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The Efficacy and Safety of BAT8001 Injection for the Treatment of HER2-positive Advanced Breast Cancer

Phase 3
Conditions
HER2-positive Advanced Breast Cancer
Interventions
Biological: BAT8001 for injection
Registration Number
NCT04185649
Lead Sponsor
Bio-Thera Solutions
Brief Summary

To evaluate the safety and efficacy of BAT8001 for the treatment of HER2-positive advanced breast cancer, using lapatinib in combination with capecitabine as the positive control drug.

Detailed Description

This is a multicenter, randomized, open-label, positive-controlled, superiority phase III clinical study. The object is to evaluate the safety and efficacy of BAT8001 for the treatment of HER2-positive advanced breast cancer, using lapatinib in combination with capecitabine as the positive control drug.

Eligible subjects will be randomized to the experimental or control group in a 1:1 ratio and stratified by the number of HER2-positive advanced/metastatic breast cancer treatment regimens (0, 1 VS \> 1) and lesion site (organ VS non-organ).

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
410
Inclusion Criteria
  1. Patients are required to provide at least 10 unstained sections.
  2. HER2-positive (defined as: IHC 3+ or FISH+) confirmed by the central laboratory of this study.
  3. Histologically and/or cytologically confirmed invasive breast cancer, including unresectable locally advanced breast cancer (LABC) or metastatic breast cancer (MBC).
  4. LABC or MBC that has progressed during or after treatment, or during or within 12 month following adjuvant therapy as confirmed by imaging.
  5. Previously received adjuvant therapy, or locally advanced/metastatic breast cancer treatment regimen that included taxanes and trastuzumab (including approved biosimilars) as monotherapy or combination therapy。
  6. At least one measurable lesion or a single metastatic tumor in the bone as per the Response Evaluation Criteria in Solid Tumor (RECIST) 1.1.
  7. A score of 0-1 for performance status as per the Eastern Cooperative Oncology Group (ECOG) scale.
  8. Expected survival ≥ 3 months.
  9. Left ventricular ejection fraction (LVEF) ≥ 50%.
  10. If anthracyclines are used, the cumulative dose must meet the following criteria: the cumulative dose must not exceed the equivalent dose of doxorubicin 500 mg/m2.
  11. Women of childbearing age or fertile male subjects must agree to use oral, implanted, or injectable hormone contraceptives as well as one or two forms of non-hormonal contraceptive measures during the study period and until 6 months after the end of the study.
  12. Blood pregnancy test must indicate non-pregnant for all women of childbearing potential and those who do not meet the definition of postmenopause.
Exclusion Criteria
  1. Current presence of grade ≥ 2 peripheral neuropathy.
  2. History of other malignant tumors within the past 5 years, but does not include properly treated cervical carcinoma in situ, non-melanoma skin cancer, stage 1 uterine cancer, or other tumors with good prognosis.
  3. Received treatment with a cancer drug or investigational drug within 21 days from the first dose of the study drug, except for hormone therapy..
  4. Received radiation therapy within 14 days prior to the first test drug administration of this study; or subject has not recovered from the acute toxicity of radiation therapy prior to the first test drug administration of this study.
  5. Brain metastasis that is symptomatic or requires treatment to control symptoms within 30 days before randomization.
  6. Subjects who must receive the first test drug administration within less than 14 days following the completion of radiation therapy for symptomatic brain metastasis.
  7. Currently experiences moderate or severe dyspnea at rest caused by advanced malignancy or other complications or severe primary lung diseases, or currently requires continuous oxygen therapy, or subject currently suffers from interstitial lung disease (ILD) or pneumonia/pneumonitis.
  8. History of myocardial infarction or unstable angina within 6 months prior to first test drug administration.
  9. Previous history of LVEF falling below 40%; or presence of symptomatic congestive heart failure (CHF) during trastuzumab (including other analogues) treatment.
  10. Symptomatic congestive heart failure (CHF; New York Heart Association [NYHA] Class II-IV); Severe arrhythmias requiring treatment.
  11. Presence of severe and uncontrollable systemic diseases (e.g. clinically significant cardiovascular, lung or metabolic diseases).
  12. Patients who currently require coumarin derivative-based anticoagulation therapy such as warfarin and phenprocoumon.
  13. Presence of diseases that may affect intestinal absorption, including malabsorption syndrome, stomach and small bowel resection, and ulcerative colitis.
  14. Intolerance (grade 3-4 infusion reactions) or allergy to trastuzumab (and other analogues) or mouse proteins or any ingredient of the medication.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
BAT8001 for injectionBAT8001 for injectionParticipants with HER2-positive, unresectable LABC or MBC who have experienced disease progression after treatment with trastuzumab and a taxane will be treated with trastuzumab emtansine. Participants may continue to receive study treatment until disease progression (as assessed by the investigator), unmanageable toxicity, or study termination by the Sponsor.
Control (lapatinib + capecitabine)LapatinibParticipants with HER2-positive, unresectable LABC or MBC who have experienced disease progression after treatment with trastuzumab and a taxane will be treated with lapatinib plus capecitabine. Participants may continue to receive study treatment until disease progression (as assessed by the investigator), unmanageable toxicity, or study termination by the Sponsor.
Control (lapatinib + capecitabine)CapecitabineParticipants with HER2-positive, unresectable LABC or MBC who have experienced disease progression after treatment with trastuzumab and a taxane will be treated with lapatinib plus capecitabine. Participants may continue to receive study treatment until disease progression (as assessed by the investigator), unmanageable toxicity, or study termination by the Sponsor.
Primary Outcome Measures
NameTimeMethod
Progression-free survival (PFS)Up to approximately 18 months

PFS is defined as the time from randomization to the first occurrence of disease progression as determined by the investigator using Response Evaluation Criteria in Solid Tumors (RECIST) Version (v1.1), or death from any cause during the study, whichever occurs first.

Secondary Outcome Measures
NameTimeMethod
Objective Response Rate (ORR)Up to approximately 30 months

ORR is defined as percentage of participants with partial response (PR) or complete response (CR) determined on the basis of investigator assessments with the use of RECIST v1.1.

Overall Survival (OS)Up to approximately 30 months

OS is defined as the time from the date of randomization to the date of death from any cause.

Duration of Response (DOR)Up to approximately 30 months

DOR is defined as as the time from the date of initial confirmed PR or CR to the date of disease progression or death within the study.

Clinical Benefit Rate (CBR)Up to approximately 30 months

CBR is defined as the proportion of subjects with best overall response (confirmed PR or CR) or with stable disease (confirmed SD) for at least 6 months;

Serum Concentration of BAT8001Pre-dose and 15-30 minutes after dose on Day 1, Day 8, Day 15 of each 21-day cycle during Cycles 1-4 and at completion/early termination visit (up to approximately 30 months)

Concentration of BAT8001 will be measured in serum from participants, who received BAT8001.

Serum Concentration of total antibody of BAT8001 for injectionPre-dose and 15-30 minutes after dose on Day 1, Day 8, Day 15 of each 21-day cycle during Cycles 1-4 and at completion/early termination visit (up to approximately 30 months)

Concentration of total antibody will be measured in serum from participants, who received BAT8001.

Plasma Concentration of batansine (a maytansine derivative, which is the 3AA-MDC complex)Pre-dose and 15-30 minutes after dose on Day 1, Day 8, Day 15 of each 21-day cycle during Cycles 1-4 and at completion/early termination visit (up to approximately 30 months)

Concentration of batansine will be measured in plasma from participants, who received BAT8001.

Percentage of Participants with Anti-therapeutic Antibodies (ATA) to BAT8001Pre-dose on Day 1 of each 21-day cycle during Cycles 1-4 and at completion/early termination visit (up to approximately 30 months)

ATA to BAT8001 were measured in serum of participants, who received BAT8001.

Trial Locations

Locations (51)

Beijing Shijitan Hospital

🇨🇳

Beijing, Beijing, China

The First Affiliated Hospital of Bengbu Medical College

🇨🇳

Bengbu, Anhui, China

Anhui Provincial Hospital

🇨🇳

Hefei, Anhui, China

Chinese PLA General Hospital

🇨🇳

Peking, Beijing, China

The First Affiliated Hospital of Xiamen University

🇨🇳

Xiamen, Fujian, China

Foshan City No. 1 People's Hospital

🇨🇳

Foshan, Guangdong, China

Cancer Center of Guangzhou Medical University

🇨🇳

Guangzhou, Guangdong, China

Beijing Hospital

🇨🇳

Beijing, Beijing, China

Sun Yat-sen Memorial Hospital. SYSU

🇨🇳

Guangzhou, Guangdong, China

The First Affiliated Hospital of Hainan Medical College

🇨🇳

Haikou, Hainan, China

Peking union medical college hospital

🇨🇳

Beijing, Beijing, China

Chongqing Cancer Hospital

🇨🇳

Chongqing, Chongqing, China

Sun Yat-sen University Cancer Center

🇨🇳

Guangzhou, Guangdong, China

Peking University Shenzhen Hospital

🇨🇳

Shenzhen, Guangdong, China

Shenzhen People's Hospital

🇨🇳

Shenzhen, Guangdong, China

The First Affiliated Hospital of Guangdong Medical University

🇨🇳

Zhanjiang, Guangdong, China

The Fifth Affiliated Hospital Sun Yat-sen University

🇨🇳

Zhuhai, Guangdong, China

The First Affiliated Hospital of Henan University of science and technology

🇨🇳

Luoyang, Henan, China

The First Affiliated Hospital of Xixiang Medical College

🇨🇳

Xinxiang, Henan, China

Liuzhou workers hospital

🇨🇳

Liuzhou, Guangxi, China

Harbin Medical University Cancer Hospital

🇨🇳

Harbin, Heilongjiang, China

Hubei Cancer Hospital

🇨🇳

Wuhan, Hubei, China

Tongji Hospital of Tongji Medical College of HUST

🇨🇳

Wuhan, Hubei, China

Yichang Central Hospital

🇨🇳

Yichang, Hubei, China

Zhongnan Hospital of Wuhan University

🇨🇳

Wuhan, Hubei, China

Hunan Cancer Hospital

🇨🇳

Changsha, Hunan, China

Xiangya Hospital Central South University

🇨🇳

Changsha, Hunan, China

Yancheng City No. 1 People's Hospital

🇨🇳

Yancheng, Jiangsu, China

Jiangxi Cancer Hospital

🇨🇳

Nanchang, Jiangxi, China

Jilin Cancer Hospital

🇨🇳

Chang chun, Jilin, China

The First Bethune Hospital of Jilin University

🇨🇳

Changchun, Jilin, China

Jinzhou Central Hospital

🇨🇳

Jinzhou, Liaoning, China

Shandong Cancer Hospital

🇨🇳

Jinan, Shandong, China

Linyi Cancer Hospital

🇨🇳

Linyi, Shandong, China

Weifang People's Hospital

🇨🇳

Weifang, Shandong, China

Liaoning Cancer Hospital

🇨🇳

Shenyang, Liaoning, China

General Hospital of Ningxia Medical University

🇨🇳

Yinchuan, Ningxia, China

Shanxi Cancer Hospital

🇨🇳

Xi'an, Shanxi, China

Shanghai General Hospital

🇨🇳

Shanghai, Shanghai, China

Shanghai Sixth People's Hospital

🇨🇳

Shanghai, Shanghai, China

The Second Hospital of Anhui Medical University

🇨🇳

Shanghai, Shanghai, China

Zhejiang Cancer Hospital

🇨🇳

Hangzhou, Zhejiang, China

Taizhou Hispotal of Zhejiang Province

🇨🇳

Taizhou, Zhejiang, China

Jiangsu Cancer Hospital

🇨🇳

Nanning, Jiangsu, China

Affiliated Hospital of Jiangnan University

🇨🇳

Wuxi, Jiangsu, China

The Third Hospital of Nanchang

🇨🇳

Nanchang, Jiangxi, China

Fudan University Shanghai Cancer Hospital

🇨🇳

Shanghai, Shanghai, China

The First Affiliated Hospital of Xi'an Jiaotong University

🇨🇳

Xi'an, Shanxi, China

Yunnan Cancer Hospital

🇨🇳

Kunming, Yunnan, China

West China Hospital of Sichuan University

🇨🇳

Chengdu, Sichuan, China

The Second Affiliated Hospital of Zhejiang University School of Medicine

🇨🇳

Hangzhou, Zhejiang, China

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