ICARUS-BREAST02 is an open-label, multicenter, phase 1b/2, platform study that aims to evaluate the safety, tolerability, and efficacy of HER3-DXd monotherapy and in combination with other anti-cancer agents in patients with ABC. The first 2 modules will evaluate: i. safety and efficacy of HER3-DXd with olaparib in patients with HER2-low and HER2-positive ABC progressed on T-DXd (Module 1) and HER3-DXd monotherapy in patients with HER2-low ABC progressed on T-DXd (Module 0). The main objective of Part 1 is to assess the safety and tolerability of HER3-DXd monotherapy and combination and to determine the recommended phase 2 dose (RP2D) of the combination containing HER3-DXd. The main objective of Part 2 is to assess the efficacy of study therapies in each module based on investigator assessment as evaluated by the objective response rate (ORR) at 6 months.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
152
5.6 mg/kg every 21 days
100 mg b.i.d PO days 8-14 every 21 days
Gustave Roussy Institut
Villejuif, France
RECRUITINGDLTs (dose-limiting toxicity) for part 1a and 1b
DLTs
Time frame: 21 months after the beginning of enrolment
Frequency of safety event for part 1a and 1b
frequency of any AEs, TEAEs, SAEs, AESIs graded by NCI-CTCAE v5.0
Time frame: 21 months after the beginning of enrolment
Severity of safety event for part 1a and 1b
severity of any AEs, TEAEs, SAEs, AESIs graded by NCI-CTCAE v5.0
Time frame: 21 months after the beginning of enrolment
Proportion of treatment modification due to AEs for part 1a and 1b
Proportion of treatment discontinuations, interruptions, and dose reductions due to any AEs
Time frame: 21 months after the beginning of enrolment
frequency of laboratory abnormalities for part 1a and 1b
frequency of laboratory abnormalities defined by NCI-CTCAE v5.0 laboratory findings
Time frame: 21 months after the beginning of enrolment
Severity of laboratory abnormalities for part 1a and 1b
Severity of laboratory abnormalities defined by NCI-CTCAE v5.0 laboratory findings
Time frame: 21 months after the beginning of enrolment
radiographic changes potentially consistent with ILD/pneumonitis or any other pulmonary signs/symptoms for part 1a and 1b
Evaluations must include CT (preferably high-resolution CT) and pulmonologist consultation (when the Investigator is not a pulmonologist). Those will be reviewed by an internal multidisciplinary team at GRCC.
Time frame: 21 months after the beginning of enrolment
ORR for part 2
ORR is defined as the proportion of patients who achieved a confirmed complete response (CR) or partial response (PR) assessed by investigators after 6 months of treatment initiation. The objective response will be radiologically assessed every 6 weeks during the first year than every 12 weeks thereafter using RECIST v1.1.
Time frame: 51 months
DOR for part 2
DOR is defined as the time from the date of the first documentation of confirmed response (CR or PR) to the date of the first documentation of progression (PD) or death due to any cause, whichever occurs first. Duration of response will be measured for responding patients (CR or PR) only
Time frame: 51 months
PFS for part 2
PFS is defined as the time from date of first dose until the date of the first objective documentation of disease progression or death from any cause, whichever occurs first. For patients without documented radiological progression, PFS will be censored at the date of last adequate radiological assessment without progression
Time frame: 51 months
CBR for part 2
CBR is defined as the presence of at least a confirmed PR or CR, or a stable disease (SD) ≥ 6 months
Time frame: 51 months
ORR for part 1
ORR is defined as the proportion of patients who achieved a confirmed complete response (CR) or partial response (PR) assessed by investigators after 6 months of treatment initiation. The objective response will be radiologically assessed every 6 weeks during the first year than every 12 weeks thereafter using RECIST v1.1.
Time frame: 45 months
DOR for part 1
DOR is defined as the time from the date of the first documentation of confirmed response (CR or PR) to the date of the first documentation of progression (PD) or death due to any cause, whichever occurs first.Duration of response will be measured for responding patients (CR or PR) only
Time frame: 45 months
PFS for part 1
PFS is defined as the time from date of first dose until the date of the first objective documentation of disease progression or death from any cause, whichever occurs first. For patients without documented radiological progression, PFS will be censored at the date of last adequate radiological assessment without progression.
Time frame: 45 months
CBR for part 1
CBR is defined as the presence of at least a confirmed PR or CR, or a stable disease (SD) ≥6 months
Time frame: 45 months
PK analysis for part 1
Serum concentration of HER3-DXd (Anti-HER3-ac-DXd total, anti-HER3 antibody and DXd), plasma concentration of olaparib, will be assessed for PK analysis. Estimation of the proportion of deconjugated payload-linker complex binding with circulating albumin will also be assessed.
Time frame: 45 months
ADA analysis for part 1
Serum concentration of HER3-DXd (Anti-HER3-ac-DXd total, anti-HER3 antibody and DXd), plasma concentration of olaparib, will be assessed for incidence and prevalence of anti-drug antibody (ADA) for HER3-DXd. Estimation of the proportion of deconjugated payload-linker complex binding with circulating albumin will also be assessed.
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Time frame: 45 months
DLTs for part 2
Time frame: 39 months from the beginning of enrolment
Frequency of safety event for part 2
Frequency of any AEs, TEAEs, SAEs, AESIs graded by NCI-CTCAE v5.0;
Time frame: 39 months from the beginning of enrolment
Severity of safety event for part 2
Frequency of any AEs, TEAEs, SAEs, AESIs graded by NCI-CTCAE v5.0;
Time frame: 39 months from the beginning of enrolment
proportion of treatment modification event for part 2
proportion of treatment discontinuations, interruptions, and dose reductions due to any AEs
Time frame: 39 months from the beginning of enrolment
frequency of laboratory abnormalities for part 2
frequency of laboratory abnormalities defined by NCI-CTCAE v5.0;
Time frame: 39 months from the beginning of enrolment
Severity of laboratory abnormalities for part 2
Severity of laboratory abnormalities defined by NCI-CTCAE v5.0;
Time frame: 39 months from the beginning of enrolment
radiographic changes potentially consistent with ILD/pneumonitis or any other pulmonary signs/symptoms for part 2
Evaluations must include CT (preferably high-resolution CT) and pulmonologist consultation (when the Investigator is not a pulmonologist). Those will be reviewed by an internal multidisciplinary team at GRCC.
Time frame: 39 months from the beginning of enrolment
PK analysis for part 2
Serum concentration of HER3-DXd (Anti-HER3-ac-DXd total, anti-HER3 antibody and DXd), plasma concentration of olaparib, will be assessed for PK analysis. Estimation of the proportion of deconjugated payload-linker complex binding with circulating albumin will also be assessed.
Time frame: 39 months from the beginning of enrolment
ADA analysis for part 2
Serum concentration of HER3-DXd (Anti-HER3-ac-DXd total, anti-HER3 antibody and DXd), plasma concentration of olaparib, will be assessed incidence and prevalence of anti-drug antibody (ADA) for HER3-DXd. Estimation of the proportion of deconjugated payload-linker complex binding with circulating albumin will also be assessed.
Time frame: 39 months from the beginning of enrolment