Lux-Breast 3; Afatinib Alone or in Combination With Vinorelbine in Patients With Human Epidermal Growth Factor Receptor 2 (HER2) Positive Breast Cancer Suffering From Brain Metastases
Breast Neoplasms, Neoplasm Metastasis
About this trial
This is an interventional treatment trial for Breast Neoplasms
Eligibility Criteria
Inclusion criteria:
- patients with HER2 positive breast cancer with a documented central nervous system (CNS) recurrence/progression (by imaging) during or after a HER2 inhibitor (Trastuzumab and/or Lapatinib) based therapy (no leptomeningeal carcinomatosis as the only site of CNS metastases)
- at least one measurable and progressive lesion in the brain (=10 mm on T1-weighted, gadolinium-enhanced Magnetic Resonance Imaging). Measurable or non measurable extracranial metastases allowed.
- previous treatment with HER2 inhibitors to be discontinued prior to first study treatment administration (at least 14 days for trastuzumab and other antibodies, at least 7 days for lapatinib).
- previous chemotherapy and hormonal therapy (adjuvant and metastatic regimens) allowed, but chemotherapy must have been discontinued at least 14 days and hormonal therapy at least 7 days prior to first study treatment administration.
- Patients must have recovered to baseline condition or to Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 grade = 1 from any acute CTCAE v. 3.0 grade =2 side effects of previous treatments.
- prior surgery, whole brain radiotherapy or stereotactic radiosurgery allowed provided that there is unequivocal evidence of one or more new and/or progressive brain metastases after completion of whole brain radiotherapy or stereotactic radiosurgery.
Exclusion criteria:
- Prior treatment with HER2- tyrosine kinase inhibitor other than lapatinib
- Any other current malignancy or malignancy diagnosed within the past five (5) years (other than bilateral primary breast cancer, metastases to the contralateral breast, non-melanomatous skin cancer and in situ cervical cancer).
- Significant chronic or recent acute gastrointestinal disorders with diarrhoea as a major symptom e.g. Crohn's disease, malabsorption or Common Terminology Criteria (CTC) grade =2 diarrhoea of any aetiology.
Sites / Locations
- 1200.67.10106 Boehringer Ingelheim Investigational Site
- 1200.67.10105 Boehringer Ingelheim Investigational Site
- 1200.67.10001 Boehringer Ingelheim Investigational Site
- 1200.67.10108 Boehringer Ingelheim Investigational Site
- 1200.67.10003 Boehringer Ingelheim Investigational Site
- 1200.67.10004 Boehringer Ingelheim Investigational Site
- 1200.67.11004 Boehringer Ingelheim Investigational Site
- 1200.67.11003 Boehringer Ingelheim Investigational Site
- 1200.67.11002 Boehringer Ingelheim Investigational Site
- 1200.67.35801 Boehringer Ingelheim Investigational Site
- 1200.67.35802 Boehringer Ingelheim Investigational Site
- 1200.67.35803 Boehringer Ingelheim Investigational Site
- 1200.67.33009 Boehringer Ingelheim Investigational Site
- 1200.67.33010 Boehringer Ingelheim Investigational Site
- 1200.67.33008 Boehringer Ingelheim Investigational Site
- 1200.67.33001 Boehringer Ingelheim Investigational Site
- 1200.67.33004 Boehringer Ingelheim Investigational Site
- 1200.67.33011 Boehringer Ingelheim Investigational Site
- 1200.67.33002 Boehringer Ingelheim Investigational Site
- 1200.67.33003 Boehringer Ingelheim Investigational Site
- 1200.67.33012 Boehringer Ingelheim Investigational Site
- 1200.67.33005 Boehringer Ingelheim Investigational Site
- 1200.67.49002 Boehringer Ingelheim Investigational Site
- 1200.67.49008 Boehringer Ingelheim Investigational Site
- 1200.67.49005 Boehringer Ingelheim Investigational Site
- 1200.67.49006 Boehringer Ingelheim Investigational Site
- 1200.67.49007 Boehringer Ingelheim Investigational Site
- 1200.67.49003 Boehringer Ingelheim Investigational Site
- 1200.67.49004 Boehringer Ingelheim Investigational Site
- 1200.67.39001 Boehringer Ingelheim Investigational Site
- 1200.67.39002 Boehringer Ingelheim Investigational Site
- 1200.67.82001 Boehringer Ingelheim Investigational Site
- 1200.67.82002 Boehringer Ingelheim Investigational Site
- 1200.67.82003 Boehringer Ingelheim Investigational Site
- 1200.67.82004 Boehringer Ingelheim Investigational Site
- 1200.67.34002 Boehringer Ingelheim Investigational Site
- 1200.67.34006 Boehringer Ingelheim Investigational Site
- 1200.67.34005 Boehringer Ingelheim Investigational Site
- 1200.67.34003 Boehringer Ingelheim Investigational Site
- 1200.67.34004 Boehringer Ingelheim Investigational Site
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Active Comparator
arm A: Afatinib monotherapy
arm B: Afatinib in combination with vino
arm C: investigator's choice of treatmen
Afatinib monotherapy: starting dose 40 mg per day, continuous treatment in a 3-weekly course. If well tolerated, the dose may be escalated to 50 mg.
Afatinib 40 mg per day, continuous treatment, in combination with vinorelbine Vinorelbine 25 mg/m² on days 1, 8, 15 in a 3-weekly course.
Patients will receive, at the investigator's discretion, the most appropriate medical treatment consisting of single agent or combination regimen approved for the treatment of metastatic breast cancer, and according to patient status and local guidelines.