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Study of Poziotinib in Participants With HER2-Positive Metastatic Breast Cancer

A Phase 2 Study of Poziotinib in Patients With HER2-Positive Metastatic Breast Cancer (MBC) Who Have Received Prior HER2 Regimens for MBC

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02659514
Enrollment
67
Registered
2016-01-20
Start date
2016-02-22
Completion date
2020-03-11
Last updated
2022-03-11

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

Conditions

Breast Cancer

Keywords

Poziotinib, Metastatic Breast Cancer, HER2-positive, Pan-HER inhibitor

Brief summary

The purpose of this study is to establish the dose regimen and evaluate the preliminary efficacy and the safety/tolerability of poziotinib in participants with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer who have received at least two prior HER2-directed treatment regimens.

Detailed description

This is a phase 2, open-label, multicenter study to establish the dose regimen and evaluate the preliminary efficacy and the safety/tolerability of poziotinib in participants with HER2-positive metastatic breast cancer who have received at least two prior HER2-directed treatment regimens. Each treatment cycle will be 21 days in duration. During each 21-day cycle, participants who are eligible for participation will receive poziotinib orally once daily. All treated participants will be followed up until disease progression, death, intolerable adverse events or up to a maximum of 24 months whichever comes earlier.

Interventions

8 mg oral tablets, administered QD.

Sponsors

Spectrum Pharmaceuticals, Inc
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No

Inclusion criteria

1. Histopathologically confirmed primary breast cancer with metastatic lesions. 2. Confirmed HER2 overexpression or gene-amplified tumor 3. At least two prior HER2-directed therapy regimens for breast cancer, including trastuzumab and trastuzumab emtansine 4. Measurable disease per Response Evaluation Criteria for Solid Tumors version 1.1 (RECIST v1.1) 5. Participant is at least 18, and ≤90 years of age. 6. Adequate hematologic, hepatic, and renal function 7. Eastern Cooperative Oncology Group (ECOG) performance status \<= 2

Exclusion criteria

1. Previous treatment with poziotinib prior to study participation 2. Brain metastases that are symptomatic or require therapy to control symptoms, as well as any history of radiation, surgery, or other therapy, including steroids, to control symptoms from brain metastases within 15 days of enrollment. 3. Anticancer chemotherapy, biologics, immunotherapy, cure-intent radiotherapy, or investigational treatment within 15 days, except for hormone therapy, palliative therapy, or supportive therapy. 4. History of congestive heart failure Class III/IV according to the New York Heart Association (NYHA) Functional Classification or serious cardiac arrhythmias requiring treatment. 5. Cardiac ejection fraction \<50% 6. History of other malignancies within the last 5 years 7. Participant is pregnant or breast-feeding. 8. Unable to take drugs orally

Design outcomes

Primary

MeasureTime frameDescription
Objective Response Rate (ORR)Up to 24 monthsORR was defined as the percentage of participants whose best overall response (BOR) was complete response (CR) or partial response (PR) among participants in the Evaluable Population assessed per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1). ORR was based on investigator assessed BOR. Per RECIST v1.1 for target lesions, CR was disappearance of all target tumor lesions (TLs) and all target lymph nodes (LNs) with short axis \<10mm. PR was ≥30% decrease in sum of diameters (SOD) from Baseline, and not progressive disease (PD) (≥20% increase in SOD from previous smallest SOD on study, and an absolute increase of ≥5mm).

Secondary

MeasureTime frameDescription
Disease Control Rate (DCR)Up to 24 monthsDCR was the percentage of participants whose best response was CR, PR or stable disease (SD) among participants in the Evaluable Population assessed per RECIST v1.1. DCR was based on investigator-assessed BOR. Per RECIST v1.1 for target lesions, CR was defined as disappearance of all target TLs and all target LNs with short axis \<10mm. PR was ≥30% decrease in sum of diameters (SOD) from Baseline, and not progressive disease (≥20% increase in SOD from previous smallest SOD on study, and an absolute increase of ≥5mm). SD was SOD change neither sufficient for PR nor sufficient for PD.
Time to Progression (TTP)Up to 24 monthsTTP was defined as the time (in months) from first administration of study drug to tumor progression, which excluded death without tumor progression, by the end of study. TTP of participants who died without documented PD was censored at date of death. TTP of living participants without documented PD was censored at the same time as PFS, which was the last tumor assessment or the date of first treatment if there was no post-baseline tumor assessment. Per RECIST v1.1 for target lesions, PD was defined as ≥20% increase in SOD from previous smallest SOD on study, and an absolute increase of ≥5mm.
Progression Free Survival (PFS)Up to 24 MonthsPFS was the duration of time (in months) from first administration of study treatment to date of first documented disease progression or death from any cause. PFS of living participants without documented PD was censored at the time of last tumor assessment or the date of first treatment if there was no post-baseline tumor assessment. Per RECIST v1.1 for target lesions, PD was defined as ≥20% increase in SOD from previous smallest SOD on study, and an absolute increase of ≥5mm.
Number of Participants With One or More Treatment-Emergent Adverse Events (TEAEs)From the first dose of study drug administration until 35 (± 5) days after the last dose of study drug administration (Up to approximately 25 months)An AE was defined as any untoward medical occurrence in a participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. TEAEs were AEs that occurred or worsened from the first dose of study treatment until 35 (± 5) days after the last dose of study treatment.
Pharmacokinetic Analysis (Drug Concentration Measurements)For Cohort 1: Pre-dose and 1 and 2 hours post-dose on Day 1 of Cycles 1, 2, and 3, and pre-dose on Day 14 of Cycle 1 For Cohort 2: Day 1 of Cycle 1 pre-dose and 30 minutes, 1,1.5,2,3, 4, 6, and 24 hours post-dose of Day 1 of Cycle 1
Duration of Response (DoR)Up to 24 monthsDoR was evaluated only for participants whose BOR was CR or PR and was defined as the time (in months) from the date that response evaluation criteria were first met for CR or PR (whichever status was recorded first) until the first subsequent date that PD or death was documented. DoR of participants without documented PD or death was censored at the time of last tumor assessment. Per RECIST v1.1 for target lesions, CR was defined as disappearance of all target tumor lesions (TLs) and all target lymph nodes (LNs) with short axis \<10mm. PR was defined as ≥30% decrease in sum of diameters (SOD) from Baseline, and not PD. PD was defined as ≥20% increase in SOD from previous smallest SOD on study, and an absolute increase of ≥5mm).

Countries

United States

Participant flow

Recruitment details

A total of 67 participants were enrolled at 19 sites in the United States in the study which was conducted from 22 February 2016 to 11 March 2020.

Participants by arm

ArmCount
Cohort 1: Poziotinib 24 mg
Participants received poziotinib 24 mg, administered as three 8 mg tablets, orally, QD on an intermittent dosing schedule of 14 days on treatment followed by 7 days off treatment, in a 21-day cycle until disease progression, death, intolerable AEs or for up to a maximum of 24 months, whichever occurs first.
33
Cohort 2: Poziotinib 16 mg
Participants received poziotinib 16 mg, administered as two 8 mg tablets, orally, QD, on a continuous dosing schedule in a 21-day cycle until disease progression, death, intolerable AEs or for up to a maximum of 24 months, whichever occurs first.
34
Total67

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event312
Overall StudyDeath61
Overall StudyDisease Progression2313
Overall StudyLost to Follow-up01
Overall StudyReason Unspecified03
Overall StudyWithdrawal by Subject04

Baseline characteristics

CharacteristicTotalCohort 1: Poziotinib 24 mgCohort 2: Poziotinib 16 mg
Age, Continuous57.3 years
STANDARD_DEVIATION 12.45
56.4 years
STANDARD_DEVIATION 13.82
58.1 years
STANDARD_DEVIATION 11.1
Ethnicity (NIH/OMB)
Hispanic or Latino
10 Participants5 Participants5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
57 Participants28 Participants29 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Asian
2 Participants2 Participants0 Participants
Race/Ethnicity, Customized
Black or African American
5 Participants1 Participants4 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
1 Participants0 Participants1 Participants
Race/Ethnicity, Customized
White
59 Participants30 Participants29 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
2 Participants2 Participants0 Participants
Race (NIH/OMB)
Black or African American
5 Participants1 Participants4 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants0 Participants1 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
59 Participants30 Participants29 Participants
Sex: Female, Male
Female
67 Participants33 Participants34 Participants
Sex: Female, Male
Male
0 Participants0 Participants0 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
6 / 331 / 34
other
Total, other adverse events
33 / 3333 / 34
serious
Total, serious adverse events
14 / 3316 / 34

Outcome results

Primary

Objective Response Rate (ORR)

ORR was defined as the percentage of participants whose best overall response (BOR) was complete response (CR) or partial response (PR) among participants in the Evaluable Population assessed per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1). ORR was based on investigator assessed BOR. Per RECIST v1.1 for target lesions, CR was disappearance of all target tumor lesions (TLs) and all target lymph nodes (LNs) with short axis \<10mm. PR was ≥30% decrease in sum of diameters (SOD) from Baseline, and not progressive disease (PD) (≥20% increase in SOD from previous smallest SOD on study, and an absolute increase of ≥5mm).

Time frame: Up to 24 months

Population: Evaluable Population included all enrolled participants who completed at least 1 cycle of poziotinib treatment and had at least 1 post-baseline tumor response evaluation using RECIST, v 1.1.

ArmMeasureValue (NUMBER)
Cohort 1: Poziotinib 24 mgObjective Response Rate (ORR)30 percentage of participants
Cohort 2: Poziotinib 16 mgObjective Response Rate (ORR)30 percentage of participants
Secondary

Disease Control Rate (DCR)

DCR was the percentage of participants whose best response was CR, PR or stable disease (SD) among participants in the Evaluable Population assessed per RECIST v1.1. DCR was based on investigator-assessed BOR. Per RECIST v1.1 for target lesions, CR was defined as disappearance of all target TLs and all target LNs with short axis \<10mm. PR was ≥30% decrease in sum of diameters (SOD) from Baseline, and not progressive disease (≥20% increase in SOD from previous smallest SOD on study, and an absolute increase of ≥5mm). SD was SOD change neither sufficient for PR nor sufficient for PD.

Time frame: Up to 24 months

Population: Evaluable Population included all enrolled participants who completed at least 1 cycle of poziotinib treatment and had at least 1 post-baseline tumor response evaluation using RECIST, v 1.1.

ArmMeasureValue (NUMBER)
Cohort 1: Poziotinib 24 mgDisease Control Rate (DCR)60 percentage of participants
Cohort 2: Poziotinib 16 mgDisease Control Rate (DCR)78 percentage of participants
Secondary

Duration of Response (DoR)

DoR was evaluated only for participants whose BOR was CR or PR and was defined as the time (in months) from the date that response evaluation criteria were first met for CR or PR (whichever status was recorded first) until the first subsequent date that PD or death was documented. DoR of participants without documented PD or death was censored at the time of last tumor assessment. Per RECIST v1.1 for target lesions, CR was defined as disappearance of all target tumor lesions (TLs) and all target lymph nodes (LNs) with short axis \<10mm. PR was defined as ≥30% decrease in sum of diameters (SOD) from Baseline, and not PD. PD was defined as ≥20% increase in SOD from previous smallest SOD on study, and an absolute increase of ≥5mm).

Time frame: Up to 24 months

Population: Evaluable Population included all participants who had received at least one cycle of poziotinib and had at least one evaluable post-baseline tumor response evaluation using response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST, v1.1). Overall number of participants analyzed is the number of participants with best overall response of CR or PR.

ArmMeasureValue (MEDIAN)
Cohort 1: Poziotinib 24 mgDuration of Response (DoR)5.7 months
Cohort 2: Poziotinib 16 mgDuration of Response (DoR)13.0 months
Secondary

Number of Participants With One or More Treatment-Emergent Adverse Events (TEAEs)

An AE was defined as any untoward medical occurrence in a participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. TEAEs were AEs that occurred or worsened from the first dose of study treatment until 35 (± 5) days after the last dose of study treatment.

Time frame: From the first dose of study drug administration until 35 (± 5) days after the last dose of study drug administration (Up to approximately 25 months)

Population: Safety Population included all participants who received at least 1 dose of poziotinib.

ArmMeasureValue (NUMBER)
Cohort 1: Poziotinib 24 mgNumber of Participants With One or More Treatment-Emergent Adverse Events (TEAEs)33 participants
Cohort 2: Poziotinib 16 mgNumber of Participants With One or More Treatment-Emergent Adverse Events (TEAEs)33 participants
Secondary

Pharmacokinetic Analysis (Drug Concentration Measurements)

Time frame: For Cohort 1: Pre-dose and 1 and 2 hours post-dose on Day 1 of Cycles 1, 2, and 3, and pre-dose on Day 14 of Cycle 1 For Cohort 2: Day 1 of Cycle 1 pre-dose and 30 minutes, 1,1.5,2,3, 4, 6, and 24 hours post-dose of Day 1 of Cycle 1

Population: Pharmacokinetic analyses specified in the protocol were not performed as the samples were no longer stable at the time of the analysis.

Secondary

Progression Free Survival (PFS)

PFS was the duration of time (in months) from first administration of study treatment to date of first documented disease progression or death from any cause. PFS of living participants without documented PD was censored at the time of last tumor assessment or the date of first treatment if there was no post-baseline tumor assessment. Per RECIST v1.1 for target lesions, PD was defined as ≥20% increase in SOD from previous smallest SOD on study, and an absolute increase of ≥5mm.

Time frame: Up to 24 Months

Population: Evaluable Population included all enrolled participants who completed at least 1 cycle of poziotinib treatment and had at least 1 post-baseline tumor response evaluation using RECIST, v 1.1.

ArmMeasureValue (MEDIAN)
Cohort 1: Poziotinib 24 mgProgression Free Survival (PFS)4.1 months
Cohort 2: Poziotinib 16 mgProgression Free Survival (PFS)4.9 months
Secondary

Time to Progression (TTP)

TTP was defined as the time (in months) from first administration of study drug to tumor progression, which excluded death without tumor progression, by the end of study. TTP of participants who died without documented PD was censored at date of death. TTP of living participants without documented PD was censored at the same time as PFS, which was the last tumor assessment or the date of first treatment if there was no post-baseline tumor assessment. Per RECIST v1.1 for target lesions, PD was defined as ≥20% increase in SOD from previous smallest SOD on study, and an absolute increase of ≥5mm.

Time frame: Up to 24 months

Population: Evaluable Population included all enrolled participants who completed at least 1 cycle of poziotinib treatment and had at least 1 post-baseline tumor response evaluation using RECIST, v 1.1.

ArmMeasureValue (MEDIAN)
Cohort 1: Poziotinib 24 mgTime to Progression (TTP)4.1 months
Cohort 2: Poziotinib 16 mgTime to Progression (TTP)4.9 months

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026