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Phase II Study of FTD/TPI (Lonsurf) in Metastatic Breast Cancers With or Without Prior Exposure to Fluoropyrimidines (LONBRECA)

Primary Purpose

Breast Cancer

Status
Recruiting
Phase
Phase 1
Locations
Singapore
Study Type
Interventional
Intervention
Cohort A
Cohort B
Sponsored by
National University Hospital, Singapore
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring FTD/TPI, TAS-102, Trifluridine

Eligibility Criteria

21 Years - 99 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age ≥ 21 years.
  • Histological or cytological diagnosis of breast carcinoma.
  • ECOG 0-2.
  • HER2 negative tumor (IHC 0 -1+ or IHC 2+ and confirmed on HER2 FISH to be negative based on histological report).
  • Patients with HER2 positive tumor may be enrolled if they have failed at least two lines of anti-HER2 based therapies in the metastatic setting, or are intolerant to trastuzumab
  • Any hormone receptor status.
  • Any number of lines of prior palliative endocrine therapy for patients with hormone receptor positive cancer.
  • Has measureable or evaluable disease based on RECIST 1.1 criteria
  • Estimated life expectancy of at least 12 weeks.
  • Has documented progressive disease from last line of therapy.
  • Has recovered from acute toxicities from prior anti-cancer therapies
  • Adequate organ function including the following:

oBone marrow: (I) Absolute neutrophil (segmented and bands) count (ANC) ≥1.5 x 109/L (ii) Platelets ≥100 x 109/L (ii) Hemoglobin ≥8 x 109/L oHepatic: (I)Bilirubin ≤ 1.5 x upper limit of normal (ULN), (ii)ALT or AST ≤ 2.5x ULN, (or ≤ 5 X with liver metastases) oRenal: (I) Creatinine ≤1.5x ULN

  • Signed informed consent from patient or legal representative.
  • Able to comply with study-related procedures.
  • Prior therapy (patients enrolled in phase Ib may be enrolled if they fulfil prior therapy criteria for either Cohort A or Cohort B)

    • Cohort A only: Has received at least 2 lines of palliative systemic therapy, including prior fluropyrimidines (capecitabine, TS-1 or 5-fluorouracil) in the palliative setting, or in the adjuvant setting; patients who have only prior exposure to adjuvant fluoropyrimidines must have relapsed within 12 months of completing adjuvant fluoropyrimidines
    • Cohort B only: Any number of prior lines of palliative chemotherapy and has not received fluoropyrimidines (capecitabine, TS-1 or 5-fluorouracil) in the palliative setting or in the adjuvant setting; patients who have prior exposure to adjuvant fluoropyrimidines are eligible if they have relapsed 12 months from completion of adjuvant fluoropyrimidines.

Exclusion Criteria:

  • Treatment within the last 30 days with any investigational drug.
  • Concurrent administration of any other tumour therapy, including cytotoxic chemotherapy, hormonal therapy, and immunotherapy.
  • Major surgery within 28 days of study drug administration.
  • Active infection that in the opinion of the investigator would compromise the patient's ability to tolerate therapy.
  • Pregnancy.
  • Breast feeding.
  • Serious concomitant disorders that would compromise the safety of the patient or compromise the patient's ability to complete the study, at the discretion of the investigator.
  • Active bleeding disorder or bleeding site.
  • Non-healing wound.
  • Poorly controlled diabetes mellitus.
  • Second primary malignancy that is clinically detectable at the time of consideration for study enrollment.
  • Symptomatic brain metastasis.
  • History of significant neurological or mental disorder, including seizures or dementia.
  • Unable to comply with study procedures

Phase Ib lead-in can recruit patients who fulfil criteria for either Cohort A or Cohort B AND all other inclusion/exclusion criteria

Sites / Locations

  • National University HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Cohort A

Cohort B

Arm Description

Patients with prior exposure to fluoropyrimidines

Patients without prior exposure to fluoropyrimidines

Outcomes

Primary Outcome Measures

Progression Free Survival (PFS)
Primary endpoint is proportion of patients who are PFS at 4 months in Cohort A

Secondary Outcome Measures

Overall Response
The death of any patient in the trial from any cause will be recorded and the amount of time from enrollment in the trial until death will be recorded in weeks.
Progression Free Survival (PFS)
Proportion of patients who are PFS at 6 months in Cohort B
Safety and Efficacy
All adverse events experienced by all patients (in both cohort , RP2D of FTD/TPI in MBC Patients) exposed to Trifluridine/tipiracil will be recorded and graded according to CTCAE version 5.

Full Information

First Posted
February 10, 2020
Last Updated
April 12, 2022
Sponsor
National University Hospital, Singapore
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1. Study Identification

Unique Protocol Identification Number
NCT04280536
Brief Title
Phase II Study of FTD/TPI (Lonsurf) in Metastatic Breast Cancers With or Without Prior Exposure to Fluoropyrimidines (LONBRECA)
Official Title
Phase II Study of FTD/TPI (Lonsurf) in Metastatic Breast Cancers With or Without Prior Exposure to Fluoropyrimidines (LONBRECA)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Recruiting
Study Start Date
August 14, 2019 (Actual)
Primary Completion Date
October 2024 (Anticipated)
Study Completion Date
October 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National University Hospital, Singapore

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a single arm, open-label, lead in phase Ib dose confirmation, followed by phase II study with 2 parallel study cohorts.
Detailed Description
Phase Ib Patients will be treated with twice-daily dosing of FTD/TPI in a 3+3 dose escalation design Phase II Oral FTD/TPI at RP2D will be administered until disease progression, intolerable toxicity or patient withdrawal. 2 parallel cohorts of patients will be enrolled : Cohort A : patients with prior exposure to fluoropyrimidines Cohort B : patients without prior exposure to fluoropyrimidines

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
FTD/TPI, TAS-102, Trifluridine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Model Description
2 parallel cohorts of patients will be enrolled : Cohort A : patients with prior exposure to fluoropyrimidines Cohort B : patients without prior exposure to fluoropyrimidines
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
86 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cohort A
Arm Type
Experimental
Arm Description
Patients with prior exposure to fluoropyrimidines
Arm Title
Cohort B
Arm Type
Experimental
Arm Description
Patients without prior exposure to fluoropyrimidines
Intervention Type
Drug
Intervention Name(s)
Cohort A
Other Intervention Name(s)
trifluridine/tipiracil, TAS-102 [Lonsurf]
Intervention Description
Oral FTD/TPI at RP2D will be administered until disease progression, intolerable toxicity or patient withdrawal.
Intervention Type
Drug
Intervention Name(s)
Cohort B
Other Intervention Name(s)
trifluridine/tipiracil, TAS-102 [Lonsurf]
Intervention Description
Oral FTD/TPI at RP2D will be administered until disease progression, intolerable toxicity or patient withdrawal.
Primary Outcome Measure Information:
Title
Progression Free Survival (PFS)
Description
Primary endpoint is proportion of patients who are PFS at 4 months in Cohort A
Time Frame
4 months
Secondary Outcome Measure Information:
Title
Overall Response
Description
The death of any patient in the trial from any cause will be recorded and the amount of time from enrollment in the trial until death will be recorded in weeks.
Time Frame
5 years
Title
Progression Free Survival (PFS)
Description
Proportion of patients who are PFS at 6 months in Cohort B
Time Frame
6 months
Title
Safety and Efficacy
Description
All adverse events experienced by all patients (in both cohort , RP2D of FTD/TPI in MBC Patients) exposed to Trifluridine/tipiracil will be recorded and graded according to CTCAE version 5.
Time Frame
5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 21 years. Histological or cytological diagnosis of breast carcinoma. ECOG 0-2. HER2 negative tumor (IHC 0 -1+ or IHC 2+ and confirmed on HER2 FISH to be negative based on histological report). Patients with HER2 positive tumor may be enrolled if they have failed at least two lines of anti-HER2 based therapies in the metastatic setting, or are intolerant to trastuzumab Any hormone receptor status. Any number of lines of prior palliative endocrine therapy for patients with hormone receptor positive cancer. Has measureable or evaluable disease based on RECIST 1.1 criteria Estimated life expectancy of at least 12 weeks. Has documented progressive disease from last line of therapy. Has recovered from acute toxicities from prior anti-cancer therapies Adequate organ function including the following: oBone marrow: (I) Absolute neutrophil (segmented and bands) count (ANC) ≥1.5 x 109/L (ii) Platelets ≥100 x 109/L (ii) Hemoglobin ≥8 x 109/L oHepatic: (I)Bilirubin ≤ 1.5 x upper limit of normal (ULN), (ii)ALT or AST ≤ 2.5x ULN, (or ≤ 5 X with liver metastases) oRenal: (I) Creatinine ≤1.5x ULN Signed informed consent from patient or legal representative. Able to comply with study-related procedures. Prior therapy (patients enrolled in phase Ib may be enrolled if they fulfil prior therapy criteria for either Cohort A or Cohort B) Cohort A only: Has received at least 2 lines of palliative systemic therapy, including prior fluropyrimidines (capecitabine, TS-1 or 5-fluorouracil) in the palliative setting, or in the adjuvant setting; patients who have only prior exposure to adjuvant fluoropyrimidines must have relapsed within 12 months of completing adjuvant fluoropyrimidines Cohort B only: Any number of prior lines of palliative chemotherapy and has not received fluoropyrimidines (capecitabine, TS-1 or 5-fluorouracil) in the palliative setting or in the adjuvant setting; patients who have prior exposure to adjuvant fluoropyrimidines are eligible if they have relapsed 12 months from completion of adjuvant fluoropyrimidines. Exclusion Criteria: Treatment within the last 30 days with any investigational drug. Concurrent administration of any other tumour therapy, including cytotoxic chemotherapy, hormonal therapy, and immunotherapy. Major surgery within 28 days of study drug administration. Active infection that in the opinion of the investigator would compromise the patient's ability to tolerate therapy. Pregnancy. Breast feeding. Serious concomitant disorders that would compromise the safety of the patient or compromise the patient's ability to complete the study, at the discretion of the investigator. Active bleeding disorder or bleeding site. Non-healing wound. Poorly controlled diabetes mellitus. Second primary malignancy that is clinically detectable at the time of consideration for study enrollment. Symptomatic brain metastasis. History of significant neurological or mental disorder, including seizures or dementia. Unable to comply with study procedures Phase Ib lead-in can recruit patients who fulfil criteria for either Cohort A or Cohort B AND all other inclusion/exclusion criteria
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Soo Chin Lee
Phone
6779 5555
Email
soo_chin_lee@nuhs.edu.sg
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Soo Chin Lee
Organizational Affiliation
National University Hospital, Singapore
Official's Role
Principal Investigator
Facility Information:
Facility Name
National University Hospital
City
Singapore
Country
Singapore
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Soo Chin Lee
Phone
6779 5555
Email
soo_chin_lee@nuhs.edu.sg

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
30627694
Citation
Caswell-Jin JL, Plevritis SK, Tian L, Cadham CJ, Xu C, Stout NK, Sledge GW, Mandelblatt JS, Kurian AW. Change in Survival in Metastatic Breast Cancer with Treatment Advances: Meta-Analysis and Systematic Review. JNCI Cancer Spectr. 2018 Nov;2(4):pky062. doi: 10.1093/jncics/pky062. Epub 2018 Dec 24.
Results Reference
result
PubMed Identifier
12473512
Citation
Crown J, Dieras V, Kaufmann M, von Minckwitz G, Kaye S, Leonard R, Marty M, Misset JL, Osterwalder B, Piccart M. Chemotherapy for metastatic breast cancer-report of a European expert panel. Lancet Oncol. 2002 Dec;3(12):719-27. doi: 10.1016/s1470-2045(02)00927-0.
Results Reference
result

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Phase II Study of FTD/TPI (Lonsurf) in Metastatic Breast Cancers With or Without Prior Exposure to Fluoropyrimidines (LONBRECA)

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