E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Metastatic Breast Cancer (mBC) and metastatic Triple Negative Breast Cancer (mTNBC) |
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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 |
For Phase I: -To determine the safety profile and tolerability of S 81694 given in combination with paclitaxel by assessment of the DLT and the MTD based on safety data described using Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 4.03 in patients with mBC. - To establish the recommended phase II dose (RP2D) of S 81694 in combination with paclitaxel.
For phase II: - To evaluate Progression Free Survival (PFS). |
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E.2.2 | Secondary objectives of the trial |
For phase I: -To characterize the plasma pharmacokinetic (PK) profiles of S 81694 and its metabolites (if applicable) and of paclitaxel in combination. - To investigate any preliminary antitumour activity of this combination.
For phase II: - To assess the anti-tumour activity using Response Evaluation Criteria In Solid Tumours version 1.1 in terms of: o Objective Response Rate (ORR), o Response duration (RD), o Overall survival (OS). - To characterize the safety and tolerability of S 81694 in combination with paclitaxel at RP2D according to NCI-CTCAE v4.03. - To characterize the plasma PK profiles of S 81694 and of paclitaxel and its metabolites (if applicable) in combination. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
For Phase I : - Histologically or cytologically confirmed metastatic breast cancer, refractory to any standard therapy or for which the standard therapy is considered unsuitable; - Patient must have at least one evaluable or measurable metastatic lesion (lesions as defined by revised Response Evaluation Criteria in Solid Tumors
For Phase II : - Histologically or cytologically confirmed advanced inoperable triple negative breast cancer with no prior anticancer therapy regimen in metastatic setting; - Patient with a minimum washout period of 12 months following previous taxane based adjuvant therapy; - Patient must have at least one measurable metastatic lesion. Ascites, pleural effusion, and bone metastases are not considered measurable; - Acceptance of pre-treatment metastatic biopsies for all patients and on-treatment metastatic biopsies in selected centres.
For the whole study: - Male or female subjects aged ≥ 18 years old, or legal age of the majority in the country; - Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1; - Estimated life expectancy of at least 3 months; - Adequate haematological function based on the last assessment performed within 7 days prior to the first IMP administration; -Adequate renal function based on the last assessment performed within 7 days prior to the first IMP administration; - Adequate hepatic function based on the last assessment performed within 7 days prior to the first IMP administration; - Female participant of childbearing potential must have a negative pregnancy test (serum) within 7 days prior to the first day of test drug administration. Effective contraception both for female patients of childbearing potential and male patients with parteners of childbearing potential. |
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E.4 | Principal exclusion criteria |
- Other active malignancy within the last 3 years (except for basal cell carcinoma or a non-invasive/in situ cervical cancer or intra-mucosal gastro-intestinal cancers that were treated curatively); - Presence of grade ≥ 2 toxic effects (excluding alopecia) due to prior cancer therapy; - Known hypersensitivity to the IMP (S 81694 and paclitaxel) or their excipients; - Evidence of peripheral neuropathy of grade 2 or higher; - Participant previously received paclitaxel and discontinued due to toxicity related to paclitaxel; - Participant known as refractory to taxanes; - Any prior cancer therapy within 4 weeks or 5 half-life (whichever is the shorter) before the first IMP administration; - Participant with current, serious, uncontrolled infections; - Participant with brain metastasis or leptomeningeal metastasis (except patients with brain metastasis that have been stable post-radiation therapy and who are off steroids for > 2 months); - History of cardiac disease; - Uncontrolled arterial hypertension; - Presence of risk factors for torsades de pointes (e.g. heart failure, hypokalaemia, family history of long QT syndrome); - Any clinically significant medical condition (e.g. organ dysfunction) or laboratory abnormality likely to jeopardize the patient’s safety or to interfere with the conduct of the study, in the investigator’s opinion. |
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E.5 End points |
E.5.1 | Primary end point(s) |
For phase I : - incidence of DLTs occuring during the first cycle. - Safety and tolerability of S 81694 in combination with paclitaxel assessed by: o Incidence and severity of AEs and SAEs, o Laboratory tests (haematology, haemolysis, biochemistry, urinary analysis and pregnancy test), o Vital signs and weight, o Physical examination and performance status, o ECG parameters, o Dose interruptions, dose reductions and dose intensity.
For phase II : - Progression-Free Survival is defined as the time from the date of randomisation until the date of the investigator-assessed radiological disease progression according to RECIST v1.1 or death due to any cause. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
For Phase I : All over the study For Phase II : At inclusion and during the study at the end of cycle 2, then every 2 cycles between D22 and D28
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E.5.2 | Secondary end point(s) |
For phase I: - PK parameters of S 81694 and paclitaxel plasma concentration Tumour response assessed by RECIST v1.1.
For phase II : - Objective Response Rate (ORR); - Response duration (RD); - Overall survival; - Safety and tolerability of S 81694 in combination with paclitaxel or with paclitaxel alone assessed by: o Incidence and severity of AEs and SAEs, o Laboratory tests (haematology, haemolysis biochemistry, urinary analysis and pregnancy test), o Vital signs and weight, o Physical examination and performance status, o ECG parameters, o Dose interruptions, dose reductions and dose intensity. - PK parameters of S 81694 and paclitaxel concentrations. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
Phase I/II in combination with paclitaxel |
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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 | 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 | Yes |
E.8.1.7.1 | Other trial design description |
This study = phase 1 + 2 combined. Phase 1 (dose titration)=controlled no,randomised no,open yes |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
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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 | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 10 |
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 |
Japan |
Netherlands |
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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 | 5 |
E.8.9.1 | In the Member State concerned months | 4 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 5 |
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 | 0 |