This is an international, multi-centre, non-controlled, open-label, single arm, two-stage Simon Design phase II study for non-BRCA metastatic breast cancer (MBC) patients with homologous recombination deficiency treated with Olaparib single agent. The main objective is to assess the efficacy of olaparib single agent as determined by Clinical Benefit Rate (CBR) using the Response Evaluation Criteria in Solid Tumors (RECIST 1.1). In the first stage Triple negative (TN) non-BRCA, metastatic breast cancer (MBC) patients whose tumours exhibited any characteristic related to homologous recombination deficiency (HRD). In the second stage, luminal patients (RH positive HER2 negative) will be allowed in the same conditions that TN. Patients whose tumours are identified as Homologous Recombination Deficient by deleterious HRR gene mutations (according to Foundation Medicine's Foundation One assay) will receive olaparib 300 mg (two tablets of 150mg) orally twice daily (bid) on days 1-28 each 28 days. Study commitment is 39 patients: 17 patients will be enrolled at first stage and 22 at the second stage. The total duration of the study period is 34 months.
This is an international, multi-centre, non-controlled, open-label, single arm, two-stage Simon Design phase II study for non-BRCA metastatic breast cancer (MBC) patients with homologous recombination deficiency treated with Olaparib single agent. The main objective is to assess the efficacy of olaparib single agent as determined by Clinical Benefit Rate (CBR) using the Response Evaluation Criteria in Solid Tumors (RECIST 1.1). Triple negative non-BRCA metastatic breast cancer women (for the first stage) age ≥ 18 years that had previously received at least one (and no more than three) line for their metastatic disease. Patients must have previously received taxanes either in the early or in the metastatic scenario. To be included in the trial, tumours must be considered homologous recombination deficient (HRD) according to Foundation Medicine's Foundation One assay. Evidence of measurable metastatic disease is required. In the second stage, luminal patients (RH positive HER2 negative) will be allowed to participate in the same conditions that TN patients. Patients whose tumours are identified as Homologous Recombination Deficient by deleterious HRR gene mutations (according to Foundation Medicine's Foundation One assay) will receive olaparib 300 mg (two tablets of 150mg) orally twice daily (bid) on days 1-28 each 28 days. Study commitment is 39 patients: 17 patients will be enrolled at first stage and 22 at the second stage. During the period between the end of the first stage and the beginning of the second, an interim analysis will be conducted to assess the viability of the second part of the trial. The total duration of the study period is 34 months. Stage I: * Recruitment period: 10 months * Follow-up period: Up to 6 months after last patient included in the study Stage II: * Recruitment period: 12 months * Follow-up period: up to 6 months after last patient included in the study
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
7
Olaparib 300 mg twice a day (orally) beginning on Day 1 and continuing through Day 28 of every 28-day cycle.
Hospital del Mar
Barcelona, Spain
Onkologikoa
Donostia / San Sebastian, Spain
Institut Català d' Oncologia L'Hospitalet (ICO)
L'Hospitalet de Llobregat, Spain
Hospital Ramón y Cajal
Madrid, Spain
Hospital Arnau de Vilanova de Valencia
Valencia, Spain
To assess the efficacy of olaparib single agent in non-BRCA MBC patients whose tumours exhibit an homologous recombination deficiency (HRD) signature, as determined by Clinical Benefit Rate (CBR) using RECIST 1.1 criteria
The CBR as best response, defined as the percentage of patients who experience a complete response, partial response or stable disease for at least 24 weeks and assessed by modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) criteria
Time frame: Baseline up to 24 weeks
To assess the accuracy of Foundation One's HRR assay in predicting the proportion of patients with response to olaparib.
The positive predictive value (PPV) of the signature to predict patients that achieved objective response and clinical benefit.
Time frame: Baseline up to 34 months
To assess incidence of Treatment-Emergent Adverse Events (Safety profile) of olaparib in this population
This study will consider the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE v4.03 criteria) grade 3 and 4 events (AEs) and serious AEs (SAEs) in order to assess the safety and tolerability objectives.
Time frame: Baseline up to 34 months
To investigate the prevalence of HRD signature within triple negative and luminal non-BRCA patients' cohorts
The percentage of patients with HRD according to the Foundation Medicine's Foundation One assay within triple negative and luminal (in the second stage) non-BRCA patients' cohorts
Time frame: Baseline up to 34 months
To explore the efficacy of olaparib in terms of Progression-free survival (PFS)
The PFS defined as the time from the first dose of study drugs until objective tumour progression or death, as assessed by the investigator per RECIST v1.1.
Time frame: Baseline up to 34 months
To explore the efficacy of olaparib in terms of objective response rate (ORR)
The ORR defined as the proportion of patients with best objective response of confirmed complete response (CR) or partial response (PR) according to RECIST criteria guidelines (version 1.1).
Time frame: Baseline up to 34 months
To explore the efficacy of olaparib in terms of overall survival (OS)
The OS defined as the time from the first dose of study drugs until death from any cause or the last date the patient was known to be alive.
Time frame: Baseline up to 34 months
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