E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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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 | PT |
E.1.2 | Classification code | 10006187 |
E.1.2 | Term | Breast cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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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 correlate the HER2-expression in tumors measured by 68Ga-ABY-025 PET to gold standard histopathology based on IHC-status and ISH-analyses. |
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E.2.2 | Secondary objectives of the trial |
* To compare the HER2-expression in tumors measured by 68Ga-ABY-025 PET tumor to background ratio (TBR) to standardized uptake values (SUV).
* Define optimal SUV and TBR cut-off values for separating metastatic HER2-status into HER2-negative and HER2-positive at 2, 3 and 4 hours in a subset of 40 patients.
* To correlate the HER2-expression in tumors measured by 68Ga-ABY-025 PET standardized uptake values (SUV) to IHC-status and percentage of stained cells.
* Study the intra-individual heterogeneity of HER2 expression (IHC and ISH) in patients with more than one metastasis ≥ 1cm.
* Study the variability of HER2 expression (IHC and ISH) between primary tumor and metastases.
* To study if the investigation with 68Ga-ABY-025 PET leads to changes in the proposed treatment and in which proportion of the examined patients this occur. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
* Signed written informed consent.
* Age ≥18 years.
* Histologically or cytologically confirmed HER2-positive or borderline positive (for definition see below) adenocarcinoma of the breast.
HER2-positive defined as:
a. 3+ by immunohistochemistry [IHC] in >10% of cell areas.
b. 2+ by IHC in >10% of cell areas and HER2/CEP17 ratio ≥2.0 or HER2 copy number ≥ 6.0 by in situ hybridization [ISH]).
HER2-borderline positive defines as:
c. 2+ by IHC and HER2/CEP17 ratio <2.0 and/or HER2 copy number 4.0 - 6.0 by in situ hybridization [ISH]) (“equivocal”).
d. 2+ by IHC and HER2/CEP17 ratio <2.0 and/or HER2 copy number <4.0 by in situ hybridization [ISH]) (“2+ ISH negative”).
e. Known inhomogeneous HER2-expression in the primary tumor with HER2-positive areas <10% (“inhomogeneous”).
* Primary breast cancer planned for neoadjuvant therapy (Stage II-III, T2-4N0-3) or metastatic (M1; at least 80 pts).
* At least one tumor lesion ≥ 10 mm.
* At least one tumor lesion available for biopsy.
* Newly diagnosed or confirmed progression and planned for therapy with trastuzumab emtansine or anti-HER2 targeted therapy(-ies) concomitant with chemotherapy (HER2-positive cohort) or chemotherapy (HER2-negative patients).
* WHO performance status ≤ 2.
* Predicted survival > 12 weeks |
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E.4 | Principal exclusion criteria |
* Histologically or cytologically confirmed HER2-negative breast cancer defined as IHC 0 or 1+.
* Other manifest malignancy.
* Serious uncontrolled concomitant disease including congestive heart failure that would contraindicate the use of any anti-HER2 therapy.
* Inadequate organ function, suggested by the following laboratory results:
• Absolute neutrophil count <1,500 cells/mm3
• Total bilirubin ≥1.5 x ULN (unless the patient has documented Gilbert’s syndrome)
• AST (SGOT) or ALT (SGPT) >5.0 × ULN
• Serum creatinine clearance <30 ml/min
* Patients of childbearing potential and sexually active and not willing to use adequate contraceptive.
* Assessed by the Investigator to be unable or unwilling to comply with the requirements of the protocol. |
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E.5 End points |
E.5.1 | Primary end point(s) |
To correlate the HER2-expression in tumors measured by 68Ga-ABY-025 PET to gold standard histopathology based on IHC-status and ISH-analyses. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Interim analysis year 2019, final analysis year 2021 (after end of study). |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | Yes |
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 | 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) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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 | No |
E.8.2.3 | Other | No |
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 | 8 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
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 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 | 3 |
E.8.9.1 | In the Member State concerned months | 5 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 3 |