A Phase II Clinical Trial of PM01183 in BRCA 1/2-Associated or Unselected Metastatic Breast Cancer

• ClinicalTrials.gov Identifier: NCT01525589
• Recruitment Status: Completed
• First Posted: February 3, 2012
• Results First Posted: September 25, 2020
• Last Update Posted: September 25, 2020
• Sponsor: PharmaMar
• Information provided by (Responsible Party): PharmaMar

Study Description

Brief Summary:

A Clinical Trial of PM01183 in Metastatic Breast Cancer to assess the antitumor activity of PM01183 ,to evaluate whether the presence of a known germline mutation in BRCA 1/2 predicts response to PM01183 in Metastatic Breast Cancer (MBC) patients, to evaluate the safety profile of this PM01183 to analyze the pharmacokinetics (PK) and PK/PD (pharmacokinetic/pharmacodynamic) correlations and to evaluate the pharmacogenomic (PGx) expression profile in tumor samples.

Condition or disease	Intervention/treatment	Phase
Breast Cancer	Drug: PM01183	Phase 2

Detailed Description:

A Multicenter Phase II Clinical Trial of PM01183 in BRCA 1/2-Associated or Unselected Metastatic Breast Cancer to assess the antitumor activity of PM01183 in terms of overall response rate (ORR), duration of response (DR),clinical benefit [ORR or stable disease lasting over three months (SD > 3 months)], progression free survival (PFS), and one-year overall survival (1y-OS) and to evaluate whether the presence of a known germline mutation in BRCA 1/2 predicts response to PM01183 in MBC patients, to explore the activity of PM01183 in specific breast cancer subpopulations according to hormonal receptor status, HER-2 overexpression, number and/or type of prior therapies, or according to other available histological/molecular classifications, to evaluate the safety profile of this PM01183 administration schedule [Day 1 every three weeks (q3wk)] in this patient population, to analyze the pharmacokinetics (PK) of PM01183 in this patient population, to explore PK/PD (pharmacokinetic/ pharmacodynamic) correlations, if applicable and to evaluate the pharmacogenomic (PGx) expression profile of selected putative markers potentially predictive of response to PM01183, in tissues from tumor samples.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 111 participants
• Allocation: N/A
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: A Multicenter Phase II Clinical Trial of PM01183 in BRCA 1/2-Associated or Unselected Metastatic Breast Cancer
• Actual Study Start Date: June 13, 2012
• Actual Primary Completion Date: October 2018
• Actual Study Completion Date: October 2018

Arms and Interventions

Arm	Intervention/treatment
Experimental: PM01183	Drug: PM01183; PM01183 drug product (DP) is presented as a lyophilized powder for concentrate for solution for infusion with two strengths: 1 mg/vial and 4 mg/vial

Outcome Measures

Primary Outcome Measures :

1. Overall Response Rate (ORR) [ Time Frame: Minimum 10-12 months if negative results and up to 26-28 months if study is to be complete the targeted enrollment ]
   The overall response rate is defined as the percentage of patients with a confirmed response, either complete response (CR) or partial response (PR), according to Response Evaluation Criteria In Solid Tumors Criteria (RECIST) v1.1. Per RECIST v1.1 for target lesions and assessed by MRI: CR, Disappearance of all target lesions; PR >=30% decrease in the sum of the longest diameter of target lesions.
2. Overall Response [ Time Frame: Minimum 10-12 months if negative results and up to 26-28 months if study is to be complete the targeted enrollment ]
   Overall Response Rate (ORR) in the population evaluable for efficacy according to RECIST v.1.1. ORR was defined as the percentage of patients with a confirmed response, either CR or PR, according to the RECIST v.1.1 for target lesions and assessed by MRI: CR, complete response: Disappearance of all target lesions; PD, progressive disease: 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions; PR, partial response: >=30% decrease in the sum of the longest diameter of target lesions; SD, stable disease: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD; TF, treatment failure.

Secondary Outcome Measures :

1. Duration of Response [ Time Frame: Minimum 10-12 months if negative results and up to 26-28 months if study is to be complete the targeted enrollment ]
   Duration of response (DoR), defined as the time between the date when the response criteria (PR or CR, whichever was first reached) were fulfilled to the first date when disease progression (PD), recurrence or death was documented. According to the RECIST v.1.1 for target lesions and assessed by MRI: CR, complete response: Disappearance of all target lesions; PD, progressive disease: 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions; PR, partial response: >=30% decrease in the sum of the longest diameter of target lesions.
2. Duration of Response Rate at 6 Months [ Time Frame: Time between the response criteria date and the date when disease progression, recurrence or death was documented, up to 6 months ]
   Duration of response (DoR), defined as the time between the date when the response criteria (PR or CR, whichever was first reached) were fulfilled to the first date when disease progression (PD), recurrence or death was documented. According to the RECIST v.1.1 for target lesions and assessed by MRI: CR, complete response: Disappearance of all target lesions; PD, progressive disease: 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions; PR, partial response: >=30% decrease in the sum of the longest diameter of target lesions.
3. Duration of Response Rate at 12 Months [ Time Frame: Time between the response criteria date and the date when disease progression, recurrence or death was documented, up to 12 months ]
   Duration of response (DoR), defined as the time between the date when the response criteria (PR or CR, whichever was first reached) were fulfilled to the first date when disease progression (PD), recurrence or death was documented. According to the RECIST v.1.1 for target lesions and assessed by MRI: CR, complete response: Disappearance of all target lesions; PD, progressive disease: 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions; PR, partial response: >=30% decrease in the sum of the longest diameter of target lesions.
4. Clinical Benefit Rate [ Time Frame: Minimum 10-12 months if negative results and up to 26-28 months if study is to be complete the targeted enrollment ]

   Clinical benefit, defined as the percentage of patients with ORR or SD lasting over three months (SD >3 months).

   The overall response rate is defined as the percentage of patients with a confirmed response, either complete response (CR) or partial response (PR), according to Response Evaluation Criteria In Solid Tumors Criteria (RECIST) v1.1. Per RECIST v1.1 for target lesions and assessed by MRI: CR, Disappearance of all target lesions; PR >=30% decrease in the sum of the longest diameter of target lesions.

   SD, stable disease: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD.

5. Progression-free Survival (PFS) [ Time Frame: 36 months ]
   Progression-free survival (PFS) is defined as the period of time from the date of first infusion to the date of progression disease, death (due to any cause), or last tumor evaluation. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
6. Progression-free Survival at 3 Months [ Time Frame: Time from the date of first infusion to the date of PD, death (due to any cause), or last tumor evaluation, up to 3 months ]
   Progression-free survival (PFS), defined as the period of time from the date of first infusion to the date of PD, death (due to any cause), or last tumor evaluation. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
7. Progression-free Survival at 6 Months [ Time Frame: Time from the date of first infusion to the date of PD, death (due to any cause), or last tumor evaluation, up to 6 months ]
   Progression-free survival (PFS), defined as the period of time from the date of first infusion to the date of PD, death (due to any cause), or last tumor evaluation. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
8. Progression-free Survival at 12 Months [ Time Frame: Time from the date of first infusion to the date of PD, death (due to any cause), or last tumor evaluation, up to 12 months ]
   Progression-free survival (PFS), defined as the period of time from the date of first infusion to the date of PD, death (due to any cause), or last tumor evaluation. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
9. Overall Survival (OS) [ Time Frame: 36 months ]
   Overall survival (OS) will be defined as time from the date of first infusion to the date of death or last contact
10. Overall Survival Rate at 12 Months [ Time Frame: Time from the date of first infusion to the date of death or last contact, up to 12 months ]
    Overall survival (OS), defined as the time from the date of first infusion to the date of death or last contact
11. Overall Survival Rate at 18 Months [ Time Frame: Time from the date of first infusion to the date of death or last contact, up to 18 months ]
    Overall survival (OS), defined as the time from the date of first infusion to the date of death or last contact.

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 75 Years (Adult, Older Adult)
• Sexes Eligible for Study: Female
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Women ≥ 18 and ≤ 75 years of age.
• Voluntary signed informed consent form (ICF).
• Proven diagnosis of metastatic breast cancer (MBC).
• At least one, but no more than three, prior chemotherapy regimens for MBC.
• Patients with known HER-2 overexpressing MBC must have failed at least one prior trastuzumab-containing regimen for metastatic disease.
• Disease evaluable for response by specific appropriate criteria.
• No or minimal disease-related symptoms not affecting patient daily activities.
• Adequate major organ function (normal or minimal alteration in liver, kidney, hematological, metabolic and cardiac function)
• Wash out periods prior to Day 1 of Cycle 1:

At least three weeks since the last chemotherapy (six weeks in some particular cases) and At least four weeks since the last radiotherapy (RT) > 30 Gy) and At least one week since the last hormonal therapy and At least two weeks since the last biological/investigational therapy

• Minimal or no ongoing toxicity from immediately prior therapy according to specific appropriate criteria. Mild ongoing toxicity is allowed in case of alopecia, skin toxicity, fatigue and/or finger numbness or tumbling.
• Patients of child-bearing potential must agree to use a medically approved contraception method until at least six weeks after the last study drug administration.
• Known deleterious germline mutation of BRCA1/2 (Patients in Cohorts A and A1)
• Prior treatment with PARP inhibitors (Patients in Cohort A1)

Exclusion Criteria:

• Prior treatment with PM01183 or trabectedin.
• Extensive prior RT.
• Prior or concurrent malignant disease unless cured for more than five years.
• Exceptions are breast cancer in the other breast.
• Uncommon or rare subtypes of breast cancer.
• Symptomatic or progressive brain metastases.
• Bone-limited and exclusively metastases.
• Relevant diseases or clinical situations which may increase patient's risk:

History of cardiac disease. Moderate breathing difficulties or oxygen requirement Active uncontrolled infection. Unhealed wound or presence of any external drainage. Chronically active viral hepatitis. Immunocompromised patients, including those known to be infected by human immunodeficiency virus (HIV).

Known muscular disease or functional alteration

• Pregnant or breastfeeding women.
• Impending need for immediate RT for symptomatic relief.
• Limitation of the patient's ability to comply with the treatment or to follow-up the protocol.

Contacts and Locations

Locations

United States, California

Stanford Women's Cancer Center

Stanford, California, United States, 94305

United States, Massachusetts

Massachusetts General Hospital

Boston, Massachusetts, United States, 02114

United States, New York

Weill Cornell Medical College - New York Presbyterian Hospital

New York, New York, United States, 10065

United States, Pennsylvania

Abramson Cancer Center - Hospital of the University of Pennsylvania at Perelman Center for Advanced Medicine

Philadelphia, Pennsylvania, United States, 19104

United States, Texas

The University of Texas MD Anderson Cancer Center

Houston, Texas, United States, 77030

Spain

Complexo Hospitalario Universitario A Coruña

A Coruna, A Coruña, Spain, 15006

Complexo Hospitalario Universitario de Santiago

Santiago de Compostela, A Coruña, Spain, 15706

Hospital Universitari Vall d'Hebron

Barcelona, Spain, 08035

Hospital Clínico Universitario de Valencia

Valencia, Spain, 46010

Sponsors and Collaborators

PharmaMar

  Study Documents (Full-Text)

Documents provided by PharmaMar:

Study Protocol  [PDF] March 8, 2016

Statistical Analysis Plan  [PDF] December 10, 2018

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Fernandez-Teruel C, Lubomirov R, Fudio S. Population Pharmacokinetic-Pharmacodynamic Modeling and Covariate Analyses of Neutropenia and Thrombocytopenia in Patients With Solid Tumors Treated With Lurbinectedin. J Clin Pharmacol. 2021 Sep;61(9):1206-1219. doi: 10.1002/jcph.1886. Epub 2021 Jun 9.

Cruz C, Llop-Guevara A, Garber JE, Arun BK, Perez Fidalgo JA, Lluch A, Telli ML, Fernandez C, Kahatt C, Galmarini CM, Soto-Matos A, Alfaro V, Perez de la Haza A, Domchek SM, Antolin S, Vahdat L, Tung NM, Lopez R, Arribas J, Vivancos A, Baselga J, Serra V, Balmana J, Isakoff SJ. Multicenter Phase II Study of Lurbinectedin in BRCA-Mutated and Unselected Metastatic Advanced Breast Cancer and Biomarker Assessment Substudy. J Clin Oncol. 2018 Nov 1;36(31):3134-3143. doi: 10.1200/JCO.2018.78.6558. Epub 2018 Sep 21. Erratum In: J Clin Oncol. 2018 Nov 20;36(33):3348. J Clin Oncol. 2019 Feb 1;37(4):362.

• Responsible Party: PharmaMar
• ClinicalTrials.gov Identifier: NCT01525589
• Other Study ID Numbers: PM1183-B-003-11
• First Posted: February 3, 2012
• Results First Posted: September 25, 2020
• Last Update Posted: September 25, 2020
• Last Verified: November 2018

Keywords provided by PharmaMar:

Breast cancer; PM01183; lurbinectedin; Pharma Mar

Additional relevant MeSH terms:

Breast Neoplasms; Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases