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PAKT: AZD5363 in Combination With Paclitaxel in Triple-Negative Advanced or Metastatic Breast Cancer (PAKT)

Primary Purpose

Metastatic Breast Cancer

Status
Unknown status
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Paclitaxel
AZD5363
Placebo
Sponsored by
Queen Mary University of London
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Breast Cancer focused on measuring Triple Negative Breast Cancer, Metastatic, AKT Inhibitor, Advanced, AZD5363, Paclitaxel, PAKT, Capivasertib

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Written informed consent prior to admission to this study
  2. Women, age > 18 years
  3. Histologically confirmed breast cancer
  4. Metastatic or locally recurrent disease; locally recurrent disease must not be amenable to resection with curative intent (patients who are considered suitable for surgical or ablative techniques following potential down-staging with study treatment are not eligible)
  5. Patient must have

    • At least one lesion, not previously irradiated, that can be measured accurately at baseline as ≥ 10mm in the longest diameter (except lymph nodes which must have short axis ≥15mm) with CT, or magnetic resonance imaging (MRI) which is suitable for accurate repeated measurements, OR
    • lytic or mixed bone lesions in the absence of measurable disease as defined above; patients with sclerotic/osteoblastic bone lesions only in the absence of measurable disease are not eligible.
  6. Radiological or clinical evidence of recurrence or progression
  7. Triple-negative disease
  8. Formalin fixed paraffin embedded tumour sample from the primary or recurrent cancer must be available for central testing
  9. Patients must be able to swallow and retain oral medication
  10. Haematologic and biochemical indices within protocol specified ranges
  11. ECOG performance status 0-2
  12. Non-childbearing potential. If patient is of childbearing potential, she must have a negative serum pregnancy test and agree to use adequate contraception
  13. Willing and able to provide written informed consent

Exclusion Criteria:

  1. Patients with confirm brain metastases or a history of primary central nervous system tumours or who have signs/symptoms attributable to brain metastases and have not been assessed with radiologic imaging to rule out the presence of brain metastases.
  2. Prior chemotherapy for metastatic breast cancer
  3. Radiotherapy with a wide field of radiation within 4 weeks before the first dose of study medication
  4. Prior treatment with PI3K inhibitors, AKT inhibitors or mTOR inhibitors
  5. Prior treatment with paclitaxel or docetaxel in the (neo)adjuvant setting within 12 months from inclusion into this study
  6. Pre-existing sensory or motor polyneuropathy ≥ Grade 2 according to CTCAE
  7. Malabsorption syndrome or other condition that would interfere with enteral absorption
  8. Clinically significant pulmonary dysfunction
  9. Prolongation defined as a QTc interval >470msecs or other significant abnormalities in rhythm, conduction or morphology of resting ECG including 2nd degree (Type II) or 3rd degree AV block or bradycardia (ventricular rate <50 beats/min)
  10. Any factors that increase risk of QTc prolongation or risk of arrythmic events
  11. Experience of any of the following procedures or conditions in the preceding 6 months: coronary artery bypass graft, angioplasty, vascular stent, myocardial infarction, angina pectoris, congestive heart failure NYHA Grade ≥2, or cardiac ejection fraction outside institutional range of normal or <50%
  12. Clinically significant abnormalities of glucose metabolism
  13. Patients with proteinuria or creatine >1.5xULN concurrent with creatinine clearance <50mL/min
  14. Exposure to potent inhibitors or inducers or substrates of CYP3A4 or substrates of CYP2D6 within 2 weeks before the first dose of study treatment
  15. Concurrent treatment with other experimental drugs or participation in another clinical trial with any investigational drug within 30 days prior to study entry
  16. Psychological, familial, sociological or geographical conditions that do not permit compliance with the study protocol.
  17. Detained persons or prisoners
  18. Pregnant or nursing women

Sites / Locations

  • ICO René Gauducheau
  • Centre André-lacassagne
  • Centre Hospitalier Prive Saint-Gregoire
  • Institute of Clinical Oncology
  • Országos Onkológiai Intézet
  • University of Pécs - Clinical Center Institute of Oncotherapy
  • Zala County Hospital Szent Rafael
  • Chungbuk National University Hospital
  • National Cancer Center
  • Asan Medical Center
  • Korea University Guro Hospital
  • Samsung Medical Centre
  • Yonsei University Health System
  • Prof. Dr. I. Chiricuta Oncology Institute
  • Sf. Nectarie SRL Oncologie Medical Center
  • Center of Oncology Euroclinic
  • Betsi Cadwaladr University Health Board
  • Belfast Health and Social Care Trust
  • Glan Clwyd Hospital BCU Health Board NHS Wales
  • Brighton and Sussex University Hospitals NHS Trust
  • Cambridge University Hospitals NHS Foundation Trust
  • East Kent Hospitals University NHS Foundation Trust
  • Velindre Cancer Centre
  • University Hospitals Coventry and Warwickshire NHs Trust
  • NHS Lothian
  • Medway NHS Foundation Trust
  • Beatson West of Scotland Cancer Centre
  • Leeds Teaching Hospitals NHs Trust
  • Barts Health NHS Trust
  • University College London Hospitals
  • Barking, Havering and Redbridge University Hospitals NHS Trust
  • Guys and St Thomas' NHS Foundation Trust
  • Lewisham and Greenwich NHS Trust
  • Royal Marsden NHS Foundation Trust-Fulham
  • Imperial College Healthcare NHS Trust
  • Maidstone and Tunbridge Wells NHS Trust
  • The Christie NHS Foundation Trust
  • Nottingham University Hospitals NHS Trust
  • Southampton University Hospitals NHS Trust
  • Southend University Hospital NHS Foundation Trust
  • University Hospital of North Staffordshire NHS Trust
  • Royal Marsden - Sutton
  • Abertawe Bro Margannwg University Health Board
  • Royal Cornwall Hospitals NHS Trust
  • Ysbyty Wrexham Maelor Hospital
  • Yeovil District Hospital NHS Foundation Trust

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Paclitaxel + AZD5363

Paclitaxel + Placebo

Arm Description

Paclitaxel was administered as a once-per-week intravenous infusion of 90 mg/m2 over approximately 1 hour on days 1, 8, and 15 of each 28-day treatment cycle. Capivasertib 400 mg was administered orally twice per day on an intermittent weekly dosing schedule, with treatment on days 2 to 5 of weeks 1, 2, and 3 within each 28-day cycle.

Paclitaxel was administered as a once-per-week intravenous infusion of 90 mg/m2 over approximately 1 hour on days 1, 8, and 15 of each 28-day treatment cycle. Placebo was administered orally twice per day on an intermittent weekly dosing schedule, with treatment on days 2 to 5 of weeks 1, 2, and 3 within each 28-day cycle.

Outcomes

Primary Outcome Measures

Progression-free survival
Progression-free survival, defined as the time from the date of randomisation to the date of first documented tumour progression (using RECIST 1.1) or death from any cause, whichever occurs first.

Secondary Outcome Measures

Full Information

First Posted
July 11, 2014
Last Updated
February 24, 2020
Sponsor
Queen Mary University of London
Collaborators
AstraZeneca, Cancer Research UK
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1. Study Identification

Unique Protocol Identification Number
NCT02423603
Brief Title
PAKT: AZD5363 in Combination With Paclitaxel in Triple-Negative Advanced or Metastatic Breast Cancer
Acronym
PAKT
Official Title
A Phase II, Double-blind, Randomised, Placebo-controlled Study of the AKT Inhibitor AZD5363 in Combination With Paclitaxel in Triple-Negative Advanced or Metastatic Breast Cancer (PAKT).
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Unknown status
Study Start Date
May 2014 (Actual)
Primary Completion Date
June 2020 (Anticipated)
Study Completion Date
June 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Queen Mary University of London
Collaborators
AstraZeneca, Cancer Research UK

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
PAKT was an investigator-led, placebo-controlled, randomized phase II trial performed in 42 academic medical centers in the United Kindom, South Korea, France, Hungary, Romania, and Georgia. Patients were randomly assigned (1:1) to receive paclitaxel plus capivasertib or paclitaxel plus placebo. Stratification was by number of metastatic sites (< 3 v ≥ 3) and interval from the end of prior adjuvant or neoadjuvant chemotherapy (≤ 12 v > 12 months v no prior chemotherapy). Paclitaxel was administered as a once-per-week intravenous infusion of 90 mg/m2 over approximately 1 hour on days 1, 8, and 15 of each 28-day treatment cycle. Capivasertib 400 mg or placebo was administered orally twice per day on an intermittent weekly dosing schedule, with treatment on days 2 to 5 of weeks 1, 2, and 3 within each 28-day cycle. All treatments were continued until disease progression, development of unacceptable toxicity, or withdrawal of consent. If paclitaxel treatment was discontinued before disease progression, patients could continue to receive capivasertib or placebo alone. In case of adverse events (AEs), capivasertib or placebo could be reduced to 320 mg twice per day and subsequently to 240 mg twice per day. Capivasertib or placebo could be interrupted for up to 4 weeks for toxicity. Tumor assessments included computed tomography scanning or magnetic resonance imaging of the chest, abdomen, and pelvis at baseline, every 8 weeks during treatment, and at progression. Patients who discontinued treatment for any reason other than progression were required to follow the same schedule of assessments until progression, initiation of another treatment, death, or withdrawal of consent.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Breast Cancer
Keywords
Triple Negative Breast Cancer, Metastatic, AKT Inhibitor, Advanced, AZD5363, Paclitaxel, PAKT, Capivasertib

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
140 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Paclitaxel + AZD5363
Arm Type
Active Comparator
Arm Description
Paclitaxel was administered as a once-per-week intravenous infusion of 90 mg/m2 over approximately 1 hour on days 1, 8, and 15 of each 28-day treatment cycle. Capivasertib 400 mg was administered orally twice per day on an intermittent weekly dosing schedule, with treatment on days 2 to 5 of weeks 1, 2, and 3 within each 28-day cycle.
Arm Title
Paclitaxel + Placebo
Arm Type
Placebo Comparator
Arm Description
Paclitaxel was administered as a once-per-week intravenous infusion of 90 mg/m2 over approximately 1 hour on days 1, 8, and 15 of each 28-day treatment cycle. Placebo was administered orally twice per day on an intermittent weekly dosing schedule, with treatment on days 2 to 5 of weeks 1, 2, and 3 within each 28-day cycle.
Intervention Type
Drug
Intervention Name(s)
Paclitaxel
Other Intervention Name(s)
Taxol
Intervention Description
Patient receive Once a week for three weeks - with one week off treatment
Intervention Type
Drug
Intervention Name(s)
AZD5363
Other Intervention Name(s)
Capivasertib
Intervention Description
Patients receive AZD5363/Placebo in an intermittent treatment schedule. Please see study arms for full information.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Patients receive AZD5363/Placebo in an intermittent treatment schedule. Please see study arms for full information.
Primary Outcome Measure Information:
Title
Progression-free survival
Description
Progression-free survival, defined as the time from the date of randomisation to the date of first documented tumour progression (using RECIST 1.1) or death from any cause, whichever occurs first.
Time Frame
Date of randomisation to date of first tumour progression or death (this can range on average between 3 weeks and 32 weeks).

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written informed consent prior to admission to this study Women, age > 18 years Histologically confirmed breast cancer Metastatic or locally recurrent disease; locally recurrent disease must not be amenable to resection with curative intent (patients who are considered suitable for surgical or ablative techniques following potential down-staging with study treatment are not eligible) Patient must have At least one lesion, not previously irradiated, that can be measured accurately at baseline as ≥ 10mm in the longest diameter (except lymph nodes which must have short axis ≥15mm) with CT, or magnetic resonance imaging (MRI) which is suitable for accurate repeated measurements, OR lytic or mixed bone lesions in the absence of measurable disease as defined above; patients with sclerotic/osteoblastic bone lesions only in the absence of measurable disease are not eligible. Radiological or clinical evidence of recurrence or progression Triple-negative disease Formalin fixed paraffin embedded tumour sample from the primary or recurrent cancer must be available for central testing Patients must be able to swallow and retain oral medication Haematologic and biochemical indices within protocol specified ranges ECOG performance status 0-2 Non-childbearing potential. If patient is of childbearing potential, she must have a negative serum pregnancy test and agree to use adequate contraception Willing and able to provide written informed consent Exclusion Criteria: Patients with confirm brain metastases or a history of primary central nervous system tumours or who have signs/symptoms attributable to brain metastases and have not been assessed with radiologic imaging to rule out the presence of brain metastases. Prior chemotherapy for metastatic breast cancer Radiotherapy with a wide field of radiation within 4 weeks before the first dose of study medication Prior treatment with PI3K inhibitors, AKT inhibitors or mTOR inhibitors Prior treatment with paclitaxel or docetaxel in the (neo)adjuvant setting within 12 months from inclusion into this study Pre-existing sensory or motor polyneuropathy ≥ Grade 2 according to CTCAE Malabsorption syndrome or other condition that would interfere with enteral absorption Clinically significant pulmonary dysfunction Prolongation defined as a QTc interval >470msecs or other significant abnormalities in rhythm, conduction or morphology of resting ECG including 2nd degree (Type II) or 3rd degree AV block or bradycardia (ventricular rate <50 beats/min) Any factors that increase risk of QTc prolongation or risk of arrythmic events Experience of any of the following procedures or conditions in the preceding 6 months: coronary artery bypass graft, angioplasty, vascular stent, myocardial infarction, angina pectoris, congestive heart failure NYHA Grade ≥2, or cardiac ejection fraction outside institutional range of normal or <50% Clinically significant abnormalities of glucose metabolism Patients with proteinuria or creatine >1.5xULN concurrent with creatinine clearance <50mL/min Exposure to potent inhibitors or inducers or substrates of CYP3A4 or substrates of CYP2D6 within 2 weeks before the first dose of study treatment Concurrent treatment with other experimental drugs or participation in another clinical trial with any investigational drug within 30 days prior to study entry Psychological, familial, sociological or geographical conditions that do not permit compliance with the study protocol. Detained persons or prisoners Pregnant or nursing women
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peter Schmid
Organizational Affiliation
Queen Mary University London
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Nicholas Turner
Organizational Affiliation
Royal Marsden Hospital NHS- Institute of Cancer Research
Official's Role
Principal Investigator
Facility Information:
Facility Name
ICO René Gauducheau
City
Nantes
Country
France
Facility Name
Centre André-lacassagne
City
Nice
Country
France
Facility Name
Centre Hospitalier Prive Saint-Gregoire
City
Saint-Grégoire
Country
France
Facility Name
Institute of Clinical Oncology
City
Tbilisi
Country
Georgia
Facility Name
Országos Onkológiai Intézet
City
Budapest
Country
Hungary
Facility Name
University of Pécs - Clinical Center Institute of Oncotherapy
City
Pécs
Country
Hungary
Facility Name
Zala County Hospital Szent Rafael
City
Zalaegerszeg
Country
Hungary
Facility Name
Chungbuk National University Hospital
City
Cheongju
Country
Korea, Republic of
Facility Name
National Cancer Center
City
Goyang-si
Country
Korea, Republic of
Facility Name
Asan Medical Center
City
Seoul
Country
Korea, Republic of
Facility Name
Korea University Guro Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Samsung Medical Centre
City
Seoul
Country
Korea, Republic of
Facility Name
Yonsei University Health System
City
Seoul
Country
Korea, Republic of
Facility Name
Prof. Dr. I. Chiricuta Oncology Institute
City
Cluj-Napoca
Country
Romania
Facility Name
Sf. Nectarie SRL Oncologie Medical Center
City
Craiova
Country
Romania
Facility Name
Center of Oncology Euroclinic
City
Iași
Country
Romania
Facility Name
Betsi Cadwaladr University Health Board
City
Bangor
ZIP/Postal Code
LL57 2PW
Country
United Kingdom
Facility Name
Belfast Health and Social Care Trust
City
Belfast
ZIP/Postal Code
BT9 7AB
Country
United Kingdom
Facility Name
Glan Clwyd Hospital BCU Health Board NHS Wales
City
Bodelwyddan
ZIP/Postal Code
LL18 5UJ
Country
United Kingdom
Facility Name
Brighton and Sussex University Hospitals NHS Trust
City
Brighton
ZIP/Postal Code
BN2 5BE
Country
United Kingdom
Facility Name
Cambridge University Hospitals NHS Foundation Trust
City
Cambridge
ZIP/Postal Code
CB2 0QQ
Country
United Kingdom
Facility Name
East Kent Hospitals University NHS Foundation Trust
City
Canterbury
ZIP/Postal Code
CT1 3NG
Country
United Kingdom
Facility Name
Velindre Cancer Centre
City
Cardiff
ZIP/Postal Code
CF14 2TL
Country
United Kingdom
Facility Name
University Hospitals Coventry and Warwickshire NHs Trust
City
Coventry
ZIP/Postal Code
CV2 2DX
Country
United Kingdom
Facility Name
NHS Lothian
City
Edinburgh
ZIP/Postal Code
EH4 2XR
Country
United Kingdom
Facility Name
Medway NHS Foundation Trust
City
Gillingham
ZIP/Postal Code
ME7 5NY
Country
United Kingdom
Facility Name
Beatson West of Scotland Cancer Centre
City
Glasgow
ZIP/Postal Code
G12 0YN
Country
United Kingdom
Facility Name
Leeds Teaching Hospitals NHs Trust
City
Leeds
ZIP/Postal Code
LS9 7TF
Country
United Kingdom
Facility Name
Barts Health NHS Trust
City
London
ZIP/Postal Code
EC1M 6BQ
Country
United Kingdom
Facility Name
University College London Hospitals
City
London
ZIP/Postal Code
NW1 2PG
Country
United Kingdom
Facility Name
Barking, Havering and Redbridge University Hospitals NHS Trust
City
London
ZIP/Postal Code
RM7 0AG
Country
United Kingdom
Facility Name
Guys and St Thomas' NHS Foundation Trust
City
London
ZIP/Postal Code
SE1 9RT
Country
United Kingdom
Facility Name
Lewisham and Greenwich NHS Trust
City
London
ZIP/Postal Code
SE18 4QH
Country
United Kingdom
Facility Name
Royal Marsden NHS Foundation Trust-Fulham
City
London
ZIP/Postal Code
SW3 6JJ
Country
United Kingdom
Facility Name
Imperial College Healthcare NHS Trust
City
London
ZIP/Postal Code
W2 1NY
Country
United Kingdom
Facility Name
Maidstone and Tunbridge Wells NHS Trust
City
Maidstone
ZIP/Postal Code
ME16 9QQ
Country
United Kingdom
Facility Name
The Christie NHS Foundation Trust
City
Manchester
ZIP/Postal Code
M20 4BX
Country
United Kingdom
Facility Name
Nottingham University Hospitals NHS Trust
City
Nottingham
ZIP/Postal Code
NG5 1PB
Country
United Kingdom
Facility Name
Southampton University Hospitals NHS Trust
City
Southampton
ZIP/Postal Code
SO16 6YD
Country
United Kingdom
Facility Name
Southend University Hospital NHS Foundation Trust
City
Southend
ZIP/Postal Code
SS0 0RY
Country
United Kingdom
Facility Name
University Hospital of North Staffordshire NHS Trust
City
Stoke-on-Trent
ZIP/Postal Code
ST4 6QG
Country
United Kingdom
Facility Name
Royal Marsden - Sutton
City
Sutton
ZIP/Postal Code
SM2 5PT
Country
United Kingdom
Facility Name
Abertawe Bro Margannwg University Health Board
City
Swansea
ZIP/Postal Code
SA2 8QA
Country
United Kingdom
Facility Name
Royal Cornwall Hospitals NHS Trust
City
Truro
ZIP/Postal Code
TR1 3LJ
Country
United Kingdom
Facility Name
Ysbyty Wrexham Maelor Hospital
City
Wrexham
ZIP/Postal Code
LL18 5UJ
Country
United Kingdom
Facility Name
Yeovil District Hospital NHS Foundation Trust
City
Yeovil
ZIP/Postal Code
BA21 4AT
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
31841354
Citation
Schmid P, Abraham J, Chan S, Wheatley D, Brunt AM, Nemsadze G, Baird RD, Park YH, Hall PS, Perren T, Stein RC, Mangel L, Ferrero JM, Phillips M, Conibear J, Cortes J, Foxley A, de Bruin EC, McEwen R, Stetson D, Dougherty B, Sarker SJ, Prendergast A, McLaughlin-Callan M, Burgess M, Lawrence C, Cartwright H, Mousa K, Turner NC. Capivasertib Plus Paclitaxel Versus Placebo Plus Paclitaxel As First-Line Therapy for Metastatic Triple-Negative Breast Cancer: The PAKT Trial. J Clin Oncol. 2020 Feb 10;38(5):423-433. doi: 10.1200/JCO.19.00368. Epub 2019 Dec 16.
Results Reference
result

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PAKT: AZD5363 in Combination With Paclitaxel in Triple-Negative Advanced or Metastatic Breast Cancer

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