E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
HER2-positive metastatic breast cancer |
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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 |
Assess the objective response rate by RECIST guidelines of oral deforolimus in combination with trastuzumab in patients with HER2-positive metastatic breast cancer (MBC) with progression after treatment with at most 2 prior trastuzumab-based regimens. |
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E.2.2 | Secondary objectives of the trial |
•Characterize safety and tolerability of oral deforolimus administered in combo with std dose trastuzumab •Evaluate the clinical-benefit response rate (CR or PR, SD ≥ six 4-wk cycles) •Evaluate addtn'l efficacy endpts, (e.g. duration of response, time to tumor progression, pfs, pfs rate, os). •Perform a series of exploratory molecular analyses such as: •Exploratory analysis of molecular parameters in archival tumor samples for predictive/indicative ability of mTOR inhibition impacting trastuzumab resistance (e.g. markers of tumoral PI3K/mTOR-pathway activity and related pathways). Possible analysis of the mutational/expression/activation status of specific genes (e.g. PI3CA; PTEN, p95HER2 and IGF-1R) or gene expression profiling for status of entire signaling pathways •Exploratory analysis of pre-/post-treatment changes in circulating tumor cells and their expression of certain HER2 and PI3K/mTOR pathway-related changes pending evolving technology
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
•Female patients, age ≥ 18 yrs •Histologically confirmed HER-2 positive (IHC 3+ or FISH+) metastatic breast cancer (MBC) •Trastuzumab-resistance, defined as disease progression on trastuzumab treatment, with at most 2 prior trastuzumab-based regimens permitted •Either combination or single-agent trastuzumab treatment acceptable •Maintenance after combination therapy considered part of that overall regimen (i.e., will be counted as one regimen) •Single-agent trastuzumab therapy (without disease progression) followed by combination trastuzumab therapy acceptable at the time of disease progression. •Adjuvant trastuzumab-containing therapy permitted and will count as one regimen •Measurable disease according to modified RECIST guidelines (histological/cytological confirmation of the neoplastic nature of a solitary lesion is not required in this trial) •ECOG performance status ≤ 1 •Life expectancy > 3 months •No prior treatment with temsirolimus, everolimus, rapamycin, or any other mTOR inhibitor •At least 4 weeks much have elapsed between prior investigational therapy, chemotherapy or radiotherapy, and the first dose of deforolimus (≥2 weeks for signal transduction inhibitors with a half-life known to be < 24 hours, and ≥ 6 weeks for nitrosourea or mitomycin) •Left ventricular ejection fraction of ≥ 50% •Adequate cardiovascular function (e.g., ≤ class 2 New York Heart Association congestive heart failure, no myocardial infarction in the previous six months) •Adequate haematological, hepatic and renal function as defined below: •haemoglobin ≥ 9 g/dL, absolute neutrophil counts [ANC] ≥ 1.5 x 109 /L •platelets ≥ 100 x 109 /L •bilirubin ≤ ULN •alkaline phosphatase ≤ 2.5 x ULN •AST, ALT ≤ 2.5 x ULN; albumin ≥ 2.5mg/dL; creatinine ≤ 1.5 x ULN •Serum cholesterol ≤350 mg/dL and triglycerides ≤ 400 mg/dL •Patients with childbearing potential must have a negative serum pregnancy test within 7 days prior to first dose of study drug and must use an approved contraceptive method as appropriate from time of study screening until 30 days after the last dose of study drug. Non-hormonal methods must be used in this trial. Approved contraceptive methods include, for example, intra-uterine device, diaphragm with spermicide, cervical cap with spermicide or female condom with spermicide. (Spermicides alone are not an acceptable method of contraception.) •Availability and patient consent to obtain archival tumor tissue •Signed informed consent document stating that the patient understands the investigational nature of the proposed treatment
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E.4 | Principal exclusion criteria |
•Inadequate recovery from any prior surgical procedure or having undergone any major surgery within 2 weeks before trial entry (with the exception of minor procedures, e.g., central venous access port placement) •Grade 1 or Grade 2 hypersensitivity reaction to prior trastuzumab therapy if these reactions prevented further trastuzumab administration •Grade 3 or Grade 4 hypersensitivity reaction to prior trastuzumab •Patients with symptomatic intrinsic lung disease or with extensive tumor involvement of the lungs, resulting in dyspnea at rest •Known allergy to macrolide antibiotics •Pregnant or breast-feeding •Known history of HIV sero-positivity •Diagnosis of brain metastasis or leptomeningeal carcinomatosis within 3 months, and/or active brain metastases or leptomeningeal carcinomatosis, including those requiring glucocoricoid treatment •Other malignancies within the past 3 years except for adequately treated carcinoma of the cervix or basal or squamous cell carcinoma of the skin •Active infection requiring prescribed intervention •Newly diagnosed (within 3 months before enrolment) or poorly controlled Type 1 or 2 diabetes •Newly diagnosed (within 3 months or before enrolment) or poorly controlled Type 1 or 2 diabetes •Other concurrent illness which, in the Investigator’s judgment, would either compromise the patient’s safety or interfere with the evaluation of the safety of the study drug •Concurrent treatment with medications that strongly induce or inhibit cytochrome P450 (CYP3A). Patients should be off these medications ≥ 2 weeks prior to the first dose of deforolimus. Concomitant medications that are metabolied by CYP3A are allowed (e.g., atorvastatin or simvastatin) •Any condition in the Investigator’s judgement that renders the patient unable to fully understand and provide informed consent and/or comply with the protocol
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E.5 End points |
E.5.1 | Primary end point(s) |
Objective response rate by modified RECIST guidelines |
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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 | Yes |
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 | Yes |
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 | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
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 | No |
E.8.1.1 | Randomised | Information not present in EudraCT |
E.8.1.2 | Open | Information not present in EudraCT |
E.8.1.3 | Single blind | Information not present in EudraCT |
E.8.1.4 | Double blind | Information not present in EudraCT |
E.8.1.5 | Parallel group | Information not present in EudraCT |
E.8.1.6 | Cross over | Information not present in EudraCT |
E.8.1.7 | Other | Information not present in EudraCT |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 5 |
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 | No |
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 definition of end of trial (completion) date, per the protocol, is up to 24 months after the last patient has received the first dose of study drug or has otherwise discontinued from the study. |
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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 | 3 |
E.8.9.1 | In the Member State concerned months | 4 |
E.8.9.1 | In the Member State concerned days | 15 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 4 |
E.8.9.2 | In all countries concerned by the trial days | 15 |