Phase 3
N=719
Everolimus in Combination With Trastuzumab and Paclitaxel in the Treatment of HER2 Positive Locally Advanced or Metastatic Breast Cancer
Breast Cancer
Bottom Line
View on ClinicalTrials.gov: NCT00876395 ↗Enrolled (actual)
719
Serious AEs
30.0%
Results posted
Dec 2018
Primary outcome: Primary: Progression-free Survival (PFS) Per Investigators' Assessment Based on Local Radiology Review - Full Population — 14.95; 14.49 months — p=0.1166
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Everolimus (Drug); Placebo (Drug); Trastuzumab (Drug); Paclitaxel (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- Female
- Sponsor
- Novartis Pharmaceuticals
- Primary completion
- May 2014
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Progression-free Survival (PFS) Per Investigators' Assessment Based on Local Radiology Review - Full Population |
14.95; 14.49 | 0.1166 |
| PRIMARY Progression-free Survival (PFS) Per Investigators' Assessment Based on Local Radiology Review - (Hormone Receptor (HR)-Negative Population |
20.27; 13.08 | 0.0049 sig |
| SECONDARY Overall Survival (OS) - Full Population |
48.56; 49.97 | — |
| SECONDARY Overall Survival (OS) - HR-negative Population |
56.97; 41.63 | — |
| SECONDARY Overall Response Rate (ORR) - Full Population |
67.1; 69.0 | 0.7276 |
| SECONDARY Overall Response Rate (ORR) - HR-negative Population |
73.1; 70.9 | 0.4085 |
| SECONDARY Clinical Benefit Rate (CBR) Equal to or Greater Than 24 Weeks - Full Population |
75.8; 81.2 | 0.9573 |
| SECONDARY Clinical Benefit Rate (CBR) Equal to or Greater Than 24 Weeks - HR-negative Population |
78.8; 79.6 | 0.6382 |
| SECONDARY Time to Overall Response Based on Investigator - Full Population |
2.10; 2.00 | — |
| SECONDARY Time to Overall Response Based on Investigator - HR-negative Population |
1.94; 1.97 | — |
| SECONDARY Overall Response (OR) - Full Population |
5.6; 5.9; 61.5; 63.2 | — |
| SECONDARY Overall Response (OR) - HR-negative Population |
7.7; 2.9; 65.4; 68.0 | — |
| SECONDARY Everolimus Blood Level Concentrations at Steady States for Everolimus |
14.380; 7.959; 44.485; 23.449; 13.206; 5.473 | — |
| SECONDARY Paclitaxel Plasma Concentrations |
1.424; 0; 5159.338; 4296.697 | — |
| SECONDARY Trastuzumab Serum Concentrations |
26.606; 29.180; 64.296; 67.643 | — |
| SECONDARY Time to Deterioration of Eastern Cooperative Oncology Group Performance Status (ECOG-PS) Score - Full Population |
39.20; NA | — |
| SECONDARY Time to Deterioration of Eastern Cooperative Oncology Group Performance Status (ECOG-PS) Score - HR-negative Population |
NA; NA | — |
Summary
The purpose of this Phase III study was to confirm the value of adding everolimus to weekly paclitaxel and trastuzumab as treatment of HER2-overexpressing metastatic breast cancer.
Eligibility Criteria
Inclusion Criteria
- Adult Women (≥ 18 years old).
- Histologically or cytologically confirmed invasive breast carcinoma with local recurrence or radiological evidence of metastatic disease.
- Must have at least one lesion that can be accurately measured or bone lesions in the absence of measurable disease.
- HER2+ patients by local laboratory testing (IHC 3+ staining or in situ hybridization positive).
- Prior trastuzumab and/or chemotherapy (taxanes included) as neo-adjuvant or adjuvant treatment is allowed but should be discontinued > 12 months prior to randomization.
- Prior treatment for breast cancer with endocrine therapy (adjuvant or metastatic settings) is allowed but should be discontinued at randomization. Patients treated with bisphosphonates at entry or who start bisphosphonates during study may continue this therapy during protocol treatment.
- Documentation of negative pregnancy test.
- Organ functions at time of inclusion.
Exclusion Criteria
- Prior mTOR inhibitors for the treatment of cancer.
- Other anticancer therapy for locally advanced or metastatic breast cancer except for prior hormonal therapy.
- Patients with only non-measurable lesions other than bone metastasis (e.g. pleural effusion, ascites, etc).
- Radiotherapy to ≥ 25% of the bone marrow within 4 weeks prior to randomization
- History of central nervous system metastasis.
- Impairment of gastrointestinal (GI) function or GI disease or active ulceration of the upper gastrointestinal tract.
- Serious peripheral neuropathy.
- Cardiac disease or dysfunction.
- Uncontrolled hypertension.
- HIV.
- Pregnant,
Data sourced from ClinicalTrials.gov (NCT00876395). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.