To Evaluate the Safety, Tolerability, and Pharmacokinetics of Inavolisib Single Agent in Participants With Solid Tumors and in Combination With Endocrine and Targeted Therapies in Participants With Breast Cancer
Phase 1
Active, not recruiting
- Conditions
- Breast CancerSolid Tumor
- Interventions
- Registration Number
- NCT03006172
- Lead Sponsor
- Genentech, Inc.
- Brief Summary
This is an open-label, multicenter, Phase I study designed to evaluate the safety, tolerability, and pharmacokinetics of inavolisib administered orally as a single agent in patients with locally advanced or metastatic PIK3CA-mutant solid tumors, including breast cancer, and in combination with standard-of-care endocrine and/or targeted therapies for the treatment of locally advanced or metastatic PIK3CA-mutant breast cancer. Participants will be enrolled in two stages: a dose-escalation stage (Stage I) and an expansion stage (Stage II). Participants will be assigned to one of seven regimens: inavolisib as a single agent (Arm A), inavolisib in combination with palbociclib and letrozole (Arm B), inavolisib in combination with letrozole (Arm C), inavolisib in combination with fulvestrant (Arm D), inavolisib in combination with palbociclib and fulvestrant (Arm E), inavolisib in combination with palbociclib, fulvestrant, and metformin (Arm F), and inavolisib in combination with trastuzumab and pertuzumab (and letrozole or fulvestrant, if applicable (Arm G)).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 200
Inclusion Criteria
- Evaluable or measurable disease per RECIST, Version 1.1 (measurable disease only for Arm D)
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Life expectancy of greater than or equal to (>=) 12 weeks
- Adequate hematologic and organ function, including blood counts, liver and kidney function
Stage I Arm A (Inavolisib):
- Locally advanced, recurrent, or metastatic, PIK3CA mutant, incurable solid tumor malignancy, including breast cancer
Stages I and II, Arms B and C:
- Postmenopausal female participants with locally advanced or metastatic PIK3CA-mutant HR+/HER2- breast cancer
Stage II, Arms D, E, or F:
- Female participants with locally advanced or metastatic PIK3CA-mutant HR+/HER2- breast cancer
Stage II Arm D:
- Prior treatment with CDK4/6 inhibitor
Stage II Arm G:
- Female participants with locally advanced or metastatic PIK3CA-mutant HER2+ breast cancer
- Left ventricular ejection fraction 50% or greater
Stages I and II:
- All participants must provide tumor tissue from the primary or metastatic tumor site obtained from a prior or new biopsy or surgical procedure for detection of PIK3CA mutation by central laboratory test.
Exclusion Criteria
- Metaplastic breast cancer
- History of leptomeningeal disease
- Type 1 or 2 diabetes requiring anti-hyperglycemic medication
- Inability or unwillingness to swallow pills
- Malabsorption syndrome or other condition that would interfere with enteral absorption
- Known and untreated, or active central nervous system metastases
- Uncontrolled pleural effusion or ascites
- Any active infection that could impact patient safety or serious infection requiring intravenous antibiotics
- History of other malignancy within 5 years, except for treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, or Stage I uterine cancer
- History of or active ventricular dysrhythmias or congestive heart failure requiring medication or symptomatic coronary heart disease
- Congenital long QT syndrome, prolonged QT interval, or family history of sudden unexplained death or long QT syndrome
Stage II Arms B, C, D, and E only:
- Prior treatment with >1 chemotherapy regimen for metastatic disease
- Prior treatment with PI3K inhibitor
- History of significant toxicity related to mTOR inhibitor requiring treatment discontinuation
Stage II Arms B and E only:
- Prior CDK4/6 inhibitor treatment
Stage II Arm G only:
- Current uncontrolled hypertension or unstable angina
- History of congestive heart failure, serious cardiac arrhythmia, or recent myocardial infarction
- Prior ejection fraction decrease on trastuzumab
- Prior cumulative doxorubicin greater than 360 mg/m2
- Symptomatic active lung disease
- History of significant toxicity related to trastuzumab and/or pertuzumab requiring discontinuation of treatment
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SEQUENTIAL
- Arm && Interventions
Group Intervention Description Stage I Arm B: Inavolisib + Palbociclib + Letrozole Letrozole Participants will receive inavolisib in escalating dose levels (starting dose 3 mg) on Days 1-28, palbociclib on Days 1-21, and letrozole on Days 1-28 of each 28-day cycle. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage I Arm B: Inavolisib + Palbociclib + Letrozole Palbociclib Participants will receive inavolisib in escalating dose levels (starting dose 3 mg) on Days 1-28, palbociclib on Days 1-21, and letrozole on Days 1-28 of each 28-day cycle. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage I Arm C: Inavolisib + Letrozole Letrozole Participants will receive inavolisib in escalating dose levels along with letrozole on Days 1-28 of each 28-day cycle. The starting dose of inavolisib will not exceed the starting dose in Stage I Arm A. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm B: Inavolisib + Palbociclib + Letrozole Letrozole Participants will receive inavolisib on Days 1-28 in combination with palbociclib on Days 1-21 and letrozole on Days 1-28 of each 28-day cycle. Dose of inavolisib will be decided based on the results of Stage I Arm B. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm B: Inavolisib + Palbociclib + Letrozole Palbociclib Participants will receive inavolisib on Days 1-28 in combination with palbociclib on Days 1-21 and letrozole on Days 1-28 of each 28-day cycle. Dose of inavolisib will be decided based on the results of Stage I Arm B. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm C: Inavolisib + Letrozole Letrozole Participants will receive inavolisib in combination with letrozole on Days 1-28 of each 28-day cycle. Dose of inavolisib will be decided based on the results of Stage I Arm C. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm D: Inavolisib + Fulvestrant Fulvestrant Participants will receive inavolisib on Days 1-28 in combination with fulvestrant on Day 1 and 15 of Cycle 1 and then on Day 1 from Cycle 2 (cycle length: 28 days). Dose of inavolisib will be decided based on the results of Stage I Arm C. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm E: Inavolisib + Palbociclib + Fulvestrant Palbociclib Participants will receive inavolisib (Days 1-28) in combination with palbociclib (Days 1-21) and fulvestrant (Days 1 and 15 of Cycle 1; Day 1 for subsequent cycles)(Cycle = 28 days). Dose of inavolisib will be determined from the results of Stage I Arm B. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm E: Inavolisib + Palbociclib + Fulvestrant Fulvestrant Participants will receive inavolisib (Days 1-28) in combination with palbociclib (Days 1-21) and fulvestrant (Days 1 and 15 of Cycle 1; Day 1 for subsequent cycles)(Cycle = 28 days). Dose of inavolisib will be determined from the results of Stage I Arm B. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm F: Inavolisib + Palbociclib + Fulvestrant + Metformin Fulvestrant Participants will receive inavolisib (Days 1-28) in combination with palbociclib (Days 1-21), fulvestrant (Days 1 and 15 of Cycle 1; Day 1 for subsequent cycles) and metformin (Days 1-28)(Cycle = 28 days). Dose of inavolisib will be determined from the results of Stage I Arm B. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm F: Inavolisib + Palbociclib + Fulvestrant + Metformin Palbociclib Participants will receive inavolisib (Days 1-28) in combination with palbociclib (Days 1-21), fulvestrant (Days 1 and 15 of Cycle 1; Day 1 for subsequent cycles) and metformin (Days 1-28)(Cycle = 28 days). Dose of inavolisib will be determined from the results of Stage I Arm B. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm F: Inavolisib + Palbociclib + Fulvestrant + Metformin Metformin Participants will receive inavolisib (Days 1-28) in combination with palbociclib (Days 1-21), fulvestrant (Days 1 and 15 of Cycle 1; Day 1 for subsequent cycles) and metformin (Days 1-28)(Cycle = 28 days). Dose of inavolisib will be determined from the results of Stage I Arm B. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm G: Inavolisib + Trastuzumab + Pertuzumab Trastuzumab Participants will receive inavolisib in combination with trastuzumab and pertuzumab (Days 1-21). Dose of inavolisib will be determined from the results of Stage I Arm A. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm G: Inavolisib + Trastuzumab + Pertuzumab Pertuzumab Participants will receive inavolisib in combination with trastuzumab and pertuzumab (Days 1-21). Dose of inavolisib will be determined from the results of Stage I Arm A. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage I Arm C: Inavolisib + Letrozole Inavolisib Participants will receive inavolisib in escalating dose levels along with letrozole on Days 1-28 of each 28-day cycle. The starting dose of inavolisib will not exceed the starting dose in Stage I Arm A. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm B: Inavolisib + Palbociclib + Letrozole Inavolisib Participants will receive inavolisib on Days 1-28 in combination with palbociclib on Days 1-21 and letrozole on Days 1-28 of each 28-day cycle. Dose of inavolisib will be decided based on the results of Stage I Arm B. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage I Arm A: Inavolisib Single Agent Inavolisib Participants will receive inavolisib in escalating dose levels with starting dose of 6 milligrams (mg). Participants will receive single dose of inavolisib on Day 1 of Cycle 1 followed by once daily from Day 8 of Cycle 1. (Cycle length: 35 days for Cycle 1 and 28 days for all other cycles). Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage I Arm B: Inavolisib + Palbociclib + Letrozole Inavolisib Participants will receive inavolisib in escalating dose levels (starting dose 3 mg) on Days 1-28, palbociclib on Days 1-21, and letrozole on Days 1-28 of each 28-day cycle. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm C: Inavolisib + Letrozole Inavolisib Participants will receive inavolisib in combination with letrozole on Days 1-28 of each 28-day cycle. Dose of inavolisib will be decided based on the results of Stage I Arm C. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm D: Inavolisib + Fulvestrant Inavolisib Participants will receive inavolisib on Days 1-28 in combination with fulvestrant on Day 1 and 15 of Cycle 1 and then on Day 1 from Cycle 2 (cycle length: 28 days). Dose of inavolisib will be decided based on the results of Stage I Arm C. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm E: Inavolisib + Palbociclib + Fulvestrant Inavolisib Participants will receive inavolisib (Days 1-28) in combination with palbociclib (Days 1-21) and fulvestrant (Days 1 and 15 of Cycle 1; Day 1 for subsequent cycles)(Cycle = 28 days). Dose of inavolisib will be determined from the results of Stage I Arm B. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm F: Inavolisib + Palbociclib + Fulvestrant + Metformin Inavolisib Participants will receive inavolisib (Days 1-28) in combination with palbociclib (Days 1-21), fulvestrant (Days 1 and 15 of Cycle 1; Day 1 for subsequent cycles) and metformin (Days 1-28)(Cycle = 28 days). Dose of inavolisib will be determined from the results of Stage I Arm B. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. Stage II Arm G: Inavolisib + Trastuzumab + Pertuzumab Inavolisib Participants will receive inavolisib in combination with trastuzumab and pertuzumab (Days 1-21). Dose of inavolisib will be determined from the results of Stage I Arm A. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression.
- Primary Outcome Measures
Name Time Method Stage 1: Percentage of Participants With Dose Limiting Toxicities Day 1 up to Day 28 (for Stage 1 Arm A: Day 1 up to Day 35) Recommended Phase II Dose of Inavolisib Day 1 up to Day 28 (for Stage 1 Arm A: Day 1 up to Day 35) Percentage of Participants With Adverse Events and Serious Adverse Events Day 1 up to 6 years
- Secondary Outcome Measures
Name Time Method Minimum Plasma Concentration (Cmin) of Inavolisib Predose (0-2 hours before dosing) on Cycle 1 Day 1 up to EOS (up to approximately 6 years); Cycle length=28 days (Cycle 1 of Stage 1 Arm A=35 days) Time to Cmax (tmax) of Inavolisib Predose (0-2 hours before dosing) on Cycle 1 Day 1 up to EOS (up to approximately 6 years); Cycle length=28 days (Cycle 1 of Stage 1 Arm A=35 days) Half-Life of Inavolisib Predose (0-2 hours before dosing) on Cycle 1 Day 1 up to EOS (up to approximately 6 years); Cycle length=28 days (Cycle 1 of Stage 1 Arm A=35 days) Maximum Plasma Concentration (Cmax) of Inavolisib Predose (0-2 hours before dosing) on Cycle 1 Day 1 up to EOS (up to approximately 6 years); Cycle length=28 days (Cycle 1 of Stage 1 Arm A=35 days) Area Under the Concentration Time-Curve (AUC) from Time Zero to Infinity (AUCinf) of Inavolisib Predose (0-2 hours before dosing) on Cycle 1 Day 1 up to end of study (EOS; up to approximately 6 years); Cycle length=28 days (Cycle 1 of Stage 1 Arm A=35 days) AUC from Time Zero to Dosing Interval (AUC0-tau) of Inavolisib Predose (0-2 hours before dosing) on Cycle 1 Day 1 up to EOS (up to approximately 6 years); Cycle length=28 days (Cycle 1 of Stage 1 Arm A=35 days) Apparent Clearance (CL/F) of Inavolisib Predose (0-2 hours before dosing) on Cycle 1 Day 1 up to EOS (up to approximately 6 years); Cycle length=28 days (Cycle 1 of Stage 1 Arm A=35 days) Accumulation Ratio (AR) of Inavolisib at Steady-State Predose (0-2 hours before dosing) on Cycle 1 Day 1 up to EOS (up to approximately 6 years); Cycle length=28 days (Cycle 1 of Stage 1 Arm A=35 days) AUC of Palbociclib Predose (0-2 hours before inavolisib) dosing) on Cycle 1 Day 1 up to Cycle 6; Cycle length=28 days Cmax of Palbociclib Predose (0-2 hours before inavolisib) dosing) on Cycle 1 Day 1 up to Cycle 6; Cycle length=28 days AUC of Letrozole Predose (0-2 hours before inavolisib dosing) on Cycle 1 Day 1 up to EOS (up to approximately 6 years); Cycle length=28 days Cmax of Letrozole Predose (0-2 hours before inavolisib dosing) on Cycle 1 Day 1 up to EOS (up to approximately 6 years); Cycle length=28 days AUC of Fulvestrant Predose (0-2 hours before inavolisib dosing) on Cycle 1 Day 1 up to EOS (up to approximately 6 years); Cycle length=28 days Cmax of Fulvestrant Predose (0-2 hours before inavolisib dosing) on Cycle 1 Day 1 up to EOS (up to approximately 6 years); Cycle length=28 days Percentage of Participants With Objective Response as Assessed by Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1 (v1.1) Baseline up to occurrence of complete response (CR) or partial response (PR) on 2 consecutive occasions >/=4 weeks apart (up to approximately 6 years) Duration of Response, as Assessed by RECIST v1.1 From first occurrence of a documented objective response (CR or PR) to disease progression or death from any cause, whichever occurs first (up to approximately 6 years) Percentage of Participants With Clinical Benefit as Assessed by RECIST v1.1 Baseline up to disease progression or death from any cause, whichever occurs first (up to approximately 6 years) Progression Free Survival (PFS) as Assessed by RECIST v1.1 Baseline up to disease progression or death from any cause, whichever occurs first (up to approximately 6 years) Change in Maximum Standard Uptake Value (SUV) of Tumor Regions of Interest (as assessed by [18] F-fluorodeoxyglucose-positron emission tomography) From Baseline to Approximately 2 Weeks of Inavolisib Treatment Baseline, Week 2 AUC of Pertuzumab Predose (0-2 hours before inavolisib dosing) on Cycle 1 Day 1 up to EOS (up to approximately 6 years); Cycle length=21 days Cmax of Pertuzumab Predose (0-2 hours before inavolisib dosing) on Cycle 1 Day 1 up to EOS (up to approximately 6 years); Cycle length=21 days AUC of Trastuzumab Predose (0-2 hours before inavolisib dosing) on Cycle 1 Day 1 up to EOS (up to approximately 6 years); Cycle length=21 days Cmax of Trastuzumab Predose (0-2 hours before inavolisib dosing) on Cycle 1 Day 1 up to EOS (up to approximately 6 years); Cycle length=21 days
Trial Locations
- Locations (9)
Institut Gustave Roussy
🇫🇷Villejuif, France
Royal Marsden Hospital - Surrey
🇬🇧Surrey, Sutton, United Kingdom
Royal Marsden Hospital - London
🇬🇧London, United Kingdom
Princess Margaret Hospital
🇨🇦Toronto, Ontario, Canada
St Bartholomew's Hospital
🇬🇧London, United Kingdom
Dana Farber Cancer Institute
🇺🇸Boston, Massachusetts, United States
Columbia University Medical Center
🇺🇸New York, New York, United States
SCRI Oncology Partners
🇺🇸Nashville, Tennessee, United States
Institut Bergonie
🇫🇷Bordeaux, France