Moffitt Cancer Center: Clinical Trial 19340

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Clinical Trial 19340

Cancer Type:
Interventions:Herceptin (Trastuzumab); Not Applicable; Placebo; Trastuzumab; Tucatinib; Xeloda (capecitabine); capecitabine; rhuMAb HER2 (Trastuzumab)

Study Type: Treatment
Phase of Study: Phase II
Investigators:

Hatem Soliman

Overview

Study Title

Phase 2 Randomized, Double-Blinded, Controlled Study of Tucatinib vs. Placebo in Combination with Capecitabine and Trastuzumab in Patients with Pretreated Unresectable Locally Advanced or Metastatic HER2+ Breast Carcinoma (HER2CLIMB)

Summary

The purpose of this study is to assess the effect of tucatinib vs. placebo in combination with capecitabine and trastuzumab on progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 based on independent central radiology review.

Objective

Primary Objective: To assess the effect of tucatinib vs. placebo in combination with capecitabine and trastuzumab on progression-free survival (PFS) per RECIST 1.1 based on independent central review

Inclusion Criteria

Histologically confirmed HER2+ breast carcinoma, with HER2+ defined by in situ hybridization (ISH) or fluorescence in situ hybridization (FISH) methodology

Received previous treatment with trastuzumab, pertuzumab, and T-DM1

Progression of unresectable locally advanced or metastatic breast cancer after last systemic therapy (as confirmed by investigator), or be intolerant of last systemic therapy

Have measurable or non-measurable disease assessable by RECIST 1.1

At least 18 years of age at time of consent

Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0 or 1

Adequate hepatic and renal function

Left ventricular ejection fraction (LVEF) ≥ 50%

Central nervous system (CNS) Inclusion - Based on screening brain magnetic resonance imaging (MRI), patients must have one of the following: No evidence of brain metastases; Untreated brain metastases not needing immediate local therapy; Previously treated brain metastases not needing immediate local therapy: 1.) Brain metastases previously treated with local therapy may either be stable since treatment or may have progressed since prior local CNS therapy 2.) Patients treated with CNS local therapy for newly identified lesions found on contrast brain MRI performed during screening for this study may be eligible to enroll if the following criteria are met: a.) Time since whole brain radiation therapy (WBRT) is ≥ 21 days prior to first dose of study treatment, time since stereotactic radiosurgery (SRS) is ≥ 7 days prior to first dose of study treatment, or time since surgical resection is ≥ 28 days. B.) Other sites of evaluable disease are present

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

Exclusion Criteria

Previously been treated with: 1.) lapatinib within 12 months of starting study treatment (except in cases where lapatinib was given for ≤ 21 days and was discontinued for reasons other than disease progression or toxicity); 2.) neratinib, afatinib, or other investigational HER2/epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) at any time previously; 3.) previously been treated with capecitabine for metastatic disease except in cases where capecitabine was given for > Clinically significant cardiopulmonary disease

Carriers of Hepatitis B or Hepatitis C or have other known chronic liver disease

Positive for human immunodeficiency virus (HIV)

Unable for any reason to undergo MRI of the brain

Central nervous system (CNS) Exclusion - Based on screening brain MRI, patients must not have any of the following:

Any untreated brain lesions > 2.0 cm in size, unless discussed with medical monitor

Ongoing use of systemic corticosteroids for control of symptoms of brain metastases at a total daily dose of > 2 mg of dexamethasone (or equivalent)

Any brain lesion thought to require immediate local therapy. Patients who undergo local treatment for such lesions identified by screening contrast brain MRI may still be eligible for the study based on criteria described under CNS inclusion criteria

Known or concurrent leptomeningeal disease (LMD)

Poorly controlled seizures