- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT07582887
Impact of Genetic Variants on the Toxicity of Antibody-Drug Conjugates in Locally Advanced or Metastatic Breast Cancer: The Role of the UGT1A1 Gene as a Predictive Biomarker of Therapeutic Response
The metabolism of anticancer drugs is influenced by genetic variants that affect their bioavailability and toxicity. In the case of antibody-drug conjugates (ADCs), such as sacituzumab-govitecan (SG), trastuzumab-deruxtecan (T-DXd), and datopotamab-deruxtecan (Dato-DXd), the enzyme UDP-glucuronosyltransferase 1A1 (UGT1A1) plays a central role in the glucuronidation and elimination of their cytotoxic components. In particular, the metabolism of SN-38, the active metabolite of irinotecan and SG, is highly influenced by variants in UGT1A1, leading to drug accumulation and the development of severe toxicities. Patients with variants such as UGT1A1*28 (rs3064744) and UGT1A1*6 (rs4148323) exhibit reduced enzyme activity, increasing the risk of neutropenia and severe diarrhea.
The relevance of UGT1A1 is not limited to sacituzumab-govitecan; its role in the elimination of camptothecin derivatives suggests it could also impact the toxicity of trastuzumab-deruxtecan and datopotamab-deruxtecan, which contain deruxtecan, a cytotoxic agent 10 times more potent than irinotecan. Despite strong evidence linking the UGT1A1 genotype to irinotecan toxicity, there are currently no established pharmacogenetic recommendations for antidiuretic peptides (ADCs) in metastatic breast cancer.
Studieöversikt
Status
Betingelser
Intervention / Behandling
Studietyp
Inskrivning (Beräknad)
Kontakter och platser
Studiekontakt
- Namn: Isabel Blancas López-Barajas, MD, PhD
- Telefonnummer: +34 958 023265
- E-post: ensayosclinicosom.husc.sspa@juntadeandalucia.es
Studieorter
-
-
Granada
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Granada, Granada, Spanien, 18016
- Rekrytering
- Hospital Universitario Clínico San Cecilio
-
Kontakt:
- Isabel Blancas López-Barajas, MD, PhD
- Telefonnummer: +34 958 023265
- E-post: ensayosclinicosom.husc.sspa@juntadeandalucia.es
-
Huvudutredare:
- Isabel Blancas López-Barajas, MD, PhD
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Testmetod
Studera befolkning
Beskrivning
Inclusion Criteria:
- Patients aged 18 years or older.
- Patients diagnosed with breast cancer starting or undergoing treatment with Sacituzumab Govitecan, Trastuzumab Deruxtecan, or Datopotamab Deruxtecan.
- Provision of signed informed consent for the genetic study.
Exclusion Criteria:
- Patients who are ultimately not treated with the specified Antibody-Drug Conjugates.
- Refusal to provide informed consent for genetic analysis.
Studieplan
Hur är studien utformad?
Designdetaljer
Kohorter och interventioner
Grupp / Kohort |
Intervention / Behandling |
|---|---|
|
Patients undergoing treatment with sacituzumab govitecan
Standard clinical dose of sacituzumab govitecan administered as per routine clinical practice.
|
Administered according to standard clinical practice and product label.
|
|
Patients undergoing treatment with trastuzumab-deruxtecan
Standard clinical dose of trastuzumab-deruxtecan administered as per routine clinical practice.
|
Administered according to standard clinical practice and product label.
|
|
Patients undergoing treatment with datopotamab deruxtecan
Standard clinical dose of datopotamab deruxtecan administered as per routine clinical practice.
|
Administered according to standard clinical practice and product label.
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Incidence of Severe Drug-Related Toxicities (Grade ≥ 3)
Tidsram: From the start of treatment until the end of the follow-up period (up to 2 years).
|
Number of patients experiencing severe hematological or gastrointestinal toxicities (defined as Grade 3 or higher according to CTCAE v5.0) that are definitely, probably, or possibly related to the treatment with Sacituzumab Govitecan, Trastuzumab Deruxtecan, or Datopotamab Deruxtecan.
|
From the start of treatment until the end of the follow-up period (up to 2 years).
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Frequency of UGT1A1*28 Allele
Tidsram: At baseline (once the genetic study is performed).
|
Distribution and allelic frequency of the UGT1A1*28 variant in the study population of breast cancer patients.
|
At baseline (once the genetic study is performed).
|
|
Correlation Between Genetic Variants and Toxicity Severity
Tidsram: Analyzed at the completion of the 2-year study period.
|
Statistical association (using Odds Ratio) between the identified genetic variants (rs4148323, rs35350906, rs3064744, rs887829, rs111741722) and the severity of adverse events.
|
Analyzed at the completion of the 2-year study period.
|
|
Predictive Model for Severe Toxicity
Tidsram: At the end of the study (2 years).
|
Design of a predictive model based on genetic markers to anticipate the appearance of severe toxicities for each ADC studied.
|
At the end of the study (2 years).
|
Samarbetspartners och utredare
Publikationer och användbara länkar
Allmänna publikationer
- Trita AS, Biafora A, Pichette Drapeau M, Weber P, Goossen LJ. Regiospecific ortho-C-H Allylation of Benzoic Acids. Angew Chem Int Ed Engl. 2018 Oct 26;57(44):14580-14584. doi: 10.1002/anie.201712520. Epub 2018 Mar 5.
- Sony M, Antony J, McDermott O. The Impact of Healthcare 4.0 on the Healthcare Service Quality: A Systematic Literature Review. Hosp Top. 2023;101(4):288-304. doi: 10.1080/00185868.2022.2048220. Epub 2022 Mar 24.
- Bardia A, Hurvitz SA, Tolaney SM, Loirat D, Punie K, Oliveira M, Brufsky A, Sardesai SD, Kalinsky K, Zelnak AB, Weaver R, Traina T, Dalenc F, Aftimos P, Lynce F, Diab S, Cortes J, O'Shaughnessy J, Dieras V, Ferrario C, Schmid P, Carey LA, Gianni L, Piccart MJ, Loibl S, Goldenberg DM, Hong Q, Olivo MS, Itri LM, Rugo HS; ASCENT Clinical Trial Investigators. Sacituzumab Govitecan in Metastatic Triple-Negative Breast Cancer. N Engl J Med. 2021 Apr 22;384(16):1529-1541. doi: 10.1056/NEJMoa2028485.
Studieavstämningsdatum
Studera stora datum
Studiestart (Faktisk)
Primärt slutförande (Beräknad)
Avslutad studie (Beräknad)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- FIB-MAM-2025-04
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