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A Study of DS-8201a in Metastatic Breast Cancer Previously Treated With Trastuzumab Emtansine (T-DM1)

Phase 2
Active, not recruiting
Conditions
Breast Cancer
Interventions
Registration Number
NCT03248492
Lead Sponsor
Daiichi Sankyo
Brief Summary

Some human epidermal growth factor receptor 2 (HER-2) breast cancer patients do not respond or become resistant to current treatment. DS-8201a is a new experimental product that is a combination of an antibody and a drug. It has not yet been approved for use. DS-8201a may slow down tumor growth. This might improve outcomes for these patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
253
Inclusion Criteria
  • Men or women the age of majority in their country

  • Has pathologically documented breast cancer that:

    1. is unresectable or metastatic
    2. has HER2 positive expression confirmed per protocol
  • Has an adequate tumor sample

  • Has at least one measurable lesion per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1

  • Has protocol-defined adequate cardiac, renal and hepatic function

  • Agrees to follow protocol-defined method(s) of contraception

Exclusion Criteria
  • Has a medical history of myocardial infarction, symptomatic congestive heart failure (CHF) (NYHA classes II-IV), unstable angina or serious cardiac arrhythmia

  • Has a corrected QT interval (QTc) prolongation to > 450 millisecond (ms) in males and > 470 ms in females

  • Has a medical history of clinically significant lung disease

  • Is suspected to have certain other protocol-defined diseases based on imaging at screening period

  • Has history of any disease, metastatic condition, drug/medication use or other condition that might, per protocol or in the opinion of the investigator, compromise:

    1. safety or well-being of the participant or offspring
    2. safety of study staff
    3. analysis of results

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
DS-8201a Low DoseDS-8201aT-DM1 resistant/refractory (R/R) patients in the low dose treatment group
DS-8201a Medium DoseDS-8201aT-DM1 resistant/refractory (R/R) patients in the medium dose treatment group
DS-8201a High DoseDS-8201aT-DM1 resistant/refractory (R/R) patients in the high dose treatment group
Exploratory ArmDS-8201aIn Part 2b- Continuation Stage, about 10 T-DM1 Intolerant patients will receive the DS-8201a recommended dose (RD) as an exploratory arm
Primary Outcome Measures
NameTimeMethod
Objective Response Rate as Confirmed by Independent Central Review Following Intravenous Administration of 5.4 mg/kg DS-8201a in Participants With Metastatic Breast Cancer (Enrolled Analysis Set)at least 6 months after last participant enrolled received first dose up to 19 months (data cut off)

The number of participants with objective response was assessed every six weeks from Cycle 1 Day 1 through discontinuation of treatment, by independent central imaging facility review based on RECIST version 1.1.

Secondary Outcome Measures
NameTimeMethod
Best Overall Tumor Response as Confirmed By the Investigator Following Intravenous Administration of DS-8201a in Participants With Metastatic Breast Cancer (Enrolled Analysis Set)at least 6 months after last participant enrolled received first dose up to 19 months (data cut off)

Best overall tumor response was defined as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD) by the investigator based on RECIST v1.1. Participants who were non-evaluable (NE) are also reported.

Percent Change From Baseline in Sum of Diameters Over Time as Determined by Independent Central Review Following Intravenous Administration of DS-8201a in Participants With Metastatic Breast Cancer (Enrolled Analysis Set)Baseline up to Week 6, 12, 18, 24, 30, 36 post dose

Best percent change in sum of diameters of measurable tumors was based on RECIST 1.1. The best percent change was defined as the percent change in the smallest sum of diameters from all post-baseline tumor assessments, taking as reference the baseline sum of diameters.

Objective Response Rate as Confirmed By the Investigator Following Intravenous Administration of DS-8201a in Participants With Metastatic Breast Cancer (Enrolled Analysis Set)at least 6 months after last participant enrolled received first dose up to 19 months (data cut off)

The number of participants with objective response is assessed every six weeks from Cycle 1 Day 1 through discontinuation of treatment. Investigator-assessed objective response rate (ORR) was defined as the proportion of participants who achieved a best overall response of complete response or partial response based on local radiologists/investigators' tumor assessments.

Disease Control Rate and Clinical Benefit Rate as Confirmed by Independent Central Review Following Intravenous Administration of DS-8201a in Participants With Metastatic Breast Cancer (Enrolled Analysis Set)at least 6 months after last participant enrolled received first dose up to 19 months (data cut off)

Number of participants with controlled disease and who received clinical benefit from treatment as assessed by independent central review. DCR was defined as the proportion of participants who achieved a best overall response of complete response, partial response, or stable disease. CBR was defined as the proportion of participants who achieved a best overall response of complete response or partial response or more than 6 months of stable disease.

Duration of Response (Complete Response or Partial Response) as Confirmed by Independent Central Review Following Intravenous Administration of DS-8201a in Participants With Metastatic Breast Cancer (Enrolled Analysis Set)at least 6 months after last participant enrolled received first dose up to 19 months (data cut off)

The estimated duration of confirmed response (complete response \[CR\] or partial response \[PR\]) was assessed by independent central review. Duration of response was defined as the time interval between the date of first documentation of objective response (CR or PR) and the date of the first objective documentation of disease progression or death due to any cause.

Progression-Free Survival Estimate As Confirmed by Independent Central Review Following Intravenous Administration of DS-8201a in Participants With Metastatic Breast Cancer (Enrolled Analysis Set)at least 6 months after last participant enrolled received first dose up to 19 months (data cut off)

The point estimate of progression-free survival (PFS) is reported. PFS was defined as the time interval between the date of randomization/registration and the first documentation of disease progression or death due to any cause.

Overall Summary of Treatment-emergent Adverse Events (TEAEs) Following Intravenous Administration of DS-8201a in Participants With Metastatic Breast Cancer (Safety Analysis Set)Day 0 to Day 47 post last dose

TEAEs were assessed by severity and seriousness according to unique criteria. Severity described the intensity of an event and was graded using National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03, where Grade 1: Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated; Grade 2: Moderate; minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental activities of daily living (ADL); Grade 3: Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care ADL; Grade 4: Life-threatening consequences; urgent intervention indicated; and Grade 5: Death related to AE. Serious TEAEs were defined as any untoward medical occurrence that at any dose results in death, is life threatening, requires inpatient hospitalization, or causes prolongation of existing hospitalization.

Trial Locations

Locations (99)

The Regents of the University of California

🇺🇸

Los Angeles, California, United States

Virginia Cancer Specialists, PC

🇺🇸

Fairfax, Virginia, United States

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

Texas Oncology - Memorial City

🇺🇸

Houston, Texas, United States

Miami Cancer Institute at Baptist Health, Inc.

🇺🇸

Miami, Florida, United States

MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

The Methodist Hospital Research Institute

🇺🇸

Houston, Texas, United States

CRLCC Eugene Marquis

🇫🇷

Rennes, France

Grand Hôpital de Charleroi

🇧🇪

Charleroi, Belgium

AZ Sint-Maarten

🇧🇪

Mechelen, Belgium

Institut Sainte Catherine

🇫🇷

Avignon, France

Piedmont Cancer Institute

🇺🇸

Atlanta, Georgia, United States

UZ Leuven

🇧🇪

Leuven, Belgium

Dana Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Centre Catherine de Sienne

🇫🇷

Nantes, France

Ospedale San Raffaele

🇮🇹

Milano, Italy

Innovative Clinical Research Institute, LLC

🇺🇸

Whittier, California, United States

Aichi Cancer Center Hospital

🇯🇵

Aichi, Japan

University of Calgary

🇨🇦

Calgary, Alberta, Canada

Sylvester Comprehensive Cancer Center - Deerfield Beach

🇺🇸

Boca Raton, Florida, United States

UPMC Cancer Center

🇺🇸

Pittsburgh, Pennsylvania, United States

Imeldaziekenhuis

🇧🇪

Bonheiden, Belgium

Providence Regional Medical Center - Everett

🇺🇸

Everett, Washington, United States

CHU Besançon - Hôpital Jean Minjoz

🇫🇷

Besançon, France

Hôpital d'Instruction des Armees Begin

🇫🇷

Saint-Mandé, France

Centre Paul Strauss

🇫🇷

Strasbourg, France

Texas Oncology, P.A. - Longview

🇺🇸

Tyler, Texas, United States

Hôpital Nord - CHU Marseille

🇫🇷

Marseille, France

Centre Hospitalier Lyon Sud

🇫🇷

Pierre-Bénite, France

NHO Kyushu Cancer Center

🇯🇵

Fukuoka, Japan

Toranomon Hospital

🇯🇵

Minato-Ku, Tokyo-To, Japan

Kyungpook National University Chilgok Hospital

🇰🇷

Daegu, Korea, Republic of

Fondazione IRCCS Istituto Nazionale dei Tumori

🇮🇹

Milano, Italy

National Cancer Center Hospital

🇯🇵

Tokyo, Japan

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Hospital Universitari Vall d'Hebron

🇪🇸

Barcelona, Spain

Azienda Socio Sanitaria Territoriale di Monza (Presidio San Gerardo)

🇮🇹

Monza, Italy

Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona

🇮🇹

Torrette, Italy

St. Luke's International Hospital

🇯🇵

Tokyo, Japan

University of California San Francisco

🇺🇸

San Francisco, California, United States

Clinique Victor Hugo - Centre Jean Bernard

🇫🇷

Le Mans, France

Hospital Universitario Virgen Macarena

🇪🇸

Sevilla, Spain

CH de la Rochelle - Hopital St Louis

🇫🇷

La Rochelle, France

Arizona Oncology Associates

🇺🇸

Tucson, Arizona, United States

Sharp Clinical Oncology Research

🇺🇸

San Diego, California, United States

Sansum Clinic

🇺🇸

Santa Barbara, California, United States

Specialist Global Research

🇺🇸

Hialeah, Florida, United States

Aultman Hospital Cancer Center

🇺🇸

Canton, Ohio, United States

Memorial Sloan Kettering Cancer Center

🇺🇸

New York, New York, United States

University of Cincinnati Medical Center

🇺🇸

Cincinnati, Ohio, United States

St Francis Hospital

🇺🇸

Greenville, South Carolina, United States

Accurate Clinical Research

🇺🇸

Baytown, Texas, United States

CHU Sart Tilman

🇧🇪

Liège, Belgium

Institut Régional du Cancer de Montpellier

🇫🇷

Montpellier, France

Institut Gustave Roussy

🇫🇷

Villejuif, France

NHO Shikoku Cancer Center

🇯🇵

Matsuyama, Ehime-Ken, Japan

IEO Istituto Europeo di Oncologia

🇮🇹

Milano, Italy

Ospedale degli Infermi

🇮🇹

Rimini, Italy

National Cancer Center Hospital East

🇯🇵

Chiba, Japan

Kanagawa Cancer Center

🇯🇵

Kanagawa, Japan

Hakuaikai Sagara Hospital

🇯🇵

Kagoshima, Japan

Kindai University Hospital

🇯🇵

Osaka, Japan

Cancer Institute Hospital of JFCR

🇯🇵

Tokyo, Japan

Korea University Anam Hospital

🇰🇷

Seoul, Korea, Republic of

Hospital Infanta Cristina

🇪🇸

Badajoz, Spain

Severance Hospital, Yonsei University

🇰🇷

Seoul, Korea, Republic of

MD Anderson Cancer Centre

🇪🇸

Madrid, Spain

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Hospital Universitari Quiron Dexeus

🇪🇸

Barcelona, Spain

Hospital Universitario Ramon y Cajal

🇪🇸

Madrid, Spain

Instituto Valenciano de Oncologia IVO

🇪🇸

Valencia, Spain

Western General Hospital

🇬🇧

Edinburgh, Lothian Region, United Kingdom

University College London Hospitals

🇬🇧

London, Greater London, United Kingdom

North Shore Hematology Oncology Associates PC DBA NY Cancer and Blood Specialists

🇺🇸

East Setauket, New York, United States

Allegheny General Hospital

🇺🇸

Pittsburgh, Pennsylvania, United States

Centre Georges François Leclerc

🇫🇷

Dijon, France

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

CHU Bordeaux - Hôpital Saint André

🇫🇷

Gironde, France

Texas Oncology, P.A.

🇺🇸

Dallas, Texas, United States

ICO l´Hospitalet - Hospital Duran i Reynals

🇪🇸

Barcelona, Spain

Hôpital Saint-Louis - Paris

🇫🇷

Paris, France

Seoul National University Bundang Hospital

🇰🇷

Seongnam-si, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

Hospital Quiron Barcelona

🇪🇸

Barcelona, Spain

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Hospital Clinico Universitario Virgen de la Victoria

🇪🇸

Málaga, Spain

Alaska Urological Institute dba Alaska Clinical Research Center

🇺🇸

Anchorage, Alaska, United States

Norton Healthcare

🇺🇸

Louisville, Kentucky, United States

University of Louisville Research Foundation

🇺🇸

Louisville, Kentucky, United States

Henry Ford Hospital

🇺🇸

Detroit, Michigan, United States

Royal Surrey County Hospital

🇬🇧

Guildford, Surrey, United Kingdom

Queen Mary University of London

🇬🇧

London, Greater London, United Kingdom

Nottingham University Hospitals City Campus

🇬🇧

Nottingham, Nottinghamshire, United Kingdom

National Cancer Center

🇰🇷

Goyang-si, Korea, Republic of

Derriford Hospital

🇬🇧

Plymouth, Devon, United Kingdom

The University of Texas Health Science Center at Tyler

🇺🇸

Tyler, Texas, United States

Straub Medical Center

🇺🇸

Honolulu, Hawaii, United States

University of Hawaii

🇺🇸

Honolulu, Hawaii, United States

Ochsner Clinic Foundation

🇺🇸

New Orleans, Louisiana, United States

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