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Study Evaluating Efficacy And Tolerability Of Veliparib in Combination With Temozolomide (TMZ) or In Combination With Carboplatin and Paclitaxel Versus Placebo in Participants With Breast Cancer Gene (BRCA)1 and BRCA2 Mutation and Metastatic Breast Cancer

A Randomized, Phase 2 Study of the Efficacy and Tolerability of Veliparib in Combination With Temozolomide or Veliparib in Combination With Carboplatin and Paclitaxel Versus Placebo Plus Carboplatin and Paclitaxel in Subjects With BRCA1 or BRCA2 Mutation and Metastatic Breast Cancer

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01506609
Enrollment
294
Registered
2012-01-10
Start date
2012-01-23
Completion date
2020-09-02
Last updated
2021-10-25

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

Conditions

Metastatic Breast Cancer

Keywords

PARP, TMZ, Temodal, Carboplatin, veliparib, BRCA2 mutation carrier, Breast cancer, Metastatic breast cancer, temozolomide, BRCA1 mutation carrier, ABT-888, Paclitaxel, Recurrent breast cancer, Temodar, Locally recurrent

Brief summary

The primary objective of the study is to assess the progression-free survival (PFS) of oral veliparib in combination with TMZ or in combination with carboplatin and paclitaxel compared to placebo plus carboplatin and paclitaxel in subjects with BRCA1 or BRCA2 mutation and locally recurrent or metastatic breast cancer.

Interventions

DRUGPlacebo
DRUGVeliparib
DRUGCarboplatin
DRUGTemozolomide
DRUGPaclitaxel

Sponsors

AbbVie
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

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

Inclusion criteria

* Histologically or cytologically confirmed breast cancer that is either locally recurrent or metastatic. * Locally recurrent disease must not be amenable to surgical resection or radiation with curative intent. * Must have a documented deleterious Breast Cancer Gene BRCA1 or BRCA2 germline mutation. * If Human Epidermal Growth Factor Receptor (HER2) positive, subjects must have received and progressed on at least one prior standard HER2 directed therapy or the subject must be ineligible to receive anti-HER2 therapy. * Measurable or non-measurable (but radiologically evaluable) disease by RECIST (Response Evaluation Criteria in Solid Tumors) criteria 1.1. * Eastern Cooperative Oncology Group (ECOG) Performance Score of 0-2. * Subject must have adequate bone marrow, renal and hepatic function. * Subject must not be pregnant or plan to conceive a child.

Exclusion criteria

* Received anticancer agent(s) or an investigational agent within 21 days prior to C1D1, or radiotherapy within 28 days prior Cycle 1 Day 1. * More than 2 prior lines of cytotoxic chemotherapy. * Prior treatment of breast cancer with temozolomide, a platinum agent, or a Poly (ADP ribose) Polymerase (PARP) inhibitor. * Prior taxane therapy for metastatic breast cancer. * A history of or evidence of brain metastases or leptomeningeal disease. * A history of uncontrolled seizure disorder. * Pre-existing neuropathy from any cause in excess of Grade 1. * Known history of allergic reaction to cremophor/paclitaxel. * Clinical significant uncontrolled conditions, active infection, myocardial infarction, stroke, or transient ischemic attack, psychiatric illness/social situations that would limit compliance. * Pregnant or breastfeeding.

Design outcomes

Primary

MeasureTime frameDescription
Progression-Free Survival (PFS)Radiographic evaluation every 9 weeks, clinical evaluation every cycle (data cutoff date: 04 March 2016); maximum duration of follow up for PFS was 34 months.PFS is defined as the number of months from the date the participant was randomized to the date of radiographic progression as determined by the central imaging center, or to the date of all cause deaths within 63 days of last tumor assessment if disease progression was not reached.

Secondary

MeasureTime frameDescription
Overall Survival (OS)From Cycle 1 Day 1 until participant's death or 3 years post discontinuation (data cutoff date: 04 March 2016); maximum duration of follow up for OS was 72 months.Time to death for a given participant was defined as the number of months from the day the participant is randomized to the date of the participant's death. All events of death were included, regardless of whether the event occurs while the participant was still taking study drug, or after the participant discontinued study drug. If a participant had not died, then the data will be censored at the date when the participant was last known to be alive.
Clinical Benefit Rate (CBR) at Week 18Week 18CBR: percentage of participants who were progression-free at 18 weeks, defined as complete response (CR), partial response (PR), stable disease (SD) or non-CR/non-disease progression (PD) per Response Evaluation Criteria in Solid Tumors \[RECIST\] 1.1. CR: The disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 0 mm. PR: \>= 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters (SOD). PD: \>= 20% increase in the SOD of target lesions, taking as reference the smallest SOD recorded since the treatment started (baseline or after) or the appearance of \>=1 new lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest SOD since the treatment started (baseline or after).
Objective Response Rate (ORR)Radiographic evaluation every 9 weeks, clinical evaluation every cycle (data cutoff date: 04 March 2016); maximum duration of follow up for ORR was 34 months.The objective response rate, defined as percentage of participants with a confirmed CR or PR based on RECIST 1.1 criteria. CR: The disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 0 mm. PR: \>= 30% decrease in the sum of diameters of target lesions, taking as reference the baseline SODs.
Change From Baseline at Week 18 in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy Module (EORTC QLQ-CIPN20) Sensory Subscale ScoreBaseline, Week 18EORTC QLQ-CIPN20 sensory subscale score was calculated following the standard scoring algorithm, transformed to a 0 (low quality of life) to 100 (best quality of life) scale. A positive change from baseline indicates improvement.

Countries

Argentina, Australia, Belgium, Brazil, Canada, Czechia, Denmark, Finland, France, Hungary, Israel, Netherlands, Norway, Poland, Romania, Russia, Spain, Sweden, Ukraine, United States

Participant flow

Recruitment details

Under the original protocol, approximately 4 participants were randomized in a 1:1:1 ratio (Group 1) to 1 of the 3 treatment arms (1 participant in veliparib 40 mg twice daily (BID)+temozolomide (TMZ) arm and a total of 3 participants in either the veliparib 80 mg BID+carboplatin+paclitaxel or the placebo BID+carboplatin+paclitaxel arms) at approximately 3 research sites. Participants randomized under the original protocol were in Group 1, and were not included in the primary efficacy analyses.

Pre-assignment details

Following approval of Amendment 1, the veliparib dose in combination with carboplatin and paclitaxel was increased to 120 mg BID. Participants were randomized 1:1:1 ratio (Group 2) to 1 of the 3 treatment arms (veliparib 40 mg BID+TMZ, veliparib 120 mg BID+carboplatin+paclitaxel, placebo BID+carboplatin+paclitaxel) at approximately 120 research sites. Participants randomized following approval of Amendment 1 were in Group 2 and were included in the primary efficacy analyses.

Participants by arm

ArmCount
Group 1 Placebo + Carboplatin/Paclitaxel
Placebo BID Days 1 through 7 plus carboplatin target AUC 6 administered on Day 3 of each 21-day cycle and paclitaxel 175 mg/m\^2 administered on Day 3 of each 21-day cycle.
2
Group 1 Veliparib + Carboplatin/Paclitaxel
Veliparib 80 mg BID Days 1 through 7 plus carboplatin target AUC 6 administered on Day 3 of each 21-day cycle and paclitaxel 175 mg/m\^2 administered on Day 3 of each 21-day cycle.
1
Group 1 Veliparib + TMZ
Veliparib 40 mg BID Days 1 through 7 plus TMZ 150 to 200 mg/m\^2 QD Days 1 through 5 in each 28-day cycle.
1
Group 2 Placebo + Carboplatin/Paclitaxel
Placebo BID Days 1 through 7 plus carboplatin target AUC 6 administered on Day 3 of each 21-day cycle and paclitaxel 175 mg/m\^2 administered on Day 3 of each 21-day cycle.
99
Group 2 Veliparib + Carboplatin/Paclitaxel
Veliparib 120 mg BID Days 1 through 7 plus carboplatin target AUC 6 administered on Day 3 of each 21-day cycle and paclitaxel 175 mg/m\^2 administered on Day 3 of each 21-day cycle.
97
Group 2 Veliparib + TMZ
Veliparib 40 mg BID Days 1 through 7 plus TMZ 150 to 200 mg/m\^2 QD Days 1 through 5 in each 28-day cycle.
94
Total294

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004FG005
Overall StudyAdverse Event Not Related to Progression0106105
Overall StudyAdverse Event Related to Progression000373
Overall StudyLost to Follow-up000120
Overall StudyMissing / Unknown Reason101442
Overall StudyOther, Not Specified0001073
Overall StudyProgressive Disease per Protocol100645774
Overall StudySponsor Discontinued Study000220
Overall StudyWithdrawal by Subject000977

Baseline characteristics

CharacteristicTotalGroup 1 Placebo + Carboplatin/PaclitaxelGroup 1 Veliparib + Carboplatin/PaclitaxelGroup 1 Veliparib + TMZGroup 2 Placebo + Carboplatin/PaclitaxelGroup 2 Veliparib + Carboplatin/PaclitaxelGroup 2 Veliparib + TMZ
Age, Customized
45 to 64 years
143 Participants0 Participants0 Participants1 Participants49 Participants47 Participants46 Participants
Age, Customized
< 45 years
140 Participants2 Participants1 Participants0 Participants47 Participants49 Participants41 Participants
Age, Customized
>= 65 years
11 Participants0 Participants0 Participants0 Participants3 Participants1 Participants7 Participants
Race/Ethnicity, Customized
Asian
2 Participants0 Participants0 Participants0 Participants0 Participants1 Participants1 Participants
Race/Ethnicity, Customized
Black
17 Participants0 Participants0 Participants0 Participants4 Participants3 Participants10 Participants
Race/Ethnicity, Customized
Hispanic or Latino
18 Participants0 Participants0 Participants0 Participants6 Participants7 Participants5 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
1 Participants0 Participants0 Participants0 Participants0 Participants1 Participants0 Participants
Race/Ethnicity, Customized
No Ethnicity
276 Participants2 Participants1 Participants1 Participants93 Participants90 Participants89 Participants
Race/Ethnicity, Customized
Other, Not Specified
2 Participants0 Participants0 Participants0 Participants2 Participants0 Participants0 Participants
Race/Ethnicity, Customized
White
272 Participants2 Participants1 Participants1 Participants93 Participants92 Participants83 Participants
Sex: Female, Male
Female
288 Participants2 Participants1 Participants1 Participants97 Participants95 Participants92 Participants
Sex: Female, Male
Male
6 Participants0 Participants0 Participants0 Participants2 Participants2 Participants2 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
deaths
Total, all-cause mortality
2 / 21 / 11 / 165 / 9659 / 9376 / 93
other
Total, other adverse events
2 / 21 / 11 / 193 / 9693 / 9391 / 93
serious
Total, serious adverse events
0 / 20 / 10 / 126 / 9632 / 9316 / 93

Outcome results

Primary

Progression-Free Survival (PFS)

PFS is defined as the number of months from the date the participant was randomized to the date of radiographic progression as determined by the central imaging center, or to the date of all cause deaths within 63 days of last tumor assessment if disease progression was not reached.

Time frame: Radiographic evaluation every 9 weeks, clinical evaluation every cycle (data cutoff date: 04 March 2016); maximum duration of follow up for PFS was 34 months.

Population: Group 2: All randomized participants with suspected deleterious or deleterious breast cancer gene (BRCA)1 or BRCA2 mutation determined by sponsor core lab.

ArmMeasureValue (MEDIAN)
Group 2 Placebo + Carboplatin/PaclitaxelProgression-Free Survival (PFS)12.3 months
Group 2 Veliparib + Carboplatin/PaclitaxelProgression-Free Survival (PFS)14.1 months
Group 2 Veliparib + TMZProgression-Free Survival (PFS)7.4 months
p-value: 0.22795% CI: [0.536, 1.162]Log Rank
p-value: 0.00195% CI: [1.278, 2.702]Log Rank
Secondary

Change From Baseline at Week 18 in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy Module (EORTC QLQ-CIPN20) Sensory Subscale Score

EORTC QLQ-CIPN20 sensory subscale score was calculated following the standard scoring algorithm, transformed to a 0 (low quality of life) to 100 (best quality of life) scale. A positive change from baseline indicates improvement.

Time frame: Baseline, Week 18

Population: Group 2: All randomized participants with suspected deleterious or deleterious BRCA1 or BRCA2 mutation determined by sponsor core lab. Participants with a baseline and post baseline value. Per protocol, this outcome measure was not planned for the Veliparib + TMZ arm.

ArmMeasureValue (MEAN)Dispersion
Group 2 Placebo + Carboplatin/PaclitaxelChange From Baseline at Week 18 in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy Module (EORTC QLQ-CIPN20) Sensory Subscale Score13.94 score on a scaleStandard Deviation 14.123
Group 2 Veliparib + Carboplatin/PaclitaxelChange From Baseline at Week 18 in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy Module (EORTC QLQ-CIPN20) Sensory Subscale Score11.24 score on a scaleStandard Deviation 13.954
p-value: 0.35495% CI: [-7.2, 2.6]ANCOVA
Secondary

Clinical Benefit Rate (CBR) at Week 18

CBR: percentage of participants who were progression-free at 18 weeks, defined as complete response (CR), partial response (PR), stable disease (SD) or non-CR/non-disease progression (PD) per Response Evaluation Criteria in Solid Tumors \[RECIST\] 1.1. CR: The disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 0 mm. PR: \>= 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters (SOD). PD: \>= 20% increase in the SOD of target lesions, taking as reference the smallest SOD recorded since the treatment started (baseline or after) or the appearance of \>=1 new lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest SOD since the treatment started (baseline or after).

Time frame: Week 18

Population: Group 2: All randomized participants with suspected deleterious or deleterious BRCA1 or BRCA2 mutation determined by sponsor core lab.

ArmMeasureValue (NUMBER)
Group 2 Placebo + Carboplatin/PaclitaxelClinical Benefit Rate (CBR) at Week 1887.0 percentage of participants
Group 2 Veliparib + Carboplatin/PaclitaxelClinical Benefit Rate (CBR) at Week 1890.7 percentage of participants
Group 2 Veliparib + TMZClinical Benefit Rate (CBR) at Week 1873.0 percentage of participants
p-value: 0.434Cochran-Mantel-Haenszel
p-value: 0.019Cochran-Mantel-Haenszel
Secondary

Objective Response Rate (ORR)

The objective response rate, defined as percentage of participants with a confirmed CR or PR based on RECIST 1.1 criteria. CR: The disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 0 mm. PR: \>= 30% decrease in the sum of diameters of target lesions, taking as reference the baseline SODs.

Time frame: Radiographic evaluation every 9 weeks, clinical evaluation every cycle (data cutoff date: 04 March 2016); maximum duration of follow up for ORR was 34 months.

Population: Group 2: All randomized participants with suspected deleterious or deleterious BRCA1 or BRCA2 mutation determined by sponsor core lab. Participants with at least 1 measurable lesion at baseline.

ArmMeasureValue (NUMBER)
Group 2 Placebo + Carboplatin/PaclitaxelObjective Response Rate (ORR)61.3 percentage of participants
Group 2 Veliparib + Carboplatin/PaclitaxelObjective Response Rate (ORR)77.8 percentage of participants
Group 2 Veliparib + TMZObjective Response Rate (ORR)28.6 percentage of participants
p-value: 0.027Cochran-Mantel-Haenszel
p-value: <0.001Cochran-Mantel-Haenszel
Secondary

Overall Survival (OS)

Time to death for a given participant was defined as the number of months from the day the participant is randomized to the date of the participant's death. All events of death were included, regardless of whether the event occurs while the participant was still taking study drug, or after the participant discontinued study drug. If a participant had not died, then the data will be censored at the date when the participant was last known to be alive.

Time frame: From Cycle 1 Day 1 until participant's death or 3 years post discontinuation (data cutoff date: 04 March 2016); maximum duration of follow up for OS was 72 months.

Population: Group 2: All randomized participants with suspected deleterious or deleterious BRCA1 or BRCA2 mutation determined by sponsor core lab.

ArmMeasureValue (MEDIAN)
Group 2 Placebo + Carboplatin/PaclitaxelOverall Survival (OS)25.4 months
Group 2 Veliparib + Carboplatin/PaclitaxelOverall Survival (OS)28.3 months
Group 2 Veliparib + TMZOverall Survival (OS)19.1 months
p-value: 0.36895% CI: [0.59, 1.218]Log Rank
p-value: 0.01795% CI: [1.074, 2.127]Log Rank

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