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    Clinical Trial Results:
    Phase II trial of trastuzumab in combination with pertuzumab in pretreated patients with non-small cell lung cancer (NSCLC) harboring a Her2 mutation and receiving docetaxel

    Summary
    EudraCT number
    2018-003506-11
    Trial protocol
    FR  
    Global end of trial date
    18 Dec 2023

    Results information
    Results version number
    v1(current)
    This version publication date
    18 Jan 2025
    First version publication date
    18 Jan 2025
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    IFCT-1703
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03845270
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    IFCT
    Sponsor organisation address
    10 rue de la Grange-Batelière, Paris, France, 75009
    Public contact
    Contact, IFCT, 33 156811045, operations-cliniques@ifct.fr
    Scientific contact
    Contact, IFCT, 33 156811045, operations-cliniques@ifct.fr
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    31 Dec 2020
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    31 Dec 2020
    Global end of trial reached?
    Yes
    Global end of trial date
    18 Dec 2023
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Evaluate the efficacy of trastuzumab in combination with pertuzumab and docetaxel in patients with HER2 mutated advanced NSCLC
    Protection of trial subjects
    Algorithms for management of adverse events were provided in the protocol.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 Feb 2019
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    France: 46
    Worldwide total number of subjects
    46
    EEA total number of subjects
    46
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    23
    From 65 to 84 years
    23
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    From May 2019 to October 2020, 47 patients were screened; 46 patients were initially included (one was deemed ineligible because of a poor performance status), and 45 patients were enrolled and received the study treatment.

    Pre-assignment
    Screening details
    Main inclusion criteria were histologically/cytologically confirmed inoperable and not suitable for radiation stage III or stage IV nonsquamous NSCLC with HER2 alterations. Other inclusion criteria were pretreatment with at least one platinum-based therapy with documented disease progression, the presence of asymptomatic or treated brain metastases

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded
    Blinding implementation details
    Not blinded

    Arms
    Arm title
    Pertuzumab - Trastuzumab - Docetaxel
    Arm description
    Pertuzumab was administered as an intravenous (IV) loading dose of 840 mg once every 3 weeks on day 1 of cycle 1 (1 cycle length 5 21 days), and 420 mg once every 3 weeks on day 1 of subsequent cycles. Trastuzumab was administered as an IV loading dose of 8 milligrams per kilogram (mg/kg) once every 3 weeks on day 2 of cycle 1 (1 cycle length 5 21 days), and 6 mg/kg once every 3 weeks on day 1 of subsequent cycles. Docetaxel was administered as an IV dose of 75 milligrams per square meter of body surface area (mg/m2) once every 3 weeks on day 2 of cycle 1 (1 cycle length 5 21 days), and 75 mg/m2 once every 3 weeks on day 1 of subsequent cycles. Treatment was given until toxicity or disease progression.
    Arm type
    Experimental

    Investigational medicinal product name
    Pertuzumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Pertuzumab was administered as an intravenous (IV) loading dose of 840 mg once every 3 weeks on day 1 of cycle 1 (1 cycle length 5 21 days), and 420 mg once every 3 weeks on day 1 of subsequent cycles. .

    Investigational medicinal product name
    Trastuzumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for concentrate for dispersion for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Trastuzumab was administered as an IV loading dose of 8 milligrams per kilogram (mg/kg) once every 3 weeks on day 2 of cycle 1 (1 cycle length 5 21 days), and 6 mg/kg once every 3 weeks on day 1 of subsequent cycles.

    Investigational medicinal product name
    Docetaxel
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate and solvent for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Docetaxel was administered as an IV dose of 75 milligrams per square meter of body surface area (mg/m2) once every 3 weeks on day 2 of cycle 1 (1 cycle length 5 21 days), and 75 mg/m2 once every 3 weeks on day 1 of subsequent cycles.

    Number of subjects in period 1
    Pertuzumab - Trastuzumab - Docetaxel
    Started
    46
    Completed
    45
    Not completed
    1
         Consent withdrawn by subject
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall trial (overall period)
    Reporting group description
    -

    Reporting group values
    Overall trial (overall period) Total
    Number of subjects
    46 46
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    23 23
        From 65-84 years
    23 23
        85 years and over
    0 0
    Age continuous
    Units: years
        median (full range (min-max))
    64.5 (31 to 83.7) -
    Gender categorical
    Units: Subjects
        Female
    33 33
        Male
    13 13
    Smokers
    Units: Subjects
        Yes
    16 16
        No
    30 30
    NSCLC histologically confirmed
    Units: Subjects
        Yes
    45 45
        No
    1 1
    NSCLC cytologically confirmed
    Units: Subjects
        Yes
    24 24
        No
    19 19
        Unknown
    3 3
    Histological type
    Units: Subjects
        Adenocarcinoma
    46 46
    Number of prior lines
    The lines are counted based on interval disease progression and not the number of agents or switches in agents
    Units: Subjects
        One
    34 34
        Two
    10 10
        Three or more
    2 2
    TNM
    Units: Subjects
        IIIB
    4 4
        IVA
    9 9
        IVB
    33 33
    PS
    Units: Subjects
        PS 0
    19 19
        PS 1
    20 20
        PS 2
    7 7
    Brain result
    Units: Subjects
        Abnormal
    14 14
        Normal
    32 32
    PD-L1
    Units: Subjects
        Negative
    26 26
        Positive (>= 1 and < 50%)
    16 16
        Positive (>= 50%)
    3 3
        Unknown
    1 1
    HER2 results
    Units: Subjects
        in-frame insertions in exon 20
    32 32
        point mutations L755S and G776C
    2 2
        other mutation/insertion
    12 12
    EGFR results
    Units: Subjects
        Indeterminate
    1 1
        Wild-type (wt)
    44 44
        Not done
    1 1
    ALK results
    Units: Subjects
        Wild-type (wt)
    45 45
        Not done
    1 1
    ROS1 results
    Units: Subjects
        Wild-type (wt)
    42 42
        Not done
    4 4
    PI3K results
    Units: Subjects
        Negative
    22 22
        Not done
    24 24
    KRAS results
    Units: Subjects
        Indeterminate
    1 1
        Negative
    42 42
        Not done
    3 3
    BRAF results
    Units: Subjects
        Indeterminate
    1 1
        Negative
    42 42
        Not done
    3 3
    Number of pack year
    Units: Pack year
        median (full range (min-max))
    14.0 (3 to 40) -

    End points

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    End points reporting groups
    Reporting group title
    Pertuzumab - Trastuzumab - Docetaxel
    Reporting group description
    Pertuzumab was administered as an intravenous (IV) loading dose of 840 mg once every 3 weeks on day 1 of cycle 1 (1 cycle length 5 21 days), and 420 mg once every 3 weeks on day 1 of subsequent cycles. Trastuzumab was administered as an IV loading dose of 8 milligrams per kilogram (mg/kg) once every 3 weeks on day 2 of cycle 1 (1 cycle length 5 21 days), and 6 mg/kg once every 3 weeks on day 1 of subsequent cycles. Docetaxel was administered as an IV dose of 75 milligrams per square meter of body surface area (mg/m2) once every 3 weeks on day 2 of cycle 1 (1 cycle length 5 21 days), and 75 mg/m2 once every 3 weeks on day 1 of subsequent cycles. Treatment was given until toxicity or disease progression.

    Primary: Confirmed Overall Response Rate (ORR) at 6 weeks

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    End point title
    Confirmed Overall Response Rate (ORR) at 6 weeks [1]
    End point description
    ORR is defined as the proportion of patients with a confirmed complete response or partial response at 6 weeks (confirmed at least after 4 weeks) according to RECIST version 1.1.
    End point type
    Primary
    End point timeframe
    6 weeks
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Not applicable as the study was single arm.
    End point values
    Pertuzumab - Trastuzumab - Docetaxel
    Number of subjects analysed
    45
    Units: % of participants
        median (confidence interval 95%)
    13.3 (3.4 to 23.3)
    No statistical analyses for this end point

    Secondary: Overall Response Rate (ORR)

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    End point title
    Overall Response Rate (ORR)
    End point description
    ORR is defined as the proportion of patients with a confirmed complete response or partial response according to RECIST version 1.1.
    End point type
    Secondary
    End point timeframe
    Median follow-up of 12 months (95% CI, 6.7 to 14.4)
    End point values
    Pertuzumab - Trastuzumab - Docetaxel
    Number of subjects analysed
    45
    Units: % of participants
        median (confidence interval 95%)
    28.9 (15.6 to 42.1)
    No statistical analyses for this end point

    Secondary: Progression Free Survival (PFS)

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    End point title
    Progression Free Survival (PFS)
    End point description
    Progression-free survival is defined as the time from enrollment to first observation of progression (according to RECIST v1.1) or date of death (from any cause).
    End point type
    Secondary
    End point timeframe
    Median follow-up of 12 months (95% CI, 6.7 to 14.4)
    End point values
    Pertuzumab - Trastuzumab - Docetaxel
    Number of subjects analysed
    45
    Units: Months
        median (confidence interval 95%)
    6.83 (4.0 to 8.5)
    No statistical analyses for this end point

    Secondary: Duration of response

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    End point title
    Duration of response
    End point description
    Duration of response is defined as the time from documentation of tumor response to disease progression.
    End point type
    Secondary
    End point timeframe
    Median follow-up of 12 months (95% CI, 6.7 to 14.4)
    End point values
    Pertuzumab - Trastuzumab - Docetaxel
    Number of subjects analysed
    19
    Units: Months
        median (confidence interval 95%)
    5.6 (2.7 to 14.9)
    No statistical analyses for this end point

    Secondary: Overall Survival (OS)

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    End point title
    Overall Survival (OS)
    End point description
    Overall survival, defined as the time from enrollment until death due to any cause, will be the principal secondary endpoint.
    End point type
    Secondary
    End point timeframe
    Median follow-up of 12 months (95% CI, 6.7 to 14.4)
    End point values
    Pertuzumab - Trastuzumab - Docetaxel
    Number of subjects analysed
    45
    Units: % of participants
        median (confidence interval 95%)
    17.6 (11.6 to 18.9)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    The period of observation for collection of adverse events extended from the date of signature of the informed consent until 30 days after the last day of study treatment.
    Adverse event reporting additional description
    The maximal grade of adverse events was collected by cycle of treatment and during follow-up.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    19.0
    Reporting groups
    Reporting group title
    Treated
    Reporting group description
    -

    Serious adverse events
    Treated
    Total subjects affected by serious adverse events
         subjects affected / exposed
    22 / 45 (48.89%)
         number of deaths (all causes)
    3
         number of deaths resulting from adverse events
    3
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neoplasm progression
    Additional description: Neoplasm progression
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 2
    Vascular disorders
    Superior vena cava syndrome
    Additional description: Superior vena cava syndrome
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Fatigue
    Additional description: Fatigue
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sudden death
    Additional description: Sudden death
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Respiratory, thoracic and mediastinal disorders
    Pleural effusion
    Additional description: Pleural effusion
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Non-cardiac chest pain
    Additional description: Non-cardiac chest pain
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumothorax
    Additional description: Pneumothorax
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Aspartate aminotransferase increased
    Additional description: Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Alanine aminotransferase increased
    Additional description: Alanine aminotransferase increased
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Craniocerebral injury
    Additional description: Craniocerebral injury
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Femur fracture
    Additional description: Femur fracture
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infusion related reaction
    Additional description: Infusion related reaction
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Overdose
    Additional description: Overdose
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Pericardial effusion
    Additional description: Pericardial effusion
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Haemorrhage intracranial
    Additional description: Haemorrhage intracranial
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
    Additional description: Anaemia
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Febrile neutropenia
    Additional description: Febrile neutropenia
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Upper gastrointestinal haemorrhage
    Additional description: Upper gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
    Additional description: Acute kidney injury
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Endocrine disorders
    Hyperthyroidism
    Additional description: Hyperthyroidism
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Erysipelas
    Additional description: Erysipelas
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Device related infection
    Additional description: Device related infection
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Lung infection
    Additional description: Lung infection
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumocystis jirovecii pneumonia
    Additional description: Pneumocystis jirovecii pneumonia
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural infection
    Additional description: Pleural infection
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
    Additional description: Urinary tract infection
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
    Additional description: Dehydration
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Treated
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    45 / 45 (100.00%)
    Vascular disorders
    Embolism
    Additional description: Embolism
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    2
    Hot flush
    Additional description: Hot flush
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Hypertension
    Additional description: Hypertension
         subjects affected / exposed
    6 / 45 (13.33%)
         occurrences all number
    17
    Phlebitis
    Additional description: Phlebitis
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    12
    General disorders and administration site conditions
    Face oedema
    Additional description: Face oedema
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    5
    Fatigue
    Additional description: Fatigue
         subjects affected / exposed
    37 / 45 (82.22%)
         occurrences all number
    224
    Influenza like illness
    Additional description: Influenza like illness
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Malaise
    Additional description: Malaise
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    3
    Localised oedema
    Additional description: Localised oedema
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences all number
    11
    Pain
    Additional description: Pain
         subjects affected / exposed
    4 / 45 (8.89%)
         occurrences all number
    15
    Oedema peripheral
    Additional description: Oedema peripheral
         subjects affected / exposed
    7 / 45 (15.56%)
         occurrences all number
    30
    Pyrexia
    Additional description: Pyrexia
         subjects affected / exposed
    8 / 45 (17.78%)
         occurrences all number
    8
    Immune system disorders
    Anaphylactic reaction
    Additional description: Anaphylactic reaction
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Hypersensitivity
    Additional description: Hypersensitivity
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    2
    Reproductive system and breast disorders
    Pelvic pain
    Additional description: Pelvic pain
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    6
    Vulvovaginal inflammation
    Additional description: Vulvovaginal inflammation
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory distress syndrome
    Additional description: Acute respiratory distress syndrome
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Cough
    Additional description: Cough
         subjects affected / exposed
    13 / 45 (28.89%)
         occurrences all number
    36
    Dyspnoea
    Additional description: Dyspnoea
         subjects affected / exposed
    14 / 45 (31.11%)
         occurrences all number
    80
    Epistaxis
    Additional description: Epistaxis
         subjects affected / exposed
    10 / 45 (22.22%)
         occurrences all number
    26
    Oropharyngeal pain
    Additional description: Oropharyngeal pain
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Productive cough
    Additional description: Productive cough
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences all number
    16
    Pleural effusion
    Additional description: Pleural effusion
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    2
    Rhinitis allergic
    Additional description: Rhinitis allergic
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences all number
    5
    Rhinorrhoea
    Additional description: Rhinorrhoea
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Psychiatric disorders
    Anxiety
    Additional description: Anxiety
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences all number
    11
    Confusional state
    Additional description: Confusional state
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences all number
    5
    Depression
    Additional description: Depression
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    6
    Insomnia
    Additional description: Insomnia
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    2
    Investigations
    Alanine aminotransferase increased
    Additional description: Alanine aminotransferase increased
         subjects affected / exposed
    8 / 45 (17.78%)
         occurrences all number
    21
    Aspartate aminotransferase increased
    Additional description: Aspartate aminotransferase increased
         subjects affected / exposed
    5 / 45 (11.11%)
         occurrences all number
    12
    Blood alkaline phosphatase increased
    Additional description: Blood alkaline phosphatase increased
         subjects affected / exposed
    4 / 45 (8.89%)
         occurrences all number
    23
    Blood bilirubin increased
    Additional description: Blood bilirubin increased
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Blood creatinine increased
    Additional description: Blood creatinine increased
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    9
    Ejection fraction decreased
    Additional description: Ejection fraction decreased
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Gamma-glutamyltransferase increased
    Additional description: Gamma-glutamyltransferase increased
         subjects affected / exposed
    5 / 45 (11.11%)
         occurrences all number
    26
    Lymphocyte count decreased
    Additional description: Lymphocyte count decreased
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    9
    Neutrophil count decreased
    Additional description: Neutrophil count decreased
         subjects affected / exposed
    17 / 45 (37.78%)
         occurrences all number
    32
    Platelet count decreased
    Additional description: Platelet count decreased
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    3
    Weight decreased
    Additional description: Weight decreased
         subjects affected / exposed
    11 / 45 (24.44%)
         occurrences all number
    53
    Injury, poisoning and procedural complications
    Fracture
    Additional description: Fracture
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Vascular access complication
    Additional description: Vascular access complication
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Cardiac disorders
    Sinus tachycardia
    Additional description: Sinus tachycardia
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    3
    Ventricular hypokinesia
    Additional description: Ventricular hypokinesia
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Nervous system disorders
    Amnesia
    Additional description: Amnesia
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    5
    Aphasia
    Additional description: Aphasia
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    2
    Dizziness
    Additional description: Dizziness
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    3
    Dysgeusia
    Additional description: Dysgeusia
         subjects affected / exposed
    7 / 45 (15.56%)
         occurrences all number
    37
    Encephalopathy
    Additional description: Encephalopathy
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    6
    Dysarthria
    Additional description: Dysarthria
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    2
    Headache
    Additional description: Headache
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences all number
    7
    Memory impairment
    Additional description: Memory impairment
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    8
    Myasthenia gravis
    Additional description: Myasthenia gravis
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    2
    Peripheral motor neuropathy
    Additional description: Peripheral motor neuropathy
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    5
    Paraesthesia
    Additional description: Paraesthesia
         subjects affected / exposed
    10 / 45 (22.22%)
         occurrences all number
    45
    Peripheral sensory neuropathy
    Additional description: Peripheral sensory neuropathy
         subjects affected / exposed
    14 / 45 (31.11%)
         occurrences all number
    55
    Pyramidal tract syndrome
    Additional description: Pyramidal tract syndrome
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    4
    Transient ischaemic attack
    Additional description: Transient ischaemic attack
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Tremor
    Additional description: Tremor
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Anaemia
    Additional description: Anaemia
         subjects affected / exposed
    25 / 45 (55.56%)
         occurrences all number
    115
    Febrile neutropenia
    Additional description: Febrile neutropenia
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Ear and labyrinth disorders
    Ear pain
    Additional description: Ear pain
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Vertigo
    Additional description: Vertigo
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    5
    Eye disorders
    Conjunctivitis
    Additional description: Conjunctivitis
         subjects affected / exposed
    9 / 45 (20.00%)
         occurrences all number
    41
    Dry eye
    Additional description: Dry eye
         subjects affected / exposed
    4 / 45 (8.89%)
         occurrences all number
    14
    Diplopia
    Additional description: Diplopia
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    4
    Lacrimation increased
    Additional description: Lacrimation increased
         subjects affected / exposed
    4 / 45 (8.89%)
         occurrences all number
    21
    Periorbital oedema
    Additional description: Periorbital oedema
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    5
    Gastrointestinal disorders
    Abdominal pain
    Additional description: Abdominal pain
         subjects affected / exposed
    5 / 45 (11.11%)
         occurrences all number
    13
    Abdominal distension
    Additional description: Abdominal distension
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    10
    Anal haemorrhage
    Additional description: Anal haemorrhage
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    9
    Aphthous ulcer
    Additional description: Aphthous ulcer
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Colitis
    Additional description: Colitis
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    2
    Constipation
    Additional description: Constipation
         subjects affected / exposed
    8 / 45 (17.78%)
         occurrences all number
    23
    Dry mouth
    Additional description: Dry mouth
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    2
    Diarrhoea
    Additional description: Diarrhoea
         subjects affected / exposed
    32 / 45 (71.11%)
         occurrences all number
    125
    Dysphagia
    Additional description: Dysphagia
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    5
    Haemorrhoids
    Additional description: Haemorrhoids
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences all number
    5
    Gastrooesophageal reflux disease
    Additional description: Gastrooesophageal reflux disease
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences all number
    14
    Gastrointestinal pain
    Additional description: Gastrointestinal pain
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    3
    Gastritis
    Additional description: Gastritis
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    3
    Nausea
    Additional description: Nausea
         subjects affected / exposed
    19 / 45 (42.22%)
         occurrences all number
    43
    Oral pain
    Additional description: Oral pain
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    2
    Rectal haemorrhage
    Additional description: Rectal haemorrhage
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Toothache
    Additional description: Toothache
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    2
    Stomatitis
    Additional description: Stomatitis
         subjects affected / exposed
    14 / 45 (31.11%)
         occurrences all number
    41
    Vomiting
    Additional description: Vomiting
         subjects affected / exposed
    11 / 45 (24.44%)
         occurrences all number
    20
    Hepatobiliary disorders
    Hepatic pain
    Additional description: Hepatic pain
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    4
    Skin and subcutaneous tissue disorders
    Alopecia
    Additional description: Alopecia
         subjects affected / exposed
    22 / 45 (48.89%)
         occurrences all number
    123
    Dry skin
    Additional description: Dry skin
         subjects affected / exposed
    7 / 45 (15.56%)
         occurrences all number
    17
    Dermatitis acneiform
    Additional description: Dermatitis acneiform
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences all number
    7
    Eczema
    Additional description: Eczema
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Erythema multiforme
    Additional description: Erythema multiforme
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences all number
    17
    Nail discolouration
    Additional description: Nail discolouration
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    13
    Nail disorder
    Additional description: Nail disorder
         subjects affected / exposed
    4 / 45 (8.89%)
         occurrences all number
    23
    Onychomadesis
    Additional description: Onychomadesis
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences all number
    16
    Onycholysis
    Additional description: Onycholysis
         subjects affected / exposed
    4 / 45 (8.89%)
         occurrences all number
    14
    Pain of skin
    Additional description: Pain of skin
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    3
    Palmar-plantar erythrodysaesthesia syndrome
    Additional description: Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    4 / 45 (8.89%)
         occurrences all number
    14
    Psoriasis
    Additional description: Psoriasis
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    5
    Pruritus
    Additional description: Pruritus
         subjects affected / exposed
    9 / 45 (20.00%)
         occurrences all number
    34
    Rash maculo-papular
    Additional description: Rash maculo-papular
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    16
    Rash
    Additional description: Rash
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    3
    Skin fissures
    Additional description: Skin fissures
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    10
    Skin reaction
    Additional description: Skin reaction
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Urticaria
    Additional description: Urticaria
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    2
    Renal and urinary disorders
    Acute kidney injury
    Additional description: Acute kidney injury
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    2
    Chronic kidney disease
    Additional description: Chronic kidney disease
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    10
    Cystitis noninfective
    Additional description: Cystitis noninfective
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    5
    Dysuria
    Additional description: Dysuria
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    2
    Proteinuria
    Additional description: Proteinuria
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    6
    Renal failure
    Additional description: Renal failure
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Urinary retention
    Additional description: Urinary retention
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    8
    Endocrine disorders
    Hyperparathyroidism
    Additional description: Hyperparathyroidism
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    6
    Hypothyroidism
    Additional description: Hypothyroidism
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    6
    Thyroiditis
    Additional description: Thyroiditis
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Arthritis
    Additional description: Arthritis
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    3
    Arthralgia
    Additional description: Arthralgia
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences all number
    20
    Back pain
    Additional description: Back pain
         subjects affected / exposed
    4 / 45 (8.89%)
         occurrences all number
    13
    Bone pain
    Additional description: Bone pain
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    9
    Muscle spasms
    Additional description: Muscle spasms
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    5
    Musculoskeletal chest pain
    Additional description: Musculoskeletal chest pain
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    9
    Myalgia
    Additional description: Myalgia
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences all number
    4
    Neck pain
    Additional description: Neck pain
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    5
    Pain in extremity
    Additional description: Pain in extremity
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    2
    Infections and infestations
    Bronchitis
    Additional description: Bronchitis
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    3
    Corona virus infection
    Additional description: Corona virus infection
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Conjunctivitis
    Additional description: Conjunctivitis
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Device related infection
    Additional description: Device related infection
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Fungal infection
    Additional description: Fungal infection
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Folliculitis
    Additional description: Folliculitis
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    3
    Herpes zoster
    Additional description: Herpes zoster
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Gastroenteritis
    Additional description: Gastroenteritis
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Nail infection
    Additional description: Nail infection
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences all number
    18
    Paronychia
    Additional description: Paronychia
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    3
    Pharyngitis
    Additional description: Pharyngitis
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Rhinitis
    Additional description: Rhinitis
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    5
    Rash pustular
    Additional description: Rash pustular
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences all number
    12
    Sinusitis
    Additional description: Sinusitis
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    2
    Skin infection
    Additional description: Skin infection
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    14
    Tooth infection
    Additional description: Tooth infection
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Urinary tract infection
    Additional description: Urinary tract infection
         subjects affected / exposed
    9 / 45 (20.00%)
         occurrences all number
    13
    Metabolism and nutrition disorders
    Decreased appetite
    Additional description: Decreased appetite
         subjects affected / exposed
    8 / 45 (17.78%)
         occurrences all number
    31
    Hypomagnesaemia
    Additional description: Hypomagnesaemia
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Hyponatraemia
    Additional description: Hyponatraemia
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences all number
    1
    Hypokalaemia
    Additional description: Hypokalaemia
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    3
    Hypoalbuminaemia
    Additional description: Hypoalbuminaemia
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    4
    Hypercalcaemia
    Additional description: Hypercalcaemia
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences all number
    7

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    05 Dec 2019
    A substantial modification was done in order to: - clarify main objective and update secondary objectives - clarify some inclusion criteria : possibilty to include patients with HER mutations not listed upon IFCT approval ; possibilty to include patients with history of haematological toxicity grade 2 if previous treatment with taxanes, delete the type of exam required for the evaluation of LVEF, update of criteria about contraception - add a maximum of 14 days between enrolment and start of treatment - clarify surveillance period after infusion of pertuzumab and trastuzumab including the repetition of the loading dose if the delay between 2 injections exceeds 6 weeks. - add the managment of toxicity in case LVEF <50%
    05 Aug 2020
    A substantial modification was done in order to: - change main objective, secondary objectives and exploratory objectives - delete the interim analysis - addition of a blood sample at progression and the possibility of rebiopsy at progression
    25 Jan 2021
    A substantial modification was done in order to: - homogenize study design according the sample size assumptions - correct the main objective according to the analysis of the primary endpoint - correct statistical section after the deletion of the interim analysis
    22 Dec 2021
    A substantial modification was done in order to increase the duration of the study.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/35073148
    For support, Contact us.
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