- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04680442
Safety of Continuing HER-2 Directed Therapy in Overt Left Ventricular Dysfunction (SCHOLAR-2)
Safety of Continuing HER-2 Directed Therapy in Overt Left Ventricular Dysfunction: A Randomized, Controlled Trial
Trastuzumab is an important treatment for HER 2 positive breast cancer. But trastuzumab can cause injury to the heart, and this is one of the main reasons it cannot be administered as planned. Heart injury can often be successfully treated using cardiac medications. The objectives of SCHOLAR-2 are to evaluate whether is it safe and effective to continue trastuzumab, pertuzumab or trastuzumab-emtansine (T-DM1) in patients with early stage HER-2 positive breast cancer despite mild, minimally symptomatic or asymptomatic systolic left ventricular dysfunction as compared with a guideline-driven approach of withholding or discontinuing trastuzumab, pertuzumab or trastuzumab-emtansine (T-DM1).
In SCHOLAR-2, we will compare two thresholds of withholding or discontinuing trastuzumab/pertuzumab/trastuzumab-emtansine: a threshold that is currently advocated for by existing treatment practice guidelines versus a more aggressive threshold that allows trastuzumab/pertuzumab/trastuzumab-emtansine to continue at lower levels of LVEF than currently supported by guideline documents.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
SCHOLAR-2 is a Phase II open-label randomized controlled trial with blinded outcome event ascertainment with a target sample size of 130.
Control Group Recommendations for continuing or holding trastuzumab, pertuzumab, or trastuzumab-emtansine (T-DM1) for the control group are guided by an adaptation of the 2008 Canadian recommendations.
Intervention Group The intervention group will continue to receive trastuzumab, pertuzumab, or trastuzumab-emtansine (T-DM1) in the setting of asymptomatic decline in LVEF up to an LVEF of 40% as outlined in the criteria listed in Table 3. For reasons of practicality, in the intervention group, the first dose of trastuzumab, pertuzumab, or trastuzumab-emtansine (T-DM1) after randomization can be administered up to 3 weeks late. This will allow time for the participant to be reviewed by a cardiologist and to receive ACE-I/angiotensin receptor blocker and/or beta-blocker, and for dose titration.
Study assessments will occur:
- 3 weeks after randomization
- 6 weeks after randomization
- Follow-up at every 3 months thereafter until 12 months after the last dose of trastuzumab, pertuzumab, or trastuzumab-emtansine (T-DM1)
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Maha Mushtaha, BSc
- Phone Number: 41084 9052973479
- Email: maha.mushtaha@phri.ca
Study Contact Backup
- Name: Sumathy Rangarajan, MSc
- Phone Number: 40464 9052973479
- Email: sumathy.rangarajan@phri.ca
Study Locations
-
-
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São Paulo, Brazil, 01327-903
- Recruiting
- Hospital Alemão Oswaldo Cruz
-
Contact:
- Nathalia Santos
- Email: natsantos@haoc.com.br
-
Principal Investigator:
- Pedro Exman
-
São Paulo, Brazil, 1317000
- Recruiting
- Clinica de Pesquisa e Centro de Estudos em Oncologia Ginecologica e Mamaria Ltda
-
Contact:
- Nathalia Santos
- Email: natsantos@haoc.com.br
-
Principal Investigator:
- Andre Mattar
-
-
Rio Grande Do Sul
-
Porto Alegre, Rio Grande Do Sul, Brazil, 90050-170
- Recruiting
- Irmandade da Santa Casa de Misericordia de Porto Alegre
-
Contact:
- Nathalia Santos
- Email: natsantos@haoc.com
-
Principal Investigator:
- Katsuki Tiscoski
-
Porto Alegre, Rio Grande Do Sul, Brazil, 90035903 / 90410000
- Recruiting
- Hospital de Clinicas de Porto Alegre
-
Contact:
- Nathalia Santos
- Email: natsantos@haoc.com.br
-
Contact:
- Rafael Zimmer
- Email: rzimmer@hcpa.edu.br
-
Principal Investigator:
- Felipe Homem Valle
-
-
-
-
Ontario
-
Hamitlon, Ontario, Canada
- Recruiting
- Juravnski Cancer Centre
-
Contact:
- Som Mukherjee
- Phone Number: 63123 905-387-9711
- Email: mukherjee@HHSC.CA
-
Principal Investigator:
- Som Mukherjee
-
Ottawa, Ontario, Canada
- Recruiting
- Ottawa Hospital Research Institute
-
Contact:
- Kelsey Ross
- Email: kelross@ohri.ca
-
Principal Investigator:
- Marie-France Savard
-
Toronto, Ontario, Canada, M5G 2N2
- Recruiting
- Toronto General Hospital, University Health Network
-
Contact:
- Tiffanie Kei
- Email: tiffanie.kei@uhn.ca
-
Principal Investigator:
- Dinesh Thavendiranathan
-
-
-
-
-
Novosibirsk, Russian Federation, 630055
- Suspended
- E.Meshalkin National medical research center of the Ministry of Health of the Russian Federation
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Stage I-III HER-2 positive breast cancer
- Receiving adjuvant or neoadjuvant therapy with trastuzumab, pertuzumab, or trastuzumab-emtansine (T-DM1)
Evidence of left ventricular dysfunction, as defined by at least one of:
a) LVEF < 54% or b) LVEF ≥54% and either i) fall in LVEF of ≥15% from prior to trastuzumab, pertuzumab, or trastuzumab-emtansine (T-DM1) exposure, or ii) New York Heart Association (NYHA) class II heart failure symptoms within the past 6 months
Exclusion Criteria:
- Current use of both angiotensin converting enzyme inhibitor (ACEI) /angiotensin receptor blocker (ARB) and beta-blocker
- Contra-indication to both ACE-I/ARB and beta-blockers
- NYHA class III or IV heart failure
- LVEF <40%
- Systolic blood pressure <100mmHg
- Current or planned pregnancy or breastfeeding
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Control Group
Recommendations for continuing or holding trastuzumab, pertuzumab, or trastuzumab-emtansine (T-DM1) for the control group are guided by an adaptation of the 2008 Canadian recommendations.
|
Trastuzumab is a HER-2 targeting monoclonal antibody that improves overall survival and reduces the risk of recurrent disease in early stage HER-2 positive breast cancer.
Other Names:
Pertuzumab (also called 2C4, trade name Perjeta) is a monoclonal antibody used in combination with trastuzumab and docetaxel for the treatment of metastatic HER2-positive breast cancer; it also used in the same combination as a neoadjuvant in early HER2-positive breast cancer
Other Names:
Ado-trastuzumab emtansine is approved to treat: Breast cancer that is HER2 positive and has already been treated with a taxane and trastuzumab.
Other Names:
|
Experimental: Intervention Group
The intervention group will continue to receive trastuzumab, pertuzumab, or trastuzumab-emtansine (T-DM1) in the setting of asymptomatic decline in LVEF up to an LVEF of 40% as outlined in the criteria listed in Table 3.
For reasons of practicality, in the intervention group, the first dose of trastuzumab, pertuzumab, or trastuzumab-emtansine (T-DM1) after randomization can be administered up to 3 weeks late.
This will allow time for the participant to be reviewed by a cardiologist and to receive ACE-I/angiotensin receptor blocker and/or beta-blocker, and for dose titration.
|
Trastuzumab is a HER-2 targeting monoclonal antibody that improves overall survival and reduces the risk of recurrent disease in early stage HER-2 positive breast cancer.
Other Names:
Pertuzumab (also called 2C4, trade name Perjeta) is a monoclonal antibody used in combination with trastuzumab and docetaxel for the treatment of metastatic HER2-positive breast cancer; it also used in the same combination as a neoadjuvant in early HER2-positive breast cancer
Other Names:
Ado-trastuzumab emtansine is approved to treat: Breast cancer that is HER2 positive and has already been treated with a taxane and trastuzumab.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
primary efficacy outcome
Time Frame: one year
|
the proportion of participants completing trastuzumab, pertuzumab, or trastuzumab-emtansine (T-DM1) as planned at its initiation
|
one year
|
co-primary safety outcomes
Time Frame: one year
|
|
one year
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
secondary outcome measures the composite of NYHA class III or IV heart failure, breast cancer relapse, or all-cause mortality.
Time Frame: one year
|
the composite of NYHA class III or IV heart failure, breast cancer relapse, or all-cause mortality.
|
one year
|
Collaborators and Investigators
Investigators
- Principal Investigator: Darryl Leong, PhD. MBBSm, McMaster University
- Principal Investigator: Som Mukherjee, MD MSc FRCPC, Hamilton Health Sciences Corporation
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
- Heart Diseases
- Cardiovascular Diseases
- Ventricular Dysfunction
- Ventricular Dysfunction, Left
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Immunologic Factors
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Phytogenic
- Antineoplastic Agents, Immunological
- Immunoconjugates
- Immunotoxins
- Trastuzumab
- Maytansine
- Ado-Trastuzumab Emtansine
- Pertuzumab
Other Study ID Numbers
- PHRI.SCHOLAR-2
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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