Gedatolisib Plus Fulvestrant With or Without Palbociclib vs Standard-of-Care for the Treatment of Patients With Advanced or Metastatic HR+/HER2- Breast Cancer (VIKTORIA-1) (VIKTORIA-1)
Breast Cancer
About this trial
This is an interventional treatment trial for Breast Cancer focused on measuring Breast Cancer, Advanced or Metastatic, gedatolisib, HR Positive, ER Positive, HER2 Negative, PIK3CA MT, PI3K
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed diagnosis of metastatic or locally advanced breast cancer Adult females, pre- and/or post-menopausal, and adult males. Pre-menopausal (and peri-menopausal) women can be enrolled if amenable to treatment with an LHRH agonist. Patients are to have commenced concomitant treatment with LHRH agonist prior to or on Cycle 1, Day 1 and must be willing to continue on it for the duration of the study.
- Negative pregnancy test for women of childbearing potential. Female subjects of childbearing potential must use an effective and/or acceptable contraceptive method from screening until 1 year after the last dose of study treatment
- Confirmed diagnosis of estrogen receptor positive and/or progesterone receptor positive, as per American Society of Clinical Oncology/College of American Pathologists (ASCO-CAP) guidelines (2020), based on most recent tumor biopsy utilizing an assay consistent with local standards
- Documented HER2 immunohistochemistry (IHC) negative as per ASCO-CAP 2018 guidance
- Adequate archival or fresh tumor tissue for the analysis of PIK3CA mutational status
- Subject must have documentation of radiological disease progression on or after the last prior treatment and also have radiologically evaluable disease (measurable and/or non-measurable) according to RECIST v1.1, per local assessment. Subjects with bone only disease must have lytic or mixed lytic/blastic lesions that can be accurately assessed; bone only blastic lesions with no soft tissue component is not allowed.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-1
- Life expectancy of at least 3 months
- Progressed during or after CDK4/6 inhibitor combination treatment with non-steroidal aromatase inhibitor (AI)
- Adequate bone marrow, hepatic, renal and coagulation function
Exclusion Criteria:
- History of malignancies other than adequately treated non-melanoma skin cancer, curatively treated in situ cancer of the cervix, or other solid tumors curatively treated with no evidence of disease for ≥3 years
- Prior treatment with a phosphoinositide 3-kinase (PI3K) inhibitor, a protein kinase B (Akt) inhibitor, or a mechanistic target of rapamycin (mTOR) inhibitor
- Prior treatment with chemotherapy and antibody drug conjugates for advanced disease is not permitted (prior adjuvant or neoadjuvant chemotherapy is permitted)
- More than 2 lines of prior endocrine therapy treatment
- Bone only disease that is only blastic with no soft tissue component
- Subjects with type 1 diabetes or uncontrolled type 2 diabetes
Known and untreated, or active, brain or leptomeningeal metastases
a. Subjects with previously treated central nervous system (CNS) metastases may be enrolled in the study if they meet the following criteria: do not require supportive therapy with steroids; do not have seizures and do not exhibit uncontrolled neurological symptoms; stable disease confirmed by radiographic assessment within at least 4 weeks prior to enrollment
- Patients with advanced, symptomatic, visceral spread that are at risk of life-threatening complication in the short-term
History of clinically significant cardiovascular abnormalities such as: Congestive heart failure (New York Heart Association (NYHA) classification ≥ II within 6 months of study entry
- Myocardial infarction within 12 months of study entry
- History of any uncontrolled (or untreated) clinically significant cardiac arrhythmias, (e.g., ventricular tachycardia), complete left bundle branch block, high grade AV block (e.g., bifascicular block, Mobitz type II and third degree AV block), supraventricular, nodal arrhythmias, or conduction abnormality in the previous 12 months
- Uncontrolled hypertension defined by systolic blood pressure (SBP) ≥160 mmHg and/or diastolic blood pressure (DBP) ≥100 mmHg, with or without antihypertensive medication (initiation or adjustment of antihypertensive medication[s] is allowed prior to screening)
Long QT syndrome, family history of idiopathic sudden death or congenital long QT syndrome, or any of the following:
- i. Risk factors for Torsades de Pointes (TdP) including uncorrected hypokalemia or hypomagnesemia, or history of clinically significant/symptomatic bradycardia
- ii. On screening, inability to determine the corrected QT interval using Fridericia's formula (QTcF) on the ECG (i.e., unreadable or not interpretable) or QTcF >480 msec (determined by mean of triplicate ECGs at screening)
- Known hypersensitivity to the study drugs or their components
- Pregnant or breast-feeding women
Concurrent participation in another interventional clinical trial
- Subjects must agree not to participate in another clinical trial (other than observational) at any time during participation in VIKTORIA-1.
Sites / Locations
- University of Alabama at BirminghamRecruiting
- Arizona Oncology (US Oncology/McKesson) - GoodyearRecruiting
- St. Bernards Medical CenterRecruiting
- CARTI Cancer CenterRecruiting
- Pacific Cancer Medical Center IncRecruiting
- Kaiser Permanente South Bay Medical CenterRecruiting
- Cancer and Blood Specialty ClinicRecruiting
- Pacific Cancer CareRecruiting
- University of California, Irvine Medical CenterRecruiting
- Ventura County Hematology Oncology Specialists
- Redlands Hematology OncologyRecruiting
- UCSF Helen Diller Family Comprehensive Cancer Center
- UCLA Hematology/Oncology-Santa MonicaRecruiting
- Torrance Memorial Physician Network - Cancer CareRecruiting
- Kaiser Permanente Medical Center - VallejoRecruiting
- PIH Health Hospital WhittierRecruiting
- Yale Cancer Center - New HavenRecruiting
- South Broward Hospital District d/b/a Memorial Healthcare SystemRecruiting
- Cancer Specialists of North Florida - JacksonvilleRecruiting
- H. Lee Moffitt Cancer Center & Research InstituteRecruiting
- Bond & Steele Clinic, P.A. d/b/a Bond Clinic, P.A.Recruiting
- John D. Archbold Memorial HospitalRecruiting
- Illinois Cancer Specialists - Arlington HeightsRecruiting
- Fort Wayne Medical Oncology and HematologyRecruiting
- University of Kentucky Medical CenterRecruiting
- Mercy Health - PaducahRecruiting
- American Oncology Partners of Maryland, PARecruiting
- Maryland Oncology Hematology, P.A. - RockvilleRecruiting
- Dana Farber Cancer InstituteRecruiting
- Beth Israel Deaconess Medical CenterRecruiting
- Henry Ford HospitalRecruiting
- Nebraska Hematology - Oncology, P.C.Recruiting
- Oncology Hematology West PC dba Nebraska Cancer SpecialistsRecruiting
- University of Nebraska Medical CenterRecruiting
- New York Oncology Hematology, P.C. - AlbanyRecruiting
- Montefiore Medical CenterRecruiting
- Queens Hospital Cancer CenterRecruiting
- Coleman, Pasmantier & Decter, MDsRecruiting
- Weill Cornell Medicine/New York-Presbyterian HospitalRecruiting
- University of Rochester Medical Center
- Hematology/Oncology Associates of Central New YorkRecruiting
- White Plains HospitalRecruiting
- Cone Health Cancer Center at Alamance Regional, Hematology/OncologyRecruiting
- Southeast Regional Cancer CenterRecruiting
- University Hospitals Cleveland Medical CenterRecruiting
- The James Cancer Hospital and Solove Research InstituteRecruiting
- OU Health Stephenson Cancer CenterRecruiting
- Oregon Oncology SpecialistsRecruiting
- Northwest Cancer Specialists, PC - TigardRecruiting
- Consultants In Medical Oncology and Hematology, P.C.Recruiting
- Alliance Cancer Specialists PCRecruiting
- Cancer Care Associates of YorkRecruiting
- Sanford Gynecologic Oncology ClinicRecruiting
- Texas Oncology - AustinRecruiting
- Texas Oncology P.A. - DallasRecruiting
- Texas Oncology - Baylor Charles A. Sammons Cancer CenterRecruiting
- William Beaumont Army Medical CenterRecruiting
- Oncology ConsultantsRecruiting
- University of Texas MD Anderson Cancer CenterRecruiting
- Brooke Army Medical CenterRecruiting
- Texas Oncology - McKinneyRecruiting
- Texas Oncology - Gulf CoastRecruiting
- Texas Oncology - TylerRecruiting
- Fort Belvoir Community HospitalRecruiting
- Bon Secours St. Francis Medical Oncology CenterRecruiting
- Virginia Oncology Associates - Newport NewsRecruiting
- VCU Massey Cancer CenterRecruiting
- Oncology & Hematology Associates of Southwest Virginia, Inc., DBA Blue Ridge Cancer Care - RoanokeRecruiting
- Fred Hutchinson Cancer CenterRecruiting
- Northwest Medical Specialties, PLLC - TacomaRecruiting
- Alexander Fleming InstituteRecruiting
- Buenos Aires British HospitalRecruiting
- CENIT FoundationRecruiting
- Center for Medical Education and Clinical Research (CEMIC)Recruiting
- Fleischer Medical CenterRecruiting
- Medical Center AustralRecruiting
- Pergamino Clinic
- Cordoba Oncology Institute (IONC)Recruiting
- Center of Nuclear and Molecular Medicine of Entre Rios (CEMENER)Recruiting
- CEDIT Diagnostic and treatment centerRecruiting
- CER San JuanRecruiting
- Rosario's Oncology Institute and Medical Specialities (IOR)Recruiting
- 9 of July SanatoriumRecruiting
- Adelaide Oncology & HaematologyRecruiting
- St Vincent's Hospital (Melbourne) LtdRecruiting
- Peninsula & South Eastern Hematology and Oncology Group (PSEHOG)Recruiting
- Hollywood Private Hospital, Breast Cancer Research CentreRecruiting
- Mater Hospital Brisbane, Mater Cancer Care CentreRecruiting
- Icon Cancer Centre- SouthportRecruiting
- Sydney Adventist HospitalRecruiting
- The Queen Elizabeth HospitalRecruiting
- University Hospital Graz, Department of Gynecology and ObstetricsRecruiting
- University Hospital Innsbruck - Tyrolean Hospital, Department of Gynaecology and ObstetricsRecruiting
- Order Hospital Linz Ltd. - Hospital of Sisters of Mercy, Department of Internal Medicine IRecruiting
- Salzburg Regional Hospital, Department of Internal Medicine IIIRecruiting
- University Hospital St. Poelten, Department of Internal Medicine IRecruiting
- Hospital Hietzing, Department of GynecologyRecruiting
- Medical University Vienna, Department of Gynecology and ObstetricsRecruiting
- Saint Luc University HospitalRecruiting
- Charleroi Grand Hospital (GHDC)Recruiting
- University Hospital Antwerp (UZA)Recruiting
- AZ GroeningeRecruiting
- University Hospitals Leuven, Campus GasthuisbergRecruiting
- Citadelle Regional Hospital CenterRecruiting
- VITAZRecruiting
- Centre Hospitalier Peltzer-la-TourelleRecruiting
- UCL Mont-Godinne University HospitalsRecruiting
- Oncology Treatment CenterRecruiting
- PronutrirRecruiting
- ONCOSITE - Clinical Research Center in OncologyRecruiting
- Juiz de Fora Eurolatino Research CenterRecruiting
- Bahia Oncology CenterRecruiting
- D'OR InstituteRecruiting
- Hospital A.C.CamargoRecruiting
- Multiprofile Hospital for Active Treatment - Uni Hospital, PanagyurishteRecruiting
- MHAT for Women's Health "Nadezhda"Recruiting
- Multiprofile Hospital for Active Treatment "Serdika", SofiaRecruiting
- Specialized Hospital for Active Treatment in Oncology, Clinic of Medicial Oncology (Chemotherapy)Recruiting
- University Multiprofile Hospital for Active Treatment "Sveta Marina"Recruiting
- BC Cancer - Vancouver, Medical Oncology
- CIUSSS du Saguenay Lac St-JeanRecruiting
- Hospital Notre-Dame
- Maisonneuve-Rosemont HospitalRecruiting
- University Hospital Olomouc, Clinic of OncologyRecruiting
- Thomayer University Hospital, Clinic of OncologyRecruiting
- University Hospital Bulovka, Institute of Radiation OncologyRecruiting
- University Hospital Motol, Clinic of OncologyRecruiting
- Bergonie InstituteRecruiting
- Francois Baclesse CenterRecruiting
- La Roche-sur-Yon HospitalRecruiting
- CHU La Timone - La Timone Children's HospitalRecruiting
- University Hospital Center of PoitiersRecruiting
- Saint Anne ClinicRecruiting
- Gustave RoussyRecruiting
- Hospital BayreuthRecruiting
- Vivantes Hospital Am UrbanRecruiting
- Private Practice with Focus on OncologyRecruiting
- University Hospital Johannes Gutenberg - University of MainzRecruiting
- Hospital Suedstadt RostockRecruiting
- University Hospital MuensterRecruiting
- Caritas KlinikumRecruiting
- Helios Clinic WuppertalRecruiting
- Alexandra General HospitalRecruiting
- University General Hospital of IoanninaRecruiting
- IASO Thessaly SARecruiting
- EUROMEDICA General Clinic of ThessalonikiRecruiting
- Theageneio Anticancer Hospital of ThessalonikiRecruiting
- University of Debrecen Clinical Center, Institute of OncologyRecruiting
- Bacs-Kiskun County Hospital, Center for OncoradiologyRecruiting
- Szabolcs-Szatmar-Bereg County Hospitals and University Teaching Hospital, Department of OncologyRecruiting
- HCG Cancer Centre
- Postgraduate Institute of Medical Education and Research (PGIMER)
- Tata Medical Center
- Tata Memorial Hospital
- Christian Medical College, Department of Medical Oncology
- European Institute of Oncology (IEO), IRCCSRecruiting
- University Polyclinic Hospital of ModenaRecruiting
- Local Healthcare Company of Monza (ASST Monza)Recruiting
- University Hospital of ParmaRecruiting
- New Hospital of Prato (NOP)Recruiting
- University Hospital Campus Bio-MedicoRecruiting
- University Polyclinic Foundation "Agostino Gemelli" - IRCCSRecruiting
- Santa Maria della Misericordia University Hospital of UdineRecruiting
- Asan Medical CenterRecruiting
- Gangnam Severance HospitalRecruiting
- Korea University Anam HospitalRecruiting
- Samsung Medical CenterRecruiting
- Severance Hospital, Yonsei University Health SystemRecruiting
- Ulsan University HospitalRecruiting
- Clinical Research Center Chapultepec Mexico CityRecruiting
- CRYPTEXRecruiting
- ProcliniQ Clinical ResearchRecruiting
- Filios High MedicineRecruiting
- Administrative Society of Health Services, SCRecruiting
- Avix Clinical ResearchRecruiting
- Zambrano Hellion Medical CenterRecruiting
- InbiomedycRecruiting
- ONCOR Life Medical CenterRecruiting
- Prof. Franciszek Lukaszczyk Oncology Center in Bydgoszcz, Chemotherapy Outpatient ClinicRecruiting
- Medical Clinic "Komed"Recruiting
- Maria Sklodowska-Curie Institute of Oncology, Branch in KrakowRecruiting
- Independent Public Healthcare Facility Prof. Tadeusz Koszarowski Opole Oncology Center in Opole, Clinical Oncology Department and Day Hospitalization UnitRecruiting
- St. John Paul 2nd Mazovian Provincial Hospital in Siedlce Limited Liability Company, Siedlce Oncology CentreRecruiting
- West Pomeranian Oncology CenterRecruiting
- LUX MED Oncology LLC, Szamocka Hospital, Department of Clinical Oncology/ChemotherapyRecruiting
- Maria Sklodowska-Curie - National Research Institute of OncologyRecruiting
- Provincial Specialist Hospital in Wroclaw, Department of ChemotherapyRecruiting
- Polish Mother's Memorial Hospital-Research InstituteRecruiting
- S.C. Oncopremium-Team SRLRecruiting
- Prof. Dr. Alexandru Trestioreanu Institute of OncologyRecruiting
- Prof. Dr. Ion Chiricuta Institute of OncologyRecruiting
- Onco Clinic Consult S.A.Recruiting
- Oncology Center "Sf. Nectarie"Recruiting
- S.C. Topmed Medical Center SRLRecruiting
- Curie OncologyRecruiting
- ICON SOC Farrer Park Medical ClinicRecruiting
- OncoCare Cancer CentreRecruiting
- Raffles HospitalRecruiting
- Tan Tock Seng HospitalRecruiting
- Infanta Cristina HospitalRecruiting
- Catalan Institute of Oncology, Hospital Duran i ReynalsRecruiting
- Caceres Hospital Complex - San Pedro de Alcantara General HospitalRecruiting
- Hospital Ruber InternacionalRecruiting
- University Hospital Foundation Jimenez DiazRecruiting
- University Clinical Hospital Virgen de la Arrixaca, Department of OncologyRecruiting
- University Hospital Complex of Santiago (CHUS), Department of OncologyRecruiting
- Kaohsiung Medical University Chung-Ho Memorial HospitalRecruiting
- Taipei Medical University - Shuang Ho Hospital
- China Medical University Hospital
- National Cheng Kung University HospitalRecruiting
- National Taiwan University HospitalRecruiting
- Taipei Veterans General Hospital
- Royal United Hospital, Department of Oncology/Hematology
- Velindre Cancer Centre
- Guy's Hospital
- Royal Marsden Hospital - London, Department of Medical Oncology
- The Christie NHS Foundation Trust
- Nottingham City Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Experimental
Experimental
Active Comparator
Experimental
Active Comparator
Experimental
Arm A - Patients Lacking PIK3CA Mutations (WT)
Arm B - Patients Lacking PIK3CA Mutations (WT)
Arm C - Patients Lacking PIK3CA Mutations (WT)
Arm D - Patients with PIK3CA Mutation (MT)
Arm E - Patients with PIK3CA Mutation (MT)
Arm F - Patients with PIK3CA Mutation (MT)
Gedatolisib + Palbociclib + Fulvestrant
Gedatolisib + Fulvestrant
Fulvestrant
Gedatolisib + Palbociclib + Fulvestrant
Alpelisib + Fulvestrant
Gedatolisib + Fulvestrant