HER2-positive primary breast cancer MedDRA version: 20.0 Level: SOC Classification code 10029104 Term: Neoplasms benign, malignant and unspecified (incl cysts and polyps) System Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Conditions
Interventions
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: 1. Signed written informed consent approved by the reviewing independent Ethics Committee 2. Female or male aged 18 years or above 3. Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 4. Histologically confirmed early invasive HER2-positive carcinoma of the breast with no evidence of residual, locally recurrent or metastatic disease and defined as clinical stage I (T1, N0, M0) to IIIC (any T, N3, M0) that is eligible for treatment with trastuzumab. Note: Patients treated without neoadjuvant or adjuvant chemotherapy, such as patients with low risk node negative tumours = 1.0 cm, elderly patients (>65 years of age) or patients with HER2-positive EBC but denying chemotherapy, will also be eligible to participate in the study, but their enrolment will be limited to approximately 10% of the total study population. 5. HER2-positive EBC, defined as IHC 3+, or a positive in situ hybridisation (ISH testing) by validated and approvded methods within a certified laboratory. 6. Screening left ventricular ejection fraction (LVEF) = 55% as measured by echocardiography, Multi Gated Acquisition (MUGA) scan or Magnetic Resonance Imaging (MRI) per local practice. 7. Agreement to use an adequate, non-hormonal means of contraception by women of childbearing potential (defined as pre-menopausal and not surgically sterilised or =65 years) yes F.1.3.1 Number of subjects for this age range 300
Exclusion criteria
Exclusion criteria: Cancer Related Criteria 1. Previous neoadjuvant or adjuvant breast cancer treatment with an approved or investigational anti-HER2 agent 2. History of other malignancy which could affect compliance with the protocol or interpretation of results (including previous invasive, ipsilateral or contralateral breast cancer). Patients with curatively treated carcinoma in situ of the cervix or basal cell carcinoma, and patients with other curatively-treated malignancies, other than breast cancer, who have been disease-free for at least 5 years, are eligible. 3. Past history of ductal carcinoma in situ (DCIS) within the last 5 years that has been treated with any systemic therapy OR with radiation therapy to the ipsilateral breast where invasive cancer subsequently develops. Patients who had their DCIS treated with surgery only are allowed to enter the study. 4. Metastatic disease Haematological, Biochemical and Organ Function Related Criteria 5. Inadequate bone marrow function (as indicated by any of the following): • Total white blood cell count 1.5 x upper limit of normal (ULN) • Alanine amino transferase > 2.5 x ULN • Aspartate amino transferase > 2.5 x ULN • Alkaline phosphatase > 2.5 x ULN 7. Impaired renal function: serum creatinine > 1.5 x ULN Other Study Drug Related Exclusion Criteria 8. Serious cardiac illness or medical conditions including but not confined to: • History of documented heart failure or systolic dysfunction (LVEF 100/min at rest, significant ventricular arrhythmia (ventricular tachycardia) or higher-grade atrioventricular (AV) block (second degree AV-block Type 2 [Mobitz 2] or third degree AV-block) • Angina pectoris requiring anti-anginal medication • Clinically significant valvular heart disease • Evidence of transmural infarction on electrocardiogram (ECG) • Poorly controlled or uncontrolled hypertension (blood pressure constantly over 140/90 mm/hg, despite treatment), or history of hypertensive crisis or hypertensive encephalopathy 9. Other concurrent serious diseases that may interfere with planned treatment including severe pulmonary conditions/illness 10. Prior maximum cumulative dose of doxorubicin >360 mg/m2 or maximum cumulative dose of epirubicin >720 mg/m2 or equivalent 11. Known hypersensitivity to trastuzumab, murine proteins, or excipients, or a general hypersenstivity to adhesives (Cohort B only) 12. History of severe allergic or immunological reactions, e.g. difficult to control asthma General Exclusion Criteria 13. Pregnancy or lactation 14. Unable or unwilling to comply with the requirements of the protocol as assessed by the investigator 15. Concurrent enrolment in another clinical trial using an investigational anti-cancer treatment, including hormonal therapy, bisphosphonate therapy and immunotherapy, within 28 days prior to the first dose of study treatment 16. Major surgical procedure or significant traumatic injury within 14 days prior to the first dose of study treatment or anticipated need for major surgery during the course of study treatment except for breast cancer surgery for patient receiving study drug in the neoadjuvant sett
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: To assess the overall safety and tolerability of subcutaneous (SC) trastuzumab in HER2-positive early breast cancer (EBC) patients with assisted administration using a conventional syringe and needle (vial formulation) and with assisted administration with or without self-administration using a single-use injection device (SID).;Secondary Objective: • Efficacy (both cohorts): - disease-free survival (DFS) - overall survival (OS) • Patient satisfaction with trastuzumab SC administration using the SID (patients in Cohort B who went on to self-administration of the study drug).;Primary end point(s): Safety endpoints are the primary objectives in this study and will include: all AEs, Grade =3 AEs, SAEs, AEs leading to premature discontinuation of study treatment, AEs causing interruption of trastuzumab SC, cardiac AEs, CHF-related SAEs, premature withdrawals from study and study medication, exposure to treatment, laboratory parameters, LVEF, vital signs, ECG, weight, and ECOG performance status.;Timepoint(s) of evaluation of this end point: The primary analysis of the safety endpoints will take place when all patients have received 18 cycles of trastuzumab SC and have completed the Safety Follow-up assessments (4 weeks after their last dose of study treatment). | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): Secondary efficacy endpoints include DFS, OS (both cohorts) and patients’ satisfaction with trastuzumab SC administration using the SID (Cohort B patients who went on to self administration only). ;Timepoint(s) of evaluation of this end point: A preliminary analysis of DFS and OS will be undertaken at the time of the primary safety analysis, i.e. when all patients have received 18 cycles of trastuzumab SC and have completed the Safety Follow-up assessments (4 weeks after their last dose of study treatment). The final analysis of OS and DFS will take place when the last patient has been followed up for approximately 5 years after her/his last study treatment, or earlier, if one of the following is documented for all treated patients: withdrawal of consent, loss to follow-up or death. | — |
Countries
Albania, Algeria, Argentina, Australia, Bosnia and Herzegovina, Brazil, Bulgaria, Canada, Chile, Colombia, Croatia, Czech Republic, Dominican Republic, Ecuador, Egypt, El Salvador, European Union, Finland, France, Germany, Greece, Guatemala, Hong Kong, Hungary, India, Indonesia, Ireland, Italy, Korea, Republic of, Lithuania, Malaysia, Mexico, Morocco, Netherlands, New Zealand, Pakistan, Panama, Peru, Philippines, Poland, Portugal, Russian Federation, Saudi Arabia, Serbia, Singapore, Slovakia, Slovenia, South Africa, Spain, Sweden, Switzerland, Taiwan, Thailand, Turkey, Ukraine, United Arab Emirates, United Kingdom, Venezuela, Bolivarian Republic of, Vietnam
Contacts
F. Hoffmann-La Roche Ltd