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Safety and Efficacy Study of Enzalutamide in Patients With Advanced, Androgen Receptor-Positive, Triple Negative Breast Cancer

Phase 2
Completed
Conditions
Advanced, Androgen Receptor Positive Triple Negative Breast Cancer
Interventions
Registration Number
NCT01889238
Lead Sponsor
Pfizer
Brief Summary

The purpose of this study is to determine if enzalutamide is safe and effective in the treatment of patients with advanced breast cancer that express the androgen receptor but do not express the estrogen or progesterone receptor and are not Her2 amplified.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
118
Inclusion Criteria
  • Women at least 18 years of age;
  • Advanced AR+ TNBC;
  • Availability of a representative tumor specimen:
  • Either measurable disease or bone only nonmeasurable disease;
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
Exclusion Criteria
  • Any severe concurrent disease, infection, or comorbid condition;
  • Any condition or reason that interferes with the patient's ability to participate in the trial, that may cause undue risk, or complicates the interpretation of safety data;
  • Current or previously treated brain metastasis or active leptomeningeal disease;
  • Current hormone replacement therapy;
  • Local palliative radiation therapy within 7 days before day 1;
  • History of another invasive cancer within 5 years of day 1;
  • Absolute neutrophil count < 1500/µL, platelet count < 75,000/µL, or hemoglobin < 9 g/dL (5.6 mmol/L) at the screening visit;
  • Creatinine > 1.5 times upper limit of normal (ULN) at the screening visit;
  • History of seizure or any condition that may predispose to seizure;
  • Clinically significant cardiovascular disease;
  • Active gastrointestinal disorder affecting absorption;
  • Major surgery within 4 weeks before day 1;
  • Treatment with any commercially available anticancer agent within 14 days before day 1;
  • Treatment with any investigational agent within 2 weeks before day 1;
  • Treatment with any of the following medications within 2 weeks before day 1: Estrogens, including hormone replacement therapy; Androgens (testosterone, dihydroepiandrosterone, etc);Systemic radionuclides (eg, samarium or strontium);Vaccine therapy;
  • Hypoglycemic episode requiring medical intervention while on insulin treatment within 12 months before day 1;
  • Hypersensitivity reaction to the active pharmaceutical ingredient or any of the capsule components, including Labrasol, butylated hydroxyanisole, and butylated hydroxytoluene.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
EnzalutamideEnzalutamide160 mg administered as four 40 mg soft gelatin capsules orally once daily
Primary Outcome Measures
NameTimeMethod
Percentage of Participants With Clinical Benefit at Week 16: Evaluable PopulationWeek 16

Percentage of participants with a clinical benefit at Week 16 defined as percentage of participants with a best response of complete response (CR), partial response(PR), stable disease(SD) for \>=16 weeks on radiologic imaging based on Investigator assessment using Response Evaluation Criteria in Solid Tumors version 1.1(RECIST 1.1). An estimate of the percentage and its exact 2-sided 85% confidence interval(CI) were calculated using the Blaker method. As per RECIST 1.1, CR defined as disappearance of all target, non-target lesions and normalization of tumor marker level and all lymph nodes decreased to non-pathological in size \<10mm short axis. PR: At least 30% decrease in sum of longest diameter (LD) of target lesions taking as reference baseline sum of LD, without progression of non-target lesions, no appearance of new lesions. SD: Neither sufficient reduction to qualify as PR nor sufficient increase to qualify as PD, using the smallest sum diameters during the study as a reference.

Percentage of Participants With Clinical Benefit at Week 16: Intent-to-Treat (ITT) PopulationWeek 16

Percentage of participants with a clinical benefit at Week 16 defined as percentage of participants with a best response of CR, PR, or SD for \>= 16 weeks on radiologic imaging based on Investigator assessment using RECIST 1.1. An estimate of the percentage and its exact 2-sided 85% CI were calculated using the Blaker method. As per RECIST 1.1, CR defined as disappearance of all target, non-target lesions and normalization of tumor marker level and all lymph nodes decreased to non-pathological in size \<10 mm short axis. PR: At least 30% decrease in sum of LD of target lesions taking as reference baseline sum of LD, without progression of non-target lesions, no appearance of new lesions. SD: Neither sufficient reduction to qualify as PR nor sufficient increase to qualify as PD, using the smallest sum diameters during the study as a reference.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Clinical Benefit at Week 24: Evaluable PopulationWeek 24

Percentage of participants with a clinical benefit at Week 24 defined as percentage of participants with a best response of CR, PR, or SD for \>= 24 weeks on radiologic imaging based on investigator assessment using RECIST 1.1. An estimate of the percentage and its exact 2-sided 85% CI were calculated using the Blaker method. As per RECIST 1.1, CR defined as disappearance of all target, non-target lesions and normalization of tumor marker level and all lymph nodes decreased to non-pathological in size \<10 mm short axis. PR: At least 30% decrease in sum of LD of target lesions taking as reference baseline sum of LD, without progression of non-target lesions, no appearance of new lesions. SD: Neither sufficient reduction to qualify as PR nor sufficient increase to qualify as PD, using the smallest sum diameters during the study as a reference.

Percentage of Participants With Clinical Benefit at Week 24: ITT PopulationWeek 24

Percentage of participants with a clinical benefit at Week 24 defined as percentage of participants with a best response of CR, PR, or SD for \>= 24 weeks on radiologic imaging based on investigator assessment using RECIST 1.1. An estimate of the percentage and its exact 2-sided 85% CI were calculated using the Blaker method. As per RECIST 1.1, CR defined as disappearance of all target, non-target lesions and normalization of tumor marker level and all lymph nodes decreased to non-pathological in size \<10 mm short axis. PR: At least 30% decrease in sum of LD of target lesions taking as reference baseline sum of LD, without progression of non-target lesions, no appearance of new lesions. SD: Neither sufficient reduction to qualify as PR nor sufficient increase to qualify as PD, using the smallest sum diameters during the study as a reference.

Percentage of Participants With Best Objective Response: Evaluable PopulationFrom Baseline up to disease progression or death due to any cause (up to 87 Weeks)

Percentage of participants with best objective response defined as percentage of participants with a best response of CR and PR based on investigator assessment of target, non-target and new lesions using RECIST 1.1. As per RECIST 1.1, CR defined as disappearance of all target, non-target lesions and normalization of tumor marker level and all lymph nodes decreased to non-pathological in \<10 mm short axis. PR: At least 30% decrease in sum of LD of target lesions taking as reference baseline sum of LD, without progression of non-target lesions, no appearance of new lesions.

Percentage of Participants With Best Objective Response: ITT PopulationFrom Baseline up to disease progression or death due to any cause (up to 87 Weeks)

Percentage of participants with best objective response defined as percentage of participants with a best response of CR and PR based on investigator assessment of target, non-target and new lesions using RECIST 1.1. As per RECIST 1.1, CR defined as disappearance of all target, non-target lesions and normalization of tumor marker level and all lymph nodes decreased to non-pathological in \<10 mm short axis. PR: At least 30% decrease in sum of LD of target lesions taking as reference baseline sum of LD, without progression of non-target lesions, no appearance of new lesions.

Progression-Free Survival (PFS): Evaluable PopulationFrom Baseline up to disease progression or death due to any cause (up to 87 Weeks)

PFS was defined as the time (in weeks) from the date of first dose of study drug to the date of documented disease progression or death due to any cause whichever occurs first as determined by the investigator using RECIST 1.1. As per RECIST 1.1, progression was defined as: \>=20 percent increase in sum of LD of target lesions taking as a reference the smallest sum of the LD recorded since the treatment started, or the appearance of one or more new lesions and/or unequivocal progression of existing non target-lesions.

Progression-Free Survival: ITT PopulationFrom Baseline up to disease progression or death due to any cause (up to 87 Weeks)

PFS was defined as the time (in weeks) from the date of first dose of study drug to the date of documented disease progression or death due to any cause whichever occurs first as determined by the investigator using RECIST 1.1. As per RECIST 1.1, progression was defined as: \>=20 percent increase in sum of LD of target lesions taking as a reference the smallest sum of the LD recorded since the treatment started, or the appearance of one or more new lesions and/or unequivocal progression of existing non target-lesions.

Time to Response: Evaluable PopulationFrom first dose of study drug until first documentation of CR or PR or data censoring date, whichever occurred first (up to 87 Weeks)

The time to response is defined as the time from the date of first dose of study drug to initial CR or PR. Participants without response of CR or PR before the data cutoff date were censored at the last tumor assessment date before the data cutoff. Kaplan-Meier method was used to summarize time to response.

Duration of Response: Evaluable PopulationFrom first documentation of CR or PR until first documentation of tumor progression or death due to any cause or data censoring date, whichever occurred first (up to 87 Weeks)

Duration of objective response is defined as the time from initial CR or PR to documented disease progression or death due to any cause, whichever occurs first. Participants without disease progression or death due to any cause before the data cutoff date were censored at the last tumor assessment date before the data cutoff.

Number of Participants With Postbaseline Laboratory Toxicities Grade 3 or 4From start of study treatment on Day 1 up to 30 days after the last dose of study drug (up to maximum of 9.6 years)

Laboratory parameters included hematology parameters \[low lymphocytes (10\^6/L), neutrophils (10\^6/L) and Leukocytes (10\^9/L)\] and chemistry parameters \[high phosphate (mmol/L), bilirubin, Alkaline phosphatase (U/L) and glucose (mmol/L)\]. Number of participants with postbaseline laboratory toxicity Grade 3 or 4 as per NCI-CTCAE (version 4.0) (Grade 3= Severe, Grade 4= Life-threatening) were reported.

Trial Locations

Locations (70)

Rocky Mountain Cancer Center Sky Ridge

🇺🇸

Lone Tree, Colorado, United States

Texas Oncology - Memorial City

🇺🇸

Houston, Texas, United States

Florida Cancer Specialist South Division

🇺🇸

Fort Myers, Florida, United States

UZA

🇧🇪

Edegem, Antwerpen, Belgium

Cancer Clinical Trials Unit, Mid-Western Cancer center

🇮🇪

Limerick, Ireland

Dipartimento di Oncologia Medica, IRCCS Ospedale San Raffaele

🇮🇹

Milano, Italy

Farmacia (magazzino ricevimento merc), IRCCS Ospedale San Raffaele

🇮🇹

Milano, Italy

U.O. Oncologia Medica, Nuovo Ospedale di Prato

🇮🇹

Prato, Italy

Rocky Mountain Cancer Centers

🇺🇸

Lone Tree, Colorado, United States

Florida Cancer Specialists

🇺🇸

Venice, Florida, United States

Northwestern Medical Faculty Foundation(NMFF)/ Women's Cancer Center Shared Laboratories

🇺🇸

Chicago, Illinois, United States

Northwestern Medical Faculty Foundation

🇺🇸

Chicago, Illinois, United States

Northwestern Memorial Hospital

🇺🇸

Chicago, Illinois, United States

The University of Chicago Medical Center, Investigational Drug Service Department of Pharmacy

🇺🇸

Chicago, Illinois, United States

The University of Chicago

🇺🇸

Chicago, Illinois, United States

University of Chicago Comprehensive Cancer Center at Silver Cross Hospital

🇺🇸

New Lenox, Illinois, United States

Indiana University Health Hospital

🇺🇸

Indianapolis, Indiana, United States

Indiana University Health Melvin and Bren Simon Cancer Center

🇺🇸

Indianapolis, Indiana, United States

Investigational Drug Services

🇺🇸

Indianapolis, Indiana, United States

Sidney and Lois Eskenazi Hospital

🇺🇸

Indianapolis, Indiana, United States

Springmill Medical Clinic

🇺🇸

Indianapolis, Indiana, United States

Oncology Hematology Care, Inc.

🇺🇸

Fairfield, Ohio, United States

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

Dana-Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

The West Clinic, PC

🇺🇸

Memphis, Tennessee, United States

Barnes-Jewish Hospital

🇺🇸

Saint Louis, Missouri, United States

Washington University Infusion Center Pharmacy

🇺🇸

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-West County

🇺🇸

Saint Louis, Missouri, United States

Siteman Cancer Center

🇺🇸

Saint Peters, Missouri, United States

Hematology Oncology Associates of Northern NJ

🇺🇸

Morristown, New Jersey, United States

Memorial Sloan Kettering - I Chemotherapy Practice/Investigational Drug Service

🇺🇸

New York, New York, United States

Memorial Sloan-Kettering Cancer Center

🇺🇸

New York, New York, United States

Cone Health Cancer Center

🇺🇸

Greensboro, North Carolina, United States

Wesley Long Community Hospital

🇺🇸

Greensboro, North Carolina, United States

Greenville Health System

🇺🇸

Spartanburg, South Carolina, United States

Tennessee Oncology, PLLC

🇺🇸

Smyrna, Tennessee, United States

The Sarah Cannon Research Institute

🇺🇸

Nashville, Tennessee, United States

Vanderbilt Breast Center at One Hundred Oaks

🇺🇸

Nashville, Tennessee, United States

Vanderbilt Health Pharmacy One Hundred Oaks

🇺🇸

Nashville, Tennessee, United States

Henry-Joyce Cancer Clinic

🇺🇸

Nashville, Tennessee, United States

Texas Oncology-Baylor Charles A. Sammons Cancer Center

🇺🇸

Dallas, Texas, United States

Texas Oncology - Longview Cancer Center

🇺🇸

Longview, Texas, United States

Texas Oncology-Tyler

🇺🇸

Tyler, Texas, United States

Virginia Cancer Institute

🇺🇸

Richmond, Virginia, United States

Virginia Oncology Associates

🇺🇸

Virginia Beach, Virginia, United States

Institut Jules Bordet

🇧🇪

Brussels, Belgium

British Columbia Cancer Agency - Vancouver Centre

🇨🇦

Vancouver, British Columbia, Canada

Sunnybrook Research Institute

🇨🇦

Toronto, Ontario, Canada

McGill University Health Centre-Cedars Cancer Centre

🇨🇦

Montreal, Quebec, Canada

Department of Radiology

🇬🇧

Truro, England, United Kingdom

Pharmacy Department

🇬🇧

Truro, England, United Kingdom

3rd Floor,Oncology Link office

🇮🇪

Dublin, Ireland

Institute for Cancer Research

🇮🇪

Dublin, Ireland

Mater Private Hospital

🇮🇪

Dublin, Ireland

Radiology Department

🇬🇧

Nottingham, England, United Kingdom

U.O Farmaceutica, Nuovo Ospedale di Prato Palazzina dei servizi

🇮🇹

Prato, Italy

Hospital Universitario HM Monteprincipe

🇪🇸

Boadilla del Monte, Madrid, Spain

Grupo Hospitalario Quiron - Hospital Quiron Barcelona

🇪🇸

Barcelona, Spain

Hospital Universitari Vall d'Hebron

🇪🇸

Barcelona, Spain

Hospital Universitario Ramon Y Cajal

🇪🇸

Madrid, Spain

Hospital Universitario 12 Octubre

🇪🇸

Madrid, Spain

Centro Intergral Oncologico Clara Campal

🇪🇸

Madrid, Spain

Hospital de Madrid Norte-Sanchinarro.

🇪🇸

Madrid, Spain

Clinical Investigation and Research Unit

🇬🇧

Brighton, England, United Kingdom

Radiation Safety Service, Medical Physics Department

🇬🇧

Brighton, England, United Kingdom

Histopathology Department

🇬🇧

Nottingham, England, United Kingdom

Nottingham University Hospital

🇬🇧

Nottingham, England, United Kingdom

Royal Cornwall Hospitals NHS trust

🇬🇧

Truro, Cornwall, England, United Kingdom

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