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A Study of Ramucirumab (IMC-1121B) in Combination With Eribulin Versus Eribulin Alone in Participants With Breast Cancer

An Open-Label, Multicenter, Randomized, Phase 2 Study Evaluating the Efficacy and Safety of Ramucirumab (IMC-1121B) Drug Product in Combination With Eribulin Versus Eribulin Monotherapy in Unresectable, Locally-Recurrent or Metastatic Breast Cancer Patients Previously Treated With Anthracycline and Taxane Therapy

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01427933
Enrollment
141
Registered
2011-09-02
Start date
2011-11-30
Completion date
2014-06-30
Last updated
2017-02-06

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Breast Cancer

Keywords

Breast Cancer

Brief summary

This is a study to compare the antitumor activity of ramucirumab (IMC-1121B) and eribulin together versus eribulin alone, in participants with locally recurrent or metastatic breast cancer.

Interventions

DRUGEribulin

Administered intravenously

Administered intravenously

Sponsors

Eli Lilly and Company
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Have histologically or cytologically confirmed invasive breast cancer which at the time of study entry is either locally recurrent disease not amenable to curative therapy or Stage IV disease (American Joint Committee on Cancer Staging Criteria for breast cancer) * Have measurable and/or nonmeasurable disease per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) * Have received at least 2 but not more than 4 prior cytotoxic chemotherapy regimens in the locally recurrent or metastatic setting * Have received prior treatment with both anthracyclines and taxanes, either in the metastatic, adjuvant or neoadjuvant setting * Have received Human Epidermal Growth Factor Receptor 2 (HER-2) directed treatment; or are not a candidate for HER-2-directed treatment if the patient has HER-2 positive disease * Have completed any prior radiotherapy and/or hormonal therapy at least 1 week prior to randomization and have recovered from all clinically significant treatment-related toxicities * Have an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 * Have left ventricular ejection fraction within normal limits * Have discontinued all previous chemotherapy treatments for cancer at least 3 weeks prior to randomization and recovered from clinically significant toxic effects * Have resolution to Grade less than or equal to 1 \[by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), Version 4.0\] of all clinically significant toxicities of prior chemotherapy, surgery, radiotherapy, or hormonal therapy with the exception of peripheral neuropathy, which must have resolved to Grade less than or equal to 2 * Have adequate hematologic, hepatic, renal, and coagulation function * Test negative for pregnancy * Have a life expectancy of at least 3 months

Exclusion criteria

* Have a concurrent active other malignancy other than adequately treated non-melanomatous skin cancer or other noninvasive or in situ neoplasms * Are currently enrolled in, or recently discontinued from, a clinical trial involving an investigational product, or concurrently enrolled in any other type of medical research judged not to be medically compatible with the study * Have received investigational therapy within 3 weeks prior to randomization * Have received prior ramucirumab or eribulin * Have a known sensitivity to agents of similar biologic composition as ramucirumab, halichondrin B and/or halichondrin B chemical derivative * Have received bevacizumab within 6 weeks prior to randomization * Have uncontrolled or poorly controlled hypertension * Have congenital prolonged QTc syndrome (or have a family history) or prolongation of QTc at baseline * Have a history of additional risk factors for torsades de pointes within the last year prior to randomization * Have an implantable pacemaker or automatic implantable cardioverter defibrillator * Have bradycardia * Have an acute/subacute bowel obstruction or history of chronic diarrhea requiring ongoing medical intervention within 6 months prior to randomization * Have a history of uncontrolled hereditary or acquired bleeding or thrombotic disorders * Have experienced a Grade 3 or greater bleeding event within 3 months prior to randomization * Have experienced any Grade 3 or greater arterial thromboembolic events within 6 months prior to randomization, or venous thromboembolic event within 3 months prior to randomization * Have undergone major surgery within 4 weeks prior to randomization or subcutaneous venous access device placement within 7 days prior to randomization * Have a planned major surgery to be performed during the course of the trial * Have uncontrolled metabolic conditions * Have an ongoing or active infection requiring parenteral antibiotic, antifungal, or antiviral therapy * Have known human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) * Have pulmonary lymphangitic involvement that results in pulmonary dysfunction requiring active treatment including the use of oxygen * Have received a prior allogeneic organ or tissue transplantation * Have had a serious nonhealing wound, ulcer, or bone fracture within 4 weeks prior to randomization * Have known leptomeningeal metastases * Have cirrhosis (Child-Pugh Level B or worse) or cirrhosis (any degree) and a history of hepatic encephalopathy or clinically meaningful ascites

Design outcomes

Primary

MeasureTime frameDescription
Progression-Free Survival (PFS)Start of treatment until documented disease progression or death from any cause up to 16.5 monthsPFS was defined as time from date of randomization until the date of objectively determined progression defined by Response Evaluation Criteria in Solid Tumors (RECIST v1.1) criteria or death from any cause, whichever is first. Progressive disease (PD) defined as ≥20% increase in sum of diameter (SOD) of target lesion with the sum demonstrating an increase of ≥5 mm; appearance of ≥1 new lesions or unequivocal progression of non-target lesions. Participants with no baseline disease assessment were censored at randomization date, regardless of whether or not objectively determined PD or death was observed; participants not known to have died or to have objective progression as of data inclusion cutoff date were censored at last post baseline radiological assessment date or randomization date, if there was no post baseline radiological assessment.

Secondary

MeasureTime frameDescription
Overall Survival (OS) Randomization to Date of Death From Any CauseRandomization to date of death from any cause up to 28.6 monthsTime from the date of randomization to the date of death from any cause. For participants who were not known to have died as of the data-inclusion cut-off date, OS data were censored on the last date the participants were known to be alive prior to that cut-off date.
Objective Response Rate (ORR) Percentage of Participants With Measurable Disease Achieving a Best Overall Response of Partial Response (PR) or Complete Response (CR)Start of treatment until documented CR or PR up to 16.5 monthsORR was defined as the percentage of participants with measurable disease achieving a best overall response of PR or CR as defined by RECIST v.1.1. CR defined as disappearance of all lesions and pathological lymph nodes reduction in short axis to \<10 mm. PR was defined as ≥30% decrease in SOD of target lesions. Participants who did not have any post baseline tumor response assessments for any reason were considered non-responders and included in the denominator when calculating the response rate. ORR for each treatment arm calculated as: \[(CR + PR in the treatment arm) divided by (total number of participants in the treatment arm)\] x 100.
Change in Tumor Size (CTS)Baseline, 6 weeksCTS was defines as the change from baseline measurement of target lesions to the post treatment measurement in participants with measurable disease. Change was assessed using radiographic imagining. Log ratio calculated as: log of (tumor size post baseline) divided by (tumor size at baseline). A negative result indicated a shrinking tumor.
Number of Participants With Anti-Ramucirumab AntibodiesDay 1 of Cycle 1, Cycle 3, Cycle 5 and 30 days after last dose of study drug up to 17.7 monthsThe number of participants who developed treatment-emergent antibody responses after baseline. The antibody test can produce positive results in participants without ramucirumab exposure. Treatment emergent anti-ramucirumab antibody positive was defined as: when baseline titer was greater than 0 and post baseline titer was equal to or greater than 4-fold the baseline titer or if the baseline titer was not detected and post baseline titer is equal to or greater than a value of 20.
Duration of Response (DOR) Time of Response to Progressive DiseaseTime from Observed CR or PR to PD up to 12.1 monthsDOR was measured from the time criteria were met for first objectively recorded CR or PR until first date criteria for PD was met or death. Response defined using RECIST v1.1 criteria. CR defined as disappearance of all lesions and pathological lymph nodes reduction in short axis to \<10 mm. PR was defined as ≥30% decrease in sum of diameter (SOD) of target lesions. PD defined ≥20% increase in SOD of target lesion with the sum demonstrating an increase of ≥5 mm; appearance of ≥1 new lesions or unequivocal progression of non-target lesions. Participants who were not known to have died and who did not have PD were censored at the date of the last tumor assessment prior to the date of any subsequent systemic anticancer therapy.

Other

MeasureTime frameDescription
Number of Participants With Adverse Events (AE) and Participants Who DiedBaseline up to end of treatment and within 30 days of last dose of study drug (22.6 months)Participants who died or who had clinically significant events defined as serious AEs (SAEs) and other non-serious AEs (regardless of causality). A summary of SAEs and other non-serious AEs, regardless of causality, is located in the Reported Adverse Events module.

Countries

United States

Participant flow

Pre-assignment details

Participant Flow reports participants who discontinued from the study. Participants who died due to any cause and participants who were alive at conclusion of the study but off treatment were considered to have completed the study.

Participants by arm

ArmCount
Ramucirumab and Eribulin
Ramucirumab (IMC-1121B) 10 mg/kg administered by intravenous (IV) infusion on Day 1 of each 3-week cycle Eribulin 1.4 mg/m² administered by IV bolus on Day 1 and Day 8 of each 3-week cycle
71
Eribulin Monotherapy
Eribulin 1.4 mg/m² administered by IV bolus on Day 1 and Day 8 of each 3-week cycle
70
Total141

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyInvestigator's Decision10
Overall StudyLost to Follow-up15
Overall StudyOther10
Overall StudyWithdrawal by Subject58

Baseline characteristics

CharacteristicRamucirumab and EribulinEribulin MonotherapyTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
9 Participants17 Participants26 Participants
Age, Categorical
Between 18 and 65 years
62 Participants53 Participants115 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
5 Participants3 Participants8 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
65 Participants67 Participants132 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants0 Participants1 Participants
Gender
Female
71 Participants70 Participants141 Participants
Gender
Male
0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
0 participants1 participants1 participants
Race/Ethnicity, Customized
Asian
1 participants1 participants2 participants
Race/Ethnicity, Customized
Black or African American
11 participants8 participants19 participants
Race/Ethnicity, Customized
Other
5 participants2 participants7 participants
Race/Ethnicity, Customized
White
54 participants58 participants112 participants
Region of Enrollment
United States
71 participants70 participants141 participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
67 / 6964 / 65
serious
Total, serious adverse events
26 / 6912 / 65

Outcome results

Primary

Progression-Free Survival (PFS)

PFS was defined as time from date of randomization until the date of objectively determined progression defined by Response Evaluation Criteria in Solid Tumors (RECIST v1.1) criteria or death from any cause, whichever is first. Progressive disease (PD) defined as ≥20% increase in sum of diameter (SOD) of target lesion with the sum demonstrating an increase of ≥5 mm; appearance of ≥1 new lesions or unequivocal progression of non-target lesions. Participants with no baseline disease assessment were censored at randomization date, regardless of whether or not objectively determined PD or death was observed; participants not known to have died or to have objective progression as of data inclusion cutoff date were censored at last post baseline radiological assessment date or randomization date, if there was no post baseline radiological assessment.

Time frame: Start of treatment until documented disease progression or death from any cause up to 16.5 months

Population: Intent-to-treat Population (ITT): all participants according to their randomized treatment group. Participants censored: Ramucirumab+Eribulin=14; Eribulin=17.

ArmMeasureValue (MEDIAN)
Ramucirumab and EribulinProgression-Free Survival (PFS)4.4 months
Eribulin MonotherapyProgression-Free Survival (PFS)4.1 months
Secondary

Change in Tumor Size (CTS)

CTS was defines as the change from baseline measurement of target lesions to the post treatment measurement in participants with measurable disease. Change was assessed using radiographic imagining. Log ratio calculated as: log of (tumor size post baseline) divided by (tumor size at baseline). A negative result indicated a shrinking tumor.

Time frame: Baseline, 6 weeks

Population: All participants with measurable disease at baseline and at 6 weeks.

ArmMeasureValue (MEAN)Dispersion
Ramucirumab and EribulinChange in Tumor Size (CTS)-0.20 log ratioStandard Deviation 0.33
Eribulin MonotherapyChange in Tumor Size (CTS)-0.20 log ratioStandard Deviation 0.28
Secondary

Duration of Response (DOR) Time of Response to Progressive Disease

DOR was measured from the time criteria were met for first objectively recorded CR or PR until first date criteria for PD was met or death. Response defined using RECIST v1.1 criteria. CR defined as disappearance of all lesions and pathological lymph nodes reduction in short axis to \<10 mm. PR was defined as ≥30% decrease in sum of diameter (SOD) of target lesions. PD defined ≥20% increase in SOD of target lesion with the sum demonstrating an increase of ≥5 mm; appearance of ≥1 new lesions or unequivocal progression of non-target lesions. Participants who were not known to have died and who did not have PD were censored at the date of the last tumor assessment prior to the date of any subsequent systemic anticancer therapy.

Time frame: Time from Observed CR or PR to PD up to 12.1 months

Population: ITT population: all participants according to their randomized treatment group and who had CR or PR. Participants censored: Ramucirumab+Eribulin=1, Eribulin=3.

ArmMeasureValue (MEDIAN)
Ramucirumab and EribulinDuration of Response (DOR) Time of Response to Progressive Disease5.5 months
Eribulin MonotherapyDuration of Response (DOR) Time of Response to Progressive Disease3.0 months
Secondary

Number of Participants With Anti-Ramucirumab Antibodies

The number of participants who developed treatment-emergent antibody responses after baseline. The antibody test can produce positive results in participants without ramucirumab exposure. Treatment emergent anti-ramucirumab antibody positive was defined as: when baseline titer was greater than 0 and post baseline titer was equal to or greater than 4-fold the baseline titer or if the baseline titer was not detected and post baseline titer is equal to or greater than a value of 20.

Time frame: Day 1 of Cycle 1, Cycle 3, Cycle 5 and 30 days after last dose of study drug up to 17.7 months

Population: All randomized participants who received at least 1 dose of study drug and assessed for treatment emergent antibodies.

ArmMeasureValue (NUMBER)
Ramucirumab and EribulinNumber of Participants With Anti-Ramucirumab Antibodies4 participants
Eribulin MonotherapyNumber of Participants With Anti-Ramucirumab Antibodies2 participants
Secondary

Objective Response Rate (ORR) Percentage of Participants With Measurable Disease Achieving a Best Overall Response of Partial Response (PR) or Complete Response (CR)

ORR was defined as the percentage of participants with measurable disease achieving a best overall response of PR or CR as defined by RECIST v.1.1. CR defined as disappearance of all lesions and pathological lymph nodes reduction in short axis to \<10 mm. PR was defined as ≥30% decrease in SOD of target lesions. Participants who did not have any post baseline tumor response assessments for any reason were considered non-responders and included in the denominator when calculating the response rate. ORR for each treatment arm calculated as: \[(CR + PR in the treatment arm) divided by (total number of participants in the treatment arm)\] x 100.

Time frame: Start of treatment until documented CR or PR up to 16.5 months

Population: ITT population: all participants according to their randomized treatment group.

ArmMeasureValue (NUMBER)
Ramucirumab and EribulinObjective Response Rate (ORR) Percentage of Participants With Measurable Disease Achieving a Best Overall Response of Partial Response (PR) or Complete Response (CR)19.7 percentage of participants
Eribulin MonotherapyObjective Response Rate (ORR) Percentage of Participants With Measurable Disease Achieving a Best Overall Response of Partial Response (PR) or Complete Response (CR)24.3 percentage of participants
Secondary

Overall Survival (OS) Randomization to Date of Death From Any Cause

Time from the date of randomization to the date of death from any cause. For participants who were not known to have died as of the data-inclusion cut-off date, OS data were censored on the last date the participants were known to be alive prior to that cut-off date.

Time frame: Randomization to date of death from any cause up to 28.6 months

Population: ITT Population: All randomized participants. Participants censored: Ramucirumab and Eribulin=24 , Eribulin Monotherapy=28

ArmMeasureValue (MEDIAN)
Ramucirumab and EribulinOverall Survival (OS) Randomization to Date of Death From Any Cause13.5 Months
Eribulin MonotherapyOverall Survival (OS) Randomization to Date of Death From Any Cause11.5 Months
Other Pre-specified

Number of Participants With Adverse Events (AE) and Participants Who Died

Participants who died or who had clinically significant events defined as serious AEs (SAEs) and other non-serious AEs (regardless of causality). A summary of SAEs and other non-serious AEs, regardless of causality, is located in the Reported Adverse Events module.

Time frame: Baseline up to end of treatment and within 30 days of last dose of study drug (22.6 months)

Population: All randomized participants who received at least 1 dose of study drug and according to the treatment received.

ArmMeasureGroupValue (NUMBER)
Ramucirumab and EribulinNumber of Participants With Adverse Events (AE) and Participants Who DiedOther non-SAE68 participants
Ramucirumab and EribulinNumber of Participants With Adverse Events (AE) and Participants Who DiedSAE26 participants
Ramucirumab and EribulinNumber of Participants With Adverse Events (AE) and Participants Who DiedDied30 participants
Eribulin MonotherapyNumber of Participants With Adverse Events (AE) and Participants Who DiedSAE12 participants
Eribulin MonotherapyNumber of Participants With Adverse Events (AE) and Participants Who DiedOther non-SAE65 participants
Eribulin MonotherapyNumber of Participants With Adverse Events (AE) and Participants Who DiedDied32 participants

Source: ClinicalTrials.gov · Data processed: Mar 8, 2026