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Rand, double blind, Ph3 of tucatinib placebo in combo with T-DM1 for HER2+ bc

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)

  • Clinical Trial Information

    Trial Contact: Jarquin-Castillo, Katherine ; Jobson, Gillian S; Durand, Jennifer

  • IRB No: WIRB20193074

    Protocol Abbrev: TRIO SGNTUC-016

    Principal Investigator: Ana Elisa Cuesta Fernandez, MD

    Phase: Drug: Phase III

    Age Group: Adult

    Secondary Protocol No: SGNTUC -016

    Treatment: Tucatinibor/placebo in combination with T-DM1

    Therapies Involved: Medication

    ClinicalTrials.gov ID: NCT03975647

  • Objective

    This study is designed to evaluate the efficacy and safety of tucatinib in combination with T-DM1 in subjects with unresectable locally-advanced or metastatic HER2+ breast cancer who have had prior treatment with a taxane and trastuzumab in any setting.

  • Key Eligibility

    •  Inclusion Criteria:
    ◦Histologically confirmed HER2+ metastatic 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 LA/M breast cancer after last systemic therapy, or be intolerant of last systemic therapy
    ◦Measurable or non-measurable disease assessable by RECIST v1.1
    ◦Hormone receptor (estrogen receptor/progesterone receptor) status must be known prior to randomization
    ◦ECOG performance status score of 0 or 1
    ◦Life expectancy ≥6 months

    ◦CNS Inclusion - Based on screening contrast brain magnetic resonance imaging (MRI), subjects 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.Subjects treated with CNS local therapy for newly identified 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 21 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, neratinib, afatinib, trastuzumab deruxtecan (DS-8201a), or any other investigational anti-HER2, anti-EGFR, or HER2 TKI agent. Prior treatment with 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 severe toxicity).
    ◦Prior treatment with T-DM1
    ◦Treatment with any systemic anti-cancer therapy (including hormonal therapy), non-CNS radiation, experimental agent or participation in another interventional clinical trial ≤3 weeks prior to first dose of study treatment

    ◦Any toxicity related to prior cancer therapies that has not resolved to ≤ Grade 1, with the following exceptions:
    1.Alopecia;
    2.Neuropathy, which must have resolved to ≤ Grade 2;
    3.Congestive heart failure (CHF), which must have been ≤ Grade 1 in severity at the time of occurrence, and must have resolved completely

    ◦Clinically significant cardiopulmonary disease
    ◦Myocardial infarction or unstable angina within 6 months prior to first dose of study treatment
    ◦Carrier of Hepatitis A or Hepatitis C or has other known chronic liver disease
    ◦Positive for human immunodeficiency virus (HIV)
    ◦Subjects who are pregnant, breastfeeding, or planning to become pregnant from time of informed consent until 7 months following the last dose of study drug
    ◦Unable to swallow pills or has significant gastrointestinal disease which would preclude the adequate oral absorption of medications
    ◦Use of a strong CYP3A4 or CYP2C8 inhibitor within 2 weeks, or use of a strong CYP3A4 or CYP2C8 inducer within 5 days prior to the first dose of study treatment

    ◦CNS Exclusion - Based on screening contrast brain magnetic resonance imaging (MRI), subjects 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