The purpose of this study is to evaluate the safety and tolerability of talectrectinib as treatment for Stage IV ILC with CDH1 mutation
Invasive lobular cancer (ILC) represents 10-15% of all breast cancers, up to 75% of ILCs carry a mutation in CDH1 gene which encodes for e-cadherin (ECAD), which is a cell adhesion glycoprotein. Preclinical data using patient derived xenografts have shown loss of ECAD due to CDH1 mutation is associated with an upregulation ROS1 activity, and ROS1 inhibitors have demonstrated synthetic lethality in CDH1-mutated cell lines. Taletrectinib is a novel ROS1/NTRK inhibitor with demonstrated activity in ROS1 mutated non-small cell lung cancer. The purpose of the trial is to estimate the activity of taletrectinib in previously treated CDH1-mutated metastatic breast ILC.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
61
Taletrectinib (AB-106/DS-6051b) is a potent, highly selective, orally bioavailable ROS1 and TRK family inhibitor, which has activity against mutations conferring resistance to crizotinib including in vitro and in vivo against the acquired ROS1 G2032R solvent front mutation. Taletrectinib has been shown to have anti-tumor activity against recombinant ROS1, NTRK1, and NTRK3 in sub-nanomolar concentration in an ATP dependent manner, in addition to completely inhibiting ACK, ALK, DDR1 and LTK at micromolar concentrations. Anti-tumor activity of taletrectinib was observed in two ROS1 rearranged lung cancer cell lines, glioblastoma cell line, and in NTRK-rearranged colorectal cancer cell lines.
Marone Cancer Center Cleveland Clinic Florida
Weston, Florida, United States
Cleveland Clinic Taussig Cancer institute, Case Comprehensive Cancer Center
Cleveland, Ohio, United States
Objective response rate (ORR) as measured by RECIST v1
The best overall response is the best response recorded from the start of the treatment until disease progression/recurrence.
Time frame: 24 Weeks
Progression Free Survival Rate(PFS)
Progression-Free Survival (PFS) is defined as the duration of time from start of treatment to time of progression or death, whichever occurs first.
Time frame: Every 12 weeks until 180 days from EOT until death, withdrawal of informed consent, loss of follow-up or termination of the study by the sponsor, whichever occurs first.
Clinical Benefit Rate
Clinical benefit rate as measured by total number of participants with complete response, partial response and stable disease in participants treated with taletrectinib
Time frame: Up to 6 months (180 days) after completion of therapy or until death, whichever comes first
Duration Of Response(DOR)
Defined as the subset of participants who achieved a confirmed CR or PR from the date of first documentation of objective response (CR or PR) to the date of first documentation of progressive disease (PD).
Time frame: Up to 6 months (180 days) after completion of therapy or until death, whichever comes first
Safety analysis, with toxicities graded according to NCI CTCAE v5.0
Incidence tables will be generated to summarize incidence of participants reporting at least one episode of each specific adverse event, incidence of adverse events causing withdrawals and incidence of serious adverse events. Listing of adverse events by participants will include the time to onset, the duration of each event, the severity of each event, and the relationship of the event to study therapy, whether it was a serious event, and whether it caused withdrawal. Proportion and exact confidence boundaries (95% CI) will be estimated for toxicity.
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Time frame: Up to 30 days after the final dose of the study drug
Overall Quality Of Life(QOL) with EORTC QLQ-C30 assessments
The EORTC QLQ-C30 questionnaire is a 30-item cancer-specific questionnaire that incorporates 5 functioning scales (physical, role, cognition, emotional, and social), 8 symptom scales (fatigue, pain, nausea/vomiting, dyspnea, insomnia, loss of appetite, constipation, diarrhea), financial well-being scale and a global scale (based on 2 items: "How would you rate your overall health during the past week?" and "How would you rate your overall quality of life during the past week?").
Time frame: Assessed every 12 weeks starting from first treatment visit till EOT and then every 12 weeks until 6 months after EOT
Overall Quality Of Life(QOL) with FACT-B assessments
The FACT-B v4.0 is a 37-item self-reported instrument designed for participants to report on quality of life measures within 5 domains: Physical Well-Being, Social/Family Well-Being, Emotional Well-Being, Functional Well-Being, Breast Cancer Subscale.
Time frame: Assessed every 12 weeks starting from first treatment visit till EOT and then every 12 weeks until 6 months after EOT