A Study of T-DXd in Participants With or Without Brain Metastasis Who Have Previously Treated Advanced or Metastatic HER2 Positive Breast Cancer

Official Title

An Open-Label, Multinational, Multicentre, Phase 3b/4 Study of Trastuzumab Deruxtecan in Patients With or Without Baseline Brain Metastasis With Previously Treated Advanced/Metastatic HER2-Positive Breast Cancer (DESTINY-Breast12).

Summary:

This is open-label, multicentre, international study, assessing the efficacy and safety of Trastuzumab deruxtecan (T-DXd) in participants with or without brain metastasis (BMs), with previously-treated advanced/metastatic HER2-positive breast cancer whose disease has progressed on prior anti-HER2-based regimens and who received no more than 2 lines/regimens of therapy in the metastatic setting (excluding tucatinib).

Trial Description

Primary Outcome:

  • Objective Response Rate (ORR) in Participants without BM at Baseline (Cohort 1)
  • Progression-free Survival (PFS) in Participants with BM at Baseline (Cohort 2)
Secondary Outcome:
  • Overall Survival (OS) in Months
  • Duration of Response (DoR)
  • Time to Progression
  • Duration of Treatment on Subsequent Lines of Therapy
  • Time to Second Progression or Death (PFS2)
  • Incidence of new Symptomatic Central Nervous System (CNS) Metastasis During Treatment in Participants without BM at Baseline (Cohort 1)
  • Time to Next Progression (CNS or extracranial) or Death
  • Site (CNS vs extracranial vs both) of Next Progression
  • Objective Response Rate in Participants with BM at Baseline (Cohort 2)
  • Central Nervous System Progression-free Survival in Participants with BM at Baseline (Cohort 2)
  • Time to new CNS Lesions in Participants with BM at Baseline (Cohort 2)
  • Central Nervous System Objective Response Rate in Participants with BM at Baseline by ICR (Cohort 2)
  • Central Nervous System Duration of Response in Participants with BM at Baseline (Cohort 2)
  • European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)
  • Neurologic Assessment in Neuro-Oncology Scale
  • Cognitive Functions Tests
  • MD Anderson Symptom Inventory Brain Tumour-specific Items
  • St. George's Respiratory Questionnaire - idiopathic pulmonary fibrosis version in Participants with Interstitial Lung Disease (ILD)/Pneumonitis
  • Number of Participants with Adverse Events
  • Number of Participants with Investigator-assessed ILD/Pneumonitis or Rate of Investigator-assessed ILD/Pneumonitis
  • Number of Participants with Adverse Events with BM at Baseline
Approximately 500 eligible participants will be enrolled into 1 of 2 cohorts (250 participants in each cohort) according to the presence or absence of BMs at baseline. Cohort 1 will include participants without BM at baseline and Cohort 2 will consist of participants with BM at baseline. After study intervention discontinuation, all participants will undergo an end-of-treatment visit (within 7 days of discontinuation) and will be followed up for safety assessments 40 (+ up to 7) days after the discontinuation of all study intervention. All participants will be followed up for survival status and duration of treatment on subsequent therapies after intervention discontinuation every 3 months (┬▒ 14 days) from the date of the safety follow-up until death, withdrawal of consent, or the end of the study, as per defined in the protocol.

View this trial on ClinicalTrials.gov

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Resources

Canadian Cancer Society

These resources are provided in partnership with the Canadian Cancer Society