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To determine whether the combination MM-121 + Exemestane in ER+ and/or PR+ breast cancer patients is more effective than Exemestane alone
The study is a double-blind, randomized Phase 2 trial of Exemestane +/- MM-121. The trial is designed to demonstrate whether MM-121 + Exemestane is more effective than Exemestane alone in ER+ and/or PR+ and Her2 negative breast cancer patients that have failed first-line anti-estrogen therapy in the locally advanced or metastatic setting and patients that have progressed during (or within 6 months of completing) adjuvant treatment with a non-steroidal aromatase inhibitor (AI)and/or tamoxifen. Patients will be treated until radiologic or clinical progression of their disease is documented. Local radiologist and/or PI assessment is accepted.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| MM-121 (SAR256212) + exemestane | Experimental |
| |
| Placebo + exemestane | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MM-121 | Drug | MM-121 (40mg/kg loading dose week 1, then 20 mg/kg weekly) administered over 60 minutes as an intravenous infusion once per week |
|
| Measure | Description | Time Frame |
|---|---|---|
| Progression Free Survival (PFS) | To determine whether MM-121 + exemestane was more effective than placebo + exemestane in prolonging progression-free survival. PFS was a time to event measure, and progression of disease 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". Progression free survival was defined as the number of months from the date of randomization to the date of death or progression. If neither death nor progression was observed during the study, PFS data was censored at the last non-progressive disease valid tumor assessment unless the patient was discontinued due to symptomatic deterioration. If this occurred, the patient was counted as having progressive disease (PD). | Time from first dose to date of progression, the longest time frame of 79.1 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Overall Survival | To determine whether MM-121 + exemestane is more effective than placebo + exemestane in prolonging overall survival. This was a time-to-event analysis of time from first dose to date of death. | Time from first dose to date of death, over approximately 2 years |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Victor Moyo, MD | Merrimack Pharmaceuticals, Inc. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Achieve Clinical Research | Birmingham | Alabama | 35209 | United States | ||
| Achieve Clinical Research |
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| ID | Title | Description |
|---|---|---|
| FG000 | MM-121 + Exemestane | MM-121 (40mg/kg loading dose week 1, then 20 mg/kg weekly) administered over 60 minutes as an intravenous infusion once per week, plus exemestane (25 mg) administered orally once per day |
| FG001 | Placebo + Exemestane |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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|
| Placebo | Drug | Placebo (histidine solution) administered over 60 minutes as an intravenous infusion once per week and exemestane (25 mg) administered orally once per day |
|
| Exemestane | Drug | Exemestane (25 mg) administered orally once per day |
|
|
| Birmingham |
| Alabama |
| 35216 |
| United States |
| Arizona Center for Cancer Care | Glendale | Arizona | 85306 | United States |
| Pacific Cancer Medical Center | Anaheim | California | 92801 | United States |
| Beverly Hills Cancer Center | Beverly Hills | California | 90211 | United States |
| Wilshire Oncology Medical Group, Inc. | Corona | California | 92879 | United States |
| Southwest Cancer Center | Escondido | California | 92025 | United States |
| Hematology Oncology Associates, INC. | Oakland | California | 94609 | United States |
| San Jose Medical Center | San Jose | California | 95124 | United States |
| Central Coast Medical Oncology Corporation | Santa Maria | California | 93454 | United States |
| Pasco-Pinellas Oncology | New Port Richey | Florida | 34652 | United States |
| Hematology Oncology Associates of the Treasure Coast | Port Saint Lucie | Florida | 34952 | United States |
| Rush University Medical Center | Chicago | Illinois | 60612 | United States |
| Indiana University Simon Cancer Center | Indianapolis | Indiana | 46202 | United States |
| Horizon Oncology Center | Lafayette | Indiana | 47905 | United States |
| Massachusetts General Hospital | Boston | Massachusetts | 02114 | United States |
| Tennessee Cancer Specialists Oncology Clinical Trials Center for Biomedical Research | Knoxville | Tennessee | 37909 | United States |
| Tennessee Cancer Specialists, Oncology Clincial Trials Center for Biomedical Research | Knoxville | Tennessee | 37909 | United States |
| Hopital Maissoneuve-Rosemont | Montreal | Quebec | H1T2M4 | Canada |
| McGill University Jewish General Hospital | Montreal | Quebec | H3T 1E2 | Canada |
| Hopital du Sacre-Coeur de Montreal | Montreal | H4J 1C5 | Canada |
| CHA St. Sacrement | Québec | G1S 4L8 | Canada |
| Onkogologisches zentrum Munich | Munich | 80836 | Germany |
| Brustzentrum HS Kliniken Wiesbaden | Wiesbaden | 65189 | Germany |
| Medico-Diagnostically Center of International Institution of biological systems n.a.S.M. | Berezina | Russia |
| Railway Clinical Hospital | Saint Petersburg | 125271 | Russia |
| Leningrad Regional Oncology Center | Saint Petersburg | 188663 | Russia |
| City Clinical Oncology Center | Saint Petersburg | 197022 | Russia |
| Vall d'Hebrón University Hospital | Barcelona | 8035 | Spain |
| Hospital Clinic (Barcelona) | Barcelona | 8036 | Spain |
| Hospital Parc Tauli - Barcelona | Barcelona | 8208 | Spain |
| Servicio de Oncología Médica / Hospital Universitario Gregorio Marañón | Madrid | 28007 | Spain |
| Puerta de Hierro | Madrid | 28220 | Spain |
Placebo and Exemestane: Placebo (histidine solution) administered over 60 minutes as an intravenous infusion once per week plus exemestane (25 mg) administered orally once per day |
| COMPLETED |
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| NOT COMPLETED |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | MM-121 + Exemestane | MM-121 and Exemestane: MM-121 (40mg/kg loading dose week 1, then 20 mg/kg weekly) administered over 60 minutes as an intravenous infusion once per week plus exemestane (25 mg) administered orally once per day |
| BG001 | Placebo + Exemestane | Placebo and Exemestane: Placebo (histidine solution) administered over 60 minutes as an intravenous infusion once per week plus exemestane (25 mg) administered orally once per day |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
| ||||||||||||||||||
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||||
| Bone-Only Disease (Y/N) | Number | participants |
| ||||||||||||||||||
| Progression Setting (Adjuvant, Metastatic) | Number | participants |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Progression Free Survival (PFS) | To determine whether MM-121 + exemestane was more effective than placebo + exemestane in prolonging progression-free survival. PFS was a time to event measure, and progression of disease 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". Progression free survival was defined as the number of months from the date of randomization to the date of death or progression. If neither death nor progression was observed during the study, PFS data was censored at the last non-progressive disease valid tumor assessment unless the patient was discontinued due to symptomatic deterioration. If this occurred, the patient was counted as having progressive disease (PD). | Posted | Median | 95% Confidence Interval | weeks | Time from first dose to date of progression, the longest time frame of 79.1 weeks |
|
|
| |||||||||||||||||||||||||||||
| Post-Hoc | To Explore the Utility of an EGFR Family Receptor-ligand (Heregulin, HRG) as a Predictor of Response to MM-121 and /or Exemestane in Formalin Fixed (FFPE) Tumor Samples | Fresh tumor samples were obtained from patients prior to enrollment and formalin-fixed for analysis. Samples were analyzed using RT-PCR for the expression of the biomarker, heregulin. Progression-free survival was assessed using RECIST v 1.1 to determine whether patients whose tumors express HRG have a lower PFS than those whose tumors do not express HRG, and to assess whether the addition of MM-121 to exemestane can increase PFS in HRG-high patients. | Patients with available tissue for RT-PCR analysis | Posted | Median | 95% Confidence Interval | months PFS | Time from first dose to date of progression, the longest time frame of 79.1 weeks |
| ||||||||||||||||||||||||||||||
| Secondary | Overall Survival | To determine whether MM-121 + exemestane is more effective than placebo + exemestane in prolonging overall survival. This was a time-to-event analysis of time from first dose to date of death. | Posted | Median | 95% Confidence Interval | weeks | Time from first dose to date of death, over approximately 2 years |
|
|
AEs were collected from a patient's first dose until 30 days after treatment termination. SAEs were collected from time of informed consent until 30 days after termination. If related, events could be reported at any time after termination.
All related AEs ongoing at treatment discontinuation were followed until resolution. Investigators were to report any AEs/SAEs assumed to be related any time, even if occurring more than 30 days after last dose. Though different for each patient, on average, patients could be followed for related AEs/SAEs for up to 2 years after termination.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | MM-121 + Exemestane | MM-121 (40mg/kg loading dose week 1, then 20 mg/kg weekly) administered over 60 minutes as an intravenous infusion once per week, plus exemestane (25 mg) administered orally once per day | 7 | 56 | 48 | 56 | ||
| EG001 | Placebo + Exemestane | Placebo and Exemestane: Placebo (histidine solution) administered over 60 minutes as an intravenous infusion once per week plus exemestane (25 mg) administered orally once per day | 11 | 59 | 50 | 59 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Febrile Neutropenia | Blood and lymphatic system disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Cardiovascular insufficiency | Cardiac disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Tacchycardia | Cardiac disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Abdominal Pain (Upper) | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Gastritis | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Nausea | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Chest Pain | General disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Disease Progression | General disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Hepatic Failure | Hepatobiliary disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Cellulitis | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
| |
| Gastroenteritis Viral | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
| |
| Pneumonia | General disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Hip Fracture | Injury, poisoning and procedural complications | MedDRA (13.0) | Non-systematic Assessment |
| |
| Overdose | Injury, poisoning and procedural complications | MedDRA (13.0) | Non-systematic Assessment |
| |
| Hyponatremia | Metabolism and nutrition disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Back Pain | Musculoskeletal and connective tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Pathological Fracture | Musculoskeletal and connective tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Metastases to Central Nervous System | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA (13.0) | Non-systematic Assessment |
| |
| Dizziness | Nervous system disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Epilepsy | Nervous system disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Intracranial hemorrhage | Nervous system disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Horner's Syndrome | Nervous system disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Chronic Obstructive Pulmonary Disease | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Pleuritic Pain | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Skin ulcer | Skin and subcutaneous tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Diarrhea | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Nausea | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Fatigue | General disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Decreased Appetite | Metabolism and nutrition disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Dysgeusia | Nervous system disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Dyspnea | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Muscle Spasms | Musculoskeletal and connective tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Aspartate Aminotransferase Increased | Investigations | MedDRA (13.0) | Non-systematic Assessment |
| |
| Asthenia | General disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Dry Skin | Skin and subcutaneous tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Headache | Nervous system disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Insomnia | Psychiatric disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Pain in Extremity | Musculoskeletal and connective tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Rash | Skin and subcutaneous tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Alopecia | Skin and subcutaneous tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Back Pain | Musculoskeletal and connective tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Constipation | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Dizziness | Nervous system disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Stomatatitis | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Alanine Aminotransferase Increased | Investigations | MedDRA (13.0) | Non-systematic Assessment |
| |
| Hypokalemia | Metabolism and nutrition disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Hypomagnesemia | Metabolism and nutrition disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Oropharyngeal Pain | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Abdominal Pain | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Anemia | Blood and lymphatic system disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Influenza-like illness | General disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Peripheral edema | General disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Pruritis | Skin and subcutaneous tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Pyrexia | General disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Sinusitis | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Upper Respiratory Tract Infection | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
| |
| Urinary Tract Infection | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
| |
| Abdominal Pain Upper | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Anxiety | Psychiatric disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Bone Pain | Musculoskeletal and connective tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Cellulitis | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
| |
| Chest Pain | General disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Dry Eye | Eye disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Dyspepsia | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Dyspnea Exertional | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Hot Flush | General disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Influenza | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
| |
| Nasopharyngitis | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
| |
| Parasthesia | Nervous system disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Pollakuria | Renal and urinary disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Rash Maculopapular | Skin and subcutaneous tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
| |
| Weight Decreased | Investigations | MedDRA (13.0) | Non-systematic Assessment |
|
If no overall study publication has occurred by the Sponsor within 12 months of the completion of this Study, the Investigator shall have the right to publish or present independently the results of this Study subject to the review procedure set forth herein. The Investigator will provide the Sponsor with a copy of any such presentation or publication derived from the Study for review, and the Sponsor may delay publication for up to 90 days to preserve patent activities and proprietary rights.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Clinical Trial Manager | Merrimack Pharmaceuticals | 617-441-1000 | smathews@merrimack.com |
| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| C000589319 | seribantumab |
| C056516 | exemestane |
Not provided
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| >=65 years |
|
| Male |
|
| Not Hispanic or Latino |
|
| Unknown or Not Reported |
|
| Asian |
|
| Native Hawaiian or Other Pacific Islander |
|
| Black or African American |
|
| White |
|
| More than one race |
|
| Unknown or Not Reported |
|
| Bone-Only (No) |
|
| Metastatic |
|
Placebo and Exemestane: Placebo (histidine solution) administered over 60 minutes as an intravenous infusion once per week plus exemestane (25 mg) administered orally once per day |
| OG003 | HRG Low: MM-121 + Exemestane | MM-121 (40mg/kg loading dose week 1, then 20 mg/kg weekly) administered over 60 minutes as an intravenous infusion once per week, plus exemestane (25 mg) administered orally once per day |
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