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A Trial Using ARV-471 or Anastrozole in Post-Menopausal Women With Breast Cancer Prior to Surgery

Phase 2
Active, not recruiting
Conditions
Breast Cancer
Interventions
Procedure: Surgical resection of breast tumor
Registration Number
NCT05549505
Lead Sponsor
Arvinas Inc.
Brief Summary

This trial is a Phase 2 neoadjuvant study evaluating ARV-471 or anastrozole in post-menopausal women with ER+/HER2- localized breast cancer.

Detailed Description

This is a Phase 2, open-label, randomized, non-comparative proof of concept study of ARV-471 or anastrozole in participants with ER+/HER2- breast cancer amenable to definitive surgical resection. The main goal of this study is to evaluate the biological activity of ARV-471 and anastrozole, respectively.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Female
Target Recruitment
152
Inclusion Criteria
  • Post-menopausal females ≥ 18 years

  • Histologically or cytologically confirmed ER+ and HER2- breast cancer (per local assessment). ER and HER2 status must be documented:

    • ER+ disease, with ER staining of ≥ 10% of tumor cell nuclei by IHC per ASCO/CAP Guidelines (Allison 2020).
    • HER2- disease by either IHC or in situ hybridization per ASCO/CAP guidelines
    • Ki-67 score ≥ 5%, analyzed locally
  • Clinical T1c-T4c, N0-N2, M0 breast cancer amenable to definitive surgical resection, without bilateral breast ductal carcinoma in situ or invasive breast cancer

  • The primary tumor must be at least 1.5 cm by imaging

  • ECOG performance status of 0 or 1 Willingness to undergo a screening biopsy, an on-treatment biopsy and surgical resection

Exclusion Criteria
  • Any other active malignancy within 3 years prior to enrollment, except for adequately treated basal cell or squamous cell skin cancer, or cervical carcinoma in situ
  • Any of the following in the previous 6 months: Myocardial infarction; Severe unstable angina; Coronary/peripheral artery bypass graft; Symptomatic congestive heart failure (New York Heart Association class III or IV); Cerebrovascular accident; Transient ischemic attack; Symptomatic pulmonary embolism or other clinically significant episode of thromboembolism
  • Any of the following in the previous 6 months: Congenital long QT syndrome; Torsade de Pointes; Sustained ventricular tachyarrhythmia and ventricular fibrillation; Left anterior hemiblock (bifascicular block); Ongoing cardiac dysrhythmias of NCI CTCAE ≥ Grade 2; Atrial fibrillation of any grade (≥ Grade 2 in the case of asymptomatic lone atrial fibrillation)
  • QTcF > 470 msec
  • Active, uncontrolled bacterial, fungal or viral infection, including HBV, HCV, and HIV or AIDS-related illness
  • Active inflammatory gastrointestinal disease, chronic diarrhea, known uncontrolled diverticular disease, or previous gastric resection or lap band surgery
  • Cirrhosis meeting criteria for Child Pugh B and C
  • Prior treatment for breast cancer including systemic therapy (eg, chemotherapy, hormonal therapy), radiation, surgery, or any investigational agents
  • Any live vaccines within 14 days of planned start of first dose of study drug.
  • Major surgery (as defined by the Investigator) within four weeks of first dose of study drug

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ARV-471 monotherapySurgical resection of breast tumorARV-471 taken once daily until surgical resection
Anastrozole monotherapySurgical resection of breast tumorAnastrozole 1mg taken once daily until surgical resection
ARV-471 monotherapyARV-471ARV-471 taken once daily until surgical resection
Anastrozole monotherapyAnastrozoleAnastrozole 1mg taken once daily until surgical resection
Primary Outcome Measures
NameTimeMethod
Evaluate the effects of ARV-471 and anastrozole, respectively, on Ki-67 expression in tumors after 2 weeks of treatment2 weeks

Percent change in Ki-67 expression between baseline and C1D15 tumor biopsies

Secondary Outcome Measures
NameTimeMethod
Evaluate the safety/tolerability of ARV-471 and anastrozole, respectivelyFrom signing of consent to minimum of 30 days after last administration of study drug

Incidence of all adverse events, serious adverse events, and adverse events leading to study drug discontinuation

Evaluate the pathological response of ARV-471 and anastrozole, respectively (pathologic stage)Approximately 5.5 months

Pathologic stage at the time of surgical resection

Evaluate the pathological response of ARV-471 and anastrozole, respectively (pathologic complete response rate)Approximately 5.5 months

pathologic complete response rate at the time of surgical resection

Evaluate the pathological response of ARV-471 and anastrozole, respectively (modified Pre-operative Endocrine Prognostic Index score)Approximately 5.5 months

modified Pre-operative Endocrine Prognostic Index score at the time of surgical resection

Evaluate the clinical response of ARV-471 and anastrozole, respectively (breast conserving surgery rate)Approximately 5.5 months

rates of breast conserving surgery

Evaluate the clinical response of ARV-471 and anastrozole, respectively (radiographic response)Approximately 5 months

radiographical response rate in the primary tumor during cycle 6

Evaluate the clinical response of ARV-471 and anastrozole, respectively (caliper-based response)Approximately 5 months

Best percentage change from baseline up to C6D1 in caliper measurement of the primary tumor

Trial Locations

Locations (1)

Clinical Trial Site

🇪🇸

Zaragoza, Spain

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