Neoplasms, Breast
Conditions
Keywords
CLAP016A2206, biomarker, Lapatinib, Prosigna, ErbB2, PAM50, HER2, HER2-overexpressing metastatic breast cancer, HER2-enriched, Trastuzumab
Brief summary
This was a multicenter, open-label, Phase II study in subjects with Human epidermal growth factor receptor (HER2)-positive metastatic breast cancer who received at least 2 prior lines of anti-HER2-targeted therapies of which at least one included a Trastuzumab-containing regimen. This study was a post-approval commitment with regulatory authorities. It was designed to evaluate whether treatment with Dual blockade promoted changes to biomarkers associated with immunomodulation.
Detailed description
This study was designed to address the post-authorization measures as agreed with the Committee for Medicinal Products for Human Use (CHMP). Recruitment of subjects into this study was challenging, and following agreement with the European Medicines Agency (EMA) enrollment into this study was halted after the enrollment of 42 of the 225 planned subjects. The primary endpoint of the study evaluated changes in expression of biomarkers associated with immunomodulation between a pre-treatment biopsy and the disease progression biopsy. Secondary efficacy endpoints included overall response rate, clinical benefit rate and progression-free survival (PFS), as well as safety/tolerability. All subjects received study treatment until disease progression, death, unacceptable toxicity, or subject withdrawal. In case of disease progression during the treatment period, the subject was followed-up for 30 days for safety evaluation. In case of study treatment discontinuation for any reasons other than disease progression, the subject was followed-up for safety and efficacy assessments until disease progression, new anticancer therapy, death, withdrawal of consent or end of study, whichever came first. This study supported a better understanding of the rapidly accumulating evidence for the importance of the immune microenvironment in HER2-positive breast cancer and the observed immunomodulation in the neoadjuvant setting could be confirmed in the advanced setting and supported the putative mechanism of action of HER2 dual blockade and its potential function on the tumor microenvironment. No formal comparisons between treatment arms were undertaken.
Interventions
DRUGLapatinib
Lapatinib is available as 250-mg orange tablets. Subjects randomized to the Lapatinib plus Trastuzumab arm received 1000 mg per day of Lapatinib, so wre instructed to take 4 x 250 mg tablets per day. Lapatinib was to be taken either 1 hour (or more) before a meal or 1 hour (or more) after a meal
BIOLOGICALTrastuzumab
Trastuzumab is a sterile, white to pale yellow, preservative-free lyophilized powder for IV administration. Trastuzumab was administered on Day 1 of the start of Lapatinib or in conjunction with the first cycle of chemotherapy, as an 8 mg/kg loading dose. Subsequently, Trastuzumab was administered q3weekly as a 6 mg/kg maintenance dose. At the discretion of the investigator, weekly Trastuzumab could be given in either of the three treatment arms (loading dose 4mg/kg followed by weekly administration of 2mg/kg).
Subjects who were hormone receptor-positive were required to receive an aromatase inhibitor as combination treatment; however the choice of the aromatase inhibitor selected for each patient was determined by the patients' investigator. The AIs the Investigator could choose from were anastrozole, exemestane, and letrozole and dosing was per product information.
Sponsors
Novartis Pharmaceuticals
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
This was a two-cohort, three-arm, open-label Phase II study to evaluate the changes in the expression of biomarkers between pre-treatment and progression biopsy in subjects with Human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer. Subjects were allocated to 1 of 2 cohorts depending on the molecular subtype of their biopsy. Cohort 1 HER2 -enriched included HER2-positive subjects with a HER2-Enriched molecular subtype, and were randomized in a 1:1 ratio to receive either trastuzumab in combination with lapatinib (Arm A) or trastuzumab in combination with chemotherapy (Arm B). Cohort 2 non-HER2-enriched, included HER2-positive subjects with luminal A, luminal B, and basal-like molecular subtypes and were to receive trastuzumab in combination with lapatinib (Arm C). Subjects with hormone receptor (ER and/or PgR)-positive MBC in this arm were required to be treated with an AI of the Investigator's choice.
Intervention model description
Participants were randomized to Arms A and B but randomized to Arm C.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Signed written informed consent * Female \>=18 years * Histologically or cytologically confirmed invasive breast cancer with distant metastasis * Subjects must have at least one measurable lesion per RECIST 1.1 * Note: Biopsied lesions should not be used as target lesions. * Documentation of HER2 overexpression or gene amplification, in the invasive component of either the primary tumor or metastatic disease site as defined as: 3+ by Immunohistochemistry (IHC) and/or * HER2/neu gene amplification by fluorescence, chromogenic, or silver in situ hybridization \[FISH, CISH or SISH;\>=6 HER2/neu gene copies per nucleus or a FISH, CISH, or SISH test ratio (HER2 gene copies to chromosome 17 signals) of \>=2.0 OR HER2/chromosome 17 ratio \<=2.0 with average HER2 copy number \>=6 signals/cell nucleus\] * Centrally determined HER2-positive, hormone receptor status, breast molecular subtype by Prediction Analysis of Microarray 50 (PAM50) on the pre-treatment biopsy of metastatic lesion obtained during screening * Note: Biopsied lesions should not be used as target lesions. * Progression on at least 2 lines of anti-HER2-targeted therapies for metastatic breast cancer (MBC) * Documented radiological disease progression during the most recent treatment regimen for metastatic disease * Most recent treatment regimen for metastatic disease must include Trastuzumab and chemotherapy. * Note: Trastuzumab emtansine (T-DM1) is considered acceptable as prior Trastuzumab/chemotherapy regimen * Agreement to provide 2 tumor biopsies * Prior treatment with pertuzumab, Lapatinib, and/or Trastuzumab emtansine is allowed; however, the last treatment for MBC must not include Trastuzumab in combination with pertuzumab. * Subjects with radiographically stable Central nervous system (CNS) metastases, defined as radiographically stable on the previous 2 brain imaging scans, asymptomatic, and off systemic steroids and anticonvulsants for at least 1 month are eligible; treatment with prophylactic anticonvulsants is permitted unless listed under Prohibited Medications * Discontinuation of all prior chemotherapy, immunotherapy, or biological therapy at least 3 weeks prior to the first dose of investigational product is required. * Note: Discontinuation of Trastuzumab is not necessary. * All treatment related toxicities, except alopecia, must have recovered to Grade 1 or better (Common Terminology Criteria for Adverse Events (CTCAE); version 4.0) prior to administration of the first dose of study treatment. * Baseline Left ventricular ejection fraction (LVEF) \>=50% as measured by Echocardiogram (ECHO) or Multigated acquisition (MUGA) and above the testing institution's lower limit of normal * QT interval corrected (QTc) \<450 millisecond (msec) or QTc \<480 msec for patients with bundle branch block. * The QTc is the QT interval corrected for heart rate according to either Bazett's formula (QTcB) * Fridericia's formula (QTcF), or another method, machine or manual overread. * For subject eligibility and withdrawal, QT correction formula QTcB will be used. * For purposes of this data analysis, Bazett's formula will be used as the primary method of calculating the corrected QT interval. The QTc should be based on either a single Electrocardiogram (ECG) or an average of 3 sequential ECGs obtained within 24 hours of each other. * The QTc should be based on single or averaged QTc values of triplicate ECGs obtained over a brief recording period. * Women of childbearing potential must have a negative serum pregnancy test within 7 days prior to the first dose of study treatment and agree to use effective contraception, during the study and for 30 days following the last dose of study treatment. * Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 * Completion of screening and baseline assessments * Able to swallow and retain orally administered medication and does not have any clinically significant gastrointestinal abnormalities that may alter absorption such as malabsorption syndrome or major resection of the stomach or bowels. * At least 4 weeks must have elapsed since the last surgery and 2 weeks must have elapsed since radiotherapy * Adequate baseline organ function as defined below * Screening laboratory values should be used to confirm subject eligibility. Laboratory results may be retested if necessary to confirm eligibility. * Hematologic(These values must be independent of growth factor support and stable for at least one week post transfusion) * Absolute neutrophil count \>=1.5 x 10\^9/litre (L) * Hemoglobin \>=9.0 grams/decilitre(g/dL) (after transfusion if needed) * Platelets\>=100 x 10\^9/L * Hepatic * Albumin \>=2.5 g/dL * Serum bilirubin \<=1.25 x upper limit of normal (ULN)( These values must be independent of growth factor support and stable for at least one week post transfusion) * Alanine aminotransferase; and, Aspartate aminotransferase AST and ALT\<=2.5 x ULN * Renal * Calculate creatinine clearance \>=40 millilitre/ minute (mL/min) (With the exception of those subjects who have Gilbert's syndrome; the bilirubin in these subjects should be at their baseline)
Exclusion criteria
* Lactating female * Note: Women with potential to have children must be willing to practice acceptable methods of birth control during the study * Bone-only disease and/or disease that cannot be biopsied. * Unstable CNS metastases or leptomeningeal carcinomatosis not considered radiographically stable * Note: Subjects with radiographically stable CNS metastases are defined as radiographically stable on the previous 2 brain imaging studies, asymptomatic, and off systemic steroids and anticonvulsants for at least 1 month; treatment with prophylactic anticonvulsants is permitted unless listed under prohibited medications * Any serious and/or unstable pre-existing medical, psychiatric disorder, or other conditions including concurrent disease that could interfere with subject's safety, obtaining informed consent, or compliance with the study procedures. * Serious cardiac illness or medical condition including but not confined to: Uncontrolled arrhythmias (e.g. ventricular tachycardia, high-grade atrioventricular (AV)-block, supraventricular arrhythmias which are not adequately rate-controlled); * Angina pectoris requiring antianginal medication * History of congestive heart failure or systolic dysfunction (LVEF \<50%) * Documented myocardial infarction \<6 months from study entry * Evidence of transmural infarction on ECG * Poorly controlled hypertension (e.g. systolic \>160milimiter (mm) Mercury (Hg) or diastolic \>100mm Hg) * Clinically significant valvular heart disease * Current active hepatic or biliary disease (with exception of subjects with Gilbert's syndrome, asymptomatic gallstones, liver metastases, or stable chronic liver disease per investigator assessment) * Any clinically significant gastrointestinal abnormalities that may alter absorption such as malabsorption syndrome or major resection of the stomach or bowels as well as subjects with ulcerative colitis are also excluded * Any prohibited medication * Prior treatment with Trastuzumab in combination with Lapatinib or prior treatment with an irreversible inhibitor of the intracellular domain of the HER2 receptor such as neratinib * Last treatment for metastatic disease including Trastuzumab in combination with pertuzumab * Administration of an investigational drug within 30 days or 5 half-lives, whichever is longer, preceding the first dose of study treatment * A known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to any of the study drugs or their excipients that, in the opinion of the investigator or medical monitor, contraindicates participation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | At screening and at disease progression, assessed up to approx. 3.5 years | Evaluate changes in biomarkers associated with immunomodulation between pre-treatment biopsy and disease progression biopsy within each arm. Biomarker analysis was performed using an mRNA gene expression panel derived from Nanostring platform in a total of 20 subjects who received the study treatment as per the study design and with baseline tumor biopsies available. For the selected biomarkers associated with immunomodulation, the median fold changes of gene expression level and 95% confidence interval are presented. The fold change was calculated as the ratio of the expression level of a biomarker at disease progression over the baseline. |
| Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | At screening and at disease progression, assessed up to approx. 3.5 years | Evaluate changes in biomarkers associated with immunomodulation between pre-treatment biopsy and disease progression biopsy within each arm. Biomarker analysis was performed using an mRNA gene expression panel derived from Nanostring platform in a total of 20 subjects who received the study treatment as per the study design and with baseline tumor biopsies available. For the selected biomarkers associated with immunomodulation, the median fold changes of gene expression level and 95% confidence interval are presented. The fold change was calculated as the ratio of the expression level of a biomarker at disease progression over the baseline. |
| Fold Change in Expression Profile of Genes and /or Proteins for Arm C (Non-HER2- Enriched) From Screening to Approx. 3.5 Years | At screening and at disease progression, assessed up to approx. 3.5 years | Evaluate changes in biomarkers associated with immunomodulation between pre-treatment biopsy and disease progression biopsy within each arm. Biomarker analysis was performed using an mRNA gene expression panel derived from Nanostring platform in a total of 20 subjects who received the study treatment as per the study design and with baseline tumor biopsies available. For the selected biomarkers associated with immunomodulation, the median fold changes of gene expression level and 95% confidence interval are presented. The fold change was calculated as the ratio of the expression level of a biomarker at disease progression over the baseline. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Progression-free Survival (PFS) | From randomization to disease progression or death, up to approx. 5.6 years | PFS was defined as the time from the date of randomization (for Arm A and B) / treatment start date (for Arm C) to the date of the first documented disease progression or death due to any cause, whichever was earlier. If a subject had not progressed or died at the analysis cutoff date, PFS was censored at the time of the last adequate tumor assessment. PFS was summarized using Kaplan-Meier estimates. |
| Association Between Biomarkers and PFS | From randomization to disease progression or death, up to approx. 5.6 years | Describe if changes of biomarker expression at disease progression from baseline correlate with PFS. |
| Overall Response Rate (ORR) | From enrollment/randomization to the end of study, approximately 5.6 years | Overall response rate was defined as the percentage of subjects achieving either a confirmed complete response (CR) or partial response (PR) and was calculated from the Investigator's assessment of response per RECIST 1.1 criteria. . The confirmed CR or PR was derived using the following rules: confirmed CR - at least two determinations of CR at least 4 weeks apart before disease progression; confirmed PR - at least two determinations of PR or better at least 4 weeks apart before progression. |
| Clinical Benefit Rate (CBR) | From enrollment/randomization the end of study, approximately 5.6 years | CBR is defined as percentage of subjects with a complete response (CR), partial response (PR), or maintaining stable disease (SD) for at least 24 weeks while on study according to the investigator assessment of response per RECIST 1.1 criteria. CR and PR are confirmed responses derived using the following rules: Confirmed CR - at least 2 determinations of CR at least 4 weeks apart before disease progression. Confirmed PR - at least 2 determinations of PR or better at least 4 weeks apart before progression. |
Countries
Argentina, Austria, Brazil, Hong Kong, Italy, Mexico, Peru, Philippines, Russia, Spain, Thailand, United States
Participant flow
Recruitment details
Overall, 225 subjects were planned and 42 subjects were enrolled in this study
Pre-assignment details
This study was designed to address the post-authorization measures as agreed with the Committee for Medicinal Products for Human Use (CHMP). Recruitment of subjects into this study was challenging, and following agreement with the European Medicines Agency (EMA) enrollment into this study was halted after the enrollment of 42 of the 225 planned subjects.
Participants by arm
| Arm | Count |
|---|---|
| LAP+TRAS±AI (HER2-Enriched) - Arm A Lapatinib 1000mg + Trastuzumab in HER2 Enriched In subjects with HER2-overexpressing MBC with a molecular subtype of HER2 Enriched, Lapatinib 1000mg once daily orally along with Trastuzumab (loading dose of 8 milligram/ kilogram (mg/kg) followed by the maintenance dose of 6 mg/kg Intravenous (IV) Every 3 weeks (q3weekly)) or Lapatinib 1000 milligram (mg) once daily orally along with Weekly Trastuzumab (loading dose of 4 mg/kg) followed by maintenance dose of 2 mg/kg IV weekly. For subjects who were hormone receptor positive, an aromatase inhibitor of the investigator's choice was required. | 17 |
| TRAS+CHEM±AI (HER2-Enriched) - Arm B Trastuzumab in HER2 Enriched: In subjects with HER2-overexpressing MBC with a molecular subtype of HER2 Enriched, Trastuzumab (loading dose of 8 mg/kg followed by the maintenance dose of 6 mg/kg IV q3weekly) along with chemotherapy of the investigator's choice or Weekly Trastuzumab (loading dose of 4 mg/kg) followed by maintenance dose of 2 mg/kg IV weekly along with chemotherapy of the investigators choice. Subjects randomized to this arm and hormone receptor positive received an aromatase inhibitor at the discretion of the investigator. | 15 |
| Non-HER2- Enriched - Arm C Lapatinib 1000mg + Trastuzumab in Non- HER2 Enriched: In subjects with HER2-overexpressing MBC with a molecular subtype of Non- HER2 Enriched (luminal A, luminal B or Basal type), Lapatinib 1000mg once daily orally along with Trastuzumab (loading dose of 8 milligram/ kilogram (mg/kg) followed by the maintenance dose of 6 mg/kg Intravenous (IV) Every 3 weeks (q3weekly)) or Lapatinib 1000 milligram (mg) once daily orally along with Weekly Trastuzumab (loading dose of 4 mg/kg) followed by maintenance dose of 2 mg/kg IV weekly. For subjects who were hormone receptor positive, an aromatase inhibitor of the investigator's choice was required. | 10 |
| Total | 42 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Overall Study | Adverse Event | 2 | 1 | 0 |
| Overall Study | Disease progression (incl. death due to disease progression) | 14 | 13 | 8 |
| Overall Study | Investigator discretion | 0 | 0 | 1 |
| Overall Study | Protocol Violation | 1 | 0 | 0 |
| Overall Study | Withdrawal by Subject | 0 | 1 | 1 |
Baseline characteristics
| Characteristic | LAP+TRAS±AI (HER2-Enriched) - Arm A | TRAS+CHEM±AI (HER2-Enriched) - Arm B | Non-HER2- Enriched - Arm C | Total |
|---|---|---|---|---|
| Age, Customized < 65 years | 14 Participants | 15 Participants | 6 Participants | 35 Participants |
| Age, Customized >= 65 years | 3 Participants | 0 Participants | 4 Participants | 7 Participants |
| Race/Ethnicity, Customized African American | 1 participants | 2 participants | 0 participants | 3 participants |
| Race/Ethnicity, Customized Asian | 1 participants | 2 participants | 0 participants | 3 participants |
| Race/Ethnicity, Customized Caucasian | 14 participants | 11 participants | 10 participants | 35 participants |
| Race/Ethnicity, Customized Native Hawaiian or Pacific Islander | 1 participants | 0 participants | 0 participants | 1 participants |
| Sex: Female, Male Female | 17 Participants | 15 Participants | 10 Participants | 42 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 3 / 17 | 1 / 15 | 0 / 10 |
| other Total, other adverse events | 15 / 17 | 14 / 15 | 10 / 10 |
| serious Total, serious adverse events | 1 / 17 | 1 / 15 | 2 / 10 |
Outcome results
Primary
Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years
Evaluate changes in biomarkers associated with immunomodulation between pre-treatment biopsy and disease progression biopsy within each arm. Biomarker analysis was performed using an mRNA gene expression panel derived from Nanostring platform in a total of 20 subjects who received the study treatment as per the study design and with baseline tumor biopsies available. For the selected biomarkers associated with immunomodulation, the median fold changes of gene expression level and 95% confidence interval are presented. The fold change was calculated as the ratio of the expression level of a biomarker at disease progression over the baseline.
Time frame: At screening and at disease progression, assessed up to approx. 3.5 years
Population: Evaluable Set: Included all subjects in Arm A who received the study treatment and had both baseline and progression tumor biopsies available, with evaluable data for at least 1 biomarker.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Membrane spanning 4-domains A1 | 0.25 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | POU class 2 associating factor 1 | 0.32 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | CD19+ | 0.35 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Interleukin 6 | 0.36 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | G antigen 1 | 0.43 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | ubiquitin specific peptidase 9, Y-linked | 0.50 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Thy-1 cell surface antigen | 0.50 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Chemerin chemokine-like receptor 1 | 0.51 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Major histocompatibility complex, class II, DR beta 4 | 0.51 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Collectin subfamily member 12 | 0.51 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Complement C3b/C4b receptor 1 (Knops blood group) | 0.51 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | CD33 molecule | 0.56 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | B-cell linker | 0.56 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Interleukin 12A | 0.57 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | CD163+ | 0.57 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | C-C motif chemokine ligand 8 | 0.58 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Chemokine (C-C motif) receptor 1 | 0.59 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | POU class 2 homeobox 2 | 0.60 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Cyclin dependent kinase inhibitor 1A | 0.62 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | CD27 molecule | 0.62 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Lymphocyte antigen 86 | 0.63 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | TNF superfamily member 8 | 0.64 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | CD34+ | 0.67 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Integrin subunit alpha 6 | 0.68 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | C-type lectin domain containing 7A | 0.69 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | CD180 molecule | 0.70 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Integrin subunit alpha M | 0.72 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Toll like receptor 6 | 0.72 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Autophagy related 10 | 0.73 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | C-C motif chemokine ligand 3 like 1 | 0.74 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Bone marrow stromal cell antigen 1 | 0.75 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | CD22+ | 0.76 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | CD37 molecule | 0.76 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | NEG_A | 0.77 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Sperm auto antigenic protein 17 | 0.79 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | CD200 molecule | 0.79 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | TNF receptor associated factor 3 | 0.82 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Interferon alpha and beta receptor subunit 1 | 1.10 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and/or Proteins for Arm A (LAP+TRAS±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | TNF receptor associated factor 6 | 1.21 Ratio of gene expression level |
Primary
Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years
Evaluate changes in biomarkers associated with immunomodulation between pre-treatment biopsy and disease progression biopsy within each arm. Biomarker analysis was performed using an mRNA gene expression panel derived from Nanostring platform in a total of 20 subjects who received the study treatment as per the study design and with baseline tumor biopsies available. For the selected biomarkers associated with immunomodulation, the median fold changes of gene expression level and 95% confidence interval are presented. The fold change was calculated as the ratio of the expression level of a biomarker at disease progression over the baseline.
Time frame: At screening and at disease progression, assessed up to approx. 3.5 years
Population: Evaluable Set: Included all subjects in Arm B who received the study treatment and had both baseline and progression tumor biopsies available, with evaluable data for at least 1 biomarker.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | C-type lectin domain containing 5A | 0.16 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Interferon induced transmembrane protein 1 | 0.25 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Fibronectin 1 | 0.27 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | C-C motif chemokine ligand 7 | 0.27 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Triggering receptor expressed on myeloid cells 1 | 0.27 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Plasminogen activator, urokinase | 0.27 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Interleukin 22 receptor subunit alpha 2 | 0.28 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | C-C motif chemokine ligand 8 | 0.28 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Tumor necrosis factor (ligand) superfamily member 4 gene | 0.31 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Major histocompatibility complex, Class I-related | 0.32 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Cathepsin L | 0.32 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | SPP-1 (Osteopontin) | 0.33 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Thy-1 cell surface antigen | 0.34 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Transforming growth factor beta 2 | 0.35 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Hepatitis A virus cellular receptor 2 | 0.36 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Bone marrow stromal cell antigen 1 | 0.37 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | C-type lectin domain containing 7A | 0.37 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | C-X-C motif chemokine ligand 5 | 0.38 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Collagen type III alpha 1 chain | 0.40 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Complement C1s | 0.41 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | IFIT1 gene | 0.41 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Major histocompatibility complex, class I, G | 0.41 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Tumour necrosis factor gene | 0.42 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Integrin subunit beta 1 | 0.43 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Pro-melanin concentrating hormone | 0.43 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | CD86+ | 0.44 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | FCGR3A SNP rs396991 | 0.44 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | TNF receptor superfamily member 10c | 0.44 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Integrin subunit alpha M | 0.45 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | TNF receptor superfamily member 11b | 0.45 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Platelet derived growth factor C | 0.45 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Mannan binding lectin serine peptidase 1 | 0.46 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Recombination activating 1 | 0.46 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Interleukin 22 | 0.47 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Tumor necrosis factor (ligand) superfamily member 13b gene | 0.47 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | BMI1 proto-oncogene, polycomb ring finger | 0.47 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | CXCL10 gene | 0.48 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Leukocyte immunoglobulin like receptor B1 | 0.48 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | MX1 gene | 0.48 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Tumor necrosis factor (ligand) superfamily member 11 gene | 0.48 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Cathepsin S | 0.49 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Interferon induced transmembrane protein 2 | 0.49 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | LYN proto-oncogene, Src family tyrosine kinase | 0.50 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Platelet derived growth factor receptor beta | 0.50 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | OAS3 gene | 0.50 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | CD58 molecule | 0.50 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | complement C3a receptor 1 | 0.51 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Chemokine (C-C motif) receptor 1 | 0.52 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Interleukin 24 gene | 0.52 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Chemokine (C-X-C motif) receptor 2 | 0.53 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Strawberry notch homolog 2 | 1.13 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Zinc finger protein 205 | 1.42 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Fas associated via death domain | 1.58 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | CD3e molecule associated protein | 1.67 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Baculoviral IAP repeat containing 5 | 1.73 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm B (TRAS+CHEM±AI (HER2-Enriched)) From Screening to Approx. 3.5 Years | Interleukin 17 receptor B | 2.01 Ratio of gene expression level |
Primary
Fold Change in Expression Profile of Genes and /or Proteins for Arm C (Non-HER2- Enriched) From Screening to Approx. 3.5 Years
Evaluate changes in biomarkers associated with immunomodulation between pre-treatment biopsy and disease progression biopsy within each arm. Biomarker analysis was performed using an mRNA gene expression panel derived from Nanostring platform in a total of 20 subjects who received the study treatment as per the study design and with baseline tumor biopsies available. For the selected biomarkers associated with immunomodulation, the median fold changes of gene expression level and 95% confidence interval are presented. The fold change was calculated as the ratio of the expression level of a biomarker at disease progression over the baseline.
Time frame: At screening and at disease progression, assessed up to approx. 3.5 years
Population: Evaluable Set: Included all subjects in Arm C who received the study treatment and had both baseline and progression tumor biopsies available, with evaluable data for at least 1 biomarker.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm C (Non-HER2- Enriched) From Screening to Approx. 3.5 Years | Triggering receptor expressed on myeloid cells 1 | 0.50 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm C (Non-HER2- Enriched) From Screening to Approx. 3.5 Years | Interleukin 1 receptor, type 1 gene | 1.58 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm C (Non-HER2- Enriched) From Screening to Approx. 3.5 Years | Complement component 2 | 2.13 Ratio of gene expression level |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Fold Change in Expression Profile of Genes and /or Proteins for Arm C (Non-HER2- Enriched) From Screening to Approx. 3.5 Years | Coagulation factor XII | 2.69 Ratio of gene expression level |
Secondary
Association Between Biomarkers and PFS
Describe if changes of biomarker expression at disease progression from baseline correlate with PFS.
Time frame: From randomization to disease progression or death, up to approx. 5.6 years
Population: The number of patients with available biomarker data at both baseline and at progression is very small within each treatment arm (Arm A: n=7, Arm B: n=5, Arm C: n=5). This number of subjects is insufficient for an analysis to establish a relationship between the changes in biomarker at disease progression and progression free survival and would be statistically inappropriate to fit a model correlating changes in biomarkers with progression free survival with so few patients.
Secondary
Clinical Benefit Rate (CBR)
CBR is defined as percentage of subjects with a complete response (CR), partial response (PR), or maintaining stable disease (SD) for at least 24 weeks while on study according to the investigator assessment of response per RECIST 1.1 criteria. CR and PR are confirmed responses derived using the following rules: Confirmed CR - at least 2 determinations of CR at least 4 weeks apart before disease progression. Confirmed PR - at least 2 determinations of PR or better at least 4 weeks apart before progression.
Time frame: From enrollment/randomization the end of study, approximately 5.6 years
Population: Full Analysis Set (FAS): Consisted of all subjects who were randomized to study Arm A or Arm B or assigned to study Arm C, irrespective of whether they actually received study treatment.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Clinical Benefit Rate (CBR) | 35.3 Percentage of participants |
| TRAS+CHEM±AI (HER2-Enriched) - Arm B | Clinical Benefit Rate (CBR) | 46.7 Percentage of participants |
| Non-HER2- Enriched - Arm C | Clinical Benefit Rate (CBR) | 30.0 Percentage of participants |
Secondary
Overall Response Rate (ORR)
Overall response rate was defined as the percentage of subjects achieving either a confirmed complete response (CR) or partial response (PR) and was calculated from the Investigator's assessment of response per RECIST 1.1 criteria. . The confirmed CR or PR was derived using the following rules: confirmed CR - at least two determinations of CR at least 4 weeks apart before disease progression; confirmed PR - at least two determinations of PR or better at least 4 weeks apart before progression.
Time frame: From enrollment/randomization to the end of study, approximately 5.6 years
Population: Full Analysis Set (FAS): Consisted of all subjects who were randomized to study Arm A or Arm B or assigned to study Arm C, irrespective of whether they actually received study treatment.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Overall Response Rate (ORR) | 35.3 Percentage of participants |
| TRAS+CHEM±AI (HER2-Enriched) - Arm B | Overall Response Rate (ORR) | 33.3 Percentage of participants |
| Non-HER2- Enriched - Arm C | Overall Response Rate (ORR) | 30.0 Percentage of participants |
Secondary
Progression-free Survival (PFS)
PFS was defined as the time from the date of randomization (for Arm A and B) / treatment start date (for Arm C) to the date of the first documented disease progression or death due to any cause, whichever was earlier. If a subject had not progressed or died at the analysis cutoff date, PFS was censored at the time of the last adequate tumor assessment. PFS was summarized using Kaplan-Meier estimates.
Time frame: From randomization to disease progression or death, up to approx. 5.6 years
Population: Full Analysis Set (FAS): Consisted of all subjects who were randomized to study Arm A or Arm B or assigned to study Arm C, irrespective of whether they actually received study treatment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| LAP+TRAS±AI (HER2-Enriched) - Arm A | Progression-free Survival (PFS) | 6.0 Months |
| TRAS+CHEM±AI (HER2-Enriched) - Arm B | Progression-free Survival (PFS) | 7.2 Months |
| Non-HER2- Enriched - Arm C | Progression-free Survival (PFS) | 6.0 Months |
Post Hoc
All-Collected Deaths
On treatment deaths were collected from FPFT up to 30 days after study drug discontinuation, for a maximum duration of 168 weeks for Lapatinib, (treatment duration ranged from 151 to 164 weeks), 164 weeks for Trastuzumab (treatment duration ranged from 0 to 160 weeks), 168 weeks for Aromatase Inhibitors (treatment duration ranged from 9 to 164 weeks). Deaths post treatment survival follow up were collected after the on- treatment period, up to approx. 5.6 years.
Time frame: On-treatment deaths: up to approx. 168 weeks, Total deaths: up to approx. 5.6 years
Population: Clinical Database Population: All treated participants.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| LAP+TRAS±AI (HER2-Enriched) - Arm A | All-Collected Deaths | Total Deaths | 11 Participants |
| LAP+TRAS±AI (HER2-Enriched) - Arm A | All-Collected Deaths | On-treatment deaths | 3 Participants |
| TRAS+CHEM±AI (HER2-Enriched) - Arm B | All-Collected Deaths | Total Deaths | 9 Participants |
| TRAS+CHEM±AI (HER2-Enriched) - Arm B | All-Collected Deaths | On-treatment deaths | 1 Participants |
| Non-HER2- Enriched - Arm C | All-Collected Deaths | Total Deaths | 6 Participants |
| Non-HER2- Enriched - Arm C | All-Collected Deaths | On-treatment deaths | 0 Participants |