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A Study Comparing the Efficacy and Safety of Zanidatamab to Trastuzumab, Each in Combination With Physician's Choice Chemotherapy, for the Treatment of Participants With Metastatic HER2-positive Breast Cancer

Phase 3
Recruiting
Conditions
Metastatic HER2-positive Breast Cancer
Interventions
Registration Number
NCT06435429
Lead Sponsor
Jazz Pharmaceuticals
Brief Summary

The efficacy and safety of zanidatamab in combination with physician's choice of chemotherapy compared with trastuzumab in combination with physician's choice of chemotherapy will be evaluated for the treatment of participants with metastatic HER2-positive breast cancer who have progressed on, or are intolerant to, previous T-DXd treatment.

Detailed Description

Zanidatamab, as a monotherapy or in combination with other antineoplastic agents, has shown clinically meaningful efficacy against multiple HER2-positive advanced/metastatic tumors, including in patients with metastatic breast cancer (mBC). Zanidatamab may offer a viable treatment option for patients with metastatic HER2-positive breast cancer.

The primary objective of the study is to compare the efficacy of zanidatamab plus chemotherapy versus trastuzumab plus chemotherapy. The secondary objectives of the study will include further comparing the efficacy, safety and tolerability, patient-reported tolerability, and patient-reported physical functioning of zanidatamab plus chemotherapy versus trastuzumab plus chemotherapy. The pharmacokinetics and immunogenicity of zanidatamab in combination with chemotherapy will also be evaluated.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
550
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Trastuzumab plus physician's choice of chemotherapyTrastuzumabParticipants with HER2-positive metastatic breast cancer (mBC) who have progressed on, or are intolerant to, previous T-DXd treatment will be randomized to receive intravenous infusion of trastuzumab plus physician's choice of chemotherapy (eribulin, or gemcitabine, or vinorelbine, or capecitabine).
Trastuzumab plus physician's choice of chemotherapyEribulinParticipants with HER2-positive metastatic breast cancer (mBC) who have progressed on, or are intolerant to, previous T-DXd treatment will be randomized to receive intravenous infusion of trastuzumab plus physician's choice of chemotherapy (eribulin, or gemcitabine, or vinorelbine, or capecitabine).
Zanidatamab plus physician's choice of chemotherapyEribulinParticipants with HER2-positive metastatic breast cancer (mBC) who have progressed on, or are intolerant to, previous T-DXd treatment will be randomized to receive intravenous infusion of zanidatamab plus physician's choice of chemotherapy (eribulin, or vinorelbine, or gemcitabine, or capecitabine).
Zanidatamab plus physician's choice of chemotherapyCapecitabineParticipants with HER2-positive metastatic breast cancer (mBC) who have progressed on, or are intolerant to, previous T-DXd treatment will be randomized to receive intravenous infusion of zanidatamab plus physician's choice of chemotherapy (eribulin, or vinorelbine, or gemcitabine, or capecitabine).
Trastuzumab plus physician's choice of chemotherapyVinorelbineParticipants with HER2-positive metastatic breast cancer (mBC) who have progressed on, or are intolerant to, previous T-DXd treatment will be randomized to receive intravenous infusion of trastuzumab plus physician's choice of chemotherapy (eribulin, or gemcitabine, or vinorelbine, or capecitabine).
Trastuzumab plus physician's choice of chemotherapyGemcitabineParticipants with HER2-positive metastatic breast cancer (mBC) who have progressed on, or are intolerant to, previous T-DXd treatment will be randomized to receive intravenous infusion of trastuzumab plus physician's choice of chemotherapy (eribulin, or gemcitabine, or vinorelbine, or capecitabine).
Trastuzumab plus physician's choice of chemotherapyCapecitabineParticipants with HER2-positive metastatic breast cancer (mBC) who have progressed on, or are intolerant to, previous T-DXd treatment will be randomized to receive intravenous infusion of trastuzumab plus physician's choice of chemotherapy (eribulin, or gemcitabine, or vinorelbine, or capecitabine).
Zanidatamab plus physician's choice of chemotherapyZanidatamabParticipants with HER2-positive metastatic breast cancer (mBC) who have progressed on, or are intolerant to, previous T-DXd treatment will be randomized to receive intravenous infusion of zanidatamab plus physician's choice of chemotherapy (eribulin, or vinorelbine, or gemcitabine, or capecitabine).
Zanidatamab plus physician's choice of chemotherapyVinorelbineParticipants with HER2-positive metastatic breast cancer (mBC) who have progressed on, or are intolerant to, previous T-DXd treatment will be randomized to receive intravenous infusion of zanidatamab plus physician's choice of chemotherapy (eribulin, or vinorelbine, or gemcitabine, or capecitabine).
Zanidatamab plus physician's choice of chemotherapyGemcitabineParticipants with HER2-positive metastatic breast cancer (mBC) who have progressed on, or are intolerant to, previous T-DXd treatment will be randomized to receive intravenous infusion of zanidatamab plus physician's choice of chemotherapy (eribulin, or vinorelbine, or gemcitabine, or capecitabine).
Primary Outcome Measures
NameTimeMethod
Progression-free Survival (PFS) Per RECIST Version 1.1 As Assessed by Blinded Independent Central Review (BICR)Until disease progression or death, up to approximately 44 months

PFS is defined as the time in months from randomization to the date of first documented disease progression (as assessed by BICR according to RECIST v1.1) or death from any cause, whichever occurs first.

Secondary Outcome Measures
NameTimeMethod
Overall Survival (OS)Until death, up to approximately 80 months

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

Confirmed Objective Response Rate (ORR) Per RECIST Version 1.1, As Assessed by BICRUntil disease progression or death, up to approximately 44 months

The BICR-assessed confirmed ORR is defined as the proportion of participants who had a best overall response of BICR-assessed Complete Response (CR) or Partial Response (PR) after randomization.

Duration of Response (DOR) Per RECIST Version 1.1, As Assessed by BICRUntil disease progression or death, up to approximately 44 months

BICR-assessed DOR is defined as the time in months from the first objective response (CR or PR) that is subsequently confirmed to documented progressive disease (PD) as assessed by BICR per RECIST v1.1 or death from any cause.

PFS Per RECIST Version 1.1, As Assessed By InvestigatorUntil disease progression or death, up to approximately 44 months

Investigator-assessed PFS is defined as the time in months from randomization to the date of first documented disease progression (as assessed by investigator according to RECIST v1.1) or death from any cause, whichever occurs first

Confirmed ORR Per RECIST Version 1.1, As Assessed By InvestigatorUntil disease progression or death, up to approximately 44 months

The investigator-assessed confirmed ORR is defined as the proportion of participants who had a best overall response of investigator-assessed confirmed CR or PR after randomization.

DOR Per RECIST Version 1.1, As Assessed By InvestigatorUntil disease progression or death, up to approximately 44 months

Investigator-assessed DOR is defined as the time in months from the first objective response (CR or PR) that is subsequently confirmed to documented PD as assessed by the investigator per RECIST v1.1 or death from any cause.

Number of Participants Reporting Treatment-emergent Adverse Events (TEAEs) and Serious Adverse Events As Graded by NCI CTCAE Version 5.0Up to approximately 44 months
Number of Participants With Dose ReductionsUp to approximately 44 months
Number of Participants Discontinuing Study Treatment Due to TEAEsUp to approximately 44 months
Serum Concentrations of ZanidatamabUp to approximately 44 months
Number of Participants Positive for Anti-drug Antibodies to ZanidatamabUp to approximately 44 months
Proportion of All Treated Participants, As Treated, Reporting Symptomatic Adverse Events While On Treatment Based on Patient-reported Outcome-Common Terminology Criteria for AEs and European Organisation for Research and Treatment of Cancer Item LibraryUp to approximately 44 months
Proportion of All Treated Participants, As Treated, Reporting Overall Side-effect Bother on the Functional Assessment of Chronic Illness Therapy General Physical Item 5 (FACIT-GP5)Up to approximately 44 months

The Functional Assessment of Chronic Illness Therapy (FACIT) GP5 Item score ranges from 0 (Not at all) to 4 (Very Much), where higher scores reflect greater bother from treatment side effects.

Proportion of Treated Participants, As Treated, With Maintained or Improved Physical Function While On Treatment Based On The Physical Functioning Subscale of the EORTC Quality of Life Questionnaire Core Module (EORTC QLQ-C30)Up to approximately 44 months

The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core Module Physical Functioning score ranges from 0 to 100, where higher scores reflect better functioning.

Trial Locations

Locations (159)

Mayo Clinic Scottsdale - PPDS

🇺🇸

Phoenix, Arizona, United States

Arizona Oncology Tucson - Wilmot

🇺🇸

Tucson, Arizona, United States

University of Arizona Cancer Center

🇺🇸

Tucson, Arizona, United States

The Oncology Institute Of Hope And Innovation

🇺🇸

Cerritos, California, United States

Los Angeles Hematology Oncology Medical Group Glendale

🇺🇸

Glendale, California, United States

USC-Norris Comprehensive Cancer Center - Investigational Drug Service IDS

🇺🇸

Los Angeles, California, United States

UCSF at Mission Bay MB

🇺🇸

San Francisco, California, United States

University of Colorado-Cancer Center-PPDS

🇺🇸

Aurora, Colorado, United States

Rocky Mountain Cancer Centers

🇺🇸

Denver, Colorado, United States

Medstar Georgetown University Hospital

🇺🇸

Washington D.C., District of Columbia, United States

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Mayo Clinic Scottsdale - PPDS
🇺🇸Phoenix, Arizona, United States

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