ACTIVE_NOT_RECRUITING • Phase I, II • Stage III, IV • Post-Menopausal • Brain Metastases present • Interventional

The following is imported from ClinicalTrials.gov:

A Phase 1b/2 Study of T-DXd Combinations in HER2-positive Metastatic Breast Cancer

Brief Summary

DESTINY-Breast07 will investigate the safety, tolerability, and anti-tumour activity of trastuzumab deruxtecan (T-DXd) in combination with other anti-cancer agents in patients with HER2-positive Metastatic Breast Cancer

Description

This study is modular in design allowing assessment of safety, tolerability and anti-tumour activity of T-DXd in combination with other anti-cancer agents. Combination-treatment modules will have 2 parts: a dose-finding phase (Part 1), and a dose expansion phase (Part 2); the recommended Phase 2 dose (RP2D) determined in Part 1 will be used for the dose-expansion in Part 2. The target population of interest in this study is patients with HER2-positive (as per ASCO/CAP 2018 guidelines) advanced/MBC inclusive of patients with active and stable brain metastases. Part 1 of each module will enroll patients with locally assessed HER2-positive advanced/MBC in second-line or later patients. Part 2 of each module will enroll patients with locally assessed HER2-positive breast cancer who have not received prior treatment for advanced/metastatic disease.

Study Design

Eligibility Criteria

Arms and Intervention

• Trastuzumab deruxtecan

• Durvalumab

• Paclitaxel

• Pertuzumab

• Tucatinib

Inclusion criteria

• * patients must be at least 18 years of age

• * pathologically documented breast cancer that:

• 1. is advanced/unresectable (patients that can be treated with curative intent are not eligible) or metastatic

• 2. her2-positive (ihc 3+ or ihc 2+/ish+) based on local assessment. the local her2 result must be from a tumour sample obtained in the metastatic setting.

• 3. is documented as hormone receptor-positive (estrogen or progesterone receptor) or negative in the metastatic setting

• * patient must have adequate tumor sample from the metastatic setting for biomarker assessment

• * ecog performance status of 0 or 1

• * part 1

• 1. disease progression on or after the last systemic therapy prior to starting study treatment

• 2. at least 1 prior treatment line in metastatic setting required.

• * part 2 (modules 0 - 5)

• a) no prior lines of therapy for advanced/mbc allowed

• * part 2 (module 6 and 7) a) zero or one prior lines of therapy for advanced/mbc allowed

• cns inclusion

• * modules 0 - 5 patients must have no brain metastases or stable brain metastases.

• * module 6 and 7 patients must have untreated brain metastases not needing local therapy or previously treated brain metastases that have progressed since prior local therapy

• key

Exclusion criteria

• * uncontrolled or significant cardiovascular disease

• * active or prior documented (non-infectious) ild/pneumonitis that required steroids, or suspected ild/pneumonitis that cannot be ruled out by imaging at screening

• * lung-specific intercurrent clinically significant illnesses

• * uncontrolled infection requiring iv antibiotics, antivirals, or antifungals

• * spinal cord compression or a history of leptomeningeal carcinomatosis

• * prior treatment with immune checkpoint inhibitors

• * prior treatment with an adc containing a topoisomerase i inhibitor

• * prior treatment with tucatinib

• cns exclusion

• * modules 0 - 5: has untreated brain metastasis

• * module 6 and 7: ongoing use of systemic corticosteroids for control of symptoms of brain metastases at a total daily dose of \> 2 mg dexamethasone or any brain lesion thought to require immediate local therapy