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University of North Carolina at Chapel Hill | Institute of Global Health and Infectious Disease

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A Study of LY2835219 (Abemaciclib) in Combination With Therapies for Breast Cancer That Has Spread

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Lilly

Status and phase

Active, not recruiting
Phase 1

Conditions

Breast Neoplasms

Treatments

Drug: Trastuzumab
Drug: Pertuzumab
Drug: Loperamide
Drug: Fulvestrant
Drug: LY3023414
Drug: Tamoxifen
Drug: Anastrozole
Drug: Exemestane
Drug: Endocrine therapy
Drug: Letrozole
Drug: Everolimus
Drug: LY2835219

Study type

Interventional

Funder types

Industry

Identifiers

NCT02057133
I3Y-MC-JPBH (Other Identifier)
15252

Details and patient eligibility

About

This study evaluates the safety of abemaciclib in combination therapies (letrozole, anastrozole, tamoxifen, exemestane, exemestane plus everolimus, trastuzumab, LY3023414 plus fulvestrant, pertuzumab plus trastuzumab with loperamide, or ongoing endocrine therapy) for breast cancer that has spread to other parts of the body.

Enrollment

198 estimated patients

Sex

Female

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Have a diagnosis of hormone receptor positive (HR+), human epidermal growth factor receptor 2 (HER2) negative metastatic breast cancer for Parts A to E, G, and I.

  • Have a diagnosis of human epidermal growth factor receptor 2 (HER2) positive metastatic breast cancer for Parts F and H.

  • For Part A (LY2835219 + letrozole): Except for ongoing therapy with letrozole, the participant must not have received prior systemic endocrine therapy for metastatic disease.

  • For Part B (LY2835219 + anastrozole): Except for ongoing therapy with anastrozole, the participant must not have received prior systemic endocrine therapy for metastatic disease.

  • For Part C (LY2835219 + tamoxifen): The participant may have received prior systemic endocrine therapy for metastatic disease and may be receiving ongoing therapy with tamoxifen.

  • For Part D (LY2835219 + exemestane): The participant must have received prior systemic endocrine therapy with at least one nonsteroidal aromatase inhibitor (anastrozole, letrozole) for metastatic disease and may be receiving ongoing therapy with exemestane.

  • For Part E (LY2835219 + exemestane + everolimus): The participant must have received prior systemic endocrine therapy with at least one nonsteroidal aromatase inhibitor (anastrozole, letrozole) for metastatic disease and may be receiving ongoing therapy with either exemestane or exemestane + everolimus.

  • For Part F (LY2835219 + trastuzumab):The participant must have received at least 1 chemotherapy regimen for metastatic disease and may be receiving ongoing therapy with trastuzumab. The participant must have an estimated left ventricular ejection fraction within the normal range by either echocardiogram or multigated acquisition (MUGA) scan

  • For Part G (abemaciclib + LY3023414 + fulvestrant): The participant may have received prior systemic endocrine therapy with at least one nonsteroidal aromatase inhibitor (anastrozole, letrozole) for metastatic disease.

  • For Part H: (abemaciclib + trastuzumab + pertuzumab): The participant must have received at least 1 chemotherapy regimen for metastatic disease. The participant may be receiving ongoing therapy with trastuzumab and/or pertuzumab at the time of study entry. The participant must have an estimated left ventricular ejection fraction (LVEF) within the normal range by either echocardiogram or multigated acquisition (MUGA) scan.

  • For Part I (abemaciclib + endocrine therapy): The participant must have demonstrated evidence of disease progression on a Cyclin Dependent Kinase 4 (CDK4) and Cyclin Dependent Kinase 6 (CDK6) inhibitor (either palbociclib or ribociclib) plus endocrine therapy for advanced or metastatic disease as the most recent therapy immediately preceding study entry. The participant should remain on the current endocrine therapy while receiving abemaciclib.

  • For Parts A, B, C, D, E, and F: Have either measureable disease or nonmeasureable but evaluable bone disease as defined by the Response Evaluation Criteria in Solid Tumors (RECIST 1.1)

  • For Part G, H, and I: Have measureable disease as defined by RECIST 1.1.

  • For all Parts except Part F and H: Participants must have either post-menopausal status or pre-menopausal status if continuing or beginning ovarian suppression with a luteinizing hormone-releasing hormone (LHRH) agonist such as goserelin.

  • Parts H, and I: Must be able and willing to undergo mandatory tumor biopsies prior to study treatment and at the time of discontinuation from study treatment.

  • Have adequate organ function, including:

    • Hematologic: Absolute neutrophil count (ANC) ≥1.5 x 10^9/liter (L), platelets ≥ 100 x 10^9/L, and hemoglobin ≥ 8 gram/deciliter (g/dL).
    • Hepatic: Bilirubin ≤1.5 times upper limits of normal (ULN), alanine aminotransferase (ALT) ≤ 3.0 times ULN.
    • Renal: Serum creatinine ≤ 1.5 times ULN.
  • Have a performance status of ≤1 on the Eastern Cooperative Oncology Group (ECOG) scale.

  • Have discontinued all previous therapies for breast cancer (including chemotherapy, radiotherapy, immunotherapy, and investigational therapy), except for ongoing corresponding combination therapy, for at least 21 days for myelosuppressive agents or 14 days for nonmyelosuppressive agents prior to receiving study drug(s), and recovered from the acute effects of therapy (until the toxicity resolves to either baseline or at least Grade 1) except for residual alopecia or peripheral neuropathy. For Part F and H: concurrent treatment with trastuzumab emtansine (T-DM1) is not allowed.

Exclusion criteria

  • Have metastatic breast cancer with severe organ dysfunction as assessed by symptoms and signs, laboratory studies, and rapid progression of the disease.
  • Have brain metastasis without prior radiotherapy.
  • For Parts A, B, C, D, E, G and I: Have received prior systemic chemotherapy for metastatic disease. However, the participant may have received prior systemic chemotherapy in the neoadjuvant or adjuvant setting.
  • For Parts A, B, C, D, E, F, H: Have received prior therapy with a CDK4/6 inhibitor, Part G: Have received prior therapy with fulvestrant or any PI3K and/or mTOR inhibitor (including LY3023414); Part I: Have received prior treatment with abemaciclib in any setting.
  • Have serious preexisting medical conditions that, in the judgment of the investigator, would preclude participation in this study (including interstitial lung disease (ILD), severe dyspnea at rest or requiring oxygen therapy or, history of major surgical resection involving the stomach or small bowel).
  • Have central nervous system (CNS) metastasis with either radiotherapy or development of neurological changes ≤14 days prior to receiving study treatment. Participants may be receiving a stable dose of corticosteroids. Screening of asymptomatic participants without history of CNS metastasis is not required. Untreated CNS metastases are not permitted.
  • For Parts F and H: Cardiac disease including myocardial infarction within 6 months, unstable angina, or New York Heart Association (NYHA) Grade II or greater functional impairment.
  • For Part G: Have type 1 diabetes mellitus or a history of gestational diabetes mellitus. Participants with a type 2 diabetes mellitus are eligible if adequate control of blood glucose level is obtained with oral therapy as documented by Hemoglobin A1c <7%.
  • For Part G: Have a baseline electrocardiogram (obtained from Day -14 to Day -1) with any of the following abnormal findings: ventricular arrhythmia, evidence of acute myocardial ischemia, heart block (of any degree), or QTc prolongation (defined as QTcB ≥450 milliseconds).

Trial design

Primary purpose

Treatment

Allocation

Non-Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

198 participants in 13 patient groups

LY2835219 + Letrozole
Experimental group
Description:
LY2835219 administered orally. Letrozole administered orally. This arm is closed to enrollment.
Treatment:
Drug: LY2835219
Drug: Letrozole
LY2835219 + Anastrozole
Experimental group
Description:
LY2835219 administered orally. Anastrozole administered orally. This arm is closed to enrollment.
Treatment:
Drug: LY2835219
Drug: Anastrozole
LY2835219 + Tamoxifen
Experimental group
Description:
LY2835219 administered orally. Tamoxifen administered orally. This arm is closed to enrollment.
Treatment:
Drug: LY2835219
Drug: Tamoxifen
LY2835219 + Exemestane
Experimental group
Description:
LY2835219 administered orally. Exemestane administered orally. This arm is closed to enrollment.
Treatment:
Drug: LY2835219
Drug: Exemestane
LY2835219 + Exemestane + Everolimus Dose Escalation
Experimental group
Description:
LY2835219 administered orally. Exemestane administered orally. Everolimus administered orally. This arm is closed to enrollment.
Treatment:
Drug: LY2835219
Drug: Everolimus
Drug: Exemestane
LY2835219 + Exemestane + Everolimus Dose Expansion
Experimental group
Description:
LY2835219 administered orally. Exemestane administered orally. Everolimus administered orally. This arm is closed to enrollment.
Treatment:
Drug: LY2835219
Drug: Everolimus
Drug: Exemestane
LY2835219+ Trastuzumab Dose Escalation
Experimental group
Description:
LY2835219 administered orally. Trastuzumab administered intravenously (IV) infusion. This arm is closed to enrollment.
Treatment:
Drug: LY2835219
Drug: Trastuzumab
LY2835219+ Trastuzumab Dose Expansion
Experimental group
Description:
LY2835219 administered orally. Trastuzumab administered IV infusion. This arm is closed to enrollment.
Treatment:
Drug: LY2835219
Drug: Trastuzumab
LY3023414 + LY2835219 + Fulvestrant Dose Escalation
Experimental group
Description:
LY3023414 administered orally. LY2835219 administered orally. Fulvestrant administered intramuscularly (IM).
Treatment:
Drug: Fulvestrant
Drug: LY2835219
Drug: LY3023414
LY3023414 + LY2835219 + Fulvestrant Dose Expansion
Experimental group
Description:
LY3023414 administered orally. LY2835219 administered orally. Fulvestrant administered IM.
Treatment:
Drug: Fulvestrant
Drug: LY2835219
Drug: LY3023414
LY2835219 +Trastuzumab +Pertuzumab +Loperamide Dose Escalation
Experimental group
Description:
LY2835219 administered orally. Loperamide administered orally. Trastuzumab administered IV infusion. Pertuzumab administered IV infusion.
Treatment:
Drug: Loperamide
Drug: LY2835219
Drug: Pertuzumab
Drug: Trastuzumab
LY2835219 +Trastuzumab + Pertuzumab +Loperamide Dose Expansion
Experimental group
Description:
Hormone Receptor Negative (HR-): LY2835219 administered orally. Loperamide administered orally. Trastuzumab administered IV infusion. Pertuzumab administered IV infusion. Hormone Receptor Positive (HR+): LY2835219 administered orally. Loperamide administered orally. Trastuzumab administered IV infusion. Pertuzumab administered IV infusion. Endocrine therapy administered orally.
Treatment:
Drug: Loperamide
Drug: LY2835219
Drug: Endocrine therapy
Drug: Pertuzumab
Drug: Trastuzumab
LY2835219 + Endocrine Therapy
Experimental group
Description:
LY2835219 administered orally. Ongoing endocrine therapy administered orally.
Treatment:
Drug: LY2835219
Drug: Endocrine therapy

Trial contacts and locations

13

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Data sourced from clinicaltrials.gov

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