Phase 1/2 Study to Evaluate EP0062 in Patients With Relapsed Locally Advanced or Metastatic Androgen Receptor Positive (AR+)/HER2-/ER+ Breast Cancer

Metastatic Breast Cancer Clinical Trial

Official title:

A Modular, Open-Label, Multi-Centre Phase 1/2 Dose-Finding, Optimisation and Expansion Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Efficacy of EP0062 in Patients With Relapsed Locally Advanced or Metastatic AR+/HER2-/ER+ Breast Cancer

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05573126
• Other study ID #: EP0062-101
• Status: Recruiting
• Phase: Phase 1/Phase 2
• Start date: January 11, 2023
• Est. completion date: March 2025

Study information

• Verified date: April 2024
• Source: Ellipses Pharma
• Contact: Aidan Doherty
• Phone: +44 (0)20 3743 0992
• Email: Aidan[@]ellipses.life
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The aim of this study is to identify the optimal dose for EP0062 as monotherapy and to assess its Safety, Tolerability, Pharmacokinetics, and Efficacy in Patients with Relapsed Locally Advanced or Metastatic AR+/HER2-/ER+ Breast Cancer

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 128
• Est. completion date: March 2025
• Est. primary completion date: December 2024
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Women 18 years or older at the time of informed consent

2. Histologically proven diagnosis of breast cancer with evidence of metastatic or locally advanced breast adenocarcinoma as defined by the American Joint Committee on Cancer/Union for International Cancer Control/Tumour Node Metastases (AJCC/UICC TNM) staging classification (8th Ed, 2017) and where no conventional therapy is available or considered appropriate by the Investigator or is declined by the patient

3. Availability of archival tumour sample (formalin-fixed, paraffin-embedded block(s) or slides from a primary tumour or biopsy of a metastatic tumour lesion or lesions); in the absence of an archival tumour sample, or if only archival bone tissue is available, a fresh biopsy will need to be collected

4. Biopsy-proven AR+ and ER+ breast cancer

• For Module A, AR+ breast cancer is defined as = 10% AR nuclei staining by central immunohistochemistry (IHC) using the Ventana assay
• For Modules B and C, AR+ breast cancer is defined as = 30% AR nuclei staining by central IHC using the Ventana assay

5. HER2-negative breast cancer, defined as negative by fluorescence in situ hybridisation (FISH) or IHC score of 0 or 1+. If IHC is equivocal at 2+, a negative FISH test (HER2/Amplification of the centromeric region of chromosome 17)CEP17 ratio of <2.0) is required

6. Postmenopausal, as defined by at least one of the following:

1. Age over 60 years

2. Amenorrhea > 12 months at the time of informed consent and an intact uterus, with follicle-stimulating hormone (FSH) and oestradiol in the postmenopausal ranges (as per local practice)

3. FSH and oestradiol in the postmenopausal ranges (as per local practice) in women aged <55 years who have undergone hysterectomy

4. Prior bilateral oophorectomy Exclusion Criteria:

Patients with any of the following will not be included in the study:

1. Prior anti-cancer or investigational drug treatment within the following time windows:

• Any chemotherapy within 21 days prior to the first dose of study drug
• Any non-chemotherapy investigational anti-cancer drug < 5 half-lives (28 days for biologics) or < 14 days for small-molecule therapeutics or if half-life is not known
• Tamoxifen and aromatase inhibitors within 14 days prior to the first dose of study drug
• Fulvestrant or other investigational Selective Estrogen Receptor Degraders (SERDs) within 21 days prior to first dose of study drug

2. Currently taking testosterone, methyltestosterone, oxandrolone, oxymetholone, danazol, fluoxymesterone, testosterone-like agents (e.g., dehydroepiandrosterone, androstenedione, and other androgenic compounds, including herbals), or antiandrogens

3. Radiation therapy within 14 days prior to the first dose of study drug and scheduled to have radiation therapy during participation in this study. Short courses of palliative radiation therapy during the study might be allowed following discussion with and approval by the Medical Monitor. Palliative radiotherapy within 6 weeks prior to first dose of study drug is permitted

4. Unresolved or unstable serious toxic side effects of prior chemotherapy or radiotherapy, i.e., = Grade 2 per Common Terminology Criteria for Adverse Events (CTCAE) v5.0, except fatigue, alopecia, and Grade 2 chemotherapy-induced neuropathy

5. Confirmed Corrected QT Interval by Fridericia (QTcF) > 470 ms on screening ECG, or history of torsades de pointes (TdP), or history of congenital long QT syndrome, or immediate family history of long QT syndrome, unexplained sudden death at a young age, or sudden cardiac death

6. Any other clinically important abnormalities in rhythm, conduction, or morphology on resting ECG (e.g., complete left bundle branch block, third-degree heart block); rate-controlled atrial fibrillation is permitted

7. Concomitant medications that prolong the corrected QT interval and/or increase the risk for TdP that cannot be discontinued or substituted with another drug within 5 half-lives or 14 days before the first dose of study drug, whichever is longer

8. Congestive heart failure Grades II-IV according to the New York Heart Association at the time of screening

9. Myocardial infarction or unstable angina within the previous 6 months

10. Patients receiving medications that are known to be strong inhibitors or inducers of CYP3A4 within 5 half-lives or 14 days, whichever is longer, before the first dose of study drug

Related Conditions & MeSH terms

• Breast Neoplasms
• Hormone Receptor Positive HER-2 Negative Breast Cancer
• Hormone Receptor-positive Breast Cancer
• Metastatic Breast Cancer

Intervention

Drug:
• EP0062
EP0062 is an orally administered investigational selective androgen receptor modulator (SARM)

Locations

Country	Name	City	State
Spain	Hospital Universitari Vall d'Hebron (VHIO)	Barcelona
Spain	Hospital 12 de Octubre	Madrid
Spain	Hospital Universitario Ramón y Cajal	Madrid
Spain	NEXT Oncology Hospital Quironsalud	Madrid
United Kingdom	The Clatterbridge Cancer Centre	Liverpool
United Kingdom	Sarah Cannon Research Institute UK	London
United Kingdom	The Christie NHS Foundation Trust	Manchester
United States	Massachusetts General Hospital	Boston	Massachusetts
United States	Texas Oncology Baylor University Medical Center	Dallas	Texas
United States	Henry Ford Hospital	Detroit	Michigan
United States	Virginia Cancer Specialists	Fairfax	Virginia
United States	Sarah Cannon Research Institute	Nashville	Tennessee
United States	Yale School of Medicine	New Haven	Connecticut
United States	Moffitt Cancer Center	Tampa	Florida

Sponsors (1)

Lead Sponsor	Collaborator
Ellipses Pharma

Countries where clinical trial is conducted

United States,  Spain,  United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Incidence of dose-limiting toxicities (DLTs) during Cycle 1 of EP0062 treatment	Module A	first 28 days
Primary	Maximum tolerated dose (MTD) and doses for evaluation in the expansion cohorts	Module A	1 year
Primary	Incidence and severity of adverse events (AEs) and serious adverse events (SAEs)		up to 30 days after the end of treatment
Secondary	Plasma pharmacokinetic (PK) parameters - Half life		1, 2, 4, 8, 24 and 48 hours during cycle 1
Secondary	Plasma pharmacokinetic (PK) parameters - Cmax		1, 2, 4, 8, 24 and 48 hours during cycle 1
Secondary	Plasma pharmacokinetic (PK) parameters - Area under the curve (exposure)		1, 2, 4, 8, 24 and 48 hours during cycle 1
Secondary	Tumour response		screening and every 8 weeks up to 12 months
Secondary	Clinical Benefit Rate (CBR)		every 8 weeks up to 12 months
Secondary	Objective Response Rate (ORR)		every 8 weeks up to 12 months