Clinical Trial to Assess Efficacy and Safety of NNG-TMAB (Trastuzumab) on Recurrent or Metastatic Breast Cancer Patients

Breast Cancer Female Clinical Trial

Official title:

Randomized, Single-blind, Multicenter, Parallel Group Clinical Trial to Assess Efficacy and Safety of NNG-TMAB (Trastuzumab) in Combination With Docetaxel on Recurrent or Metastatic Breast Cancer Patients With Positive HER2

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05301010
• Other study ID #: NNG17.2
• Status: Completed
• Phase: Phase 3
• Start date: February 2, 2018
• Est. completion date: February 19, 2021

Study information

• Verified date: January 2023
• Source: Nanogen Pharmaceutical Biotechnology Joint Stock Company
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Targeted therapy in the treatment of breast cancer targets HER2 receptor (Human Epidermal growth factor Receptor). HER2 receptor plays an important role in cell growth and differentiation (5). However, when HER2 overexpresses, it may lead to cancer. HER2 positive malignance exacerbates pathology and worsens clinical outcome, such as shortened overall survival (OS) compared with non-HER2 overexpression patients (6), (7). About 20-30% overexpression HER2/neogene breast cancer patients and patients having HER2 overexpression tumor have disease progression and poor prognosis in metastatic process (8), (9).

Currently, targeted therapeutic, which attaches to the HER2 receptor, inhibiting the growth of cancer cells has been approved. One of these products is Trastuzumab.

The study processed on 128 females aged between 18 and 65, recurrent or metastatic breast cancer patients with positive HER2.

The subjects were randomly distributed in 2 groups as NNG-TMAB + docetaxel or Herceptin® + docetaxel, in blocks of 4 in a 1: 1 ratio (NNG-TMAB: Herceptin®). In each block of 4 will be 2 patients in the experimental group and 2 patients in the control group

Primany endpoints is Overall Response Rate (ORR) according to RECIST 1.1. ORR includes Complete Response Rate and Partial Response Rate. ORR will be independently evaluated by an Independent Tumor Evaluation Board (ITEB).

This trial is intended to assess the biosimilarity of efficacy and safety between NNG-TMAB (Trastuzumab) and Herceptin® in combination with Docetaxel on recurrent or metastatic breast cancer patients with positive HER2.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 128
• Est. completion date: February 19, 2021
• Est. primary completion date: February 19, 2021
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

• Female patients from 18 to 65 years old.

• Willing to give written and signed informed consent.

• Have pathologically or cytologically confirmed breast cancer.

• Inoperable, recurrent or metastatic breast cancer according to TNM classification and investigator' s assessment.

• Presence of at least 1 tumour with a size not less than 1 cm (revealed with computed tomography (CT) slice thickness not more than 5 mm). Patients having bone metastasis as the only measurable tumour are not eligible for the trial.

• Grade 3+ HER2 overexpression confirmed by immunohistochemical (IHC) staining or grade 2+ HER2 overexpression accompanied by HER2 gene amplification confirmed by fluorescent hybridization in situ (FISH).

• Eastern Cooperative oncology group performance status = 2

• Willing to comply the requirements of the study protocol.

• Have a survival expectancy of at least 6 months.

• At screening period: Hb = 9 g/dL; Neutrophils = 1,5x10^9/L; platelets = 100x10^9/L; creatinine level = 1,5 x upper limit of normal (ULN); bilirubin level < 1,5 x ULN; ALT/AST < 2,5 x ULN (< 5 x ULN for patients with liver metastases), ALP < 5 x ULN.

• Patients of childbearing potential and her partner must implement reliable contraceptive measures during the study treatment, starting 4 weeks prior to inclusion into the trial and until 6 months after the last administration of the study drug

Exclusion Criteria:

• Previous anticancer therapy for metastatic BC, including previous anticancer therapy with signal transduction inhibitors (e.g. lapatinib), biological drugs (e.g. trastuzumab, bevacizumab), experimental (not approved for BC therapy) anticancer drugs. Any previous chemotherapy or hormonal therapy is allowed.

• Previously treated with doxorubicin > 400 mg/m2; epirubicin > 800 mg/m2 in accumulative dosages.

• Surgery, radiation therapy, use of any experimental medications within 4 weeks prior to randomization.

• Clinical evidence or X-ray show that breast cancer metastases in central nervous system

• Patients with metastatic tumor to the bone is the only tumor to be measured

• Systolic blood pressure >150mmHg and/or diastolic blood pressure >100mmHg. Uncontrolled hypertension comprising all cases of arterial hypertension when no decrease in blood pressure could be achieved despite treatment with a combination of 3 antihypertensive drugs including one diuretic and non-medicamental correction methods (low salt diet, physical exercise)

• Cardiovascular system pathology (congestive heart failure (CHF) stage III-IV according to New York Heart Association (NYHA) classification, unstable angina pectoris, myocardial infarction) within 12 months prior to randomization. LVEF < 50% according to echocardiogram when screening.

• Acute or chronic infection (except for acute or chronic infection that is stable and does not affect the study evaluation). Infecting HIV, HBV or HCV, Syphilis

• Patients with a history of severe allergic reaction to trastuzumab, paclitaxel, docetaxel or other ingredients in the formulation

• The patient has evidence of a serious illness (such as resting dyspnea or severe lung disease, etc.) or an abnormal laboratory test that, in the judgment of the researcher, will affect participation. research and completion of patient research, or may affect the patient's response evaluation.

• Pregnancy, intend to get pregnant, lactation

Related Conditions & MeSH terms

• Breast Cancer Female
• Breast Cancer Metastatic
• Breast Cancer Recurrent
• Breast Neoplasms
• Recurrence

Intervention

Drug:
• Faceptor
NNG-TMAB (trastuzumab) 150 mg, 440 mg, lyophilized power for injection, manufacturered by Nanogen Pharmaceutical Biotechnology JSC.
• Herceptin
Herceptin (trastuzumab) 150mg, 440mg, powder for concentrate for solution, manufactured by Roche.
• Docetaxel
The drug Docetaxel in this study has the brand name Taxotere manufactured by Sanofi company.

Locations

Country	Name	City	State
Vietnam	19-8 Hospital	Hanoi
Vietnam	HCMC Oncology Hospital	Ho Chi Minh City

Sponsors (3)

Lead Sponsor	Collaborator
Nanogen Pharmaceutical Biotechnology Joint Stock Company	MedProve Inc, Vietstar Biomedical Research

Country where clinical trial is conducted

Vietnam, 

References & Publications (22)

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Chan S, Friedrichs K, Noel D, Pinter T, Van Belle S, Vorobiof D, Duarte R, Gil Gil M, Bodrogi I, Murray E, Yelle L, von Minckwitz G, Korec S, Simmonds P, Buzzi F, Gonzalez Mancha R, Richardson G, Walpole E, Ronzoni M, Murawsky M, Alakl M, Riva A, Crown J; 303 Study Group. Prospective randomized trial of docetaxel versus doxorubicin in patients with metastatic breast cancer. J Clin Oncol. 1999 Aug;17(8):2341-54. doi: 10.1200/JCO.1999.17.8.2341. — View Citation

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Joensuu H, Bono P, Kataja V, Alanko T, Kokko R, Asola R, Utriainen T, Turpeenniemi-Hujanen T, Jyrkkio S, Moykkynen K, Helle L, Ingalsuo S, Pajunen M, Huusko M, Salminen T, Auvinen P, Leinonen H, Leinonen M, Isola J, Kellokumpu-Lehtinen PL. Fluorouracil, epirubicin, and cyclophosphamide with either docetaxel or vinorelbine, with or without trastuzumab, as adjuvant treatments of breast cancer: final results of the FinHer Trial. J Clin Oncol. 2009 Dec 1;27(34):5685-92. doi: 10.1200/JCO.2008.21.4577. Epub 2009 Nov 2. — View Citation

Lara PN Jr, Chee KG, Longmate J, Ruel C, Meyers FJ, Gray CR, Edwards RG, Gumerlock PH, Twardowski P, Doroshow JH, Gandara DR. Trastuzumab plus docetaxel in HER-2/neu-positive prostate carcinoma: final results from the California Cancer Consortium Screening and Phase II Trial. Cancer. 2004 May 15;100(10):2125-31. doi: 10.1002/cncr.20228. — View Citation

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* Note: There are 22 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Overall Response Rate (ORR) according to RECIST 1.1 after 6 cycles	ORR includes Complete Response Rate and Partial Response Rate. ORR will be independently evaluated by an Independent Tumor Evaluation Board (ITEB).	at the end of cycle 6 (each cycle is 21 days)
Primary	Overall Response Rate (ORR) according to RECIST 1.1 at the end of study	ORR includes Complete Response Rate and Partial Response Rate. ORR will be independently evaluated by an Independent Tumor Evaluation Board (ITEB).	baseline through end of study (up to 128 days)
Secondary	Progressive Disease Rate (PDR) according to RECIST 1.1	Progressive Disease Rate (PDR). PDR will be independently evaluated by an Independent Tumor Evaluation Board (ITEB).	PDR will be evaluated every 3 cycles (each cycle is 21 days) through the end of study (up to 128 days)
Secondary	Stable Disease Rate (SDR) according to RECIST 1.1	Stable Disease Rate (SDR). SDR will be independently evaluated by an Independent Tumor Evaluation Board (ITEB).	SDR will be evaluated every 3 cycles (each cycle is 21 days) through the end of study (up to 128 days)
Secondary	Progression-free survival (PFS) according to RECIST 1.1	Progression-free survival (PFS) was defined as the time between the date patient signed the Informed Consent Form (ICF) and the date of disease progression or death from any cause.	Baseline up to disease progression or death due to any cause, whichever occurs first (up to 128 days (6 cycles - each cycle is 21 days))
Secondary	Evaluate the patient's quality of life	Quality of life of patients according to the EORTC QLQ-C30 questionnaire combined with EORTC QLQ-BR23 at week 24. All scores were linearly transformed to a 0 to 100 scale, according to international guidelines before assessment. A high or healthy level of functioning is represented by a high functional score. A high QOL is represented by a high score for global health status or QOL. More severe symptoms or problems are represented by high symptom scores or items.; (i) EORTC QLQ-C30: is designed to measure cancer patients' physical, psychological and social functions.; (ii) EORTC QLQ-BR23: is a breast-specific module that comprises of 23 questions.	At week 24th
Secondary	Anti-drug antibody evaluation	Percentage of participants with positive Anti-drug antibody	At baseline,after 3 cycles of treatment, after 6 cycles of treatment (each cycle is 21 days)
Secondary	Rate of AE and SAE occurence	Frequency of adverse events, including clinical examination, vital signs and laboratory tests	up to 128 days (6 cycles - each cycle is 21 days)