Metastatic Breast Cancer
Conditions
Brief summary
The primary objective of this study is to assess and compare the efficacy and safety of sacituzumab govitecan-hzi versus treatment of physician's choice (TPC) in participants with hormonal receptor-positive (HR+) human epidermal growth factor receptor 2 (HER2-) negative metastatic breast cancer (MBC).
Interventions
Administered intravenously
Administered intravenously per NCCN guidelines
Administered orally per NCCN guidelines
Administered intravenously per NCCN guidelines
Administered intravenously per NCCN guidelines
Sponsors
Study design
Eligibility
Inclusion criteria
Key Inclusion Criteria: * Documented evidence of hormone receptor-positive human epidermal growth factor receptor 2 negative (HER2-negative) (hormonal receptor-positive (HR+)/HER2-) metastatic breast cancer (MBC) confirmed. * Refractory to or relapsed after at least 2, and no more than 4, prior systemic chemotherapy regimens for metastatic disease: * At least 1 taxane in any setting. * At least 1 prior anticancer hormonal treatment in any setting. * At least 1 cyclin-dependent kinase inhibitor 4/6 in any setting. * Eligible for one of the chemotherapy options listed in the TPC arm. * Documented disease progression after the most recent therapy. * Adequate bone marrow function (hemoglobin ≥ 9 g/dL, absolute neutrophil count (ANC) ≥ 1,500 per mm\^3, platelets ≥ 100,000 per mm\^3). * Adequate renal function: calculated creatinine clearance ≥ 30 mL/minute according to the Cockcroft and Gault formula . * Adequate liver function (bilirubin ≤ 1.5 institutional upper limit of normal (IULN), or ≤ 3 IULN for individuals with documented Gilbert's syndrome, aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) ≤ 2.5 x IULN (in the case of liver metastases ≤ 5.0 x IULN)). * Females must not be lactating or pregnant at Screening or Baseline (as documented by a negative beta human chorionic gonadotropin (ß-hCG)). Key
Exclusion criteria
* Previous treatment with topoisomerase 1 Inhibitors as a free form or as other formulations. * History of significant cardiovascular disease or clinically significant electrocardiogram (ECG) abnormality. * Active serious infection requiring antibiotics. * Any medical or other condition which, in the opinion of the Investigator, causes the individual to be medically unfit to receive sacituzumab govitecan or unsuitable for any reason. * Locally advanced MBC (stage IIIc) in individuals who are candidates for curative intent therapy at the time of study enrollment. Note: Other protocol defined Inclusion/
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Progression-Free Survival (PFS) by Blinded Independent Central Review (BICR) Assessment | Up to 42.8 months | PFS was defined as the time from the date of randomization to the date of the first documentation of disease progression or death (whichever occurred first) according to BICR using Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). Disease progression was defined as an increase of greater than 20% in the sum of the longest diameter (LD) of target lesions and a 5 mm absolute increase, taking as a reference the smallest sum LD recorded since the baseline assessment or the appearance of new non-target lesions. PFS was estimated using Kaplan-Meier estimate. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Objective Response Rate (ORR) by BICR and Local Investigator Review (LIR) Assessment | Up to 42.8 months | ORR was defined as the percentage of participants who had the best overall response of either complete response (CR) or partial response (PR) that was confirmed at 4 weeks or later after initial response by BICR and LIR using RECIST 1.1. CR: Disappearance of all target and non-target lesions; and normalization of tumor marker levels initially above upper limits of normal; PR: ≥30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD. |
| Duration of Response (DOR) by BICR and LIR Assessment | Up to 42.8 months | DOR was defined as the time from the date a response of CR or PR was first documented until the date of the first documentation of disease progression or date of death (whichever occurred first). DOR was analyzed based on both BICR and LIR assessments. CR: Disappearance of all target and non-target lesions; and normalization of tumor marker levels initially above upper limits of normal; PR: ≥30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD. Disease progression was defined as an increase of greater than 20% in the sum of the LD of target lesions and a 5 mm absolute increase, taking as a reference the smallest sum LD recorded since the baseline assessment or the appearance of new non-target lesions. DOR was estimated using Kaplan-Meier estimate. |
| Clinical Benefit Rate (CBR) by BICR and LIR Assessment | Up to 42.8 months | CBR was defined as the percentage of participants with the best overall response of CR, PR, or durable stable disease (duration of SD ≥ 6 months after randomization). CBR was analyzed based on both BICR and LIR assessments. CR: Disappearance of all target and non-target lesions; and normalization of tumor marker levels initially above upper limits of normal; PR: ≥30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD. SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD), taking as reference the smallest sum LD since the treatment started. PD: Disease progression was defined as an increase of greater than 20% in the sum of the LD of target lesions and a 5 mm absolute increase, taking as a reference the smallest sum LD recorded since the baseline assessment or the appearance of new non-target lesions. |
| PFS by LIR Assessment | Up to 42.8 months | PFS was defined as the time from the date of randomization to the date of the first documentation of disease progression or death (whichever occurred first) according to LIR using RECIST 1.1. Disease progression was defined as an increase of greater than 20% in the sum of the LD of target lesions and a 5 mm absolute increase, taking as a reference the smallest sum LD recorded since the baseline assessment or the appearance of new non-target lesions. PFS was estimated using Kaplan-Meier estimate. |
| Time to Deterioration (TTD) of Global Health Status/Quality of Life (QoL) Scale as Measured by European Organization for Research and Treatment of Cancer Quality of Life for Cancer Patients, Core Questionnaire Version 3.0 (EORTC QLQ-C30) | Up to 37.8 months | TTD was defined as the time from randomization to the first date a subject achieves 10-point deterioration from baseline in the global health status/QoL scale.The EORTC QLQ-C30 is a 30-item questionnaire to assess QoL of cancer patients. It has 5 functional scales(physical,role,emotional,cognitive, social)1 global health status scale,3 symptom scales (fatigue, nausea and vomiting, pain),and 6 single items(dyspnea, insomnia, loss of appetite, constipation, diarrhea, financial difficulties). Participant responses to global health status,'How would you rate your overall health during the past week?' (Item 29)and the QoL 'How would you rate your overall quality of life during the past week?'(Item 30)questions were scored on 7-point scale (1=very poor; 7=excellent). All scales and single-item measures range in score from 0 to 100. Summed raw scores were standardized by linear transformation so that scores ranged from 0 to 100. Higher scores for GHS show a better level of functioning. |
| Overall Survival (OS) | Up to 42.8 months | OS was defined as the time from the date of randomization to the date of death from any cause. OS was estimated using Kaplan-Meier estimate. Participants without documentation of death were censored on the date they were last known to be alive. |
| TTD of Fatigue Score as Measured by EORTC QLQ-C30 | Up to 37.8 months | TTD was defined as the time from randomization to the first date a subject achieves 10-point deterioration from baseline in the fatigue score.The EORTC QLQ-C30 is a questionnaire to assess quality of life, it is composed of 30 questions(items) resulting in 5 functional scales(physical, role, emotional, cognitive, social),1 global health status scale,3 symptom scales (fatigue, nausea and vomiting, pain),and 6 single items(dyspnea, insomnia, loss of appetite, constipation, diarrhea, financial difficulties).All of the scales and single-item measures range in score from 0 to 100.Participant responses to 3 questions about fatigue 'Did you need to rest', 'Have you felt weak' and 'Were you tired' were scored on a 4-point scale (1=not at all;4=very much).Summed raw scores were standardized by linear transformation so that scores ranged from 0 to 100. Higher scores on the symptom scales indicate a higher level of symptoms (i.e. a worse state of the participant). |
| Percentage of Participants Who Experienced Treatment Emergent Adverse Events (TEAEs) | Up to 43.4 months | An AE was defined as any untoward medical occurrence in a subject administered a medicinal product that does not necessarily have a causal relationship with this treatment. TEAEs were defined as any AEs that begin or worsen on or after the start of study drug through 30 days after the last dose of the study drug. The severity was graded based on the National Cancer Institute's Common Terminology Criteria for Adverse Events Version 5.0. |
| Percentage of Participants Who Experienced Treatment Emergent Serious Adverse Events (TESAEs) | Up to 43.4 months | Treatment-emergent adverse events (TEAEs) were defined as any adverse events (AEs) that begin or worsen on or after the start of study drug through 30 days after the last dose of study drug. The severity was graded based on the National Cancer Institute's Common Terminology Criteria for Adverse Events Version 5.0. An AE that met one or more of the following outcomes was classified as serious: * Fatal * Life-threatening * Disabling/incapacitating * Results in hospitalization or prolongs a hospital stay * A congenital abnormality * Other important medical events may also be considered serious AEs if they may require medical or surgical intervention to prevent one of the outcomes listed above |
| Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Up to 43.4 months | Blood samples were collected for hematology, serum chemistry, and the laboratory abnormalities were assessed. A treatment-emergent laboratory abnormality was defined as an increase of at least 1 toxicity grade from baseline at any time postbaseline up to and including the date of last study drug dose plus 30 days.The most severe graded abnormality observed post-baseline for each graded test was counted for each participant. Safety as assessed by grading of laboratory values and AEs according to the National Cancer Institutes' Common Terminology Criteria for Adverse Events (NCI CTCAE) covering grades 0-5 (0=Normal, 1=Mild, 2=Moderate, 3=Severe, 4=Life-threatening, 5=Death). The percentage of participants with worst postbaseline grades 3 or 4 are reported. |
| Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) - Shift From Baseline Value to Best Value During Treatment | Up to 43.4 months | ECOG performance status (PS) measured on-therapy assessed participant's performance status on 5 point scale: 0=Fully active/able to carry on all pre-disease performance without restriction;1=Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature;2=Ambulatory and capable of all self-care but unable to carry out any work activities; up and about more than 50% of waking hours;3=Capable of only limited self-care;confined to bed or chair more than 50% of waking hours;4=Completely disabled; cannot carry on any self-care; totally confined to bed or chair;5=Dead. Lower score indicated good performance status. Percentage of participants with Baseline ECOG PS score and corresponding changes to the best values post-baseline have been reported. |
| TTD of Pain Score as Measured by EORTC QLQ-C30 | Up to 37.8 months | TTD was defined as the time from randomization to the first date a subject achieves 10-point deterioration from baseline in the pain score.The EORTC QLQ-C30 is a questionnaire to assess quality of life, it is composed of 30 questions(items) resulting in 5 functional scales(physical, role, emotional, cognitive, social),1 global health status scale,3 symptom scales (fatigue, nausea and vomiting, pain),and 6 single items(dyspnea, insomnia, loss of appetite, constipation, diarrhea, financial difficulties). All of the scales and single-item measures range in score from 0 to 100. Participant responses to 2 questions about pain, 'Have you had pain' and 'Did pain interfere with your daily activities' were scored on 4-point scale (1=not at all;4=very much). Summed raw scores were standardized by linear transformation so that scores ranges from 0 to 100. Higher scores on the symptom scales indicate a higher level of symptoms (i.e. a worse state of the participant). |
Countries
Belgium, Canada, France, Germany, Italy, Netherlands, Spain, United Kingdom, United States
Participant flow
Recruitment details
Participants were enrolled at study sites in Belgium, Canada, France, Germany, Italy, the Netherlands, Spain, the United Kingdom, and the United States.
Pre-assignment details
776 participants were screened.
Participants by arm
| Arm | Count |
|---|---|
| Sacituzumab Govitecan Participants received sacituzumab govitecan 10 mg/kg of body weight, administered as a slow IV infusion on Days 1 and 8 of a 21-day treatment cycle until progression of disease, occurrence of unacceptable AEs, or another treatment discontinuation criterion was met (up to 40.1 months). | 272 |
| Treatment of Physician's Choice (TPC) Participants received TPC (ie, eribulin, capecitabine, gemcitabine, or vinorelbine), administered as a single-agent treatment that was determined by the investigator before participant randomization until progression of disease, occurrence of unacceptable AEs, or another treatment discontinuation criterion was met. Dosing per NCCN guidelines (with dose modifications for if toxic)
* Eribulin was administered IV at a dose 1.4 mg/m\^2 at North American sites and 1.2 mg/m\^2 at European sites on Days 1 and 8 of a 21-day cycle (up to 22.5 months).
* Capecitabine 1000 to 1250 mg/m\^2 was administered in a 21-day cycle, with capecitabine administered orally twice daily for 2 weeks followed by 1-week rest period (up to 12.9 months).
* Gemcitabine 800 to 1200 mg/m\^2 was administered IV on Days 1, 8, and 15 of a 28-day cycle (up to 22.3 months).
* Vinorelbine 25 mg/m\^2 was administered as a weekly IV injection (up to 8.1 months). Vinorelbine was not allowed as TPC for any participant with Grade 2 neuropathy. | 271 |
| Total~(N=543) | 543 |
| Total | 1,086 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Covid19 | 0 | 2 |
| Overall Study | Death | 220 | 192 |
| Overall Study | Informed consent withdrawn | 13 | 40 |
| Overall Study | Lost to Follow-up | 4 | 7 |
| Overall Study | Reason not specified | 5 | 7 |
| Overall Study | Sponsor request | 30 | 23 |
Baseline characteristics
| Characteristic | Total~(N=543) | Sacituzumab Govitecan | Treatment of Physician's Choice (TPC) |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 140 Participants | 73 Participants | 67 Participants |
| Age, Categorical Between 18 and 65 years | 403 Participants | 199 Participants | 204 Participants |
| Age, Continuous | 56 years STANDARD_DEVIATION 11 | 57 years STANDARD_DEVIATION 11.5 | 56 years STANDARD_DEVIATION 10.4 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 18 Participants | 6 Participants | 12 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 426 Participants | 222 Participants | 204 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 99 Participants | 44 Participants | 55 Participants |
| Race/Ethnicity, Customized Race Asian | 16 Participants | 11 Participants | 5 Participants |
| Race/Ethnicity, Customized Race Black or African American | 21 Participants | 8 Participants | 13 Participants |
| Race/Ethnicity, Customized Race Native Hawaiian or Other Pacific Islander | 1 Participants | 0 Participants | 1 Participants |
| Race/Ethnicity, Customized Race Other or More Than One Race | 4 Participants | 0 Participants | 4 Participants |
| Race/Ethnicity, Customized Race Unknown or Not Reported | 139 Participants | 69 Participants | 70 Participants |
| Race/Ethnicity, Customized Race White | 362 Participants | 184 Participants | 178 Participants |
| Region of Enrollment Belgium | 25 Participants | 16 Participants | 9 Participants |
| Region of Enrollment Canada | 1 Participants | 0 Participants | 1 Participants |
| Region of Enrollment France | 137 Participants | 64 Participants | 73 Participants |
| Region of Enrollment Germany | 46 Participants | 20 Participants | 26 Participants |
| Region of Enrollment Italy | 15 Participants | 9 Participants | 6 Participants |
| Region of Enrollment Netherlands | 8 Participants | 6 Participants | 2 Participants |
| Region of Enrollment Spain | 69 Participants | 35 Participants | 34 Participants |
| Region of Enrollment United Kingdom | 14 Participants | 7 Participants | 7 Participants |
| Region of Enrollment United States | 228 Participants | 115 Participants | 113 Participants |
| Sex: Female, Male Female | 538 Participants | 270 Participants | 268 Participants |
| Sex: Female, Male Male | 5 Participants | 2 Participants | 3 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 234 / 272 | 238 / 271 |
| other Total, other adverse events | 264 / 268 | 234 / 249 |
| serious Total, serious adverse events | 74 / 268 | 48 / 249 |
Outcome results
Progression-Free Survival (PFS) by Blinded Independent Central Review (BICR) Assessment
PFS was defined as the time from the date of randomization to the date of the first documentation of disease progression or death (whichever occurred first) according to BICR using Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). Disease progression was defined as an increase of greater than 20% in the sum of the longest diameter (LD) of target lesions and a 5 mm absolute increase, taking as a reference the smallest sum LD recorded since the baseline assessment or the appearance of new non-target lesions. PFS was estimated using Kaplan-Meier estimate.
Time frame: Up to 42.8 months
Population: The ITT Population included all participants who were randomized, regardless of whether they received study treatment or not.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Sacituzumab Govitecan | Progression-Free Survival (PFS) by Blinded Independent Central Review (BICR) Assessment | 5.5 months |
| Treatment of Physician's Choice (TPC) | Progression-Free Survival (PFS) by Blinded Independent Central Review (BICR) Assessment | 4.0 months |
Clinical Benefit Rate (CBR) by BICR and LIR Assessment
CBR was defined as the percentage of participants with the best overall response of CR, PR, or durable stable disease (duration of SD ≥ 6 months after randomization). CBR was analyzed based on both BICR and LIR assessments. CR: Disappearance of all target and non-target lesions; and normalization of tumor marker levels initially above upper limits of normal; PR: ≥30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD. SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD), taking as reference the smallest sum LD since the treatment started. PD: Disease progression was defined as an increase of greater than 20% in the sum of the LD of target lesions and a 5 mm absolute increase, taking as a reference the smallest sum LD recorded since the baseline assessment or the appearance of new non-target lesions.
Time frame: Up to 42.8 months
Population: Participants in the ITT Population with available data were analyzed.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Sacituzumab Govitecan | Clinical Benefit Rate (CBR) by BICR and LIR Assessment | CBR by BICR Assessment | 33.8 percentage of participants |
| Sacituzumab Govitecan | Clinical Benefit Rate (CBR) by BICR and LIR Assessment | CBR by LIR Assessment | 32.4 percentage of participants |
| Treatment of Physician's Choice (TPC) | Clinical Benefit Rate (CBR) by BICR and LIR Assessment | CBR by BICR Assessment | 22.1 percentage of participants |
| Treatment of Physician's Choice (TPC) | Clinical Benefit Rate (CBR) by BICR and LIR Assessment | CBR by LIR Assessment | 21.0 percentage of participants |
Duration of Response (DOR) by BICR and LIR Assessment
DOR was defined as the time from the date a response of CR or PR was first documented until the date of the first documentation of disease progression or date of death (whichever occurred first). DOR was analyzed based on both BICR and LIR assessments. CR: Disappearance of all target and non-target lesions; and normalization of tumor marker levels initially above upper limits of normal; PR: ≥30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD. Disease progression was defined as an increase of greater than 20% in the sum of the LD of target lesions and a 5 mm absolute increase, taking as a reference the smallest sum LD recorded since the baseline assessment or the appearance of new non-target lesions. DOR was estimated using Kaplan-Meier estimate.
Time frame: Up to 42.8 months
Population: Participants in the ITT Population with confirmed objective response were analyzed.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Sacituzumab Govitecan | Duration of Response (DOR) by BICR and LIR Assessment | DOR by BICR Assessment | 8.1 months |
| Sacituzumab Govitecan | Duration of Response (DOR) by BICR and LIR Assessment | DOR by LIR Assessment | 7.0 months |
| Treatment of Physician's Choice (TPC) | Duration of Response (DOR) by BICR and LIR Assessment | DOR by BICR Assessment | 5.6 months |
| Treatment of Physician's Choice (TPC) | Duration of Response (DOR) by BICR and LIR Assessment | DOR by LIR Assessment | 4.3 months |
Objective Response Rate (ORR) by BICR and Local Investigator Review (LIR) Assessment
ORR was defined as the percentage of participants who had the best overall response of either complete response (CR) or partial response (PR) that was confirmed at 4 weeks or later after initial response by BICR and LIR using RECIST 1.1. CR: Disappearance of all target and non-target lesions; and normalization of tumor marker levels initially above upper limits of normal; PR: ≥30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD.
Time frame: Up to 42.8 months
Population: Participants in the ITT Population with available data were analyzed.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Sacituzumab Govitecan | Objective Response Rate (ORR) by BICR and Local Investigator Review (LIR) Assessment | ORR by BICR Assessment | 21.3 percentage of participants |
| Sacituzumab Govitecan | Objective Response Rate (ORR) by BICR and Local Investigator Review (LIR) Assessment | ORR by LIR Assessment | 16.5 percentage of participants |
| Treatment of Physician's Choice (TPC) | Objective Response Rate (ORR) by BICR and Local Investigator Review (LIR) Assessment | ORR by BICR Assessment | 14.0 percentage of participants |
| Treatment of Physician's Choice (TPC) | Objective Response Rate (ORR) by BICR and Local Investigator Review (LIR) Assessment | ORR by LIR Assessment | 9.2 percentage of participants |
Overall Survival (OS)
OS was defined as the time from the date of randomization to the date of death from any cause. OS was estimated using Kaplan-Meier estimate. Participants without documentation of death were censored on the date they were last known to be alive.
Time frame: Up to 42.8 months
Population: Participants in the ITT Population were analyzed.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Sacituzumab Govitecan | Overall Survival (OS) | 14.5 months |
| Treatment of Physician's Choice (TPC) | Overall Survival (OS) | 11.2 months |
Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline
Blood samples were collected for hematology, serum chemistry, and the laboratory abnormalities were assessed. A treatment-emergent laboratory abnormality was defined as an increase of at least 1 toxicity grade from baseline at any time postbaseline up to and including the date of last study drug dose plus 30 days.The most severe graded abnormality observed post-baseline for each graded test was counted for each participant. Safety as assessed by grading of laboratory values and AEs according to the National Cancer Institutes' Common Terminology Criteria for Adverse Events (NCI CTCAE) covering grades 0-5 (0=Normal, 1=Mild, 2=Moderate, 3=Severe, 4=Life-threatening, 5=Death). The percentage of participants with worst postbaseline grades 3 or 4 are reported.
Time frame: Up to 43.4 months
Population: Participants in the Safety Population with post-baseline values were analyzed. 'Number Analyzed' indicates participants with post-baseline values with available data were analyzed.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hypoalbuminemia | 0 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Alanine Aminotransferase Increased | 1.1 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Alkaline Phosphatase Increased | 0 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Aspartate Aminotransferase Increased | 1.5 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Bilirubin Increased | 2.3 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Creatinine Increased | 0.4 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Creatinine Clearance Decreased | 2.3 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hypoglycemia | 1.1 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hypermagnesemia | 0.4 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hypomagnesemia | 0.8 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hyperkalemia | 1.9 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hypokalemia | 4.2 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hyponatremia | 0.8 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Anemia | 7.5 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hemoglobin Increased | 1.1 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Leukocytes Decreased | 38.9 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Leukocytosis | 0.4 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Lymphocytes Decreased | 21.5 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Lymphocytes Increased | 1.9 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Neutrophils Decreased | 53.2 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Platelets Decreased | 1.9 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hyperkalemia | 0 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Lymphocytes Increased | 2.1 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Alanine Aminotransferase Increased | 2.1 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hypoalbuminemia | 0.4 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hypokalemia | 0.4 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Alkaline Phosphatase Increased | 0.8 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Leukocytosis | 0.4 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Aspartate Aminotransferase Increased | 1.3 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hyponatremia | 0.4 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Bilirubin Increased | 0.8 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Platelets Decreased | 3.7 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Creatinine Increased | 1.7 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Anemia | 5.0 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Creatinine Clearance Decreased | 1.3 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Lymphocytes Decreased | 13.7 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hypoglycemia | 0.8 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hemoglobin Increased | 0 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hypermagnesemia | 0 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Neutrophils Decreased | 40.2 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Hypomagnesemia | 0 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline | Leukocytes Decreased | 25.7 percentage of participants |
Percentage of Participants Who Experienced Treatment Emergent Adverse Events (TEAEs)
An AE was defined as any untoward medical occurrence in a subject administered a medicinal product that does not necessarily have a causal relationship with this treatment. TEAEs were defined as any AEs that begin or worsen on or after the start of study drug through 30 days after the last dose of the study drug. The severity was graded based on the National Cancer Institute's Common Terminology Criteria for Adverse Events Version 5.0.
Time frame: Up to 43.4 months
Population: The Safety Population included all participants who received at least 1 dose of study drug.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Sacituzumab Govitecan | Percentage of Participants Who Experienced Treatment Emergent Adverse Events (TEAEs) | 100.0 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced Treatment Emergent Adverse Events (TEAEs) | 96.0 percentage of participants |
Percentage of Participants Who Experienced Treatment Emergent Serious Adverse Events (TESAEs)
Treatment-emergent adverse events (TEAEs) were defined as any adverse events (AEs) that begin or worsen on or after the start of study drug through 30 days after the last dose of study drug. The severity was graded based on the National Cancer Institute's Common Terminology Criteria for Adverse Events Version 5.0. An AE that met one or more of the following outcomes was classified as serious: * Fatal * Life-threatening * Disabling/incapacitating * Results in hospitalization or prolongs a hospital stay * A congenital abnormality * Other important medical events may also be considered serious AEs if they may require medical or surgical intervention to prevent one of the outcomes listed above
Time frame: Up to 43.4 months
Population: Participants in the Safety Population were analyzed.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Sacituzumab Govitecan | Percentage of Participants Who Experienced Treatment Emergent Serious Adverse Events (TESAEs) | 27.6 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants Who Experienced Treatment Emergent Serious Adverse Events (TESAEs) | 19.3 percentage of participants |
Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) - Shift From Baseline Value to Best Value During Treatment
ECOG performance status (PS) measured on-therapy assessed participant's performance status on 5 point scale: 0=Fully active/able to carry on all pre-disease performance without restriction;1=Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature;2=Ambulatory and capable of all self-care but unable to carry out any work activities; up and about more than 50% of waking hours;3=Capable of only limited self-care;confined to bed or chair more than 50% of waking hours;4=Completely disabled; cannot carry on any self-care; totally confined to bed or chair;5=Dead. Lower score indicated good performance status. Percentage of participants with Baseline ECOG PS score and corresponding changes to the best values post-baseline have been reported.
Time frame: Up to 43.4 months
Population: Participants in the Safety Population were analyzed.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Sacituzumab Govitecan | Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) - Shift From Baseline Value to Best Value During Treatment | Baseline ECOG 0, During Treatment ECOG 1 | 7.8 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) - Shift From Baseline Value to Best Value During Treatment | Baseline ECOG 0, During Treatment ECOG 0 | 34.9 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) - Shift From Baseline Value to Best Value During Treatment | Baseline ECOG 0, During Treatment ECOG 2 | 0 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) - Shift From Baseline Value to Best Value During Treatment | Baseline ECOG 1, During Treatment ECOG 0 | 19.4 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) - Shift From Baseline Value to Best Value During Treatment | Baseline ECOG 1, During Treatment ECOG 1 | 36.4 percentage of participants |
| Sacituzumab Govitecan | Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) - Shift From Baseline Value to Best Value During Treatment | Baseline ECOG 1, During Treatment ECOG 2 | 1.6 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) - Shift From Baseline Value to Best Value During Treatment | Baseline ECOG 1, During Treatment ECOG 1 | 38.3 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) - Shift From Baseline Value to Best Value During Treatment | Baseline ECOG 1, During Treatment ECOG 0 | 11.5 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) - Shift From Baseline Value to Best Value During Treatment | Baseline ECOG 0, During Treatment ECOG 0 | 38.7 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) - Shift From Baseline Value to Best Value During Treatment | Baseline ECOG 0, During Treatment ECOG 1 | 8.9 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) - Shift From Baseline Value to Best Value During Treatment | Baseline ECOG 1, During Treatment ECOG 2 | 2.1 percentage of participants |
| Treatment of Physician's Choice (TPC) | Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) - Shift From Baseline Value to Best Value During Treatment | Baseline ECOG 0, During Treatment ECOG 2 | 0.4 percentage of participants |
PFS by LIR Assessment
PFS was defined as the time from the date of randomization to the date of the first documentation of disease progression or death (whichever occurred first) according to LIR using RECIST 1.1. Disease progression was defined as an increase of greater than 20% in the sum of the LD of target lesions and a 5 mm absolute increase, taking as a reference the smallest sum LD recorded since the baseline assessment or the appearance of new non-target lesions. PFS was estimated using Kaplan-Meier estimate.
Time frame: Up to 42.8 months
Population: Participants in the ITT Population were analyzed.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Sacituzumab Govitecan | PFS by LIR Assessment | 4.3 months |
| Treatment of Physician's Choice (TPC) | PFS by LIR Assessment | 3.1 months |
Time to Deterioration (TTD) of Global Health Status/Quality of Life (QoL) Scale as Measured by European Organization for Research and Treatment of Cancer Quality of Life for Cancer Patients, Core Questionnaire Version 3.0 (EORTC QLQ-C30)
TTD was defined as the time from randomization to the first date a subject achieves 10-point deterioration from baseline in the global health status/QoL scale.The EORTC QLQ-C30 is a 30-item questionnaire to assess QoL of cancer patients. It has 5 functional scales(physical,role,emotional,cognitive, social)1 global health status scale,3 symptom scales (fatigue, nausea and vomiting, pain),and 6 single items(dyspnea, insomnia, loss of appetite, constipation, diarrhea, financial difficulties). Participant responses to global health status,'How would you rate your overall health during the past week?' (Item 29)and the QoL 'How would you rate your overall quality of life during the past week?'(Item 30)questions were scored on 7-point scale (1=very poor; 7=excellent). All scales and single-item measures range in score from 0 to 100. Summed raw scores were standardized by linear transformation so that scores ranged from 0 to 100. Higher scores for GHS show a better level of functioning.
Time frame: Up to 37.8 months
Population: The HRQOL-Evaluable Population included all participants who had an evaluable assessment at baseline and at least 1 evaluable assessment at postbaseline visits. Participants with a baseline global health status/QOL score ≥ 10 were analyzed.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Sacituzumab Govitecan | Time to Deterioration (TTD) of Global Health Status/Quality of Life (QoL) Scale as Measured by European Organization for Research and Treatment of Cancer Quality of Life for Cancer Patients, Core Questionnaire Version 3.0 (EORTC QLQ-C30) | 4.3 months |
| Treatment of Physician's Choice (TPC) | Time to Deterioration (TTD) of Global Health Status/Quality of Life (QoL) Scale as Measured by European Organization for Research and Treatment of Cancer Quality of Life for Cancer Patients, Core Questionnaire Version 3.0 (EORTC QLQ-C30) | 3.0 months |
TTD of Fatigue Score as Measured by EORTC QLQ-C30
TTD was defined as the time from randomization to the first date a subject achieves 10-point deterioration from baseline in the fatigue score.The EORTC QLQ-C30 is a questionnaire to assess quality of life, it is composed of 30 questions(items) resulting in 5 functional scales(physical, role, emotional, cognitive, social),1 global health status scale,3 symptom scales (fatigue, nausea and vomiting, pain),and 6 single items(dyspnea, insomnia, loss of appetite, constipation, diarrhea, financial difficulties).All of the scales and single-item measures range in score from 0 to 100.Participant responses to 3 questions about fatigue 'Did you need to rest', 'Have you felt weak' and 'Were you tired' were scored on a 4-point scale (1=not at all;4=very much).Summed raw scores were standardized by linear transformation so that scores ranged from 0 to 100. Higher scores on the symptom scales indicate a higher level of symptoms (i.e. a worse state of the participant).
Time frame: Up to 37.8 months
Population: Participants in the HRQOL-Evaluable Population with baseline fatigue score ≤ 90 were analyzed.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Sacituzumab Govitecan | TTD of Fatigue Score as Measured by EORTC QLQ-C30 | 2.2 months |
| Treatment of Physician's Choice (TPC) | TTD of Fatigue Score as Measured by EORTC QLQ-C30 | 1.4 months |
TTD of Pain Score as Measured by EORTC QLQ-C30
TTD was defined as the time from randomization to the first date a subject achieves 10-point deterioration from baseline in the pain score.The EORTC QLQ-C30 is a questionnaire to assess quality of life, it is composed of 30 questions(items) resulting in 5 functional scales(physical, role, emotional, cognitive, social),1 global health status scale,3 symptom scales (fatigue, nausea and vomiting, pain),and 6 single items(dyspnea, insomnia, loss of appetite, constipation, diarrhea, financial difficulties). All of the scales and single-item measures range in score from 0 to 100. Participant responses to 2 questions about pain, 'Have you had pain' and 'Did pain interfere with your daily activities' were scored on 4-point scale (1=not at all;4=very much). Summed raw scores were standardized by linear transformation so that scores ranges from 0 to 100. Higher scores on the symptom scales indicate a higher level of symptoms (i.e. a worse state of the participant).
Time frame: Up to 37.8 months
Population: Participants in the HRQOL-Evaluable Population with baseline pain score ≤ 90 were analyzed.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Sacituzumab Govitecan | TTD of Pain Score as Measured by EORTC QLQ-C30 | 3.8 months |
| Treatment of Physician's Choice (TPC) | TTD of Pain Score as Measured by EORTC QLQ-C30 | 3.5 months |