This is a multicenter, open-label, single-arm, phase II clinical trial, phase II trial will evaluate the efficacy and safety of olaparib plus trastuzumab in patients with HER2\[+\], BRCA-mutated advanced breast cancer
This open-label, multicenter, single arm, two cohorts, Simon's Two-Stage minimax design, phase II clinical trial will assess the efficacy of olaparib in combination with trastuzumab in patients with HER2-positive ABC with gene alterations in HRR DNA pathway. To be included in the cohort A of the study, patients must exhibit germinal deleterious mutations in BRCA1 or BRCA2 genes. Eligible patients will have histologically proven diagnosis of adenocarcinoma of the breast with evidence of advanced disease, and at least one measurable disease as per RECIST v.1.1. Patients will have a documented history of progression on HER2-directed therapy for the treatment of HER2-positive breast cancer with not limits on prior therapies of chemotherapy and/or trastuzumab-lapatinib in advanced scenario, and at least one regimen of chemotherapy including trastuzumab. The accrual goal will be a total of 20 patients
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
5
Participants will receive olaparib (300 mg tablets, orally twice daily during 21-day cycles) in combination with herceptin (intravenous dose of 4 mg/kg body weight with subsequent weekly doses of 2 mg/kg or subcutaneous dose of 600 mg every 3 weeks) until progression or unacceptable toxicity.
Hospital Universitari Vall d'Hebron
Barcelona, Spain
Complejo Hospitalario de Jaén
Jaén, Spain
Hospital Clínico San Carlos
Madrid, Spain
Hospital Virgen del Rocío
Seville, Spain
Assess the efficacy of olaparib in combination with trastuzumab
as determined by the Clinical benefit rate (CBR) response (PR) divided by the number of patients in the analysis set- in patients with germinal BRCA-mutated \[cohort A\] based on local investigator's assessment according to Response Evaluation Criteria In Solid Tumors (RECIST) criteria guidelines v.1.1.
Time frame: Baseline up to 12 months.
ORR
ORR -defined as the number of patients with CR and PR divided by the number of patients in the analysis set- in patients with wild-type germinal BRCA/HRD-positive tumors \[cohort B\] based on local investigator's assessment according to RECIST criteria guidelines v.1.1.
Time frame: Baseline up to 30 months.
PFS i
PFS -defined as the period of time from treatment initiation to the first occurrence of disease progression or death from any cause, whichever occurs first- in patients with wild-type germinal BRCA/HRD-positive tumors \[cohort B\] based on local investigator's assessment according to RECIST criteria guidelines v.1.1.
Time frame: Baseline up to 30 months.
Clinical benefit rate (CBR
CBR -defined as the number of patients with CR, PR or stable disease (SD) divided by the number of patients in the analysis set- both in patients with germinal BRCA-mutated \[cohort A\] and wild-type germinal BRCA/HRD-positive \[cohort B\] tumors based on local investigator's assessment according to RECIST criteria guidelines v.1.1.
Time frame: Baseline up to 30 months.
Duration of response (DoR)
DoR -defined as the time from the first occurrence of a documented objective response to disease progression or death from any cause, whichever occurs first- both in patients with germinal BRCA-mutated \[cohort A\] and wild-type germinal BRCA/HRD-positive \[cohort B\] tumors based on local investigator's assessment according to RECIST criteria guidelines v.1.1.
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Time frame: From documented objective response up to 30 months.
Maximum Tumor Shrinkage
Maximum Tumor Shrinkage -defined as the percentage of tumor shrinkage from baseline \[obtained from the sum of the largest diameters of the target lesions\]- both in patients with germinal BRCA-mutated \[cohort A\] and wild-type germinal BRCA/HRD-positive \[cohort B\] tumors based on local investigator's assessment according to RECIST criteria guidelines v.1.1.
Time frame: Baseline up to 30 months.
Overall survival (OS)
OS -defined as the period of time from treatment initiation to death from any cause- both in patients with germinal BRCA-mutated \[cohort A\] and wild-type germinal BRCA/HRD-positive \[cohort B\] tumors based on local investigator's assessment according to RECIST criteria guidelines v.1.1.
Time frame: Baseline up to 30 months.
Health-Related Quality of Life (HRQoL) in cohorts A and B
Change from baseline in scores using the European Organisation for Research and Treatment of Cancer QoL Questionnaire Core 30 (QLQ-C30) \[with 5 functional and 3 symptom scales, a Global Health Status (GHS)/QoL scale, and 6 single items\], QLQ-BR23 \[with 4 functional and 4 symptom scales\], and EQ-5D \[with 5 dimensions and a health status rating scales\] modules at baseline, Day 1 of cycles 2-4, then on Day 1 of each subsequent cycle starting with cycle 6, and at the end-of-treatment. Responses to all items are converted to a 0-100 scale using a standard scoring algorithm. For functional scales, higher score represents a better level of functioning; for symptom scales, a higher score represents a higher severity of symptoms.
Time frame: Baseline up to 30 months.
Safety adverse events (AEs)
Number of patients with treatment-related AEs (Grade 3 and 4 AEs and serious adverse events \[SAEs\]) by using the National Cancer Institute (NCI)-Common Terminology Criteria for Adverse Events (CTCAE) v.5.0.
Time frame: Baseline up to 30 months.