A Study of Novel Anti-cancer Agents in Patients With Metastatic Triple Negative Breast Cancer (BEGONIA)

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AstraZeneca

Status and phase

Enrolling
Phase 2
Phase 1

Conditions

Triple Negative Breast Neoplasms

Treatments

Drug: Capivasertib
Drug: Datopotamab deruxtecan
Drug: Trastuzumab deruxtecan
Drug: Oleclumab
Drug: Paclitaxel
Drug: Durvalumab

Study type

Interventional

Funder types

Industry

Identifiers

NCT03742102
2018-000764-29 (EudraCT Number)
D933LC00001

Details and patient eligibility

About

This study is designed to determine the efficacy and safety of durvalumab in combination with novel oncology therapies with or without paclitaxel and durvalumab + paclitaxel for first-line metastatic triple negative breast cancer

Full description

This is a Phase IB/II, 2-stage, open-label, multicenter study to determine the efficacy and safety of durvalumab in combination with novel oncology therapies (i.e. therapies designed for immune modulation) with or without paclitaxel and durvalumab + paclitaxel as first-line treatment in patients with metastatic triple negative breast cancer (TNBC). The study is designed to concurrently evaluate potential novel treatment combinations with clinical promise using a 2-stage approach. The study will use a Simon 2-Stage design to evaluate which cohorts may proceed to expansion. Part 1 is a Phase IB study of safety and initial efficacy, and Part 2 may expand patient enrollment if adequate efficacy signal is observed in Part 1. The treatment regimens evaluated in Part 2 will depend on the evaluation of safety and efficacy outcomes in Part 1.

Enrollment

240 estimated patients

Sex

Female

Ages

18 to 130 years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion criteria

  • Female
  • At least 18 years of age at the time of screening
  • Patient must have locally confirmed advanced/unresectable or metastatic TNBC.
  • No prior treatment for metastatic (Stage IV) TNBC
  • Patient must have at least 1 lesion, not previously irradiated, that can be accurately measured
  • WHO/ECOG status at 0 or 1 at enrollment

Patients enrolled to Arm 6 (durvalumab and DS-8201a) Must provide documentation of locally determined advanced/unresectable or metastatic TNBC with HER2 low tumor expression (IHC 2+/ISH-, IHC 1+/ISH-, or IHC 1+/ISH untested)

Patients enrolled in Arm 8 (durvalumab + Dato-DXd) Must have PD-L1 positive tumor as determined by an IHC based assay

Exclusion criteria

  • History of allogeneic organ transplantation
  • Active or prior documented autoimmune or inflammatory disorders
  • Active infection including tuberculosis, hepatitis B (known positive HBV surface antigen [HBsAg] result), hepatitis C virus (HCV), or human immunodeficiency virus (positive HIV 1/2 antibodies)
  • Untreated CNS metastases
  • Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients
  • Any concurrent chemotherapy, IP, or biologic therapy for cancer treatment
  • Female patients who are pregnant, breastfeeding
  • Cardiac Ejection Fraction less than 50%

Patients enrolled in Arm 2 only:

  • Potent inhibitors or inducers or substrates of CYP3A4 or substrates of CYP2C9 or CYP2D6 within 2 weeks before the first dose of study treatment (3 weeks for St John's Wort)
  • Diagnosis of diabetes mellitus Type I or diabetes mellitus Type II requiring insulin treatment.
  • Any factors that increase the risk of QTc prolongation or risk of arrhythmic events, such as heart failure, hypokalemia, potential for torsades de pointes, congenital long QT syndrome, family history of long QT syndrome or unexplained sudden death under 40 years of age, or any concomitant medication known to prolong the QT interval
  • Prior treatment with PI3K inhibitors, AKT inhibitors, or mammalian target of rapamycin (mTOR) inhibitors.

Patients enrolled in Arm 5 only: History of venous thromboembolism in the past 3 months

Patients enrolled in Arm 7 and 8 only: Clinically significant corneal disease in the opinion of the Investigator.

Patients enrolled in Arm 6, 7 and 8 only:

  • History of or active interstitial lung disease/pneumonitis
  • Use of chloroquine or hydroxychloroquine in <14 days prior to Day 1 of DS-8201a (Arm 6) or Dato-DXd (DS-1062a; Arm 7 and 8) treatment
  • Patients enrolled in Arm 6 only: Previously been diagnosed as HER2+ or received HER2-targeted therapy.

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

240 participants in 6 patient groups

Arm 1
Experimental group
Description:
durvalumab + paclitaxel
Treatment:
Drug: Durvalumab
Drug: Paclitaxel
Arm 2
Experimental group
Description:
durvalumab + paclitaxel + capivasertib
Treatment:
Drug: Durvalumab
Drug: Paclitaxel
Drug: Capivasertib
Arm 5
Experimental group
Description:
durvalumab + paclitaxel + oleclumab
Treatment:
Drug: Durvalumab
Drug: Paclitaxel
Drug: Oleclumab
Arm 6
Experimental group
Description:
durvalumab + trastuzumab deruxtecan
Treatment:
Drug: Durvalumab
Drug: Trastuzumab deruxtecan
Arm 7
Experimental group
Description:
durvalumab + datopotamab deruxtecan
Treatment:
Drug: Durvalumab
Drug: Datopotamab deruxtecan
Arm 8
Experimental group
Description:
durvalumab + datopotomab deruxtecan (patients with PD-L1 positive status)
Treatment:
Drug: Durvalumab
Drug: Datopotamab deruxtecan

Trial contacts and locations

47

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Central trial contact

AstraZeneca Clinical Study Information Center; AZ Breast Cancer Study Navigators AZ Breast Cancer Study Navigators

Data sourced from clinicaltrials.gov

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