Phase 2
N=50
NeoPHOEBE: Neoadjuvant Trastuzumab + BKM120 in Combination With Weekly Paclitaxel in HER2-positive Primary Breast Cancer
HER2-positive Newly Diagnosed, Primary Breast Cancer
Bottom Line
View on ClinicalTrials.gov: NCT01816594 ↗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
| Outcome | Result | p-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
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.