DETERMINE Trial Treatment Arm 04: Trastuzumab in Combination With Pertuzumab in Adult, Paediatric and Teenage/Young Adult Patients With Cancers With HER2 Amplification or Activating Mutations

NCT ID: NCT05786716

Last Updated: 2025-12-02

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

RECRUITING

Clinical Phase

PHASE2/PHASE3

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-07

Study Completion Date

2029-10-31

Brief Summary

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

This clinical trial is looking at a combination of drugs called trastuzumab and pertuzumab. This combination of drugs is approved together as standard of care treatment for adult patients with breast cancer (often with other anti-cancer drugs). This means it has gone through clinical trials and been approved by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK.

Trastuzumab and pertuzumab work in patients with these types of cancers which have a molecular alteration called HER2 amplification or HER2 activating mutation.

Investigators now wish to find out if it will be useful in treating patients with other cancer types which are also HER2 amplified or HER2 mutated. If the results are positive, the study team will work with the NHS and the Cancer Drugs Fund to see if these drugs can be routinely accessed for patients in the future.

This trial is part of a trial programme called DETERMINE. The programme will also look at other anti-cancer drugs in the same way, through matching the drug to rare cancer types or ones with specific mutations.

Detailed Description

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

DETERMINE Treatment Arm 04: Trastuzumab in combination with pertuzumab in Adult, Paediatric and TYA patients with rare\* cancers with HER2 amplification or activating mutations and in common cancers where HER2 amplification or activating mutations are considered to be infrequent.

\*Rare is defined generally as incidence less than 6 cases in 100,000 patients (includes paediatric and teenagers/young adult cancers) or common cancers with rare alterations.

This treatment arm has a target sample size of 30 evaluable patients. Sub-cohorts may be defined and further expanded to a target of 30 evaluable patients each.

The ultimate aim is to translate positive clinical findings to the NHS (Cancer Drugs Fund) to provide new treatment options for rare adult, paediatric and TYA cancers.

OUTLINE:

Pre-screening: The Molecular Tumour Board (MTB) makes a treatment recommendation for the patient based on molecularly-defined cohorts.

Screening: Consenting patients undergo biopsy and collection of blood samples for research purposes.

Treatment: Patients will receive trastuzumab and pertuzumab until disease progression without clinical benefit, unacceptable adverse events (AEs) or withdrawal of consent. Patients will also undergo collection of blood samples at various intervals while receiving treatment and at End of Treatment (EoT).

After completion of study treatment, patients are followed up every 3 months for 2 years.

THE DETERMINE TRIAL MASTER (SCREENING) PROTOCOL:

Please see DETERMINE Trial Master (Screening) Protocol record (NCT05722886) for information on the DETERMINE Trial Master Protocol and applicable documents.

Conditions

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

Haematological Malignancy Colorectal Neoplasms Urinary Bladder Neoplasm Gallbladder Neoplasms Salivary Gland Neoplasm Lung Neoplasm Pancreatic Neoplasm Ovarian Neoplasms Prostatic Neoplasm Skin Neoplasm Solid Tumour

Study Design

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

Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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

Treatment Arm 04: trastuzumab in combination with pertuzumab

This trastuzumab and pertuzumab treatment arm is for adult, paediatric and TYA patients with cancers with HER2 amplification or activating mutations.

Group Type EXPERIMENTAL

Trastuzumab

Intervention Type DRUG

An initial loading dose of 8 mg/kg body weight, followed thereafter by a maintenance dose of 6 mg/kg body weight administered intravenously every 21 days. Patients may continue until disease progression without clinical benefit, unacceptable AEs or withdrawal of consent.

Pertuzumab

Intervention Type DRUG

An initial loading dose of 640 mg, followed thereafter by a maintenance dose of 420 mg administered intravenously every 21 days. Paediatric patients will receive an initial loading dose of 14 mg/kg (maximum 840 mg), followed thereafter by a maintenance dose of 7 mg/kg (maximum 420 mg) administered intravenously every 21 days. Patients may continue until disease progression without clinical benefit, unacceptable AEs or withdrawal of consent.

Interventions

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

Trastuzumab

An initial loading dose of 8 mg/kg body weight, followed thereafter by a maintenance dose of 6 mg/kg body weight administered intravenously every 21 days. Patients may continue until disease progression without clinical benefit, unacceptable AEs or withdrawal of consent.

Intervention Type DRUG

Pertuzumab

An initial loading dose of 640 mg, followed thereafter by a maintenance dose of 420 mg administered intravenously every 21 days. Paediatric patients will receive an initial loading dose of 14 mg/kg (maximum 840 mg), followed thereafter by a maintenance dose of 7 mg/kg (maximum 420 mg) administered intravenously every 21 days. Patients may continue until disease progression without clinical benefit, unacceptable AEs or withdrawal of consent.

Intervention Type DRUG

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Herceptin Perjeta

Eligibility Criteria

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

Inclusion Criteria

A. Confirmed diagnosis of a malignancy harbouring HER2 amplification, or an appropriate activating mutation as defined by the MTB, using an analytically validated next-generation sequencing method.

• A HER2 amplification copy number between 5-9 will require an MTB discussion. A HER2 amplification copy number ≥10 will be fast-tracked for an MTB recommendation, unless there are any patient-specific individualities (such as multiple gene amplifications) that require MTB discussion.

B. Age 12 years or above.

C. Women of childbearing potential are eligible provided that they meet the following criteria:

Have a negative serum or urine pregnancy test before enrolment and;

Agree to use one form of effective birth control method such as:

I. combined (oestrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal or transdermal):

II. progestogen-only hormonal contraception associated with or without inhibition of ovulation (oral, injectable or implantable)

III. intrauterine device (IUD)

IV. intrauterine hormone-releasing system (IUS)

V. bilateral tubal occlusion

VI. vasectomised partner

VII. sexual abstinence

VIII. male or female condom with or without spermicide

IX. cap, diaphragm or sponge with spermicide

Effective from the first administration of trastuzumab or pertuzumab (whichever is first), throughout the trial and for seven months after the last administration of trastuzumab or pertuzumab (whichever is later).

D. Male patients with partners who are women of childbearing potential are eligible provided that they agree to the following, from the first administration of trastuzumab or pertuzumab (whichever is first), throughout the trial and for seven months after the last administration of trastuzumab or pertuzumab (whichever is later):

* Agree to take measures not to father children by using a barrier method of contraception (condom plus spermicide) or to sexual abstinence.
* Non-vasectomised male patients with partners who are women of childbearing potential must also be willing to ensure that their partner uses an effective method of contraception as in C, above.
* Male patients with pregnant or lactating partners must be advised to use barrier method contraception (e.g. condom) to prevent drug exposure of the foetus or neonate.

All male patients must refrain from donating sperm for the same period.

E. Patients must be able and willing to undergo a fresh tissue biopsy at baseline and blood samples for translational research. Note that for patients with haematological malignancies or neuroblastomas, blood, bone marrow aspiration and/or trephine or lymph node biopsy samples may be taken.

F. ADULT PATIENTS (≥18 years): Adequate organ function as per haematological and biochemical indices within the ranges defined in the protocol. These measurements should be performed to confirm the patient's eligibility.

G. PAEDIATRIC PATIENTS (\<18 years): Adequate organ function as per haematological and biochemical indices within the ranges defined in the protocol. These measurements should be performed to confirm the patient's eligibility.

Exclusion Criteria

A. Diagnosis of HER2-positive early or metastatic breast cancer.

B. Female patients who are pregnant, breastfeeding or planning to become pregnant during the trial or within seven months following their last dose of trastuzumab or pertuzumab (whichever is later).

C. Severe dyspnoea at rest due to complications of advanced malignancy or requiring supplementary oxygen therapy.

D. Known hypersensitivity to trastuzumab or pertuzumab, murine proteins, or to any of the excipients.

E. Patients who were administered a live, attenuated vaccine within 28 days prior to enrolment, or anticipation of need for such a vaccine during trastuzumab and pertuzumab treatment or within six months after the final dose of trastuzumab and pertuzumab.

F. Patients with clinically significant pre-existing cardiac conditions, including uncontrolled or symptomatic angina, uncontrolled atrial or ventricular arrhythmias (within three months), NYHA class III or IV congestive heart failure.

Left Ventricular Ejection Fraction \<55%.

Patients with a cerebrovascular event (including stroke or transient ischaemic attack \[TIA\]) or cardiovascular event (including acute myocardial infarction \[MI\]) within three months before the first dose of trastuzumab and pertuzumab.

• Patients with primary CNS tumours may be considered unless intra-tumoural bleeding has occurred within 2 weeks of the first dose of trastuzumab and pertuzumab, and patients with punctate CNS haemorrhages \<3 mm may be considered.

G. Prior treatment with the same class of drug unless genetic profile demonstrates a mechanism of resistance known to be potentially sensitive to trastuzumab or pertuzumab.

H. Any clinically significant concomitant disease or condition (or its treatment) that could interfere with the conduct of the trial or absorption of oral medications or that would, in the opinion of the Investigator, pose an unacceptable risk to the patient in this trial.

I. Known active infections (bacterial, fungal or viral) that would interfere with the assessment of safety or efficacy of trastuzumab and pertuzumab, including human immunodeficiency virus (HIV) positivity. Patients with history of testing positive for HIV infection are eligible provided the each of the following conditions are met:

* CD4 count ≥350/μL;
* undetectable viral load;
* receiving antiretroviral therapy (ART) that does not interact with IMP (patients should be on established ART for at least four weeks); and
* no HIV/ acquired immune deficiency syndrome (AIDS)-associated opportunistic infection in the last 12 months.
Minimum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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

University of Manchester

OTHER

Sponsor Role collaborator

University of Birmingham

OTHER

Sponsor Role collaborator

Royal Marsden NHS Foundation Trust

OTHER

Sponsor Role collaborator

Hoffmann-La Roche

INDUSTRY

Sponsor Role collaborator

Cancer Research UK

OTHER

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.

Matthew Krebs, Dr

Role: PRINCIPAL_INVESTIGATOR

The Christie Hospital

Locations

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

Belfast City Hospital

Belfast, , United Kingdom

Site Status RECRUITING

University Hospital Birmingham

Birmingham, , United Kingdom

Site Status RECRUITING

Birmingham Children's Hospital

Birmingham, , United Kingdom

Site Status NOT_YET_RECRUITING

Bristol Royal Hospital for Children

Bristol, , United Kingdom

Site Status RECRUITING

Bristol Haematology and Oncology Centre

Bristol, , United Kingdom

Site Status RECRUITING

Addenbrooke's Hospital

Cambridge, , United Kingdom

Site Status RECRUITING

Velindre Cancer Centre

Cardiff, , United Kingdom

Site Status RECRUITING

Cardiff Children's Hospital

Cardiff, , United Kingdom

Site Status NOT_YET_RECRUITING

Western General Hospital

Edinburgh, , United Kingdom

Site Status RECRUITING

The Beatson Hospital

Glasgow, , United Kingdom

Site Status RECRUITING

Royal Hospital for Children Glasgow

Glasgow, , United Kingdom

Site Status RECRUITING

Leicester Royal Infirmary

Leicester, , United Kingdom

Site Status RECRUITING

Alder Hey Hospital

Liverpool, , United Kingdom

Site Status RECRUITING

University College London Hospital

London, , United Kingdom

Site Status RECRUITING

Guy's Hospital

London, , United Kingdom

Site Status RECRUITING

Great Ormond Street Hospital

London, , United Kingdom

Site Status RECRUITING

Royal Manchester Children's Hospital

Manchester, , United Kingdom

Site Status NOT_YET_RECRUITING

The Christie Hospital

Manchester, , United Kingdom

Site Status RECRUITING

Clatterbridge Cancer Centre

Metropolitan Borough of Wirral, , United Kingdom

Site Status RECRUITING

Great North Children's Hospital

Newcastle, , United Kingdom

Site Status RECRUITING

Freeman Hospital

Newcastle, , United Kingdom

Site Status RECRUITING

Churchill Hospital

Oxford, , United Kingdom

Site Status RECRUITING

John Radcliffe Hospital

Oxford, , United Kingdom

Site Status RECRUITING

Weston Park Hospital

Sheffield, , United Kingdom

Site Status RECRUITING

Sheffield's Children's Hospital

Sheffield, , United Kingdom

Site Status RECRUITING

Southampton General Hospital

Southampton, , United Kingdom

Site Status RECRUITING

The Royal Marsden Hospital

Sutton, , United Kingdom

Site Status RECRUITING

Countries

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

United Kingdom

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Aida Sarmiento Castro

Role: CONTACT

+44 207 242 0200

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Vicky Coyle, Prof

Role: primary

Gary Middleton, Prof

Role: primary

0121 371 3573

Gerard Millen, Dr

Role: primary

07921843607

Antony Ng, Dr

Role: primary

0117 342 8044

Antony Ng, Dr

Role: primary

0117 342 8044

Bristi Basu, Dr

Role: primary

01223 596105

Robert Jones, Dr

Role: primary

02920 615888 ext. 6327

Madeline Adams, Dr

Role: primary

+442921842285

Stefan Symeonides, Dr

Role: primary

Patricia Roxburgh, Dr

Role: primary

0141 301 7118

Milind Ronghe, Dr

Role: primary

0141 452 6692

Olubukola Ayodele, Dr

Role: primary

0116 2587601

Lisa Howell, Dr

Role: primary

0151 293 3679

Martin Forster, Prof

Role: primary

020 3447 5085

James Spicer, Dr

Role: primary

020 7188 4260

Darren Hargrave, Dr

Role: primary

0207 813 8525

Guy Makin, Dr

Role: primary

0161 701 8419

Matthew Krebs, Dr

Role: primary

0161 918 7672

Dan Palmer, Dr

Role: primary

0151 706 4172 / 0151 706 4177

Alastair Greystoke, Dr

Role: primary

0191 2138476

Alastair Greystoke, Dr

Role: primary

0191 2138476

Sarah Pratap, Dr

Role: primary

01865 235273

Sarah Pratap, Dr

Role: primary

01865 235273

Sarah Danson, Dr

Role: primary

0114 226 5068

Daniel Yeomanson, Dr

Role: primary

01142717366

Juliet Gray, Prof

Role: primary

0238 120 6639

Lynley Marshall, Dr

Role: primary

0208 661 3678

Related Links

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

http://CRUK.org/determine

Overview of the DETERMINE trial.

https://clinicaltrials.gov/ct2/show/NCT05722886

ClinicalTrials.gov record for DETERMINE Trial Master Screening Protocol (NCT05722886).

Other Identifiers

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

CRUKD/21/004 - Treatment Arm 4

Identifier Type: -

Identifier Source: org_study_id

IRAS ID: 1004057

Identifier Type: OTHER

Identifier Source: secondary_id

More Related Trials

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

T-DM1 vs Paclitaxel/Trastuzumab for Breast (ATEMPT Trial)
NCT01853748 ACTIVE_NOT_RECRUITING PHASE2