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Brief Title: A Study of Tucatinib vs. Placebo in Combination With Capecitabine & Trastuzumab in Patients With Advanced HER2+ Breast Cancer
Official Title: Phase 2 Randomized, Double-Blinded, Controlled Study of Tucatinib vs Placebo in Combination With Capecitabine and Trastuzumab in Patients With Pretreated Unresectable Locally Advanced or Metastatic HER2+ Breast Carcinoma
Study ID: NCT02614794
Brief Summary: This study is being done to see if tucatinib works better than placebo to help patients who have a specific type of breast cancer called HER2 positive breast carcinoma. The breast cancer in this study is either metastatic (spread into other parts of the body) or cannot be removed completely with surgery. All patients in the study will get capecitabine and trastuzumab, two drugs that are often used to treat this cancer. There are two parts to this study. The first part of the study is already complete. Patients were randomly assigned to get either tucatinib or placebo (a pill with no medicine). Since this part was "blinded," neither patients nor their doctors knew whether a patient got tucatinib or placebo. The second part of the study is called the Unblinded Phase. In this part of the study, participants and their doctors know which drugs are being given. Participants who used to get or are currently getting placebo may be able to start taking tucatinib instead. Each treatment cycle lasts 21 days. Patients will swallow tucatinib pills two times every day. They will swallow capecitabine pills two times a day during the first two weeks of each cycle. Patients will get trastuzumab injections from the study site staff on the first day of every cycle.
Detailed Description: This is a randomized, international, multi-center study in patients with progressive unresectable locally advanced or metastatic HER2+ breast cancer who have had prior treatment with trastuzumab, pertuzumab and T-DM1. There are two phases to this trial: the Double-blind Phase and the Unblinded Phase. In the Double-blind phase, participants were randomized in a 2:1 ratio to receive tucatinib or placebo in combination with capecitabine and trastuzumab. In the Unblinded Phase, patients on placebo may be offered tucatinib. Stratification factors include presence or history of treated or untreated brain metastases or brain lesions of equivocal significance (yes/no), Eastern Cooperative Oncology Group (ECOG) Performance Status (0 vs. 1), and region of world (US vs. Canada vs. Rest of World). Safety assessments will be performed at a minimum of once every three weeks throughout study treatment and 30 days after the last dose of study drugs. Laboratory assessments will be performed locally at sites. Left ventricular ejection fraction will be assessed by MUGA or ECHO at screening and once every 12 weeks thereafter. For the blinded phase, contrast brain MRI was performed at baseline. Efficacy assessments (CT of chest, abdomen and pelvis at a minimum) utilized RECIST 1.1 and included patients with evaluable tumors defined as measurable target lesions and non-measurable non-target lesions. RECIST assessment was performed at baseline, every 6 weeks for the first 24 weeks, and then every 9 weeks thereafter. Repeat MRI of the brain was required on this same schedule only in those patients with brain metastases identified at baseline. All treatment decisions were made based upon investigator assessment. All patients underwent a repeat MRI of the brain within 30 days of the end of treatment unless previously performed at time of disease progression. For the unblinded phase, RECIST assessments will be performed per standard clinical practice as determined by investigator with a maximum interval of 12 weeks.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
University of Alabama at Birmingham, Birmingham, Alabama, United States
University of South Alabama - Mitchell Cancer Institute, Mobile, Alabama, United States
Cancer Treatment Centers of America - Phoenix, Goodyear, Arizona, United States
Arizona Oncology Associates, PC - HAL, Phoenix, Arizona, United States
City of Hope National Medical Center, Duarte, California, United States
TRIO - Central Regulatory Office, Los Angeles, California, United States
UCLA Medical Center / David Geffen School of Medicine, Los Angeles, California, United States
Torrance Memorial Physician Network - TRIO, Redondo Beach, California, United States
University of California at San Francisco, San Francisco, California, United States
Kaiser Permanente San Marcos Medical Offices, San Marcos, California, United States
Central Coast Medical Oncology Corporation TRIO, Santa Maria, California, United States
Kaiser Permanente Medical Center Northern California, Vallejo, California, United States
University of Colorado Hospital / University of Colorado, Aurora, Colorado, United States
Yale Cancer Center, New Haven, Connecticut, United States
Lombardi Cancer Center / Georgetown University Medical Center, Washington, District of Columbia, United States
Florida Cancer Specialists - South Region, Fort Myers, Florida, United States
Memorial Regional Hospital TRIO, Hollywood, Florida, United States
Baptist MD Anderson Cancer Center, Jacksonville, Florida, United States
Mount Sinai Medical Center / Florida, Miami Beach, Florida, United States
University of Miami, Miami, Florida, United States
Orlando Health, Inc. TRIO, Orlando, Florida, United States
Florida Cancer Specialists - North Region, Saint Petersburg, Florida, United States
H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States
Florida Cancer Specialists - East West Palm Beach, FL (SCRI), West Palm Beach, Florida, United States
Winship Cancer Institute / Emory University School of Medicine, Atlanta, Georgia, United States
Northside Hospital, Atlanta, Georgia, United States
Augusta University, Augusta, Georgia, United States
Cancer Treatment Centers of America, Newnan, Georgia, United States
Rush University Medical Center, Chicago, Illinois, United States
University of Chicago, Chicago, Illinois, United States
Illinois Cancer Specialists / Advocate Lutheran General Hospital, Niles, Illinois, United States
Carle Cancer Center, Urbana, Illinois, United States
University of Kansas Cancer Center, Westwood, Kansas, United States
University of Maryland, Baltimore, Maryland, United States
Maryland Oncology Hematology, P.A., Rockville, Maryland, United States
Dana Farber Cancer Institute, Boston, Massachusetts, United States
Henry Ford Health System, Detroit, Michigan, United States
William Beaumont Hospital, Royal Oak, Michigan, United States
Virginia Piper Cancer Institute, Minneapolis, Minnesota, United States
Saint Luke's Cancer Institute LLC, Kansas City, Missouri, United States
Nebraska Cancer Specialists, Omaha, Nebraska, United States
Dartmouth-Hitchcock Medical Center/ Norris Cotton Cancer Center, Lebanon, New Hampshire, United States
Hackensack University Medical Center, Hackensack, New Jersey, United States
Montefiore Medical Center, Bronx, New York, United States
Mount Sinai Beth Israel, New York, New York, United States
New York University (NYU) Cancer Institute, New York, New York, United States
Stony Brook University Cancer Center, Stony Brook, New York, United States
UNC Lineberger Comprehensive Cancer Center / University of North Carolina, Chapel Hill, North Carolina, United States
Duke University Medical Center, Durham, North Carolina, United States
Leo W. Jenkins Cancer Services / Brody School of Medicine East Carolina University, Greenville, North Carolina, United States
James Cancer Hospital / Ohio State University, Columbus, Ohio, United States
Providence Portland Medical Center, Portland, Oregon, United States
Oregon Health and Science University, Portland, Oregon, United States
Northwest Cancer Specialists, P.C., Tualatin, Oregon, United States
University of Pennsylvania / Perelman Center for Advanced Medicine, Philadelphia, Pennsylvania, United States
Cancer Treatment Centers of America / Eastern Regional Medical Center, Philadelphia, Pennsylvania, United States
Roper St. Francis Healthcare, Charleston, South Carolina, United States
Medical University of South Carolina/Hollings Cancer Center, Charleston, South Carolina, United States
Wellmont Cancer Institute, Kingsport, Tennessee, United States
Tennessee Oncology - Nashville, Nashville, Tennessee, United States
Vanderbilt University Medical Center, Nashville, Tennessee, United States
Texas Oncology - Austin Midtown, Austin, Texas, United States
Texas Oncology Methodist, Dallas, Texas, United States
Texas Oncology - Denton South, Denton, Texas, United States
The Center for Cancer and Blood Disorders: Fortworth, Fort Worth, Texas, United States
Texas Oncology - Houston Memorial City, Houston, Texas, United States
MD Anderson Cancer Center / University of Texas, Houston, Texas, United States
Baylor Clinic, Houston, Texas, United States
Joe Arrington Cancer Research and Treatment Center, Lubbock, Texas, United States
Paris Regional Medical Center / US Oncology, Paris, Texas, United States
Texas Oncology - Plano East, Plano, Texas, United States
Texas Oncology - San Antonio Medical Center Northeast, San Antonio, Texas, United States
University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
US Oncology Central Regulatory, The Woodlands, Texas, United States
Texas Oncology - Deke Slayton Cancer Center, Webster, Texas, United States
University of Utah, Salt Lake City, Utah, United States
Virginia Cancer Specialists, PC, Fairfax, Virginia, United States
Shenandoah Oncology P.C., Winchester, Virginia, United States
Swedish Cancer Institute, Seattle, Washington, United States
Seattle Cancer Care Alliance / University of Washington, Seattle, Washington, United States
Carbone Cancer Center / University of Wisconsin, Madison, Wisconsin, United States
Austin Hospital, Heidelberg, , Australia
Cabrini Education and Research Precinct, Malvern, , Australia
Peter MacCallum Cancer Centre, Melbourne, , Australia
Breast Cancer Research Centre, Nedlands, , Australia
Mater Hospital, North Sydney, , Australia
Icon Cancer Care South Brisbane, South Brisbane, , Australia
Mater Health Services, South Brisbane, , Australia
Sunshine Hospital, St Albans, , Australia
Westmead Hospital, Westmead, , Australia
LKH- Universitat Klinikum Graz, Graz, , Austria
Medizinische Universitat Innsbruck, Innsbruck, , Austria
KH d. Barmherzigen Schwestern Linz, Linz, , Austria
LKH Salzburg, Universitatsklinikum der PMU, Salzburg, , Austria
AZ Klina, Brasschaat, , Belgium
Cliniques Universitaires Saint Luc, Brussels, , Belgium
Grand Hopital de Charleroi, Charleroi, , Belgium
Centre Hospitalier de l'Ardenne, Libramont, , Belgium
CHU UCL Namur-Site de Saint Elisabeth, Namur, , Belgium
Tom Baker Cancer Centre, Calgary, , Canada
University of Alberta / Cross Cancer Institute, Edmonton, , Canada
Queen Elizabeth II Health Sciences Centre, Halifax, , Canada
Jewish General Hospital, Montreal, , Canada
Hopital du Saint-Sacrement, CHU de Quebec-Universite Laval, Quebec, , Canada
Allan Blair Cancer Centre, Regina, , Canada
Saskatoon Cancer Centre, Saskatoon, , Canada
H. Bliss Murphy Cancer Centre, St John's, , Canada
Sunnybrook Health Sciences Centre, Toronto, , Canada
University Health Network, Princess Margaret Hospital, Toronto, , Canada
British Columbia Cancer Agency - Vancouver Centre, Vancouver, , Canada
Fakultni nemocnice Hradec Kralove-oddeleni klinicke hematologie, Hradec Kralove, , Czechia
Fakultni Nemocnice Olomouc (Fnol) - Onkologicka Klinika, Olomouc, , Czechia
Aalborg Universitetshospital, Aalborg, , Denmark
Rigs Hospiltalet, Copenhagen, , Denmark
Herlev Hospital, Herlev, , Denmark
Odense University Hospital, Odense C, , Denmark
Sygehus Lillebaelt - Vejle Sygehus, Vejle, , Denmark
University Hospital of Besancon, Besancon cedex, , France
Clinique Victor Hugo, Le Mans, , France
Centre Leon Berard - Centre regional de lutte contre le cancer Rhone-Alpes, Lyon, , France
Institut Paoli Calmettes, Marseille, , France
Institute Curie - Centre de Lutte Contre Le Cancer CLCC de Paris, Paris, , France
Centre Hospitalier Lyon Sud, Pierre Bénite Cedex, , France
Institut Jean Godinot, REIMS Cedex, , France
Centre Eugene Marquis, Rennes Cedex, , France
Hopitaux Universitaires de Strasbourg, Strasbourg, , France
Institut Claudius Regaud, Toulouse Cedex 9, , France
CHU Tours - Hopital Bretonneau, TOURS Cedex 09, , France
Charite Universitatsmedizin Berlin, Berlin, , Germany
Kliniken Essen-Mitte - Evang. Huyssens-Stiftung, Essen, , Germany
Universitaetsklinikum Hamburg-Eppendorf (UKE) - Onkologisches Zentrum - Interdisziplinaere Klinik und Poliklinik fuer Stammzelltransplantation, Hamburg, , Germany
Medizinische Hochschule Hannover, Hannover, , Germany
Universitatsklinikum Schleswig-Holstein, Kiel, , Germany
InVO- Institut fUr Versorgungsforschung in der onkologie GbR, Koblenz, , Germany
Universitatsklinikum Koln, Köln, , Germany
HOPE- Onkologisches Zentrum Rotkreuzklinikum, Munchen, , Germany
Sana Klinikum Offenbach GmbH, Offenbach am Main, , Germany
Rambam Health Corp., Haifa, , Israel
Hadassah Medical Center, Jerusalem, , Israel
Meir Medical Center, Kfar Saba, , Israel
Rabin Medical Center, Petach Tikva, , Israel
Kaplan Medical Center, Rehovot, , Israel
Tel Aviv Sourasky Medical Center, Tel Aviv, , Israel
Sheba Medical Center, Tel Hashomer, , Israel
Azienda Ospedaliero-Universitaria di Bologna Policlinico S. Orsola-Malpighi, Bologna, , Italy
Ospedale di Bolzano, Bolzano, , Italy
Presido Ospedaliero- Senatore Antonio Perrino, Brindisi, , Italy
Ospedale Ramazzini di Carpi, Carpi, , Italy
Ospedale Policlinico San Martino, Genova, , Italy
Istituto Europeo di Oncologia, Milano, , Italy
IRCSS Policlinico San Matteo, Pavia, , Italy
Azienda Ospedaliera S. Maria di Terni, Terni, , Italy
A.O.U. - Ospedali Riuniti di Ancona, Torrette, , Italy
Hospital Cuf Descobertas R. Mario Botas Parque das Nacoes, Lisboa, , Portugal
Centro Hospitalar do Porto - Hospital Santo Antonio, Porto, , Portugal
Hospital Universitario Vall d'Hebron, Barcelona, , Spain
Hospital Clinic i Provincial de Barcelona, Barcelona, , Spain
Hospital San Pedro de Alcantara, Caceres, , Spain
Complejo Asistencial Universitario de Leon, Leon, , Spain
Hospital General Universitario Gregorio Marañon, Madrid, , Spain
Hospital Universitario 12 de Octubre, Madrid, , Spain
Hospital Son Espases, Palma de Mallorca, , Spain
Hospital Clinico Univ De Santiago De Compostela, Santiago de Compostela, , Spain
Hospital Arnau De Vilanova, Valencia, , Spain
Hospital Clinico Universitario Lozano Blesa de Zaragoza, Zaragoza, , Spain
Institute of Oncology of Southern Switzerland, Bellinzona, , Switzerland
Colchester Hospital University NHS Foundation Trust, Colchester, , United Kingdom
The Royal Marsden Hospital, London, , United Kingdom
Sarah Cannon Research Institute UK, London, , United Kingdom
The Christie NHS Foundation Trust, Manchester, , United Kingdom
Mount Vernon Hospital, UK, Northwood, , United Kingdom
Nottingham University Hospitals NHS Trust, Nottingham, , United Kingdom
Peterborough City Hospital, Peterborough, , United Kingdom
Weston Park Hospital- UK, Sheffield, , United Kingdom
The Royal Marsden Hospital (Surrey), Sutton, , United Kingdom
Royal Cornwall Hospitals NHS Trust, Truro, , United Kingdom
Name: Jorge Ramos, DO
Affiliation: Seagen Inc.
Role: STUDY_DIRECTOR
Name: Corinna Palanca-Wessels, MD, PhD
Affiliation: Seagen Inc.
Role: STUDY_DIRECTOR