Trial Outcomes & Findings for Phase I/IIa Trial of Gemcitabine Plus Trastuzumab and Pertuzumab in Previously Treated Metastatic HER2+ Breast Cancer (NCT NCT02139358)

NCT ID: NCT02139358

Last Updated: 2021-02-04

Results Overview

The RP2D dose in mg/m\^2 of gemcitabine along with standard doses of pertuzumab (840 mg loading/420 mg maintenance) and Herceptin (8 mg/kg loading, 6 mg/kg maintenance). Safety data to be described using Common Terminology Criteria for Adverse Events (CTCAE) 4.0 terminology. Any participant who receives any dose of the study treatment will be evaluated for the safety/toxicity endpoints in the trial.

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

15 participants

Primary outcome timeframe

6 Months

Results posted on

2021-02-04

Participant Flow

Participants were enrolled at Moffitt Cancer Center October 2014 through October 2016.

Participant milestones

Participant milestones
Measure
Dose Escalation / Phase II Treatment
Single arm, non-randomized, open label phase I/II multisite Simon two stage minimax trial. Gemcitabine plus trastuzumab and pertuzumab. Gemcitabine: The Phase I trial will start at the recommended phase II dose (RP2D) for gemcitabine but will have a de-escalation dose levels in the event that an unacceptable toxicity requires dose reduction. Dose level 0 = gemcitabine (1200mg/m2) IV D1,8 q21 days; Dose level -1 = gemcitabine (1000 mg/m\^2) IV D1,8 q21 days; Dose level -2 = gemcitabine (850 mg/m\^2) IV D1,8 q21 days. The RP2D will be the dose level where 0-1 dose limiting toxicities (DLTs) in six patients occur. Trastuzumab: Trastuzumab will be given using an 8 mg/kg loading dose on cycle one, day one (C1D1), followed by 6 mg/kg IV on subsequent cycles every (q) 21 days. Pertuzumab: Pertuzumab will be given using an 840 mg IV loading dose on C1D1, followed by 420 mg IV on subsequent cycles q21 days.
Overall Study
STARTED
15
Overall Study
COMPLETED
15
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Phase I/IIa Trial of Gemcitabine Plus Trastuzumab and Pertuzumab in Previously Treated Metastatic HER2+ Breast Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Dose Escalation / Phase II Treatment
n=15 Participants
Single arm, non-randomized, open label phase I/II multisite Simon two stage minimax trial. Gemcitabine plus trastuzumab and pertuzumab.
Age, Continuous
58.2 years
n=99 Participants
Sex: Female, Male
Female
15 Participants
n=99 Participants
Sex: Female, Male
Male
0 Participants
n=99 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
n=99 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
12 Participants
n=99 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=99 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=99 Participants
Race (NIH/OMB)
White
12 Participants
n=99 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants
n=99 Participants
Region of Enrollment
United States
15 participants
n=99 Participants

PRIMARY outcome

Timeframe: 6 Months

Population: All participants enrolled during Phase 1

The RP2D dose in mg/m\^2 of gemcitabine along with standard doses of pertuzumab (840 mg loading/420 mg maintenance) and Herceptin (8 mg/kg loading, 6 mg/kg maintenance). Safety data to be described using Common Terminology Criteria for Adverse Events (CTCAE) 4.0 terminology. Any participant who receives any dose of the study treatment will be evaluated for the safety/toxicity endpoints in the trial.

Outcome measures

Outcome measures
Measure
Dose Escalation / Phase II Treatment
n=6 Participants
Single arm, non-randomized, open label phase I/II multisite Simon two stage minimax trial. Gemcitabine plus trastuzumab and pertuzumab.
Phase I: Recommended Phase II Dose (RP2D)
1200 dose in mg/m^2

PRIMARY outcome

Timeframe: Up to 36 Months

Population: All participants who have undergone 2 treatment cycles followed by a response scan and have documented best response data available.

Objective Response Rate: Response according to Response Evaluation in Solid Tumors (RECIST) 1.1 for the combination of gemcitabine+trastuzumab+pertuzumab at the recommended phase II dose. Complete Response (CR): Disappearance of all evidence of tumor for at least two cycles of therapy. Tumor markers must be normal. Partial Response (PR): At least a 30% decrease in the sum of the longest diameter of target lesions, taking a reference the baseline sum longest diameter. Stable Disease (SD): Neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease, taking as reference the smallest sum longest diameter since the treatment started. Progressive Disease (PD): At least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the beginning of treatment or the appearance of one or more new lesions.

Outcome measures

Outcome measures
Measure
Dose Escalation / Phase II Treatment
n=10 Participants
Single arm, non-randomized, open label phase I/II multisite Simon two stage minimax trial. Gemcitabine plus trastuzumab and pertuzumab.
Phase II: Objective Response Rate (ORR)
Complete Response
1 Participants
Phase II: Objective Response Rate (ORR)
Partial Response
1 Participants
Phase II: Objective Response Rate (ORR)
Stable Disease
8 Participants

SECONDARY outcome

Timeframe: Up to 12 months

Population: All participants

Median progression free survival (in months) for all participants evaluable for response. The time-to-event data will be summarized using Kaplan-Meir curve method for all patients who are evaluable for the ORR endpoint. Progressive disease (PD): At least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the beginning of treatment or the appearance of one or more new lesions.

Outcome measures

Outcome measures
Measure
Dose Escalation / Phase II Treatment
n=15 Participants
Single arm, non-randomized, open label phase I/II multisite Simon two stage minimax trial. Gemcitabine plus trastuzumab and pertuzumab.
Phase II: Progression Free Survival (PFS)
6.4883 months
Interval 2.7807 to 9.0372

SECONDARY outcome

Timeframe: Up to 36 months

Population: All participants

Median overall survival (in months) for all participants evaluable for response. The length of time from the start of treatment that participants are still alive.

Outcome measures

Outcome measures
Measure
Dose Escalation / Phase II Treatment
n=15 Participants
Single arm, non-randomized, open label phase I/II multisite Simon two stage minimax trial. Gemcitabine plus trastuzumab and pertuzumab.
Overall Survival (OS)
11.3545 months
Interval 6.2897 to 14.0028

Adverse Events

Dose Escalation / Phase II Treatment

Serious events: 7 serious events
Other events: 15 other events
Deaths: 2 deaths

Serious adverse events

Serious adverse events
Measure
Dose Escalation / Phase II Treatment
n=15 participants at risk
Single arm, non-randomized, open label phase I/II multisite Simon two stage minimax trial. Gemcitabine plus trastuzumab and pertuzumab.
Cardiac disorders
Cardiac arrest
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Cardiac disorders
Chest pain - cardiac
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Gastrointestinal disorders
Diarrhea
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Gastrointestinal disorders
Duodenal hemorrhage
6.7%
1/15 • Number of events 1 • 3 years, 7 months
General disorders
Fatigue
6.7%
1/15 • Number of events 1 • 3 years, 7 months
General disorders
Fever
6.7%
1/15 • Number of events 1 • 3 years, 7 months
General disorders
Sudden death NOS
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Infections and infestations
Sepsis
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Infections and infestations
Skin infection
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Investigations
Neutrophil count decreased
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Investigations
Platelet count decreased
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Metabolism and nutrition disorders
Dehydration
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Respiratory, thoracic and mediastinal disorders
Dyspnea
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Respiratory, thoracic and mediastinal disorders
Pleural effusion
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Respiratory, thoracic and mediastinal disorders
Respiratory failure
6.7%
1/15 • Number of events 2 • 3 years, 7 months
Respiratory, thoracic and mediastinal disorders
Respiratory, thoracic and mediastinal disorders - Other, Pneumonia
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Skin and subcutaneous tissue disorders
Rash maculo-papular
6.7%
1/15 • Number of events 1 • 3 years, 7 months

Other adverse events

Other adverse events
Measure
Dose Escalation / Phase II Treatment
n=15 participants at risk
Single arm, non-randomized, open label phase I/II multisite Simon two stage minimax trial. Gemcitabine plus trastuzumab and pertuzumab.
Investigations
Neutrophil count decreased
80.0%
12/15 • Number of events 47 • 3 years, 7 months
Investigations
Lymphocyte count decreased
66.7%
10/15 • Number of events 19 • 3 years, 7 months
Investigations
Platelet count decreased
60.0%
9/15 • Number of events 24 • 3 years, 7 months
Investigations
White blood cell decreased
60.0%
9/15 • Number of events 48 • 3 years, 7 months
Investigations
Alanine aminotransferase increased
40.0%
6/15 • Number of events 12 • 3 years, 7 months
Investigations
Aspartate aminotransferase increased
40.0%
6/15 • Number of events 17 • 3 years, 7 months
Investigations
Alkaline phosphatase increased
13.3%
2/15 • Number of events 3 • 3 years, 7 months
Investigations
Creatinine increased
6.7%
1/15 • Number of events 2 • 3 years, 7 months
Investigations
Ejection fraction decreased
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Investigations
Electrocardiogram QT corrected interval prolonged
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Gastrointestinal disorders
Diarrhea
66.7%
10/15 • Number of events 13 • 3 years, 7 months
Gastrointestinal disorders
Nausea
60.0%
9/15 • Number of events 11 • 3 years, 7 months
Gastrointestinal disorders
Vomiting
33.3%
5/15 • Number of events 6 • 3 years, 7 months
Gastrointestinal disorders
Abdominal pain
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Gastrointestinal disorders
Dysphagia
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Gastrointestinal disorders
Constipation
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Gastrointestinal disorders
Dry mouth
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Gastrointestinal disorders
Duodenal hemorrhage
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Gastrointestinal disorders
Duodenal ulcer
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Gastrointestinal disorders
Dyspepsia
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Gastrointestinal disorders
Fecal incontinence
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Gastrointestinal disorders
Mucositis oral
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Gastrointestinal disorders
Oral pain
6.7%
1/15 • Number of events 1 • 3 years, 7 months
General disorders
Fatigue
66.7%
10/15 • Number of events 12 • 3 years, 7 months
General disorders
Infusion related reaction
20.0%
3/15 • Number of events 3 • 3 years, 7 months
General disorders
Pain
20.0%
3/15 • Number of events 4 • 3 years, 7 months
General disorders
Edema limbs
13.3%
2/15 • Number of events 3 • 3 years, 7 months
General disorders
Fever
13.3%
2/15 • Number of events 2 • 3 years, 7 months
General disorders
Chills
6.7%
1/15 • Number of events 1 • 3 years, 7 months
General disorders
Malaise
6.7%
1/15 • Number of events 1 • 3 years, 7 months
General disorders
Non-cardiac chest pain
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Metabolism and nutrition disorders
Anorexia
40.0%
6/15 • Number of events 7 • 3 years, 7 months
Metabolism and nutrition disorders
Hypoalbuminemia
40.0%
6/15 • Number of events 8 • 3 years, 7 months
Metabolism and nutrition disorders
Hypocalcemia
33.3%
5/15 • Number of events 8 • 3 years, 7 months
Metabolism and nutrition disorders
Hypokalemia
33.3%
5/15 • Number of events 10 • 3 years, 7 months
Metabolism and nutrition disorders
Dehydration
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Metabolism and nutrition disorders
Hypernatremia
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Metabolism and nutrition disorders
Hyponatremia
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Metabolism and nutrition disorders
Hypophosphatemia
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Metabolism and nutrition disorders
Hypercalcemia
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Metabolism and nutrition disorders
Hypermagnesemia
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Blood and lymphatic system disorders
Anemia
73.3%
11/15 • Number of events 39 • 3 years, 7 months
Respiratory, thoracic and mediastinal disorders
Dyspnea
40.0%
6/15 • Number of events 8 • 3 years, 7 months
Respiratory, thoracic and mediastinal disorders
Allergic rhinitis
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Respiratory, thoracic and mediastinal disorders
Epistaxis
13.3%
2/15 • Number of events 4 • 3 years, 7 months
Respiratory, thoracic and mediastinal disorders
Nasal congestion
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Respiratory, thoracic and mediastinal disorders
Aspiration
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Respiratory, thoracic and mediastinal disorders
Cough
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Respiratory, thoracic and mediastinal disorders
Pleural effusion
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Respiratory, thoracic and mediastinal disorders
Respiratory failure
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Respiratory, thoracic and mediastinal disorders
Sore throat
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Respiratory, thoracic and mediastinal disorders
Wheezing
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Musculoskeletal and connective tissue disorders
Myalgia
40.0%
6/15 • Number of events 7 • 3 years, 7 months
Musculoskeletal and connective tissue disorders
Pain in extremity
26.7%
4/15 • Number of events 6 • 3 years, 7 months
Musculoskeletal and connective tissue disorders
Bone pain
20.0%
3/15 • Number of events 3 • 3 years, 7 months
Musculoskeletal and connective tissue disorders
Arthralgia
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Musculoskeletal and connective tissue disorders
Back pain
13.3%
2/15 • Number of events 3 • 3 years, 7 months
Musculoskeletal and connective tissue disorders
Generalized muscle weakness
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Musculoskeletal and connective tissue disorders
Musculoskeletal and connective tissue disorder - Other, Right wrist swelling
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Musculoskeletal and connective tissue disorders
Neck pain
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Musculoskeletal and connective tissue disorders
Osteoporosis
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Nervous system disorders
Dizziness
26.7%
4/15 • Number of events 4 • 3 years, 7 months
Nervous system disorders
Peripheral sensory neuropathy
20.0%
3/15 • Number of events 3 • 3 years, 7 months
Nervous system disorders
Headache
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Nervous system disorders
Somnolence
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Nervous system disorders
Dysphasia
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Skin and subcutaneous tissue disorders
Pruritus
20.0%
3/15 • Number of events 4 • 3 years, 7 months
Skin and subcutaneous tissue disorders
Rash acneiform
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Skin and subcutaneous tissue disorders
Rash maculo-papular
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Skin and subcutaneous tissue disorders
Skin and subcutaneous tissue disorders - Other, Left chest wall - Abnormal sensation
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Skin and subcutaneous tissue disorders
Skin and subcutaneous tissue disorders - Other, Rash
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Skin and subcutaneous tissue disorders
Dry skin
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Skin and subcutaneous tissue disorders
Erythema multiforme
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Skin and subcutaneous tissue disorders
Pain of skin
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Skin and subcutaneous tissue disorders
Skin ulceration
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Infections and infestations
Skin infection
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Infections and infestations
Papulopustular rash
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Infections and infestations
Sinusitis
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Infections and infestations
Tooth infection
6.7%
1/15 • Number of events 2 • 3 years, 7 months
Infections and infestations
Upper respiratory infection
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Cardiac disorders
Sinus tachycardia
20.0%
3/15 • Number of events 5 • 3 years, 7 months
Cardiac disorders
Chest pain - cardiac
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Cardiac disorders
Left ventricular systolic dysfunction
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Cardiac disorders
Palpitations
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Vascular disorders
Hot flashes
13.3%
2/15 • Number of events 2 • 3 years, 7 months
Vascular disorders
Hypotension
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Vascular disorders
Thromboembolic event
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Injury, poisoning and procedural complications
Bruising
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Injury, poisoning and procedural complications
Fracture
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Injury, poisoning and procedural complications
Wound dehiscence
6.7%
1/15 • Number of events 2 • 3 years, 7 months
Renal and urinary disorders
Cystitis noninfective
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Renal and urinary disorders
Hematuria
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Renal and urinary disorders
Proteinuria
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Renal and urinary disorders
Urinary frequency
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Renal and urinary disorders
Urinary tract pain
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Psychiatric disorders
Depression
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Psychiatric disorders
Insomnia
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Psychiatric disorders
Restlessness
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Reproductive system and breast disorders
Vaginal inflammation
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Reproductive system and breast disorders
Vaginal pain
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Ear and labyrinth disorders
Tinnitus
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Eye disorders
Blurred vision
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Eye disorders
Dry eye
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Eye disorders
Eye pain
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Neoplasms benign, malignant and unspecified (incl cysts and polyps) - Other, Cervical polyp
6.7%
1/15 • Number of events 1 • 3 years, 7 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Neoplasms benign, malignant and unspecified and polyps) - Other, Goiter with thyroid modules
6.7%
1/15 • Number of events 1 • 3 years, 7 months

Additional Information

Dr. Hatem Soliman

H. Lee Moffitt Cancer Center and Research Institute

Phone: 813-745-4933

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place