND * physician's choice of chemotherapy: 1. Vinorelbine 25 mg/m2 IV weekly times 3 with 1 week off; OR 2. Paclitaxel 80 mg/m2 IV weekly times 3 with 1 week off; OR 3. Nab-Paclitaxel 100 mg/m2 IV weekly times 3 with 1 week off; OR 4. Docetaxel 75 mg/m2 IV every 3 weeks; OR 5. Capecitabine 1500 mg by mouth twice a day (PO BID) 14 days on and then 7 days off. * AND pertuzumab given as a loading dose of 840 mg IV on Day 1 followed by 420 mg IV every 3 weeks.
Receives: Drug: Trastuzumab; Drug: Pertuzumab; Drug: Vinorelbine, Paclitaxel, Nab-Paclitaxel , Docetaxel, Capecitabine
Double TherapyActive comparatorPhysician's choice of chemotherapy plus trastuzumab * trastuzumab, given as a loading dose of 8 mg/kg intravenously (IV, or through the vein) on Day 1 followed by 6 mg/kg IV every 3 weeks thereafter, AND * physician's choice of chemotherapy: 1. Vinorelbine 25 mg/m2 IV weekly times 3 with 1 week off; OR 2. Paclitaxel 80 mg/m2 IV weekly times 3 with 1 week off; OR 3. Nab-Paclitaxel 100 mg/m2 IV weekly times 3 with 1 week off; OR 4. Docetaxel 75 mg/m2 IV every 3 weeks; OR 5. Capecitabine 1500 mg PO BID 14 days on and then 7 days off.
Receives: Drug: Trastuzumab; Drug: Vinorelbine, Paclitaxel, Nab-Paclitaxel , Docetaxel, Capecitabine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Progression-free survival (PFS)

    The primary objective of this study is to compare progression-free survival (PFS [also known as time to disease progression]) with the addition of pertuzumab to trastuzumab plus physician's choice of chemotherapy versus trastuzumab plus physician's choice of chemotherapy in patients who have previously received treatment with ado-trastuzumab emtansine (TDM1) for HER2+ metastatic breast cancer.

    Measured: 2 years

Secondary outcomes (5)
  1. Progression-free survival (PFS) in patients (pts) with prior pertuzumab

    To assess PFS with the addition of pertuzumab to trastuzumab plus physician's choice of chemotherapy in patients who have received prior pertuzumab;

    Measured: 2 years

  2. Progression-free survival (PFS) in pts with prior chemotherapy

    To compare median PFS with the addition of pertuzumab to trastuzumab plus physician's choice of chemotherapy in patients who have received 1 vs 2-3 prior chemotherapy regimens for metastatic disease;

    Measured: 2 years

  3. Number of patients with complete and partial responses

    To compare the objective response rates (ORR; complete response [CR] plus partial response [PR]) between the two treatment arms;

    Measured: 2 years

  4. Overall survival

    To assess overall survival (OS) in each of the treatment arms;

    Measured: 2 years

  5. Number of adverse events and serious adverse events

    To assess the safety of pertuzumab in combination with trastuzumab and physician's choice of chemotherapy (vinorelbine, paclitaxel, nab-paclitaxel, docetaxel, or capecitabine).

    Measured: 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Aug 2014 (estimated)
  2. Study startDec 2014
  3. Primary completionJan 2022
  4. Study completionJan 2022

Why it stopped: per Sponsor request

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
33 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02229149
Sponsor's protocol ID
13011
Other IDs
ML29212
Status last verified
Nov 2022
First submitted
27 Aug 2014
Last updated
2 Dec 2022
Results posted
No
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Trastuzumab, Pertuzumab and Vinorelbine, Paclitaxel, Nab-Paclitaxel , Docetaxel, Capecitabine in people with Breast Neoplasms and Malignant Tumor of the Breast, run by US Oncology Research at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 19 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 2 Dec 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was stopped early (reason given: per Sponsor request). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Progression-free survival (PFS) (time frame: 2 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Dec 2022.

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