Breast Neoplasms
Conditions
Brief summary
This multicenter, two-cohort, non-randomized, open-label study will evaluate the safety and tolerability of assisted and self-administered SC Herceptin as adjuvant therapy in participants with early HER2-positive breast cancer following tumor excision. Participants will receive Herceptin 600 milligrams (mg) SC every 3 weeks for 18 cycles, either by an assisted administration using a conventional syringe and needle/vial formulation (Cohort A) or with assisted and self-administration using a single-use injection device (SID) in selected participants (Cohort B).
Interventions
Herceptin will be given as 600 mg SC (into thigh) on Day 1 of each 3-week cycle for up to 18 cycles.
Sponsors
Study design
Eligibility
Inclusion criteria
* 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 to IIIC that is eligible for treatment with Herceptin * Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 * Screening left ventricular ejection fraction (LVEF) greater than or equal to (≥) 55%
Exclusion criteria
* Previous neoadjuvant or adjuvant breast cancer treatment with an approved or investigational anti-HER2 agent * History of other malignancy except for curatively treated carcinoma in situ of the cervix, basal cell carcinoma, or curatively treated malignancies (other than breast cancer) where the participant has been disease-free for at least 5 years * Past history of ductal carcinoma in situ treated with any systemic therapy or with radiation therapy to the ipsilateral breast where invasive cancer subsequently developed * Metastatic disease * Inadequate bone marrow, hepatic, or renal function * Serious cardiac or cardiovascular disease including uncontrolled hypertension or history of hypertensive crisis or hypertensive encephalopathy * History of severe allergic or immunological reactions, such as difficult-to-control asthma * Pregnant or lactating women
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants Who Received Concomitant Non-Cancer Therapy | From Baseline to data cutoff of 10 March 2015 (up to approximately 3 years) | Concomitant non-cancer treatment included any pharmacologic interventions administered during the study other than chemotherapy, radiotherapy, or hormone therapy. The percentage of participants who received any concomitant non-cancer therapies was reported. |
| Percentage of Participants With a Grade 3 or Higher AE During the Treatment Period | From Day 1 up to 19 cycles (cycle length 3 weeks) (approximately 1 year) | Participants were planned to receive a total of 18 cycles of SC Herceptin. An AE was defined as any untoward medical occurrence in a participant administered SC Herceptin. Examples included unfavorable/unintended signs and symptoms, new or exacerbated disease, recurrence of intermittent condition, deterioration in laboratory value or other clinical test, or adverse procedure-related events. AEs were graded according to National Cancer Institute Common Terminology Criteria Version 4.0. Grade 3 AEs were those considered severe or medically significant but not immediately life-threatening. Grade 4 AEs were those considered life-threatening and/or for which urgent intervention was indicated. Grade 5 AEs were those resulting in death. The percentage of participants with a Grade 3 or higher (i.e., Grade 3 to 5) AE during the treatment period was reported. |
| Percentage of Participants With Treatment Interruption Due to an AE | From Day 1 up to 19 cycles (cycle length 3 weeks) (approximately 1 year) | Participants were planned to receive a total of 18 cycles of SC Herceptin. An AE was defined as any untoward medical occurrence in a participant administered SC Herceptin. Examples included unfavorable/unintended signs and symptoms, new or exacerbated disease, recurrence of intermittent condition, deterioration in laboratory value or other clinical test, or adverse procedure-related events. The percentage of participants with SC Herceptin treatment interrupted to assess or treat AEs was reported. |
| Number of Herceptin Cycles Received | From Day 1 up to 19 cycles (cycle length 3 weeks) (approximately 1 year) | Participants were planned to receive a total of 18 cycles of SC Herceptin. The median number of cycles actually received was reported. |
| Percentage of Participants by Total Number of Herceptin Cycles Received | From Day 1 up to 19 cycles (cycle length 3 weeks) (approximately 1 year) | Participants were planned to receive a total of 18 cycles of SC Herceptin. The percentage of participants was reported by the total number of cycles actually received. Because the data are presented non-cumulatively, this table reflects participant distribution by the highest number of cycles received. |
| Percentage of Participants Who Received Concomitant Cancer Therapy | From Baseline to data cutoff of 10 March 2015 (up to approximately 3 years) | Concomitant cancer treatment included chemotherapy, radiotherapy, and hormone therapy administered during the study. The percentage of participants who received any of these concomitant therapies was reported. |
| Percentage of Participants With At Least 1 Adverse Event (AE) During the Treatment Period | From Day 1 up to 19 cycles (cycle length 3 weeks) (approximately 1 year) | Participants were planned to receive a total of 18 cycles of SC Herceptin. An AE was defined as any untoward medical occurrence in a participant administered SC Herceptin. Examples included unfavorable/unintended signs and symptoms, new or exacerbated disease, recurrence of intermittent condition, deterioration in laboratory value or other clinical test, or adverse procedure-related events. The percentage of participants with at least 1 AE during the treatment period (regardless of severity or seriousness) was reported. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants Who Died During the Safety Follow-up Period | From Baseline to Time of Event, Safety Follow-Up Period (Up to 6 Years) | The percentage of participants who died from any cause was reported during the safety follow-up period. |
| Disease-Free Survival Rate | From Baseline to time of event (up to approximately 8 years) | DFS is defined as the time from first dose of SC Herceptin to the first event of local, regional or distant recurrence, contralateral invasive breast cancer (including ipsilateral ductal carcinoma in situ) or death due to any cause. Time from the date of first dose to any DFS event was expressed in Kaplan-Meier survival probability estimates. Patients without an event will be censored at the last assessment date. |
| Overall Survival Rate | From Baseline to Time of Event (Up to Approximately 6 Years) | Overall survival was defined as the time from randomization to death from any cause. Time from the date of randomization to the date of death was expressed in Kaplan-Meier survival probability estimates. Patients without an event will be censored at the last assessment date. |
| Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4 (cycle length 3 weeks) and last safety follow-up (LSFU) (approximately 1 year) | The SID satisfaction questionnaire was administered twice during the study and asked participants to respond to five statements using a Likert scale from Strongly Disagree to Strongly Agree. Questionnaire items were as follows: I felt comfortable injecting the study drug by myself (Comfortable), The SID was convenient and easy to use (Easy to Use), I am confident giving myself an injection in the thigh with the SID (Confident), Taking all things into account I find self-administration using the SID satisfactory (Satisfactory), If given the opportunity I would choose to continue self-injecting the study drug using the SID in the future (Continue). Participants could only select one response per questionnaire item. There was no calculation of any score, but rather, descriptive summaries were generated by item response. The percentage of participants was reported by the response given for each item on the SID satisfaction questionnaire. |
| Percentage of Participants Who Died by Data Cutoff of 10 March 2015 | From Baseline to time of event (maximum follow-up approximately 3 years as of data cutoff of 10 March 2015) | The percentage of participants who died from any cause was reported. |
Countries
Albania, Algeria, Argentina, Australia, Bosnia and Herzegovina, Brazil, Bulgaria, Canada, Chile, Colombia, Croatia, Czechia, Dominican Republic, Ecuador, Egypt, El Salvador, France, Germany, Greece, Guatemala, Hong Kong, Hungary, Indonesia, Ireland, Italy, Lithuania, Malaysia, Mexico, Morocco, Netherlands, New Zealand, Norway, Pakistan, Panama, Peru, Philippines, Poland, Portugal, Romania, Russia, Saudi Arabia, Serbia, Singapore, Slovakia, Slovenia, South Africa, South Korea, Spain, Sweden, Switzerland, Taiwan, Thailand, Turkey (Türkiye), Ukraine, United Arab Emirates, United Kingdom, Uruguay, Venezuela, Vietnam
Participant flow
Pre-assignment details
Of the 2984 participants screened, a total of 2577 participants were enrolled into the trial, and 2573 participants received at least one dose of study treatment. 4 Participants were not included in the Safety Follow-Up (SFU) ITT due to the lack of Principal Investigator signatures.
Participants by arm
| Arm | Count |
|---|---|
| Cohort A: SC Herceptin by Needle/Syringe Participants received SC Herceptin by an assisted administration as 600 mg every 3 weeks for a total of 18 doses/cycles. Each dose of SC Herceptin was taken from a single-use vial and injected by needle/syringe. | 1,867 |
| Cohort B: SC Herceptin by SID Participants received SC Herceptin as 600 mg every 3 weeks for a total of 18 doses/cycles. Each dose of SC Herceptin was administered from a pre-filled SID. The first administration was performed by an HCP. Subsequent doses were self-administered by participants who were willing and judged competent by the HCP. | 710 |
| Total | 2,577 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Safety Follow-up | Adverse Event | 8 | 4 |
| Safety Follow-up | Death | 28 | 4 |
| Safety Follow-up | Disease progression /disease recurrence | 223 | 90 |
| Safety Follow-up | Erroneous reporting or late reporting | 2 | 0 |
| Safety Follow-up | Lost to Follow-up | 101 | 48 |
| Safety Follow-up | Missing | 7 | 2 |
| Safety Follow-up | Non-compliance | 7 | 3 |
| Safety Follow-up | Physician Decision | 6 | 4 |
| Safety Follow-up | Protocol Violation | 7 | 0 |
| Safety Follow-up | Site closure | 2 | 3 |
| Safety Follow-up | Sponsor decision | 1 | 0 |
| Safety Follow-up | Withdrawal by Subject | 155 | 49 |
| Treatment Period | Adverse Event | 100 | 30 |
| Treatment Period | Disease Progression/Recurrence | 37 | 13 |
| Treatment Period | Investigator/Sponsor Decision | 6 | 3 |
| Treatment Period | Lack of Compliance | 5 | 1 |
| Treatment Period | Other | 13 | 2 |
| Treatment Period | Pregnancy | 1 | 0 |
| Treatment Period | Withdrawal by Subject | 35 | 9 |
Baseline characteristics
| Characteristic | Cohort A: SC Herceptin by Needle/Syringe | Cohort B: SC Herceptin by SID | Total |
|---|---|---|---|
| Age, Continuous | 54.0 years STANDARD_DEVIATION 12.01 | 53.0 years STANDARD_DEVIATION 11.32 | 53.7 years STANDARD_DEVIATION 11.83 |
| Sex: Female, Male Female | 1863 Participants | 710 Participants | 2573 Participants |
| Sex: Female, Male Male | 4 Participants | 0 Participants | 4 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — | — / — |
| other Total, other adverse events | 1,499 / 1,864 | 576 / 709 | 0 / 1,862 | 0 / 707 |
| serious Total, serious adverse events | 242 / 1,864 | 84 / 709 | 202 / 1,862 | 53 / 707 |
Outcome results
Number of Herceptin Cycles Received
Participants were planned to receive a total of 18 cycles of SC Herceptin. The median number of cycles actually received was reported.
Time frame: From Day 1 up to 19 cycles (cycle length 3 weeks) (approximately 1 year)
Population: Safety Population. The endpoint also included an analysis of a subgroup of participants from Cohort B who received doses of self-administered SC Herceptin via SID.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Cohort A: SC Herceptin by Needle/Syringe | Number of Herceptin Cycles Received | 16.0 cycles |
| Cohort B: SC Herceptin by SID | Number of Herceptin Cycles Received | 18.0 cycles |
| Cohort B: SC Herceptin by SID | Number of Herceptin Cycles Received | 18.0 cycles |
Percentage of Participants by Total Number of Herceptin Cycles Received
Participants were planned to receive a total of 18 cycles of SC Herceptin. The percentage of participants was reported by the total number of cycles actually received. Because the data are presented non-cumulatively, this table reflects participant distribution by the highest number of cycles received.
Time frame: From Day 1 up to 19 cycles (cycle length 3 weeks) (approximately 1 year)
Population: Safety Population. The endpoint also included an analysis of a subgroup of participants from Cohort B who received doses of self-administered SC Herceptin via SID.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 2 Cycles Received | 1.3 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 14 Cycles Received | 6.9 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 8 Cycles Received | 2.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 1 Cycle Received | 2.7 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 13 Cycles Received | 4.9 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 9 Cycles Received | 1.8 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 4 Cycles Received | 1.6 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 12 Cycles Received | 2.5 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 10 Cycles Received | 1.5 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 19 Cycles Received | 0 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 11 Cycles Received | 3.5 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 17 Cycles Received | 32.5 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 5 Cycles Received | 1.3 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 18 Cycles Received | 0 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 16 Cycles Received | 21.6 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 6 Cycles Received | 1.6 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 3 Cycles Received | 1.1 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 15 Cycles Received | 10.7 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Total Number of Herceptin Cycles Received | 7 Cycles Received | 2.2 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 17 Cycles Received | 1.0 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 1 Cycle Received | 1.0 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 2 Cycles Received | 0.5 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 3 Cycles Received | 0.5 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 4 Cycles Received | 1.2 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 5 Cycles Received | 0.8 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 6 Cycles Received | 0.5 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 7 Cycles Received | 0.7 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 8 Cycles Received | 0.9 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 9 Cycles Received | 0.2 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 10 Cycles Received | 0.3 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 11 Cycles Received | 0.4 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 12 Cycles Received | 0.9 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 13 Cycles Received | 0.2 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 14 Cycles Received | 0.5 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 15 Cycles Received | 0.5 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 16 Cycles Received | 0.6 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 18 Cycles Received | 89.2 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 19 Cycles Received | 0.2 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 13 Cycles Received | 0 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 7 Cycles Received | 0.8 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 19 Cycles Received | 0 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 14 Cycles Received | 0.6 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 6 Cycles Received | 0.1 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 18 Cycles Received | 91.8 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 15 Cycles Received | 0.4 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 5 Cycles Received | 0.6 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 1 Cycle Received | 0.8 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 16 Cycles Received | 0.3 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 4 Cycles Received | 0.7 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 10 Cycles Received | 0.1 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 3 Cycles Received | 0.1 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 11 Cycles Received | 0.3 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 9 Cycles Received | 0.6 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 17 Cycles Received | 1.1 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 12 Cycles Received | 0.8 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 8 Cycles Received | 0.3 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants by Total Number of Herceptin Cycles Received | 2 Cycles Received | 0.4 percentage of participants |
Percentage of Participants Who Received Concomitant Cancer Therapy
Concomitant cancer treatment included chemotherapy, radiotherapy, and hormone therapy administered during the study. The percentage of participants who received any of these concomitant therapies was reported.
Time frame: From Baseline to data cutoff of 10 March 2015 (up to approximately 3 years)
Population: Safety Population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants Who Received Concomitant Cancer Therapy | Chemotherapy | 58.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants Who Received Concomitant Cancer Therapy | Radiotherapy | 51.3 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants Who Received Concomitant Cancer Therapy | Hormone Therapy | 53.5 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants Who Received Concomitant Cancer Therapy | Chemotherapy | 63.9 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants Who Received Concomitant Cancer Therapy | Radiotherapy | 48.5 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants Who Received Concomitant Cancer Therapy | Hormone Therapy | 50.4 percentage of participants |
Percentage of Participants Who Received Concomitant Non-Cancer Therapy
Concomitant non-cancer treatment included any pharmacologic interventions administered during the study other than chemotherapy, radiotherapy, or hormone therapy. The percentage of participants who received any concomitant non-cancer therapies was reported.
Time frame: From Baseline to data cutoff of 10 March 2015 (up to approximately 3 years)
Population: Safety Population
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants Who Received Concomitant Non-Cancer Therapy | 89.1 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants Who Received Concomitant Non-Cancer Therapy | 89.7 percentage of participants |
Percentage of Participants With a Grade 3 or Higher AE During the Treatment Period
Participants were planned to receive a total of 18 cycles of SC Herceptin. An AE was defined as any untoward medical occurrence in a participant administered SC Herceptin. Examples included unfavorable/unintended signs and symptoms, new or exacerbated disease, recurrence of intermittent condition, deterioration in laboratory value or other clinical test, or adverse procedure-related events. AEs were graded according to National Cancer Institute Common Terminology Criteria Version 4.0. Grade 3 AEs were those considered severe or medically significant but not immediately life-threatening. Grade 4 AEs were those considered life-threatening and/or for which urgent intervention was indicated. Grade 5 AEs were those resulting in death. The percentage of participants with a Grade 3 or higher (i.e., Grade 3 to 5) AE during the treatment period was reported.
Time frame: From Day 1 up to 19 cycles (cycle length 3 weeks) (approximately 1 year)
Population: Safety Population
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants With a Grade 3 or Higher AE During the Treatment Period | 24.0 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants With a Grade 3 or Higher AE During the Treatment Period | 21.0 percentage of participants |
Percentage of Participants With At Least 1 Adverse Event (AE) During the Treatment Period
Participants were planned to receive a total of 18 cycles of SC Herceptin. An AE was defined as any untoward medical occurrence in a participant administered SC Herceptin. Examples included unfavorable/unintended signs and symptoms, new or exacerbated disease, recurrence of intermittent condition, deterioration in laboratory value or other clinical test, or adverse procedure-related events. The percentage of participants with at least 1 AE during the treatment period (regardless of severity or seriousness) was reported.
Time frame: From Day 1 up to 19 cycles (cycle length 3 weeks) (approximately 1 year)
Population: Safety Population: All enrolled participants who received at least one dose of study medication according to assigned treatment.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants With At Least 1 Adverse Event (AE) During the Treatment Period | 88.6 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants With At Least 1 Adverse Event (AE) During the Treatment Period | 89.0 percentage of participants |
Percentage of Participants With Treatment Interruption Due to an AE
Participants were planned to receive a total of 18 cycles of SC Herceptin. An AE was defined as any untoward medical occurrence in a participant administered SC Herceptin. Examples included unfavorable/unintended signs and symptoms, new or exacerbated disease, recurrence of intermittent condition, deterioration in laboratory value or other clinical test, or adverse procedure-related events. The percentage of participants with SC Herceptin treatment interrupted to assess or treat AEs was reported.
Time frame: From Day 1 up to 19 cycles (cycle length 3 weeks) (approximately 1 year)
Population: Safety Population
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants With Treatment Interruption Due to an AE | 9.8 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants With Treatment Interruption Due to an AE | 10.4 percentage of participants |
Disease-Free Survival Rate
DFS is defined as the time from first dose of SC Herceptin to the first event of local, regional or distant recurrence, contralateral invasive breast cancer (including ipsilateral ductal carcinoma in situ) or death due to any cause. Time from the date of first dose to any DFS event was expressed in Kaplan-Meier survival probability estimates. Patients without an event will be censored at the last assessment date.
Time frame: From Baseline to time of event (up to approximately 8 years)
Population: ITT Population who completed Safety Follow-up
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Cohort A: SC Herceptin by Needle/Syringe | Disease-Free Survival Rate | 0.5 Year | 0.990 Kaplan-Meier survival probability |
| Cohort A: SC Herceptin by Needle/Syringe | Disease-Free Survival Rate | 1 Year | 0.975 Kaplan-Meier survival probability |
| Cohort A: SC Herceptin by Needle/Syringe | Disease-Free Survival Rate | 1.5 Year | 0.960 Kaplan-Meier survival probability |
| Cohort A: SC Herceptin by Needle/Syringe | Disease-Free Survival Rate | 2 Years | 0.934 Kaplan-Meier survival probability |
| Cohort A: SC Herceptin by Needle/Syringe | Disease-Free Survival Rate | 3 Years | 0.904 Kaplan-Meier survival probability |
| Cohort A: SC Herceptin by Needle/Syringe | Disease-Free Survival Rate | 4 Years | 0.881 Kaplan-Meier survival probability |
| Cohort A: SC Herceptin by Needle/Syringe | Disease-Free Survival Rate | 5 Years | 0.868 Kaplan-Meier survival probability |
| Cohort A: SC Herceptin by Needle/Syringe | Disease-Free Survival Rate | 6 Years | 0.851 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Disease-Free Survival Rate | 6 Years | 0.853 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Disease-Free Survival Rate | 0.5 Year | 0.987 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Disease-Free Survival Rate | 3 Years | 0.896 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Disease-Free Survival Rate | 1 Year | 0.976 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Disease-Free Survival Rate | 5 Years | 0.863 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Disease-Free Survival Rate | 1.5 Year | 0.957 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Disease-Free Survival Rate | 4 Years | 0.874 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Disease-Free Survival Rate | 2 Years | 0.939 Kaplan-Meier survival probability |
Overall Survival Rate
Overall survival was defined as the time from randomization to death from any cause. Time from the date of randomization to the date of death was expressed in Kaplan-Meier survival probability estimates. Patients without an event will be censored at the last assessment date.
Time frame: From Baseline to Time of Event (Up to Approximately 6 Years)
Population: ITT population: All randomized participants received at least one dose of drug and completed the follow up period
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Cohort A: SC Herceptin by Needle/Syringe | Overall Survival Rate | 3 Years | 0.968 Kaplan-Meier survival probability |
| Cohort A: SC Herceptin by Needle/Syringe | Overall Survival Rate | 4 Years | 0.947 Kaplan-Meier survival probability |
| Cohort A: SC Herceptin by Needle/Syringe | Overall Survival Rate | 0.5 Year | 0.999 Kaplan-Meier survival probability |
| Cohort A: SC Herceptin by Needle/Syringe | Overall Survival Rate | 1 Year | 0.998 Kaplan-Meier survival probability |
| Cohort A: SC Herceptin by Needle/Syringe | Overall Survival Rate | 1.5 Year | 0.993 Kaplan-Meier survival probability |
| Cohort A: SC Herceptin by Needle/Syringe | Overall Survival Rate | 2 Years | 0.985 Kaplan-Meier survival probability |
| Cohort A: SC Herceptin by Needle/Syringe | Overall Survival Rate | 5 Years | 0.937 Kaplan-Meier survival probability |
| Cohort A: SC Herceptin by Needle/Syringe | Overall Survival Rate | 6 Years | 0.927 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Overall Survival Rate | 5 Years | 0.929 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Overall Survival Rate | 2 Years | 0.985 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Overall Survival Rate | 3 Years | 0.960 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Overall Survival Rate | 0.5 Year | 0.996 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Overall Survival Rate | 4 Years | 0.950 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Overall Survival Rate | 1 Year | 0.994 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Overall Survival Rate | 6 Years | 0.921 Kaplan-Meier survival probability |
| Cohort B: SC Herceptin by SID | Overall Survival Rate | 1.5 Year | 0.990 Kaplan-Meier survival probability |
Percentage of Participants by Item Response to SID Satisfaction Questionnaire
The SID satisfaction questionnaire was administered twice during the study and asked participants to respond to five statements using a Likert scale from Strongly Disagree to Strongly Agree. Questionnaire items were as follows: I felt comfortable injecting the study drug by myself (Comfortable), The SID was convenient and easy to use (Easy to Use), I am confident giving myself an injection in the thigh with the SID (Confident), Taking all things into account I find self-administration using the SID satisfactory (Satisfactory), If given the opportunity I would choose to continue self-injecting the study drug using the SID in the future (Continue). Participants could only select one response per questionnaire item. There was no calculation of any score, but rather, descriptive summaries were generated by item response. The percentage of participants was reported by the response given for each item on the SID satisfaction questionnaire.
Time frame: Cycle 4 (cycle length 3 weeks) and last safety follow-up (LSFU) (approximately 1 year)
Population: Safety Population. Only participants who performed self-administration were included. The number of participants who responded to the questionnaire item at each assessment (n) is shown in the table.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Satisfactory, Response Missing (n=514) | 0.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Continue, Response Missing (n=514) | 0.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Comfortable, Unsure (n=415) | 5.3 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Easy to Use, Response Missing (n=415) | 0 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Satisfactory, Agree (n=415) | 30.8 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Comfortable, Strongly Disagree (n=514) | 4.7 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Comfortable, Disagree (n=514) | 2.3 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Comfortable, Unsure (n=514) | 7.6 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Comfortable, Agree (n=514) | 41.6 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Comfortable, Strongly Agree (n=514) | 43.6 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Comfortable, Response Missing (n=514) | 0.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Easy to Use, Strongly Disagree (n=514) | 3.7 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Easy to Use, Disagree (n=514) | 0.6 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Easy to Use, Unsure (n=514) | 1.8 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Easy to Use, Agree (n=514) | 37.7 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Easy to Use, Strongly Agree (n=514) | 56.0 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Easy to Use, Response Missing (n=514) | 0.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Confident, Strongly Disagree (n=514) | 3.9 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Confident, Disagree (n=514) | 0.8 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Confident, Unsure (n=514) | 7.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Confident, Agree (n=514) | 42.8 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Confident, Strongly Agree (n=514) | 45.1 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Confident, Response Missing (n=514) | 0.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Satisfactory, Strongly Disagree (n=514) | 3.9 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Satisfactory, Disagree (n=514) | 0.6 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Satisfactory, Unsure (n=514) | 2.7 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Satisfactory, Agree (n=514) | 38.7 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Satisfactory, Strongly Agree (n=514) | 53.9 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Continue, Strongly Disagree (n=514) | 3.9 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Continue, Disagree (n=514) | 1.4 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Continue, Unsure (n=514) | 5.3 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Continue, Agree (n=514) | 33.5 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | Cycle 4: Continue, Strongly Agree (n=514) | 55.8 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Comfortable, Strongly Disagree (n=415) | 3.6 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Comfortable, Disagree (n=415) | 3.1 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Comfortable, Agree (n=415) | 35.9 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Comfortable, Strongly Agree (n=415) | 51.8 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Comfortable, Response Missing (n=415) | 0.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Easy to Use, Strongly Disagree (n=415) | 3.9 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Easy to Use, Disagree (n=415) | 1.0 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Easy to Use, Unsure (n=415) | 1.7 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Easy to Use, Agree (n=415) | 34.9 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Easy to Use, Strongly Agree (n=415) | 58.6 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Confident, Strongly Disagree (n=415) | 4.6 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Confident, Disagree (n=415) | 1.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Confident, Unsure (n=415) | 4.3 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Confident, Agree (n=415) | 33.3 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Confident, Strongly Agree (n=415) | 56.6 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Confident, Response Missing (n=415) | 0 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Satisfactory, Strongly Disagree (n=415) | 4.3 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Satisfactory, Disagree (n=415) | 1.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Satisfactory, Unsure (n=415) | 2.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Satisfactory, Strongly Agree (n=415) | 61.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Satisfactory, Response Missing (n=415) | 0.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Continue, Strongly Disagree (n=415) | 4.6 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Continue, Disagree (n=415) | 1.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Continue, Unsure (n=415) | 2.9 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Continue, Agree (n=415) | 28.2 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Continue, Strongly Agree (n=415) | 63.1 percentage of participants |
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants by Item Response to SID Satisfaction Questionnaire | LSFU: Continue, Response Missing (n=415) | 0 percentage of participants |
Percentage of Participants Who Died by Data Cutoff of 10 March 2015
The percentage of participants who died from any cause was reported.
Time frame: From Baseline to time of event (maximum follow-up approximately 3 years as of data cutoff of 10 March 2015)
Population: ITT Population
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants Who Died by Data Cutoff of 10 March 2015 | 1.5 percentage of participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants Who Died by Data Cutoff of 10 March 2015 | 0.8 percentage of participants |
Percentage of Participants Who Died During the Safety Follow-up Period
The percentage of participants who died from any cause was reported during the safety follow-up period.
Time frame: From Baseline to Time of Event, Safety Follow-Up Period (Up to 6 Years)
Population: ITT Population
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cohort A: SC Herceptin by Needle/Syringe | Percentage of Participants Who Died During the Safety Follow-up Period | 6.8 Percentage of Participants |
| Cohort B: SC Herceptin by SID | Percentage of Participants Who Died During the Safety Follow-up Period | 7.3 Percentage of Participants |