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A multicenter randomized phase II study to compare the combination trastuzumab and capecitabine, with or without pertuzumab, in patients with HER2-positive metastatic breast cancer that have progressed after one line of trastuzumab-based therapy in the metastatic setting (PHEREXA). - Pherexa

Phase 1
Active, not recruiting
Conditions
HER2 positive metastatic breast cancer which has progressed after one line of trastuzumab-based therapy in the metastatic setting.
MedDRA version: 12.0Level: LLTClassification code 10065430Term: HER-2 positive breast cancer
Registration Number
EUCTR2008-006801-17-IT
Lead Sponsor
F. Hoffmann - La Roche Ltd.
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Not Recruiting
Sex
Female
Target Recruitment
450
Inclusion Criteria

Disease-Specific: 1. Pathologically confirmed breast cancer and documented metastatic disease. 2. HER2-positive (FISH/CISH-positive or IHC 3+) MBC confirmed by a Sponsor-designated central laboratory. Availability of a FFPE tumor tissue sample from primary tumor for eligibility testing (HER2-status) is mandatory (minimum 6 slides). Additional tumor tissue material for biomarker assessment is requested (if available). 3. Disease progression during or following a trastuzumab-based treatment for first-line metastatic breast cancer. 4. Trastuzumab must have been part of the last prior treatment regimen. 5. Prior treatment with a taxane-containing regimen. General: 6. Female patients, age ≥18 years. 7. LVEF ≥ 50% at baseline (assessed within 42 days prior to randomization) as determined by either 2D echocardiogram (ECHO) or MUGA (ECHO is the preferred method). If the patient is randomized, the same method of LVEF assessment, ECHO or MUGA, must be used throughout the study, and to the extent possible, be obtained at the same institution. 8. Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1. 9. For women of childbearing potential, agreement to use highly
effective non-hormonal form of contraception or two effective
forms of non-hormonal contraception by the patient and/or partner. Contraception use must continue for the duration of study treatment and for at least 6 months after the last dose of study treatment. For details see Section 7.2.6.
10. Written and signed informed consent (approved by the Independent Ethics Committee) obtained prior to beginning any protocol-specific procedures.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range

Exclusion Criteria

Cancer-Related: 1. Prior therapy with pertuzumab or capecitabine; 2. Concurrent immunotherapy or anticancer hormonal therapy; 3. Existing acute reversible effects of prior treatment. This generally means at least 3 weeks should have elapsed since prior chemotherapy and at least 4 weeks since prior (radical) radiotherapy or major surgery; 4. History of another malignancy which could affect compliance with the protocol or interpretation of results. Patients treated with curative intent and disease-free for at least 5 years are generally eligible, as are patients treated curatively for carcinoma in situ of the cervix or non-melanomatous skin cancer; 5. CNS metastases which are not well controlled. Eligible patients must be asymptomatic, can not be receiving steroids, and must be enrolled at least 1 month after the end of the radiotherapy treatment. Note: CT or MRI scan of the brain is mandatory (within 4 weeks prior to randomization) in case of clinical suspicion of CNS metastases; 6. History of exposure to at least one of the following cumulative doses of anthracyclines: doxorubicin or liposomal doxorubicin > 360 mg/m2 epirubicin > 720 mg/m2 mitoxantrone > 120 mg/m2 idarubicin > 90 mg/m2 Other (e.g. liposomal doxorubicin or other anthracycline > the equivalent of 360 mg/m2 of doxorubicin) If more than 1 anthracycline has been used, then the cumulative dose must not exceed the equivalent of 360 mg/m2 of doxorubicin. Hematological, Biochemical and Organ Function: 7. Current uncontrolled hypertension (systolic > 150 mm Hg and/or diastolic > 100 mmHg) or unstable angina; 8. History of CHF of any New York Heart Association (NYHA) criteria, or serious cardiac arrhythmia requiring treatment (except for atrial fibrillation and/or paroxysmal supraventricular tachycardia); 9. History of myocardial infarction within 6 months of randomization; 10. History of LVEF decline to below 50% during or after prior trastuzumab therapy or other cardiac toxicity during previous trastuzumab treatment that necessitated discontinuation of trastuzumab; 11. Current dyspnoea at rest requiring supportive oxygen therapy or with significant pleural effusions. Et al...

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Main Objective: To compare progression-free survival (PFS) between the two treatment arms based on assessments by an independent review facility (IRF).;Secondary Objective: - Overall survival (OS); - PFS based on tumor assessments by the Investigators; - Time to progression (TTP); - Time to treatment failure (TTF); - Overall objective response rate (ORR) clinical benefit rate (CBR), based on Investigator and IRF assessments; - Duration of objective response; - Safety and tolerability of trastuzumab plus capecitabine in combination with pertuzumab; - Correlation between biomarkers from tumor tissues and clinical outcomes.;Primary end point(s): The primary endpoint is PFS based on IRF evaluation. PFS is defined as the time from randomization to the first documented radiographical progressive disease, as determined by IRF using RECIST version 1.0,1 or death from any cause, whichever occurs first.
Secondary Outcome Measures
NameTimeMethod
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