- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04632992
A Study Evaluating Targeted Therapies in Participants Who Have Advanced Solid Tumors With Genomic Alterations or Protein Expression Patterns Predictive of Response (MyTACTIC)
MyTACTIC: An Open-Label Phase II Study Evaluating Targeted Therapies in Patients Who Have Advanced Solid Tumors With Genomic Alterations or Protein Expression Patterns Predictive of Response
This is a Phase II, multicenter, non-randomized, open-label, multi-arm study designed to evaluate the safety and efficacy of targeted therapies as single agents or in rational, specified combinations in participants with advanced unresectable or metastatic solid tumors determined to harbor specific biomarkers.
Patients will be enrolled based on local testing performed at a Clinical Laboratory Improvement Amendments (CLIA)-certified or equivalently accredited diagnostic laboratory. The multi-arm structure of the MyTACTIC study allows patients with solid tumors to be treated with a drug or drug regimen tailored to their biomarker identified at screening.
Study Overview
Status
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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Alaska
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Anchorage, Alaska, United States, 99508
- Alaska Oncology and Hematology
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Arizona
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Oro Valley, Arizona, United States, 85755-6216
- Arizona Clinical Research Ctr
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Arkansas
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Hot Springs, Arkansas, United States, 71913
- Genesis Cancer Center
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California
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Encinitas, California, United States, 92024-1328
- California Cancer Associates for Research and Excellence - Encinitas
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Los Angeles, California, United States, 90017
- Los Angeles Hematology Oncology Medical Group
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Monterey, California, United States, 93940
- Pacific Cancer Care - Monterey
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San Francisco, California, United States, 94118
- Kaiser Permanente - San Francisco Medical Center
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Santa Monica, California, United States, 90403
- Sarcoma Oncology Center
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Vallejo, California, United States, 94589
- Kaiser Permanente Medical Ctr
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Ventura, California, United States, 93003
- Ventura County Hematology Oncology Specialists
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Connecticut
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Norwich, Connecticut, United States, 06360-2740
- Eastern CT Hematology and Oncology Associates
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Florida
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Fort Myers, Florida, United States, 33916
- SCRI Florida Cancer Specialists South
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Saint Petersburg, Florida, United States, 33705-1400
- Florida Cancer Specialists - NORTH - SCRI - PPDS
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Tallahassee, Florida, United States, 32308
- Florida Cancer Specialists - PAN - SCRI - PPDS
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West Palm Beach, Florida, United States, 33401-3406
- Florida Cancer Specialists - EAST - SCRI - PPDS
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Idaho
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Boise, Idaho, United States, 83712
- St Luke?s Cancer Institute
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Louisiana
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Baton Rouge, Louisiana, United States, 70809
- Hematology and Oncology Clinic
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Maryland
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Baltimore, Maryland, United States, 21229-5201
- Saint Agnes Hospital - Baltimore - Hunt - PPDS
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Michigan
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Detroit, Michigan, United States, 48236
- Ascension St. John Hospital
-
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Montana
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Billings, Montana, United States, 59102
- Frontier Cancer Center and Blood Institute
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Nebraska
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Lincoln, Nebraska, United States, 68510-2496
- Southeast Nebraska Cancer Center
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New Jersey
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Brick, New Jersey, United States, 08724-3009
- New Jersey Hematology Oncology Associates LLC
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East Brunswick, New Jersey, United States, 08816
- Astera Cancer Care East Brunswick
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New York
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Bronx, New York, United States, 10469
- Eastchester Center for Cancer Care
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Bronx, New York, United States, 10469
- New York Cancer & Blood Specialists
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New York, New York, United States, 10028-0506
- Central Park Hematology and Oncology
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North Carolina
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Asheville, North Carolina, United States, 28806
- Messino Cancer Centers
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Ohio
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Canton, Ohio, United States, 44718
- Gabrail Cancer Center
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Canton, Ohio, United States, 44718
- Tri County Hematologyoncology
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Columbus, Ohio, United States, 43219
- SCRI Mark H. Zangmeister Center
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Oregon
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Portland, Oregon, United States, 97227
- Kaiser Permanente Center for Health Research
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Tennessee
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Chattanooga, Tennessee, United States, 37404
- Sarah Cannon Research Institute / Tennessee Oncology
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Memphis, Tennessee, United States, 38138
- The West Clinic, PC dba West Cancer Center
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Nashville, Tennessee, United States, 37203
- SCRI Oncology Partners
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Texas
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Fort Worth, Texas, United States, 76104-4611
- The Center for Cancer and Blood Disorders - PPDS
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San Antonio, Texas, United States, 78229
- Mays Cancer Center at UT Health San Antonio MD Anderson Cancer
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Virginia
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Richmond, Virginia, United States, 23219
- Virginia Commonwealth University - Massey Cancer Center
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Washington
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Federal Way, Washington, United States, 98003
- Northwest Medical Specialties B
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Histologically or cytologically confirmed diagnosis of advanced unresectable or metastatic solid malignancy
- Positive biomarker results from a Clinical Laboratory Improvement Amendments (CLIA)-certified or equivalently accredited diagnostic laboratory and availability of a full report of the testing results. This may be from a tissue or blood sample.
- Evaluable or measurable disease
- Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2
- Life expectancy ≥8 weeks
- Adequate hematologic and end-organ function, as defined in the protocol, obtained within 14 days prior to initiation of study treatment
- Agrees to take measures to prevent pregnancy in the patient or partner
- In addition to the general inclusion criteria above, there are treatment-specific inclusion criteria that apply for each respective treatment arm (as detailed in the protocol)
Exclusion Criteria:
- Current participation or enrollment in another therapeutic clinical trial
- Symptomatic or actively progressing CNS metastases (asymptomatic patients with treated or untreated CNS metastases may be eligible, provided all protocol-defined criteria are met)
- History of leptomeningeal disease, unless noted otherwise for a specific treatment arm of the study
- Wide field radiotherapy within 14 days prior to start of study treatment
- Stereotactic radiosurgery within 7 days prior to start of study treatment
- Severe infection within 4 weeks prior to initiation of study treatment, including, but not limited to, hospitalization for complications of infections, or any active infection that, in the opinion of the investigator, could impact patient safety
- Receipt of any anticancer drug/biologic or investigational treatment 21 days prior to Cycle 1, Day 1 except hormone therapy, which can be given up to 7 days prior to Cycle 1, Day 1 (androgen blockage may be continued for male patients with prostate cancer)
- Known human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B virus (HBV) infection with status outside of study-allowed criteria
- History of or concurrent serious medical condition or abnormality in clinical laboratory tests that precludes the patient's safe participation in and completion of the study or confounds the ability to interpret data from the study
- History of malignancy other than disease under study within 3 years prior to screening, with the exception of malignancies with a negligible risk of metastasis or death
- Incomplete recovery from any surgery prior to the start of study treatment that would interfere with the determination of safety or efficacy of study treatment
- Major surgical procedure, other than for diagnosis, or significant traumatic injury within 4 weeks prior to initiation of study treatment, or anticipation of need for a major surgical procedure during the study
- Significant cardiovascular disease, such as New York Heart Association cardiac disease (Class II or higher), myocardial infarction, or cerebrovascular accident within 3 months prior to enrollment, unstable arrhythmias, or unstable angina
- Pregnant or breastfeeding, or intending to become pregnant during the study
- In addition to the general exclusion criteria above, there are treatment-specific exclusion criteria that apply for each respective treatment arm (as detailed in the protocol)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: Arm A: Entrectinib
Participants in this treatment arm must have a positive tumor biomarker result for ROS1 gene fusion.
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Entrectinib will be self-administered by participants orally at home (except on clinic days), at the same time each day, on a starting dose of 600 milligrams (mg) per day once a day (QD) until disease progression, intolerable toxicity, or consent withdrawal.
Other Names:
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Experimental: Arm B: Inavolisib
Participants in this treatment arm must have a positive tumor biomarker result for PI3KCA activating mutation.
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Inavolisib will be self-administered by participants orally at home (except on clinic days) at the same time each day, on a starting dose of 9 mg/day QD until disease progression, intolerable toxicity, or consent withdrawal.
Other Names:
|
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Experimental: Arm C: Alectinib
Participants in this treatment arm must have a positive tumor biomarker result for ALK rearrangement tumors.
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Alectinib will be self-administered by participants orally at home (except on clinic days), at the same times each day, on a starting dose of 600 mg twice a day (BID) until disease progression, intolerable toxicity, or consent withdrawal.
Other Names:
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Experimental: Arm D: Ipatasertib
Participants in this treatment arm must have a positive tumor biomarker result for either AKT1/2/3 activating mutation or PTEN loss/loss of function.
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Ipatasertib will be self-administered by participants orally at home (except on clinic days), at the same time each day, on a starting dose of 400 mg QD until disease progression, intolerable toxicity, or consent withdrawal.
Other Names:
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Experimental: Arm E: Atezolizumab + Investigator's Choice of Chemotherapy
Participants in this treatment arm must have a positive tumor biomarker result for either tumor mutational burden (TMB) high or microsatellite instability (MSI) high/deficient mismatch repair (dMMR).
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Atezolizumab will be administered by intravenous (IV) infusion at a fixed dose of 1200 mg for participants on Day 1 of each 21-day cycle until unacceptable toxicity or progressive disease (or loss of clinical benefit).
Other Names:
Chemotherapy will consist of docetaxel, paclitaxel, or capecitabine, as determined by the investigator, and will be administered per the respective package insert and institutional guidelines.
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Experimental: Arm K: Ipatasertib + Atezolizumab
Participants in this treatment arm must have a positive tumor biomarker result for PI3KCA activating mutation.
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Ipatasertib will be self-administered by participants orally at home (except on clinic days), at the same time each day, on a starting dose of 400 mg QD until disease progression, intolerable toxicity, or consent withdrawal.
Other Names:
Atezolizumab will be administered by intravenous (IV) infusion at a fixed dose of 1200 mg for participants on Day 1 of each 21-day cycle until unacceptable toxicity or progressive disease (or loss of clinical benefit).
Other Names:
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Experimental: Arm L: Ipatasertib + Atezolizumab
Participants in this treatment arm must have a positive tumor biomarker result for either AKT1/2/3 activating mutation or PTEN loss/loss of function.
|
Ipatasertib will be self-administered by participants orally at home (except on clinic days), at the same time each day, on a starting dose of 400 mg QD until disease progression, intolerable toxicity, or consent withdrawal.
Other Names:
Atezolizumab will be administered by intravenous (IV) infusion at a fixed dose of 1200 mg for participants on Day 1 of each 21-day cycle until unacceptable toxicity or progressive disease (or loss of clinical benefit).
Other Names:
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Experimental: Arm M: Ipatasertib + Paclitaxel
Participants in this treatment arm must have a positive tumor biomarker results for PI3KCA activating mutations and either AKT1/2/3 activating mutation or PTEN loss/loss of function.
|
Ipatasertib will be self-administered by participants orally at home (except on clinic days), at the same time each day, on a starting dose of 400 mg QD until disease progression, intolerable toxicity, or consent withdrawal.
Other Names:
The dose of paclitaxel is 80 mg/m2 administered by IV infusion on Days 1, 8, and 15 of each 28-day cycle.
The paclitaxel infusion will be delivered over at least 60 minutes for each dose per institutional guidelines and administered after the oral dose of ipatasertib.
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Experimental: Arm N: Atezolizumab + Tiragolumab
Participants in this treatment arm must have a positive tumor biomarker result for either TMB high or MSI high/dMMR.
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Atezolizumab will be administered by intravenous (IV) infusion at a fixed dose of 1200 mg for participants on Day 1 of each 21-day cycle until unacceptable toxicity or progressive disease (or loss of clinical benefit).
Other Names:
Following the administration of atezolizumab and an observation period, participants will receive 600 mg tiragolumab at a fixed dose administered by IV infusion on Day 1 of each 21-day cycle.
Other Names:
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Experimental: Arm O: Pralsetinib
Participants in this treatment arm must have a positive tumor biomarker result for RET fusion.
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Pralsetinib will be self-administered by participants orally at home (except on clinic days), at the same time each day, on a starting dose of 400 mg/day (four 100-mg capsules per day) once a day (QD) until disease progression, intolerable toxicity, or consent withdrawal.
Other Names:
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Experimental: Arm F: Trastuzumab Emtansine + Atezolizumab
Participants in this treatment arm must have a positive tumor biomarker result for human epidermal growth factor receptor 2 (HER2) mutations or amplification without known TMB high or MSI high/dMMR.
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Atezolizumab will be administered by intravenous (IV) infusion at a fixed dose of 1200 mg for participants on Day 1 of each 21-day cycle until unacceptable toxicity or progressive disease (or loss of clinical benefit).
Other Names:
Trastuzumab emtansine will be administered at 3.6 mg per kilogram (kg) of body weight by IV infusion every 21 days (unless dose reduction and/or dose delays are required) until disease progression or unacceptable toxicity.
Other Names:
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Experimental: Arm G: PH FDC SC
Participants in this treatment arm must have a positive tumor biomarker result for HER2 mutation or amplification without known TMB high or MSI high/dMMR.
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PH FDC SC will be administered subcutaneously (SC) at a fixed non-weight-based dose.
A loading dose of 1200 mg SC pertuzumab and 600 mg SC trastuzumab is then followed by a maintenance dose of 600 mg SC pertuzumab and 600 mg SC trastuzumab once every 3 weeks.
Other Names:
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Experimental: Arm H: PH FDC SC + Investigator's Choice of Chemotherapy
Participants in this treatment arm must have a positive tumor biomarker result for HER2 mutation or amplification without known TMB high or MSI high/dMMR.
|
Chemotherapy will consist of docetaxel, paclitaxel, or capecitabine, as determined by the investigator, and will be administered per the respective package insert and institutional guidelines.
PH FDC SC will be administered subcutaneously (SC) at a fixed non-weight-based dose.
A loading dose of 1200 mg SC pertuzumab and 600 mg SC trastuzumab is then followed by a maintenance dose of 600 mg SC pertuzumab and 600 mg SC trastuzumab once every 3 weeks.
Other Names:
|
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Experimental: Arm I: Trastuzumab Emtansine + Tucatinib
Participants in this treatment arm must have a positive tumor biomarker result for HER2 mutation or amplification without known TMB high or MSI high/dMMR.
|
Trastuzumab emtansine will be administered at 3.6 mg per kilogram (kg) of body weight by IV infusion every 21 days (unless dose reduction and/or dose delays are required) until disease progression or unacceptable toxicity.
Other Names:
Tucatinib 300 mg will be administered orally BID continuously starting from Cycle 1 Day 1 onwards.
Other Names:
|
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Experimental: Arm J: Trastuzumab Emtansine + Atezolizumab
Participants in this treatment arm must have positive tumor biomarker results for HER2 mutation or amplification and TMB high or MSI high/dMMR.
|
Atezolizumab will be administered by intravenous (IV) infusion at a fixed dose of 1200 mg for participants on Day 1 of each 21-day cycle until unacceptable toxicity or progressive disease (or loss of clinical benefit).
Other Names:
Trastuzumab emtansine will be administered at 3.6 mg per kilogram (kg) of body weight by IV infusion every 21 days (unless dose reduction and/or dose delays are required) until disease progression or unacceptable toxicity.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Confirmed Objective Response Rate (ORR) Assessed by Investigator According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) or Response Assessment in Neuro-Oncology (RANO) Criteria for Primary Central Nervous System (CNS) Tumors
Time Frame: Up to 32 months
|
Confirmed objective response rate (cORR)=percentage of participants with best response as complete response (CR) or partial response (PR) for measurable disease & CR for non-measurable disease.
Confirmation=CR/PR on 2 consecutive visits ≥4 weeks apart for 3-week cycles & ≥6 weeks apart for 4-week cycles.
Per RECIST, CR=disappearance of all target lesions.
PR= ≥30% decrease in sum of diameters of target lesions, in absence of CR.
Per RANO, CR=complete disappearance of all measurable & non-measurable disease for ≥4 weeks; no new lesions/abnormality on T2/FLAIR imaging; stable/improved non-enhancing lesions; participants must be off corticosteroids or on physiological doses; clinical status stable/improved.
PR= ≥50% decrease in the sum of products of perpendicular diameters of measurable enhancing lesions on T2/FLAIR imaging for ≥4 weeks; no progression of non-measurable T1 disease; stable/improved non-enhancing lesions; corticosteroid dose ≤ baseline; clinical status stable/improved.
|
Up to 32 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Progression-Free Survival (PFS) as Determined by the Investigator According to RECIST v1.1 or RANO Criteria
Time Frame: Time from start of treatment to the first occurrence of disease progression or death from any cause (Up to 32 months)
|
PFS=time from start of treatment to the first occurrence of disease progression (PD) or death from any cause, whichever occurs first, per RECIST v1.1, or RANO.
Per RECIST, PD=≥20% increase in sum of diameters of lesions, using the smallest sum during the study as reference, including baseline (BL).
Per RANO, PD= ≥25% increase in sum of products of perpendicular diameters of enhancing lesions compared to smallest tumor measurement at BL/best response, on stable/increasing corticosteroids (CS) dose; Significant/ ≥25% increase of T2/FLAIR non-enhancing lesion on stable/increasing CS dose compared to BL/best response after therapy start; Presence of new lesions/increase of enhancement; Clear progression of non-measurable disease; Definite clinical deterioration only due to tumor/decrease in CS dose; Failure to return for evaluation due to death/deterioration. Kaplan-Meier methodology was used to estimate PFS; patients without an event were censored on the last available assessment day.
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Time from start of treatment to the first occurrence of disease progression or death from any cause (Up to 32 months)
|
|
Duration of Response (DOR) as Determined by the Investigator According to RECIST v1.1 or RANO Criteria
Time Frame: Time from the date of the first confirmed CR/PR to PD or death from any cause (Up to 32 months)
|
DOR was defined as the time from the date of the first confirmed complete response (CR) or partial response (PR) to disease progression (PD) or death from any cause, whichever occurs first, as determined by the investigator according to RECIST v1.1 or RANO.
CR & PR were defined per RECIST or RANO as outlined in the description for the cORR outcome measure (OM).
PD was defined per RECIST or RANO as outlined in the description for the PFS OM.
Kaplan-Meier methodology was used to estimate the median DOR.
The 95% confidence intervals for the median DOR were computed by the method of Brookmeyer and Crowley.
Participants who did not experience death or PD were censored on the day of the last available assessment.
|
Time from the date of the first confirmed CR/PR to PD or death from any cause (Up to 32 months)
|
|
PFS Rate at Month 3, 6, 9, and 12 as Determined by the Investigator According to RECIST v1.1 or RANO Criteria
Time Frame: At Months 3, 6, 9 and 12
|
The PFS rates were calculated using the Kaplan-Meier (KM) method to estimate the percent survival probability of participants (i.e., PFS event-free: did not experience PD or death from any cause) in each treatment arm at landmark timepoints.
The 95% confidence intervals for each PFS rate were computed by the method of Greenwood.
PFS was defined as the time from the start of study treatment to the first occurrence of PD or death from any cause, whichever occurs first, as determined by the investigator according to RECIST v1.1 or RANO.
PD was defined per RECIST or RANO as outlined in the description for the PFS OM.
Participants who did not experience death or PD were censored on the day of the last available assessment.
The number analyzed per landmark timepoint actually represents the number of participants who remained at risk of experiencing a PFS event at that timepoint.
Percentages are rounded off to the nearest decimal point.
|
At Months 3, 6, 9 and 12
|
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Percentage of Participants With Disease Control, as Determined by the Investigator According to RECIST v1.1 or RANO Criteria
Time Frame: Up to 32 months
|
Disease control rate was defined as the percentage of participants whose best response was confirmed CR, confirmed PR, or a response of CR, PR, stable disease (SD), or non-CR/non-PD for a minimum of 98 days for 28-day cycle arms or 70 days for 21-day cycle arms after the first treatment date.
CR & PR were defined per RECIST/RANO as outlined in the description for the cORR OM.
SD per RECIST: Neither sufficient shrinkage to qualify for CR or PR nor sufficient increase to qualify for PD.
SD per RANO: Participant does not qualify for CR, PR, or minor response or PD; Stable non-enhancing (T2/FLAIR) lesions or abnormalities on same or lower dose of corticosteroids compared to baseline; No new lesions or new T2 or FLAIR abnormalities apart from those consistent with radiation effect, & no new or increased enhancement; Participants on a should be corticosteroid dose that is not greater than dose at baseline scan & is stable or improved clinically; Clinical status, stable/improved.
|
Up to 32 months
|
|
Number of Participants With at Least One Adverse Event (AE) and Severity of AEs Determined According to National Cancer Institute Common Terminology Criteria for Adverse Events Version 5.0 (NCI CTCAE v5.0)
Time Frame: From initiation of study drug until 28 days after the final dose of study drugs other than atezolizumab and until 90 days after the final dose of atezolizumab (Up to 32 months)
|
An AE is an untoward medical occurrence in participant administered a pharmaceutical product & regardless of causal relationship with the product.
An AE can therefore be any unfavorable & unintended sign (including an abnormal laboratory finding), symptom/disease temporally associated with use of investigational product, whether or not considered related to it.
AEs were graded for severity according to NCI CTCAE v5.0.
Grade 1= Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; or intervention not indicated; Grade 2=Moderate; minimal, local or non-invasive intervention indicated; or limiting age-appropriate instrumental activities of daily living; Grade 3 = Severe or medically significant, but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; or limiting self-care activities of daily living; Grade 4= Life-threatening consequences/urgent intervention indicated; Grade 5= Death related to adverse event.
|
From initiation of study drug until 28 days after the final dose of study drugs other than atezolizumab and until 90 days after the final dose of atezolizumab (Up to 32 months)
|
Collaborators and Investigators
Sponsor
Investigators
- Study Director: Clinical Trials, Genentech, Inc.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms
- Antineoplastic Agents, Immunological
- Immune Checkpoint Inhibitors
- Phosphoinositide-3 Kinase Inhibitors
- Tyrosine Kinase Inhibitors
- Antineoplastic Agents
- Immunologic Factors
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Protein Kinase Inhibitors
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Phytogenic
- Immunoconjugates
- Immunotoxins
- Trastuzumab
- Atezolizumab
- Ado-Trastuzumab Emtansine
- Tucatinib
- Pralsetinib
- Entrectinib
- Inavolisib
- Ipatasertib
- Pertuzumab
- Alectinib
- Maytansine
Other Study ID Numbers
- ML42439
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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