Breast Cancer
Conditions
Keywords
Breast cancer over-expressing HER2. First-line treatment with sunitinib/docetaxel/trastuzumab.
Brief summary
This is an exploratory trial evaluating the tolerability and preliminary anti-tumor activity of SU011248 combined with docetaxel and trastuzumab in patients with locally recurrent or metastatic breast cancer over-expressing Her-2, who have not received chemotherapy treatment in the advanced disease setting.
Interventions
Trastuzumab will be administered intravenously on Day 1 before docetaxel - loading dose of 4 mg/kg over 90-minute on Day 1 followed by weekly maintenance doses of 2 mg/kg on Days 1, 8, 15 given as 30-minute infusions if the initial loading dose was well tolerated. Loading dose of 8 mg/kg over 90-minute on Day 1 followed by 3-weekly maintenance doses of 6 mg/kg given as 90-minute infusions. The administration of 6 mg/kg will be repeated on Day 1 every 3 weeks.
SU011248 will be administered at 37.5 mg once daily for 2 weeks every 3 weeks (Schedule 2/1) starting from Day 2, when in combination with docetaxel. SU011248 will be administered at the starting dose of 37.5 mg daily in a continuous regimen when docetaxel is discontinued.
The starting dose of docetaxel will be 75 mg/m2 every 3 weeks, administered on Day 1 of each cycle as a 1-hour IV infusion.
Sponsors
Study design
Eligibility
Inclusion criteria
* Breast cancer with evidence of unresectable, locally recurrent, or metastatic disease. * Tumors over-expressing Her-2 * Candidate for treatment with docetaxel/trastuzumab
Exclusion criteria
* Histology of inflammatory carcinoma * AST and/or ALT \>1.5 x ULN concomitant with ALP \>2.5 x ULN
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Treatment-Emergent Adverse Events (AEs) or Serious Adverse Events (SAEs) | From screening until 28 days post last dose of study drug | An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. A SAE was an AE resulting in any of following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent are events between first dose of study drug and up to 28 days after last dose that were absent before treatment or that worsened relative to pretreatment state. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Objective Response (OR) | Baseline, assessed every 6 weeks starting from Day1 of Cycle 3 up to end of treatment (Day 1344) | Percentage of participants with objective response based assessment of confirmed complete response (CR) or confirmed partial response (PR) according to Response Evaluation Criteria in Solid Tumors (RECIST). Confirmed responses are those that persist on repeat imaging study at least 4 weeks after initial documentation of response. CR are defined as disappearance of all target lesions. PR are those with at least 30% decrease in the sum of the longest dimensions of the target lesions taking as a reference the baseline sum longest dimensions. |
| Progression-free Survival (PFS) | Baseline, assessed every 6 weeks starting from Day1 of Cycle 3 up to end of treatment (Day 1344) | Time in weeks from start of study treatment to first documentation of objective tumor progression or death due to any cause. PFS was calculated as (first event date minus the date of first dose of study medication plus 1) divided by 7. Tumor progression was determined from oncologic assessment data (where data meet the criteria for progressive disease \[PD\]), or from adverse event (AE) data (where the outcome was Death). |
| Duration of Response (DR) | Baseline, assessed every 6 weeks starting from Day1 of Cycle 3 up to end of treatment (Day 1344) | Time in weeks from the first documentation of objective tumor response to objective tumor progression or death due to any cancer. Duration of tumor response was calculated as (the date of the first documentation of objective tumor progression or death due to cancer minus the date of the first CR or PR that was subsequently confirmed plus 1) divided by 7. DR was calculated for the subgroup of participants with a confirmed objective tumor response. |
| Maximum Observed Plasma Concentration (Cmax) of Docetaxel | End of infusion (1 H) on Day 1 of Cycle 1, 2, 4 and 6 | Concentration values below the lower limit of quantification were taken as zero. |
| Plasma Trough Concentrations (Ctrough) of Trastuzumab | Weekly trastuzumab: Pre-dose (0 H) on Day 1 and 15 of Cycle 1, 2, 4 and 6; 3-weekly trastuzumab: Pre-dose (0 H) on Day 1 of Cycle 1, 2, 4 and 6 | Ctrough = the concentration prior to study medication administration. |
| Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Pre-dose (0 hours [H]) on Day 1 and Day 15 of Cycle 2, 4, 6 and additionally Day 15 of Cycle 1 | Ctrough = the concentration prior to study medication administration. Ctrough was calculated for SU011248 (Sunitinib), SU012662 (Sunitinib metabolite) and total drug (SU011248+SU012662). Concentration values below the lower limit of quantification were taken as zero. |
Other
| Measure | Time frame |
|---|---|
| Maximum Observed Plasma Concentration (Cmax) of Paclitaxel | End of infusion (1 H) on Day 1 of Cycle 1, 2, 4 and 6 |
Countries
Belgium, Italy
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Sunitinib + Docetaxel + Trastuzumab Sunitinib 37.5 milligram (mg) capsule orally once daily continuously starting from Day 2 up to Day 15 in each cycle, in schedule 2/1 (2 week on treatment, 1 week off treatment) along with docetaxel 75 milligram/square meter (mg/m\^2) intravenous infusion over 1 hour on Day 1 of each cycle and trastuzumab either weekly: loading dose of 4 milligram/kilogram (mg/kg) intravenous infusion over 90 minutes on Day 1 followed by weekly maintenance doses of 2 mg/kg intravenous infusion over 30 minutes; or every 3 weeks: loading dose of 8 mg/kg intravenous infusion over 90 minutes on Day 1 followed by maintenance doses of 6 mg/kg intravenous infusion over 90 minutes every 3 weeks. Cycle length was 3 weeks. | 25 |
| Total | 25 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 2 |
| Overall Study | Death | 1 |
| Overall Study | Enrolled, Not Treated | 1 |
| Overall Study | Objective Progression or Relapse | 14 |
| Overall Study | Other | 7 |
| Overall Study | Withdrawal by Subject | 1 |
Baseline characteristics
| Characteristic | Sunitinib + Docetaxel + Trastuzumab |
|---|---|
| Age Continuous | 57.0 years STANDARD_DEVIATION 12.8 |
| Sex: Female, Male Female | 25 Participants |
| Sex: Female, Male Male | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 23 / 25 |
| serious Total, serious adverse events | 11 / 25 |
Outcome results
Number of Participants With Treatment-Emergent Adverse Events (AEs) or Serious Adverse Events (SAEs)
An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. A SAE was an AE resulting in any of following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent are events between first dose of study drug and up to 28 days after last dose that were absent before treatment or that worsened relative to pretreatment state.
Time frame: From screening until 28 days post last dose of study drug
Population: Safety population included all participants enrolled in the study who received at least 1 dose of study medication.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Sunitinib + Docetaxel + Trastuzumab | Number of Participants With Treatment-Emergent Adverse Events (AEs) or Serious Adverse Events (SAEs) | AEs | 24 participants |
| Sunitinib + Docetaxel + Trastuzumab | Number of Participants With Treatment-Emergent Adverse Events (AEs) or Serious Adverse Events (SAEs) | SAEs | 11 participants |
Duration of Response (DR)
Time in weeks from the first documentation of objective tumor response to objective tumor progression or death due to any cancer. Duration of tumor response was calculated as (the date of the first documentation of objective tumor progression or death due to cancer minus the date of the first CR or PR that was subsequently confirmed plus 1) divided by 7. DR was calculated for the subgroup of participants with a confirmed objective tumor response.
Time frame: Baseline, assessed every 6 weeks starting from Day1 of Cycle 3 up to end of treatment (Day 1344)
Population: Study population, subgroup of participants with a confirmed objective tumor response (CR or PR).
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Sunitinib + Docetaxel + Trastuzumab | Duration of Response (DR) | 51.3 weeks |
Maximum Observed Plasma Concentration (Cmax) of Docetaxel
Concentration values below the lower limit of quantification were taken as zero.
Time frame: End of infusion (1 H) on Day 1 of Cycle 1, 2, 4 and 6
Population: PK analysis set included participants from study population who had completed sampling for pharmacokinetic profiles for study medication. 'n' is number of participants who were evaluable at given time points.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Sunitinib + Docetaxel + Trastuzumab | Maximum Observed Plasma Concentration (Cmax) of Docetaxel | Cycle1/Day1 (n= 23) | 1117.05 ng/mL | Standard Deviation 1159.53 |
| Sunitinib + Docetaxel + Trastuzumab | Maximum Observed Plasma Concentration (Cmax) of Docetaxel | Cycle2/Day1 (n= 19) | 1388.63 ng/mL | Standard Deviation 1260.94 |
| Sunitinib + Docetaxel + Trastuzumab | Maximum Observed Plasma Concentration (Cmax) of Docetaxel | Cycle4/Day1 (n= 16) | 1316.88 ng/mL | Standard Deviation 1096.97 |
| Sunitinib + Docetaxel + Trastuzumab | Maximum Observed Plasma Concentration (Cmax) of Docetaxel | Cycle6/Day1 (n= 15) | 1670.40 ng/mL | Standard Deviation 1614.07 |
Percentage of Participants With Objective Response (OR)
Percentage of participants with objective response based assessment of confirmed complete response (CR) or confirmed partial response (PR) according to Response Evaluation Criteria in Solid Tumors (RECIST). Confirmed responses are those that persist on repeat imaging study at least 4 weeks after initial documentation of response. CR are defined as disappearance of all target lesions. PR are those with at least 30% decrease in the sum of the longest dimensions of the target lesions taking as a reference the baseline sum longest dimensions.
Time frame: Baseline, assessed every 6 weeks starting from Day1 of Cycle 3 up to end of treatment (Day 1344)
Population: Per protocol (PP) population included all participants who received at least 1 dose of sunitinib and had at least a tumor assessment post baseline.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Sunitinib + Docetaxel + Trastuzumab | Percentage of Participants With Objective Response (OR) | 72.7 percentage of participants |
Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662)
Ctrough = the concentration prior to study medication administration. Ctrough was calculated for SU011248 (Sunitinib), SU012662 (Sunitinib metabolite) and total drug (SU011248+SU012662). Concentration values below the lower limit of quantification were taken as zero.
Time frame: Pre-dose (0 hours [H]) on Day 1 and Day 15 of Cycle 2, 4, 6 and additionally Day 15 of Cycle 1
Population: Pharmacokinetic (PK) analysis set included participants from study population who had completed sampling for pharmacokinetic profiles for study medication. 'n' is number of participants who were evaluable at given time points.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Sunitinib: Cycle1/Day15 (n= 19) | 40.17 nanogram/milliliter (ng/mL) | Standard Deviation 32.17 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Sunitinib: Cycle2/Day1 (n= 17) | 5.96 nanogram/milliliter (ng/mL) | Standard Deviation 6.17 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Sunitinib: Cycle2/Day15 (n= 16) | 37.29 nanogram/milliliter (ng/mL) | Standard Deviation 31.07 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Sunitinib: Cycle4/Day1 (n= 17) | 5.26 nanogram/milliliter (ng/mL) | Standard Deviation 5.71 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Sunitinib: Cycle4/Day15 (n= 16) | 43.21 nanogram/milliliter (ng/mL) | Standard Deviation 27.31 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Sunitinib: Cycle6/Day1 (n= 16) | 3.36 nanogram/milliliter (ng/mL) | Standard Deviation 4.34 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Sunitinib: Cycle6/Day15 (n= 13) | 28.46 nanogram/milliliter (ng/mL) | Standard Deviation 21.19 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Sunitinib Metabolite: Cycle1/Day15 (n= 19) | 16.15 nanogram/milliliter (ng/mL) | Standard Deviation 12.09 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Sunitinib Metabolite: Cycle2/Day1 (n= 17) | 4.76 nanogram/milliliter (ng/mL) | Standard Deviation 3.92 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Sunitinib Metabolite: Cycle2/Day15 (n= 16) | 14.43 nanogram/milliliter (ng/mL) | Standard Deviation 11.34 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Sunitinib Metabolite: Cycle4/Day1 (n= 17) | 3.95 nanogram/milliliter (ng/mL) | Standard Deviation 2.57 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Sunitinib Metabolite: Cycle4/Day15 (n= 16) | 17.62 nanogram/milliliter (ng/mL) | Standard Deviation 11.17 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Sunitinib Metabolite: Cycle6/Day1 (n= 16) | 2.96 nanogram/milliliter (ng/mL) | Standard Deviation 2.89 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Sunitinib Metabolite: Cycle6/Day15 (n= 13) | 11.54 nanogram/milliliter (ng/mL) | Standard Deviation 9.66 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Total Drug: Cycle1/Day15 (n= 19) | 56.31 nanogram/milliliter (ng/mL) | Standard Deviation 42.7 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Total Drug: Cycle2/Day1 (n= 17) | 10.72 nanogram/milliliter (ng/mL) | Standard Deviation 9.8 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Total Drug: Cycle2/Day15 (n= 16) | 51.72 nanogram/milliliter (ng/mL) | Standard Deviation 41.45 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Total Drug: Cycle4/Day1 (n= 17) | 9.21 nanogram/milliliter (ng/mL) | Standard Deviation 7.97 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Total Drug: Cycle4/Day15 (n= 16) | 60.83 nanogram/milliliter (ng/mL) | Standard Deviation 37.43 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Total Drug: Cycle6/Day1 (n= 16) | 6.32 nanogram/milliliter (ng/mL) | Standard Deviation 7.02 |
| Sunitinib + Docetaxel + Trastuzumab | Plasma Trough Concentrations (Ctrough) of SU011248 (Sunitinib), SU012662 (Sunitinib Metabolite) and Total Drug (SU011248+SU012662) | Total Drug: Cycle6/Day15 (n= 13) | 40.00 nanogram/milliliter (ng/mL) | Standard Deviation 30.04 |
Plasma Trough Concentrations (Ctrough) of Trastuzumab
Ctrough = the concentration prior to study medication administration.
Time frame: Weekly trastuzumab: Pre-dose (0 H) on Day 1 and 15 of Cycle 1, 2, 4 and 6; 3-weekly trastuzumab: Pre-dose (0 H) on Day 1 of Cycle 1, 2, 4 and 6
Population: Data was not summarized since majority of observed Ctrough values were below lower limit of quantification.
Progression-free Survival (PFS)
Time in weeks from start of study treatment to first documentation of objective tumor progression or death due to any cause. PFS was calculated as (first event date minus the date of first dose of study medication plus 1) divided by 7. Tumor progression was determined from oncologic assessment data (where data meet the criteria for progressive disease \[PD\]), or from adverse event (AE) data (where the outcome was Death).
Time frame: Baseline, assessed every 6 weeks starting from Day1 of Cycle 3 up to end of treatment (Day 1344)
Population: Study population included all participants who received at least 1 dose of study medication.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Sunitinib + Docetaxel + Trastuzumab | Progression-free Survival (PFS) | 58.4 weeks |
Maximum Observed Plasma Concentration (Cmax) of Paclitaxel
Time frame: End of infusion (1 H) on Day 1 of Cycle 1, 2, 4 and 6
Population: Data not analyzed since paclitaxel was not administered in the study.