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eoadjuvant study of targeting ROS1 in combination with endocrine therapy in invAsive Lobular carcINoma of the breast

Phase 1
Conditions
ER-positive/HER2-negative invasive lobular carcinoma
MedDRA version: 20.0Level: PTClassification code 10073096Term: Invasive lobular breast carcinomaSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Therapeutic area: Diseases [C] - Cancer [C04]
Registration Number
EUCTR2019-004942-14-BE
Lead Sponsor
Institut Jules Bordet
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised-recruitment may be ongoing or finished
Sex
Female
Target Recruitment
50
Inclusion Criteria

1.Female
2.Age = 18 years
3.Histological diagnosis of invasive lobular breast adenocarcinoma that is ER+, and HER2- as per the updated American Society of Clinical Oncology (ASCO) - College of American Pathologists (CAP) guidelines according to local testing.
4.Multifocal unilateral or bilateral breast adenocarcinoma tumours are allowed if all tested foci are lobular, ER+ and HER2-.
oER positive (ER+ is defined as having an IHC of 1% or more and/or an Allred of 3 or more and HER2-).
oHER2 negative (HER2- is defined as having an IHC of 0 or 1+ without ISH OR IHC 2+ and ISH non-amplified with ratio less than 2.0 and if reported, average HER2 copy number < 4 signals/cells OR ISH non-amplified with ratio less than 2.0 and if reported, average HER2 copy number < 4 signals/cells [without IHC]);
5.A primary non metastatic or locally advanced tumour of more than 20 mm as measured by breast MRI, cN0 or cN1 without prior treatment candidate for preoperative treatment.
6.ECOG Performance Status (PS) 0 or 1.
7.Adequate Bone Marrow Function including:
oAbsolute Neutrophil Count (ANC) =1500/µL or =1.5x109/L;
oPlatelets =100000/µL or =100 x 109/L;
oHaemoglobin = 9 g/dL.
8.Adequate Renal Function including:
oSerum creatinine = 1.5 x upper limit of normal (ULN) or estimated creatinine clearance = 60 ml/min as calculated using the method standard for the institution.
9.Adequate Liver Function, including all of the following parameters:
oTotal serum bilirubin = 2.0 x ULN unless the subject has documented Gilbert syndrome
oAspartate and Alanine Aminotransferase (AST and ALT) = 3 x ULN;

10.Signed Informed Consent form (ICF) obtained prior to any study related procedure.
11.Completion of all necessary screening procedures within 28 days prior to enrolment. Biopsies at screening must have been obtained up to max 6 weeks before the beginning of treatment.
12.Subject is willing and able to comply with the protocol for the duration of the study including treatment and scheduled visits and examinations.
13.Women who are not postmenopausal or have not undergone hysterectomy must have documented negative pregnancy test (serum) within 28 days prior to enrolment.
14.Women of childbearing potential and their partners, who are sexually active, must agree to use one highly effective form of contraception (see protocol section 6.6.1) from the signing of the ICF until at least 5 weeks after last administration of entrectinib, or they must totally/truly abstain from any form of sexual intercourse. Use of oral hormonal contraceptive agents in this study is not permitted.

Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 20
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 13

Exclusion Criteria

Subjects who exhibit any of the following conditions at screening will not be eligible for admission into the study.
1.Clinical T4 disease including inflammatory breast cancer and/or cN2 or cN3.
2.Prior history of invasive cancer in the past 5 years except basal or squamous cell carcinoma of skin that has been definitively treated.
3.Known hypersensitivity to the study drugs or excipients.
4.Hyperuricemia > Grade 1
5.Any illness or medical condition that is unstable or could jeopardize the safety of the subject or her compliance with study requirements.
6.Subjects unable to swallow oral medications.
7.Prior intake of letrozole, any ROS1 inhibitor, any TRK inhibitor or anticancer therapy (including endocrine therapy).
8.Concurrent treatment with strong or moderate CYP3A inhibitor.
9.Concurrent treatment with any of the drugs not permitted, i.e. strong CYP3A inducers and drugs known to cause QTc interval prolongation.
10.Significant cardiac disease, including recent (less than 6 months) myocardial infarction, congestive heart failure, unstable angina, and bradyarrhythmias.
11.LVEF = 55% measured by ECHO or MUGA (ECHO should be the preferred method)
12.QTc exceeding 450 msec, history of prolonged QTc interval prolongation; risk factors for torsade de pointes; other concomitant medications that may prolong QTc; family or personal history of long or short QT syndrome, Brugada syndrome or known history of QTc prolongation, or Torsade de Pointes (TdP); uncorrected electrolyte imbalances
13.Pregnant or lactating women.
14.Known interstitial lung disease, interstitial fibrosis, or history of tyrosine kinase inhibitor-induced pneumonitis
15.Peripheral neuropathy = Grade 2
16.Active gastrointestinal disease (e.g., Crohn’s disease, ulcerative colitis, or short gut syndrome) or other malabsorption syndromes that would reasonably impact drug absorption.

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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