Clinical Trial to Assess Efficacy and Safety of NNG-TMAB (Trastuzumab) on Recurrent or Metastatic Breast Cancer Patients
Primary Purpose
Breast Cancer Metastatic, Breast Cancer Recurrent, Breast Cancer Female
Status
Completed
Phase
Phase 3
Locations
Vietnam
Study Type
Interventional
Intervention
Faceptor
Herceptin
Docetaxel
Sponsored by

About this trial
This is an interventional treatment trial for Breast Cancer Metastatic
Eligibility Criteria
Inclusion Criteria:
- Female patients from 18 to 65 years old.
- Willing to give written and signed informed consent.
- Have pathologically or cytologically confirmed breast cancer.
- Inoperable, recurrent or metastatic breast cancer according to TNM classification and investigator' s assessment.
- Presence of at least 1 tumour with a size not less than 1 cm (revealed with computed tomography (CT) slice thickness not more than 5 mm). Patients having bone metastasis as the only measurable tumour are not eligible for the trial.
- Grade 3+ HER2 overexpression confirmed by immunohistochemical (IHC) staining or grade 2+ HER2 overexpression accompanied by HER2 gene amplification confirmed by fluorescent hybridization in situ (FISH).
- Eastern Cooperative oncology group performance status ≤ 2
- Willing to comply the requirements of the study protocol.
- Have a survival expectancy of at least 6 months.
- At screening period: Hb ≥ 9 g/dL; Neutrophils ≥ 1,5x10^9/L; platelets ≥ 100x10^9/L; creatinine level ≤ 1,5 x upper limit of normal (ULN); bilirubin level < 1,5 x ULN; ALT/AST < 2,5 x ULN (< 5 x ULN for patients with liver metastases), ALP < 5 x ULN.
- Patients of childbearing potential and her partner must implement reliable contraceptive measures during the study treatment, starting 4 weeks prior to inclusion into the trial and until 6 months after the last administration of the study drug
Exclusion Criteria:
- Previous anticancer therapy for metastatic BC, including previous anticancer therapy with signal transduction inhibitors (e.g. lapatinib), biological drugs (e.g. trastuzumab, bevacizumab), experimental (not approved for BC therapy) anticancer drugs. Any previous chemotherapy or hormonal therapy is allowed.
- Previously treated with doxorubicin > 400 mg/m2; epirubicin > 800 mg/m2 in accumulative dosages.
- Surgery, radiation therapy, use of any experimental medications within 4 weeks prior to randomization.
- Clinical evidence or X-ray show that breast cancer metastases in central nervous system
- Patients with metastatic tumor to the bone is the only tumor to be measured
- Systolic blood pressure >150mmHg and/or diastolic blood pressure >100mmHg. Uncontrolled hypertension comprising all cases of arterial hypertension when no decrease in blood pressure could be achieved despite treatment with a combination of 3 antihypertensive drugs including one diuretic and non-medicamental correction methods (low salt diet, physical exercise)
- Cardiovascular system pathology (congestive heart failure (CHF) stage III-IV according to New York Heart Association (NYHA) classification, unstable angina pectoris, myocardial infarction) within 12 months prior to randomization. LVEF < 50% according to echocardiogram when screening.
- Acute or chronic infection (except for acute or chronic infection that is stable and does not affect the study evaluation). Infecting HIV, HBV or HCV, Syphilis
- Patients with a history of severe allergic reaction to trastuzumab, paclitaxel, docetaxel or other ingredients in the formulation
- The patient has evidence of a serious illness (such as resting dyspnea or severe lung disease, etc.) or an abnormal laboratory test that, in the judgment of the researcher, will affect participation. research and completion of patient research, or may affect the patient's response evaluation.
- Pregnancy, intend to get pregnant, lactation
Sites / Locations
- 19-8 Hospital
- HCMC Oncology Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Faceptor + Docetacel
Herceptin + Docetacel
Arm Description
Patients received a loading dose of Faceptor 8 mg/kg IV + docetaxel 75 mg/m^2 IV on Cycle 1 followed by Faceptor 6 mg/kg IV + docetaxel 75 mg/m^2 IV on the next 5 cycles (each cycle is 21 days)
Patients received a loading dose of Herceptin 8 mg/kg IV + docetaxel 75 mg/m^2 IV on Cycle 1 followed by Herceptin 6 mg/kg IV + docetaxel 75 mg/m^2 IV on the next 5 cycles (each cycle is 21 days)
Outcomes
Primary Outcome Measures
Overall Response Rate (ORR) according to RECIST 1.1 after 6 cycles
ORR includes Complete Response Rate and Partial Response Rate. ORR will be independently evaluated by an Independent Tumor Evaluation Board (ITEB).
Overall Response Rate (ORR) according to RECIST 1.1 at the end of study
ORR includes Complete Response Rate and Partial Response Rate. ORR will be independently evaluated by an Independent Tumor Evaluation Board (ITEB).
Secondary Outcome Measures
Progressive Disease Rate (PDR) according to RECIST 1.1
Progressive Disease Rate (PDR). PDR will be independently evaluated by an Independent Tumor Evaluation Board (ITEB).
Stable Disease Rate (SDR) according to RECIST 1.1
Stable Disease Rate (SDR). SDR will be independently evaluated by an Independent Tumor Evaluation Board (ITEB).
Progression-free survival (PFS) according to RECIST 1.1
Progression-free survival (PFS) was defined as the time between the date patient signed the Informed Consent Form (ICF) and the date of disease progression or death from any cause.
Evaluate the patient's quality of life
Quality of life of patients according to the EORTC QLQ-C30 questionnaire combined with EORTC QLQ-BR23 at week 24. All scores were linearly transformed to a 0 to 100 scale, according to international guidelines before assessment. A high or healthy level of functioning is represented by a high functional score. A high QOL is represented by a high score for global health status or QOL. More severe symptoms or problems are represented by high symptom scores or items.
(i) EORTC QLQ-C30: is designed to measure cancer patients' physical, psychological and social functions.
(ii) EORTC QLQ-BR23: is a breast-specific module that comprises of 23 questions.
Anti-drug antibody evaluation
Percentage of participants with positive Anti-drug antibody
Rate of AE and SAE occurence
Frequency of adverse events, including clinical examination, vital signs and laboratory tests
Full Information
NCT ID
NCT05301010
First Posted
March 17, 2022
Last Updated
February 23, 2023
Sponsor
Nanogen Pharmaceutical Biotechnology Joint Stock Company
Collaborators
Vietstar Biomedical Research, MedProve Inc
1. Study Identification
Unique Protocol Identification Number
NCT05301010
Brief Title
Clinical Trial to Assess Efficacy and Safety of NNG-TMAB (Trastuzumab) on Recurrent or Metastatic Breast Cancer Patients
Official Title
Randomized, Single-blind, Multicenter, Parallel Group Clinical Trial to Assess Efficacy and Safety of NNG-TMAB (Trastuzumab) in Combination With Docetaxel on Recurrent or Metastatic Breast Cancer Patients With Positive HER2
Study Type
Interventional
2. Study Status
Record Verification Date
January 2023
Overall Recruitment Status
Completed
Study Start Date
February 2, 2018 (Actual)
Primary Completion Date
February 19, 2021 (Actual)
Study Completion Date
February 19, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Nanogen Pharmaceutical Biotechnology Joint Stock Company
Collaborators
Vietstar Biomedical Research, MedProve Inc
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Targeted therapy in the treatment of breast cancer targets HER2 receptor (Human Epidermal growth factor Receptor). HER2 receptor plays an important role in cell growth and differentiation (5). However, when HER2 overexpresses, it may lead to cancer. HER2 positive malignance exacerbates pathology and worsens clinical outcome, such as shortened overall survival (OS) compared with non-HER2 overexpression patients (6), (7). About 20-30% overexpression HER2/neogene breast cancer patients and patients having HER2 overexpression tumor have disease progression and poor prognosis in metastatic process (8), (9).
Currently, targeted therapeutic, which attaches to the HER2 receptor, inhibiting the growth of cancer cells has been approved. One of these products is Trastuzumab.
The study processed on 128 females aged between 18 and 65, recurrent or metastatic breast cancer patients with positive HER2.
The subjects were randomly distributed in 2 groups as NNG-TMAB + docetaxel or Herceptin® + docetaxel, in blocks of 4 in a 1: 1 ratio (NNG-TMAB: Herceptin®). In each block of 4 will be 2 patients in the experimental group and 2 patients in the control group
Primany endpoints is Overall Response Rate (ORR) according to RECIST 1.1. ORR includes Complete Response Rate and Partial Response Rate. ORR will be independently evaluated by an Independent Tumor Evaluation Board (ITEB).
This trial is intended to assess the biosimilarity of efficacy and safety between NNG-TMAB (Trastuzumab) and Herceptin® in combination with Docetaxel on recurrent or metastatic breast cancer patients with positive HER2.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer Metastatic, Breast Cancer Recurrent, Breast Cancer Female
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Two group: study drug and reference
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
128 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Faceptor + Docetacel
Arm Type
Experimental
Arm Description
Patients received a loading dose of Faceptor 8 mg/kg IV + docetaxel 75 mg/m^2 IV on Cycle 1 followed by Faceptor 6 mg/kg IV + docetaxel 75 mg/m^2 IV on the next 5 cycles (each cycle is 21 days)
Arm Title
Herceptin + Docetacel
Arm Type
Active Comparator
Arm Description
Patients received a loading dose of Herceptin 8 mg/kg IV + docetaxel 75 mg/m^2 IV on Cycle 1 followed by Herceptin 6 mg/kg IV + docetaxel 75 mg/m^2 IV on the next 5 cycles (each cycle is 21 days)
Intervention Type
Drug
Intervention Name(s)
Faceptor
Other Intervention Name(s)
NNG-TMAB, Trastazumab
Intervention Description
NNG-TMAB (trastuzumab) 150 mg, 440 mg, lyophilized power for injection, manufacturered by Nanogen Pharmaceutical Biotechnology JSC.
Intervention Type
Drug
Intervention Name(s)
Herceptin
Other Intervention Name(s)
Trastazumab
Intervention Description
Herceptin (trastuzumab) 150mg, 440mg, powder for concentrate for solution, manufactured by Roche.
Intervention Type
Drug
Intervention Name(s)
Docetaxel
Other Intervention Name(s)
Taxotere
Intervention Description
The drug Docetaxel in this study has the brand name Taxotere manufactured by Sanofi company.
Primary Outcome Measure Information:
Title
Overall Response Rate (ORR) according to RECIST 1.1 after 6 cycles
Description
ORR includes Complete Response Rate and Partial Response Rate. ORR will be independently evaluated by an Independent Tumor Evaluation Board (ITEB).
Time Frame
at the end of cycle 6 (each cycle is 21 days)
Title
Overall Response Rate (ORR) according to RECIST 1.1 at the end of study
Description
ORR includes Complete Response Rate and Partial Response Rate. ORR will be independently evaluated by an Independent Tumor Evaluation Board (ITEB).
Time Frame
baseline through end of study (up to 128 days)
Secondary Outcome Measure Information:
Title
Progressive Disease Rate (PDR) according to RECIST 1.1
Description
Progressive Disease Rate (PDR). PDR will be independently evaluated by an Independent Tumor Evaluation Board (ITEB).
Time Frame
PDR will be evaluated every 3 cycles (each cycle is 21 days) through the end of study (up to 128 days)
Title
Stable Disease Rate (SDR) according to RECIST 1.1
Description
Stable Disease Rate (SDR). SDR will be independently evaluated by an Independent Tumor Evaluation Board (ITEB).
Time Frame
SDR will be evaluated every 3 cycles (each cycle is 21 days) through the end of study (up to 128 days)
Title
Progression-free survival (PFS) according to RECIST 1.1
Description
Progression-free survival (PFS) was defined as the time between the date patient signed the Informed Consent Form (ICF) and the date of disease progression or death from any cause.
Time Frame
Baseline up to disease progression or death due to any cause, whichever occurs first (up to 128 days (6 cycles - each cycle is 21 days))
Title
Evaluate the patient's quality of life
Description
Quality of life of patients according to the EORTC QLQ-C30 questionnaire combined with EORTC QLQ-BR23 at week 24. All scores were linearly transformed to a 0 to 100 scale, according to international guidelines before assessment. A high or healthy level of functioning is represented by a high functional score. A high QOL is represented by a high score for global health status or QOL. More severe symptoms or problems are represented by high symptom scores or items.
(i) EORTC QLQ-C30: is designed to measure cancer patients' physical, psychological and social functions.
(ii) EORTC QLQ-BR23: is a breast-specific module that comprises of 23 questions.
Time Frame
At week 24th
Title
Anti-drug antibody evaluation
Description
Percentage of participants with positive Anti-drug antibody
Time Frame
At baseline,after 3 cycles of treatment, after 6 cycles of treatment (each cycle is 21 days)
Title
Rate of AE and SAE occurence
Description
Frequency of adverse events, including clinical examination, vital signs and laboratory tests
Time Frame
up to 128 days (6 cycles - each cycle is 21 days)
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Female patients from 18 to 65 years old.
Willing to give written and signed informed consent.
Have pathologically or cytologically confirmed breast cancer.
Inoperable, recurrent or metastatic breast cancer according to TNM classification and investigator' s assessment.
Presence of at least 1 tumour with a size not less than 1 cm (revealed with computed tomography (CT) slice thickness not more than 5 mm). Patients having bone metastasis as the only measurable tumour are not eligible for the trial.
Grade 3+ HER2 overexpression confirmed by immunohistochemical (IHC) staining or grade 2+ HER2 overexpression accompanied by HER2 gene amplification confirmed by fluorescent hybridization in situ (FISH).
Eastern Cooperative oncology group performance status ≤ 2
Willing to comply the requirements of the study protocol.
Have a survival expectancy of at least 6 months.
At screening period: Hb ≥ 9 g/dL; Neutrophils ≥ 1,5x10^9/L; platelets ≥ 100x10^9/L; creatinine level ≤ 1,5 x upper limit of normal (ULN); bilirubin level < 1,5 x ULN; ALT/AST < 2,5 x ULN (< 5 x ULN for patients with liver metastases), ALP < 5 x ULN.
Patients of childbearing potential and her partner must implement reliable contraceptive measures during the study treatment, starting 4 weeks prior to inclusion into the trial and until 6 months after the last administration of the study drug
Exclusion Criteria:
Previous anticancer therapy for metastatic BC, including previous anticancer therapy with signal transduction inhibitors (e.g. lapatinib), biological drugs (e.g. trastuzumab, bevacizumab), experimental (not approved for BC therapy) anticancer drugs. Any previous chemotherapy or hormonal therapy is allowed.
Previously treated with doxorubicin > 400 mg/m2; epirubicin > 800 mg/m2 in accumulative dosages.
Surgery, radiation therapy, use of any experimental medications within 4 weeks prior to randomization.
Clinical evidence or X-ray show that breast cancer metastases in central nervous system
Patients with metastatic tumor to the bone is the only tumor to be measured
Systolic blood pressure >150mmHg and/or diastolic blood pressure >100mmHg. Uncontrolled hypertension comprising all cases of arterial hypertension when no decrease in blood pressure could be achieved despite treatment with a combination of 3 antihypertensive drugs including one diuretic and non-medicamental correction methods (low salt diet, physical exercise)
Cardiovascular system pathology (congestive heart failure (CHF) stage III-IV according to New York Heart Association (NYHA) classification, unstable angina pectoris, myocardial infarction) within 12 months prior to randomization. LVEF < 50% according to echocardiogram when screening.
Acute or chronic infection (except for acute or chronic infection that is stable and does not affect the study evaluation). Infecting HIV, HBV or HCV, Syphilis
Patients with a history of severe allergic reaction to trastuzumab, paclitaxel, docetaxel or other ingredients in the formulation
The patient has evidence of a serious illness (such as resting dyspnea or severe lung disease, etc.) or an abnormal laboratory test that, in the judgment of the researcher, will affect participation. research and completion of patient research, or may affect the patient's response evaluation.
Pregnancy, intend to get pregnant, lactation
Facility Information:
Facility Name
19-8 Hospital
City
Hanoi
Country
Vietnam
Facility Name
HCMC Oncology Hospital
City
Ho Chi Minh City
Country
Vietnam
12. IPD Sharing Statement
Plan to Share IPD
No
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Clinical Trial to Assess Efficacy and Safety of NNG-TMAB (Trastuzumab) on Recurrent or Metastatic Breast Cancer Patients
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