E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Triple Negative Breast Cancer |
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E.1.1.1 | Medical condition in easily understood language |
Triple Negative Breast Cancer |
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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 | 10075566 |
E.1.2 | Term | Triple negative 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 evaluate clinical efficacy of bintrafusp alfa in participants with TNBC with high HMGA2 expression, based on ORR |
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E.2.2 | Secondary objectives of the trial |
To evaluate clinical efficacy of bintrafusp alfa based on DOR
To evaluate clinical efficacy of bintrafusp alfa based on DRR
To evaluate clinical efficacy based on PFS
To evaluate ORR, DOR, DRR, and PFS by Investigator read
To evaluate clinical efficacy based on OS
To evaluate clinical safety of bintrafusp alfa
To characterize the PK profile of bintrafusp alfa
To characterize the immunogenicity of bintrafusp alfa |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Study participants are ≥ 18 years of age at the time of signing the informed consent.
2. Study participants have histologically or cytologically confirmed TNBC.
• Absence of HER2, estrogen receptor, and progesterone receptor expression must be documented (criteria for defining TNBC are outlined in the protocol).
• Participants must have received at least one line of systemic therapy for metastatic disease and have progressed on the line of therapy immediately prior to study entry. There is no limit to the number of prior therapies.
• Participants may prescreen for HMGA2 expression while on preceding treatment, however screening should only occur if in the opinion of the Investigator, the participant would likely be eligible for study within 6 months.
3. Participants must have measurable disease.
4. Availability of either archival tumor tissue or fresh core or excisional biopsy of a tumor lesion (primary or metastatic, excluding bone biopsies) is mandatory to determine HMGA2 expression level prior to enrollment.
5. HMGA2 high tumor expression is required and will be determined by a central lab.
6. Participants who have Eastern Cooperative Oncology Group (ECOG) PS of 0 to 1.
7. Participants have a life expectancy ≥ 12 weeks as judged by the Investigator at study start.
8. Participants have adequate hematological, hepatic and renal and coagulation function as defined in the protocol.
9. Participants with known HIV infections are in general eligible if the criteria as defined in the protocol are met (FDA Guidance on Cancer Clinical Trial Eligibility, March 2019).
10. Participants with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infections are in general eligible if the criteria as defined in the protocol are met (FDA Guidance on Cancer Clinical Trial Eligibility, March 2019).
Other protocol defined inclusion criteria could apply. |
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E.4 | Principal exclusion criteria |
1. Participants with active central nervous system (CNS) metastases causing clinical symptoms or metastases that require therapeutic intervention are excluded. Participants with a history of treated CNS metastases (by surgery or radiation therapy) are not eligible unless they have fully recovered from treatment, demonstrated no progression for at least 4 weeks, and are not using steroids for at least 7 days prior to the start of study intervention.
2. Participants with interstitial lung disease or has had a history of pneumonitis that has required oral or intravenous (IV) steroids
3. Participants must not have received prior cancer treatment with any other immunotherapy or checkpoint inhibitors, or any other immune-modulating monoclonal antibody.
4. Participants that received any organ transplantation, including stem-cell transplantation, but with the exception of transplants that do not require immunosuppression.
5. Participants with significant acute or chronic infections.
6. Participants with active autoimmune disease that might deteriorate when receiving an immunostimulatory agent.
7. Participants with clinically significant cardiovascular/cerebrovascular disease including: cerebral vascular accident/stroke, myocardial infarction, unstable angina, congestive heart failure, or serious cardiac arrhythmia.
Other protocol defined exclusion criteria could apply. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Confirmed objective response according to RECIST 1.1 assessed by an IRC |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
from first administration of study intervention up to study end |
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E.5.2 | Secondary end point(s) |
1.DOR according to RECIST 1.1 assessed by an IRC
2.Durable response of at least 6 months assessed by an IRC
3.PFS according to RECIST 1.1 assessed by an IRC
4.Objective response, DOR, DRR, and PFS according to RECIST 1.1 as assessed by the Investigator
5.OS
6.Occurrence of TEAEs and treatment-related AEs including AEs of special interest
7.PK (pharmacokinetic) parameters for bintrafusp alfa
8.Immunogenicity of bintrafusp alfa as measured by ADA assay |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1-2-3-4.from first documentation of objective response to the date of first documentation of objective PD or death due to any cause
5.from first administration of study intervention to the date of death due to any cause
6.from first dose to final assessment up to approximately 2 years
7.From first assessment up to 28 days after last treatment
8.Time from first administration of treatment intervention to planned final assessment at approximately 2 years. |
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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 | 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) | 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 | 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.8.2.4 | Number of treatment arms in the trial | 1 |
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 | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 30 |
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 |
Russian Federation |
United States |
Belgium |
France |
Italy |
Spain |
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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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The end of the study is defined as the date of completion of 24 months of follow-up after the accrual of the last participant. After the stipulated end of study, Survival Follow-up may continue until the last participant has died or at the discretion of the Sponsor. |
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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 | 1 |
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 | 6 |