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
- 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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Participants with history of MDS/AML or with features suggestive of MDS/AML
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Participants with any known predisposition to bleeding
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Any history of persisting severe cytopenia
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Any evidence of severe or uncontrolled systemic diseases or active uncontrolled infections
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Refractory nausea and vomiting, chronic GI disease, inability to swallow the formulated product, or previous significant bowel resection
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History of another primary malignancy
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Persistent toxicities (CTCAE Grade ≥ 2) caused by previous anti-cancer therapy excluding alopecia
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Spinal cord compression, brain metastases, carcinomatous meningitis, or leptomeningeal disease
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Evidence of active and uncontrolled hepatitis B and/or hepatitis C
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Evidence of active and uncontrolled HIV infection
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Active tuberculosis infection
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Cardiac criteria, including history of arrythmia and cardiovascular disease
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Concurrent exogenous reproductive hormone therapy or non-topical hormonal therapy for non-cancer-related conditions
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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
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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
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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
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Prior treatment within 28 days with blood product support or growth factor support
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Any systemic concurrent anti-cancer treatment
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Concomitant use of the following types of medications or herbal supplements within 21 days or at least 5 half-lives of randomisation:
- Strong and moderate CYP3A4 inducers/inhibitors
- Sensitive CYP2B6 substrates
- Substrates of CYP2C9 and/or CYP2C19 which have a narrow therapeutic index, eg, warfarin (and other coumarin-derived vitamin K antagonist anticoagulants) and phenytoin.
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Concomitant use of drugs that are known to prolong QT and have a known risk of TdP
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Systemic use of atropine
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The following exclusion criteria apply to treatments administered for early breast cancer:
- Disease progression ≤ 84 days following the last dose of neo-adjuvant or adjuvant chemotherapy
- Disease progression ≤ 1 year (365 days) from the last dose of treatment with a PARPi and/or platinum agent for early breast cancer
- Disease progression ≤ 1 year (365 days) from the last dose with a CDK4/6i in the adjuvant setting
- Disease progression ≤ 1 year (365 days) from the last dose of an oral SERD including camizestrant.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Arm 1: saruparib (AZD5305) plus camizestrant Saruparib (AZD5305) participants will receive saruparib (AZD5305) orally and camizestrant orally Arm 1: saruparib (AZD5305) plus camizestrant Camizestrant participants will receive saruparib (AZD5305) orally and camizestrant orally Arm 3: Physician's choice CDK4/6i plus camizestrant Camizestrant participants 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 camizestrant Ribociclib participants 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 ET Abemaciclib agents 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 ET Ribociclib agents 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 camizestrant Palbociclib participants 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 camizestrant Abemaciclib participants 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 ET Palbociclib agents 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 ET Fulvestrant agents 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 ET Letrozole agents 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 ET Anastrozole agents 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 ET Exemestane agents 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
Name Time Method Progression-Free Survival Up 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
Name Time Method 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 camizestrant Up to approximately 59 months Overall Survival Up to approximately 88 months OS is defined as the time from randomisation until the date of death due to any cause.
Progression Free Survival 2 Up 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 chemotherapy Up 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 Rate Up 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 Response Up 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 tolerability Up 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