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P2 Clinical Efficacy & Safety Study of V-111 Monotherapy & Sacituzumab Govitecan-hziy/V-111 Combo Therapy for mTNBC . (VERU-111)

Primary Purpose

Metastatic Triple Negative Breast Cancer

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Sabizabulin
Sacituzumab Govitecan-hziy
Sabizabulin/Sacituzumab govitecan-hziy Combo
Sponsored by
Veru Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Triple Negative Breast Cancer

Eligibility Criteria

18 Years - 100 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Provide informed consent
  • Be able to communicate effectively with the study personnel
  • Aged ≥18 years
  • For Female Subjects
  • Menopausal status Be postmenopausal as defined by the National Comprehensive Cancer

Network as either:

  • Age ≥55 years and one year or more of amenorrhea
  • Age <55 years and one year or more of amenorrhea, with an estradiol assay <20 pg/mL
  • Age <55 years and surgical menopause with bilateral oophorectomy Be premenopausal or perimenopausal with a negative urine pregnancy test. If subject is of child-bearing potential, the subject must agree to use acceptable methods of contraception:
  • If female study participant could become pregnant, use acceptable methods of contraception from the time of the first administration of study medication until 6 months following administration of the last dose of study medication. Acceptable methods of contraception are as follows: Condom with spermicidal foam/gel/film/cream/suppository [i.e., barrier method of contraception], surgical sterilization of male partner (vasectomy with documentation of azoospermia) and a barrier method {condom used with spermicidal foam/gel/film/cream/suppository}
  • If female study participant has undergone documented tubal ligation (female sterilization), a barrier method (condom used with spermicidal foam/gel/film/cream/suppository) should also be used
  • If female study participant has undergone documented placement of an intrauterine device (IUD) or intrauterine system (IUS), a barrier method (condom with spermicidal foam/gel/film/cream/suppository) should also be used
  • For Male Subjects
  • Subject must agree to use acceptable methods of contraception:

If the study subject's partner could become pregnant, use acceptable methods of contraception from the time of the first administration of study medication until 6 months following administration of the last dose of study medication. Acceptable methods of contraception are as follows: Condom with spermicidal foam/gel/film/cream/suppository [i.e., barrier method of contraception], surgical sterilization (vasectomy with documentation of azoospermia) and a barrier method {condom used with spermicidal foam/gel/film/cream/suppository}, the female partner uses oral contraceptives (combination estrogen/progesterone pills), injectable progesterone or subdermal implants and a barrier method (condom used with spermicidal foam/gel/film/cream/suppository)

  • If female partner of a study subject has undergone documented tubal ligation (female sterilization), a barrier method (condom used with spermicidal foam/gel/film/cream/suppository) should also be used
  • If female partner of a study subject has undergone documented placement of an intrauterine device (IUD) or intrauterine system (IUS), a barrier method (condom with spermicidal foam/gel/film/cream/suppository) should also be used
  • If female partner of a study subject has undergone documented placement of an intrauterine device (IUD) or intrauterine system (IUS), a barrier method (condom with spermicidal foam/gel/film/cream/suppository) should also be used
  • Eastern Cooperative Oncology Group (ECOG) performance status of ≤2
  • Histologically or cytologically confirmed TNBC based on the most recent analyzed biopsy or other pathology specimen. Triple negative defined as <1% expression for estrogen receptor (ER) and progesterone receptor (PR) and negative for human epidermal growth factor receptor 2 (HER2) by in-situ hybridization.
  • Measurable disease is required as per RECIST 1.1 confirmed by BICR (NOTE: Bone only metastatic disease is acceptable but requires a measurable component).
  • Refractory to or relapsed after at least two prior standard chemotherapy regimens for advanced/metastatic TNBC and have not received Sacituzumab govitecan-hziy.
  • At least 2 weeks beyond prior anti-cancer treatment (chemotherapy, radiotherapy, and/or major surgery), and recovered from all acute toxicities to Grade 1 or less (except alopecia and peripheral neuropathy).
  • At least 2 weeks beyond high dose systemic corticosteroids (however, low dose corticosteroids < 20 mg prednisone or equivalent daily are permitted).
  • Adequate hematology without ongoing transfusional support (hemoglobin > 9 g/dL, ANC > 1,500 per mm3, platelets > 100,000 per mm3).
  • Adverse events at study entry < Grade 1 by NCI CTCAE v5.0 (Patients with ≤ Grade 2 neuropathy and any grade of alopecia are eligible).
  • Patients with treated, non-progressive brain metastases, off high-dose steroids (>20 mg prednisone or equivalent) for at least 4 weeks can be enrolled in the trial.
  • Subject is willing to comply with the requirements of the protocol through the end of the study.

Exclusion Criteria:

  • Women who are pregnant or lactating
  • Women of childbearing potential or fertile men with a female partner of childbearing potential not willing to use effective contraction during the study and 6 months after last dose of study drug for the women of childbearing potential participating in the study and for 3 months after last dose of study drug in fertile men with a female partner of childbearing potential.
  • Known hypersensitivity or allergy to sabizabulin or Sacituzumab govitecan-hziy
  • Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >2.5 X upper limit of normal (ULN) or total bilirubin >ULN (an elevated total bilirubin up to 1.5 X ULN attributed to a previously confirmed diagnosis of Gilbert's disease is acceptable if all other eligibility criteria are met). In patients with documented metastases to the liver, the limits for inclusion are ALT or AST >5.0 X ULN or total bilirubin >1.5 X ULN.
  • Patients with biliary catheter
  • Creatinine Clearance ≤60 mL/min by the Cockroft-Gault equation
  • Has a known additional, invasive, malignancy that is progressing or required active treatment in the last 5 years (note: subjects with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, superficial bladder cancer, or cervical carcinoma in situ that have undergone potentially curative therapy are not excluded)
  • Any comorbid disease or condition (medical or surgical) which might compromise the hematologic, cardiovascular, endocrine, pulmonary, renal, gastrointestinal, hepatic, or central nervous system; or other conditions that may interfere with the absorption, distribution, metabolism or excretion of study drug, or would place the subject at increased risk
  • Infection requiring antibiotic use within one week or randomization or uncontrolled infection.
  • Treatment with any investigational product within < 4 half-lives for each individual investigational product OR within 28 days prior to randomization
  • Pregnant, lactating, or breastfeeding, or intending to become pregnant during the study or within 60 days after the final dose of study treatment

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Active Comparator

    Arm Label

    Sabizabulin Monotherapy

    Sacituzumab govitecan-hziy/Sabizabulin Combination

    Sacituzumab govitecan-hziy Monotherpy

    Arm Description

    Subjects in the Sabizabulin Treated Group will receive sabizabulin 32 mg each day by mouth until disease progression confirmed by BICR is observed.

    Subjects in the Sacituzumab govitecan-hziy /Sabizabulin Combination Treated Group will receive sabizabulin 32 mg each day by mouth and Sacituzumab govitecan-hziy at the FDA approved dose and dosage regimen for mTNBC until disease progression confirmed by BICR is observed.

    Subjects in the Control Treated Group will receive Sacituzumab govitecan-hziy intravenous infusion of 10 mg/kg in accordance with the FDA approved use and dosage regimen for mTNBC until disease progression confirmed by BICR is observed.

    Outcomes

    Primary Outcome Measures

    To compare the efficacy of sabizabulin monotherapy to Sacituzumab govitecan-hziy monotherapy
    The comparison will be made in the efficacy in the treatment of metastatic triple negative breast cancer (mTNBC) in patients previously treated with at least two systemic chemotherapies for metastatic disease as measured by radiographic progression free survival (rPFS) as the primary endpoint.
    To compare the efficacy of Sacituzumab govitecan-hziy/sabizabulin combination therapy to Sacituzumab govitecan-hziy monotherapy
    The comparison will be made in the efficacy in the treatment of metastatic triple negative breast cancer (mTNBC) in patients previously treated with at least two systemic chemotherapies for metastatic disease as measured by radiographic progression free survival (rPFS) as the primary endpoint.

    Secondary Outcome Measures

    Objective Response Rate (ORR), proportion of subjects with a best tumor response of ORR (PR or CR) on study
    Objective Response Rate (ORR), proportion of subjects with a best tumor response of ORR (PR or CR) on study

    Full Information

    First Posted
    August 10, 2021
    Last Updated
    January 24, 2022
    Sponsor
    Veru Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05008510
    Brief Title
    P2 Clinical Efficacy & Safety Study of V-111 Monotherapy & Sacituzumab Govitecan-hziy/V-111 Combo Therapy for mTNBC .
    Acronym
    VERU-111
    Official Title
    Phase 2 Clinical Efficacy and Safety Study of Sabizabulin (VERU-111) Monotherapy and Sacituzumab Govitecan-hziy/Sabizabulin Combination Therapy for the Treatment of Metastatic Triple Negative Breast Cancer
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    January 2022
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Decided to halt and will potentially reopen in the future.
    Study Start Date
    December 30, 2021 (Anticipated)
    Primary Completion Date
    July 30, 2022 (Anticipated)
    Study Completion Date
    June 30, 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Veru Inc.

    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
    To compare the following: The efficacy of sabizabulin monotherapy to sacituzumab govitecan-hziy monotherapy The efficacy of sacituzumab govitecan-hziy/sabizabulin combination therapy to sacituzumab govitecan-hziy monotherapy These comparisons will be made in the efficacy in the treatment of metastatic triple negative breast cancer (mTNBC) in patients previously treated with at least two systemic chemotherapies for metastatic disease as measured by radiographic progression free survival (rPFS) as the primary endpoint.
    Detailed Description
    Stage 1: This is a safety run-in portion of the study for the combination therapy. Three subjects will be enrolled into Stage 1 of the study to receive sacituzumab govitecan-hziy for injection + sabizabulin 32 mg. Dosing with sabizabulin should be within 1 hour prior to initiation of the sacituzumab govitecan-hziy infusion. Safety will be assessed for 21 days. Samples for assessment of pharmacokinetics of sacutizumab (in the Control Treated Group and TS Combination Group), and sabizabulin (in the Sabizabulin Treated Group and TS Combination Group) will be collected on Day 1 (prior to dosing and within 1 hour after the sacituzumab govitecan-hziy infusion has been completed in Stage 1 and Stage 2, Cycle 1 only), Day 3 (prior to dosing with sabizabulin, Stage 1, Cycle 1 only), and Day 8 (prior to dosing and within 1 hour after the sacituzumab govitecan-hziy infusion has been completed in Stage 1 and Stage 2, Cycle 1 only). The primary objective of Stage 1 is to demonstrate an acceptable safety profile of the combination therapy regimen that is planned for Stage 2 of the protocol. If an acceptable safety profile and no unacceptable drug related adverse event is observed in Stage 1, then Stage 2 will be initiated as designed. If an unacceptable drug related adverse event is observed in one patient in the combination treatment group in Stage 1, then an additional 3 patients will be enrolled to the combination treatment arm. If 2 out of 3 or 2 out of 6 patients experience an unacceptable drug related adverse event in Stage 1, then the combination treatment regimen will not be dosed in Stage 2 of this protocol. Stage 2: This study is a multicenter, randomized, open-label, three treatment-arm, efficacy and safety study. Subjects will be randomized to the three treatment arms. Patients will be randomized in a 1:1:1 fashion to the sacituzumab govitecan-hziy monotherapy, sabizabulin monotherapy, and the sacituzumab govitecan-hziy/sabizabulin combination therapy treatment arms. Subjects in the Sabizabulin Treated Group and sacituzumab govitecan-hziy/sabizabulin Combination Group will receive sabizabulin 32 mg per day orally until radiographic progression (blinded independent central read) in observed. Subjects in the Control Treated Group and in the sacituzumab govitecan-hziy/sabizabulin Combination Group will receive sacituzumab govitecan-hziy using the dose and dosing regimen defined in the FDA approved prescribing information for the treatment of mTNBC until radiographic progression in observed. The primary efficacy endpoint of the study will be the median rPFS. Subjects will continue study treatment until disease progression confirmed by blinded independent central reader (BICR) is observed. A follow up visit will occur approximately 30 days after last dose of study drug.

    6. Conditions and Keywords

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

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Model Description
    This study is a multicenter, randomized, open-label, three treatment-arm, efficacy and safety study. Subjects will be randomized to the three treatment arms.
    Masking
    Outcomes Assessor
    Masking Description
    Central reader for scans will be blinded
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Sabizabulin Monotherapy
    Arm Type
    Experimental
    Arm Description
    Subjects in the Sabizabulin Treated Group will receive sabizabulin 32 mg each day by mouth until disease progression confirmed by BICR is observed.
    Arm Title
    Sacituzumab govitecan-hziy/Sabizabulin Combination
    Arm Type
    Experimental
    Arm Description
    Subjects in the Sacituzumab govitecan-hziy /Sabizabulin Combination Treated Group will receive sabizabulin 32 mg each day by mouth and Sacituzumab govitecan-hziy at the FDA approved dose and dosage regimen for mTNBC until disease progression confirmed by BICR is observed.
    Arm Title
    Sacituzumab govitecan-hziy Monotherpy
    Arm Type
    Active Comparator
    Arm Description
    Subjects in the Control Treated Group will receive Sacituzumab govitecan-hziy intravenous infusion of 10 mg/kg in accordance with the FDA approved use and dosage regimen for mTNBC until disease progression confirmed by BICR is observed.
    Intervention Type
    Drug
    Intervention Name(s)
    Sabizabulin
    Other Intervention Name(s)
    Veru-111
    Intervention Description
    Sabizabulin (Veru-111)
    Intervention Type
    Drug
    Intervention Name(s)
    Sacituzumab Govitecan-hziy
    Intervention Description
    Sacituzumab govitecan-hziy
    Intervention Type
    Drug
    Intervention Name(s)
    Sabizabulin/Sacituzumab govitecan-hziy Combo
    Other Intervention Name(s)
    Sacituzumab govitecan-hziy and Veru-111 combo
    Intervention Description
    Sabizabulin/Sacituzumab govitecan-hziy Combo therpy
    Primary Outcome Measure Information:
    Title
    To compare the efficacy of sabizabulin monotherapy to Sacituzumab govitecan-hziy monotherapy
    Description
    The comparison will be made in the efficacy in the treatment of metastatic triple negative breast cancer (mTNBC) in patients previously treated with at least two systemic chemotherapies for metastatic disease as measured by radiographic progression free survival (rPFS) as the primary endpoint.
    Time Frame
    360 days
    Title
    To compare the efficacy of Sacituzumab govitecan-hziy/sabizabulin combination therapy to Sacituzumab govitecan-hziy monotherapy
    Description
    The comparison will be made in the efficacy in the treatment of metastatic triple negative breast cancer (mTNBC) in patients previously treated with at least two systemic chemotherapies for metastatic disease as measured by radiographic progression free survival (rPFS) as the primary endpoint.
    Time Frame
    360 days
    Secondary Outcome Measure Information:
    Title
    Objective Response Rate (ORR), proportion of subjects with a best tumor response of ORR (PR or CR) on study
    Description
    Objective Response Rate (ORR), proportion of subjects with a best tumor response of ORR (PR or CR) on study
    Time Frame
    360 days

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    100 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Provide informed consent Be able to communicate effectively with the study personnel Aged ≥18 years For Female Subjects Menopausal status Be postmenopausal as defined by the National Comprehensive Cancer Network as either: Age ≥55 years and one year or more of amenorrhea Age <55 years and one year or more of amenorrhea, with an estradiol assay <20 pg/mL Age <55 years and surgical menopause with bilateral oophorectomy Be premenopausal or perimenopausal with a negative urine pregnancy test. If subject is of child-bearing potential, the subject must agree to use acceptable methods of contraception: If female study participant could become pregnant, use acceptable methods of contraception from the time of the first administration of study medication until 6 months following administration of the last dose of study medication. Acceptable methods of contraception are as follows: Condom with spermicidal foam/gel/film/cream/suppository [i.e., barrier method of contraception], surgical sterilization of male partner (vasectomy with documentation of azoospermia) and a barrier method {condom used with spermicidal foam/gel/film/cream/suppository} If female study participant has undergone documented tubal ligation (female sterilization), a barrier method (condom used with spermicidal foam/gel/film/cream/suppository) should also be used If female study participant has undergone documented placement of an intrauterine device (IUD) or intrauterine system (IUS), a barrier method (condom with spermicidal foam/gel/film/cream/suppository) should also be used For Male Subjects Subject must agree to use acceptable methods of contraception: If the study subject's partner could become pregnant, use acceptable methods of contraception from the time of the first administration of study medication until 6 months following administration of the last dose of study medication. Acceptable methods of contraception are as follows: Condom with spermicidal foam/gel/film/cream/suppository [i.e., barrier method of contraception], surgical sterilization (vasectomy with documentation of azoospermia) and a barrier method {condom used with spermicidal foam/gel/film/cream/suppository}, the female partner uses oral contraceptives (combination estrogen/progesterone pills), injectable progesterone or subdermal implants and a barrier method (condom used with spermicidal foam/gel/film/cream/suppository) If female partner of a study subject has undergone documented tubal ligation (female sterilization), a barrier method (condom used with spermicidal foam/gel/film/cream/suppository) should also be used If female partner of a study subject has undergone documented placement of an intrauterine device (IUD) or intrauterine system (IUS), a barrier method (condom with spermicidal foam/gel/film/cream/suppository) should also be used If female partner of a study subject has undergone documented placement of an intrauterine device (IUD) or intrauterine system (IUS), a barrier method (condom with spermicidal foam/gel/film/cream/suppository) should also be used Eastern Cooperative Oncology Group (ECOG) performance status of ≤2 Histologically or cytologically confirmed TNBC based on the most recent analyzed biopsy or other pathology specimen. Triple negative defined as <1% expression for estrogen receptor (ER) and progesterone receptor (PR) and negative for human epidermal growth factor receptor 2 (HER2) by in-situ hybridization. Measurable disease is required as per RECIST 1.1 confirmed by BICR (NOTE: Bone only metastatic disease is acceptable but requires a measurable component). Refractory to or relapsed after at least two prior standard chemotherapy regimens for advanced/metastatic TNBC and have not received Sacituzumab govitecan-hziy. At least 2 weeks beyond prior anti-cancer treatment (chemotherapy, radiotherapy, and/or major surgery), and recovered from all acute toxicities to Grade 1 or less (except alopecia and peripheral neuropathy). At least 2 weeks beyond high dose systemic corticosteroids (however, low dose corticosteroids < 20 mg prednisone or equivalent daily are permitted). Adequate hematology without ongoing transfusional support (hemoglobin > 9 g/dL, ANC > 1,500 per mm3, platelets > 100,000 per mm3). Adverse events at study entry < Grade 1 by NCI CTCAE v5.0 (Patients with ≤ Grade 2 neuropathy and any grade of alopecia are eligible). Patients with treated, non-progressive brain metastases, off high-dose steroids (>20 mg prednisone or equivalent) for at least 4 weeks can be enrolled in the trial. Subject is willing to comply with the requirements of the protocol through the end of the study. Exclusion Criteria: Women who are pregnant or lactating Women of childbearing potential or fertile men with a female partner of childbearing potential not willing to use effective contraction during the study and 6 months after last dose of study drug for the women of childbearing potential participating in the study and for 3 months after last dose of study drug in fertile men with a female partner of childbearing potential. Known hypersensitivity or allergy to sabizabulin or Sacituzumab govitecan-hziy Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >2.5 X upper limit of normal (ULN) or total bilirubin >ULN (an elevated total bilirubin up to 1.5 X ULN attributed to a previously confirmed diagnosis of Gilbert's disease is acceptable if all other eligibility criteria are met). In patients with documented metastases to the liver, the limits for inclusion are ALT or AST >5.0 X ULN or total bilirubin >1.5 X ULN. Patients with biliary catheter Creatinine Clearance ≤60 mL/min by the Cockroft-Gault equation Has a known additional, invasive, malignancy that is progressing or required active treatment in the last 5 years (note: subjects with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, superficial bladder cancer, or cervical carcinoma in situ that have undergone potentially curative therapy are not excluded) Any comorbid disease or condition (medical or surgical) which might compromise the hematologic, cardiovascular, endocrine, pulmonary, renal, gastrointestinal, hepatic, or central nervous system; or other conditions that may interfere with the absorption, distribution, metabolism or excretion of study drug, or would place the subject at increased risk Infection requiring antibiotic use within one week or randomization or uncontrolled infection. Treatment with any investigational product within < 4 half-lives for each individual investigational product OR within 28 days prior to randomization Pregnant, lactating, or breastfeeding, or intending to become pregnant during the study or within 60 days after the final dose of study treatment
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Barnette
    Organizational Affiliation
    Veru Inc.
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided

    Learn more about this trial

    P2 Clinical Efficacy & Safety Study of V-111 Monotherapy & Sacituzumab Govitecan-hziy/V-111 Combo Therapy for mTNBC .

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