A Phase 1/2 Study Of HKI-272 (Neratinib) in Combination With Trastuzumab (Herceptin) In Subjects With Advanced Breast Cancer

Puma Biotechnology

Status and phase: Completed; Phase 2; Phase 1

Conditions: Advanced Breast Cancer

Treatments: Drug: HKI-272; Drug: trastuzumab

Study type: Interventional

Funder types: Industry

Identifiers

NCT00398567

3144A1-202 / B1891013

Details and patient eligibility

About

The purpose of this study is to determine the safety and efficacy of HKI-272 (neratinib) in combination with trastuzumab in patients with advanced breast cancer.

Full description

Open label phase 1/2 study of ascending multiple oral doses of HKI-272 in combination with IV trastuzumab in subjects with advanced human epidermal growth factor receptor 2 positive (HER2+) breast cancer. Three to six subjects will be enrolled in each dose group. Adverse events and dose limiting toxicities will be assessed from the first dose of study drug though day 21. When the maximum tolerated dose (MTD) of HKI-272 plus trastuzumab is determined, an additional 30 subjects will be enrolled at that dose level, and followed for progression free survival for approximately 1 year.

Enrollment: 45 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Pathologic diagnosis of breast cancer with current stage IIIB, IIIC or IV not curable by available therapy
• Progression following at least one Herceptin-containing cytotoxic chemotherapy regimen (neoadjuvant, adjuvant, or metastatic setting)
• HER2 positive breast cancer
• At least one measurable target lesion
• Adequate performance status
• Adequate cardiac, kidney, and liver function
• Adequate blood counts
• Willingness of all subjects who are not surgically sterile or post menopausal to use acceptable methods of birth control

Exclusion criteria

• More than 3 prior cytotoxic chemotherapy regimens for locally advanced or metastatic disease
• Major surgery, chemotherapy, radiotherapy, investigational agents, Herceptin or other cancer therapy within 2 weeks of treatment day 1
• Prior treatment with anthracyclines with cumulative dose of >400 mg/m^2
• Extensive visceral disease
• Active central nervous system metastases
• Pregnant or breast feeding women
• Significant chronic or recent acute gastrointestinal disorder with diarrhea as a major symptom
• Prior exposure to HKI-272 or other HER2 targeted agents (except Herceptin and Tykerb)
• Significant cardiac disease or dysfunction
• History of life-threatening hypersensitivity to Herceptin
• Inability or unwillingness to swallow HKI-272 capsules
• Any other cancer within 5 years with the exception of contralateral breast cancer, adequately treated cervical carcinoma in situ, or adequately treated basal or squamous cell carcinoma of the skin

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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45 participants in 3 patient groups

Part 1 - dose level 1 (160 mg)

Experimental group

Description:

All subjects receiving HKI-272 dose level 1 in combination with trastuzumab

Treatment:

Drug: trastuzumab

Drug: HKI-272

Part 1 - dose level 2 (240 mg)

Experimental group

Description:

All subjects receiving HKI-272 dose level 2 in combination with trastuzumab

Treatment:

Drug: trastuzumab

Drug: HKI-272

Part 2 - expanded MTD cohort

Experimental group

Description:

All subjects receiving HKI-272 in combination with trastuzumab

Treatment:

Drug: trastuzumab

Drug: HKI-272