A Phase II Study of U3-1402 in Patients with Metastatic Breast Cancer.
Primary Objective:
To evaluate overall response rate (ORR) and progression-free survival at 6 months (PFS-6) of single agent U3-1402 in patients with metastatic breast cancer (MBC).
Secondary Objectives:
1. To assess the safety and tolerability of U3-1402 in patients with MBC.
2. To estimate the duration of response (DoR) and PFS in patients with MBC.
- Rutgers Cancer Institute of New Jersey
- RWJBarnabas Health
- Jersey City Medical Center, Jersey City
Eligibility Criteria:
Inclusion criteria for Part A and B (HER2-negative) and Part Z (HER2-positive) cohorts:
1. Written informed consent, according to local guidelines, signed and dated by the
patient or by a legal guardian prior to the performance of any study-specific
procedures, sampling, or analyses
2. Women and men at least 18 years-of-age at the time of signature of the informed
consent form (ICF)
3. Histologically documented locally advanced or metastatic breast cancer
4. Triple-negative breast cancer (TNBC) patients should have received at least 1 but no
more than 5 prior lines of chemotherapy in the metastatic setting
5. Parts A and B patients only: Patients with HR+ HER2-negative MBC should have
received prior treatment with endocrine therapy +CDK 4/6 inhibitor. No limit to
prior endocrine therapy regimens, but no more than 2 prior chemotherapy regimens in
the metastatic setting are allowed. HR+ = Estrogen receptor (ER) and/or Progesterone
(PgR) positivity that are defined as ≥1% of cells expressing HR via IHC analysis.
HER2 negativity is defined as either of the following: IHC 0, IHC 1+, or IHC 2+/in
situ hybridization (ISH) negative.
6. Part B patients only: Patients with HER2-negative MBC will be included into one of
the following 2 subgroups: 1) MBC HR+, HER2-, regardless of HER3 expression, who
have received trastuzumab deruxtecan and/or sacituzumab govitecan, or, 2) mTNBC,
regardless of HER3 expression, who have received sacituzumab govitecan and/or
datopotamab deruxtecan.
7. Part Z patients only: should have documented HER2-positive expression as per
American Society of Clinical Oncology - College of American Pathologists guidelines
based on local testing.
8. Part Z patients only: should have had prior treatment with at least 2 anti-HER2
therapies, 1 of which must be trastuzumab deruxtecan. These patients must have
experienced disease progression after receiving trastuzumab deruxtecan.
9. At least 1 measurable lesion per Response Evaluation Criteria in Solid Tumors
(RECIST) v1.1 (bone-only disease excluded)
10. Patients who have received radiation or surgery for brain metastases are eligible if
therapy was completed ≥4 weeks prior to initiation of study treatment (2 weeks for
patients who received palliative radiation therapy), there is no evidence of central
nervous system disease progression on a scan or mild neurologic symptoms, and there
is no requirement for chronic corticosteroid therapy for the treatment of brain
metastases
11. Willingness to undergo pre-treatment biopsy and on-treatment biopsies; must have a
tumor amenable to pre-treatment biopsy (unless archived tissue is available and was
obtained within 2 months prior to starting treatment) and on-treatment biopsy
(excludes bone lesions and previously irradiated lesions)
12. Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0 or 1
13. Has adequate organ function within 7 days before the start of study treatment,
defined as:
- Platelet count ≥100 × 109/L
- Hemoglobin (Hb) ≥9 g/dL (transfusion and/or growth factor support allowed)
- Absolute neutrophil count ≥1.5 × 109/L
- Prothrombin time (PT) and partial thromboplastin time (PTT) ≤1.5 × the upper
limit of normal (ULN), except for patients on coumadin-derivative
anticoagulants or other similar anticoagulant therapy, who must have
PT-international normalized ratio (INR) within therapeutic range as deemed
appropriate by the Investigator
- Serum creatinine ≤1.5 × ULN, or creatinine clearance ≥50 mL/min as calculated
using the modified Cockcroft-Gault equation; confirmation of creatinine
clearance is only required when creatinine is >1.5 × ULN
- AST/ALT ≤3 × ULN (if liver metastases are present, ≤5 × ULN)
- Total bilirubin ≤1.5 × ULN if no liver metastases or <3 × ULN in the presence
of documented Gilbert's syndrome or liver metastases
- Serum albumin ≥2.5 g/dL
14. Male patients with female partners of childbearing potential and female patients of
childbearing potential are required to use two forms of acceptable contraception,
including one barrier method, during their participation in the study and for at
least 7 months following last dose. Male patients must also refrain from donating
sperm during their participation in the study.
Exclusion Criteria
Patients who meet any of the following criteria will be excluded from study entry:
Exclusion criteria for Parts A and B (HER2-negative) and Part Z (HER2-positive) cohorts:
1. Treatment with any of the following:
- Any systemic anti-cancer chemotherapy, small molecule, biologic, hormonal
agent, or immune checkpoint inhibitor therapy from a previous treatment regimen
or clinical study within 21 days prior to the first dose of patritumab
deruxtecan
- Prior treatment with any HER3-targeting agent
- Major surgery (excluding placement of vascular access) within 4 weeks of the
first dose of study drug treatment
- Radiotherapy treatment to more than 30% of the bone marrow or with a wide field
of radiation within 4 weeks of the first dose of study drug treatment, or
palliative radiation therapy within 2 weeks of the first dose of study drug
treatment
- Chloroquine /hydroxychloroquine ≤14 days prior to the first dose of study drug
treatment
2. Has any hypersensitivity to drug substances or inactive ingredients in drug product
3. Has any history of ILD (including pulmonary fibrosis or radiation pneumonitis), has
clinically significant ILD, or is suspected to have such disease by imaging during
screening. If imaging findings are unlikely to indicate a history of pneumonitis,
then the Investigator should discuss the considerations with the Medical Monitor
about potential enrollment and record the reasoning in the source documentation.
4. Clinically severe pulmonary compromise (based on Investigator's assessment)
resulting from intercurrent pulmonary illnesses including, but not limited to:
- Any underlying pulmonary disorder (e.g., pulmonary emboli, severe asthma,
severe chronic obstructive pulmonary disease, restrictive lung disease, pleural
effusion)
- Any autoimmune, connective tissue or inflammatory disorder with pulmonary
involvement (e.g., rheumatoid arthritis, Sjögren's syndrome, sarcoidosis)
OR prior pneumonectomy
5. With the exception of alopecia, any unresolved toxicities from prior therapy greater
than Common Terminology Criteria for Adverse Events (CTCAE) Grade 1 or baseline at
the time of starting study treatment. Note: patients with chronic Grade 2 toxicities
who are asymptomatic or adequately managed with stable medication may be eligible
with approval by the Medical Monitor.
6. Leptomeningeal metastases or evidence of spinal cord compression or brain
metastases, defined as being clinically active and symptomatic, or requiring therapy
with corticosteroids or anticonvulsants to control associated symptoms. Patients
with clinically inactive or treated brain metastases who are asymptomatic (i.e.,
without neurologic signs or symptoms and do not require treatment with
corticosteroids or anticonvulsants) may be included in the study. Patients must have
a stable neurologic status for at least 2 weeks prior to Cycle 1 Day 1.
7. Women who are pregnant, nursing, or plan to become pregnant while in the study and
for at least 7 months after the last administration of study treatment
8. Men who plan to father a child while in the study and for at least 7 months after
the last administration of study treatment
9. Uncontrolled or significant cardiovascular disorder prior to Cycle 1 Day 1,
including:
- Mean resting corrected QT interval using Fridericia's formula (QTcF)
prolongation to >470 ms for females and >450 ms for males in three successive
screening measurements
- Patients with a left ventricular ejection fraction (LVEF) <50%
- Resting systolic blood pressure >180 mmHg or diastolic blood pressure >110
mmHg).
- Documented myocardial infarction within 6 months
- Congestive heart failure (New York Heart Association ≥ Grade 2 within 28 days
10. Has known clinically significant corneal disease from prior therapies such as
drug-induced keratitis
11. Is receiving chronic systemic corticosteroids dosed at >10 mg prednisone or
equivalent anti-inflammatory activity or any form of immunosuppressive therapy prior
to Cycle 1 Day 1. Patients who require use of bronchodilators, inhaled or topical
steroids, or local steroid injections may be included in the study.
12. As judged by the Investigator, any evidence of severe or uncontrolled systemic
diseases, including uncontrolled hypertension, uncontrolled diabetes mellitus,
active bleeding diatheses, or active infection, including hepatitis B, hepatitis C,
and human immunodeficiency virus. Screening for chronic conditions is not required.
13. Presence of other active invasive cancers other than the one treated in this study
within 3 years prior to screening, except appropriately treated basal cell carcinoma
of the skin, in situ carcinoma of uterine cervix, or other local tumors considered
cured by local treatment
14. Psychological, familial, sociological, or geographical conditions that do not permit
compliance with the protocol and/or follow-up procedures outlined in the protocol
Additional exclusion criteria only for Parts A and B (HER2-negative) cohorts:
15. Patients with HER2+ breast cancer per ASCO-CAP guidelines
16. Part A only: Prior treatment with an antibody drug conjugate that consists of an
exatecan derivative that is a topoisomerase I inhibitor (e.g., trastuzumab
deruxtecan, DS-1062a [datopotamab deruxtecan], and DS-7300a [B7-H3 DXd-ADC])
17. Part B patients only: Prior treatment with trastuzumab deruxtecan, sacituzumab
govitecan, and/or datopotamab deruxtecan with any of the following:
- A severe reaction or severe tolerability issues that necessitated stopping
treatment with the therapy
- Any unresolved toxicities from the prior therapy greater than Grade 1, with the
exception of alopecia
Additional exclusion criteria only for Part Z (HER2-positive) cohort:
18. Treatment with any of the following:
- Prior treatment with an antibody drug conjugate that consists of an exatecan
derivative that is a topoisomerase I inhibitor except trastuzumab deruxtecan
- Prior treatment with trastuzumab deruxtecan within 4 weeks prior to the first
dose of patritumab deruxtecan
19. Uncontrolled or significant cardiovascular disease, including history of myocardial
infarction within 6 months before enrollment
20. A severe reaction or severe tolerability issues that necessitated stopping treatment
with trastuzumab deruxtecan
21. Any unresolved toxicities from prior therapy with trastuzumab deruxtecan
Please note that we have obtained the inclusion and exclusion criteria information from the National Institutes of Health’s clinical trials web site ClinicalTrials.gov. The listed criteria may not necessarily reflect recent amendments to the protocol and the current criteria.
For further information about clinical trials, please contact us at 732-235-7356.