E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10027475 |
E.1.2 | Term | Metastatic breast cancer |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To assess if the addition of oral ABT-869 to paclitaxel can prolong progression-free survival (PFS) compared to paclitaxel alone in the first line treatment of subjects with metastatic breast cancer. |
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E.2.2 | Secondary objectives of the trial |
To evaluate overall survival and other efficacy endpoints, as well as the safety and tolerability of the combination. The tertiary objectives are to evaluate quality of life and performance status. |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
At selected clinical study sites, an optional pharmacogenetic sample collection will be performed. For subjects who have signed the appropriate Informed Consent Form, DNA samples from this protocol may be used to assess the influence of genetic variants on pharmacokinetics, safety or efficacy. For example, polymorphisms in genes encode drug metabolizing enzymes (such as cytochrome P450s or uridine glucuronosyltransferases) or drug transport proteins (such as ATP-binding cassette or solute-linked carrier proteins) may be assessed for their influence on ABT-869 pharmacokinetics. Genetic variants of potential ABT-869 targets (such as VEGF or PDGF RTKs) may also be assessed. |
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E.3 | Principal inclusion criteria |
1. The subject is female and ≥ 18 years of age. 2. The subject is diagnosed with adenocarcinoma of the breast. 3. The subject must have metastatic disease or locally recurrent disease that is not amenable to local treatment (surgical or radiation) with curative intent. 4. The subject must have received no prior chemotherapy for locally recurrent or metastatic breast cancer. 5. At least 12 months have passed since the subject received prior adjuvant or neoadjuvant cytotoxic chemotherapy (including prior taxane therapy and prior anti-angiogenic therapy [i.e., bevacizumab or a TKI]). 6. The subject does not have HER-2 –overexpression (3+) breast cancer (unless treated previously with trastuzumab [Herceptin] or lapatinib). 7. The subject has measurable disease, defined as at least 1 unidimensionally measurable lesion on a CT scan as defined by RECIST (for subjects in the randomized portion only). 8. The subject has an Eastern Cooperative Oncology Group (ECOG) performance score of 0-1. 9. The subject must have adequate bone marrow, renal and hepatic function as follows: a. Bone Marrow: absolute neutrophil count (ANC) ≥ 1,500/mm3 (1.5 × 109/L); platelets ≥ 100,000/mm3 (100 × 109/L); hemoglobin ≥ 9.0 g/dL (1.4 mmol/L); b. Renal function: serum creatinine ≤ 2.0 mg/dL (0.81 mmol/L); c. Hepatic function: AST and ALT ≤ 1.5 × ULN unless liver metastases are present, then AST and ALT ≤ 5.0 × ULN; bilirubin ≤ 1.5 mg/dL (0.026 mmol/L). 10. The subject must have PTT ≤ 1.5 × ULN and INR ≤ 1.5. 11. Women of childbearing potential must have a negative urine pregnancy test within 7 days prior to initiation of treatment and/or post menopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential. Women of childbearing potential must agree to use adequate contraception (one of the following listed below) prior to study entry, for the duration of study participation and up to two months following completion of therapy. ● Total abstinence from sexual intercourse (minimum one complete menstrual cycle); ● A vasectomized partner; ● Double-barrier method (condoms, contraceptive sponge, diaphragm or vaginal ring with spermicidal jellies or cream). 12. The subject is capable of understanding and complying with parameters as outlined in the protocol and able to sign and date the informed consent, approved by an Independent Ethics Committee (IEC)/Institutional Review Board (IRB), prior to the initiation of any screening or study-specific procedures. |
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E.4 | Principal exclusion criteria |
1. The subject has received anti-cancer therapy (other than chemotherapy) including investigational agents (any agent not approved for use in humans), immunotherapy, anti-cancer Chinese medicine/herbal remedies, or biologic therapy within 21 days or within a period defined by 5 half lives if the previous agent was a chronically dosed, targeted therapy (e.g., trastuzumab), whichever is shorter, prior to Study Day 1. Clinically significant adverse effects/toxicities of the previous therapy must have recovered to ≤ Grade 1. 2. The subject has had major surgery within 21 days of Study Day 1. 3. The subject has received radiation therapy (including palliative radiation) within 14 days of Study Day 1. 4. The subject has received anti-cancer hormonal therapy (e.g., tamoxifen) within 14 days of Study Day 1. 5. The subject has symptomatic or untreated brain or meningeal metastases. CT scans are not required to rule out brain or meningeal metastases unless there is a clinical suspicion of central nervous system disease. Subjects with treated brain metastases that are radiographically or clinically stable for at least 4 weeks after therapy and have no evidence of cavitation or hemorrhage in the brain lesion are eligible providing that they are asymptomatic and do not require corticosteroids (must have discontinued steroids at least 1 week prior to Study Day 1). 6. The subject has hypersensitivity to paclitaxel or to other drugs formulated with polyethoxylated castor oil (Crempahor) not able to be controlled with medication. 7. The subject has proteinuria CTC grade > 1 at baseline as measured by a UPC ratio of > 1 and confirmed by a 24-hour urine collection. 8. The subject is receiving therapeutic anticoagulation therapy. Low dose anticoagulation (e.g., low dose warfarin) for catheter prophylaxis will be permitted. 9. The subject has a history of, or currently exhibits, clinically significant cancer related events of bleeding (e.g., gross hemoptysis defined as bright red blood of at least ½ teaspoon or 2.5 mL per episode within 3 months prior to randomization unless definitively treated with surgery or radiation) or the subject has a recent history of (within 4 weeks of Study Day 1) or currently exhibits other clinically significant signs of bleeding. 10. The subject currently exhibits symptomatic or persistent, uncontrolled hypertension defined as diastolic blood pressure (BP) > 100 mmHg; or systolic blood pressure (BP) > 150 mmHg. Subjects may be re-screened if blood pressure is shown to be controlled with or without intervention. 11. The subject has a history of myocardial infarction, stroke, or transient ischemic attack (TIA) within 6 months of Study Day 1. 12. The subject has a documented left ventricular (LV) ejection fraction < 50%. 13. The subject has known autoimmune disease with renal involvement (e.g., lupus). 14. The subject is receiving combination anti-retroviral therapy for HIV. 15. The subject is pregnant or breast-feeding. 16. The subject has clinically significant uncontrolled condition(s) including but not limited to: • active uncontrolled infection, • symptomatic congestive heart failure, • unstable angina pectoris or cardiac arrhythmia, • history of adrenal insufficiency, • psychiatric illness/social situation that would limit compliance with study requirements. 17. The subject has active ulcerative colitis, Crohn's disease, celiac disease or any other conditions that interfere with absorption. 18. The subject has had another active malignancy within the past 5 years except for cervical cancer in situ, in situ carcinoma of the bladder or non-melanoma carcinoma of the skin. Questions regarding inclusion of individual subjects should be directed to the Abbott Medical Monitor. 19. The subject has a medical condition, which in the opinion of the study investigator, places them at an unacceptably high risk for toxicities. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint of the study is progression free survival. The secondary endpoints of the study will be overall survival, 12-month survival rate, time to disease progression, objective response rate, best response rate, maximum percent reduction in tumor size, duration of response as well as the safety and tolerability of the combination. The tertiary endpoints are quality of life and performance status. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | Information not present in EudraCT |
E.7.1.2 | Bioequivalence study | Information not present in EudraCT |
E.7.1.3 | Other | Information not present in EudraCT |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| Information not present in EudraCT |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 25 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The end of study is defined as the date of the last subject's last scheduled visit or the actual date of follow-up contact, whichever is longer. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | 21 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 21 |