Breast Cancer Clinical Trial
Official title:
Imaging the Effect of HSP90 Inhibitor AUY922 on HER2 Expression by Means of 89Zr-trastuzumab PET. Side Study to Phase I-II Study With AUY922 in Either HER2 or ER Positive Locally Advanced or Metastatic Breast Cancer: Protocol CAUY922A2101
HSP90 inhibition is a potentially new targeted drug modality in the treatment of HER2
positive, trastuzumab refractory breast cancer. Little is known about the pharmacodynamics
of HSP90 inhibitors in vivo, but non-invasive PET/CT imaging in a xenograft mouse model
could visualize and quantify HER2 reduction after AUY922 treatment by 89Zr-trastuzumab PET
imaging. Two doses of 50 mg/kg AUY922 resulted in a decrease in HER2 expression of
approximately 50%, quantified 6 days after the last administration of AUY922.
Visualizing HER2 expression in breast cancer patients before and early following HSP90
inhibition by means of 89Zr-trastuzumab PET, is likely to provide insight in the early in
vivo effect of HSP90 inhibition and could potentially support patient tailored therapy.
This study is designed as a side study to the multicenter, international phase I-II trial
with the HSP90 inhibitor AUY922 (protocol CAUY922A2101), as part of the biomarker
assessment. In protocol CAUY922A2101, section 4, the design of this phase I-II trial is
described (p36, 37). Briefly, a dose-escalation study is performed according to phase I
design. This part is followed by a dose-expansion study according to a phase II design. In
the latter part, breast cancer patients are enrolled that are either refractory to hormone-
or trastuzumab treatment (both treatment arms, n=40 patients). Patients with HER2 positive,
trastuzumab refractory breast cancer, will receive a 89Zr-trastuzumab PET scan as part of
the present side study protocol, which will be performed in collaboration with the Royal
Marsden Hospital (United Kingdom).
To this end, a 89Zr-trastuzumab PET scan will be performed before (baseline) and during
treatment with the HSP90 inhibitor AUY922, as described below.
A minimum of six patients are needed to evaluate whether the 89Zr-trastuzumab PET scan can
be used for the detection of a decrease of HER2 expression, induced by HSP90 inhibition.
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