- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT01216176
A Pharmacokinetic and Randomized Trial of Neoadjuvant Treatment With Anastrozole Plus AZD0530 in Postmenopausal Patients With Hormone Receptor Positive Breast Cancer
11. července 2019 aktualizováno: Joyce Marie Slingerland
A Phase I Pharmacokinetic and Randomized Phase II Trial of Neoadjuvant Treatment With Anastrozole Plus AZD0530 in Postmenopausal Patients With Hormone Receptor Positive Breast Cancer
The investigators propose to conduct a Phase I/randomized Phase II study design in order to test the tolerability and efficacy of AZD0530 (also called saracatinib) when used together with anastrozole in therapy for ER+ and/or PR+, postmenopausal breast cancer.
The Phase I pharmacokinetic (PK) cohort of the study (cohort A) in postmenopausal women with metastatic breast cancer 2008-2009 showed initial safety,tolerability and good bioavailability of both drugs and determined the doses for use in the ongoing Phase II trial.
In the randomized Phase II cohort of the study (cohort B), postmenopausal women with newly diagnosed, previously untreated ER+, HER2 negative breast cancer that is at least 2 cm or more in diameter by clinical exam or radiology will be randomized to either neoadjuvant treatment with anastrozole plus placebo, or anastrozole in combination with AZD0530 (saracatinib).
The Phase II cohort will permit extended assays of tolerability, initial estimates of efficacy, and the investigation of molecular predictors of drug efficacy.
Přehled studie
Postavení
Dokončeno
Podmínky
Intervence / Léčba
Typ studie
Intervenční
Zápis (Aktuální)
71
Fáze
- Fáze 2
- Fáze 1
Kontakty a umístění
Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.
Studijní místa
-
-
California
-
Palo Alto, California, Spojené státy, 94304
- Stanford University
-
-
Florida
-
Miami, Florida, Spojené státy, 33136
- University of Miami
-
-
Kritéria účasti
Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.
Kritéria způsobilosti
Věk způsobilý ke studiu
18 let a starší (Dospělý, Starší dospělý)
Přijímá zdravé dobrovolníky
Ne
Pohlaví způsobilá ke studiu
Ženský
Popis
Inclusion Criteria - Phase 1 (Cohort A):
- Female patient ≥ 18 years
Patient must be postmenopausal, verified by 1 of the following:
- Bilateral surgical oophorectomy
- No spontaneous menses > 1 year
- No menses for < 1 year with FSH and estradiol levels in postmenopausal range. If a study subject under the age of 60 reports prior surgery in which the ovaries were removed and if the operative report cannot be obtained to confirm bilateral salpingo-oophorectomy, the subject will have serum estradiol, LH and FSH drawn to confirm menopausal status prior to study entry
- Postmenopausal women with primary invasive breast cancer, histologically confirmed by core needle (or incisional biopsy), whose tumors are estrogen (ER) and/or progesterone (PgR) positive. Estrogen- and/or progesterone-receptor positive disease based on 10% or more nuclear staining of the invasive component of the tumor
- Stage IV disease (as defined by the AJCC Staging Manual, 6th Edition, 2002); or locally relapsed, unresectable disease
- Measurable or evaluable disease according to RECIST criteria (see appendix VII)
- Both HER2-positive and HER2-negative disease (as defined by IHC or by fluorescence in situ hybridization [FISH]). HER2+ must have had prior treatment with trastuzumab and/or lapatinib.
- ECOG performance status 0-2 (see appendix VI)
- Patients are suitable candidates for treatment with anastrozole (patients may have had any prior endocrine therapy or prior chemotherapy for treatment of their disease, either as adjuvant therapy, or as treatment for advanced disease). There is no restriction on the number of prior regimens in the phase I cohort A.
- Patient is accessible and willing to comply with treatment and follow-up
- Patient is willing to provide written informed consent prior to the performance of any study-related procedures
Required laboratory values
- Absolute neutrophil count ≥ to 1.5 x 10^9/L
- Hemoglobin ≥ to 9.0 g/dL
- Platelet count ≥ to 100 x 10^9/L
- Creatinine ≤ 1.5 mg/dL
- Total bilirubin ≤ 1.0 x upper limit of normal (ULN)
- Alkaline phosphatase and AST/ALT within protocol parameters. In determining eligibility, the more abnormal of the two values (AST or ALT) should be used.
Inclusion Criteria - Phase 2 (Cohort B):
- Female patient ≥ 18 years
Patient must be postmenopausal, verified by 1 of the following:
- Bilateral surgical oophorectomy
- No spontaneous menses ≥ 1 year
- No menses for < 1 year with FSH and estradiol levels in postmenopausal range. If a study subject under the age of 60 reports prior surgery in which the ovaries were removed and if the operative report cannot be obtained to confirm bilateral salpingo-oophorectomy, the subject will have serum estradiol, LH and FSH drawn to confirm menopausal status prior to study entry
- Postmenopausal women with primary invasive breast cancer, histologically confirmed by core needle (or incisional biopsy), whose tumors are estrogen (ER) and/or progesterone (PgR) positive. Estrogen- and/or progesterone-receptor positive disease based on 10% or more nuclear staining of the invasive component of the tumor. Patients may have bilateral or multifocal invasive breast cancers. The patient may have concurrent DCIS in either breast but the DCIS will not be measured as part of the study endpoints.
- Tumor size ≥ 2 cm
- Tumor measurable either by clinical examination, mammography, MRI, or ultrasound
- HER2-negative disease (as defined by fluorescence in situ hybridization [FISH] or by IHC)
- ECOG performance status 0-1 (see Appendix VI)
- Patient is accessible and willing to comply with treatment and follow-up
- Patient is willing to provide written informed consent prior to the performance of any study-related procedures
Required laboratory values
- Absolute neutrophil count ≥ 1.5 x 10^9/L
- Hemoglobin ≥ 9.0 g/dL
- Platelet count ≥ 70 x 10^9/L
- Creatinine ≤ 1.5 mg/dL
- Total bilirubin ≤ 1.5 x upper limit of normal (ULN)
- Alkaline phosphatase and AST/ALT ≤ 1.5 x upper limit of normal (ULN)
Exclusion Criteria - Phase 1 (Cohort A):
Concurrent therapy with any other non-protocol anti-cancer therapy
- Any agent with estrogenic or putatively estrogenic properties, including herbal preparations, must be stopped at least one week prior to registration.
- Ongoing, chronic administration of bisphosphonate therapy is allowed so long as such treatment was ongoing at the time of study entry.
- Current therapy with hormone replacement therapy, or any hormonal agent such as raloxifene, tamoxifen, or other selective estrogen receptor modulators (agents must be stopped prior to randomization)
- Presence of neuropathy ≥ grade 2 (NCI-CTC version 3.0) at baseline
- History of any other malignancy within the past 5 years, with the exception of non-melanoma skin cancer or carcinoma-in-situ of the cervix
- Clinically significant cardiovascular disease (e.g., hypertension [BP > 150/100], history of myocardial infarction or stroke within 6 months, unstable angina), New York Heart Association (NYHA) Grade II or greater congestive heart failure, or serious cardiac arrhythmia requiring medication
- Active, uncontrolled infection requiring parenteral antimicrobials
- A history of a severe hypersensitivity reaction to anastrozole, or AZD0530 or their excipients
- Evidence of bleeding diathesis or coagulopathy.
- Resting EKG with measurable QTc interval of >480msec at 2 or more time points within a 24 hr period.
- Since AZD0530 is a substrate and inhibitor of CYP3A4, patients requiring medication with drugs listed in Appendix XI should be excluded from study.
- Any evidence of severe or uncontrolled systemic medical or psychiatric conditions (e.g. Severe hepatic impairment, interstitial lung disease [bilateral, diffuse, parenchymal lung disease]) or current unstable or uncompensated respiratory or cardiac conditions which make it undesirable for the patient to participate in the study or which could jeopardize compliance with the protocol
- Evidence of underlying pulmonary dysfunction as evidenced by oxygen saturation <90% by pulse oximetry, interstitial pulmonary infiltrates on high resolution CT scan prior to study entry and/or symptomatic pulmonary (pleural or parenchymal) metastasis.
Exclusion Criteria - Phase 2 (Cohort B):
- Prior chemotherapy, endocrine therapy or radiotherapy for the presenting breast cancer. Prior incidence and treatment of contralateral invasive or non-invasive breast cancer is not an exclusion criterion.
- Inflammatory breast cancer, clinically defined as the presence of erythema or induration involving one-third or more of the breast, or pathologically defined as dermal lymphatic invasion
- Prior excisional biopsy or complete resection of the primary invasive tumor (prior sentinel node biopsy allowed)
- Prior ipsilateral radiation therapy for invasive or non-invasive breast cancer
- Distant metastasis is an exclusion criterion - Isolated ipsilateral supraclavicular node involvement and/or direct invasion of the primary tumor into skin is allowed
- Concurrent therapy with any other non-protocol anti-cancer therapy
- Any agent with estrogenic or putatively estrogenic properties, including herbal preparations, must be stopped at least one week prior to registration
- Current therapy with hormone replacement therapy, or any hormonal agent such as raloxifene, tamoxifen, or other selective estrogen receptor modulators (agents must be stopped for one week prior to randomization)
- Presence of neuropathy ≥ grade 2 (NCI-CTC AE version 3.0) at baseline
- History of any other malignancy within the past 5 years, with the exception of non-melanoma skin cancer or carcinoma-in-situ of the cervix
- Clinically significant cardiovascular disease (e.g. history of myocardial infarction or stroke within 6 months, unstable angina), New York Heart Association (NYHA) Grade II or greater congestive heart failure, or serious cardiac arrhythmia requiring medication
- Active, uncontrolled infection requiring parenteral antimicrobials
- A history of a severe hypersensitivity reaction to anastrozole, or AZD0530 (saracatinib) or their excipients
- Evidence of bleeding diathesis or coagulopathy
- Resting EKG with measurable QTc interval of >480msec at 2 or more time points within a 24 hr period.
- AZD0530 (saracatinib) is a substrate and inhibitor of CYP3A4. Since concurrent administration of AZD0530 with other CYP3A4 substrates has been shown to be well tolerated, continuation or initiation of medically indicated drugs that are substrates of CYP3A4 is permitted at MD discretion. Drugs listed in Appendix X that are known to strongly induce or inhibit CYP3A4 activity should be discontinued prior to study entry and should not be initiated during protocol treatment.
- Any evidence of severe or uncontrolled systemic psychiatric or medical conditions (eg. Severe hepatic impairment, interstitial lung disease [bilateral, diffuse, parenchymal lung disease]) or current unstable or uncompensated respiratory or cardiac conditions which make it undesirable for the patient to participate in the study or which could jeopardize compliance with the protocol
- Evidence of underlying pulmonary dysfunction as evidenced by oxygen saturation <90% by pulse oximetry prior to study entry and/or symptomatic pulmonary (pleural or parenchymal) disease.
- Subjects unwilling or unable to undergo breast MRI as required by protocol will be excluded from study
Studijní plán
Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Dvojnásobek
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
---|---|
Experimentální: Phase 1 - Cohort A
Dual treatment with 1 mg anastrozole orally once daily together with AZD0530 (saracatinib) 175 mg orally once daily, or as specified per protocol, until disease progression for treatment of metastatic breast cancer
|
|
Aktivní komparátor: Phase 2 - Cohort B [Anastrozole + AZD0530]
Dual treatment with 1 mg anastrozole orally once daily together with AZD0530 (saracatinib) 175 mg orally once daily, or as specified per protocol, until disease progression or 4-6 months of treatment completed.
|
|
Komparátor placeba: Phase 2 - Cohort B [Anastrozole + Placebo]
Dual treatment with 1 mg anastrozole orally once daily together with Placebo orally once daily, or as specified per protocol, until disease progression or4-6 months of treatment completed.
|
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
---|---|---|
Phase I Cohort A: Maximum Tolerated AZD0530 Daily Dose Used in Combination With Daily Oral Anastrozole
Časové okno: Cycle 1: Days 1 - 28
|
To identify a well tolerated dose of AZD0530 (saracatinib) that can be used together with anastrozole in the Phase 2 trial with tolerable toxicity and PK, subjects were followed as AEs recorded and evaluated and drug concentrations were in the therapeutic range.
|
Cycle 1: Days 1 - 28
|
Phase II - Cohort B: Compare Treatment Groups (AZD0530 + Anastrozole Versus Anastrozole With Placebo) With Respect to Clinical Response
Časové okno: Baseline, cycle 6
|
Clinical response is defined as percentage change in tumor size calculated from bi-dimensional clinical tumor measurement at diagnosis and on completion of neoadjuvant treatment.
The mean reduction in tumor size ( +/-SD) will be derived form the change in largest tumor dimension ( RECIST) and by calculated tumor volume
|
Baseline, cycle 6
|
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
---|---|---|
Phase I - Cohort A: Plasma Concentrations of AZD0530 (Saracatinib) and Anastrozole
Časové okno: 0 hrs, 6 hrs, 12 hrs, 24hrs, 48 hrs, 72 hrs, 8 days, 15 days, 22 days after first dose of AZD0530
|
Summarized as mean plasma concentrations (ng/ml) of each drug (AZD0530 (saracatinib) and Anastrozole) after exposure to dual therapy.
|
0 hrs, 6 hrs, 12 hrs, 24hrs, 48 hrs, 72 hrs, 8 days, 15 days, 22 days after first dose of AZD0530
|
Phase 1-Cohort A: Peak Concentration of Each Study Drug ( AZD0530 (Saracatinib) and Anastrozole)
Časové okno: 0 hrs, 6 hrs, 12 hrs, 24hrs, 48 hrs, 72 hrs, 7 days, 14 days, 21 days after first dose of AZD0530
|
Summarized as the geometric means and standard deviations for the corresponding for peak plasma concentration of each study drug ( AZD0530 (saracatinib) and anastrozole) after exposure
|
0 hrs, 6 hrs, 12 hrs, 24hrs, 48 hrs, 72 hrs, 7 days, 14 days, 21 days after first dose of AZD0530
|
Phase II Cohort B: Change in Tumor Size by Comparison of Serial MRI
Časové okno: Baseline to 10 weeks;and baseline to 6 months
|
MRI will be used to compare tumor size at baseline and at 10 weeks.
MRI will also be used to compare tumor size at baseline and after completion of 6 months of study medication or disease progression.
|
Baseline to 10 weeks;and baseline to 6 months
|
Phase II - Cohort B: Number of Participants With Pathologic Complete Response (pCR)
Časové okno: At completion of 4-6 cycles of therapy or after disease progression
|
A pathologic complete response will be defined as the absence of viable tumor cells in the resected specimen, as determined by standard histologic examination.
All specimens will be reviewed by a central pathologist to determine pathologic response.
|
At completion of 4-6 cycles of therapy or after disease progression
|
Phase II - Cohort B: The Number of Participants Achieving Clinical Benefit Defined as Complete Response (CR), or Partial Response (PR) or Stable Disease (SD)
Časové okno: At the end of neoadjuvant therapy
|
Based on physician measurement of tumor size and by MRI measurements of tumor volume using RECIST criteria
|
At the end of neoadjuvant therapy
|
Phase II - Cohort B: To Report the Pharmacokinetics (Mean Blood Levels of Drug) of AZD0530 (Saracatinib) and Anastrozole
Časové okno: Day 28, 56, 84
|
Blood draws at protocol-specified timepoints to determine mean blood levels of drug for each of AZD0530 and Anastrozole.
|
Day 28, 56, 84
|
Phase II - Cohort B: Treatment Emergent Adverse Events Associated With AZD0530 (Saracatinib) Given With Anastrozole and of Anastrozole Given With Placebo
Časové okno: From day 1 of treatment until a maximum of 6 months of treatment
|
Cinically significant AEs defined as clinically significant changes in the patient's symptoms, physical examination and clinical laboratory results are reported as toxicity for AZD0530 (saracatinib) given with anastrozole and for anastrozole given with placebo
|
From day 1 of treatment until a maximum of 6 months of treatment
|
Spolupracovníci a vyšetřovatelé
Zde najdete lidi a organizace zapojené do této studie.
Sponzor
Spolupracovníci
Vyšetřovatelé
- Vrchní vyšetřovatel: Joyce Slingerland, MD, University of Miami
Termíny studijních záznamů
Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.
Hlavní termíny studia
Začátek studia (Aktuální)
21. října 2008
Primární dokončení (Aktuální)
7. února 2018
Dokončení studie (Aktuální)
7. února 2018
Termíny zápisu do studia
První předloženo
5. října 2010
První předloženo, které splnilo kritéria kontroly kvality
6. října 2010
První zveřejněno (Odhad)
7. října 2010
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
31. července 2019
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
11. července 2019
Naposledy ověřeno
1. května 2019
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
- Kožní choroby
- Novotvary
- Novotvary podle místa
- Nemoci prsu
- Novotvary prsu
- Fyziologické účinky léků
- Molekulární mechanismy farmakologického působení
- Inhibitory enzymů
- Antineoplastická činidla
- Hormony, hormonální náhražky a antagonisté hormonů
- Antineoplastická činidla, Hormonální
- Antagonisté hormonů
- Inhibitory aromatázy
- Inhibitory syntézy steroidů
- Antagonisté estrogenu
- Anastrozol
- Saracatinib
Další identifikační čísla studie
- 20080325
- SCCC-2008002 (Jiný identifikátor: University of Miami Sylvester Comprehensive Cancer Center)
Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .
Klinické studie na Rakovina prsu
-
Tianjin Medical University Cancer Institute and...Guangxi Medical University; Sun Yat-sen University; Chinese PLA General Hospital a další spolupracovníciDokončenoPrůvodce klinickou aplikací Conebeam Breast CTČína
-
Gangnam Severance HospitalNáborHER2 Enriched Subtype Cancer Breast, Herzuma, PAM50 StudyKorejská republika
-
BioNTech SESeventh Framework ProgrammeDokončenoRakovina prsu (Triple Negative Breast Cancer (TNBC))Švédsko, Německo
-
Jonsson Comprehensive Cancer CenterNational Cancer Institute (NCI); National Institutes of Health (NIH)Zatím nenabírámeAnatomický karcinom prsu stadia II AJCC v8 | Anatomický karcinom prsu stadia III AJCC v8 | Rané stadium karcinomu prsu | Anatomic Stage I Breast Cancer American Joint Committee on Cancer (AJCC) v8Spojené státy
-
Emory UniversityNational Cancer Institute (NCI)StaženoPrognostický karcinom prsu stadia IV AJCC v8 | Metastatický maligní novotvar v mozku | Metastatický karcinom prsu | Anatomic Stage IV Breast Cancer American Joint Committee on Cancer (AJCC) v8
-
NRG OncologyNational Cancer Institute (NCI)Aktivní, ne náborAnatomický karcinom prsu stadia IV AJCC v8 | Prognostický karcinom prsu stadia IV AJCC v8 | Metastatický maligní novotvar v kosti | Metastatický maligní novotvar v lymfatických uzlinách | Metastatický maligní novotvar v játrech | Metastatický karcinom prsu | Metastatický maligní novotvar v plicích | Metastatický... a další podmínkySpojené státy, Kanada, Saudská arábie, Korejská republika