An Explorative Study of Afatinib in the Treatment of Advanced Cancer Carrying an EGFR, a HER2 or a HER3 Mutation

AZ-VUB

Status and phase

Unknown

Phase 2

Conditions

Cancers Harbouring an EGFR Mutation, (Excluding Non-squamous Non- Small Cell Lung Cancer, a Registered Indication), a HER2 Mutation or a HER3 Mutation

Treatments

Drug: Paclitaxel

Drug: Afatinib

Study type

Interventional

Funder types

Other

Identifiers

NCT03810872

Precision 2 - 1200.264

Details and patient eligibility

About

Objective(s):To investigate the efficacy and safety of afatinib in EGFR, HER 2 and HER3 mutated cancers, regardless of cancer type, excluding EGFR mutated non-small cell lung cancer.

Methodology:Open label, genomic driven trial (basket trial)

No. of patients total entered:Optimal Simon two stage design for the three genetic driven cohorts: 10 patients will be enrolled per cancer type in the first stage and an additional 19 in the second stage (maximum total 87 patients)

Indication : cancers harbouring an EGFR mutation(excluding non-squamous non- small cell lung cancer, a registered indication), a HER2 mutation or a HER3 mutation

Test product(s) : Afatinib At progression paclitaxel will be added for those patients that have no contra-indications

dose: Starting dose of afatinib at 40 mg/day. Dose increase to 50 mg in the absence of adverse events. Stepwise dose reduction to 30,20, 10 mg/day according to drug-related adverse events.

At progression, addition of paclitaxel 80 mg/m2 weekly 3w/4 to afatinib 40 mg/day .

mode of admin. : Oral for afatinib Intravenous for paclitaxel

Duration of treatment: Continuous treatment until progression or unacceptable adverse events or withdrawal of consent.

At disease progression, add paclitaxel until progression or unacceptable adverse event or withdrawal of consent if no contra-indications.

Criteria for efficacy: Primary Endpoint:

• Response rate (CR+ PR) via RECIST v1.1

Secondary Endpoints:

Disease control rate (CR+PR+SD)
Progression free survival
Overall survival
To correlate tumor response with findings on tumor biopsies
To investigate resistance mechanisms
response rate (CR+ PR) determined by RECIST and progression free survival on the combination therapy of afatinib and paclitaxel

Criteria for safety: Incidence and intensity of adverse events according CTCAE v4.0

Enrollment

87 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Women and men with locally advanced or metastatic cancers harboring either an activating EGFR mutation or a HER2 mutation or a HER3 mutation
Failure of at least one line of standard systemic therapy
No eligibility for other open genomic driven phase I, II or III trial available for these tumor genotypes
ECOG performance status ≤2
Patient with a life expectancy >3 months
Patients able to provide written informed consent prior to enrollment into the clinical trial.
Adequate organ function

Exclusion criteria

Non squamous non-small cell lung cancer harbouring an EGFR mutation (registered indication)
Chemotherapy, biological therapy or investigational agents within four weeks prior to the start of study treatment
Known hypersensitivity to afatinib or the excipients of any of the trial drugs
Prior treatment with afatinib