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A Study to Evaluate the Safety and Tolerability of Venetoclax Tablets in Combination With Capecitabine Tablets in Adult Participants With Hormone Receptor-Positive, HER2-Negative Locally Advanced or Metastatic Breast Cancer Who Had Disease Progression During or After CDK4/6 Inhibitor Therapy

Phase 1
Terminated
Conditions
Breast Cancer
Cancer
Interventions
Registration Number
NCT04274933
Lead Sponsor
AbbVie
Brief Summary

Endocrine therapy is the initial treatment for most hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) breast cancers. This study will evaluate the use of venetoclax in combination with capecitabine in adult participants with HR+, HER2-, metastatic breast cancer (MBC) who had disease progression following treatment that included a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor.

Venetoclax is an investigational drug being developed for the treatment of breast cancer. This study is open-label meaning both the participants and study doctors will know what treatment is being given. The study includes two phases: dose escalation and dose expansion. In dose escalation, participants will receive various doses of venetoclax in combination with capecitabine. In dose expansion, participants will receive the recommended dose of venetoclax determined during dose escalation in combination with capecitabine. Adult participants with locally advanced or MBC that is not amenable to curative therapy will be enrolled. Around 42 participants will be enrolled at approximately 20 sites worldwide.

Venetoclax and capecitabine will be administered on a 21-day cycle. During dose escalation, participants will take various doses of venetoclax as a tablet by mouth once a day and capecitabine as a tablet by mouth twice per day on days 1 - 14 of each cycle for approximately 30 weeks. During dose expansion, participants will take venetoclax at the dose identified during dose escalation as a tablet by mouth once a day and capecitabine as a tablet by mouth twice per day on days 1 - 14 of each cycle for approximately 30 weeks.

There may be a higher burden for participants in this trial compared to standard of care. Participants will attend weekly visits during the course of the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, and evaluating for side effects.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
4
Inclusion Criteria
  • Diagnosis of advanced or metastatic breast cancer that is hormone receptor positive (HR+) and HER2 negative (HER2-).

  • Eastern Cooperative Oncology Group (ECOG) performance score of 0-1.

  • Willing to provide tissue biopsy sample prior to start of study treatment, and in participants with measurable disease, at Day 1 of Cycle 3.

    • Escalation cohort: Able to provide a tissue sample obtained at any time in disease history prior to start of study treatment.
    • Expansion cohort: Able to provide a fresh tissue sample from either primary tumor or metastatic site; if fresh sample collection is deemed unsafe by the investigator, then an archival tissue block is acceptable if obtained at time of most recent progression and within 16 weeks of study treatment.
  • Experienced disease progression during or after CDK4/6 inhibitor therapy administered in combination with endocrine therapy for a minimum of 8 weeks prior to progression.

Exclusion Criteria
  • History of receiving systemic cytotoxic chemotherapy in the locally advanced or metastatic setting.
  • Received anti-cancer therapy within the previous 21 days prior to the start of study drugs.
  • No known uncontrolled metastases to the central nervous system (CNS). Participants with brain metastases are eligible provided they have shown positive clinical and radiographic stable disease for at least 4 weeks after definitive therapy and have not used steroids for at least 2 weeks prior to first dose of study drugs.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Dose Escalation: Venetoclax and CapecitabineVenetoclaxVenetoclax at various doses will be administered in combination with capecitabine until a recommended dose is determined.
Dose Expansion: Venetoclax and CapecitabineVenetoclaxVenetoclax at the dose identified in Dose Escalation administered in combination with capecitabine.
Dose Escalation: Venetoclax and CapecitabineCapecitabineVenetoclax at various doses will be administered in combination with capecitabine until a recommended dose is determined.
Dose Expansion: Venetoclax and CapecitabineCapecitabineVenetoclax at the dose identified in Dose Escalation administered in combination with capecitabine.
Primary Outcome Measures
NameTimeMethod
Maximum observed plasma concentration (Cmax) of venetoclaxUp to 9 days after first dose of study drug

Maximum observed plasma concentration (Cmax) of venetoclax

Maximum observed plasma concentration (Cmax) of capecitabineUp to 9 days after first dose of study drug

Maximum observed plasma concentration (Cmax) of capecitabine.

Maximum observed plasma concentration (Cmax) of 5-fluorouracilUp to 9 days after first dose of study drug

Maximum observed plasma concentration (Cmax) of 5-fluorouracil.

Time to Cmax (peak time, Tmax) of venetoclaxUp to 9 days after first dose of study drug

Time to Cmax (peak time, Tmax) of venetoclax.

Time to Cmax (peak time, Tmax) of 5-fluorouracilUp to 9 days after first dose of study drug

Time to Cmax (peak time, Tmax) of 5-fluorouracil.

Time to Cmax (peak time, Tmax) of capecitabineUp to 9 days after first dose of study drug

Time to Cmax (peak time, Tmax) of capecitabine.

Area under the plasma concentration versus time curve (AUC) for venetoclax up to 24 hours post-dose (AUC0-24)Up to 24 hours

Area under the plasma concentration versus time curve for venetoclax up to 24 hours post-dose.

Area under the plasma concentration versus time curve (AUC) for capecitabine/5-fluorouracil up to 12 hours post-dose (AUC0-12)Up to 12 hours

Area under the plasma concentration versus time curve for capecitabine/5-fluorouracil up to 12 hours post-dose.

Number of participants with Dose Limiting Toxicities (DLTs)Up to 21 days after first dose of study drug

Adverse events that are considered by the investigator to have a reasonable possibility of relationship to the administration of venetoclax in combination with capecitabine will be considered a DLT.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (18)

Greenville Health System Cance /ID# 216059

🇺🇸

Greenville, South Carolina, United States

Universitaetsklinik Heidelberg /ID# 214679

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Heidelberg, Baden-Wuerttemberg, Germany

GCM Medical Group PSC - Hato Rey /ID# 216904

🇵🇷

San Juan, Puerto Rico

Dana-Farber Cancer Institute /ID# 214832

🇺🇸

Boston, Massachusetts, United States

Masonic Cancer Center /ID# 216101

🇺🇸

Minneapolis, Minnesota, United States

MD Anderson Cancer Center /ID# 214867

🇺🇸

Houston, Texas, United States

University of Pennsylvania /ID# 216357

🇺🇸

Philadelphia, Pennsylvania, United States

Vanderbilt University Med Ctr /ID# 213852

🇺🇸

Nashville, Tennessee, United States

Swedish Cancer Institute /ID# 216120

🇺🇸

Seattle, Washington, United States

Joliet Oncology-Hematology Associates, LTD /ID# 215051

🇺🇸

Joliet, Illinois, United States

Massachusetts General Hospital /ID# 214833

🇺🇸

Boston, Massachusetts, United States

Aichi Cancer Center Hospital /ID# 224527

🇯🇵

Nagoya-shi, Aichi, Japan

Universitaetsklinikum Ulm /ID# 214678

🇩🇪

Ulm, Thueringen, Germany

Universitatsklinikum Tubingen /ID# 217021

🇩🇪

Tuebingen, Germany

Memorial Sloan Kettering Cancer Center /ID# 214886

🇺🇸

New York, New York, United States

Charite Universitaetsmedizin Berlin /ID# 215287

🇩🇪

Berlin, Germany

Pan American Center for Oncology Trials, LLC /ID# 216862

🇵🇷

Rio Piedras, Puerto Rico

Utah Cancer Specialists /ID# 215375

🇺🇸

Salt Lake City, Utah, United States

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