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| ID | Type | Description | Link |
|---|---|---|---|
| 2020-000930-16 | EudraCT Number |
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| Name | Class |
|---|---|
| Pfizer | INDUSTRY |
| Apices Soluciones S.L. | INDUSTRY |
| Pierre Fabre Ibérica, S.A. | INDUSTRY |
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This study is an interventional, prospective, multicentric, single-arm, open label, phase Ib clinical trial. This study will be carried out in patients diagnosed of metastatic or locally advanced unresectable triple negative breast cancer with activation of ERK and/or CDK4/6 in which the following will be assesed: the overall response rate, the aggregation of antitumor effect depending on the different kinome profiles and the safety profile to the combination of palbociclib and binimetinib.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Palbociclib + Binimetinib | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Combination, Palbociclib + Binimetinib | Drug | Patients will then start treatment with continuous oral binimetinib 45 mg/BID and palbociclib 100 mg daily, 21 days on / 7 days off, until disease progression. Study treatment will continue until disease progression. If treatment tolerance is good, after a full cycle patients will be allowed to escalate palbociclib to 125 mg, according to the study investigators' decision. Alternatively, patients with non tolerable grade 2 events will resume at 30 mg/BID of binimetinib upon recovery, maintaining palbociclib at 100 mg 21-on/7-off. Depending on the side-effects, in case of clear relationship with palbociclib is established, palbociclib -instead of binimetinib - will be reduced to 75 mg daily. |
| Measure | Description | Time Frame |
|---|---|---|
| 3 Months Progression Free Survival. Probability That the Cancer Has Not Progressed at 3 Months Calculated With Kaplan Meier. | Progression free survival (PFS) is defined as the time from the date of start treatment until objective tumor progression or death from any reason. Patients who have not progressed or died at the time of analysis will be censored at the time of the latest date of assessment from their last evaluable RECIST 1.1 assessment. Progression free survival at three months is provided. | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Progression Free Survival | Time from the date of first dose of study treatment to the date of progression or death (from any cause). | 3 months |
| Overall Response Rate | Percentage of patients that achieve complete response or partial response according to RECIST 1.1 criteria |
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Inclusion Criteria:
Women >18 years-old.
Diagnostic of metastatic or locally advanced non-resectable TNBC.
Patient that have received at least one and up to two previous lines of therapy for metastatic TNBC and failed to last treatment. Previous treatments can be of any nature (chemotherapy, immunotherapy, antiangiogenics, experimental therapy, etc.).
Women with known BRCA1/BRCA2 germline mutations must have received a platinum based treatment or treatment with a PARP inhibitor.
Patient must have experienced disease progression to the previous treatment line according to the RECIST 1.1 or iRECIST criteria.
Availability of tumor tissue for ERK and CDK4/6 testing is mandatory prior to study inclusion, preferably obtained after last treatment or the most recent sample as possible (from metastatic site or first diagnosis according to sample availability). If the patient has not a tumor sample available prior to study inclusion, the patient will not be allowed to participate in the study.
Ability to understand and signing of the written patient information/informed consent form (PIS/ICF) for ERK and CDK4/6 testing. ERK and CDK4/6 testing will be performed centrally at CNIO.
Ability to understand and signing the written PIS/ICF for study treatment eligibility. Signed informed consent form must be available before any studyspecific procedure for the respective study parts may begin.
Positivity for ERK and/or CDK4/6, defined as showing an H-score above the top-quartile according to published definitions [1].
ECOG performance status of 0-1.
Evaluable disease according to RECIST 1.1 criteria.
Life expectancy >24 weeks.
Adequate bone marrow, liver and renal function as assessed by laboratory requirements conducted within 7 days before first study drug administration:
Patients must have recovered to ≤ Grade 1 in terms of toxicity from prior treatments (excluding neuropathy which can be ≤ Grade 2, and alopecia).
Patients must be able to take oral medications.
Patients must have adequate cardiac function, defined as:
Negative serum pregnancy test in women of childbearing potential (performed within 7 days before the first treatment). Negative results must be available before the first study drug administration. Pregnancy test will not be performed in postmenopausal women.
Women of reproductive potential must agree to use adequate contraception when sexually active. This applies for the time period since the signature of the informed consent form and until at least 1 month after the last study drug administration. The definition of adequate contraception will be based on the judgment of the investigator and on local requirements. Acceptable methods of contraception include, but are not limited to, (i) condoms (male or female) with or without a spermicidal agent; (ii) diaphragm or cervical cap with spermicide; (iii) intra-uterine device; (iv) hormone-based contraception.Zoledronic acid or denosumab started prior to trial registration is allowed, but in case they are required after initiation of trial procedures, adequate justification is required.
Exclusion Criteria:
Participants who have had chemotherapy, radiotherapy, or major surgery within 2 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study.
Patients that received during the metastatic disease setting any of the study drugs, palbociclib or binimetinib.
Participants receiving any other study agents concurrently with the study drugs. Zoledronic acid or denosumab for bone metastases, started at least 15 days prior to enrollment are allowed.
Participants with symptomatic brain metastases that require chronic steroids. Patients with a history of brain metastases are permitted to enroll as long as they have been treated, are off of steroids, and have been stable for a minimum of one month on imaging.
Irradiation of single lesions in the last 28 days prior to trial recruitment, if it is the only location of the disease and it has not progressed. Patients with radiated single lesions that has progressed are allowed.
Concurrent use of strong CYP3A4 inhibitors/inducers is prohibited due to drug-drug interactions with palbociclib. Moderate CYP3A4 inhibitors/inducers should be used with caution.
Uncontrolled intercurrent illness including, but not limited to:
History of QT syndrome, Brugada syndrome, known history of QTc prolongation, or Torsades de Pointes.
History of Gilbert's syndrome.
History of neuromuscular disorders that are associated with elevated CK (e.g. inflammatory myopathies, muscular dystrophy, amyotrophic lateral sclerosis, spinal muscular atrophy).
Previous or concurrent cancer except:
Malabsorption syndrome or uncontrolled nausea, vomiting, or diarrhea that may interfere with the absorption of oral study medication in the opinion of the investigator.
Pregnant women or breast-feeding.
Known HIV-positive individuals on combination antiretroviral therapy.
Active hepatitis B virus (HBV; chronic or acute; defined as having a known positive hepatitis B surface antigen [HBsAg] test at the time of screening) or hepatitis C infection requiring treatment.
Any condition that in the opinion of the investigator would interfere with evaluation of study treatment or interpretation of patient safety or study results, or inability to comply with the study and follow-up procedures.
Participation in another clinical study with investigational medicinal products within 4 weeks before the first study drug administration.
Clinically active infections within 2 weeks before the first study drug administration.
Treatment with therapeutic oral or i.v. antibiotics within 2 weeks before the first study drug administration. Patients receiving prophylactic antibiotics (e.g. for prevention of a urinary tract infection or to prevent chronic obstructive pulmonary disease exacerbation) are eligible.
Known hypersensitivity to any of the study drugs, study drug classes, or excipients in the formulation.
Current diagnosis of any retinal disorders including retinal detachment, retinal pigment epithelial detachment (RPED), serous retinopathy or retinal vein occlusion or risk factors for RVO (e.g., uncontrolled glaucoma or history of hyperviscosity or hypercoagulability syndrome).
Peripheral sensory neuropathy of CTCAE v.5.0 Grade 2 or higher
Major surgery, open biopsy or significant traumatic injury within 4 weeks before the first study drug administration (central line surgery is not considered major surgery).
Renal failure requiring peritoneal dialysis or hemodialysis.
Substance abuse, medical, psychological or social conditions that may interfere with the patient's participation in the study or evaluation of the study results.
In this Case, gender is a eligibility criteria because it is a specific cancer in women.
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| Name | Affiliation | Role |
|---|---|---|
| Miguel Ángel Quintela-Fandino, MD | Centro Nacional de Investigaciones Oncológicas | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Universitari Arnau de Vilanova de Lleida | Lleida | 25198 | Spain | |||
| Hospìtal Universitario de la Princesa |
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| ID | Title | Description |
|---|---|---|
| FG000 | Palbociclib + Binimetinib | Combination, Palbociclib + Binimetinib: Patients will then start treatment with continuous oral binimetinib 45 mg/BID and palbociclib 100 mg daily, 21 days on / 7 days off, until disease progression. Study treatment will continue until disease progression. If treatment tolerance is good, after a full cycle patients will be allowed to escalate palbociclib to 125 mg, according to the study investigators' decision. Alternatively, patients with non tolerable grade 2 events will resume at 30 mg/BID of binimetinib upon recovery, maintaining palbociclib at 100 mg 21-on/7-off. Depending on the side-effects, in case of clear relationship with palbociclib is established, palbociclib -instead of binimetinib - will be reduced to 75 mg daily. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Palbociclib + Binimetinib | Combination, Palbociclib + Binimetinib: Patients will then start treatment with continuous oral binimetinib 45 mg/BID and palbociclib 100 mg daily, 21 days on / 7 days off, until disease progression. Study treatment will continue until disease progression. If treatment tolerance is good, after a full cycle patients will be allowed to escalate palbociclib to 125 mg, according to the study investigators' decision. Alternatively, patients with non tolerable grade 2 events will resume at 30 mg/BID of binimetinib upon recovery, maintaining palbociclib at 100 mg 21-on/7-off. Depending on the side-effects, in case of clear relationship with palbociclib is established, palbociclib -instead of binimetinib - will be reduced to 75 mg daily. |
| 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 |
| 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 | 3 Months Progression Free Survival. Probability That the Cancer Has Not Progressed at 3 Months Calculated With Kaplan Meier. | Progression free survival (PFS) is defined as the time from the date of start treatment until objective tumor progression or death from any reason. Patients who have not progressed or died at the time of analysis will be censored at the time of the latest date of assessment from their last evaluable RECIST 1.1 assessment. Progression free survival at three months is provided. | All patients includeed in the study that received at least one dose of study treatment and have at least one evaluation visit after received the first dose of treatment. | Posted | Number | 95% Confidence Interval | perceent probability at 3 months | 3 months |
|
All adverse events that occur during the period comprehended from the start of study treatment to 30 days after last dose of the investigational products were recorded, an average of 3 months.
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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 | Palbociclib + Binimetinib | Combination, Palbociclib + Binimetinib: Patients will then start treatment with continuous oral binimetinib 45 mg/BID and palbociclib 100 mg daily, 21 days on / 7 days off, until disease progression. Study treatment will continue until disease progression. If treatment tolerance is good, after a full cycle patients will be allowed to escalate palbociclib to 125 mg, according to the study investigators' decision. Alternatively, patients with non tolerable grade 2 events will resume at 30 mg/BID of binimetinib upon recovery, maintaining palbociclib at 100 mg 21-on/7-off. Depending on the side-effects, in case of clear relationship with palbociclib is established, palbociclib -instead of binimetinib - will be reduced to 75 mg daily. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Pleural effusion | Respiratory, thoracic and mediastinal disorders | MedDRA (27.0) | Non-systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anaemia | Blood and lymphatic system disorders | MedDRA (27.0) | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Juan Luis Sanz | APICES | 91 816 68 04 | 112 | juanluis.sanz@apices.es |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jun 16, 2021 | Oct 25, 2024 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jan 8, 2024 | Mar 19, 2025 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D064726 | Triple Negative Breast Neoplasms |
| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
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| ID | Term |
|---|---|
| C500026 | palbociclib |
| C581313 | binimetinib |
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Prospective, multicentric, single-arm, open label, phase IB clinical trial.
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|
| 1 year |
| Madrid |
| 28006 |
| Spain |
| Hospital Ramon y Cajal | Madrid | 28034 | Spain |
| Hospital Clínico San Carlos | Madrid | 28040 | Spain |
| Hospital Universitario 12 de Octubre | Madrid | 28041 | Spain |
| Hospital QuirónSalud Madrid | Madrid | 28223 | Spain |
| Hospital Universitario de Fuenlabrada | Madrid | 28942 | Spain |
| Hospital Clínico Universitario de Valencia | Valencia | 46010 | Spain |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
|
| Secondary | Progression Free Survival | Time from the date of first dose of study treatment to the date of progression or death (from any cause). | All patients included in this study that received at least one dose of study treatment and have at least one evaluation visit after received the first dose of treatment | Posted | Median | 95% Confidence Interval | Months | 3 months |
|
|
|
| Secondary | Overall Response Rate | Percentage of patients that achieve complete response or partial response according to RECIST 1.1 criteria | All patients included in this study that received at least one dose of study treatment and have at least one evaluation visit after received the first dose of treatment | Posted | Count of Participants | Participants | 1 year |
|
|
|
| 9 |
| 24 |
| 4 |
| 24 |
| 24 |
| 24 |
| Radiculopathy | Nervous system disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Mucosal inflammation | General disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Immune-mediated lung disease | Respiratory, thoracic and mediastinal disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Neutropenia | Blood and lymphatic system disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Thrombocytopenia | Blood and lymphatic system disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Blindness | Eye disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Ocular toxicity | Eye disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Retinopathy | Eye disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Scintillating scotoma | Eye disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Vision blurred | Eye disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Abdominal pain | Gastrointestinal disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Abdominal pain upper | Gastrointestinal disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Constipation | Gastrointestinal disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Diarrhoea | Gastrointestinal disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Gingival bleeding | Gastrointestinal disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Nausea | Gastrointestinal disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Stomatitis | Gastrointestinal disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Asthenia | General disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Chest pain | General disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Mucosal inflammation | General disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Oedema | General disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Oedema peripheral | General disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Pain | General disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Pyrexia | General disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Hypertransaminasaemia | Hepatobiliary disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| COVID-19 | Infections and infestations | MedDRA (27.0) | Non-systematic Assessment |
|
| Overdose | Injury, poisoning and procedural complications | MedDRA (27.0) | Non-systematic Assessment |
|
| Alanine aminotransferase increased | Investigations | MedDRA (27.0) | Non-systematic Assessment |
|
| Aspartate aminotransferase increased | Investigations | MedDRA (27.0) | Non-systematic Assessment |
|
| Blood creatine phosphokinase increased | Investigations | MedDRA (27.0) | Non-systematic Assessment |
|
| Ejection fraction decreased | Investigations | MedDRA (27.0) | Non-systematic Assessment |
|
| Gamma-glutamyltransferase increased | Investigations | MedDRA (27.0) | Non-systematic Assessment |
|
| Neutrophil count decreased | Investigations | MedDRA (27.0) | Non-systematic Assessment |
|
| Platelet count decreased | Investigations | MedDRA (27.0) | Non-systematic Assessment |
|
| Hyperphosphataemia | Metabolism and nutrition disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Hypocalcaemia | Metabolism and nutrition disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Hypophosphataemia | Metabolism and nutrition disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Neck pain | Musculoskeletal and connective tissue disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Pain in extremity | Musculoskeletal and connective tissue disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Dizziness | Nervous system disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Headache | Nervous system disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Breast pain | Reproductive system and breast disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Dyspnoea | Respiratory, thoracic and mediastinal disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Dermatitis acneiform | Skin and subcutaneous tissue disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Rash | Skin and subcutaneous tissue disorders | MedDRA (27.0) | Non-systematic Assessment |
|
| Lymphoedema | Vascular disorders | MedDRA (27.0) | Non-systematic Assessment |
|
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| D012871 |
| Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |