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A Study to Evaluate Inetetamab + Pyrotinib + Chemotherapy in Previously Untreated HER2-Positive Metastatic Breast Cancer

Primary Purpose

HER2-positive Recurrent/Metastatic Breast Cancer

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Inetetamab, pyrotinib, chemotherapy
Sponsored by
Fujian Medical University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HER2-positive Recurrent/Metastatic Breast Cancer

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria: Aged 18 ~ 75 years old, female; Patients with HER2-positive breast cancer defined as immunohistochemical (IHC) test + + +, or FISH test positive; According to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, at least one measurable lesion exists; ECOG PS score 0-1 points; No systemic antitumor therapy (except first line endocrine therapy) in relapse/metastasis; If prior anti-HER2 therapy (including trastuzumab, trastuzumab biosimilar, Inetetamab, pertuzumab, tyrosine kinase inhibitors such as pyrotinib, T-DM1) was used in the (neo) adjuvant phase, the interval between the end of anti-HER2 therapy to the diagnosis of relapse/metastasis was ≥ 12 months; Adequate organ function; Expected survival ≥ 3 months; Patients voluntarily sign informed consent, have good compliance and are willing to cooperate in follow-up. Exclusion Criteria: Known to have a history of hypersensitivity to the drug components of this protocol; Investigators judged that they were not suitable for systemic chemotherapy; Endocrine therapy drugs were used within 14 days before baseline; Active brain metastases; Only bone or skin as target lesions; Patients with other malignant tumors within 5 years, excluding cured cervical carcinoma in situ, cutaneous basal cell carcinoma or squamous cell carcinoma; Grade≥3 peripheral neuropathy according to CTCAE 5.0 criteria; Patients who have previously received more than the following cumulative doses of anthracyclines: doxorubicin or liposomal doxorubicin > 360 mg/m2, epirubicin > 720 mg/m2, mitoxantrone > 120 mg/m2, others (such as other anthracyclines or multiple anthracyclines, cumulative dose > 360 mg/m2 of doxorubicin); Received major surgical procedures or significant trauma within 4 weeks before randomization, or patients are expected to receive major surgical treatment; Serious heart problems or discomfort; Dysphagia, chronic diarrhea, intestinal obstruction and other factors affecting administration and absorption; History of immunodeficiency, including HIV infection, or suffering from other acquired, congenital immunodeficiency diseases, or history of organ transplantation; 13. Participated in other drug clinical studies within 4 weeks before screening; 14. Presence of third space effusion (such as pleural effusion and ascites) that cannot be controlled by drainage or other methods; 15. Pregnant or lactating female patients, women of childbearing age who cannot take effective contraceptive measures throughout the trial; 16. With severe concomitant diseases or interfere with the planned treatment or any other condition that is not suitable for participating in this study, such as active hepatitis B, lung infection requiring treatment.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Inetetamab, pyrotinib, chemotherapy

    Arm Description

    Inetetamab: was administered as an intravenous (IV) loading dose of 8mg/kg q3w on Day 1 of Cycle 1 (1 Cycle length = 21 days), and 6mg/kg q3w on Day 1 of subsequent cycles, until investigator-assessed radiographic or clinical progressive disease, unmanageable toxicity, or study termination. pyrotinib: 400 mg once daily orally within 30 minutes after a meal at the same time each day. chemotherapy:Taxanes (paclitaxel, docetaxel, liposomal paclitaxel, nabpaclitaxel), vinorelbine, capecitabine, eribulin, and other chemotherapeutic agents indicated in advanced breast cancer are permitted. Refer to the appropriate package insert for dosage and administration recommendations.

    Outcomes

    Primary Outcome Measures

    Progression-Free Survival (PFS)
    PFS was defined as the time from first dose to first documented radiographical progressive disease (PD) using RECIST version 1.1, or death from any cause , whichever occurred first.

    Secondary Outcome Measures

    Overall response rate (ORR)
    An objective response was defined as the percentage of participants with confirmed best overall response of complete response (CR) or partial response (PR) determined by investigator using RECIST v1.1 on two consecutive occasions ≥4 weeks apart
    Clinical Benefit Rate (CBR)
    Clinical benefit rate was defined as the percentage of participants with confirmed best overall response of complete response (CR) or partial response (PR) or stable disease(SD)>6 months determined by investigator using RECIST v1.1 on two consecutive occasions ≥4 weeks apart.
    Number of Adverse Events using NCI CTCAE 5.0 [Safety and Tolerability]
    Number of Adverse Events using NCI CTCAE 5.0

    Full Information

    First Posted
    November 9, 2022
    Last Updated
    November 16, 2022
    Sponsor
    Fujian Medical University
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05621434
    Brief Title
    A Study to Evaluate Inetetamab + Pyrotinib + Chemotherapy in Previously Untreated HER2-Positive Metastatic Breast Cancer
    Official Title
    Inetetamab, Pyrotinib and Chemotherapy in Combination for First-line Treatment of HER2-positive Recurrent/Metastatic Breast Cancer
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    November 2022
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    December 10, 2022 (Anticipated)
    Primary Completion Date
    December 10, 2024 (Anticipated)
    Study Completion Date
    December 10, 2025 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Fujian Medical University

    4. Oversight

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

    5. Study Description

    Brief Summary
    Studies H0648g and M77001 confirmed that the combination of trastuzumab with taxanes significantly improved TTP and OS, establishing the status of trastuzumab combined with taxanes as first-line standard therapy.The CLEOPATRA and PUFFIN studies confirmed that trastuzumab combined with pertuzumab achieved PFS of 18.7 and 16.5 months, respectively, and became today 's first-line standard regimen for advanced HER2 + breast cancer. Pyrotinib acts on the intracellular segment of HER2 receptor and can inhibit tumor cell growth by covalently binding to the ATP binding site in the intracellular tyrosine kinase region and blocking the activation of downstream signaling pathways. The mechanism of action of the macromolecular drug trastuzumab combined with the small molecular drug pyrotinib dual-target in the treatment of HER2-positive breast cancer is complementary and has a synergistic anti-tumor effect. In 2022, the ESMO conference reported the results of a phase III trial of pyrotinib combined with trastuzumab combined with docetaxel in advanced HER2-positive breast cancer with an LBA, with the primary endpoint of investigator-assessed PFS.The results showed a significant 59% reduction in the risk of disease progression or death compared with 10.4 months in the trastuzumab plus docetaxel arm and 24.3 months in the pyrotinib arm. Inetetamab is a monoclonal antibody against the IV domain of the HER2 receptor with the same Fab segment as trastuzumab and different amino acid sequences from trastuzumab at positions 359 and 361 of the Fc segment heavy chain constant region, Antibody-dependent cell-mediated cytotoxicity (ADCC) was 1.11-fold higher than trastuzumab. PFS reached 11.1 months in the first-line subgroup analysis of the Phase III registration study of Inetetamab (HOPES study), which was similar to historical data from trastuzumab first-line treatment of HER2-positive metastatic breast cancer, with comparable safety. The results of this study contribute to further understanding the efficacy and safety of first-line treatment with Inetetamab Combined with Pyrotinib and Chemotherapy in HER2-positive recurrent/metastatic breast cancer patients.
    Detailed Description
    This Prospective, multicenter study will include 63 patients with first-line patients with HER2-positive recurrent/metastatic breast cancer. After providing written informed consent, patients receiving Inetetamab in combination with pyrotinib and investigator 's choice chemotherapy. The effectiveness of the combined treatment will be evaluated by MRI every two treatment cycles. If the disease progresses, the participant will withdraw from the trial.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    HER2-positive Recurrent/Metastatic Breast Cancer

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Single Group Assignment
    Model Description
    single arm study
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    63 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Inetetamab, pyrotinib, chemotherapy
    Arm Type
    Experimental
    Arm Description
    Inetetamab: was administered as an intravenous (IV) loading dose of 8mg/kg q3w on Day 1 of Cycle 1 (1 Cycle length = 21 days), and 6mg/kg q3w on Day 1 of subsequent cycles, until investigator-assessed radiographic or clinical progressive disease, unmanageable toxicity, or study termination. pyrotinib: 400 mg once daily orally within 30 minutes after a meal at the same time each day. chemotherapy:Taxanes (paclitaxel, docetaxel, liposomal paclitaxel, nabpaclitaxel), vinorelbine, capecitabine, eribulin, and other chemotherapeutic agents indicated in advanced breast cancer are permitted. Refer to the appropriate package insert for dosage and administration recommendations.
    Intervention Type
    Drug
    Intervention Name(s)
    Inetetamab, pyrotinib, chemotherapy
    Other Intervention Name(s)
    Inetetamab for injection, Pyrotinib maleate
    Intervention Description
    Inetetamab: was administered as an intravenous (IV) loading dose of 8mg/kg q3w on Day 1 of Cycle 1 (1 Cycle length = 21 days), and 6mg/kg q3w on Day 1 of subsequent cycles, until investigator-assessed radiographic or clinical progressive disease, unmanageable toxicity, or study termination. pyrotinib: 400 mg once daily orally within 30 minutes after a meal at the same time each day. chemotherapy:Taxanes (paclitaxel, docetaxel, liposomal paclitaxel, nabpaclitaxel), vinorelbine, capecitabine, eribulin, and other chemotherapeutic agents indicated in advanced breast cancer are permitted. Refer to the appropriate package insert for dosage and administration recommendations.
    Primary Outcome Measure Information:
    Title
    Progression-Free Survival (PFS)
    Description
    PFS was defined as the time from first dose to first documented radiographical progressive disease (PD) using RECIST version 1.1, or death from any cause , whichever occurred first.
    Time Frame
    Tumor assessments every 6 weeks from randomization to radiographical PD or death from any cause, whichever occurred first,up to the primary completion date (up to 2 years)
    Secondary Outcome Measure Information:
    Title
    Overall response rate (ORR)
    Description
    An objective response was defined as the percentage of participants with confirmed best overall response of complete response (CR) or partial response (PR) determined by investigator using RECIST v1.1 on two consecutive occasions ≥4 weeks apart
    Time Frame
    Tumor assessments every 6 weeks from Baseline until radiographical progressive disease (PD), death (whichever occurred first), up to the primary completion date (up to 2 years)
    Title
    Clinical Benefit Rate (CBR)
    Description
    Clinical benefit rate was defined as the percentage of participants with confirmed best overall response of complete response (CR) or partial response (PR) or stable disease(SD)>6 months determined by investigator using RECIST v1.1 on two consecutive occasions ≥4 weeks apart.
    Time Frame
    Tumor assessments every 6 weeks from Baseline until radiographical progressive disease (PD), death (whichever occurred first), up to the primary completion date (up to 2 years)
    Title
    Number of Adverse Events using NCI CTCAE 5.0 [Safety and Tolerability]
    Description
    Number of Adverse Events using NCI CTCAE 5.0
    Time Frame
    From signing the informed consent to 30 days after last dose

    10. Eligibility

    Sex
    Female
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    75 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Aged 18 ~ 75 years old, female; Patients with HER2-positive breast cancer defined as immunohistochemical (IHC) test + + +, or FISH test positive; According to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, at least one measurable lesion exists; ECOG PS score 0-1 points; No systemic antitumor therapy (except first line endocrine therapy) in relapse/metastasis; If prior anti-HER2 therapy (including trastuzumab, trastuzumab biosimilar, Inetetamab, pertuzumab, tyrosine kinase inhibitors such as pyrotinib, T-DM1) was used in the (neo) adjuvant phase, the interval between the end of anti-HER2 therapy to the diagnosis of relapse/metastasis was ≥ 12 months; Adequate organ function; Expected survival ≥ 3 months; Patients voluntarily sign informed consent, have good compliance and are willing to cooperate in follow-up. Exclusion Criteria: Known to have a history of hypersensitivity to the drug components of this protocol; Investigators judged that they were not suitable for systemic chemotherapy; Endocrine therapy drugs were used within 14 days before baseline; Active brain metastases; Only bone or skin as target lesions; Patients with other malignant tumors within 5 years, excluding cured cervical carcinoma in situ, cutaneous basal cell carcinoma or squamous cell carcinoma; Grade≥3 peripheral neuropathy according to CTCAE 5.0 criteria; Patients who have previously received more than the following cumulative doses of anthracyclines: doxorubicin or liposomal doxorubicin > 360 mg/m2, epirubicin > 720 mg/m2, mitoxantrone > 120 mg/m2, others (such as other anthracyclines or multiple anthracyclines, cumulative dose > 360 mg/m2 of doxorubicin); Received major surgical procedures or significant trauma within 4 weeks before randomization, or patients are expected to receive major surgical treatment; Serious heart problems or discomfort; Dysphagia, chronic diarrhea, intestinal obstruction and other factors affecting administration and absorption; History of immunodeficiency, including HIV infection, or suffering from other acquired, congenital immunodeficiency diseases, or history of organ transplantation; 13. Participated in other drug clinical studies within 4 weeks before screening; 14. Presence of third space effusion (such as pleural effusion and ascites) that cannot be controlled by drainage or other methods; 15. Pregnant or lactating female patients, women of childbearing age who cannot take effective contraceptive measures throughout the trial; 16. With severe concomitant diseases or interfere with the planned treatment or any other condition that is not suitable for participating in this study, such as active hepatitis B, lung infection requiring treatment.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Fan Wu, MD
    Phone
    +8613859082118
    Email
    alienglass@fjmu.edu.cn
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Jian Liu, PHD
    Organizational Affiliation
    Fujian Cancer Hospital
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    Findings from this study will indicate whether Inetetamab Combined with Pyrotinib and Chemotherapy treatment of HER2-Positive Recurrent/Metastatic Breast Cancer is safe and effective
    IPD Sharing Time Frame
    6 months to 5 years after publication
    IPD Sharing Access Criteria
    Unlimited

    Learn more about this trial

    A Study to Evaluate Inetetamab + Pyrotinib + Chemotherapy in Previously Untreated HER2-Positive Metastatic Breast Cancer

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