The multicenter, two-cohort, non-comparative, open-label, phase II clinical trial SABINA aims to analyze the safety and efficacy of MEN1611 in monotherapy and in combination with eribulin, a non-taxane chemotherapy agent, in Hormone Receptor (HR)-known/Human Epidermial Growth Factor Receptor 2 (HER2)-negative, phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA)/ Phosphatase and Tensin Homolog (PTEN)-altered, unresectable locally advanced or metastatic metaplastic breast carcinoma (MpBC) patients. A run-in phase for safety and tolerability of MEN1611 in combination with standard doses of eribulin will be conducted as an initial step of the cohort A. This first step aims at evaluating the dosing schedule of MEN1611, by analyzing the toxicity profile of the combined regimen. With the background of the first-in-human study (PA-001EU), the safe dose of MEN1611 has been established as 48 mg orally BID (two intakes of 3 capsules of 16 mg each, for a total daily dose of 96 mg MEN1611 free-base).
This is a multicenter, two-cohort, non-comparative, open-label, phase II clinical trial to assess: * the efficacy of MEN1611 in combination with eribulin as determined by the clinical benefit rate (CBR) in unresectable locally advanced or metastatic HR-known/HER2-negative, PIK3CA/ PTEN-altered MpBC patients (Cohort A), and * the efficacy of MEN1611 as monotherapy as determined by the objective response rate (ORR) at 6 weeks in unresectable locally advanced or metastatic HR-known/HER2-negative, PIK3CA/ PTEN-altered MpBC patients (Cohort B). Upon meeting all selection criteria, 28 patients will be enrolled as follows: \- Cohort A: A run-in phase for safety and tolerability of MEN1611 in combination with eribulin will be conducted in this patient population (N=3). A Steering Committee decision/agreement is needed, after reviewing all toxicities, to expand this cohort with 11 additional patients (up to N=14). Cohort B will be run only if positive finding in Cohort A, defined as ≥ 6 patients (42.9%) with achieved clinical benefit (CB) among 14 first recruited patients. \- Cohort B: Simon's two-stage minimax design. Stage I (N=7) will be initiated with MEN1611 monotherapy. This cohort will be stopped for futility if no responders (no complete response \[CR\] or partial response \[PR\]) are observed after 2 cycles among the first 7 patients included. Otherwise, Cohort B will be expanded with 7 additional patients for Stage II (up to N=14).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
14
MEN1611 is a potent, orally bioavailable selective inhibitor of the class I phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K) with a novel structure which exhibits a strong inhibitory activity especially against the PI3K catalytic subunit alpha (PIK3CA), with potential antineoplastic activity. PI3K alpha inhibitor MEN1611 selectively binds to and inhibits PIK3CA and its mutated forms in the PI3K/Akt (protein kinase B)/mammalian target of rapamycin (mTOR) pathway.
Eribulin mesylate (eribulin), a non-taxane inhibitor of microtubule dynamics of the halichondrin class of antineoplastics, suppresses microtubule growth and sequesters tubulin into nonfunctional aggregates, preventing mitotic spindle formation with subsequent G2-M stop and apoptosis.
Hospital Universitario Clínico San Cecilio de Granada
Granada, Andalusia, Spain
RECRUITINGHospital Universitario Virgen del Rocio
Seville, Andalusia, Spain
RECRUITINGOnkologikoa
Donostia / San Sebastian, Basque Country, Spain
RECRUITINGHospital Universitario Marqués de Valdecilla
Santander, Cantabria, Spain
RECRUITINGCentro Oncológico de Galicia
A Coruña, Galicia, Spain
RECRUITINGHospital Universitario de Torrejón
Torrejón de Ardoz, Madrid, Spain
RECRUITINGCHUVI - Complejo Hospitalario Universitario de Vigo
Vigo, Pontevedra, Spain
RECRUITINGHospital Clínic i Provincial de Barcelona
Barcelona, Spain
RECRUITINGInstitut Català d' Oncologia L'Hospitalet (ICO)
Barcelona, Spain
RECRUITINGHospital Universitari Vall D'Hebron
Barcelona, Spain
RECRUITING...and 3 more locations
To assess the efficacy of MEN1611 in combination with eribulin as determined by the clinical benefit rate (CBR).
CBR, defined as the percentage of patients who experience a complete response (CR), partial response (PR) or stable disease (SD) for at least 12 weeks after the start of MEN1611 in combination with eribulin treatment, as determined locally by the investigator per RECIST v1.1 criteria.
Time frame: Baseline up to at least 12 weeks
To determine the efficacy of MEN1611 in combination with eribulin defined as ORR of patients.
ORR, defined as the proportion of patients with confirmed CR or PR who received MEN1611 in combination with eribulin treatment as determined locally by the Investigator as per RECIST v1.1 criteria.
Time frame: Baseline up to 24 months
To determine the efficacy of MEN1611 in combination with eribulin defined as Time To Response (TTR).
TTR, defined as the time from the start of MEN1611 in combination with eribulin treatment to the first objective tumor response (tumor shrinkage of ≥ 30%).
Time frame: Baseline up to 24 months
To determine the efficacy of MEN1611 in combination with eribulin defined as Duration of Response (DoR) of patients.
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.
Time frame: Baseline up to 24 months
To determine the efficacy of MEN1611 in combination with eribulin defined as Progression-Free Survival (PFS).
PFS defined as the time from the first dose of Study drugs until objective tumor progression or death, whichever occurs first.
Time frame: Baseline up to 24 months
To determine the efficacy of MEN1611 in combination with eribulin defined as Overall Survival (OS).
OS defined as the time from the first dose of Study drugs until death from any cause.
Time frame: Baseline up to 24 months
To assess the safety and tolerability of MEN1611 in combination with eribulin defined as incidence and severity of adverse events.
To evaluate the incidence of AEs of MEN1611 in combination with eribulin as assessed by the Investigator, with severity determined by NCI-CTCAE v.5.0.
Time frame: Baseline up to 24 months
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