A Study to Evaluate Patient Preference and Satisfaction of Subcutaneous Administration of the Fixed-Dose Combination of Pertuzumab and Trastuzumab in Participants With HER2-Positive Early Breast Cancer

NCT ID: NCT03674112

Last Updated: 2024-01-02

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-12-19

Study Completion Date

2022-10-12

Brief Summary

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This is a Phase II, randomized, multicentre, multinational, open-label, cross-over study in adult patients who have completed neoadjuvant chemotherapy with neoadjuvant pertuzumab and trastuzumab and have undergone surgical treatment of human epidermal growth factor receptor 2 (HER2)-positive early breast cancer. The study will consist of two adjuvant treatment periods: a treatment cross-over period and a treatment continuation period. It will evaluate participant-reported preference for a subcutaneously administered fixed-dose combination formulation (FDC SC) of pertuzumab and trastuzumab compared with intravenously (IV) administered pertuzumab and trastuzumab formulations. The study will also evaluate participant-reported satisfaction with pertuzumab and trastuzumab FDC SC and health-related quality of life outcomes; healthcare professionals' perceptions of time/resource use and convenience of pertuzumab and trastuzumab FDC SC compared with pertuzumab and trastuzumab IV formulations; as well as the safety and efficacy of each study regimen.

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Detailed Description

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Conditions

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HER2-Positive Early Breast Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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A: P+H IV Followed by PH FDC SC

In the Treatment Cross-Over Period of the study, participants randomized to Arm A first received pertuzumab IV and trastuzumab IV (P+H IV) administration for 3 treatment cycles followed by the pertuzumab and trastuzumab fixed-dose combination for subcutaneous administration (PH FDC SC) for 3 treatment cycles (1 cycle = 21 days). Following completion of this study period, participants chose one of the two study treatments to receive in the Treatment Continuation Period for the remaining anti-HER2 treatment cycles (18 planned cycles in total, including pre-study neoadjuvant treatment). After completing study treatment, participants entered the Follow-up Period wherein they were to be followed for 3 years from the date the last participant was randomized.

Group Type EXPERIMENTAL

Pertuzumab and Trastuzumab Fixed-Dose Combination for Subcutaneous Administration (PH FDC SC)

Intervention Type DRUG

PH FDC SC will be administered subcutaneously (SC) at a fixed non-weight-based dose. A loading dose of 1200 mg pertuzumab and 600 mg trastuzumab is then followed by a maintenance dose of 600 mg pertuzumab and 600 mg trastuzumab once every 3 weeks (Q3W).

Pertuzumab IV

Intervention Type DRUG

Pertuzumab will be administered intravenously (IV) as a fixed non-weight-based dose of 840-mg IV loading dose and then 420-mg IV maintenance dose Q3W.

Trastuzumab IV

Intervention Type DRUG

Trastuzumab will be administered intravenously (IV) as an 8-mg/kg IV loading dose and then 6 mg/kg IV maintenance dose Q3W.

B: PH FDC SC Followed by P+H IV

In the Treatment Cross-Over Period of the study, participants randomized to Arm B first received the pertuzumab and trastuzumab fixed-dose combination for subcutaneous administration (PH FDC SC) for 3 treatment cycles followed by pertuzumab intravenous (IV) and trastuzumab IV (P+H IV) administration for 3 treatment cycles (1 cycle = 21 days). Following completion of this study period, participants chose one of the two study treatments to receive in the Treatment Continuation Period for the remaining anti-HER2 treatment cycles (18 planned cycles in total, including pre-study neoadjuvant treatment). After completing study treatment, participants entered the Follow-up Period wherein they were to be followed for 3 years from the date the last participant was randomized.

Group Type EXPERIMENTAL

Pertuzumab and Trastuzumab Fixed-Dose Combination for Subcutaneous Administration (PH FDC SC)

Intervention Type DRUG

PH FDC SC will be administered subcutaneously (SC) at a fixed non-weight-based dose. A loading dose of 1200 mg pertuzumab and 600 mg trastuzumab is then followed by a maintenance dose of 600 mg pertuzumab and 600 mg trastuzumab once every 3 weeks (Q3W).

Pertuzumab IV

Intervention Type DRUG

Pertuzumab will be administered intravenously (IV) as a fixed non-weight-based dose of 840-mg IV loading dose and then 420-mg IV maintenance dose Q3W.

Trastuzumab IV

Intervention Type DRUG

Trastuzumab will be administered intravenously (IV) as an 8-mg/kg IV loading dose and then 6 mg/kg IV maintenance dose Q3W.

Interventions

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Pertuzumab and Trastuzumab Fixed-Dose Combination for Subcutaneous Administration (PH FDC SC)

PH FDC SC will be administered subcutaneously (SC) at a fixed non-weight-based dose. A loading dose of 1200 mg pertuzumab and 600 mg trastuzumab is then followed by a maintenance dose of 600 mg pertuzumab and 600 mg trastuzumab once every 3 weeks (Q3W).

Intervention Type DRUG

Pertuzumab IV

Pertuzumab will be administered intravenously (IV) as a fixed non-weight-based dose of 840-mg IV loading dose and then 420-mg IV maintenance dose Q3W.

Intervention Type DRUG

Trastuzumab IV

Trastuzumab will be administered intravenously (IV) as an 8-mg/kg IV loading dose and then 6 mg/kg IV maintenance dose Q3W.

Intervention Type DRUG

Other Intervention Names

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PH FDC SC Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf PHESGO™ RO7198574 RG6264 Perjeta® Herceptin®

Eligibility Criteria

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Inclusion Criteria

Disease-specific criteria:

* Female or male with histologically confirmed, HER2-positive (HER2+) inflammatory, locally advanced or early-stage breast cancer who have received neoadjuvant pertuzumab and trastuzumab and have completed neoadjuvant chemotherapy and subsequently undergone surgery for their breast cancer.
* HER2+ breast cancer assessed at the local laboratory prior to initiation of neoadjuvant therapy. HER2+ status must be determined based on breast biopsy material obtained prior to neoadjuvant treatment and is defined as 3+ by immunohistochemistry (IHC) and/or positive by HER2 amplification by in situ hybridization (ISH) with a ratio of ≥2 for the number of HER2 gene copies to the number of chromosome 17 copies.
* Hormone receptor status of the primary tumour determined by local assessment. Hormone receptor status may be either positive or negative.
* Completed all neoadjuvant chemotherapy and surgery. Adjuvant radiotherapy may be planned or ongoing at study entry and adjuvant hormone therapy is allowed during the study. Note that study treatment cannot be initiated within \<2 weeks of surgery but must be initiated ≤9 weeks from the last administration of systemic neoadjuvant therapy.
* No evidence of residual, locally recurrent or metastatic disease after completion of surgery. Patients with clinical suspicion of metastases must undergo radiological assessments per institutional practice to rule out distant disease.
* Wound healing after breast cancer surgery adequate per investigator's assessment to allow initiation of study treatment within ≤9 weeks of last systemic neoadjuvant therapy
* No adjuvant chemotherapy planned. Note that adjuvant hormonal treatment is allowed during the study.

General criteria:

* Ability to comply with the study protocol, in the investigator's judgment
* Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
* Intact skin at planned site of subcutaneous injections (thigh)
* Left ventricular ejection fraction (LVEF) ≥55% measured by echocardiogram (ECHO) or multiple-gated acquisition (MUGA) scan within 28 days of study randomization
* No major surgical procedure unrelated to breast cancer within 28 days prior to randomization or anticipation of the need for major surgery during the course of study treatment
* For women of childbearing potential: agreement to remain abstinent or use contraceptive measures, and agreement to refrain from donating eggs, Women must remain abstinent or use non-hormonal contraceptive methods with a failure rate of \<1% per year, or two effective non-hormonal contraceptive methods during the study treatment periods and for 7 months after the last dose of study treatment
* For men: agreement to remain abstinent or use a condom, and agreement to refrain from donating sperm, men must remain abstinent or use a condom during the study treatment periods and for seven months after the last dose of study treatment to avoid exposing the embryo. Men must refrain from donating sperm during this same period
* A negative serum pregnancy test must be available prior to randomization for women of childbearing potential

Exclusion Criteria

Cancer-specific criteria:

* Stage IV (metastatic) breast cancer
* Current or prior history of active malignancy within the last five years. Appropriately treated non-melanoma skin cancer; in situ carcinomas, including cervix, colon, or skin; or Stage I uterine cancer within the last five years are allowed
* Previous systemic therapy for treatment or prevention of breast cancer, except neoadjuvant Perjeta, Herceptin and chemotherapy for current breast cancer

General criteria:

* Investigational treatment within four weeks of enrolment
* Serious cardiac illness or medical conditions
* History of ventricular dysrhythmias or risk factors for ventricular dysrhythmias, such as structural heart disease, coronary heart disease, clinically significant electrolyte abnormalities, or family history of sudden unexplained death or long QT syndrome
* Inadequate bone marrow, renal and impaired liver function
* Current severe, uncontrolled systemic disease that may interfere with planned treatment
* Pregnant or breastfeeding, or intending to become pregnant during the study or within seven months after the last dose of study treatment. Women of childbearing potential must have a negative serum pregnancy test result within seven days prior to initiation of study treatment
* Any serious medical condition or abnormality in clinical laboratory tests that, in the investigator's judgment, precludes the patient's safe participation in, and completion of, the study
* Known active liver disease, for example, active viral hepatitis infection, autoimmune hepatic disorders, or sclerosing cholangitis
* Concurrent, serious, uncontrolled infections, or known infection with human immunodeficiency virus (HIV)
* Known hypersensitivity to any of the study drugs, excipients, and/or murine proteins
* Current chronic daily treatment with corticosteroids
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hoffmann-La Roche

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Clinical Trials

Role: STUDY_DIRECTOR

Hoffmann-La Roche

Locations

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Clinical Centre Nis, Clinic for Oncology

Niš, , Serbia

Site Status

Hospital General Universitario de Elche; Servicio de Oncologia

Elche, Alicante, Spain

Site Status

Rocky Mountain Cancer Center - Lakewood (West)

Lakewood, Colorado, United States

Site Status

Illinois Cancer Care

Peoria, Illinois, United States

Site Status

Cancer Center of Kansas

Wichita, Kansas, United States

Site Status

Maryland Oncology Hematology

Rockville, Maryland, United States

Site Status

Texas Oncology - Dallas Presbyterian Hospital

Dallas, Texas, United States

Site Status

Texas Oncology - Baylor Charles A. Sammons Cancer Center

Dallas, Texas, United States

Site Status

Texas Oncology - Memorial City

Houston, Texas, United States

Site Status

USOR - Texas Oncology - San Antonio Northeast

San Antonio, Texas, United States

Site Status

Texas Oncology- Northeast Texas

Tyler, Texas, United States

Site Status

Hospital Britanico de Buenos Aires

Ciudad Autonoma Buenos Aires, , Argentina

Site Status

Instituto de Câncer E Transplante

Curitiba, Paraná, Brazil

Site Status

Clinicas Oncologicas Integradas - COI

Rio de Janeiro, Rio de Janeiro, Brazil

Site Status

Instituto de Ensino e Pesquisa Sao Lucas - IEP

São Paulo, São Paulo, Brazil

Site Status

Núcleo de Pesquisa São Camilo; ONCOLOGIA CLINICA / QUIMIOTERAPIA

São Paulo, São Paulo, Brazil

Site Status

Bradford Hill Centro de Investigaciones Clinicas

Recoleta, , Chile

Site Status

Hospital Hermanos Ameijeiras

La Habana, , Cuba

Site Status

Instituto Nacional de Oncología y Radiología (INOR)

La Habana, , Cuba

Site Status

KYS Sadesairaala; Syopatautien poliklinikka

Kuopio, , Finland

Site Status

VAASAN KESKUSSAIRAALA; Onkologian poliklinikka

Vaasa, , Finland

Site Status

Princess Margaret Hospital, Oncology; Department of Oncology

Hong Kong, , Hong Kong

Site Status

Prince of Wales Hosp; Dept. Of Clinical Onc

Shatin, , Hong Kong

Site Status

King Hussein Cancer Center

Amman, , Jordan

Site Status

Bellevue Medical Center

El-Metn, , Lebanon

Site Status

Hammoud Hospital

Saida, , Lebanon

Site Status

Consultorio Privado (José Luis González Trujillo)

León, Guanajuato, Mexico

Site Status

Centro Médico Zambrano Hellion

Monterrey, Nuevo León, Mexico

Site Status

Cuidados oncologicos

Querétaro City, Querétaro, Mexico

Site Status

Centro Oncológico de Panamá

Panama City, , Panama

Site Status

Centro Hemato Oncologico Panama

Panama City, , Panama

Site Status

Hospital da Luz; Departamento de Oncologia Medica

Lisbon, , Portugal

Site Status

Hospital de Santa Maria; Servico de Oncologia Medica

Lisbon, , Portugal

Site Status

IPO do Porto; Servico de Oncologia Medica

Porto, , Portugal

Site Status

National Center for Cancer Care and Research

Doha, , Qatar

Site Status

King Fahad Medical City; Gastroentrology

Riyadh, , Saudi Arabia

Site Status

Institute of Oncology and Radiology of Serbia

Belgrade, , Serbia

Site Status

Hospital Universitario de Canarias;servicio de Oncologia

San Cristóbal de La Laguna, Tenerife, Spain

Site Status

Sodersjukhuset; Onkologkliniken

Stockholm, , Sweden

Site Status

Västmanlands sjukhus Västerås, Onkologkliniken

Västerås, , Sweden

Site Status

Countries

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United States Argentina Brazil Chile Cuba Finland Hong Kong Jordan Lebanon Mexico Panama Portugal Qatar Saudi Arabia Serbia Spain Sweden

References

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O'Shaughnessy J, Sousa S, Cruz J, Fallowfield DL, Auvinen P, Pulido C, Cvetanovic A, Wilks S, Ribeiro L, Burotto M, Boulet T, Revelant V, Theron N, Trask P, Wahyudi L, Kirchmayer Machackova Z, Stamatovic L. Long-Term Safety and Efficacy of the Fixed-Dose Combination of Pertuzumab and Trastuzumab for Subcutaneous Injection in Patients With HER2-Positive Early Breast Cancer in PHranceSCa, a Randomized, Open-Label Phase II Study. Clin Breast Cancer. 2025 Aug;25(6):554-559.e1. doi: 10.1016/j.clbc.2025.04.016. Epub 2025 May 3.

Reference Type DERIVED
PMID: 40461387 (View on PubMed)

O'Shaughnessy J, Sousa S, Cruz J, Fallowfield L, Auvinen P, Pulido C, Cvetanovic A, Wilks S, Ribeiro L, Burotto M, Klingbiel D, Messeri D, Alexandrou A, Trask P, Fredriksson J, Machackova Z, Stamatovic L; PHranceSCa study group. Preference for the fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection in patients with HER2-positive early breast cancer (PHranceSCa): A randomised, open-label phase II study. Eur J Cancer. 2021 Jul;152:223-232. doi: 10.1016/j.ejca.2021.03.047. Epub 2021 Jun 16.

Reference Type DERIVED
PMID: 34147014 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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2018-002153-30

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

MO40628

Identifier Type: -

Identifier Source: org_study_id

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