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Phase 2 N=50 Randomized Triple-blind Treatment

NeoPHOEBE: Neoadjuvant Trastuzumab + BKM120 in Combination With Weekly Paclitaxel in HER2-positive Primary Breast Cancer

HER2-positive Newly Diagnosed, Primary Breast Cancer

Enrolled (actual)
50
Serious AEs
20.0%
Results posted
Nov 2019
Primary outcome: Primary: Pathological Complete Response (pCR) Rate at the Time of Surgery - All Participants — 32.0; 40.0 Percentage of participants — p=0.811

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
BKM120 (Drug); Trastuzumab (Drug); Paclitaxel (Drug); BKM120 Placebo (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
Female
Sponsor
Novartis Pharmaceuticals
Primary completion
Feb 2015

Outcome Measures

OutcomeResultp-value
PRIMARY
Pathological Complete Response (pCR) Rate at the Time of Surgery - All Participants
32.0; 40.0 0.811
PRIMARY
Pathological Complete Response (pCR) Rate at the Time of Surgery - PIK3CA Wild Type (WT)
33.3; 42.9 0.830
PRIMARY
Pathological Complete Response (pCR) Rate at the Time of Surgery - PIK3CA Mutant (MT)
25.0; 25.0 0.786
SECONDARY
Overall Objective Clinical Response Rate at the End of the Biologic Window (After Week 6) Compared to Baseline (Key Secondary) - All Participants
56.0; 44.0 0.286
SECONDARY
Overall Objective Clinical Response Rate at the End of the Biologic Window (After Week 6) Compared to Baseline (Key Secondary) - PIK3A Wild Type Participants
61.9; 42.9 0.177
SECONDARY
Overall Objective Clinical Response Rate at the End of the Biologic Window (After Week 6) Compared to Baseline (Key Secondary) - PIK3A Mutant Participants
25.0; 50.0 0.929
SECONDARY
Rate of Breast Conserving Surgery (Most Radical Surgery)
60.0; 68.0 0.811
SECONDARY
Percentage of Participants With No Invasive and Non-invasive (DCIS) Residuals in Breast and Lymph Nodes Per GBG Definition
20.0; 28.0 0.840
SECONDARY
Percentage of Participants With No Invasive and Non-invasive (DCIS) Residuals in Breast and Lymph Nodes Per MD Anderson Definition
32.0; 36.0 0.724
SECONDARY
Overall Objective Response Rate (ORR) Prior to Surgery for All Participants
56.0; 76.0 0.964
SECONDARY
Percentage of Participants With pCR Rates by Hormone Receptor Status - Positive Estrogen Receptor (ER+)
31.3; 26.7 0.546
SECONDARY
Percentage of Participants With pCR Rates by Hormone Receptor Status Negative Estrogen Receptor (ER-)
33.3; 60.0 0.949
SECONDARY
Percentage of Participants With Objective Response Rates by Hormone Receptor Status - Positive Estrogen Receptor (ER+)
68.8; 33.3 0.053
SECONDARY
Percentage of Participants With Objective Response Rates by Hormone Receptor Status - Negative Estrogen Receptor (ER-)
33.3; 60.0 0.949
SECONDARY
Percentage of Participants With Remaining Ductal Carcinoma in Situ (DCIS) (ypTis)
12.0; 12.0 0.666
SECONDARY
Percentage of Participants With Node-negative Disease at Definitive Surgery (ypN0)
52.0; 60.0 0.803

Summary

This randomized, parallel cohort, two stage, double-blind, placebo-controlled study evaluated the oral PI3K inhibitor BKM120 in combination with trastuzumab and paclitaxel in HER2-positive, PIK3CA wild-type and PIK3CA mutant primary breast cancer prior to surgery (neo-adjuvant setting).

Eligibility Criteria

Inclusion Criteria

  • Patient had provided a signed study ICF prior to any screening procedure
  • Patient was a female ≥ 18 years of age
  • Patient has an ECOG performance status of 0-1
  • Patient has a unilateral (multifocal or multicentric disease allowed), histologically confirmed, newly diagnosed early breast cancer >2cm by clinical examination and/or >1.5 cm confirmed by ultrasound or by MRI
  • Patient has tumor tissue available for central review of ER, HER2 and PI3K status with centrally confirmed HER2-positive disease and known PI3KCA mutation status
  • Patient has adequate bone marrow, renal and liver function
  • Patient is able to swallow and retain oral medication

Exclusion Criteria

  • Patient has received prior systemic treatment for currently diagnosed disease
  • Patient has a known contraindications, hypersensitivity or intolerance to trastuzumab, paclitaxel or products containing cremophor
  • Patient has bilateral breast cancer or metastatic disease or inflammatory breast cancer
  • LVEF below 50% as determined by MUGA scan or ECHO
  • Patient has active cardiac disease or a history of cardiac abnormalities as defined in the protocol
  • Patient has impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of BKM120
  • Patient is currently receiving warfarin or other coumarin derived anti-coagulants
  • Patient is currently receiving chronic treatment with corticosteroids or another immunosuppressive agents (standard premedication for paclitaxel and local applications allowed)
  • Patient is currently receiving treatment with drugs known to be strong inhibitors or inducers of CYP3A
  • Patient has certain scores on an anxiety and depression mood questionnaires
  • Pregnant or nursing (lactating) women or patients not willing to apply apply highly effective contraception as defined in the protocol
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01816594). 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.

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