Phase 2 Study of AMG 386 Plus Paclitaxel With or Without Bevacizumab as First Line Therapy in Her2-Negative Breast Cancer Patients

NCT ID: NCT00511459

Last Updated: 2015-10-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

228 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-07-31

Study Completion Date

2014-05-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This is a phase 2, randomized, placebo controlled, multi-center study to estimate the treatment effect and evaluate the safety and tolerability of AMG 386 in combination with paclitaxel and paclitaxel/bevacizumab in the treatment of subjects with Her2-negative metastatic or locally recurrent breast cancer.

AMG 386 is a man-made medication that is designed to stop the development of blood vessels in cancer tissues. Cancer tissues rely on the development of new blood vessels, a process called angiogenesis, to obtain a supply of oxygen and nutrients to grow.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Primary Objective: To estimate the treatment effect as measured by progression free survival (PFS) of subjects receiving AMG 386 (at 2 doses) in combination with paclitaxel + bevacizumab relative to paclitaxel + bevacizumab + placebo.

Secondary Objective(s):

* To compare the treatment effect as measured by PFS of subjects receiving open-label AMG 386 in combination with paclitaxel relative to paclitaxel + bevacizumab + placebo
* To compare the treatment effect as measured by PFS of subjects receiving AMG 386 in combination with paclitaxel and bevacizumab relative to paclitaxel + AMG 386
* To evaluate the safety and tolerability of the combination and non-bevacizumab regimens
* To estimate other measures (RR, DOR, TTR, TTP) of treatment effect
* To evaluate the pharmacokinetics (PK) of AMG 386 and bevacizumab when used in combination
* To estimate the incidence of anti-AMG386 antibody formation

Exploratory Objective(s):

* To explore the pharmacodynamic (PD) response as assessed by changes in blood levels of angiogenic cytokines, tumor apoptosis, and other markers
* To explore the association of histological features and selected immunologic, biochemical, pharmacogenetic, or angiogenic markers in tumor biopsies, plasma, or serum samples with safety and/or efficacy outcomes

Study Design:

This is a phase 2, randomized, placebo controlled, multi-center study to estimate the treatment effect and evaluate the safety and tolerability of AMG 386 in combination with paclitaxel and paclitaxel/bevacizumab in the treatment of subjects with Her2-negative metastatic or locally recurrent breast cancer.

Two hundred twenty subjects will be randomized 1:1:1:1 to each of the following arms:

Arm A: Paclitaxel 90 mg/m² IV QW (3 on/1 off) + bevacizumab 10 mg/kg IV Q2W + AMG 386 10 mg/kg IV QW Arm B: Paclitaxel 90 mg/m² IV QW (3 on/1 off) + bevacizumab 10 mg/kg IV Q2W + AMG 386 3 mg/kg IV QW Arm C: Paclitaxel 90 mg/m² IV QW (3 on/1 off) + bevacizumab 10 mg/kg IV Q2W + AMG 386 placebo IV QW Arm D: Paclitaxel 90 mg/m² IV QW (3 on/1 off) + Open Label AMG 386 10 mg/kg IV QW To maintain the double-blind in arms A, B, and C, each subject will be infused weekly with a volume of investigational product equivalent to 10 mg/kg AMG 386 IV. Arm D will receive open label AMG 386 and will not receive a placebo for bevacizumab.

Subjects will be discontinued from study treatment at any time for radiographic disease progression, clinical progression, unacceptable toxicity, subject withdrawal of consent, or death.

Subjects alive at the time of discontinuation of all study medications will be followed for up to 48 months from the date of the last subject enrolled into the trial to evaluate overall survival.

Radiological imaging to assess disease status will be performed every 8 weeks ± 7 days (2 cycles) for 2 years and then every 4 months ± 1 month thereafter during the study until subjects develop radiographic disease progression per the modified RECIST criteria. In addition, any subject who discontinues study drug treatment prior to disease progression will continue to have radiological imaging performed every 8 weeks ± 7 days during the long term follow up period if the subject has not been in the study for 2 years until the subject develops radiographic disease progression or begins a new treatment. If the subject has been on study for 2 years, radiological imaging every 4 months ± 1 month will be performed during long term follow-up period until the subject develops radiographic disease progression or begins a new treatment.

The overall study design is described by a study schema immediately following this synopsis. Amgen Global Safety (AGS) will charter a data review team (DRT) that is independent of the team conducting the study and will review unblinded safety data after 20, 40, and 80 subjects have been randomized and have had the opportunity to receive at least 1 cycle (4 weeks) of study treatment.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Locally Recurrent and Metastatic Breast Cancer

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

A

Paclitaxel 90 mg/m² IV QW (3 on/1 off) + bevacizumab 10 mg/kg IV Q2W + AMG 386 10 mg/kg IV QW

Group Type EXPERIMENTAL

Bevacizumab

Intervention Type DRUG

Bevacizumab 10mg/kg IV Q2W

AMG 386

Intervention Type DRUG

AMG 386 10mg/kg IV QW \[blinded\]

Paclitaxel

Intervention Type DRUG

Paclitaxel 90mg/m2 IV QW (3 on/1 0ff)

D

Paclitaxel 90 mg/m² IV QW (3 on/1 off) + Open Label AMG 386 10 mg/kg IV QW

Group Type EXPERIMENTAL

AMG 386

Intervention Type DRUG

AMG 386 10mg/kg IV QW \[Open-Label\]

Paclitaxel

Intervention Type DRUG

Paclitaxel 90mg/m2 IV QW (3 on/1 0ff)

B

Paclitaxel 90 mg/m² IV QW (3 on/1 off) + bevacizumab 10 mg/kg IV Q2W + AMG 386 3 mg/kg IV QW

Group Type EXPERIMENTAL

AMG 386

Intervention Type DRUG

AMG 386 3mg/kg IV QW \[blinded\]

Bevacizumab

Intervention Type DRUG

Bevacizumab 10mg/kg IV Q2W

Paclitaxel

Intervention Type DRUG

Paclitaxel 90mg/m2 IV QW (3 on/1 0ff)

C

Paclitaxel 90 mg/m² IV QW (3 on/1 off) + bevacizumab 10 mg/kg IV Q2W + AMG 386 placebo IV QW

Group Type ACTIVE_COMPARATOR

AMG 386 Placebo

Intervention Type DRUG

AMG 386 Placebo \[blinded\]

Bevacizumab

Intervention Type DRUG

Bevacizumab 10mg/kg IV Q2W

Paclitaxel

Intervention Type DRUG

Paclitaxel 90mg/m2 IV QW (3 on/1 0ff)

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

AMG 386 Placebo

AMG 386 Placebo \[blinded\]

Intervention Type DRUG

AMG 386

AMG 386 3mg/kg IV QW \[blinded\]

Intervention Type DRUG

Bevacizumab

Bevacizumab 10mg/kg IV Q2W

Intervention Type DRUG

AMG 386

AMG 386 10mg/kg IV QW \[Open-Label\]

Intervention Type DRUG

AMG 386

AMG 386 10mg/kg IV QW \[blinded\]

Intervention Type DRUG

Paclitaxel

Paclitaxel 90mg/m2 IV QW (3 on/1 0ff)

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Subjects must have histologically or cytologically confirmed adenocarcinoma of the breast with locally recurrent or metastatic disease. Locally recurrent disease must not be amenable to resection with curative intent.
* Measurable or non-measurable disease per modified RECIST guidelines
* ECOG of 0 or 1 (within 14 days prior to randomization)
* Adequate organ and hematological function as evidenced by the following laboratory studies within 14 days prior to randomization:

• Cardiac function, as follows:
* Normal sinus rhythm (no significant ECG changes)
* Left ventricular ejection fraction ≥ LLN, as determined by echocardiogram or MUGA scan, according to institutional standards within 28 days prior to randomization

Exclusion Criteria

* Inflammatory Breast Cancer
* Common Terminology Criteria for Adverse Events (CTCAE) Version 3.0 peripheral neuropathy \> grade 1 at randomization
* History of arterial or venous thrombosis, including transient ischemic attack (TIA), within 1 year prior to randomization
* Adjuvant or neoadjuvant taxane treatment within 12 months of randomization. Any other adjuvant chemotherapy regimen must be discontinued at least 21 days prior to randomization
* Prior chemotherapy, vaccine, or biological therapy for locally recurrent or metastatic breast cancer (prior endocrine therapy is permitted)
* Prior radiation therapy, radiofrequency ablation, percutaneous cryotherapy or hepatic chemoembolization on all sites of disease unless disease progression was subsequently documented 14 days prior to randomization.
* Overexpression of HER-2 (gene amplification by FISH or 3+ over expression by immunohistochemistry).
* Current or prior history of central nervous system metastasis
* History of bleeding diathesis or clinically significant bleeding within 6 months prior to randomization
* Major surgical procedure within 28 days prior to randomization
* Open breast biopsy within 14 days prior to randomization
* Minor surgical procedure, placement of access device, or fine needle aspiration within 7 days of first dose
* Prior malignancy (other than thyroid cancer, in situ cervical cancer, or basal cell cancer of the skin, treated with curative intent and without evidence of disease for ≥ 3 years prior to randomization)
* Clinically significant cardiac disease within 12 months prior to randomization, including myocardial infarction, unstable angina, grade 2 or greater peripheral vascular disease, cerebrovascular accident, transient ischemic attack, congestive heart failure, or arrhythmias not controlled by outpatient medication
* Non-healing wound, ulcer or fracture
* Known hypersensitivity to paclitaxel or drugs using the vehicle cremophor
* Known hypersensitivity to bacterial proteins, or any of the drugs required in this study
* Known positive test for human immunodeficiency virus (HIV), hepatitis C, or hepatitis B surface antigen
* Known active or chronic hepatitis
* Uncontrolled hypertension as defined as systolic blood pressure ≥ 150 mm Hg and diastolic blood pressure ≥ 90 mm Hg. Anti-hypertensive medications are allowed if the subject is stable on their current dose at the time of randomization
* Currently or previously treated with any VEGF or VEGFr inhibitor, including but not limited to, bevacizumab, SU11248 (sunitinib), PTK787 (vatalinib), AZD 2171, AEE-788, BAY 43-9006 (sorafenib) and AMG 706.
* Treatment with coumarin-type anticoagulants, (other than low dose prophylaxis for central venous catheters ≤ 1mg/day) within 7 days prior to randomization
* Currently or previously treated with angiopoietin inhibitors, or inhibitors of TIE-1 or TIE-2 including, but not limited to, AMG 386, XL880, XL820
* Treatment with immune modulators such as cyclosporine and tacrolimus within 30 days prior to randomization
* Concomitant therapy with any hormonal agent such as raloxifene, tamoxifen, or other selective estrogen receptor modulators (SERMS), given for breast cancer prevention or for osteoporosis. Subjects must have discontinued these agents 28 days prior to randomization
* Pregnant (ie, positive beta-human chorionic gonadotropin test) or is breast feeding
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Amgen

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

MD

Role: STUDY_DIRECTOR

Amgen

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Research Site

Litchfield Park, Arizona, United States

Site Status

Research Site

Tucson, Arizona, United States

Site Status

Research Site

Hot Springs, Arkansas, United States

Site Status

Research Site

Little Rock, Arkansas, United States

Site Status

Research Site

Campbell, California, United States

Site Status

Research Site

Los Angeles, California, United States

Site Status

Research Site

Murrieta, California, United States

Site Status

Research Site

Santa Maria, California, United States

Site Status

Research Site

New Haven, Connecticut, United States

Site Status

Research Site

Stamford, Connecticut, United States

Site Status

Research Site

Orlando, Florida, United States

Site Status

Research Site

Robbinsdale, Minnesota, United States

Site Status

Research Site

Henderson, Nevada, United States

Site Status

Research Site

Lebanon, New Hampshire, United States

Site Status

Research Site

Nashua, New Hampshire, United States

Site Status

Research Site

Edison, New Jersey, United States

Site Status

Research Site

Mountain Lakes, New Jersey, United States

Site Status

Research Site

Asheville, North Carolina, United States

Site Status

Research Site

Charlotte, North Carolina, United States

Site Status

Research Site

Hershey, Pennsylvania, United States

Site Status

Research Site

Philadelphia, Pennsylvania, United States

Site Status

Research Site

Columbia, South Carolina, United States

Site Status

Research Site

Richardson, Texas, United States

Site Status

Research Site

San Antonio, Texas, United States

Site Status

Research Site

Sugar Land, Texas, United States

Site Status

Research Site

Ogden, Utah, United States

Site Status

Research Site

Kurralta Park, South Australia, Australia

Site Status

Research Site

Epping, Victoria, Australia

Site Status

Research Site

Fitzroy, Victoria, Australia

Site Status

Research Site

Footscray, Victoria, Australia

Site Status

Research Site

Malvern, Victoria, Australia

Site Status

Research Site

Perth, Western Australia, Australia

Site Status

Research Site

Innsbruck, , Austria

Site Status

Research Site

Vienna, , Austria

Site Status

Research Site

Wels, , Austria

Site Status

Research Site

Leuven, , Belgium

Site Status

Research Site

Liège, , Belgium

Site Status

Research Site

Wilrijk, , Belgium

Site Status

Research Site

Herlev, , Denmark

Site Status

Research Site

Helsinki, , Finland

Site Status

Research Site

La Roche-sur-Yon, , France

Site Status

Research Site

Lyon, , France

Site Status

Research Site

Marseille, , France

Site Status

Research Site

Montpellier, , France

Site Status

Research Site

Paris, , France

Site Status

Research Site

Paris, , France

Site Status

Research Site

Toulouse, , France

Site Status

Research Site

Vandœuvre-lès-Nancy, , France

Site Status

Research Site

Gyula, , Hungary

Site Status

Research Site

Kaposvár, , Hungary

Site Status

Research Site

Szombathely, , Hungary

Site Status

Research Site

Veszprém, , Hungary

Site Status

Research Site

Bangalore, Karnataka, India

Site Status

Research Site

Miraj, Maharashtra, India

Site Status

Research Site

Mumbai, Maharashtra, India

Site Status

Research Site

Nagpur, Maharashtra, India

Site Status

Research Site

Pune, Maharashtra, India

Site Status

Research Site

Jaipur, Rajasthan, India

Site Status

Research Site

Jaipur, Rajasthan, India

Site Status

Research Site

Maastricht, , Netherlands

Site Status

Research Site

Gdansk, , Poland

Site Status

Research Site

Lubin, , Poland

Site Status

Research Site

Poznan, , Poland

Site Status

Research Site

Warsaw, , Poland

Site Status

Research Site

Warsaw, , Poland

Site Status

Research Site

Wroclaw, , Poland

Site Status

Research Site

Jaén, AndalucÃ-a, Spain

Site Status

Research Site

Sabadell, Cataluña, Spain

Site Status

Research Site

Santiago de Compostela, Galicia, Spain

Site Status

Research Site

Madrid, Madrid, Spain

Site Status

Research Site

Guildford, , United Kingdom

Site Status

Research Site

Leicester, , United Kingdom

Site Status

Research Site

London, , United Kingdom

Site Status

Research Site

London, , United Kingdom

Site Status

Research Site

Manchester, , United Kingdom

Site Status

Research Site

Northwood, , United Kingdom

Site Status

Research Site

Nottingham, , United Kingdom

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States Australia Austria Belgium Denmark Finland France Hungary India Netherlands Poland Spain United Kingdom

References

Explore related publications, articles, or registry entries linked to this study.

Dieras V, Wildiers H, Jassem J, Dirix LY, Guastalla JP, Bono P, Hurvitz SA, Goncalves A, Romieu G, Limentani SA, Jerusalem G, Lakshmaiah KC, Roche H, Sanchez-Rovira P, Pienkowski T, Segui Palmer MA, Li A, Sun YN, Pickett CA, Slamon DJ. Trebananib (AMG 386) plus weekly paclitaxel with or without bevacizumab as first-line therapy for HER2-negative locally recurrent or metastatic breast cancer: A phase 2 randomized study. Breast. 2015 Jun;24(3):182-90. doi: 10.1016/j.breast.2014.11.003. Epub 2015 Mar 5.

Reference Type DERIVED
PMID: 25747197 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

http://www.amgentrials.com

AmgenTrials clinical trials website

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

20060341

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.