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Durvalumab With Trastuzumab and Pertuzumab in HER2-Enriched Breast Cancer (DTP)

Primary Purpose

Breast Cancer

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Durvalumab
Trastuzumab
Pertuzumab
Sponsored by
The Methodist Hospital Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Female aged >18 years at the time of study entry.
  2. Histologically confirmed HER2-enriched (by BluePrint) and HER2-amplified (ERBB2 mRNA >7.5-10) breast cancer.
  3. Estrogen receptor and progesterone receptor negative.
  4. Stage I or II disease.
  5. Node-negative breast cancer according to the American Joint Committee on Cancer 7th Edition.
  6. T2 disease.
  7. Bilateral breast cancers that individually meet eligibility criteria are allowed.
  8. Eastern Cooperative Oncology Group performance status of 0 or 1.
  9. Adequate organ and marrow function.
  10. Baseline left ventricular ejection fraction greater than or equal to 50%, as measured by multigated acquisition scan or echocardiogram.
  11. Evidence of postmenopausal status or negative serum pregnancy test for premenopausal patients. Negative serum beta-human chorionic gonadotropin pregnancy test within 7 days prior to the first dose of study treatment for premenopausal patients.
  12. Willing to provide biopsy tissues as required by the study.
  13. Willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations including follow-up.

Exclusion Criteria:

  1. Participation in another clinical study with an investigational product within 28 days prior to the first dose of study treatment.
  2. Concurrent enrollment in another clinical study, unless it is an observational (non-interventional) clinical study or during the follow-up period of an interventional study.
  3. Unresolved or unstable adverse events from prior administration of another investigational drug.
  4. Any concurrent chemotherapy, radiation therapy, immunotherapy, or biologic therapy for cancer treatment.
  5. Major surgical procedure (as defined by the investigator) within 28 days prior to the first dose of study treatment.
  6. History of allogenic organ transplantation.
  7. Active or prior documented autoimmune or inflammatory disorders.
  8. Uncontrolled intercurrent illness including but not limited to ongoing or active infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris, cardiac arrhythmia, interstitial lung disease, serious chronic gastrointestinal conditions associated with diarrhea, or psychiatric illness/social situations that would limit compliance with study requirements, substantially increase the risk of incurring adverse events, or compromise the ability of the patient to give written informed consent.
  9. History of another primary malignancy except for: malignancy treated with curative intent and with no known active disease for more than 5 years before the first dose of study treatment and of low potential risk for recurrence.
  10. History of active primary immunodeficiency.
  11. Active infection including tuberculosis, hepatitis B, hepatitis C, or human immunodeficiency virus.
  12. Current or prior use of immunosuppressive medication within 14 days prior to the first dose of study treatment.
  13. Receipt of live attenuated vaccine within 30 days prior to the first dose of study treatment.
  14. Patients who are pregnant or breastfeeding or patients of reproductive potential who are not willing to employ effective birth control from screening to 7 months after the last dose of study treatment.
  15. Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients.

Sites / Locations

  • Houston Methodist Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Durvalumab + Trastuzumab + Pertuzumab

Arm Description

Durvalumab, trastuzumab, and pertuzumab will be administered on Day 1 every 3 weeks for 6 cycles. Trastuzumab will be administered as 8 mg/kg intravenous (IV) loading dose, followed by 6 mg/kg IV. Pertuzumab will be administered as 840 mg IV loading dose, followed by 420 mg. Durvalumab will be administered at a fixed dose of 1120 mg IV.

Outcomes

Primary Outcome Measures

Pathological complete response (pCR) rate in the breast in patients with HER2-enriched and HER2-amplified breast cancer
Determine pCR rate in the breast in patients with HER2-enriched and HER2-amplified breast cancer

Secondary Outcome Measures

pCR rate in the breast in patients whose tumors have <5% and ≥5% tumor-infiltrating lymphocytes (TILs)
Determine pCR rate in the breast in patients whose tumors have <5% and ≥5% TILs
pCR rate in patients with programmed cell death-ligand 1 (PD-L1)-positive and PD-L1-negative tumors
Determine pCR rate in the breast in patients with PD-L1-positive and PD-L1-negative tumors
Three-year disease-free survival (DFS) rate in patients who achieve pCR
Determination of 3-year DFS rate in patients who achieve pCR
Number of participants with treatment-related adverse events
Number of participants with treatment-related adverse events, as assessed by the National Cancer Institute Common Terminology Criteria for Adverse Events v5.0

Full Information

First Posted
January 25, 2019
Last Updated
September 15, 2023
Sponsor
The Methodist Hospital Research Institute
Collaborators
AstraZeneca
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1. Study Identification

Unique Protocol Identification Number
NCT03820141
Brief Title
Durvalumab With Trastuzumab and Pertuzumab in HER2-Enriched Breast Cancer
Acronym
DTP
Official Title
Multicenter Phase II Trial of Durvalumab (MEDI4736) With Trastuzumab and Pertuzumab Combination in HER2-Enriched and HER2-Amplified Breast Cancer (DTP Trial)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 3, 2020 (Actual)
Primary Completion Date
September 2024 (Anticipated)
Study Completion Date
February 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The Methodist Hospital Research Institute
Collaborators
AstraZeneca

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this research study is to test the safety and effectiveness of using durvalumab with trastuzumab and pertuzumab in participants with human epidermal growth factor receptor 2 (HER2)-enriched breast cancer.
Detailed Description
The purpose of this research study is to test the safety and effectiveness of using durvalumab with trastuzumab and pertuzumab in participants with HER2-enriched breast cancer. The standard or usual pre-surgery treatment for this type of disease are drugs called trastuzumab and pertuzumab that target HER2. Studies have shown that trastuzumab and pertuzumab treatment can stimulate the body's own immune system to attack cancer cells. Durvalumab is a drug that also activates the immune system. The use of durvalumab together with trastuzumab and pertuzumab treatment may allow the immune system to work harder to kill cancer cells.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
39 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Durvalumab + Trastuzumab + Pertuzumab
Arm Type
Experimental
Arm Description
Durvalumab, trastuzumab, and pertuzumab will be administered on Day 1 every 3 weeks for 6 cycles. Trastuzumab will be administered as 8 mg/kg intravenous (IV) loading dose, followed by 6 mg/kg IV. Pertuzumab will be administered as 840 mg IV loading dose, followed by 420 mg. Durvalumab will be administered at a fixed dose of 1120 mg IV.
Intervention Type
Drug
Intervention Name(s)
Durvalumab
Other Intervention Name(s)
IMFINZI, MEDI4736
Intervention Description
programmed cell death-ligand 1 inhibitor
Intervention Type
Drug
Intervention Name(s)
Trastuzumab
Other Intervention Name(s)
Herceptin
Intervention Description
anti-HER2 monoclonal antibody
Intervention Type
Drug
Intervention Name(s)
Pertuzumab
Other Intervention Name(s)
Perjeta
Intervention Description
anti-HER2 monoclonal antibody
Primary Outcome Measure Information:
Title
Pathological complete response (pCR) rate in the breast in patients with HER2-enriched and HER2-amplified breast cancer
Description
Determine pCR rate in the breast in patients with HER2-enriched and HER2-amplified breast cancer
Time Frame
18 weeks
Secondary Outcome Measure Information:
Title
pCR rate in the breast in patients whose tumors have <5% and ≥5% tumor-infiltrating lymphocytes (TILs)
Description
Determine pCR rate in the breast in patients whose tumors have <5% and ≥5% TILs
Time Frame
18 weeks
Title
pCR rate in patients with programmed cell death-ligand 1 (PD-L1)-positive and PD-L1-negative tumors
Description
Determine pCR rate in the breast in patients with PD-L1-positive and PD-L1-negative tumors
Time Frame
18 weeks
Title
Three-year disease-free survival (DFS) rate in patients who achieve pCR
Description
Determination of 3-year DFS rate in patients who achieve pCR
Time Frame
3 years
Title
Number of participants with treatment-related adverse events
Description
Number of participants with treatment-related adverse events, as assessed by the National Cancer Institute Common Terminology Criteria for Adverse Events v5.0
Time Frame
18 weeks

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Female aged >18 years at the time of study entry. Histologically confirmed HER2-enriched (by BluePrint) and HER2-amplified (ERBB2 mRNA >7.5-10) breast cancer. Estrogen receptor and progesterone receptor negative. Primary tumor greater than 1 cm diameter, measured by clinical examination and mammography or echography. Any nodal status Bilateral breast cancers that individually meet eligibility criteria are allowed. Eastern Cooperative Oncology Group performance status of 0 or 1. Adequate organ and marrow function. Baseline left ventricular ejection fraction greater than or equal to 50%, as measured by multigated acquisition scan or echocardiogram. Evidence of postmenopausal status or negative serum pregnancy test for premenopausal patients. Negative serum beta-human chorionic gonadotropin pregnancy test within 7 days prior to the first dose of study treatment for premenopausal patients. Willing to provide biopsy tissues as required by the study. Willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations including follow-up. Exclusion Criteria: Participation in another clinical study with an investigational product within 28 days prior to the first dose of study treatment. Concurrent enrollment in another clinical study, unless it is an observational (non-interventional) clinical study or during the follow-up period of an interventional study. Unresolved or unstable adverse events from prior administration of another investigational drug. Any concurrent chemotherapy, radiation therapy, immunotherapy, or biologic therapy for cancer treatment. Major surgical procedure (as defined by the investigator) within 28 days prior to the first dose of study treatment. History of allogenic organ transplantation. Active or prior documented autoimmune or inflammatory disorders. History of active primary immunodeficiency. Active infection including tuberculosis, hepatitis B, hepatitis C, or human immunodeficiency virus. Current or prior use of immunosuppressive medication within 14 days prior to the first dose of study treatment. Receipt of live attenuated vaccine within 30 days prior to the first dose of study treatment. Patients who are pregnant or breastfeeding or patients of reproductive potential who are not willing to employ effective birth control from screening to 7 months after the last dose of study treatment. Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients. Patients with a mean QT interval of greater than or equal to 470ms calculated from 3 EKGs Patients with underlying cardiovascular conditions that have recently undergone interventions including: cardiac ventricular arrhythmia requiring medication, history of second or third degree AV blocks, myocardial infarction with the previous year, congestive heart failure, and unstable angina Patients with a LVEF less than 50%
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Houston Methodist Cancer Center
Phone
713-441-0629
Email
ccresearch@houstonmethodist.org
First Name & Middle Initial & Last Name or Official Title & Degree
Jenny Chang, M.D.
Phone
713-441-0629
Email
ccresearch@houstonmethodist.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jenny Chang, M.D.
Organizational Affiliation
Houston Methodist Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Houston Methodist Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jenny C Chang, MD
Phone
713-441-0629
Email
ccresearch@houstonmethodist.org

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Durvalumab With Trastuzumab and Pertuzumab in HER2-Enriched Breast Cancer

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