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DZD1516 in Combination With Trastuzumab and Capecitabine, or in Combination With T-DM1, in Patients With Metastatic HER2 Positive Breast Cancer

Primary Purpose

Breast Cancer Metastatic

Status
Active
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
DZD1516 mono therapy in Part A, DZD1516 in combination with trastuzumab and/or capecitabine in Part B, DZD1516 in combination with T-DM1 in Part C
Sponsored by
Dizal Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer Metastatic

Eligibility Criteria

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

Inclusion Criteria:

  • Signed informed consent.
  • Male or female patients aged ≥ 18 years
  • histologically or cytologically confirmed HER2 positive advanced breast cancer which failed prior therapies
  • Predicted life expectancy ≥ 12 weeks.
  • ECOG performance status 0 to 1 for patients without LM, and 0 to 2 for patients with LM at the time of signing ICF
  • Adequate bone marrow reserve and organ system functions
  • For patients without CNS metastases, patients must have at least one measurable lesion according to RECIST (version 1.1)
  • For patients with Brain metastasis: Patient must have at least one measurable intracranial lesion according to modified RECIST 1.1

Exclusion Criteria:

  • Intervention with any of the following: Any investigational agents or study drugs from a previous clinical study within 4 weeks of the first dose of study treatment; Any cytotoxic chemotherapy or other anticancer drugs for the treatment of metastatic breast cancer from a previous treatment regimen within 4 weeks of the first dose of study treatment; Any intrathecal chemotherapy within 2 weeks of the first dose of study treatment;Major surgery procedure (excluding placement of vascular access), or significant traumatic injury within 4 weeks of the first dose of study treatment, or have an anticipated need for major surgery during the study; Radiotherapy with a wide field of radiation within 4 weeks or radiotherapy with a limited field of radiation for palliation within 1 week of the first dose of study treatment;
  • CNS complications that require urgent neurosurgical intervention
  • Any evidence of severe or uncontrolled systemic diseases
  • Another malignancy within 5 years prior to enrolment with the exception of adequately treated in-situ carcinoma of the cervix, uterus, basal or squamous cell carcinoma or non-melanomatous skin cancer.
  • Live vaccines within 4 weeks prior to first dose.
  • Active infections including:Tuberculosis (clinical evaluation that includes clinical history, physical examination and radiographic findings, and tuberculosis testing in line with local practice);Positive Hepatitis B surface antigen (HBsAg) or positive HCV antibodies or confirmed positive HIV test result.
  • Refractory nausea and vomiting if not controlled by supportive therapy, chronic gastrointestinal diseases, inability to swallow the formulated product or previous significant bowel resection that would preclude adequate absorption of DZD1516
  • Involvement in the planning and conduct of the study (applies to Sponsor staff or staff at the study site).
  • Judgment by the investigator that the patient should not participate in the study if the patient is unlikely to comply with study procedures, restrictions and requirements.

Sites / Locations

  • UCLA Hematology/Oncology Parkside
  • Zhejiang Cancer Hospital
  • Cancer Hospital, Fudan University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

daily dose of DZD1516

Arm Description

daily dose of DZD1516

Outcomes

Primary Outcome Measures

Incidence of adverse events (AEs) and serious adverse events (SAEs)
To investigate the safety and tolerability of DZD1516
Incidence of dose limiting toxicities (DLTs)
To investigate the safety and tolerability of DZD1516
To define maximum tolerated dose (MTD) of DZD1516 if possible (Part A only)
To investigate the safety and tolerability of DZD1516
To define Recommended Phase II Combination Dose (RP2CD) of DZD1516 in combination with trastuzumab and capecitabine (Part B only)
To investigate the safety and tolerability of DZD1516 in combination with either trastuzumab, capecitabine, or both trastuzumab and capecitabine
To define Recommended Phase II Combination Dose (RP2CD) of DZD1516 in combination with T-DM1 (Part C only)
To investigate the safety and tolerability of DZD1516 in combination with T-DM1

Secondary Outcome Measures

Drug concentrations of DZD1516 and its metabolite DZ2678 in plasma, urine and CSF
Pharmacokinetics endpoints
Maximum plasma concentration (Cmax) of DZD1516 and its metabolite DZ2678
Pharmacokinetics endpoints
Area under the plasma concentration-time curve (AUC) of DZD1516 and its metabolite DZ2678
Pharmacokinetics endpoints
Plasma concentration of capecitabine and metabolites 5-FU (Part B only)
Pharmacokinetics endpoints
Plasma Cmax of capecitabine and 5-FU (Part B only)
Pharmacokinetics endpoints
Plasma AUC of capecitabine and 5-FU (Part B only)
Pharmacokinetics endpoints
Plasma concentration of DM1 (Part C only)
Pharmacokinetics endpoints
Objective Response Rate (ORR)
To assess preliminary anti-tumor efficacy of DZD1516 as monotherapy and as combination therapy
Disease Control Rate (DCR)
To assess preliminary anti-tumor efficacy of DZD1516 as monotherapy and as combination therapy
Duration of Response (DoR)
To assess preliminary anti-tumor efficacy of DZD1516 as monotherapy and as combination therapy
Progression free survival (PFS) (Part B and Part C on)
To assess preliminary anti-tumor efficacy of DZD1516 as combination therapy
Overall survival (for patients with leptomeningeal metastasis in Part B and Part C only)
To assess preliminary anti-tumor efficacy of DZD1516 as combination therapy

Full Information

First Posted
August 3, 2020
Last Updated
September 11, 2023
Sponsor
Dizal Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT04509596
Brief Title
DZD1516 in Combination With Trastuzumab and Capecitabine, or in Combination With T-DM1, in Patients With Metastatic HER2 Positive Breast Cancer
Official Title
A Phase I, Open-Label, Multicenter Study to Investigate the Safety, Tolerability, Pharmacokinetics and Anti-tumor Activity of DZD1516 in Combination With Trastuzumab and Capecitabine, or DZD1516 in Combination With T-DM1, in Patients With Metastatic HER2 Positive (HER2+) Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 21, 2020 (Actual)
Primary Completion Date
January 2024 (Anticipated)
Study Completion Date
May 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Dizal Pharmaceuticals

4. Oversight

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

5. Study Description

Brief Summary
DZD1516 is an oral, blood brain barrier penetrable, selective HER2 tyrosine kinase inhibitor. This study is designed to evaluate the safety and tolerability of DZD1516 in patients with metastatic HER2 positive breast cancer who have progressed following prior therapy. This is the first time this drug has ever been tested in patients, and so it will help to understand what type of side effects may occur with the drug treatment. It will also measure the levels of drug in the body and assess its anti-cancer activity as monotherapy and in combination with trastuzumab and/or capecitabine, or in combination with T-DM1

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 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
23 (Actual)

8. Arms, Groups, and Interventions

Arm Title
daily dose of DZD1516
Arm Type
Experimental
Arm Description
daily dose of DZD1516
Intervention Type
Drug
Intervention Name(s)
DZD1516 mono therapy in Part A, DZD1516 in combination with trastuzumab and/or capecitabine in Part B, DZD1516 in combination with T-DM1 in Part C
Intervention Description
Part A is twice daily (except Cycle 0) oral dosing of DZD1516, starting from 50 mg. If tolerated, dose will be escalated in subsequent cohorts until MTD. Part B is twice daily oral dosing of DZD1516 in combination with capecitabine 1000 mg/m2 orally twice daily on Days 1-14 of each 21-day cycle or with trastuzumab 8 mg/kg intravenously (IV) on Day 1 of Cycle 1, followed by 6 mg/kg on Day 1 of each 21-day cycle. Part C is twice daily oral dosing of DZD1516 in combination with T-DM1 3.6 mg/kg intravenously (IV) once every 21 days
Primary Outcome Measure Information:
Title
Incidence of adverse events (AEs) and serious adverse events (SAEs)
Description
To investigate the safety and tolerability of DZD1516
Time Frame
up to approximately 1 year
Title
Incidence of dose limiting toxicities (DLTs)
Description
To investigate the safety and tolerability of DZD1516
Time Frame
21 days after the first multiple dose
Title
To define maximum tolerated dose (MTD) of DZD1516 if possible (Part A only)
Description
To investigate the safety and tolerability of DZD1516
Time Frame
21 days after the first multiple dose
Title
To define Recommended Phase II Combination Dose (RP2CD) of DZD1516 in combination with trastuzumab and capecitabine (Part B only)
Description
To investigate the safety and tolerability of DZD1516 in combination with either trastuzumab, capecitabine, or both trastuzumab and capecitabine
Time Frame
21 days after the first multiple dose
Title
To define Recommended Phase II Combination Dose (RP2CD) of DZD1516 in combination with T-DM1 (Part C only)
Description
To investigate the safety and tolerability of DZD1516 in combination with T-DM1
Time Frame
21 days after the first multiple dose
Secondary Outcome Measure Information:
Title
Drug concentrations of DZD1516 and its metabolite DZ2678 in plasma, urine and CSF
Description
Pharmacokinetics endpoints
Time Frame
up to approximately 6 months
Title
Maximum plasma concentration (Cmax) of DZD1516 and its metabolite DZ2678
Description
Pharmacokinetics endpoints
Time Frame
up to approximately 6 months
Title
Area under the plasma concentration-time curve (AUC) of DZD1516 and its metabolite DZ2678
Description
Pharmacokinetics endpoints
Time Frame
up to approximately 6 months
Title
Plasma concentration of capecitabine and metabolites 5-FU (Part B only)
Description
Pharmacokinetics endpoints
Time Frame
up to approximately 6 months
Title
Plasma Cmax of capecitabine and 5-FU (Part B only)
Description
Pharmacokinetics endpoints
Time Frame
up to approximately 6 months
Title
Plasma AUC of capecitabine and 5-FU (Part B only)
Description
Pharmacokinetics endpoints
Time Frame
up to approximately 6 months
Title
Plasma concentration of DM1 (Part C only)
Description
Pharmacokinetics endpoints
Time Frame
up to approximately 6 months
Title
Objective Response Rate (ORR)
Description
To assess preliminary anti-tumor efficacy of DZD1516 as monotherapy and as combination therapy
Time Frame
up to approximately 1 year
Title
Disease Control Rate (DCR)
Description
To assess preliminary anti-tumor efficacy of DZD1516 as monotherapy and as combination therapy
Time Frame
up to approximately 1 year
Title
Duration of Response (DoR)
Description
To assess preliminary anti-tumor efficacy of DZD1516 as monotherapy and as combination therapy
Time Frame
up to approximately 1 year
Title
Progression free survival (PFS) (Part B and Part C on)
Description
To assess preliminary anti-tumor efficacy of DZD1516 as combination therapy
Time Frame
up to approximately 1 year
Title
Overall survival (for patients with leptomeningeal metastasis in Part B and Part C only)
Description
To assess preliminary anti-tumor efficacy of DZD1516 as combination therapy
Time Frame
up to approximately 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consent. Male or female patients aged ≥ 18 years histologically or cytologically confirmed HER2 positive advanced breast cancer which failed prior therapies Predicted life expectancy ≥ 12 weeks. ECOG performance status 0 to 1 for patients without LM, and 0 to 2 for patients with LM at the time of signing ICF Adequate bone marrow reserve and organ system functions For patients without CNS metastases, patients must have at least one measurable lesion according to RECIST (version 1.1) For patients with Brain metastasis: Patient must have at least one measurable intracranial lesion according to modified RECIST 1.1 Exclusion Criteria: Intervention with any of the following: Any investigational agents or study drugs from a previous clinical study within 4 weeks of the first dose of study treatment; Any cytotoxic chemotherapy or other anticancer drugs for the treatment of metastatic breast cancer from a previous treatment regimen within 4 weeks of the first dose of study treatment; Any intrathecal chemotherapy within 2 weeks of the first dose of study treatment;Major surgery procedure (excluding placement of vascular access), or significant traumatic injury within 4 weeks of the first dose of study treatment, or have an anticipated need for major surgery during the study; Radiotherapy with a wide field of radiation within 4 weeks or radiotherapy with a limited field of radiation for palliation within 1 week of the first dose of study treatment; CNS complications that require urgent neurosurgical intervention Any evidence of severe or uncontrolled systemic diseases Another malignancy within 5 years prior to enrolment with the exception of adequately treated in-situ carcinoma of the cervix, uterus, basal or squamous cell carcinoma or non-melanomatous skin cancer. Live vaccines within 4 weeks prior to first dose. Active infections including:Tuberculosis (clinical evaluation that includes clinical history, physical examination and radiographic findings, and tuberculosis testing in line with local practice);Positive Hepatitis B surface antigen (HBsAg) or positive HCV antibodies or confirmed positive HIV test result. Refractory nausea and vomiting if not controlled by supportive therapy, chronic gastrointestinal diseases, inability to swallow the formulated product or previous significant bowel resection that would preclude adequate absorption of DZD1516 Involvement in the planning and conduct of the study (applies to Sponsor staff or staff at the study site). Judgment by the investigator that the patient should not participate in the study if the patient is unlikely to comply with study procedures, restrictions and requirements.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
McAndrew
Organizational Affiliation
UCLA Hematology/Oncology Parkside
Official's Role
Principal Investigator
Facility Information:
Facility Name
UCLA Hematology/Oncology Parkside
City
Santa Monica
State/Province
California
ZIP/Postal Code
90404
Country
United States
Facility Name
Zhejiang Cancer Hospital
City
Hangzhou
Country
China
Facility Name
Cancer Hospital, Fudan University
City
Shanghai
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

DZD1516 in Combination With Trastuzumab and Capecitabine, or in Combination With T-DM1, in Patients With Metastatic HER2 Positive Breast Cancer

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