This is a multicenter, Phase 2a, open-label, 2-part study to investigate the safety, tolerability, and anti-tumor activity of ZW25 (zanidatamab) in combination with palbociclib plus fulvestrant. Eligible patients include those with locally advanced (unresectable) and/or metastatic human epidermal growth factor receptor 2 (HER2)-positive, hormone receptor (HR)-positive breast cancer.
Part 1 of the study will first evaluate the safety and tolerability of ZW25 in combination with palbociclib plus fulvestrant and will confirm the recommended doses (RDs) of ZW25 and palbociclib in this combination. Part 2 of the study will evaluate the anti-tumor activity of the combination of ZW25 with palbociclib plus fulvestrant at the RD level in patients with HER2-positive, HR-positive advanced breast cancer.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
51
Administered intravenously
Administered orally
Administered as an intramuscular injection
UCLA Hematology/Oncology Parkside
Santa Monica, California, United States
Sarah Cannon Research Institute
Nashville, Tennessee, United States
Seattle Cancer Care Alliance
Seattle, Washington, United States
Number of Participants With Dose-Limiting Toxicities
Dose-limiting toxicities, defined using NCI CTCAE version 5.0, are events that 1) occur following administration of ZW25, palbociclib, and fulvestrant, or any combination of ZW25 and 1 or more of these drugs; and 2) meet the criteria as specified in the protocol.
Time frame: Cycle 1 Day 1 to Day 28 (each cycle is 28 days)
Number of Participants Reporting Grade 3 or Higher Treatment-emergent Adverse Events
A treatment-emergent adverse event occurs after the start of study treatment and is defined as any unfavorable or unintended symptom, sign, or disease (including abnormal lab) temporally associated with the use of treatment that may or may not be considered related to treatment. TEAEs were coded using MedDRA v24.0.
Time frame: Baseline from the start of dosing of any study drug up until 30 days after last study dose, up to approximately 2 years 10 months.
Progression-free Survival 6
The progression-free survival at 6 months (PFS6) is a binary endpoint variable based on the progression-free survival (PFS) time, defined as the proportion of participants having PFS time greater than or equal to 24 weeks (168 days).
Time frame: 6 months from first dose of any study drug to the date of documented disease progression or death
Number of Participants Reporting Any Treatment-emergent Adverse Event, Serious Adverse Event, and Adverse Event of Special Interest
A treatment-emergent adverse events (TEAEs) was defined as an adverse event (AE) with onset on or after 1st dose of study treatment through 30 days after final dose of study treatment inclusive. An AE is classified as a serious adverse event (SAE) if fatal, life threatening, requires hospitalization, is disabling/incapacitating, causes congenital anomaly or birth defect, and medically significant. Adverse events of special interest (AESI) include absolute decreases in LVEF greater than or equal to 10 percentage points from baseline, symptomatic heart failure, infusion-related reactions, and all greater than or equal to Grade 2 events of pneumonitis and/or interstitial lung disease, including pulmonary fibrosis.
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Tom Baker Cancer Centre
Calgary, Alberta, Canada
The Ottawa Hospital Cancer Centre
Ottawa, Ontario, Canada
Sunnybrook Research Institute
Toronto, Ontario, Canada
Jewish General Hospital
Montreal, Quebec, Canada
Hospital General Universitario de Elche
Elche, Alicante, Spain
Hospital Universitario Vall d'Hebrón
Barcelona, Spain
Hospital Ruber Internacional
Madrid, Spain
...and 3 more locations
Time frame: From the start of dosing of any study drug up until 30 days after last study dose, up to approximately 2 years 10 months
Maximum Serum Concentration of ZW25
Time frame: Cycle 1, Days 1, 2, 5, 15; Cycle 2, Days 1 and 15; Day 1 of all subsequent cycles (each cycle is 28 days); and end of treatment, up to approximately 5 years 4 months
Trough Concentration of ZW25
Time frame: Cycle 1, Days 1, 2, 5, 15; Cycle 2, Days 1 and 15; Day 1 of all subsequent cycles (each cycle is 28 days); and end of treatment, up to approximately 5 years 4 months
Incidence of Anti-drug Antibodies (ADAs)
Time frame: Cycles 1 and 2, Day 15; Day 1 of all subsequent cycles (each cycle is 28 days); end of treatment, 30 days post-last dose (safety follow up), and every 8 weeks (efficacy follow up), up to approximately 5 years 4 months
Objective Response Rate
Time frame: Baseline up to end of study, approximately 5 years 4 months
Duration of Response
Time frame: Baseline up to end of study, approximately 5 years 4 months
Disease Control Rate
Time frame: Baseline up to end of study, approximately 5 years 4 months
Progression-free Survival
Time frame: Baseline up to end of study, approximately 5 years 4 months
Overall Survival
Time frame: Baseline up to end of study, approximately 5 years 4 months
Incidence of Lab Abnormalities
Time frame: Baseline up to end of study, approximately 5 years 4 months