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A Study of Tucatinib vs. Placebo in Combination With Ado-trastuzumab Emtansine (T-DM1) for Patients With Advanced or Metastatic HER2+ Breast Cancer

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ClinicalTrials.gov Identifier: NCT03975647
Recruitment Status : Recruiting
First Posted : June 5, 2019
Last Update Posted : April 16, 2024
Sponsor:
Information provided by (Responsible Party):
Seagen Inc.

Study Description
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Brief Summary:

This study is being done to see if tucatinib with ado-trastuzumab emtansine (T-DM1) works better than T-DM1 alone to help patients who have a specific type of breast cancer called HER2 positive breast carcinoma. The breast cancer in this study is either metastatic (spread into other parts of the body) or cannot be removed completely with surgery.

Patients in this study will be randomly assigned to get either tucatinib or placebo (a pill with no medicine). This is a blinded study, so neither patients nor their doctors will know whether a patient gets tucatinib or placebo. All patients in the study will get T-DM1, a drug that is often used to treat this cancer.

Each treatment cycle lasts 21 days. Patients will swallow tucatinib pills or placebo pills two times every day. Patients will get T-DM1 injections from the study site staff on the first day of every cycle.


Condition or disease Intervention/treatment Phase
HER2-positive Breast Cancer Drug: tucatinib Drug: placebo Drug: T-DM1 Phase 3

Detailed Description:

This study is designed to evaluate the efficacy and safety of tucatinib in combination with T-DM1 in participants with unresectable locally-advanced or metastatic HER2+ breast cancer who have had prior treatment with a taxane and trastuzumab in any setting. Prior pertuzumab treatment is permitted, but not required. Participants will be randomized in a 1:1 manner to receive 21-day cycles of either tucatinib or placebo in combination with T-DM1.

While on study treatment, participants will be assessed for progression every 6 weeks for the first 24 weeks, and every 9 weeks thereafter, irrespective of dose holds or interruptions. Study treatment will continue until unacceptable toxicity, disease progression, withdrawal of consent, or study closure. After completion of study treatment and after occurrence of disease progression, participants in both arms of the study will continue to be followed for survival until study closure or withdrawal of consent.

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 565 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Randomized, Double-blind, Phase 3 Study of Tucatinib or Placebo in Combination With Ado-trastuzumab Emtansine (T-DM1) for Subjects With Unresectable Locally-advanced or Metastatic HER2+ Breast Cancer (HER2CLIMB-02)
Actual Study Start Date : October 2, 2019
Actual Primary Completion Date : June 29, 2023
Estimated Study Completion Date : October 31, 2027

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Breast Cancer

Arms and Interventions
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Arm Intervention/treatment
Experimental: Tucatinib + T-DM1
Tucatinib + T-DM1
 Drug: tucatinib
300mg given twice per day by mouth (orally)
Other Name: ONT-380

Drug: T-DM1
3.6 mg/kg given into the vein (IV; intravenously) every 21 days
Other Name: Kadcyla
Active Comparator: Placebo + T-DM1
Placebo + T-DM1
 Drug: placebo
Given twice per day orally

Drug: T-DM1
3.6 mg/kg given into the vein (IV; intravenously) every 21 days
Other Name: Kadcyla


Outcome Measures
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Primary Outcome Measures :
  1. Progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 by investigator assessment [ Time Frame: Up to approximately 5 years ]
    PFS per investigator is defined as the time from the date of randomization to the investigator assessment of disease progression according to RECIST v1.1 or death from any cause, whichever occurs first.


Secondary Outcome Measures :
  1. Overall Survival [ Time Frame: Up to approximately 5 years ]
    OS is defined as the time from randomization to death due to any cause.

  2. PFS per RECIST v1.1 by blinded independent committee review (BICR) [ Time Frame: Up to approximately 5 years ]
    PFS per BICR is defined as the time from the date of randomization to the centrally-reviewed documented disease progression according to RECIST v1.1 or death from any cause, whichever occurs first.

  3. PFS per RECIST v1.1 by investigator assessment in participants with brain metastases at baseline (PFS.BM per investigator) [ Time Frame: Up to approximately 5 years ]
    PFS.BM is defined as the time from the date of randomization in participants with brain metastases at baseline to the investigator assessment of disease progression according to RECIST v1.1 or death from any cause, whichever occurs first.

  4. PFS.BM per RECIST v1.1 by BICR [ Time Frame: Up to approximately 5 years ]
  5. Objective response rate (ORR) per RECIST v1.1 by investigator assessment [ Time Frame: Up to approximately 3 years ]
    ORR is defined as the proportion of participants with complete response (CR) or partial response (PR) according to RECIST v1.1.

  6. ORR per RECIST v1.1 by BICR [ Time Frame: Up to approximately 3 years ]
  7. Overall survival in participants with brain metastases at baseline (OS.BM) [ Time Frame: Up to approximately 5 years ]
    OS.BM is defined as the time from randomization to death due to any cause in participants with brain metastases at baseline.

  8. Duration of response (DOR) per RECIST v1.1 by investigator assessment [ Time Frame: Up to approximately 5 years ]
    DOR is defined as the time from first documentation of objective response (CR or PR that is subsequently confirmed) to the first documentation of disease progression or death from any cause, whichever occurs earlier.

  9. DOR per RECIST v1.1 by BICR [ Time Frame: Up to approximately 5 years ]
  10. Clinical benefit rate (CBR) per RECIST v1.1 by investigator assessment [ Time Frame: Up to approximately 3 years ]
    CBR is defined as the proportion of participants with stable disease (SD) or non-CR or non-PD for ≥6 months or best response of CR or PR according to RECIST v1.1.

  11. CBR per RECIST v1.1 by BICR [ Time Frame: Up to approximately 3 years ]
  12. Number of participants with adverse events (AEs) [ Time Frame: Through 1 month following last dose; up to approximately 9 months overall per participant ]
    An AE is any untoward medical occurrence in a subject or clinical investigational subject administered a medicinal product and which does not necessarily have a causal relationship with this treatment.


Eligibility Criteria
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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

  • Inclusion Criteria:

    • Histologically confirmed HER2+ breast carcinoma as determined by a sponsor-designated central laboratory
    • History of prior treatment with a taxane and trastuzumab in any setting, separately or in combination
    • Have progression of unresectable locally advanced/metastatic breast cancer after last systemic therapy, or be intolerant of last systemic therapy
    • Measurable or non-measurable disease assessable by RECIST v1.1
    • ECOG performance status score of 0 or 1

    • CNS Inclusion - Based on screening contrast brain magnetic resonance imaging (MRI), participants must have at least one of the following:

      (a) No evidence of brain metastases

      (b) Untreated brain metastases not needing immediate local therapy

      (c) Previously treated brain metastases

      1. Brain metastases previously treated with local therapy may either be stable since treatment or may have progressed since prior local CNS therapy, provided that there is no clinical indication for immediate re-treatment with local therapy

      2. Participants treated with CNS local therapy for newly identified lesions or previously treated and progressing lesions may be eligible to enroll if all of the following criteria are met:

        (i) Time since SRS is at least 7 days prior to first dose of study treatment, time since WBRT is at least 14 days prior to first dose, or time since surgical resection is at least 28 days.

        (ii) Other sites of evaluable disease are present

      3. Relevant records of any CNS treatment must be available to allow for classification of target and non-target lesions

  • Exclusion Criteria:

    • Prior treatment with tucatinib, afatinib, trastuzumab deruxtecan (DS-8201a), or any other investigational anti-HER2, anti-EGFR, or HER2 TKI agent. Prior treatment with lapatinib or neratinib within 12 months of starting study treatment (except in cases where they were given for ≤21 days and was discontinued for reasons other than disease progression or severe toxicity). Prior treatment with pyrotinib for recurrent of mBC (except in cases where pyrotinib was given for ≤21 days and was discontinued for reasons other than disease progression or severe toxicity).

    • CNS Exclusion - Based on screening contrast brain magnetic resonance imaging (MRI), participants must not have any of the following:

      1. Any untreated brain lesions >2 cm in size
      2. Ongoing use of corticosteroids for control of symptoms of brain metastases at a total daily dose of >2 mg of dexamethasone (or equivalent).
      3. Any brain lesion thought to require immediate local therapy
      4. Known or concurrent leptomeningeal disease as documented by the investigator
      5. Poorly controlled generalized or complex partial seizures
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03975647


Contacts
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Contact: Seagen Trial Information Support 866-333-7436 clinicaltrials@seagen.com

Locations
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Sponsors and Collaborators
Seagen Inc.
Investigators
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Study Director: Kit Wong, MD Seagen Inc.
More Information
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Responsible Party: Seagen Inc.
ClinicalTrials.gov Identifier: NCT03975647    
Other Study ID Numbers: SGNTUC-016
First Posted: June 5, 2019    Key Record Dates
Last Update Posted: April 16, 2024
Last Verified: April 2024

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Seagen Inc.:
Seattle Genetics
Additional relevant MeSH terms:
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Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
 Tucatinib
Antineoplastic Agents
Molecular Mechanisms of Pharmacological Action
Protein Kinase Inhibitors
Enzyme Inhibitors