Study of Sacituzumab Govitecan Versus Treatment of Physician's Choice in Patients With HR+/HER2- Metastatic Breast Cancer Who Have Received Endocrine Therapy

JRCT ID: jRCT2061230032

Registered date:29/06/2023

Basic Information

• Recruitment status: Recruiting
• Health condition(s) or Problem(s) studied: HR+/HER2- inoperable, locally advanced, or metastatic breast cancer who have received prior ET
• Date of first enrollment: 16/08/2023
• Target sample size: 654
• Countries of recruitment: United States,Japan,Argentina,Japan,Australia,Japan,Austria,Japan,Belgium,Japan,Brazil,Japan,Canada,Japan,Chile,Japan,China,Japan,Czechia,Japan,France,Japan,Germany,Japan,Greece,Japan,Hong Kong,Japan,Hungary,Japan,Israel,Japan,Italy,Japan,Korea, Republic of,Japan,Poland,Japan,Portugal,Japan,Singapore,Japan,South Africa,Japan,Spain,Japan,Taiwan,Japan,United Kingdom,Japan
• Study type: Interventional

Intervention(s)

Eligible patients will be randomized 2:1 to receive SG or TPC.

Experimental: SG Participants will receive SG at a dose of 10 mg/kg infusion on Days 1 and 8 of a 21-day cycle.

Active Comparator: TPC Participants will receive TPC determined prior to randomization to 1 of the 3 allowed regimens:
- paclitaxel 80 mg/m^2 over 1 hour (+-10 minutes) on Days 1, 8, and 15 of a 28-day cycle.
- nab-Paclitaxel 100 mg/m^2 over 30 minutes (+-10 minutes) on Days 1, 8, and 15 of a 28-day cycle.
- capecitabine at 1000-1250 mg/m^2 twice daily for 2 weeks followed by a 1-week rest period of a 21-day cycle.

Outcome(s)

Primary Outcome

Progression Free Survival (PFS) as Assessed by Blinded Independent Central Review (BICR) per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) [Time Frame: Up to approximately 29 months]
PFS is defined as time from date of randomization until the date of first objective progressive disease (PD) or death from any cause, whichever comes first.

Secondary Outcome

Overall Survival (OS) [Time Frame: Until death, up to approximately 60 months]
OS is defined as the time from randomization until the date of death from any cause.

Objective Response Rate (ORR) as Assessed by BICR per RECIST Version 1.1 [Time Frame: Until progression, up to approximately 60 months]
ORR is defined as the proportion of participants who achieve a complete response (CR) or partial response (PR) that is confirmed at least 4 weeks after initial documentation of response.

Change from Baseline in the Physical Functioning Domain Using European Organisation for Research and Treatment
of Cancer Quality of Life Questionnaire Version 3.0 (EORTC QLQ-C30) at Week 16 [Time Frame: Baseline, Week 16]
The EORTC QLQ-C30 is composed of global health status/QoL scale; five functional domains (physical, role, emotional, cognitive, and social); three symptom domains (fatigue, nausea and vomiting, and pain); and six single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties).
The Physical Functioning domain includes 5 questions in which participants will be asked to rate their overall health and overall quality of life as it relates to physical functioning during the past week on a scale from 1 (very poor) to 4
(excellent), with a higher score representing a high QoL.

Time to Deterioration in Version 3.0 EORTC-QLQ-C30 Scores [Time Frame: Up to approximately 60 months]
Time to deterioration from baseline in European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) scores. Scale scores range from 0-100. For functioning and global health status/QoL scales, higher scores indicate better functioning or global health status/QoL. For symptom scales, higher scores indicate greater symptom burden.

Progression Free Survival (PFS) as Assessed by Investigator per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) [Time Frame: Until progression or death, up to approximately 60 months]
PFS is defined as time from date of randomization until the date of first objective progressive disease (PD) by investigator assessment according to RECIST v1.1 or death from any cause, whichever comes first.

Objective Response Rate (ORR) as Assessed by Investigator per RECIST Version 1.1 [Time Frame: Up to approximately 60 months]
ORR is defined as the proportion of participants who achieve a complete response (CR) or partial response (PR) that is confirmed at least 4 weeks after initial documentation of response.

Duration of Response (DOR) as Assessed by BICR and Investigator per RECIST Version 1.1 [Time Frame: Until progression or death, up to approximately 60 months]
DOR is defined as the time from the first documentation of CR or PR to the earlier of the first documentation of objective PD or death from any cause (whichever comes first).

Percentage of Participants Experiencing Treatment-emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) [Time Frame: First dose date up to 30 days post last dose, up to approximately 60 months]

Percentage of Participants Experiencing Clinically Significant Laboratory and/or Vital Sign Abnormalities [Time Frame: First dose date up to 30 days post last dose, up to approximately 60 months]

Key inclusion & exclusion criteria

• Age minimum: >= 18age old
• Age maximum: Not applicable
• Gender: Both

Include criteria

Able to understand and give written informed consent.

Must have adequate tumor tissue sample preferably from locally recurrent or metastatic site.

Documented evidence of HR+ metastatic breast cancer (mBC) confirmed with the most recently available tumor biopsy preferably from a locally recurrent or metastatic site.

Documented evidence of HER2- status.

Documented PD by computed tomography (CT) or magnetic resonance imaging during or after the most recent therapy per RECIST v1.1 criteria.

Candidate for the first chemotherapy in the locally advanced or metastatic setting.
Eligible for capecitabine, nab-paclitaxel, or paclitaxel.

Individuals must have at least one of the following:
- Disease progression on at least 2 or more previous lines of endocrine therapy (ET) with or without a targeted therapy in the metastatic setting.
->Disease recurrence while on the first 24 months of starting adjuvant ET will be considered a line of therapy; these individuals will only require 1 line of ET in the metastatic setting.
- Disease progression within 6 months of starting first-line ET with or without a cyclin-dependent kinase (CDK) 4/6 inhibitor (if ineligible or if unable to access a CDK 4/6 inhibitor) in the metastatic setting.
- Disease recurrence while on the first 24 months of starting adjuvant ET with CDK 4/6 inhibitor and if the individual is no longer a candidate for additional ET in the metastatic setting.

Individuals may have received prior targeted therapies, including but not limited to phosphatidylinositol 3-kinase (PI3K) inhibitors (for those with PIK3CA mutations) or mammalian target of rapamycin (mTOR) inhibitors. However, individuals can no longer be candidates for additional endocrine treatment with or without targeted therapies.

Individuals with HIV must be on antiretroviral therapy (ART) and have a well-controlled HIV infection/disease.

Demonstrates adequate organ function.

Male individuals and female individuals of childbearing potential who engage in heterosexual intercourse must agree to use protocol-specified method(s) of contraception.

Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

Exclude criteria

Progressive disease within 6 months of completing (neo) adjuvant chemotherapy.

Locally advanced metastatic breast cancer (mBC) (Stage IIIc) in individuals who are candidates for curative intent therapy at the time of study enrollment.

Current enrollment in another clinical study and use of any investigational device or drug (drugs not marketed for any indication) either within 5 half-lives or 28 days prior to randomization, whichever is longer.
-> Use of investigational drugs in the category of Selective Estrogen Receptor Degraders are acceptable if last dose was longer than 14 days prior to randomization.

Received any prior treatment (including antibody-drug conjugate (ADC)) containing a chemotherapeutic agent targeting topoisomerase I.

Received any prior treatment with a trophoblast cell-surface antigen 2 (Trop-2)-directed ADC.

Have an active second malignancy.

Have an active serious infection requiring antibiotics.

Have active hepatitis B virus (HBV) or hepatitis C virus (HCV).

Individuals positive for human immunodeficiency virus type 1/2 (HIV-1 or -2) with a history of Kaposi sarcoma and/or Multicentric Castleman Disease.

Have a positive serum pregnancy test or are breastfeeding for individuals who are assigned female at birth.

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Related Information

• Primary Sponsor: Akiyama Masanao
• Secondary ID(s): NCT05840211,2022-502593-17-00