Saruparib (AZD5305) Plus Camizestrant Compared With CDK4/6 Inhibitor Plus Endocrine Therapy or Plus Camizestrant in HR-Positive, HER2-Negative (IHC 0, 1+, 2+/ ISH Non-amplified), BRCA1, BRCA2, or PALB2m Advanced Breast Cancer

Registration Number
NCT06380751
Lead Sponsor
AstraZeneca
Brief Summary

The primary objective of the study is to measure efficacy of saruparib (AZD5305) plus camizestrant compared with physician's choice CDK4/6i plus ET in patients with BRCA1, BRCA2, or PALB2m, HR-positive, HER2-negative (defined as IHC 0, 1+, 2+/ ISH non-amplified) advanced breast cancer.

Detailed Description

Approximately 2,620 participants will be screened to achieve approximately 500 participants randomised to study intervention.

Participants will be randomised in a 2:2:1 ratio to one of the following intervention groups:

* Arm 1: saruparib (AZD5305) plus camizestrant

* Arm 2: Physician's choice CDK4/6i plus physician's choice ET
...

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
500
Inclusion Criteria
  • Adult females, pre/peri-menopausal and/or post-menopausal, and adult males
  • Histologically or cytologically documented diagnosis of HR-positive, HER2-negative breast cancer
  • Advanced breast cancer with either locally advanced disease not amenable to curative treatment or metastatic disease
  • ECOG performance status of 0 or 1 with no deterioration over the previous 2 weeks
  • FFPE tumour tissue from each participant
  • Documented germline tumour loss of function mutation in BRCA1, BRCA2, or PALB2
  • Adequate organ and marrow function
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Exclusion Criteria
  • Participants with history of MDS/AML or with features suggestive of MDS/AML

  • Participants with any known predisposition to bleeding

  • Any history of persisting severe cytopenia

  • Any evidence of severe or uncontrolled systemic diseases or active uncontrolled infections

  • Refractory nausea and vomiting, chronic GI disease, inability to swallow the formulated product, or previous significant bowel resection

  • History of another primary malignancy

  • Persistent toxicities (CTCAE Grade ≥ 2) caused by previous anti-cancer therapy excluding alopecia

  • Spinal cord compression, brain metastases, carcinomatous meningitis, or leptomeningeal disease

  • Evidence of active and uncontrolled hepatitis B and/or hepatitis C

  • Evidence of active and uncontrolled HIV infection

  • Active tuberculosis infection

  • Cardiac criteria, including history of arrythmia and cardiovascular disease

  • Concurrent exogenous reproductive hormone therapy or non-topical hormonal therapy for non-cancer-related conditions

  • Major surgical procedure or significant traumatic injury within 4 weeks of the first dose of study intervention or an anticipated need for major surgery during the study

  • Palliative radiotherapy with a limited field of radiation within 2 weeks or with wide field of radiation or to more than 30% of the bone marrow within 4 weeks before the first dose of study treatment

  • Prior treatment with systemic anti-cancer therapy for locoregionally recurrent or metastatic disease is not permitted, apart from treatment with ET up to 28 days before randomisation

  • Prior treatment within 28 days with blood product support or growth factor support

  • Any systemic concurrent anti-cancer treatment

  • Concomitant use of the following types of medications or herbal supplements within 21 days or at least 5 half-lives of randomisation:

    1. Strong and moderate CYP3A4 inducers/inhibitors
    2. Sensitive CYP2B6 substrates
    3. Substrates of CYP2C9 and/or CYP2C19 which have a narrow therapeutic index, eg, warfarin (and other coumarin-derived vitamin K antagonist anticoagulants) and phenytoin.
  • Concomitant use of drugs that are known to prolong QT and have a known risk of TdP

  • Systemic use of atropine

  • The following exclusion criteria apply to treatments administered for early breast cancer:

    1. Disease progression ≤ 84 days following the last dose of neo-adjuvant or adjuvant chemotherapy
    2. Disease progression ≤ 1 year (365 days) from the last dose of treatment with a PARPi and/or platinum agent for early breast cancer
    3. Disease progression ≤ 1 year (365 days) from the last dose with a CDK4/6i in the adjuvant setting
    4. Disease progression ≤ 1 year (365 days) from the last dose of an oral SERD including camizestrant.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm 1: saruparib (AZD5305) plus camizestrantSaruparib (AZD5305)participants will receive saruparib (AZD5305) orally and camizestrant orally
Arm 1: saruparib (AZD5305) plus camizestrantCamizestrantparticipants will receive saruparib (AZD5305) orally and camizestrant orally
Arm 3: Physician's choice CDK4/6i plus camizestrantCamizestrantparticipants will receive camizestrant orally. Agents for CDK4/6i treatment are indicated above and should follow local guidelines
Arm 3: Physician's choice CDK4/6i plus camizestrantRibociclibparticipants will receive camizestrant orally. Agents for CDK4/6i treatment are indicated above and should follow local guidelines
Arm 2: Physician's choice CDK4/6i plus physician's choice ETAbemaciclibagents are indicated below and should follow local guidelines: * Physician's Choice CDK4/6i: * abemaciclib orally, or * ribociclib orally, or * palbociclib orally. * Physician's Choice ET: * fulvestrant intramuscularly, or * One of the following AIs: * letrozole orally, or * anastrozole orally, or * exemestane orally
Arm 2: Physician's choice CDK4/6i plus physician's choice ETRibociclibagents are indicated below and should follow local guidelines: * Physician's Choice CDK4/6i: * abemaciclib orally, or * ribociclib orally, or * palbociclib orally. * Physician's Choice ET: * fulvestrant intramuscularly, or * One of the following AIs: * letrozole orally, or * anastrozole orally, or * exemestane orally
Arm 3: Physician's choice CDK4/6i plus camizestrantPalbociclibparticipants will receive camizestrant orally. Agents for CDK4/6i treatment are indicated above and should follow local guidelines
Arm 3: Physician's choice CDK4/6i plus camizestrantAbemaciclibparticipants will receive camizestrant orally. Agents for CDK4/6i treatment are indicated above and should follow local guidelines
Arm 2: Physician's choice CDK4/6i plus physician's choice ETPalbociclibagents are indicated below and should follow local guidelines: * Physician's Choice CDK4/6i: * abemaciclib orally, or * ribociclib orally, or * palbociclib orally. * Physician's Choice ET: * fulvestrant intramuscularly, or * One of the following AIs: * letrozole orally, or * anastrozole orally, or * exemestane orally
Arm 2: Physician's choice CDK4/6i plus physician's choice ETFulvestrantagents are indicated below and should follow local guidelines: * Physician's Choice CDK4/6i: * abemaciclib orally, or * ribociclib orally, or * palbociclib orally. * Physician's Choice ET: * fulvestrant intramuscularly, or * One of the following AIs: * letrozole orally, or * anastrozole orally, or * exemestane orally
Arm 2: Physician's choice CDK4/6i plus physician's choice ETLetrozoleagents are indicated below and should follow local guidelines: * Physician's Choice CDK4/6i: * abemaciclib orally, or * ribociclib orally, or * palbociclib orally. * Physician's Choice ET: * fulvestrant intramuscularly, or * One of the following AIs: * letrozole orally, or * anastrozole orally, or * exemestane orally
Arm 2: Physician's choice CDK4/6i plus physician's choice ETAnastrozoleagents are indicated below and should follow local guidelines: * Physician's Choice CDK4/6i: * abemaciclib orally, or * ribociclib orally, or * palbociclib orally. * Physician's Choice ET: * fulvestrant intramuscularly, or * One of the following AIs: * letrozole orally, or * anastrozole orally, or * exemestane orally
Arm 2: Physician's choice CDK4/6i plus physician's choice ETExemestaneagents are indicated below and should follow local guidelines: * Physician's Choice CDK4/6i: * abemaciclib orally, or * ribociclib orally, or * palbociclib orally. * Physician's Choice ET: * fulvestrant intramuscularly, or * One of the following AIs: * letrozole orally, or * anastrozole orally, or * exemestane orally
Primary Outcome Measures
NameTimeMethod
Progression-Free SurvivalUp to approximately 59 months

PFS is defined as time from randomisation until progression per RECIST v1.1 as assessed by BICR, or death due to any cause.

Secondary Outcome Measures
NameTimeMethod
Samples will be used to develop companion diagnostics by analyzing their performance characteristics and calculate their consistency with clinical trial assays used for enrolment onto the study.Up to approximately 59 months

Samples will be tested by a CDx to confirm BRCA1/2 and PALB2 gene mutation status

Plasma concentrations of camizestrantUp to approximately 59 months
Overall SurvivalUp to approximately 88 months

OS is defined as the time from randomisation until the date of death due to any cause.

Progression Free Survival 2Up to approximately 59 months

PFS2 is defined as the time from randomisation to the earliest of the progression event (following the initial investigator-assessed progression), after first subsequent therapy, or death.

Time to chemotherapyUp to approximately 59 months

Time to chemotherapy is defined as time from randomisation until the start date of the first subsequent chemotherapy treatment after discontinuation of randomised treatment (censoring participants who died prior to initiation of chemotherapy).

Objective Response RateUp to approximately 59 months

ORR is defined as the proportion of participants who have a complete or parial response, as determined by BICR per RECIST v1.1.

Duration of ResponseUp to approximately 59 months

DoR is defined as the time from the date of first documented response until date of documented progression per RECIST v1.1 as assessed by BICR, or death due to any cause.

Participant-reported tolerabilityUp to approximately 59 months

Proportion of all dosed participants reporting different levels of severity of diarrhoea as measured by the diarrhoea single item (EORTC IL237/IL239/IL240) and different levels of severity of abdominal pain as measured by the abdominal pain single item (EORTC IL237/IL239/IL240).

Time to deterioration in patient-reported global health status/QoL as measured by the global health status/QoL scale within the The European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)Up to approximately 59 months

This scale includes 2 items asking participants to report overall health and overall quality of life in the past week. Both items are measured on a 6-point verbal rating scale ranging from Very Poor to Excellent. Single item scores are averaged to calculate a subscale score that is transformed to range from 0 to 100, where higher scores indicate better globa...

Change from baseline in patient-reported global health status/QoL as measured by the global health status/QoL scale within the The European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)Up to approximately 59 months

This scale includes 2 items asking participants to report overall health and overall quality of life in the past week. Both items are measured on a 6-point verbal rating scale ranging from Very Poor to Excellent. Single item scores are averaged to calculate a subscale score that is transformed to range from 0 to 100, where higher scores indicate better globa...

Plasma concentrations of saruparib (AZD5305)Up to approximately 59 months

Trial Locations

Locations (1)

Research Site

🇬🇧

Taunton, United Kingdom

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