A Phase 3, Randomized, Open-Label, Two-Arm Study of Neratinib Plus Paclitaxel Versus Trastuzumab Plus Paclitaxel as First-Line Treatment for ErbB-2-Positive Locally Recurrent or Metastatic Breast Cancer
- Conditions
- ErbB2 Positive Locally Recurrent or Metastatic Breast CancerMedDRA version: 14.0 Level: LLT Classification code 10027475 Term: Metastatic breast cancer System Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
- Registration Number
- EUCTR2008-007803-10-BG
- Lead Sponsor
- Wyeth Pharmaceuticals Inc., acting through its division Wyeth research, a Pfizer company
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- Not specified
- Target Recruitment
- 479
1. Female subjects aged 18 years or older.
2. Subjects must have histologically and/or cytologically confirmed diagnosis of breast cancer.
3. Subjects must have locally recurrent or metastatic breast cancer that is not amenable to curative surgery and/or radiation.
4. Documentation of erbB-2 gene amplification by FISH (as defined by a ratio >2.2) or chromogenic in situ hybridization (CISH, as defined by the manufacturer’s kit instruction) or documentation of erbB-2-overexpression by IHC (defined as IHC3+, or IHC2+ with FISH or CISH confirmation) based on local laboratory or initial diagnostic results utilizing one of the sponsor-approved assays. If erbB-2 status is unavailable or was determined using a test other than a sponsor-approved assay (as defined in the protocol) and cannot be assessed using one of these assays prior to randomization, testing and study eligibility must be obtained from the sponsor-identified central laboratory prior to randomization.
5. All subjects must have tumor tissue available for central review of erbB-2 expression levels by FISH testing performed by the sponsor-identified central laboratory.
6. Documentation of ER/PgR status (positive or negative) based on local laboratory or initial diagnostic results must be available before study entry. If results are unavailable, tumor tissue may be sent to the sponsor-identified central vendor for assessment prior to study entry as per investigator’s discretion.
7. Subjects must have at least 1 measurable lesion as defined by Response Evaluation Criteria in Solid Tumors (RECIST) criteria (specifically, no ascites, pleural or pericardial effusions, osteoblastic bone metastases, or carcinomatous lymphangitis of the lung as only lesion).
8. Subjects must have Eastern Cooperative Oncology Group (ECOG) status of 0 to 2 (not declining within 2 weeks prior to the first dose of investigational product).
9. Subjects must have left ventricular ejection fraction (LVEF) within institutional range of normal as measured by multiple gated acquisition (MUGA) or echocardiogram (ECHO).
10. Screening laboratory values must be within the following parameters:
- Absolute neutrophil count (ANC) =1.5 x 109 /L (1500/mm3)
- Platelet count =100 x 109/L (100,000/mm3)
- Hemoglobin =9.0 g/dL (90 g/L)
- Serum creatinine =1.5 x upper limit of normal (ULN)
- Total bilirubin =1.5 x ULN (<3 ULN if Gilbert’s disease)
- Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT
=2.5 x ULN (=5 x ULN if liver metastases are present)
11. Subjects must have recovered (to grade 1 or baseline) from all clinically significant acute adverse effects of prior therapies (excluding alopecia).
12. All subjects who are not surgically sterile or postmenopausal must agree and commit to the use of a reliable method of birth control starting 2 weeks prior to the administration of the first dose of investigational product until 28 days after the last dose of investigational product. A woman of c
1. Prior systemic anti-cancer therapy (including cytotoxic chemotherapy, signal transduction inhibitors [eg, lapatinib], biologic [eg, trastuzumab]), or other investigational anticancer therapy) for locally recurrent or metastatic disease. Prior endocrine therapy in any setting is allowed.
2. Prior treatment with an erbB-2 inhibitor, other than trastuzumab, lapatinib, or the combination of the two in the neoadjuvant or adjuvant setting.
3. Prior treatment with neoadjuvant or adjuvant anthracyclines with a cumulative dose of doxorubicin of >400 mg/m2, epirubicin dose >800 mg/m2, or the equivalent dose for other anthracyclines or derivatives (eg, 72 mg/m2 of mitoxantrone).
4. Subjects with recurrence or progression of disease within 12 months after completion of adjuvant or neoadjuvant systemic anticancer therapy (including cytotoxic chemotherapy, signal transduction inhibitors [eg, lapatinib], biologic [eg, trastuzumab], or other investigational anticancer therapy), other than endocrine therapy, for early breast cancer.
5. Subjects with bone or skin as the only site of measurable disease. Subjects with skin lesions measurable by computed tomography (CT) scans or magnetic resonance imaging (MRI) as only site of measurable disease are allowed.
6. Major surgery, chemotherapy, radiotherapy, any investigational agents, or other cancer therapy within 2 weeks before the administration of the first dose of investigational product.
7. Subjects with active uncontrolled or symptomatic central nervous system (CNS) metastases, as indicated by clinical symptoms, cerebral edema, and/or progressive growth. Subjects with a history of CNS metastases or cord compression are eligible if they have been definitively treated and are off anticonvulsants and steroids for at least 4 weeks before first dose of investigational product.
8. Subjects with active uncontrolled cardiac disease, including cardiomyopathy, congestive heart failure (New York Heart Association functional classification of =3), unstable angina, and myocardial infarction (within 12 months of study entry).
9. Subjects with inadequately controlled hypertension (ie, systolic blood pressure [BP] > 180 mm Hg or diastolic BP > 100 mm Hg).
10. Subjects with family or personal history of congenital long or short QT syndrome, Brugada syndrome or QT/QTc interval > 0.45 second or known history of QT/QTc prolongation or torsade de pointe (TdP).
11. Subject with significant chronic gastrointestinal disorder with diarrhea as a major symptom (eg, Crohn’s disease, malabsorption, or grade =2 diarrhea of any etiology at baseline).
12. Subject with preexisting grade 2 or greater motor or sensory neuropathy.
13. Subjects with history of life-threatening hypersensitivity reaction to taxanes, trastuzumab or their excipients.
14. Subjects with clinical contraindication to steroids preventing their use as part of paclitaxel premedication.
15. Women who are pregnant, breast-feeding or women of child bearing potentia
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method