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TACTIVE-U: A Study to Learn About the Study Medicine (Vepdegestrant) When Given With Other Medicines in People With Advanced or Metastatic Breast Cancer. (Sub-Study C)

Phase 1
Active, not recruiting
Conditions
Breast Cancer
Interventions
Registration Number
NCT06125522
Lead Sponsor
Pfizer
Brief Summary

The purpose of this study is to learn about the safety and effects of the study medicine called vepdegestrant. The safety and effects of vepdegestrant will be see when given with other medicines. Vepdegestrant is studied to see if it can be a possible treatment for advanced metastatic breast cancer. This type of cancer would have spread from where it started (breast) to other parts of the body and would be tough to treat.

The study is seeking for participants who have breast cancer that:

* is hard to treat (advanced) and may have spread to other organs (metastatic). is sensitive to hormonal therapy (it is called estrogen receptor positive).

* is no longer responding to treatments taken before starting this study.

This study is divided into separate sub-studies.

For Sub-Study C:

All the participants will receive vepdegestrant and a medicine called samuraciclib.

Vepdegestrant and samuraciclib will be taken once in a day by mouth. The medicines will be taken at home. The experience of people receiving the study medicines will be studied. This will help see if the study medicine is safe and effective.

Participant will continue to take vepdegestrant and samuraciclib until:

* their cancer is no longer responding, or

* side effects become too severe.

They will have visits at the study clinic about every 4 weeks.

Detailed Description

C4891024 is a prospective, open-label, multicenter, Phase 1b/2 sub-study to evaluate the safety, antitumor activity, and PK of ARV-471 with samuraciclib in the treatment of participants with A/MBC. The sub-study is part of Umbrella platform, TACTIVE-U, comprising multiple sub-studies that independently evaluate ARV-471 in participants with Estrogen Receptor Positive/Human Epidermal Growth Factor Receptor 2 Negative (ER+/HER2-) Advanced or Metastatic Breast Cancer. ARV-471 will act as the backbone therapy given in combination with other anticancer agents thought to have clinical relevance in ER+ breast cancer.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
11
Inclusion Criteria
  • Histological or cytological diagnosis of breast cancer. At time of enrollment this must not be amendable to surgical resection with curative intent (≥1% ER+ stained cells as per local practice on the most recent tumor biopsy HER2- tumor by IHC or in-situ hybridization per ASCO/CAP).
  • prior anticancer therapies: up to 2 lines of prior therapies for advanced/metastatic disease; 1 line of any CDK4/6 inhibitor-based regimen is required (in any setting eg adjuvant, metastatic)
  • at least 1 measurable lesion as defined by RECIST v1.1.
  • ECOG PS ≤1.
Exclusion Criteria
  • visceral crisis at risk of life-threatening complications in the short term
  • known history of drug-induced pneumonitis or other significant symptomatic deterioration of lung functions.
  • newly diagnosed brain metastases, or symptomatic CNS metastases, carcinomatous meningitis, or leptomeningeal disease. Participants with a history of CNS metastases or cord compression are eligible if they have been definitively treated, clinically stable and discontinued anti-seizure medications and corticosteroids for at least 28 days prior to enrollment in the of study.
  • history of any other tumor malignancies within the past 3 years, except for the following: (1) adequately treated basal or squamous cell carcinoma of the skin; (2) curatively treated in situ carcinoma of the cervix.
  • inflammatory breast cancer
  • impaired cardiovascular function or clinically significant cardiovascular diseases
  • concurrent administration of medications, food, or herb supplements that are strong inhibitors/inducers of CYP3A, strong CYP2D6 inhibitors and drugs known to predispose to Torsade de Pointes or QT interval prolongation.
  • renal impairment, not adequate liver function and/or bone marrow function
  • known active infection

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
ARV-471 in combination with SamuraciclibvepdegestrantARV-471 administered orally QD continuously and Samuraciclib administered orally QD continuously on 28-day cycles
ARV-471 in combination with SamuraciclibSamuraciclibARV-471 administered orally QD continuously and Samuraciclib administered orally QD continuously on 28-day cycles
Primary Outcome Measures
NameTimeMethod
Drug Drug Interaction: To evaluate the effect of samuraciclib on PK of ARV 471.From the start of Lead-in period (maximum 13 days) to the end of cycle 1 (at least 28 days)

Steady-state Peak Plasma concentration ( Cmax) of ARV-471 with and without coadministration of samuraciclib

Drug Drug Interaction: • To evaluate the effect of ARV 471 on PK of samuraciclib.From the start of Lead-in period (maximum 13 days) to the end of cycle 1 (at least 28 days))

Single dose Cmax of samuraciclib with and without coadministration of ARV 471.

Phase 1b: Number of Participants With Dose Limiting Toxicities28 days

Dose Limiting Toxicities rate for ARV-471 in combination with Samuraciclib, estimated based on data from DLT-evaluable participants during the DLT observation period (Cycle 1).

Phase 2: Percentage of Participants With Objective Response by investigator assessmentUp to approximately 1 year

Objective response (OR) refers to confirmed complete response (CR) or partial response (PR) according to Response Evaluation Criteria in Solid Tumor (RECIST) version 1.1. as determined by investigator assessment.

Secondary Outcome Measures
NameTimeMethod
Phase 1b: Evaluation of effect of samuraciclib on PK of ARV-471At predefined intervals throughout the treatment period, up to cycle 7 (each cycle is 28 days)

Cmax of ARV-471 with and without co-administration of samuraciclib

Phase 2: To evaluate the correlation between TP53 mutation status and antitumor activityScreening

Participants classified on basis of pathological TP53 mutation detected or not detected.

Phase 1b, Drug drug interaction and Phase 2: Evaluation of Safety and Tolerability of ARV-471 in combination with SamuraciclibFirst study drug dose through a minimum of 28 Days After Last study drug administration

AEs as characterized by type, frequency, intensity as graded by NCI CTCAE version 5.0, timing, seriousness, and relationship to ARV-471 in combination with samuraciclib.

Laboratory test abnormalities as characterized by type, frequency, intensity (as graded by NCI CTCAE version 5.0), and timing.

Changes from baseline for the ECG parameters heart rate, QTcF, PR interval, and QRS complex will be summarized by treatment and time. The frequency of uncorrected QT values above 500 ms will be tabulated.

Phase 1b and Phase 2: Plasma concentrations of ARV-471 and samuraciclib.At predefined intervals throughout the treatment period, up to cycle 7 (each cycle is 28 days)

To evaluate the plasma exposure of ARV-471 and samuraciclib when ARV-471 and samuraciclib are given in combination.

Phase 2: Overall SurvivalThrough study completion, up to approximately 3 year

Overall Survival (OS) is defined as the time from the date of first dose of study interventions to the date of death due to any cause

Phase 1b: To evaluate antitumor activity of ARV-471 in combination with samuraciclibUp to approximately 1 year

Objective response (OR) refers to confirmed complete response (CR) or partial response (PR) according to Response Evaluation Criteria in Solid Tumor (RECIST) version 1.1. as determined by investigator assessment.

Phase 1b and Phase 2: Duration of Response by investigator assessment.Up to approximately 1 year

Duration of Response (DoR) is defined for participants with confirmed OR (CR or PR) as the time from the first documentation of OR to the first documentation of objective tumor progression or to death due to any cause, whichever occurs first.

Phase 1b and Phase2: Percentage of participants with Clinical Benefit Response by investigator assessment.Up to approximately 1 year

Clinical Benefit Response (CBR) is defined as the proportion of participants with Best Overall Response of confirmed CR or PR at any time, or Stable Disease (SD) ≥24 weeks

Phase 2:ctDNA plasma quantitative changes from pre-treatmentAt predefined intervals throughout the treatment period, up to cycle 3 (each cycle is 28 days) and end of treatment

To assess changes from baseline levels in plasma ctDNA with treatment and to evaluate potential predictability of their associations with clinical outcomes.

Phase 1b and Phase 2: Progression Free Survival by investigator assessment.Up to approximately 1 year

Progression Free Survival (PFS) is defined as the time from the date of first dose of study interventions to the date of first documentation of PD or death due to any cause, whichever occurs first.

Trial Locations

Locations (19)

Highlands Oncology Group

🇺🇸

Springdale, Arkansas, United States

UCHealth Poudre Valley Hospital

🇺🇸

Fort Collins, Colorado, United States

UCHealth Harmony

🇺🇸

Fort Collins, Colorado, United States

Stanford Cancer Center

🇺🇸

Palo Alto, California, United States

Stanford Cancer Institute - Clinical Trials Office

🇺🇸

Palo Alto, California, United States

UCHealth Greeley Hospital

🇺🇸

Greeley, Colorado, United States

UCHealth - Medical Center of the Rockies

🇺🇸

Loveland, Colorado, United States

Memorial Hospital East

🇺🇸

Shiloh, Illinois, United States

Siteman Cancer Center - Shiloh

🇺🇸

Shiloh, Illinois, United States

Siteman Cancer Center - West County

🇺🇸

Creve Coeur, Missouri, United States

Siteman Cancer Center - North County

🇺🇸

Florissant, Missouri, United States

Barnes-Jewish Hospital

🇺🇸

Saint Louis, Missouri, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Siteman Cancer Center - South County

🇺🇸

Saint Louis, Missouri, United States

Siteman Cancer Center - St Peters

🇺🇸

Saint Peters, Missouri, United States

Institut Jules Bordet

🇧🇪

Anderlecht, Bruxelles-capitale, Région DE, Belgium

Centre Georges François Leclerc

🇫🇷

Dijon, Côte-d'or, France

Fondazione Policlinico Universitario Agostino Gemelli IRCCS - Università Cattolica del Sacro Cuore

🇮🇹

Roma, Italy

Fondazione IRCCS San Gerardo dei Tintori

🇮🇹

Monza, Lombardia, Italy

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