To Evaluate the Safety, Tolerability, and Pharmacokinetics of Inavolisib Single Agent in Participants With Solid Tumors and in Combination With Endocrine and Targeted Therapies in Participants With Breast Cancer

Phase 1Active Not RecruitingNCT03006172

Genentech, Inc.200 enrolled

Overview

This is an open-label, multicenter, Phase I study designed to evaluate the safety, tolerability, and pharmacokinetics of inavolisib administered orally as a single agent in patients with locally advanced or metastatic PIK3CA-mutant solid tumors, including breast cancer, and in combination with standard-of-care endocrine and/or targeted therapies for the treatment of locally advanced or metastatic PIK3CA-mutant breast cancer. Participants will be enrolled in two stages: a dose-escalation stage (Stage I) and an expansion stage (Stage II). Participants will be assigned to one of seven regimens: inavolisib as a single agent (Arm A), inavolisib in combination with palbociclib and letrozole (Arm B), inavolisib in combination with letrozole (Arm C), inavolisib in combination with fulvestrant (Arm D), inavolisib in combination with palbociclib and fulvestrant (Arm E), inavolisib in combination with palbociclib, fulvestrant, and metformin (Arm F), and inavolisib in combination with trastuzumab and pertuzumab (and letrozole or fulvestrant, if applicable (Arm G)).

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

200

Conditions

Breast Cancer Solid Tumor

InavolisibDRUG

Participants will receive oral inavolisib once daily on Days 1-28 of each 28-day cycle (Arms A, B, C, D, E, F) or Days 1-21 of each 21-day cycle (Arm G).

FulvestrantDRUG

Participants will receive fulvestrant 500 mg, administered intramuscularly on Days 1 and 15 of Cycle 1. For subsequent cycles, participants will receive fulvestrant intramuscularly on Day 1 of each cycle.

LetrozoleDRUG

Participants will receive once daily oral doses of letrozole 2.5 mg on Days 1-28 of each cycle.

PalbociclibDRUG

Participants will receive once daily oral doses of palbociclib 125 mg on Days 1-21 of each cycle.

MetforminDRUG

Participants will receive oral metformin once daily, starting on Cycle 1, Day 1, as tolerated.

TrastuzumabDRUG

Participants will receive trastuzumab, administered by IV infusion on Day 1 of each 21-day cycle, at a loading dose of 8 mg/kg for Cycle 1 and a dose of 6 mg/kg for subsequent cycles, until disease progression or unacceptable toxicity.

PertuzumabDRUG

Participants will receive pertuzumab, administered by IV infusion on Day 1 of each 21-day cycle, at a loading dose of 840 mg for Cycle 1 and a dose of 420 mg for subsequent cycles, until disease progression or unacceptable toxicity.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Evaluable or measurable disease per RECIST, Version 1.1 (measurable disease only for Arm D) * Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 * Life expectancy of greater than or equal to (\>=) 12 weeks * Adequate hematologic and organ function, including blood counts, liver and kidney function Stage I Arm A (Inavolisib): \- Locally advanced, recurrent, or metastatic, PIK3CA mutant, incurable solid tumor malignancy, including breast cancer Stages I and II, Arms B and C: \- Postmenopausal female participants with locally advanced or metastatic PIK3CA-mutant HR+/HER2- breast cancer Stage II, Arms D, E, or F: \- Female participants with locally advanced or metastatic PIK3CA-mutant HR+/HER2- breast cancer Stage II Arm D: \- Prior treatment with CDK4/6 inhibitor Stage II Arm G: * Female participants with locally advanced or metastatic PIK3CA-mutant HER2+ breast cancer * Left ventricular ejection fraction 50% or greater Stages I and II: \- All participants must provide tumor tissue from the primary or metastatic tumor site obtained from a prior or new biopsy or surgical procedure for detection of PIK3CA mutation by central laboratory test. Exclusion Criteria: * Metaplastic breast cancer * History of leptomeningeal disease * Type 1 or 2 diabetes requiring anti-hyperglycemic medication * Inability or unwillingness to swallow pills * Malabsorption syndrome or other condition that would interfere with enteral absorption * Known and untreated, or active central nervous system metastases * Uncontrolled pleural effusion or ascites * Any active infection that could impact patient safety or serious infection requiring intravenous antibiotics * History of other malignancy within 5 years, except for treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, or Stage I uterine cancer * History of or active ventricular dysrhythmias or congestive heart failure requiring medication or symptomatic coronary heart disease * Congenital long QT syndrome, prolonged QT interval, or family history of sudden unexplained death or long QT syndrome Stage II Arms B, C, D, and E only: * Prior treatment with \>1 chemotherapy regimen for metastatic disease * Prior treatment with PI3K inhibitor * History of significant toxicity related to mTOR inhibitor requiring treatment discontinuation Stage II Arms B and E only: \- Prior CDK4/6 inhibitor treatment Stage II Arm G only: * Current uncontrolled hypertension or unstable angina * History of congestive heart failure, serious cardiac arrhythmia, or recent myocardial infarction * Prior ejection fraction decrease on trastuzumab * Prior cumulative doxorubicin greater than 360 mg/m2 * Symptomatic active lung disease * History of significant toxicity related to trastuzumab and/or pertuzumab requiring discontinuation of treatment

Locations (11)

Dana Farber Cancer Institute

Boston, Massachusetts, United States

Memorial Sloan Kettering Cancer Center

New York, New York, United States

Columbia University Medical Center

New York, New York, United States

SCRI Oncology Partners

Nashville, Tennessee, United States

Princess Margaret Hospital

Toronto, Ontario, Canada

Institut Bergonie

Bordeaux, France

Institut Gustave Roussy

Villejuif, France

Hospital Universitari Vall d'Hebron

Barcelona, Spain

Royal Marsden Hospital - Surrey

Surrey, Sutton, United Kingdom

St Bartholomew's Hospital

London, United Kingdom

...and 1 more locations

Outcomes

Primary Outcomes

Stage 1: Percentage of Participants With Dose Limiting Toxicities

Time frame: Day 1 up to Day 28 (for Stage 1 Arm A: Day 1 up to Day 35)

Recommended Phase II Dose of Inavolisib

Time frame: Day 1 up to Day 28 (for Stage 1 Arm A: Day 1 up to Day 35)

Percentage of Participants With Adverse Events and Serious Adverse Events

Time frame: Day 1 up to 6 years

Secondary Outcomes

Area Under the Concentration Time-Curve (AUC) from Time Zero to Infinity (AUCinf) of Inavolisib

Time frame: Predose (0-2 hours before dosing) on Cycle 1 Day 1 up to end of study (EOS; up to approximately 6 years); Cycle length=28 days (Cycle 1 of Stage 1 Arm A=35 days)

AUC from Time Zero to Dosing Interval (AUC0-tau) of Inavolisib