An Open-Label, Phase Ia/Ib/IIa Study of GDC-0810 Single Agent or in Combination With Palbociclib and/or an LHRH Agonist in Women With Locally Advanced or Metastatic Estrogen Receptor Positive Breast Cancer
Overview
- Phase
- Phase 1
- Intervention
- GDC-0810
- Conditions
- Breast Cancer
- Sponsor
- Genentech, Inc.
- Enrollment
- 152
- Locations
- 14
- Primary Endpoint
- Phase Ia: Maximum Tolerated Dose of GDC-0810 When Used as a Single Agent
- Status
- Terminated
- Last Updated
- 4 years ago
Overview
Brief Summary
This study is a multi-institution, Phase Ia/Ib/IIa open-label, dose-finding, safety, pharmacokinetics (PK), and proof-of-concept study of GDC-0810 as a single agent and in combination with palbociclib and/or LHRH agonist. The study is divided into 3 phases: Phase Ia, Phase Ib, and Phase IIa. During Phase Ia (dose escalation phase), GDC-0810 single agent will be administered orally on a continuous daily dosing regimen with a Day -7 lead-in period for single dose PK evaluation prior to the start of daily treatment. The incidence of dose-limiting toxicities (DLTs) will be evaluated from Day -7 through the first cycle (28 days) of treatment (35 days total). Depending on safety and tolerability, participants will be assigned sequentially to escalating doses of GDC-0810 using standard 3 + 3 design. During Phase Ib (dose escalation and expansion phase), participants will receive GDC-0810 with palbociclib and/or LHRH agonist to determine the recommended Phase II dose (RP2D) and assess the safety and tolerability of concomitant administration. During Phase IIa (dose expansion phase), participants previously treated with an aromatase inhibitor (AI) will be treated at the RP2D to further characterize the safety, PK, pharmacodynamics, and anti-tumor activity of GDC-0810.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Phase 1a portion
- •Histologically or cytologically proven diagnosis of adenocarcinoma of the breast with evidence of either locally recurrent disease not amenable to resection or radiation therapy with curative intent, or metastatic disease, both progressing after at least 6 months of hormonal therapy for estrogen receptor (ER) positive breast cancer
- •ER-positive, human epidermal growth factor 2 (HER2) negative
- •At least 2 months must have elapsed from the use of tamoxifen
- •At least 6 months must have elapsed from the use of fulvestrant
- •At least 2 weeks must have elapsed from the use of any other anticancer hormonal therapy
- •At least 3 weeks must have elapsed from the use of any chemotherapy
- •Postmenopausal status
- •Eastern Cooperative Oncology Group (ECOG) performance status less than or equal to 2
- •Adequate organ function
Exclusion Criteria
- •Phase 1a portion
- •Untreated or symptomatic central nervous system (CNS) metastases
- •Endometrial disorders
- •More than 2 prior chemotherapy in the advanced/metastatic setting (prior adjuvant chemotherapy is allowed so long as it occurred greater than or equal to 12 months prior to enrollment)
- •Current treatment with any systemic anticancer therapies for advanced disease
- •Any significant cardiac dysfunction within 12 months prior to enrollment
- •Active inflammatory bowel disease or chronic diarrhea, short bowel syndrome, or upper gastrointestinal surgery including gastric resection
- •Known human immunodeficiency virus (HIV) infection
- •Known clinically significant history of liver disease
- •Major surgery within 4 weeks prior to enrollment
Arms & Interventions
Phase Ia - Cohort 1
100 mg GDC-0810 once daily (QD) in fasting state.
Intervention: GDC-0810
Phase Ia - Cohort 2
200 mg GDC-0810 QD in fasting state.
Intervention: GDC-0810
Phase Ia - Cohort 3
400 mg GDC-0810 QD in fasting state.
Intervention: GDC-0810
Phase Ia - Cohort 4
600 mg GDC-0810 QD in fasting state.
Intervention: GDC-0810
Phase Ia - Cohort 5
600 mg GDC-0810 QD in non-fasting state.
Intervention: GDC-0810
Phase Ia - Cohort 6
300 mg GDC-0810 twice daily (BID) in fasting state.
Intervention: GDC-0810
Phase Ia - Cohort 7
800 mg GDC-0810 QD in fasting state.
Intervention: GDC-0810
Phase Ia - Cohort 8
800 mg GDC-0810 QD in non-fasting state.
Intervention: GDC-0810
Phase Ia - Cohort 9
400 mg GDC-0810 BID in fasting state.
Intervention: GDC-0810
Phase IIa - Cohort A1
600 mg GDC-0810 QD. Additionally, participants in this arm did not receive any prior treatment with fulvestrant and had confirmed ER-a (ESR1) mutation of the ligand binding domain (LBD).
Intervention: GDC-0810
Phase IIa - Cohort A2
600 mg GDC-0810 QD. Additionally, participants in this arm had prior treatment with fulvestrant and confirmed ER-a (ESR1) mutation of the LBD.
Intervention: GDC-0810
Phase IIa - Cohort B1
600 mg GDC-0810 QD. Additionally, participants in this arm did not receive any prior treatment with fulvestrant and had progressed following ≤1 prior therapy with an aromatase inhibitor (AI).
Intervention: GDC-0810
Phase IIa - Cohort B2
600 mg GDC-0810 QD. Additionally, participants in this arm had prior treatment with fulvestrant and progressed following ≤1 prior therapy with an AI.
Intervention: GDC-0810
Phase Ib - Cohort C1
400 mg GDC-0810 + 125 mg Palbociclib QD.
Intervention: GDC-0810
Phase Ib - Cohort C1
400 mg GDC-0810 + 125 mg Palbociclib QD.
Intervention: Palbociclib
Phase Ib - Cohort D1
≤600 mg GDC-0810 QD + LHRH agonist once monthly.
Intervention: GDC-0810
Phase Ib - Cohort D1
≤600 mg GDC-0810 QD + LHRH agonist once monthly.
Intervention: LHRH Agonist
Outcomes
Primary Outcomes
Phase Ia: Maximum Tolerated Dose of GDC-0810 When Used as a Single Agent
Time Frame: Day -7 through the first cycle (28 days) of treatment (35 days total)
Maximum Tolerated Dose (MTD) is determined based on the number of Dose Limiting Toxicities (DLTs) experienced by the participants. DLTs were defined as any of the following adverse events (AEs) that are deemed by the investigator or the Sponsor to be related to study drug (toxicities will be attributed to single agent GDC-0810 unless they are clearly related to disease progression or can clearly be attributed to a cause other than GDC-0810 administration): * Any grade ≥ 3 non-hematologic toxicity (excluding alopecia) * Any grade ≥ 3 hematologic toxicity of \> 7 days' duration * Any grade toxicity that leads to study drug interruption of \> 7 days' duration
Phase Ia: RP2D of GDC-0810 When Used as a Single Agent
Time Frame: Day -7 through the first cycle (28 days) of treatment (35 days total)
The recommended Phase II dose (RP2D) was based on the overall safety/tolerability and pharmacokinetic profile of GDC-0810.
Phase IIa: Percentage of Participants With Clinical Benefit Response of GDC-0810 According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)
Time Frame: Screening and every 8 weeks from Cycle 1 Day 1 until Cycle 12, thereafter every 3 months until disease progression (up to 3 years)
Clinical Benefit Response (CBR) is defined as the percentage of participants achieving confirmed RECIST v1.1 defined CR, PR, and/or stable disease. CR was the disappearance of all target lesions. PR was defined as at least a 30% decrease in the sum of diameters of target lesions. Stable disease was defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease.
Phase IIa: Percentage of Participants With Confirmed Objective Tumor Response of GDC-0810 According to RECIST v1.1
Time Frame: Screening and every 8 weeks from Cycle 1 Day 1 until Cycle 12, thereafter every 3 months until disease progression (up to 3 years)
Objective response (OR) is defined as a complete response (CR) or partial response (PR) as determined by investigator assessment according to RECIST v1.1. OR was based on criteria related to changes in size of target lesions. CR was the disappearance of all target lesions. PR was defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters.
Phase Ib: RP2D of GDC-0810 When Used in Combination With Palbociclib and/or LHRH
Time Frame: first cycle (Days 1 to 28 of a 28-day schedule)
The RP2D of GDC-0810 When Used in Combination With Palbociclib and/or LHRH RP2D was not determined since the development of the GDC-0810 was discontinued before enrolling Cohort C2. The RP2D would have been based on the overall safety and PK/PD profile of GDC-0810 and palbociclib, and not necessarily the MTD.
Secondary Outcomes
- Phase Ia: Maximum Plasma Concentration (Cmax) of GDC-0810 Single Agent and Its Glucuronide Metabolites(Single Dose: Day-7 at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 24, 48 hours postdose; Multiple Doses: Day 29 (Cycle 2 Day 1) at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 24, hours postdose)
- Phase Ia: Apparent Clearance (Cl/F)(Day -7 at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 24, 48 hours postdose)
- All Phases: Percentage of Participants With Adverse Events (AEs)(up to 3 years)
- Phase Ia: Area Under the Concentration-time Curves at 6 Hours (AUC0-6) of GDC-0810 Single Agent and Its Glucuronide Metabolites(Single Dose: Day-7 at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6 hours postdose; Multiple Doses: Day 29 (Cycle 2 Day 1) at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6 hours postdose)
- Phase IIa: Effect of GDC-0810 Single Agent on Ventricular Repolarization as Measured by Corrected QT Intervals (QTc) Using Fridericia's Formula(Screening; on Cycle 2 Day 1 predose and at 1, 2, 3, 4, and 6 hours postdose; Cycle 3 Day 1 predose, and at 1, 3, and 6 hours post dose)
- Phase Ia: Time to Maximum Concentration (Tmax) of GDC-0810 Single Agent and Its Glucuronide Metabolites(Single Dose: Day-7 at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 24, 48 hours postdose; Multiple Doses: Day 29 (Cycle 2 Day 1) at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 24, hours postdose)
- Phase Ia: Area Under the Concentration-time Curves at 24 Hours (AUC0-24) of GDC-0810 Single Agent and Its Glucuronide Metabolites(Single Dose: Day-7 at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 24 hours postdose; Multiple Doses: Day 29 (Cycle 2 Day 1) at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 24 hours postdose)
- Phase Ib: Tmax of GDC-0810 in Combination With Palbociclib and/or an LHRH Agonist(C1: Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 1 Day 8; D1: Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 2 Day 1)
- Phase Ib: AUC0-6 of GDC-0810 in Combination With Palbociclib and/or an LHRH Agonist(C1: Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 1 Day 8; D1: Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 2 Day 1)
- Phase Ib: t/2 of GDC-0810 in Combination With Palbociclib and/or an LHRH Agonist(C1: Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 1 Day 8; D1: Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 2 Day 1)
- Phase Ib: Tmax of LHRH Agonist in Combination With GDC-0810 and/or Palbociclib(Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 2 Day 1)
- Phase Ia: Plasma Half-life (t1/2) of GDC-0810 Single Agent(Day -7 at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 24, 48 hours postdose)
- Phase Ib: Cmax of LHRH Agonist in Combination With GDC-0810 and/or Palbociclib(Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 2 Day 1)
- Area Under the Concentration-Time Curve From Time 0 to Infinity (AUC0-Inf)(Day-7 at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 24, and 48 hours postdose)
- Phase Ib: Cmax of GDC-0810 in Combination With Palbociclib and/or an LHRH Agonist(C1: Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 1 Day 8; D1: Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 2 Day 1)
- Phase Ib: Tmax of Palbociclib in Combination With GDC-0810 and/or an LHRH Agonist(Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 1 Day 8)
- Phase Ib: Cmax of Palbociclib in Combination With GDC-0810 and/or an LHRH Agonist(Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 1 Day 8)
- Phase Ib: AUC0-6 of Palbociclib in Combination With GDC-0810 and/or an LHRH Agonist(Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 1 Day 8)
- Phase Ib: t/2 of Palbociclib in Combination With GDC-0810 and/or an LHRH Agonist(Cohort C1: Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 1 Day 8)
- Phase Ib: AUC0-6 of LHRH Agonist in Combination With GDC-0810 and/or an Palbociclib(Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 2 Day 1)
- Phase Ib: t/2 of LHRH Agonist in Combination With GDC-0810 and/or Palbociclib(Cohort D1: Predose and at 1, 2, 3, 4, and 6 hours postdose on Cycle 1 Day 1 and Cycle 2 Day 1)