E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Previously untreated metastatic triple negative breast cancer |
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E.1.1.1 | Medical condition in easily understood language |
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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 | 20.0 |
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.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
• to evaluate the efficacy of MPDL3280A + nab-paclitaxel compared with placebo + nab-paclitaxel as measured by progression-free survival (PFS; per investigator assessment using Response Evaluation Criteria in Solid Tumors [RECIST] v1.1)
• To evaluate the efficacy of atezolizumab + nab-paclitaxel compared with
placebo + nab-paclitaxel as measured by overall survival (OS) |
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E.2.2 | Secondary objectives of the trial |
• To evaluate the efficacy of atezolizumab + nab-paclitaxel compared with
placebo + nab-paclitaxel as measured by objective response rate (ORR; per
investigator assessment using RECIST v1.1)
• To evaluate the efficacy of atezolizumab + nab-paclitaxel compared with
placebo + nab-paclitaxel as measured by duration of objective response (DOR; per
investigator using RECIST v1.1) among patients with an objective response
• To evaluate patient-reported outcomes (PROs) of health status/health-related
quality of life (HRQoL) associated with atezolizumab + nab-paclitaxel compared with
placebo + nab-paclitaxel, as measured by the time to deterioration (TTD) in
Items 29 and 30 of the European Organisation for Research and Treatment of
Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Women aged ≥ 18 years
• Metastatic or locally advanced, histologically documented TNBC (absence of HER2, ER, and PR expression)
• No prior chemotherapy or targeted systemic therapy for inoperable locally advanced or metastatic TNBC
• Representative FFPE tumor specimens in paraffin blocks (preferred) or at least
15 unstained slides, with an associated pathology report documenting ER, PR, and HER2 negativity
•A tumor specimen obtained from metastatic or locally advanced disease (if applicable) must be submitted if clinically feasible
• ECOG performance status of 0 or 1
• Life expectancy ≥ 12 weeks
• Measurable disease, as defined by RECIST v1.1
•Adequate hematologic and end-organ function defined by laboratory results obtained within 2 weeks prior to first study treatment.
•Women of child bearing potential must agree to use adequate contraception (double barrier
methods of birth control or abstinence) prior to study entry, for the duration of study treatment, and for at least 5 months after the last dose of study treatment.
• Patients who are not postmenopausal (≥ 12 months of non−therapy-induced amenorrhea) or surgically sterile must have a negative serum pregnancy test result within 14 days prior to initiation of study drug
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E.4 | Principal exclusion criteria |
• Spinal cord compression not definitively treated with surgery and/or radiation, or previously
diagnosed and treated spinal cord compression without evidence that disease has been
clinically stable for > 2 weeks prior to randomization
• Known CNS disease, except for treated asymptomatic CNS metastases
• Leptomeningeal disease
• Uncontrolled pleural effusion, pericardial effusion, or ascites (indwelling drainage catheters are permitted)
• Uncontrolled tumor-related pain
• Uncontrolled hypercalcemia
•Pregnancy or lactation
• Evidence of significant uncontrolled concomitant disease that could affect compliance with
the protocol or interpretation of results, including significant liver disease (such as cirrhosis,
uncontrolled major seizure disorder, or superior vena cava syndrome)
• Significant cardiovascular disease
• Severe infection within 4 weeks prior to randomization, including but not limited to
hospitalization for complications of infection, bacteremia, or severe pneumonia
• History of autoimmune disease (Autoimmune-related hypothyroidism on a stable dose of thyroid replacement hormone and Type 1 diabetes mellitus on an stable insulin regimen may be eligible for this study)
• Prior allogeneic stem cell or solid organ transplantation
• History of idiopathic pulmonary fibrosis (including pneumonitis), drug-induced pneumonitis,
organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia), or
evidence of active pneumonitis on screening chest CT scan.
History of radiation pneumonitis in the radiation field (fibrosis) is permitted.
• Positive test for HIV
• Active hepatitis B or hepatitis C
•Active tuberculosis
•Treatment with systemic corticosteroids or other systemic immunosuppressive medications (including but not limited to prednisone, dexamethasone, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor [TNF] agents) within 2 weeks prior to randomization, or anticipated requirement for systemic immunosuppressive medications during the trial.
Low dose steroids for nausea, adrenocortical insufficiency or orthostatic hypotension, IV contrast allergic reactions and inhaled corticosteroids are permitted.
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E.5 End points |
E.5.1 | Primary end point(s) |
Progression free survival (PFS) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Tumor assessments will be performed every 8 weeks for the first 12 months and every 12 weeks thereafter until disease progression or treatment discontinuation, whichever is later |
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E.5.2 | Secondary end point(s) |
Overall survival (OS), Objective response rate (ORR) and duration of objective response (DOR), Patient reported outcomes (PRO) of health status and health quality of life (HRQoL) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
OS - every 3 months until death, withdrawal of consent, loss to follow-up, or study
termination by the Sponsor
ORR and DOR – tumor assessments will be performed every 8 weeks for the first 12 months and every 12 weeks thereafter until disease progression or treatment discontinuation, whichever is later
PRO and HRQoL - at baseline (Cycle 1,Day 1); at Day 1 of each subsequent cycle; and at the treatment discontinuation visit. In
addition, all patients will complete the PRO questionnaires every 28 days for 1 year after
treatment discontinuation, regardless of whether the patient is receiving subsequent
anti-cancer therapy.
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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 | Yes |
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 | 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) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
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 | No |
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 | 8 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 90 |
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 |
Australia |
Austria |
Belgium |
Canada |
Czech Republic |
Denmark |
Estonia |
Finland |
France |
Germany |
Greece |
Hungary |
Italy |
Korea, Republic of |
Latvia |
Norway |
Poland |
Portugal |
Romania |
Slovenia |
Spain |
United Kingdom |
United States |
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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 the study is expected to occur about 53 months after FPI when
approximately the pre-planned number of deaths will have been observed |
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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 | 4 |
E.8.9.1 | In the Member State concerned months | 4 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 6 |