Trastuzumab Deruxtecan With Nivolumab in Advanced Breast and Urothelial Cancer

NCT ID: NCT03523572

Last Updated: 2025-01-27

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

86 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-08-02

Study Completion Date

2023-09-12

Brief Summary

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This is a study of trastuzumab deruxtecan for the treatment of HER2-positive unresectable or metastatic breast cancer following two or more prior anti-HER2 based regimens.

Participants will receive this study drug along with a cancer drug, an immune checkpoint inhibitor, anti-PD1, called nivolumab.

The study will be done in two parts:

* Part 1 is to identify the recommended dose to use for treatment.
* Part 2 is to find out how well the combination works, and how safe and tolerable it is.

Detailed Description

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The purpose of this phase 1b (Part 1, Part 2) study is to assess the combination of a test drug (trastuzumab deruxtecan) with nivolumab in participants with HER2-expressing breast and urothelial cancer who had disease progression during or after prior therapies, did not respond to standard therapies, or for whom no standard therapy is available.

The study will be performed in 2 parts.

* Part 1 is to test different doses of trastuzumab deruxtecan when given along with a fixed dose of nivolumab, and establish the maximum tolerated dose/recommended dose for expansion, when used in combination with nivolumab
* Part 2 is to assess the efficacy and safety of this dose combination.

Conditions

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Breast Cancer Urothelial Carcinoma

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Part 1 will be a sequential dose-finding (dose escalation) study, Part 2 will consist of a single group of four cohorts who receive the recommended dose (determined during Part 1)
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Dose Escalation (3.2 mg/kg)

Participants with HER2-expressing breast cancer who received starting intravenous dose of trastuzumab deruxtecan at 3.2 mg/kg and a fixed intravenous dose of 360mg of nivolumab every 3 weeks (Q3W).

Escalating/de-escalating doses of trastuzumab deruxtecan in combination with a flat dose of nivolumab was administered on Day 1 of each 21-day cycle.

The DLT observation period will be the first 2 cycles.

Group Type EXPERIMENTAL

Trastuzumab deruxtecan

Intervention Type DRUG

The investigational product is a sterile lyophilized powder, which is made into solution for intravenous administration.

Nivolumab

Intervention Type DRUG

Nivolumab is an aqueous solution formulated at 10 mg/mL to be administered at a flat dose of 360 mg IV over 30 minutes. Protocol-defined thyroid testing is required while taking nivolumab.

Dose Escalation (5.4 mg/kg)

Participants with HER2-expressing breast cancer who received starting intravenous dose of trastuzumab deruxtecan at 3.2 mg/kg and a fixed intravenous dose of 360mg of nivolumab every 3 weeks (Q3W).

Escalating/de-escalating doses of trastuzumab deruxtecan in combination with a flat dose of nivolumab was administered on Day 1 of each 21-day cycle.

The DLT observation period will be the first 2 cycles.

Group Type EXPERIMENTAL

Trastuzumab deruxtecan

Intervention Type DRUG

The investigational product is a sterile lyophilized powder, which is made into solution for intravenous administration.

Nivolumab

Intervention Type DRUG

Nivolumab is an aqueous solution formulated at 10 mg/mL to be administered at a flat dose of 360 mg IV over 30 minutes. Protocol-defined thyroid testing is required while taking nivolumab.

Dose Expansion - Cohort 1

Cohort 1: Participants with pathologically documented advanced/metastatic breast cancer that has centrally-determined positive HER2 expression (IHC 3+ or IHC 2+/ISH+) \[as defined by American Society of Clinical Oncology/College of American Pathologists (ASCO-CAP) guidelines\]. These participants received prior ado-trastuzumab emtansine (T-DM1).

Participants will receive the RDE of trastuzumab deruxtecan and the flat dose of nivolumab.

Group Type EXPERIMENTAL

Trastuzumab deruxtecan

Intervention Type DRUG

The investigational product is a sterile lyophilized powder, which is made into solution for intravenous administration.

Nivolumab

Intervention Type DRUG

Nivolumab is an aqueous solution formulated at 10 mg/mL to be administered at a flat dose of 360 mg IV over 30 minutes. Protocol-defined thyroid testing is required while taking nivolumab.

Dose Expansion - Cohort 2

Cohort 2: Participants with pathologically documented advanced/metastatic breast cancer that has centrally-determined low HER2 expression (IHC 1+ or IHC 2+/ISH-), who have exhausted treatments that can confer any clinically meaningful benefit (eg, other therapies such as hormonal therapy for patients who are hormone receptor positive).

Participants received the RDE of trastuzumab deruxtecan and the flat dose of nivolumab.

Group Type EXPERIMENTAL

Trastuzumab deruxtecan

Intervention Type DRUG

The investigational product is a sterile lyophilized powder, which is made into solution for intravenous administration.

Nivolumab

Intervention Type DRUG

Nivolumab is an aqueous solution formulated at 10 mg/mL to be administered at a flat dose of 360 mg IV over 30 minutes. Protocol-defined thyroid testing is required while taking nivolumab.

Dose Expansion - Cohort 3

Cohort 3: Participants with pathologically documented advanced/metastatic urothelial carcinoma that has centrally-determined HER2 expression of IHC 2+ or 3+, who received prior platinum-based therapy with documented progression.

Participants received the RDE of trastuzumab deruxtecan and the flat dose of nivolumab.

Group Type EXPERIMENTAL

Trastuzumab deruxtecan

Intervention Type DRUG

The investigational product is a sterile lyophilized powder, which is made into solution for intravenous administration.

Nivolumab

Intervention Type DRUG

Nivolumab is an aqueous solution formulated at 10 mg/mL to be administered at a flat dose of 360 mg IV over 30 minutes. Protocol-defined thyroid testing is required while taking nivolumab.

Dose Expansion - Cohort 4

Cohort 4: Participants with pathologically documented advanced/metastatic urothelial carcinoma that has centrally-determined HER2 expression of IHC 1+, who received prior platinum-based therapy with documented progression.

Participants received the RDE of trastuzumab deruxtecan and the flat dose of nivolumab.

Group Type EXPERIMENTAL

Trastuzumab deruxtecan

Intervention Type DRUG

The investigational product is a sterile lyophilized powder, which is made into solution for intravenous administration.

Nivolumab

Intervention Type DRUG

Nivolumab is an aqueous solution formulated at 10 mg/mL to be administered at a flat dose of 360 mg IV over 30 minutes. Protocol-defined thyroid testing is required while taking nivolumab.

Interventions

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Trastuzumab deruxtecan

The investigational product is a sterile lyophilized powder, which is made into solution for intravenous administration.

Intervention Type DRUG

Nivolumab

Nivolumab is an aqueous solution formulated at 10 mg/mL to be administered at a flat dose of 360 mg IV over 30 minutes. Protocol-defined thyroid testing is required while taking nivolumab.

Intervention Type DRUG

Other Intervention Names

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Enhertu® T-DXd Opdivo®

Eligibility Criteria

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Inclusion Criteria

1. Is the age of majority (adulthood) in their country
2. Has an Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 to 1
3. Has pathologically documented breast cancer or urothelial cancer that is unresectable or metastatic, and refractory to or intolerant of existing therapy(ies) known to provide clinical benefit, and as specified in each study cohort
4. Has an adequate archival tumor sample available for the central laboratory to determine eligibility to participate
5. Has at least 1 measurable lesion per RECIST version 1.1
6. Has cardiac, bone marrow, kidney, liver, blood and clotting test results required per protocol
7. Has had an adequate washout period before enrollment since previous surgery and other treatment
8. If reproduction is possible, agrees to use protocol-defined methods of contraception (or completely abstain from heterosexual intercourse) from screening to at least 7 months for females and males after the last dose of study drug
9. Agrees to avoid harvesting sperm or ova for any reason from screening to at least 7 months for females and males after the last dose of study drug
10. Has a life expectancy of at least 3 months

Exclusion Criteria

1. Has received prior treatment with nivolumab or trastuzumab deruxtecan
2. Has medical history of myocardial infarction (MI) within 6 months before enrollment, symptomatic congestive heart failure (CHF) (New York Heart Association classes II-IV). Troponin levels above upper limit of normal (ULN) at screening (as defined by the manufacturer) and without any MI-related symptoms should have a cardiologic consultation before enrollment to rule out MI.
3. Has a corrected QT interval by Fredericia (QTcF) prolongation to \> 470 ms (females) or \> 450 ms (males) based on an average of the screening triplicate 12-lead electrocardiogram
4. Has history of non-infectious interstitial lung disease (ILD/pneumonitis) (that required steroids), has ILD/pneumonitis currently, or it cannot be ruled out by imaging at screening
5. Has a condition (other than active autoimmune disease) that requires systemic treatment with either corticosteroids (\>10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of starting study treatment
6. Is pregnant or breastfeeding, or planning to become pregnant
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bristol-Myers Squibb

INDUSTRY

Sponsor Role collaborator

AstraZeneca

INDUSTRY

Sponsor Role collaborator

Daiichi Sankyo

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Global Team Leader

Role: STUDY_DIRECTOR

Daiichi Sankyo

Locations

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UCLA - Medical Center

Santa Monica, California, United States

Site Status

Yale University

New Haven, Connecticut, United States

Site Status

University of Miami Hospital & Clinics/Sylvester Comprehensive Cancer Center

Miami, Florida, United States

Site Status

Norton Cancer Institute

Louisville, Kentucky, United States

Site Status

Icahn School of Medicine at Mount Sinai

New York, New York, United States

Site Status

Levine Cancer Institute Carolinas Healthcare System

Charlotte, North Carolina, United States

Site Status

Gabrail Cancer Center Research

Canton, Ohio, United States

Site Status

Tennessee Oncology - Sara Cannon Research Institute

Nashville, Tennessee, United States

Site Status

Huntsman Cancer Institute

Salt Lake City, Utah, United States

Site Status

University of Washington Medical Center

Seattle, Washington, United States

Site Status

AZ Groeninge

Kortrijk, West-Vlaanderen, Belgium

Site Status

Cliniques Universitaires Saint-Luc

Brussels, , Belgium

Site Status

GZA Hospital Campus Sint-Augustinus

Wilrijk, , Belgium

Site Status

Institut de Cancerologie de L'Ouest

Angers, , France

Site Status

Centre Georges Francois Leclerc

Dijon, , France

Site Status

ICO Rene Gauducheau

Saint-Herblain, , France

Site Status

Charite Campus Benjamin Franklin

Berlin, Brandenburg, Germany

Site Status

University Hospital Frankfurt

Frankfurt am Main, Hesse, Germany

Site Status

University Cancer Center

Dresden, Saxony, Germany

Site Status

Ospedale San Raffaele

Milan, , Italy

Site Status

Fondazione IRCCS Istituto Nazionale dei Tumori

Milan, , Italy

Site Status

Azienda Ospedaliera Universitaria Senese U.O.C. Immunoterapia Oncologica

Siena, , Italy

Site Status

Hospital Gregorio Maranon Madrid Spain

Madrid, , Spain

Site Status

MD Anderson Cancer Center Madrid

Madrid, , Spain

Site Status

Hospital Universitario Ramon y Cajal Madrid

Madrid, , Spain

Site Status

Fundacion Jimenez Diaz

Madrid, , Spain

Site Status

START Madrid CIOCC

Madrid, , Spain

Site Status

Sarah Cannon Research Institute UK

London, England, United Kingdom

Site Status

Royal Marsden Hospital (Surrey)

Sutton, , United Kingdom

Site Status

Countries

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United States Belgium France Germany Italy Spain United Kingdom

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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2018-000371-32

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

DS8201-A-U105

Identifier Type: -

Identifier Source: org_study_id

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