This study will examine the combination of pembrolizumab and olaparib in three populations. * Cohort 1: aBC patients with a germline mutation in BRCA1 or BRCA2, * cohort 2: aBC patients with a germline mutation in one of the moderate penetrance homologous repair genes (ATM, BARD1, CHEK2, FANCC, PALB2, RAD51C, RAD51D, SLX4, XRCC2), and * cohort 3: aBC patients with a HRD as assessed by whole genome sequencing.
This is a multicenter, prospective, phase II, one-arm, three-cohort, open-label study of pembrolizumab in combination with olaparib in patients with advanced HER2 negative breast cancer who have either * a deleterious germline mutation in BRCA1/2 irrespective of tumor HRD status (Cohort 1), * or a deleterious germline mutation in ATM, BARD1, CHEK2, FANCC, PALB2, RAD51C, RAD51D, SLX4, XRCC2 irrespective of tumor HRD status (Cohort 2), * or a centrally confirmed high tumor HRD status, but no deleterious germline mutation in BRCA1/2, ATM, BARD1, CHEK2, FANCC, PALB2, RAD51C, RAD51D, SLX4, XRCC2 (Cohort 3). HRD assessment needs to be performed on a tumor biopsy not more than 12 months before study entry. All eligible participants according to the definition of cohorts 1-3 will receive pembrolizumab i.v. 200 mg q3w in combination with olaparib tablets 300 mg twice daily (total dose 600 mg per day). Study medication will be withdrawn/ended in case of onset of unacceptable toxicities, progression, withdrawal of consent, death, or end of study, whichever occurs first. Safety follow-up is planned for 90 days after the last application of study medication. Participants will be followed for survival for a maximum of 18 months after therapy start.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
11
The planned dose of pembrolizumab for this study is 200 mg every 3 weeks (Q3W). Based on the totality of data generated in the Keytruda development program, 200 mg Q3W is the appropriate dose of pembrolizumab for adults across all indications and regardless of tumor type.
All patients will receive olaparib treatment as an addition to pembrolizumab. The dose of olaparib used in this study is 300 mg twice daily (total daily dose of 600 mg) which is the currently approved dose.
Department of Gynecology, Tübingen University Hospital
Tübingen, Baden-Wurttemberg, Germany
University Hospital Ulm
Ulm, Baden-Wurttemberg, Germany
Department of Gynecology and Obstetrics, Erlangen University Hospital
Erlangen, Bavaria, Germany
Marienhospital Bottrop
Bottrop, North Rhine-Westphalia, Germany
University Hospital Düsseldorf
Düsseldorf, North Rhine-Westphalia, Germany
Helios-Klinikum Berlin-Buch
Berlin, Germany
Efficacy of the combination of pembrolizumab and olaparib via overall response rate
Overall response rate (ORR) is defined as the number of participants with a confirmed best response of complete response (CR) or partial response (PR) per RECIST v1.1.
Time frame: baseline up to 27 weeks
duration of response (DOR) time
DOR is defined as the time between the date of first response (CR or PR) to the date of first tumor progression per RECIST v1.1.
Time frame: between the date of first response to the date of first tumor progression for up to 18 months after therapy start
progression free survival (PFS) time
PFS is defined as the time between the date of study entry and the first date of progression or death due to any cause, whichever occurs first
Time frame: between the date of study entry and the first date of progression or death for up to 18 months after therapy start
overall survival (OS) time
OS is defined as the time between the date of study entry and the date of death due to any cause
Time frame: between the date of study entry and the date of death for up to 18 months after therapy start
safety and tolerability of pembrolizumab in combination with olaparib
Incidence of adverse events (AEs) and serious adverse events (SAEs), incidence of deaths, and incidence of abnormalities in the laboratory diagnostics
Time frame: study start until 90 days post last dose
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