A Study To Evaluate the Efficacy and Safety Of Atezolizumab or Placebo in Combination With Neoadjuvant Doxorubicin + Cyclophosphamide Followed By Paclitaxel + Trastuzumab + Pertuzumab In Early Her2-Positive Breast Cancer

NCT ID: NCT03726879

Last Updated: 2024-11-05

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

PHASE3

Total Enrollment

454 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-01-11

Study Completion Date

2023-08-24

Brief Summary

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This study (also known as IMpassion050) will evaluate the efficacy and safety of atezolizumab compared with placebo when given in combination with neoadjuvant dose-dense anthracycline (doxorubicin) + cyclophosphamide followed by paclitaxel + trastuzumab + pertuzumab (ddAC-PacHP) in patients with early HER2-positive breast cancer (T2-4, N1-3, M0).

Detailed Description

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Conditions

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Breast Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers

Study Groups

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Atezolizumab +ddAC-PacHP

Participants will receive atezolizumab (atezo) 840 mg IV Q2W for 4 cycles during neoadjuvant phase with ddAC (doxorubicin 60 mg/m2 \& cyclophosphamide 600 mg/m2 IV), followed by atezo 1200 mg IV Q3W for 4 cycles with paclitaxel 80 mg/m2 IV weekly for 12 continuous weeks, trastuzumab 6 mg/kg IV (with initial 8mg/kg IV loading dose) Q3W for 4 cycles, \& pertuzumab 420 mg IV (with initial 840-mg IV loading dose) Q3W for 4 cycles. During adjuvant phase, participants will continue to receive following study treatments Q3W to complete up to 1 year HER2-target therapy inclusive of therapy given both in neoadjuvant and adjuvant setting: atezo 1200 mg IV Q3W, trastuzumab 6 mg/kg IV (with initial 8-mg/kg IV loading dose) Q3W, \& pertuzumab 420 mg IV (with initial 840-mg IV loading dose) Q3W. Participants who do not achieve pCR have option of receiving blinded atezo+trastuzumab emtansine post surgery for 14 cycles. In response to USM DIL dated 3 Feb 2021 treatment with atezo must be discontinued.

Group Type EXPERIMENTAL

Cyclophosphamide

Intervention Type DRUG

Cyclophosphamide will be administered as per the schedule specified in the respective arm.

Paclitaxel

Intervention Type DRUG

Paclitaxel will be administered as per the schedule specified in the respective arm.

Trastuzumab

Intervention Type DRUG

Trastuzumab will be administered as per the schedule specified in the respective arm.

Pertuzumab

Intervention Type DRUG

Pertuzumab will be administered as per the schedule specified in the respective arm.

Trastuzumab Emtansine

Intervention Type DRUG

Participants without pCR have the option of receiving adjuvant atezolizumab/placebo combined with Trastuzumab Emtansine 3.6 mg/kg IV Q3W.

Atezolizumab

Intervention Type DRUG

Atezolizumab will be administered as per the schedule specified in the respective arm.

Doxorubicin

Intervention Type DRUG

Doxorubicin will be administered as per the schedule specified in the respective arm.

Placebo + ddAC-PacHP

Participants will receive placebo 840 mg IV Q2W for 4 cycles during neoadjuvant phase with ddAC (doxorubicin 60 mg/m2 \& cyclophosphamide 600 mg/m2 IV), followed by placebo 1200 mg IV Q3W for 4 cycles with paclitaxel 80 mg/m2 IV weekly for 12 continuous weeks, trastuzumab 6 mg/kg IV (with initial 8-mg/kg IV loading dose) Q3W for 4 cycles \& pertuzumab 420 mg IV (with initial 840-mg IV loading dose) Q3W for 4 cycles. During adjuvant phase, participants will continue to receive following study treatments Q3W to complete up to 1 year HER2-target therapy inclusive of therapy given both in neoadjuvant \& adjuvant setting: placebo 1200 mg IV Q3W, trastuzumab 6 mg/kg IV (with initial 8-mg/kg IV loading dose) Q3W, \& pertuzumab 420 mg IV (with initial 840-mg IV loading dose) Q3W. Participants who do not achieve pCR have option of receiving blinded atezolizumab + trastuzumab emtansine post surgery for 14 cycles. In response to USM DIL, dated 3 Feb 2021 treatment with placebo must be discontinued.

Group Type PLACEBO_COMPARATOR

Cyclophosphamide

Intervention Type DRUG

Cyclophosphamide will be administered as per the schedule specified in the respective arm.

Paclitaxel

Intervention Type DRUG

Paclitaxel will be administered as per the schedule specified in the respective arm.

Trastuzumab

Intervention Type DRUG

Trastuzumab will be administered as per the schedule specified in the respective arm.

Pertuzumab

Intervention Type DRUG

Pertuzumab will be administered as per the schedule specified in the respective arm.

Trastuzumab Emtansine

Intervention Type DRUG

Participants without pCR have the option of receiving adjuvant atezolizumab/placebo combined with Trastuzumab Emtansine 3.6 mg/kg IV Q3W.

Placebo

Intervention Type DRUG

Placebo matched to atezolizumab will be administered as per the schedule specified in the respective arm.

Doxorubicin

Intervention Type DRUG

Doxorubicin will be administered as per the schedule specified in the respective arm.

Interventions

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Cyclophosphamide

Cyclophosphamide will be administered as per the schedule specified in the respective arm.

Intervention Type DRUG

Paclitaxel

Paclitaxel will be administered as per the schedule specified in the respective arm.

Intervention Type DRUG

Trastuzumab

Trastuzumab will be administered as per the schedule specified in the respective arm.

Intervention Type DRUG

Pertuzumab

Pertuzumab will be administered as per the schedule specified in the respective arm.

Intervention Type DRUG

Trastuzumab Emtansine

Participants without pCR have the option of receiving adjuvant atezolizumab/placebo combined with Trastuzumab Emtansine 3.6 mg/kg IV Q3W.

Intervention Type DRUG

Atezolizumab

Atezolizumab will be administered as per the schedule specified in the respective arm.

Intervention Type DRUG

Placebo

Placebo matched to atezolizumab will be administered as per the schedule specified in the respective arm.

Intervention Type DRUG

Doxorubicin

Doxorubicin will be administered as per the schedule specified in the respective arm.

Intervention Type DRUG

Other Intervention Names

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Tecentriq Adriamycin Cytoxan Neosar Taxol Herceptin Perjeta Kadcyla

Eligibility Criteria

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Inclusion Criteria

* Confirmed diagnosis of HER2-positive breast cancer, and hormonal and PD-L1 status, as documented through central testing of a representative tumor tissue specimen
* Primary breast tumor size of \> 2 cm by any radiographic measurement
* Stage at presentation: T2-T4, N1-N3, M0 as determined by AJCC staging system, 8th edition
* Pathologic confirmation of nodal involvement with malignancy must be determined by fine needle aspiration or core-needle biopsy. Surgical excision of lymph nodes is not permitted.
* Patients with multifocal tumors are eligible provided at least one focus is sampled and centrally confirmed as HER2-positive.
* Patients with multicentric tumors are eligible provided all discrete lesions are sampled and centrally confirmed as HER2-positive.
* Eastern Cooperative Oncology Group Performance Status of 0 or 1
* Baseline LVEF \>= 55% measured by echocardiogram (ECHO) or multiple-gated acquisition (MUGA) scans
* Adequate hematologic and end-organ function obtained within 14 days prior to initiation of study treatment
* For women of childbearing potential: agreement to remain abstinent or use contraceptive methods, and agreement to refrain from donating eggs
* For men: agreement to remain abstinent or use contraceptive measures, and agreement to refrain from donating sperm

Exclusion Criteria

* Prior history of invasive breast cancer
* Stage IV (metastatic) breast cancer
* Patients with synchronous bilateral invasive breast cancer
* Prior systemic therapy for treatment of breast cancer
* Previous therapy with anthracyclines or taxanes for any malignancy
* Ulcerating or inflammatory breast cancer
* Undergone incisional and/or excisional biopsy of primary tumor and/or axillary lymph nodes
* Sentinel lymph node procedure or axillary lymph node dissection prior to initiation of neoadjuvant therapy
* History of other malignancy within 5 years prior to screening, with the exception of those patients who have a negligible risk of metastasis or death
* Cardiopulmonary dysfunction
* Dyspnea at rest
* Active or history of autoimmune disease or immune deficiency
* Pregnancy or breastfeeding, or intention of becoming pregnant during study treatment or within 5 months after the final dose of atezolizumab/placebo, 6 months after the final dose of doxorubicin, 12 months after the final dose of cyclophosphamide, 6 months after the final dose of paclitaxel, or 7 months after the final dose of trastuzumab, pertuzumab, or trastuzumab emtansine whichever occurs last


* Patients who achieved pCR
* Evidence of clinically evident gross residual or recurrent disease following neoadjuvant therapy and surgery
* Unable to complete surgery with curative intent after conclusion of neoadjuvant systemic therapy
* Patient discontinued treatment with trastuzumab because of toxicity during the neoadjuvant phase of the study
* Clinically significant history of liver disease, including cirrhosis, current alcohol abuse, autoimmune hepatic disorders, or sclerosis cholangitis
* Patients with Grade \>=2 peripheral neuropathy
* Prior treatment with trastuzumab emtansine
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Chugai Pharmaceutical

INDUSTRY

Sponsor Role collaborator

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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HCA Midwest Division

Kansas City, Missouri, United States

Site Status

New York University Medical Center PRIME; NYU Langone Medical Center

New York, New York, United States

Site Status

Tennessee Oncology - Nashville

Nashville, Tennessee, United States

Site Status

Hospital Sao Rafael - HSR

Salvador, Estado de Bahia, Brazil

Site Status

Hospital Araujo Jorge; Departamento de Ginecologia E Mama

Goiânia, Goiás, Brazil

Site Status

Hospital Nossa Senhora da Conceicao

Porto Alegre, Rio Grande do Sul, Brazil

Site Status

Hospital Sao Lucas - PUCRS

Porto Alegre, Rio Grande do Sul, Brazil

Site Status

Hospital Perola Byington

São Paulo, São Paulo, Brazil

Site Status

Tom Baker Cancer Centre-Calgary

Calgary, Alberta, Canada

Site Status

BCCA-Vancouver Cancer Centre

Vancouver, British Columbia, Canada

Site Status

Jewish General Hospital

Montreal, Quebec, Canada

Site Status

Hopital du Saint Sacrement

Québec, Quebec, Canada

Site Status

Masarykuv onkologicky ustav

Brno, , Czechia

Site Status

Fakultni nemocnice Olomouc; Onkologicka klinika

Olomouc, , Czechia

Site Status

Klinikum Essen-Mitte Ev. Huyssens-Stiftung / Knappschafts GmbH; Klinik für Senologie / Brustzentrum

Essen, , Germany

Site Status

Praxis für Interdisziplinäre Onkologie und Hämatologie GbR

Freiburg im Breisgau, , Germany

Site Status

Kooperatives Mammazentrum Hamburg Krankenhaus Jerusalem

Hamburg, , Germany

Site Status

Sankt Elisabeth Krankenhaus; Gynaekology

Leipzig, , Germany

Site Status

Rotkreuzklinikum München; Frauenklinik

München, , Germany

Site Status

Universitätsklinikum Münster; Klinik für Frauenheilkunde und Geburtshilfe

Münster, , Germany

Site Status

St. Vincenz-Krankenhaus Paderborn; Haus 3 Frauenklinik

Paderborn, , Germany

Site Status

Universitätsfrauenklinik Ulm; Abteilung Gynäkologie

Ulm, , Germany

Site Status

Istituto Nazionale Tumori Irccs Fondazione g. PASCALE;U.O.C. Oncologia Medica Senologica

Napoli, Campania, Italy

Site Status

Università degli Studi Federico II; Clinica di Oncologia Medica

Napoli, Campania, Italy

Site Status

Irccs Centro Di Riferimento Oncologico (CRO); Dipartimento Di Oncologia Medica

Aviano, Friuli Venezia Giulia, Italy

Site Status

Policlinico Universitario Agostino Gemelli

Rome, Lazio, Italy

Site Status

ASST DEGLI SPEDALI CIVILI DI BRESCIA; Oncologia Medica

Brescia, Lombardy, Italy

Site Status

ASST DI MONZA; Oncologia Medica

Monza, Lombardy, Italy

Site Status

Istituto Clinico Humanitas;U.O. Oncologia Medica Ed Ematologia

Rozzano, Lombardy, Italy

Site Status

Fondazione Del Piemonte Per L'oncologia Ircc Di Candiolo; Dipartimento Oncologico

Candiolo, Piedmont, Italy

Site Status

IOV - Istituto Oncologico Veneto - IRCCS; Oncologia Medica II

Padua, Veneto, Italy

Site Status

National Hospital Organization Shikoku Cancer Center

Ehime, , Japan

Site Status

Hiroshima City Hiroshima Citizens Hospital

Hiroshima, , Japan

Site Status

Hiroshima University Hospital

Hiroshima, , Japan

Site Status

National Hospital Organization Hokkaido Cancer Center

Hokkaido, , Japan

Site Status

Hyogo Cancer Center

Hyōgo, , Japan

Site Status

Kanagawa Cancer Center

Kanagawa, , Japan

Site Status

Tokai University Hospital

Kanagawa, , Japan

Site Status

Kumamoto Shinto General Hospital

Kumamoto, , Japan

Site Status

Fukushima Medical University Hospital

Miyagi, , Japan

Site Status

Niigata Cancer Center Hospital

Niigata, , Japan

Site Status

Saitama Medical University International Medical Center

Saitama, , Japan

Site Status

Toranomon Hospital

Tokyo, , Japan

Site Status

Showa University Hospital

Tokyo, , Japan

Site Status

Instytut "Centrum Zdrowia Matki Polki"; Klinika Onkologii

?ód?, , Poland

Site Status

Narodowy Inst.Onkol.im.Sklodowskiej-Curie Panstw.Inst.Bad Gliwice; Centr.Diagn.i Lecz.Chor.Piersi

Gliwice, , Poland

Site Status

Regionalny Szpital Specjalistyczny im. W. Bieganskiego; Oddzial Onkologii Klinicznej

Grudzi?dz, , Poland

Site Status

Szpital Uniwersytecki w Krakowie, Oddzia? Kliniczny Kliniki Onkologii

Krakow, , Poland

Site Status

Narodowy Inst.Onkologii im.Sklodowskiej-Curie Panstw.Inst.Bad; Klinika Nowtw.Piersi i Chir.Rekonstr

Warsaw, , Poland

Site Status

FSBI National Medical Research Radiological Center; A. TSYB MEDICAL RADIOLOGICAL RESEARCH CENTER

Obninsk, Kaluga Oblast, Russia

Site Status

City Clinical Oncology Hospital

Moscow, Moscow Oblast, Russia

Site Status

SBIH "Moscow Clinical Scientific and Practical Center named after A.S. Loginov of DHM"

Moskva, Moscow Oblast, Russia

Site Status

Blokhin Cancer Research Center; Combined Treatment

Moskva, Moscow Oblast, Russia

Site Status

Republican Clinical Oncology Dispensary of Ministry of Healthcare of Tatarstan Republic

Kazan', Tatarstan Republic, Russia

Site Status

Petrov Research Inst. of Oncology

Saint Petersburg, , Russia

Site Status

Gachon University Gil Medical Center

Incheon, , South Korea

Site Status

Korea University Anam Hospital

Seoul, , South Korea

Site Status

Seoul National University Hospital

Seoul, , South Korea

Site Status

Samsung Medical Centre; Oncology

Seoul, , South Korea

Site Status

Hospital Universitari Germans Trias i Pujol; Servicio de Oncologia

Badalona, Barcelona, Spain

Site Status

Hospital Univ Vall d'Hebron; Servicio de Oncologia

Sant Andreu de la Barca, Barcelona, Spain

Site Status

Hospital Universitario Virgen de La Arrixaca; Servicio De Oncologia

El Palmar, Murcia, Spain

Site Status

Clinica Universitaria de Navarra; Servicio de Oncologia

Pamplona, Navarre, Spain

Site Status

Hospital Clínic i Provincial; Servicio de Hematología y Oncología

Barcelona, , Spain

Site Status

Complejo Asistencial Universitario De Burgos; Servicio de Oncologia

Burgos, , Spain

Site Status

Hospital Clinico de Granada; Servicio de Oncologia

Granada, , Spain

Site Status

Complejo Hospitalario de Jaen-Hospital Universitario Medico Quirurgico; Servicio de Oncologia

Jaén, , Spain

Site Status

Hospital Universitari Arnau de Vilanova de Lleida; Servicio de Oncologia

Lleida, , Spain

Site Status

Clinica Universidad de Navarra Madrid; Servicio de Oncología

Madrid, , Spain

Site Status

Centro Integral Oncologico Clara Campal; Servicio de Oncología

Madrid, , Spain

Site Status

Hospital Universitario Virgen Macarena; Servicio de Oncologia

Seville, , Spain

Site Status

Hospital Universitario Virgen del Rocio; Servicio de Oncologia

Seville, , Spain

Site Status

China Medical University Hospital; Surgery

Taichung, , Taiwan

Site Status

Mackay Memorial Hospital; Dept of Surgery

Taipei, , Taiwan

Site Status

Koo Foundation Sun Yat-Sen Cancer Center; Hemato-Oncology

Taipei, , Taiwan

Site Status

Chang Gung Medical Foundation - Linkou; Dept of Surgery

Taoyuan District, , Taiwan

Site Status

Countries

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United States Brazil Canada Czechia Germany Italy Japan Poland Russia South Korea Spain Taiwan

References

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Huober J, Barrios CH, Niikura N, Jarzab M, Chang YC, Huggins-Puhalla SL, Pedrini J, Zhukova L, Graupner V, Eiger D, Henschel V, Gochitashvili N, Lambertini C, Restuccia E, Zhang H; IMpassion050 Trial Investigators. Atezolizumab With Neoadjuvant Anti-Human Epidermal Growth Factor Receptor 2 Therapy and Chemotherapy in Human Epidermal Growth Factor Receptor 2-Positive Early Breast Cancer: Primary Results of the Randomized Phase III IMpassion050 Trial. J Clin Oncol. 2022 Sep 1;40(25):2946-2956. doi: 10.1200/JCO.21.02772. Epub 2022 Jun 28.

Reference Type DERIVED
PMID: 35763704 (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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BO40747

Identifier Type: -

Identifier Source: org_study_id

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