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A Study to Evaluate the Efficacy and Safety of Trastuzumab Emtansine in Combination With Atezolizumab or Atezolizumab-Placebo in Participants With Human Epidermal Growth Factor-2 (HER2) Positive Locally Advanced or Metastatic Breast Cancer (BC) Who Received Prior Trastuzumab and Taxane Based Therapy (KATE2)

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ClinicalTrials.gov Identifier: NCT02924883
Recruitment Status : Active, not recruiting
First Posted : October 5, 2016
Results First Posted : February 12, 2019
Last Update Posted : August 26, 2019
Sponsor:
Information provided by (Responsible Party):
Hoffmann-La Roche

Brief Summary:
This Phase II, double-blind, randomized, placebo-controlled multicenter study will investigate the efficacy and safety of trastuzumab emtansine in combination with atezolizumab or atezolizumab-placebo in participants with HER2-positive locally advanced or metastatic BC who have received prior trastuzumab and taxane based therapy, either alone or in combination, and/or who have progressed within 6 months after completing adjuvant therapy.

Condition or disease Intervention/treatment Phase
Metastatic Breast Cancer Drug: Atezolizumab Drug: Trastuzumab emtansine Other: Placebo Phase 2

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 202 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Randomized, Multicenter, Double-Blind, Placebo-Controlled Phase II Study of the Efficacy and Safety of Trastuzumab Emtansine in Combination With Atezolizumab or Atezolizumab-Placebo in Patients With HER2-Positive Locally Advanced or Metastatic Breast Cancer Who Have Received Prior Trastuzumab and Taxane Based Therapy
Actual Study Start Date : September 26, 2016
Actual Primary Completion Date : December 11, 2017
Estimated Study Completion Date : November 24, 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Breast Cancer

Arm Intervention/treatment
Experimental: Trastuzumab Emtansine + Atezolizumab
Atezolizumab 1200 milligrams (mg) intravenous (IV) infusion or matching Placebo followed by trastuzumab emtansine 3.6 milligrams per kilogram (mg/kg) IV infusion on Day 1 Cycle 1 and thereafter on Day 1 of each 21-day cycle until disease progression, unmanageable toxicity, or study termination by the Sponsor (approximately 29 months)
Drug: Atezolizumab
Atezolizumab 1200 mg IV infusion
Other Name: Tecentriq, RO5541267, MPDL3280A

Drug: Trastuzumab emtansine
Trastuzumab emtansine 3.6 mg/kg IV infusion
Other Name: Kadcyla®, T-DM1, RO5304020

Other: Placebo
Placebo matched to atezolizumab

Active Comparator: Trastuzumab Emtansine + Placebo
Placebo matched to atezolizumab followed by trastuzumab emtansine 3.6 mg/kg IV infusion on Day 1 Cycle 1 and thereafter on Day 1 of each 21-day cycle until disease progression, unmanageable toxicity, or study termination by the sponsor (approximately 29 months)
Drug: Trastuzumab emtansine
Trastuzumab emtansine 3.6 mg/kg IV infusion
Other Name: Kadcyla®, T-DM1, RO5304020

Other: Placebo
Placebo matched to atezolizumab




Primary Outcome Measures :
  1. Progression-Free Survival (PFS) as Determined by Investigator's Tumor Assessment Using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 (v1.1) [ Time Frame: Baseline up to approximately 15 months ]
    PFS was defined as the time from randomization to the first occurrence of disease progression or death from any cause, whichever occurred first, on the basis of investigator assessments. Progression was defined as at least a 20% increase in the sum of diameters of target lesions with an absolute increase of at least 5 millimeter (mm) or the appearance of one or more new lesions.

  2. Percentage of Participants With Adverse Events [ Time Frame: Baseline up to study completion, approximately 40 months ]
    An adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events.


Secondary Outcome Measures :
  1. Overall Survival (OS) [ Time Frame: Baseline up to study completion or death, whichever occurs first, approximately 40 months ]
    OS was defined as the time from randomization to death from any cause.

  2. Percentage of Participants With Objective Response (OR) as Determined by Investigator's Tumor Assessment Using RECIST v1.1 [ Time Frame: Baseline up to approximately 15 months ]
    An OR was defined as a complete or partial response determined on 2 consecutive occasions ≥ 4 weeks apart using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. Complete response was defined as the disappearance of all target and non-target lesions. Any pathological lymph nodes (whether target or non-target) must be < 10 mm on the short axis. Partial response was defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum. Participants who had no post-baseline tumor assessment were counted as non-responders.

  3. Duration of OR as Determined by Investigator's Tumor Assessment Using RECIST v1.1 [ Time Frame: Baseline up to approximately 15 months ]
    Duration of OR was defined as the time from the first tumor assessment that was judged to indicate that the patient had an objective response to the time of first documented disease progression using RECIST v1.1 per investigator assessment or death from any cause, whichever occurred first.

  4. Steady State Maximum Serum Concentration (Cmax) of Trastuzumab Emtansine [ Time Frame: 30 minutes after the end of Cycle 4 (each cycle = 21 days) trastuzumab emtansine infusion ]
    Average post infusion Trastuzumab Emtansine concentration at Cycle 4

  5. Steady State Cmax of Deacetyl Mercapto 1-Oxopropyl Maytansine [ Time Frame: 30 minutes after the end of Cycle 4 (each cycle = 21 days) trastuzumab emtansine infusion ]
    Average post infusion Deacetyl Mercapto 1-Oxopropyl Maytansine concentration at Cycle 4 of trastuzumab emtansine infusion

  6. Steady State Cmax of Total Trastuzumab [ Time Frame: Pre-infusion (0 h), 30 min after EOI (over 90 min) on Day 1 Cycles 1 and 4; pre-infusion (0 h) on Day 1 Cycle 2 (each cycle = 21 days) ]
  7. Cycle 4 Cmax of Atezolizumab [ Time Frame: 30 minutes after the end of Cycle 4 (each cycle = 21 days) of atezolizumab infusion ]
    Average post infusion atezolizumab concentration at Cycle 4

  8. Percentage of Participants With Anti-therapeutic Antibodies (ATAs) to Atezolizumab [ Time Frame: Pre-infusion (0 h) on Day 1 Cycles 1, 2, 3, 4, 8, and every 8 cycles thereafter (each cycle = 21 days) up to 120 days after treatment completion or early discontinuation (approximately 40 months) ]
    ATAs are antibodies that inactivate the therapeutic effects of Atezolizumab. Patients are considered to be ATA positive if they are ATA negative at baseline but develop an ATA response following study drug administration (treatment-induced ATA response), or if they are ATA positive at baseline and the titer of one or more post-baseline samples is at least 4-fold greater (i.e., ≥ 0.60 titer units) than the titer of the baseline sample (treatment-enhanced ATA response).

  9. Percentage of Participants With ATAs to Trastuzumab Emtansine [ Time Frame: Pre-infusion (0 h) on Day 1 Cycles 1 and 4 (each cycle = 21 days); and at any time during study treatment/early discontinuation visit (approximately 40 months) ]
    ATAs are antibodies that inactivate the therapeutic effects of Trastuzumab Emtansine. Patients are considered to be ATA positive if they are ATA negative at baseline but develop an ATA response following study drug administration (treatment-induced ATA response), or if they are ATA positive at baseline and the titer of one or more post-baseline samples is at least 4-fold greater (i.e., ≥ 0.60 titer units) than the titer of the baseline sample (treatment-enhanced ATA response).



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Archival tumor samples must be obtained from primary and/or metastatic sites
  • Able to submit tumor tissue that is evaluable for programmed death- ligand 1 (PD-L1) expression
  • HER-2 positive BC as defined by an immunohistochemistry score of 3 or gene amplified by in-situ hybridization as defined by a ratio of greater than or equal to (>=) 2.0 for the number of HER2 gene copies to the number of chromosome 17 copies
  • Histologically or cytologically confirmed invasive BC: incurable, unresectable, locally advanced BC previously treated with multimodality therapy or metastatic BC
  • Prior treatment for BC in the: adjuvant; unresectable locally advanced; or metastatic settings; which must include both, a taxane and trastuzumab (alone or in combination with another agent)
  • Progression must have occurred during or after most recent treatment for locally advanced/metastatic BC or within 6 months after completing adjuvant therapy
  • Participants must have measurable disease that is evaluable as per RECIST v1.1
  • Eastern Cooperative Oncology Group Performance Status of 0 or 1
  • Negative serum pregnancy test within 7 days of enrollment for pre-menopausal women and for women less than 12 months after the onset of menopause
  • Use of highly effective method of contraception as defined by the protocol

Exclusion Criteria:

  • Prior treatment with trastuzumab emtansine, cluster of differentiation 137 agonists, anti-programmed death-1, or anti-PD-L1 therapeutic antibody or pathway-targeting agents
  • Receipt of any anti-cancer drug/biologic or investigational treatment within 21 days prior to Cycle 1 Day 1 except hormone therapy, which can be given up to 7 days prior to Cycle 1 Day 1; recovery of treatment related toxicity consistent with other eligibility criteria
  • Radiation therapy within 2 weeks prior to Cycle 1, Day 1
  • History of exposure to the cumulative doses of anthracyclines
  • History of other malignancy within the previous 5 years, except for appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, Stage I uterine cancer, or participants who have undergone potentially curative therapy with no evidence of disease and are deemed by the treating physician to be at low risk for recurrence
  • Cardiopulmonary dysfunction, symptomatic pleural effusion, pericardial effusion, or ascites
  • Participants with severe infection within 4 weeks prior to randomization, including but not limited to hospitalization for complications of infection, bacteremia, or severe pneumonia
  • Current severe, uncontrolled systemic disease
  • Major surgical procedure or significant traumatic injury within 28 days prior to randomization or anticipation of the need for major surgery during the course of study treatment
  • Clinically significant history of liver disease, including cirrhosis, current alcohol abuse, autoimmune hepatic disorders, sclerosis cholangitis or active infection with human immunodeficiency virus, hepatitis B virus, or hepatitis C virus
  • Need for current chronic corticosteroid therapy (>=10 mg of prednisone per day or an equivalent dose of other anti-inflammatory corticosteroids)
  • Spinal cord compression not definitively treated with surgery and/or radiation, or previously diagnosed and treated spinal cord compression without evidence that disease has been clinically stable for greater than (>) 2 weeks prior to randomization
  • Participants with known central nervous system disease
  • Leptomeningeal disease
  • History of autoimmune disease
  • Prior allogeneic stem cell or solid organ transplantation
  • Active tuberculosis
  • Receipt of a live, attenuated vaccine within 4 weeks prior to randomization or anticipation that such a live, attenuated vaccine will be required during the study
  • Treatment with systemic immunostimulatory agents within 4 weeks or five half-lives of the drug (whichever is shorter) prior to randomization
  • Treatment with systemic corticosteroids or other systemic immunosuppressive medications within 2 weeks prior to randomization, or anticipated requirement for systemic immunosuppressive medications during the trial
  • Participants who are breastfeeding, or intending to become pregnant during the study

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02924883


  Show 85 Study Locations
Sponsors and Collaborators
Hoffmann-La Roche
Investigators
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Study Director: Clinical Trials Hoffmann-La Roche
  Study Documents (Full-Text)

Documents provided by Hoffmann-La Roche:
Study Protocol  [PDF] August 9, 2017
Statistical Analysis Plan  [PDF] October 16, 2017


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Responsible Party: Hoffmann-La Roche
ClinicalTrials.gov Identifier: NCT02924883     History of Changes
Other Study ID Numbers: WO30085
2015-004189-27 ( EudraCT Number )
First Posted: October 5, 2016    Key Record Dates
Results First Posted: February 12, 2019
Last Update Posted: August 26, 2019
Last Verified: August 2019
Additional relevant MeSH terms:
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Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Trastuzumab
Ado-trastuzumab emtansine
Atezolizumab
Taxane
Maytansine
Antibodies, Monoclonal
Antineoplastic Agents, Immunological
Antineoplastic Agents
Immunologic Factors
Physiological Effects of Drugs
Antineoplastic Agents, Phytogenic
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action