E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Inoperable locally advanced or metastatic triple negative breast cancer |
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E.1.1.1 | Medical condition in easily understood language |
Breast cancer that has spread beyond the initial site, without certain hormonal receptors. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 17.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10027475 |
E.1.2 | Term | Metastatic breast cancer |
E.1.2 | System Organ Class | 100000004864 |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 17.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10072740 |
E.1.2 | Term | Locally advanced breast cancer |
E.1.2 | System Organ Class | 100000004864 |
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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 estimate the efficacy of ipatasertib combined with paclitaxel compared with placebo combined with paclitaxel in patients with inoperable locally advanced or metastatic triple negative breast cancer (mTNBC), as measured by progression free survival (PFS) in all patients and in patients with PTEN low tumors |
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E.2.2 | Secondary objectives of the trial |
- To estimate the clinical activity, as measured by overall survival (OS), objective response rate (ORR), and duration of objective tumor response of ipatasertib combined with paclitaxel compared with placebo combined with paclitaxel in all patients and in patients with PTEN low tumors.
- To estimate the clinical activity, as measured by PFS, OS, ORR, and duration of objective tumor response, of ipatasertib combined with paclitaxel compared with placebo combined with paclitaxel in patients who are Akt diagnostic positive (Dx+) (defined by PTEN status, INPP4B status, and PI3K alterations) |
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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 |
Optional FFPE tumor biopsy collection |
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E.3 | Principal inclusion criteria |
- Signed Informed Consent Form,
- Premenopausal or postmenopausal women age above or equal to 18 years,
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1,
- Histologically documented triple negative adenocarcinoma of the breast that is inoperable locally advanced or metastatic and is not amenable to resection with curative intent,
- Availability of a representative formalin fixed, paraffin embedded (FFPE) tumor specimen that enables a diagnosis of triple negative adenocarcinoma of the breast, accompanied by an associated pathology report, for central molecular analysis (required prior to randomization),
- Measurable disease, according to RECIST v1.1,
- Adequate hematologic and organ function within 14 days before the first study treatment,
- For female patients of childbearing potential, agreement (by both patient and partner) to use an effective form of contraception).
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E.4 | Principal exclusion criteria |
- Any previous therapy, including chemotherapy or hormonal or targeted therapy, for inoperable locally advanced or metastatic triple negative adenocarcinoma of the breast;
- Any radiation treatment to metastatic site within 28 days of Cycle 1, Day 1;
- Known HER2 positive, ER positive, or PR positive breast cancer;
- Previous therapy with Akt, PI3K, and/or mTOR inhibitors;
- Major surgical procedure, open biopsy, or significant traumatic injury within 30 days prior to Cycle 1, Day 1 or anticipation of need for a major surgical procedure during the course of the study;
- Known presence of the brain or spinal cord metastasis;
- Need for chronic corticosteroid therapy of 10 mg or more of prednisone per day or an equivalent dose of other anti inflammatory corticosteroids or immunosuppressants for a chronic disease;
- Known hypersensitivity or contraindication to any component of the study treatments, including paclitaxel excipient macrogolglycerol ricinoleate;
- Grade equal or above 2 peripheral neuropathy;
- History of Type I or Type II diabetes mellitus requiring insulin;
- New York Heart Association (NYHA) Class II, III, or IV heart failure, or left ventricular ejection fraction < 50%, or active ventricular arrhythmia requiring medication;
- Current unstable angina or history of myocardial infarction within 6 months prior to Cycle 1, Day 1;
- Grade equeal or above 2 uncontrolled or untreated hypercholesterolemia or hypertriglyceridemia;
- Congenital long QT syndrome or screening corrected QT interval (QTc) above 480 milliseconds;
- Bisphosphonate therapy for currently symptomatic hypercalcemia;
- History of malabsorption syndrome, lack of physical integrity of the upper gastrointestinal tract, or other condition that would interfere with enteral absorption or results in the inability or unwillingness to swallow pills;
- Active infection requiring intravenous (IV) antibiotics;
- Known clinically significant history of liver disease consistent with Child Pugh Class B or C, including active viral or other hepatitis (e.g., Hepatitis B or Hepatitis C virus), current alcohol abuse, or cirrhosis;
- Known human immunodeficiency virus (HIV) infection;
- Pregnancy, lactation, or breastfeeding;
- Inability to comply with study and follow up procedures;
- Malignancies other than TNBC within 5 years prior to Cycle 1, Day 1, with the exception of those with a negligible risk of metastasis or death (such as adequately treated carcinoma in situ of the cervix, basal or squamous cell skin cancer, ductal carcinoma in situ treated surgically with curative intent);
- Unresolved, clinically significant toxicity from prior therapy, except for alopecia and Grade 1 peripheral neuropathy;
- Active small or large intestine inflammation (such as Crohn’s disease or ulcerative colitis);
- Any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding that, in the investigator’s opinion, gives reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that may affect the interpretation of the results or render the patient at high risk from treatment complications.
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E.5 End points |
E.5.1 | Primary end point(s) |
PFS, defined as the time from randomization to the first occurrence of disease progression, as determined by investigator review of tumor assessments by RECIST, v1.1 or death on study (less or equal to 30 days after the last dose of study treatment regimen) from any cause, whichever occurs first |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
There will be an interim safety analyses after the first 20 patients have completed two treatment cycles and an interim efficacy analysis after a total of approximately 40 PFS events have occurred. The primary analysis is expected to be triggered at 50 PFS events in patients with PTEN low tumors at approximately 24 months after enrollment of the first patient. |
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E.5.2 | Secondary end point(s) |
Overall survival (OS), confirmed tumor response rate by RECIST, v1.1, and duration of confirmed tumor response by RECIST, v1.1 |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
There will be an interim safety analyses after the first 20 patients have completed two treatment cycles and an interim efficacy analysis after a total of approximately 40 PFS events have occurred. The primary analysis is expected to be triggered at 50 PFS events in patients with PTEN low tumors at approximately 24 months after enrollment of the first patient |
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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 | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
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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 | 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.8.2.4 | Number of treatment arms in the trial | 2 |
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 | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 21 |
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 | No |
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 |
Belgium |
France |
Italy |
Korea, Republic of |
Singapore |
Spain |
Taiwan |
United States |
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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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 10 |