A Phase Ib Study of HS-10352 Plus Fulvestrant in Patients With Advanced Breast Cancer

Breast Cancer Clinical Trial

Official title:

A Phase Ib, Open-label, Multicenter Study to Evaluate Safety, Tolerability, Pharmacokinetics, and Efficacy of HS-10352 in Combination With Fulvestrant in Patients With Hormone Receptor (HR) Positive, Human Epidermal Growth Factor 2 (HER2)-Negative, PIK3CA Mutation, Locally Advanced or Metastatic Breast Cancer

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05504213
• Other study ID #: HS-10352-102
• Status: Recruiting
• Phase: Phase 1
• Start date: January 12, 2022
• Est. completion date: December 31, 2025

Study information

• Verified date: May 2022
• Source: Jiangsu Hansoh Pharmaceutical Co., Ltd.
• Contact: Xichun Hu, PhD
• Phone: 021-64175590
• Email: xchu2009[@]hotmail.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

HS-10352 is a highly potent and selective small molecule inhibitor of phosphoinositide 3-kinase (p110α). The purpose of this study is to assess the safety, tolerability, pharmacokinetics (PK), and efficacy of HS-10352 plus fulvestrant in patients with hormone receptor (HR) positive, human epidermal growth factor 2 (HER2)-negative, advanced breast cancer (ABC) harboring PIK3CA mutations.

Description:

This is a Phase Ib open-label, 2-Part, multi-center study in China. The study will be conducted in two stages: Stage 1 is the dose-escalation part, which is designed to evaluate the safety, tolerability, PK and efficacy, as well as to determine the maximum tolerable dosage (MTD) or maximum applicable dose (MAD) of HS-10352 in combination with fulvestrant. Stage 2 is the dose-expansion part, which is aimed to further assess the efficacy, safety, tolerability and PK, and to establish the recommended phase 2 dose (RP2D) of HS-10352 in combination with fulvestrant. All participants will be carefully monitored for adverse events (AE) during the study treatment and for 28 days after the last dose of study drug. The PK characteristics of HS-10352 and fulvestrant will be evaluated from C1 to C6. Subjects of this study will be assessed for progression once every 8 weeks until objective disease progression or withdrawal from the trial. As the disease progresses, survival follow-up is recommended bimonthly.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 224
• Est. completion date: December 31, 2025
• Est. primary completion date: July 31, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Men or women aged more than or equal to (=) 18 years

2. HR+ HER2- breast cancer confirmed by histology or cytology.

3. Locally advanced disease not amenable to curative treatment by surgery or metastatic disease.

4. Have adequate tumor tissue for the analysis of PIK3CA mutational status. At dose expansion stage, participants should be identified as PIK3CA-mutation positive before enrollment.

5. Females should have postmenopausal status due to either surgical/natural menopause or ovarian suppression with a luteinizing hormone releasing hormone (LHRH) agonist before enrollment. Males should be pre-treated with a LHRH agonist.

6. Have either measurable disease per RECIST v1.1 criteria or at least one predominantly lytic bone lesion must be present.

7. ECOG performance status was 0-1 and did not deteriorate in the previous 2 weeks.

8. Estimated life expectancy for at least three months

9. Females should be using adequate contraceptive measures and should not be breastfeeding at the time of screening, during the study and until 6 months after completion of the study; and have negative results of blood pregnancy test prior to C1D1. Males should be using adequate contraceptive measures at the time of screening, during the study and until 6 months after completion of the study.

10. Have signed Informed Consent Form

11. Dose escalation stage-Cohort 1: subjects resistant to endocrine therapy Dose expansion stage-Cohort 2: subjects resistant to endocrine therapy Dose expansion stage-Cohort 3: endocrine therapy-sensitive or endocrine-naive subjects

Exclusion Criteria:

1. Participant with symptomatic visceral disease or any disease burden that makes the participant ineligible for endocrine therapy per the investigator's best judgment

2. Treatment with any of the following:

1. Previous or current treatment with PI3K, AKT or mTOR inhibitors

2. For expansion stage, prior treatment with fulvestrant

3. Any cytotoxic chemotherapy, investigational agents within 21 days of the first dose of study drug; anticancer drugs which have been received within 14 days before the first administration.

4. Radiotherapy with a limited field of radiation for palliation within 2 weeks of the first dose of study drug, or patients received more than 30% of the bone marrow irradiation, or large-scale radiotherapy within 4 weeks of the first dose.

5. Major surgery (including craniotomy, thoracotomy, or laparotomy, etc.) within 4 weeks of the first dose of study drug.

3. With inflammatory breast cancer at screening.

4. Inadequate bone marrow reserve or organ function.

5. Uncontrolled pleural effusion or ascites or pericardial effusion.

6. Known and untreated, or active central nervous system metastases.

7. History of primary or secondary diabetes.

8. History of acute or chronic pancreatitis

9. Refractory nausea, vomiting, or chronic gastrointestinal diseases, or inability to swallow the study drug that would preclude adequate absorption of HS-10352 or fulvestrant.

10. History of hypersensitivity to any active or inactive ingredient of HS-10352/ fulvestrant or to drugs with a similar chemical structure or class to HS-10352.

11. Judgment by the investigator that the patient should not participate in the study if the patient is unlikely to comply with study procedures, restrictions, and requirements.

12. Any disease or condition that, in the opinion of the investigator, would compromise the safety of the patient or interfere with study assessments.

Related Conditions & MeSH terms

• Breast Cancer
• Breast Neoplasms

Intervention

Drug:
• HS-10352 combined with fulvestrant (Stage 1)
Drug: HS-10352 HS-10352 will be administered at escalating doses orally once daily on a continuous dosing schedule starting on Cycle 1 Day 1 (C1D1) in a 28 day cycle. Drug: Fulvestrant Fulvestrant is administered at a dose of 500 mg intramuscular on Cycle 1 Day 1, Day 15, and Day 1 of every cycle thereafter (where a cycle is 28 days).
• HS-10352 combined with fulvestrant (Stage 2)
Drug: HS-10352 participants will be enrolled into Cohort 2 (endocrine therapy-resistant) and Cohort 3 (endocrine therapy-sensitive or naïve) respectively and HS-10352 will be administered at the recommended dose identified in Part 1. Drug: Fulvestrant Fulvestrant is administered at a dose of 500 mg intramuscular on Cycle 1 Day 1, Day 15, and Day 1 of every cycle thereafter (where a cycle is 28 days).

Locations

Country	Name	City	State
China	Fudan University Shanghai Cancer Center	Shanghai	Shanghai

Sponsors (1)

Lead Sponsor	Collaborator
Jiangsu Hansoh Pharmaceutical Co., Ltd.

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	[Stage 1] Maximum tolerated dose (MTD) of HS-10352 in combination with fulvestrant	MTD is defined as the previous dose level at which 2 or more out of 2~6 subjects experienced a DLT.	Cycle 1 (28 days)
Primary	[Stage 1] Maximum applicable dose (MAD) of HS-10352 in combination with fulvestrant	MAD is defined as follows: a) based on PK data, it is anticipated that at this dose level, the dose-exposure plateau has been reached, b) based on existing safety data, it is judged that dose escalation following this dose level will have a large safety risk or subject intolerance, or c) based on the PK-PD model, it suggested that the optimal target concentration of safety and efficacy has been explored.	Cycle 1 (28 days)
Primary	[Stage 2] Objective response rate (ORR) of HS-10352 in combination with fulvestrant	ORR is defined as the proportion of participants with best overall response (BOR) of confirmed complete response (CR) or confirmed partial response (PR) based on assessment per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1).	From the date of first dose until the date of disease progression or withdrawal from study, approximately 3 years
Secondary	[Stage 1 and Stage 2] Incidence and severity of treatment-emergent adverse events	Assessed by number and severity of adverse events as evaluated according to NCI CTCAE v5.0.	From Cycle 1 Day 1 (C1D1) until 28 days after the final dose. A cycle is 28 days.
Secondary	[Stage 1 and Stage 2] PK parameters: the maximum concentration (Cmax) of HS-10352	Defines as the maximum plasma drug concentration of HS-10352	Cycle 1 Day 1 (C1D1),at the first day of Cycle 1 (each cycle is 28 days)
Secondary	[Stage 1] PK parameters: the maximum concentration (Cmax) of fulvestrant	Defines as the maximum plasma drug concentration of fulvestrant	Cycle 1 (28 days)
Secondary	[Stage 1 and Stage 2] PK parameters: time of the maximum concentration (Tmax) of HS-10352	Defined as the time to reach maximum plasma concentration following drug administration of HS-10352	Cycle 1 Day 1 (C1D1),at the first day of Cycle 1 (each cycle is 28 days)
Secondary	[Stage 1] PK parameters: time of the maximum concentration (Tmax) of fulvestrant	Defined as the time to reach maximum plasma concentration following drug administration of fulvestrant	Cycle 1 (28 days)
Secondary	[Stage 1 and Stage 2] PK parameters: elimination half life (t1/2) of HS-10352	Defines as the time measured for the concentration to decrease by one half.	Cycle 1 Day 1 (C1D1),at the first day of Cycle 1 (each cycle is 28 days)
Secondary	[Stage 1 and Stage 2] PK parameters: area under the concentration-time curve over 24 hours (AUC0-24) of HS-10352	Defines as area under the plasma concentration versus time curve from time zero to the 24-hour sampling time.	Cycle 1 Day 1 (C1D1),at the first day of Cycle 1 (each cycle is 28 days)
Secondary	[Stage 1 and Stage 2] PK parameters: area under the concentration-time curve from time zero (pre-dose) to last time of quantifiable concentration (AUC0-t) of HS-10352	Defines as area under the plasma concentration versus time curve from time zero to the last sampling time t at which the concentration was at or above the lower limit of quantification (LLOQ).	Cycle 1 Day 1 (C1D1),at the first day of Cycle 1 (each cycle is 28 days)
Secondary	[Stage 1] PK parameters: area under the concentration-time curve from time zero (pre-dose) to last time of quantifiable concentration (AUC0-t) of fulvestrant	Defines as area under the plasma concentration versus time curve from time zero to the last sampling time t at which the concentration was at or above the lower limit of quantification (LLOQ).	From Cycle 1 to Cycle 2, each cycle is 28 days
Secondary	[Stage 1 and Stage 2] PK parameters: the maximum concentration at steady-state (Css,max) of HS-10352	Defines as the maximum plasma drug concentration of HS-10352 at steady-state	Cycle 2 Day 1 (C2D1),at the first day of Cycle 2 (each cycle is 28 days) each cycle is 28 days
Secondary	[Stage 1] PK parameters: the maximum concentration at steady-state (Css,max) of fulvestrant	Defines as the maximum plasma drug concentration of fulvestrant at steady-state	Cycle 2 (28 days)
Secondary	[Stage 1 and Stage 2] PK parameters: time of the maximum concentration at steady state (Tss,max) of HS-10352	Defined as the time to reach maximum plasma concentration following drug administration of HS-10352 at steady-state	Cycle 2 Day 1 (C2D1),at the first day of Cycle 1 (each cycle is 28 days)
Secondary	[Stage 1] PK parameters: time of the maximum concentration at steady state (Tss,max) of fulvestrant	Defined as the time to reach maximum plasma concentration following drug administration of fulvestrant at steady-state	Cycle 2 (28 days)
Secondary	[Stage 1 and Stage 2] PK parameters: the minimum concentration at steady-state (Css,min) of HS-10352	Defines as the minimum plasma drug concentration of HS-10352 at steady-state	Cycle 2 Day 1 (C2D1),at the first day of Cycle 1 (each cycle is 28 days)
Secondary	[Stage 1 and Stage 2] PK parameters: the minimum concentration at steady-state (Css,min) of fulvestrant	Defines as the minimum plasma drug concentration of fulvestrant at steady-state	Cycle 2 (28 days)
Secondary	[Stage 1] Efficacy of HS-10352 in combination with fulvestrant: ORR	ORR is defined as the proportion of participants with BOR of confirmed CR or confirmed PR based on assessment per RECIST v1.1.	From the date of first dose until the date of disease progression or withdrawal from study, approximately 3 years
Secondary	[Stage 1 and Stage 2] Efficacy of HS-10352 in combination with fulvestrant: disease control rate (DCR)	The disease control was de?ned as the percentage of patients who have a best overall response (confirmed CR, PR, or stable disease for at least 6 weeks).	From the date of first dose until the date of disease progression or withdrawal from study, approximately 3 years
Secondary	[Stage 1 and Stage 2] Efficacy of HS-10352 in combination with fulvestrant: duration of response (DoR)	DOR only applies to participants whose best overall response is CR or PR based on assessment per RECIST v1.1. The start date is the date of first documented response of CR or PR (i.e. the start date of observed response, not the date when response was confirmed), and the end date is defined as the date of the first documented progression or death due to underlying cancer.	From the date of CR, PR until the date of disease progression or withdrawal from study, approximately 3 years
Secondary	[Stage 1 and Stage 2] Efficacy of HS-10352 in combination with fulvestrant: progression free survival (PFS)	PFS is defined as the time from the date of randomization or first dose (if randomization is not needed) to the date of the first documented progression or death due to any cause. PFS will be assessed per RECIST v1.1.	From the date of randomization or first dose (if randomization is not needed) until the date of disease progression or withdrawal from study, approximately 3 years
Secondary	[Stage 2] Efficacy of HS-10352 in combination with fulvestrant: overall survival (OS)	OS is defined as the time from the date of randomization or first dose (if randomization is not needed) to the date of death due to any cause. For each participant who is not known to have died as of the cutoff date for overall survival analysis, OS time was censored on the last date the participant is known to be alive.	From the date of randomization or first dose (if randomization is not needed) until the documentation of death from any cause, approximately 6 years