Overview

This trial is active, not recruiting.

Condition breast cancer
Treatments everolimus, exemestane, tamoxifen, fulvestrant, anastrozole, letrozole, toremifine
Phase phase 2
Targets mTOR, FKBP-12
Sponsor SCRI Development Innovations, LLC
Collaborator Novartis
Start date November 2014
End date May 2017
Trial size 48 participants
Trial identifier NCT02291913, SCRI BRE 212

Summary

Many patients with ER-positive or PR-positive breast cancer usually are treated with endocrine therapy. Although most ER/PR-positive tumors initially respond to hormonal therapy, patients often experience disease progression. Everolimus, in combination with exemestane, has shown activity in endocrine-resistant disease. This study will evaluate the efficacy of Everolimus+ anti-estrogen therapy in patients with ER-positive metastatic breast cancer who have progressed after receiving anti-estrogen therapy.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Endpoint classification safety/efficacy study
Intervention model single group assignment
Masking open label
Primary purpose treatment
Arm
(Experimental)
Everolimus will be administered at a dose of 10 mg PO daily combined with any one of the following anti-estrogen therapies on which the patient most recently progressed (tamoxifen, fulvestrant, anastrozole, letrozole, exemestane, toremifine, or LHRH agonists in conjunction with anti-estrogen therapy). Anti-estrogen therapy will be administered at the US Food and Drug Administration (FDA) prescribed doses.
everolimus Afinitor
exemestane
Anti-estrogen therapy
tamoxifen
Anti-estrogen therapy
fulvestrant
Anti-estrogen therapy
anastrozole
Anti-estrogen therapy
letrozole
Anti-estrogen therapy
toremifine
Anti-estrogen therapy

Primary Outcomes

Measure
Progression Free Survival (PFS)
time frame: every 8 weeks until treatment discontinuation, an expected average of 6 months

Secondary Outcomes

Measure
Number of patients with Adverse Events (AEs) as a Measure of Safety and Tolerability
time frame: every 4 weeks until treatment discontinuation, an expected average of 6 months
Overall Response Rate (ORR)
time frame: every 8 weeks until treatment discontinuation, an expected average of 6 months
Clinical Benefit Rate (CBR)
time frame: every 8 weeks until treatment discontinuation, an expected average of 6 months
Duration of Response (DOR)
time frame: every 8 weeks until treatment discontinuation, an expected average of 6 months
Overall Survival
time frame: every 8 weeks until treatment discontinuation, an expected average of 6 months and then every 12 weeks until 36 months from start of treatment

Eligibility Criteria

Female participants at least 18 years old.

Inclusion Criteria: 1. Histologic diagnosis of unresectable, locally recurrent or MBC. 2. ER and/or PR-positive tumors with staining by immunohistochemistry (IHC) based on the most recent biopsy. 3. Only 1 previous chemotherapy regimen for MBC. Patients progressing while receiving adjuvant endocrine therapy or progressing <12 months from completion of adjuvant endocrine therapy are eligible. 4. Progressed on anti-estrogen therapy (tamoxifen, fulvestrant, anastrozole, letrozole, exemestane, toremifine, or LHRH agonists in conjunction with anti-estrogen therapy) defined as: - Recurrence while on, or within 12 months of end of anti-estrogen therapy for early stage breast cancer, or - Progression while on, or within one month of anti-estrogen therapy for locally advanced or metastatic breast cancer. Note: No washout for anti-estrogen therapy required. Anti-estrogen therapy does not have to be the last treatment prior to study entry. 5. Post-menopausal or pre/peri-menopausal women on tamoxifen. LHRH agonists may be used to render ovarian suppression with postmenopausal ranges of estradiol or FSH per institutional guidelines. 6. HER2-negative breast cancer, defined as follows: - Fluorescent In Situ Hybridization (FISH)-negative (FISH ratio <2.0), or - IHC 0-1+, or - IHC 2-3+ AND FISH-negative (FISH ratio <2.0). 7. Measureable disease as measured by Response Evaluation Criteria in Solid Tumors (RECIST) criteria version 1.1 or evaluable bone lesions, lytic or mixed, in absence of measureable disease by RECIST criteria. 8. Adequate hematologic, hepatic and renal function. 9. International normalized ratio (INR) ≤1.5 or prothrombin time (PT)/partial thromboplastin time (PTT) within normal limits (WNL) of the institution (if patient is not on anti-coagulation therapy). 10. Age ≥ 18 years. 11. ECOG Performance Status score of 0-2. 12. Life expectancy of ≥ 12 weeks. Exclusion Criteria: 1. Previous therapy or known intolerance/hypersensitivity with any approved or investigational mTOR inhibitor (e.g., temsirolimus, everolimus, sirolimus). 2. Patients who are ≤21 days after their most recent chemotherapy and have not recovered from side effects. 3. Use of an investigational drug ≤21 days or 5 half-lives (whichever is shorter) prior to the first dose of everolimus. For investigational drugs for which 5 half-lives is ≤21 days, a minimum of 10 days between termination of the investigational drug and administration of everolimus is required. 4. Wide field radiotherapy (including therapeutic radioisotopes such as strontium 89) administered ≤28 days or limited field radiation for palliation ≤7 days for metastatic disease prior to first dose of everolimus or has not recovered from side effects of such therapy. 5. Previously untreated brain metastases. Patients who have received radiation or surgery for brain metastases are eligible if there is no evidence of central nervous system (CNS) disease progression, and at least 2 weeks have elapsed since treatment. Patients are not permitted to receive enzyme inducing anti-epileptic drugs (EIAEDs) during the study and should not be receiving chronic corticosteroid therapy for CNS metastases. 6. Patients with known active hepatitis B (HBV) or hepatitis C (HCV) infection. Patients with risk factors for hepatitis must have HBV DNA and HCV RNA testing by PCR, and are ineligible if these tests are positive. 7. Patients receiving immunization with attenuated live vaccines within 1 week of study entry or during study period. NOTE: There are additional inclusion/exclusion criteria. The study center will determine patient eligibility and respond to any questions.

Additional Information

Official title Phase II Open Label Study of Everolimus in Combination With Anti-estrogen Therapy in Hormone Receptor-Positive HER2-Negative Advanced Breast Cancer
Description Based on the activity of Everolimus in previous studies investigating endocrine-resistant disease, the investigators propose to evaluate the efficacy of Everolimus in patients with ER-positive (estrogen receptor-positive) metastatic breast cancer who have progressed on anti-estrogen therapy. It is hypothesized that in this group of endocrine-resistant patients, resistance to anti-estrogen therapy is driven by the activation of the PI3K/Akt/mTOR pathways and hence the addition of Everolimus, a mTOR inhibitor, to the failing anti-estrogen therapy may result in reversing the resistance established by these cellular mechanisms in these patients.
Trial information was received from ClinicalTrials.gov and was last updated in March 2016.
Information provided to ClinicalTrials.gov by SCRI Development Innovations, LLC.