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A Study to Evaluate the Efficacy and Safety of TSL-1502 Capsules in Breast Cancer Patients With Germline BRCA Mutations

Primary Purpose

Breast Cancer Metastatic

Status
Not yet recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
TSL-1502 capsules(low dose)
TSL-1502 capsules(high dose)
Investigator's choice of chemotherapy
Sponsored by
Jiangsu Tasly Diyi Pharmaceutical Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer Metastatic

Eligibility Criteria

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

Inclusion Criteria:

  • 1) Agree to follow the clinical trial protocol, volunteer, and sign the informed consent form (ICF).

    2) Women aged ≥ 18 years and ≤ 75 years at the date of signing the ICF. 3) HER2-locally advanced breast cancer diagnosed by histopathology and/or cytology (Unable to receive radical therapy) or metastatic breast cancer, and previous chemotherapeutic line of cytotoxicity for locally advanced or metastatic breast cancer was ≥ 1 (for triple-negative breast cancer only) and ≤ 3.

    4) Prior platinum therapy is allowed, but the best response to platinum therapy is required to be CR, PR, or persistent ≥ 12 weeks SD. If given as neoadjuvant/adjuvant therapy, the time from the last dose of platinum to relapse is ≥ 6 months.

    5) Hormone receptor-positive patients need to have received at least first-line of endocrine therapy for locally advanced or metastatic breast cancer but failed, or unsuitable for endocrine therapy in the judgment of the investigator.

    6) In neoadjuvant, adjuvant and/or metastatic stages, the patients who have received antitumor therapy with Taxane ± Anthracycline.

    7) Failure of front-line therapy (disease progression or toxicity intolerance), and the investigator judged that it was suitable to receive the systemic monotherapy (including capecitabine tablets, vinorelbine tartrate injection, eribulin mesylate injection).

    8) Tested or reviewed by a third-party central laboratory to determine whether there is harmful or suspected harmful gBBRCAm in the blood.

    9) At least one measurable (non-lymph node longest diameter ≥ 10 mm, lymph nodes with a minimum diameter of ≥ 15 mm, according to RECIST version 1.1 criteria) of target lesions. Note: Previously irradiated lesions cannot be used as targets lesions unless there is significant progression of the lesion.

    10) The physical condition score is 0-1 according to the scale of The Eastern Cooperative Oncology Group (ECOG).

    11) Expected survival ≥ 12 weeks. 12) Meet the following criteria (The use of any blood components and cell growth factors is not permitted within 2 weeks prior to initial administration): Bone marrow function: absolute neutrophil count (ANC) ≥ 1.5 × 109/L (1500/mm3); platelets ≥ 100 × 109/L (1 × 105/mm3); Hemoglobin ≥ 90 g/L; Liver function: serum bilirubin ≤ 1.5 × upper limit of normal (ULN), but except for Gilbert's syndrome patients (persistent or recurrent hyperbilirubinemia, unbound bilirubin elevation is present in the absence of evidence of hemolysis or liver pathology); patients without liver metastasis, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5×ULN; ALT and AST ≤ 5×ULN for patients with liver metastasis; Renal function: serum creatinine ≤ 1.5 × ULN, or creatinine clearance (Ccr) ≥ 50 mL/min (Calculated according to the Cockcroft-Gault formula); Cockcroft-Gault formula: female Ccr (mL/min) = 0.85 × weight (kg) × (140-age)/ [72 × creatinine (mg/dL)] Coagulation function: international normalized ratio (INR) ≤ 1.5 × ULN, activated partial thromboplastin time (APTT) ≤ 1.5 × ULN.

    13) Women of childbearing age are willing to take effective contraception from signing the ICF to 6 months after the last administration of the investigational drug. Women of childbearing age must have a negative blood pregnancy test result 7 days before the first dose.

Exclusion Criteria:

  • 1) Pregnant or lactating women. 2) Active inflammatory breast cancer. 3) Previous treatment with other PARP inhibitor drugs, including but not limited to TSL-1502, Olaparib, Talazoparil, Fluzoparil, Nilaparib, Rucaparib, Veliparib, etc. 4) Known to be allergic to TSL-1502 or any excipient of TSL-1502 capsules. 5) Known to have active brain metastases (defined as meeting any of the following: stable neurological imaging < 4 weeks; symptoms related to brain metastasis; steroid therapy required; leptomeningeal disease); patients must have completed any prior treatment for brain metastases ≥ 4 weeks prior to the first dose.

    6) Patients with previous or current another malignancy. 7) Have other serious or uncontrollable clinical diseases or past medical history, surgical history, including but not limited to hepatic/renal dysfunction, respiratory disorders, endocrine disorders, metabolic disorders, neuropathy, or mental disorders, organ transplantation, etc.

    8) Gastrointestinal or digestive system diseases that may affect the absorption of investigational products as judged by the investigator or past medical history, such as intractable hiccups, nausea, vomiting, chronic gastrointestinal disease (e.g. Ron's disease, ulcerative colitis, active gastric ulcer, etc.), dysphagia, etc.

    9) Have serious cardiovascular system disease or past medical history (meet any of the following conditions); Definite cardiovascular abnormality within 6 months prior to first dose (e.g., myocardial infarction, cardiac arrhythmia, angina pectoris, angioplasty, vascular stent implantation, coronary artery bypass surgery, congestive heart failure, etc.); Baseline electrocardiogram QT or Fridericia-corrected QT interval (QTcF) prolongation [QTcF = QT/(RR 0.33), QTcF > 480 ms]; Left ventricular ejection fraction < 50% by cardiac ultrasound; Uncontrolled hypertension (Patients with blood pressure ≥150/100 mmHg after lifestyle improvement and medication) 10) Participated in clinical trials of other drugs or medical devices within 4 weeks prior to initial administration (note: except for those who did not use investigational drugs or medical devices).

    11) Patients who underwent major surgery or significant traumatic injury within 4 weeks prior to initial administration, or who planned to undergo major surgery in the trial period.

    12) Chemotherapy, radiotherapy, non-hormone targeted therapy, endocrine therapy, Anti-neoplastic immunotherapy [physiologic replacement doses of corticosteroids permitted (prednisone or equivalent < 15 mg/day)], Chinese medicine therapy with a clear indication for the treatment of breast cancer, or other anti-tumor therapy were received within 4 weeks prior to initial administration.

    13) AEs related to previous surgery and previous anti-tumor therapy (CTCAE version 5.0) did not recover to ≤ 1 grade (alopecia, pigmentation, platinum-induced neurotoxicity grade 2 and lower, except for clinically significant or asymptomatic laboratory abnormalities).

    14) Patients who had received a CYP2D6 liver enzyme inhibitors or inducers within 2 weeks prior to initial dosing, or who cannot discontinue the use of CYP2D6 liver enzyme inhibitors or inducers during the trial.

    15) Patients who test positive for treponema pallidum antibody, human immunodeficiency virus (HIV) antibody, hepatitis C virus (HCV) RNA, or active hepatitis B patients [defined as hepatitis B virus (HBV) DNA ≥ ULN].

    16) The investigator considered that patients have other conditions that might affect compliance or are not suitable for participating in this trial.

Sites / Locations

  • Cancer Hospital, Chinese Academy of Medical Sciences

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

TSL-1502 low dose group

TSL-1502 high dose group

Positive control group

Arm Description

TSL-1502 capsules 350 mg,qd,po

TSL-1502 capsules 500 mg,qd,po

Investigator selects chemotherapy regimens according to the subjects' conditions.

Outcomes

Primary Outcome Measures

Objective response rate(ORR)
Defined as the proportion of patients with complete response (CR) and partial response (PR). Solid tumors evaluation criteria (RECIST) version 1.1 is used for anti-tumor efficacy evaluation. For patients with PR or CR at the first evaluation, response confirmation should be performed at least 4 weeks later

Secondary Outcome Measures

Disease Control Rate(DCR)
DCR is defined as the proportion of patients with CR, PR and stable disease (SD).
Duration of Response(DOR)
DOR is defined as the time from the first assessment of CR or PR to disease progression or death due to any cause.
Progress Free Survival(PFS)
PFS is defined as the time from randomization to the first disease progression or death due to any cause, whichever occurs first. 12 Months PFS Rate is defined as the percentage of subjects without disease progression or death from any cause 12 months after the beginning of randomization or the probability estimated by Kaplan-Meier method.
Overall Survival(OS)
OS is defined as the time from randomization to death due to any cause.
12 Months PFS Rate
12 Months PFS Rate is defined as the percentage of subjects without disease progression or death from any cause 12 months after the beginning of randomization or the probability estimated by Kaplan-Meier method.
Safety endpoints
all AEs and SAEs by CTCAE v5.0

Full Information

First Posted
May 22, 2022
Last Updated
June 13, 2022
Sponsor
Jiangsu Tasly Diyi Pharmaceutical Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05420779
Brief Title
A Study to Evaluate the Efficacy and Safety of TSL-1502 Capsules in Breast Cancer Patients With Germline BRCA Mutations
Official Title
A Randomized, Parallel, Open-label, Positive Controlled Phase II Clinical Study to Evaluate the Efficacy and Safety of TSL-1502 Capsules in HER2-negative Locally Advanced or Metastatic Breast Cancer Patients With Germline BRCA Mutations
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
August 1, 2022 (Anticipated)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
June 30, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Jiangsu Tasly Diyi Pharmaceutical Co., Ltd.

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
This research study is evaluating the efficacy and safety of TSL-1502 capsules in patients with breast cancer, will be included HER2-negative locally advanced or metastatic breast cancer patients with germline BRCA mutations.
Detailed Description
Background: Breast cancer is a collective term for a variety of malignant breast tumors.According to the World Cancer Report newly released by the World Health Organization in February 2020, breast cancer ranks first in the causes of death among women due to cancer worldwide, with about 2.1 million new cases and 627,000 deaths in 2018. At present, the main treatments for breast cancer are surgery, chemotherapy, and endocrine therapy, but the therapeutic effect is limited. The 5-year survival rate for patients with advanced breast cancer is only 20%, and the overall survival (OS) is 2 ~ 3 years. Research basis: Tumor cells can activate their own DNA repair machinery to repair DNA damage caused by drugs and thus become resistant to radiotherapy and chemotherapy, while there is overexpression of DNA repair enzymes in a variety of tumor cells. Therefore, reducing the expression of DNA repair enzymes or inhibiting their activity may exert latent anti-tumor effects. Specific aims: To evaluate the objective response rate at least 4 weeks later,disease control rate,duration of response,progression-free survival and objective response rate and overall survival in patients withHER2-negative locally advanced or metastatic breast cancer patients with germline BRCA mutations. Also we plan to estimate safety endpoints and PK endpoints in this subject population. Treatment plan: Patients will be randomized in three arms. In arm A , patients will be treated with low dose TSL-1502 capsules, 350 mg each time, orally administered QD, every 3 weeks as a treatment cycle. In arm B , patients will be treated with the same interference with high dose,500 mg each time, orally administered QD, every 3 weeks as a treatment cycle. In arm B , patients will be treated with investigator's choice of chemotherapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer Metastatic

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
125 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
TSL-1502 low dose group
Arm Type
Experimental
Arm Description
TSL-1502 capsules 350 mg,qd,po
Arm Title
TSL-1502 high dose group
Arm Type
Experimental
Arm Description
TSL-1502 capsules 500 mg,qd,po
Arm Title
Positive control group
Arm Type
Active Comparator
Arm Description
Investigator selects chemotherapy regimens according to the subjects' conditions.
Intervention Type
Drug
Intervention Name(s)
TSL-1502 capsules(low dose)
Intervention Description
350 mg each time, orally administered QD, every 3 weeks as a treatment cycle.
Intervention Type
Drug
Intervention Name(s)
TSL-1502 capsules(high dose)
Intervention Description
500 mg each time, orally administered QD, every 3 weeks as a treatment cycle.
Intervention Type
Drug
Intervention Name(s)
Investigator's choice of chemotherapy
Intervention Description
Capecitabine tablets, 1250 mg/m2 each time, BID oral administration; Vinorelbine tartrate injection, 25 ~ 30 mg/m2 each time, intravenous drip (15 ~ 20 min); Eribulin mesylate injection, 1.4 mg/m2 each time, intravenous injection (2 ~ 5 min)
Primary Outcome Measure Information:
Title
Objective response rate(ORR)
Description
Defined as the proportion of patients with complete response (CR) and partial response (PR). Solid tumors evaluation criteria (RECIST) version 1.1 is used for anti-tumor efficacy evaluation. For patients with PR or CR at the first evaluation, response confirmation should be performed at least 4 weeks later
Time Frame
Radiological scans performed at baseline then every 6 weeks thereafter until objective radiological disease progression. Assessed up to a maximum of 40 months
Secondary Outcome Measure Information:
Title
Disease Control Rate(DCR)
Description
DCR is defined as the proportion of patients with CR, PR and stable disease (SD).
Time Frame
Radiological scans performed at baseline then every 6 weeks there after until disease progression or death due to any cause.Assessed up to a maximum of 40 months
Title
Duration of Response(DOR)
Description
DOR is defined as the time from the first assessment of CR or PR to disease progression or death due to any cause.
Time Frame
Radiological scans performed at baseline then every 6 weeks there after until disease progression or death due to any cause.Assessed up to a maximum of 40 months
Title
Progress Free Survival(PFS)
Description
PFS is defined as the time from randomization to the first disease progression or death due to any cause, whichever occurs first. 12 Months PFS Rate is defined as the percentage of subjects without disease progression or death from any cause 12 months after the beginning of randomization or the probability estimated by Kaplan-Meier method.
Time Frame
Radiological scans performed at baseline then every 6 weeks there after until disease progression or death due to any cause.Assessed up to a maximum of 40 months
Title
Overall Survival(OS)
Description
OS is defined as the time from randomization to death due to any cause.
Time Frame
Radiological scans performed at baseline then every 6 weeks there after until disease progression or death due to any cause.Assessed up to a maximum of 40 months
Title
12 Months PFS Rate
Description
12 Months PFS Rate is defined as the percentage of subjects without disease progression or death from any cause 12 months after the beginning of randomization or the probability estimated by Kaplan-Meier method.
Time Frame
Radiological scans performed at baseline then every 6 weeks there after until disease progression or death due to any cause.Assessed up to a maximum of 40 months
Title
Safety endpoints
Description
all AEs and SAEs by CTCAE v5.0
Time Frame
From screening until final visit.Assessed up to a maximum of 40 months
Other Pre-specified Outcome Measures:
Title
Cmax
Description
Plasma concentrations for TSL-1502 and TSL-1502M will be analyzed to determine the maximum observed concentration
Time Frame
Cycle1(Day1、Day8、Day14 and Day21)
Title
Cmin
Description
Plasma concentrations for TSL-1502 and TSL-1502M will be analyzed to determine the minimum observed concentration
Time Frame
Cycle1(Day1、Day8、Day14 and Day21)
Title
AUC0-t
Description
Plasma concentrations for TSL-1502 and TSL-1502M will be analyzed to determine the area under the curve (AUC).
Time Frame
Cycle1(Day1、Day8、Day14 and Day21)

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: 1) Agree to follow the clinical trial protocol, volunteer, and sign the informed consent form (ICF). 2) Women aged ≥ 18 years and ≤ 75 years at the date of signing the ICF. 3) HER2-locally advanced breast cancer diagnosed by histopathology and/or cytology (Unable to receive radical therapy) or metastatic breast cancer, and previous chemotherapeutic line of cytotoxicity for locally advanced or metastatic breast cancer was ≥ 1 (for triple-negative breast cancer only) and ≤ 3. 4) Prior platinum therapy is allowed, but the best response to platinum therapy is required to be CR, PR, or persistent ≥ 12 weeks SD. If given as neoadjuvant/adjuvant therapy, the time from the last dose of platinum to relapse is ≥ 6 months. 5) Hormone receptor-positive patients need to have received at least first-line of endocrine therapy for locally advanced or metastatic breast cancer but failed, or unsuitable for endocrine therapy in the judgment of the investigator. 6) In neoadjuvant, adjuvant and/or metastatic stages, the patients who have received antitumor therapy with Taxane ± Anthracycline. 7) Failure of front-line therapy (disease progression or toxicity intolerance), and the investigator judged that it was suitable to receive the systemic monotherapy (including capecitabine tablets, vinorelbine tartrate injection, eribulin mesylate injection). 8) Tested or reviewed by a third-party central laboratory to determine whether there is harmful or suspected harmful gBBRCAm in the blood. 9) At least one measurable (non-lymph node longest diameter ≥ 10 mm, lymph nodes with a minimum diameter of ≥ 15 mm, according to RECIST version 1.1 criteria) of target lesions. Note: Previously irradiated lesions cannot be used as targets lesions unless there is significant progression of the lesion. 10) The physical condition score is 0-1 according to the scale of The Eastern Cooperative Oncology Group (ECOG). 11) Expected survival ≥ 12 weeks. 12) Meet the following criteria (The use of any blood components and cell growth factors is not permitted within 2 weeks prior to initial administration): Bone marrow function: absolute neutrophil count (ANC) ≥ 1.5 × 109/L (1500/mm3); platelets ≥ 100 × 109/L (1 × 105/mm3); Hemoglobin ≥ 90 g/L; Liver function: serum bilirubin ≤ 1.5 × upper limit of normal (ULN), but except for Gilbert's syndrome patients (persistent or recurrent hyperbilirubinemia, unbound bilirubin elevation is present in the absence of evidence of hemolysis or liver pathology); patients without liver metastasis, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5×ULN; ALT and AST ≤ 5×ULN for patients with liver metastasis; Renal function: serum creatinine ≤ 1.5 × ULN, or creatinine clearance (Ccr) ≥ 50 mL/min (Calculated according to the Cockcroft-Gault formula); Cockcroft-Gault formula: female Ccr (mL/min) = 0.85 × weight (kg) × (140-age)/ [72 × creatinine (mg/dL)] Coagulation function: international normalized ratio (INR) ≤ 1.5 × ULN, activated partial thromboplastin time (APTT) ≤ 1.5 × ULN. 13) Women of childbearing age are willing to take effective contraception from signing the ICF to 6 months after the last administration of the investigational drug. Women of childbearing age must have a negative blood pregnancy test result 7 days before the first dose. Exclusion Criteria: 1) Pregnant or lactating women. 2) Active inflammatory breast cancer. 3) Previous treatment with other PARP inhibitor drugs, including but not limited to TSL-1502, Olaparib, Talazoparil, Fluzoparil, Nilaparib, Rucaparib, Veliparib, etc. 4) Known to be allergic to TSL-1502 or any excipient of TSL-1502 capsules. 5) Known to have active brain metastases (defined as meeting any of the following: stable neurological imaging < 4 weeks; symptoms related to brain metastasis; steroid therapy required; leptomeningeal disease); patients must have completed any prior treatment for brain metastases ≥ 4 weeks prior to the first dose. 6) Patients with previous or current another malignancy. 7) Have other serious or uncontrollable clinical diseases or past medical history, surgical history, including but not limited to hepatic/renal dysfunction, respiratory disorders, endocrine disorders, metabolic disorders, neuropathy, or mental disorders, organ transplantation, etc. 8) Gastrointestinal or digestive system diseases that may affect the absorption of investigational products as judged by the investigator or past medical history, such as intractable hiccups, nausea, vomiting, chronic gastrointestinal disease (e.g. Ron's disease, ulcerative colitis, active gastric ulcer, etc.), dysphagia, etc. 9) Have serious cardiovascular system disease or past medical history (meet any of the following conditions); Definite cardiovascular abnormality within 6 months prior to first dose (e.g., myocardial infarction, cardiac arrhythmia, angina pectoris, angioplasty, vascular stent implantation, coronary artery bypass surgery, congestive heart failure, etc.); Baseline electrocardiogram QT or Fridericia-corrected QT interval (QTcF) prolongation [QTcF = QT/(RR 0.33), QTcF > 480 ms]; Left ventricular ejection fraction < 50% by cardiac ultrasound; Uncontrolled hypertension (Patients with blood pressure ≥150/100 mmHg after lifestyle improvement and medication) 10) Participated in clinical trials of other drugs or medical devices within 4 weeks prior to initial administration (note: except for those who did not use investigational drugs or medical devices). 11) Patients who underwent major surgery or significant traumatic injury within 4 weeks prior to initial administration, or who planned to undergo major surgery in the trial period. 12) Chemotherapy, radiotherapy, non-hormone targeted therapy, endocrine therapy, Anti-neoplastic immunotherapy [physiologic replacement doses of corticosteroids permitted (prednisone or equivalent < 15 mg/day)], Chinese medicine therapy with a clear indication for the treatment of breast cancer, or other anti-tumor therapy were received within 4 weeks prior to initial administration. 13) AEs related to previous surgery and previous anti-tumor therapy (CTCAE version 5.0) did not recover to ≤ 1 grade (alopecia, pigmentation, platinum-induced neurotoxicity grade 2 and lower, except for clinically significant or asymptomatic laboratory abnormalities). 14) Patients who had received a CYP2D6 liver enzyme inhibitors or inducers within 2 weeks prior to initial dosing, or who cannot discontinue the use of CYP2D6 liver enzyme inhibitors or inducers during the trial. 15) Patients who test positive for treponema pallidum antibody, human immunodeficiency virus (HIV) antibody, hepatitis C virus (HCV) RNA, or active hepatitis B patients [defined as hepatitis B virus (HBV) DNA ≥ ULN]. 16) The investigator considered that patients have other conditions that might affect compliance or are not suitable for participating in this trial.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Rui Liu
Phone
02286343626
Email
liurui2@tasly.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rui Liu
Organizational Affiliation
Jiangsu Tasly Diyi Pharmaceutical Co., Ltd.
Official's Role
Study Director
Facility Information:
Facility Name
Cancer Hospital, Chinese Academy of Medical Sciences
City
Beijing
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Binghe Xu
Phone
13501028690
Email
bhxu@hotmail.com

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study to Evaluate the Efficacy and Safety of TSL-1502 Capsules in Breast Cancer Patients With Germline BRCA Mutations

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