A Study of Subcutaneous Trastuzumab Deruxtecan in Participants With Metastatic Solid Tumors

Official title

A Phase 1, Multicenter Trial of Subcutaneous Trastuzumab Deruxtecan in Participants With Metastatic Solid Tumors

Overview

This dose escalation and dose expansion study was designed to assess the safety, tolerability, PK and efficacy of subcutaneous T-DXd in participants with metastatic solid tumors.

Interventions

• Drug Trastuzumab Deruxtecan
  Dose Escalation Part: Trastuzumab Deruxtecan will be administered at escalating doses to determine the RDE. Expansion Part: Trastuzumab Deruxtecan will be administered at RDE.

Primary outcome measures

• Number of Participants Experiencing a Treatment Emergent Adverse Event (TEAE) [Time frame: From the start of trial intervention to 21 days after the last dose, up to approximately 9 months]
• Area Under Curve (AUC) [Time frame: From the start of trial intervention to last dose, up to approximately 9 months]
• Number of Participants with Dose limiting toxicities (DLT) During the Dose-Escalation Phase [Time frame: From the start of trial intervention to 21 days after the last dose, up to approximately 9 months]

Secondary outcome measures (3)

• Percentage of Participants with Anti-Drug Antibody (ADAs) [Time frame: From baseline to post-baseline, up to approximately 12 months]
• Overall Response Rate (ORR) [Time frame: From the enrollment/randomization date until documented disease progression, up to 12 months]
• Disease Control Rate (DCR) [Time frame: From the enrollment/randomization date until documented disease progression, up to 12 months]

Eligibility criteria

Inclusion criteria

• Adults ≥18 years or the minimum legal adult age (whichever is greater).
• a) Disease State: If HER2 status is required for eligibility (for all populations), a documented HER2 test result must be available.

Breast Cancer: adults with pathologically documented unresectable or metastatic breast cancer HER2-positive BC: have received a prior anti-HER2-based regimen. For HER2-positive BC participants in Part 2 only, prior anti-HER2 based therapy should have been received in either:

• the metastatic setting, or
• the neoadjuvant or adjuvant setting and have developed disease recurrence during or within 6 months of completing therapy. HR-, HER2-low BC: have received a prior systemic cytotoxic therapy in the metastatic setting; or developed disease recurrence during or within 6 months of completing (neo)adjuvant chemotherapy. HR+, HER2-low/ultralow BC: have received previous ET AND an additional line of ET must not be the next line of treatment considered in the participant's best interest.
• For participants in Part 2 with HR+ HER-2low/ultralow BC, the following criteria also apply:
• had disease progression while receiving 1 previous line of ET with a CDK4/6i and is not expected to benefit from immediate use of a second line of ET, OR
• had disease progression on at least 2 previous lines of ET with or without a target therapy such as CDK4/6, mTOR or PI3-K inhibitors) administered for the treatment of metastatic disease
• participants may not have received more than 2 prior lines of cytotoxic therapy in the recurrent or metastatic setting. NSCLC, HER2 mut: adults with unresectable or metastatic NSCLC whose tumors have activating HER2 (ERBB2) mutations, and who have received a prior systemic therapy.

b) Part 2 only: At least 1 RECIST 1.1 measurable lesion on CT or MRI.

• Radiologic or objective evidence of disease progression on or after the last systemic therapy prior to starting trial intervention.

Exclusion criteria

1\. Prior treatment with ADC that consists of an exatecan derivative that is a topoisomerase I inhibitor; 4. Medical history of MI within 6 months before enrollment or symptomatic CHF (New York Heart Association class II to IV). Participants with troponin levels above ULN at screening (as defined by the manufacturer), and without any MI-related symptoms should have a cardiologic consultation during the Screening Period to rule out MI.

5\. Has a corrected QT interval (QTcF) prolongation to > 480 ms (regardless of participant's sex) based on average of the screening triplicate 12-lead ECG. 6. Has a history of (non-infectious) ILD/pneumonitis that required steroids, has current ILD/pneumonitis, or where suspected ILD/pneumonitis cannot be ruled out by imaging at screening.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Non-randomized

Model

Sequential

Masking

Open label

Primary purpose

Treatment

Study locations

United States · 6 centers

• Research Site — Newport Beach
• Research Site — Atlanta
• Research Site — Las Vegas
• Research Site — Charlotte
• Research Site — Maumee
• Research Site — Nashville

Brazil · 5 centers

• Research Site — Asa Sul
• Research Site — Goiás
• Research Site — Porto Alegre
• Research Site — Santo André
• Research Site — São Paulo

Japan · 5 centers

• Research Site — Chiba
• Research Site — Kanagawa
• Research Site — Tokyo
• Research Site — Tokyo
• Research Site — Tokyo

South Korea · 5 centers

• Research Site — Seongnam-si
• Research Site — Seoul
• Research Site — Seoul
• Research Site — Seoul
• Research Site — Seoul

Taiwan · 5 centers

• Research Site — Taichung
• Research Site — Tainan
• Research Site — Taipei
• Research Site — Taipei
• Research Site — Taoyuan City

Spain · 3 centers

• Research Site — Barcelona
• Research Site — Madrid
• Research Site — Seville

France · 2 centers

• Research Site Saint — Herblain
• Research Site — Rennes

Identifiers

NCT: NCT07015697 · DS8201-801

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗