Breast CancerPhase 2NCT02322814
A Study of Cobimetinib Plus Paclitaxel, Cobimetinib Plus Atezolizumab Plus Paclitaxel, or Cobimetinib Plus Atezolizumab Plus Nab-Paclitaxel as Initial Treatment for Participants With Triple-Negative Breast Cancer That Has Spread
A Phase 2 study testing Cobimetinib, Paclitaxel and Atezolizumab in people with Breast Cancer, run by Hoffmann-La Roche at 53 sites in 13 countries.
Trial summary
This three-cohort, multi-stage, randomized, Phase II, multicenter trial will evaluate the safety and tolerability and estimate the efficacy of cobimetinib plus paclitaxel versus placebo plus paclitaxel in Cohort I, of cobimetinib plus atezolizumab plus paclitaxel in Cohort II, and of cobimetinib plus atezolizumab plus… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Breast Cancer
- What is being tested?
- Cobimetinib, Paclitaxel and Atezolizumab
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 169 participants
- Where
- 53 sitesin 13 countries
- Study dates
- 12 Mar 2015to 17 Sep 2021
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Histologically confirmed estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and human epidermal growth factor 2 (HER2)-negative adenocarcinoma of the breast with measurable metastatic or locally advanced disease
- Locally advanced disease must not be amenable to resection with curative intent
- Measurable disease, according to RECIST, v1.1
- Adequate hematologic and end organ function
- Agreement to use highly effective contraceptive methods as stated in protocol
Who cannot join
- Disease-Specific Exclusion Criteria
- Known HER2-, ER-positive, or PR-positive breast cancer by local laboratory assessment
- Any prior chemotherapy, hormonal, or targeted therapy, for inoperable locally advanced or metastatic triple-negative breast cancer (mTNBC)
- Any systemic anticancer therapy within 3 weeks prior to Cycle 1, Day 1
- Any radiation treatment to metastatic site within 28 days of Cycle 1, Day 1
- Major surgical procedure, open biopsy, or significant traumatic injury within 30 days prior to Cycle 1, Day 1 or anticipation of need for major surgical procedure during the course of the study
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- Prior exposure to experimental treatment targeting rapidly accelerated fibrosarcoma (Raf), MAP kinase/ERK kinase (MEK), or the mitogen-activated protein kinase (MAPK) pathway
- Brain metastases (symptomatic or nonsymptomatic) that have not been treated previously, are progressive, or require any type of therapy (e.g., radiation, surgery, or steroids) to control symptoms from brain metastases within 30 days prior to first study treatment dose
- Cobimetinib-Specific Exclusion Criteria
- History of or evidence of retinal pathology on ophthalmologic examination that is considered a risk factor for neurosensory retinal detachment/central serous chorioretinopathy (CSCR), retinal vein occlusion (RVO), or neovascular macular degeneration
- Cobimetinib is metabolized by the hepatic cytochrome P3A4 (CYP3A4) enzyme. Drugs CYP3A4/5 inhibitors and inducers should be avoided
- Atezolizumab-Specific Exclusion Criteria (Cohorts II and III Only)
- History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins
- Known hypersensitivity or allergy to biopharmaceuticals produced in Chinese hamster ovary cells or any component of the atezolizumab formulation
- History of autoimmune disease
- Prior allogenic stem cell or solid organ transplantation
- History of idiopathic pulmonary fibrosis (including pneumonitis), drug induced pneumonitis, organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia), or evidence of active pneumonitis on screening chest computed tomography (CT) scan
- Positive test for Human Immunodeficiency Virus (HIV)
- Active hepatitis B (defined as having a positive hepatitis B surface antigen [HBsAg] or positive hepatitis B virus [HBV] deoxyribonucleic acid [DNA] test at screening) or hepatitis C
- Active tuberculosis
- Receipt of a live, attenuated vaccine within 4 weeks prior to randomization or anticipation that such a live, attenuated vaccine will be required during the study
- Prior treatment with cluster of differentiation (CD) 137 (CD137) agonists or immune checkpoint blockade therapies, including anti-cytotoxic T-lymphocyte-associated protein 4 (anti-CTLA-4), anti-programmed death-1 (anti-PD-1), or anti-programmed death ligand-1 (anti-PD-L1) therapeutic antibodies
- Treatment with systemic immunostimulatory agents (including but not limited to interferons or Interlukin-2 [IL-2]) within 4 weeks or five half-lives of the drug (whichever is shorter) prior to randomization
- Treatment with systemic corticosteroids or other systemic immunosuppressive medications within 2 weeks prior to randomization, or anticipated requirement for systemic immunosuppressive medications during the trial
- Cardiac Exclusion Criteria
- History of clinically significant cardiac dysfunction
- Corrected QT interval at screening greater than (>) 480 milliseconds (ms) (average of triplicate screening measurements)
- Left ventricular ejection fraction (LVEF) below the institutional lower limit of normal or below 50 percent (%), whichever is lower
- General Exclusion Criteria
- No other history of or ongoing malignancy that would potentially interfere with the interpretation of the pharmacodynamic or efficacy assay
- Pregnancy (positive serum pregnancy test) or lactation
- Uncontrolled serious medical or psychiatric illness
- Active infection requiring IV antibiotics on Cycle 1, Day 1
- Participants who have a history of hypersensitivity reactions to paclitaxel or other drugs formulated in Cremophor® EL (polyoxyethylated castor oil) or to nab-paclitaxel and any of the excipients
Trial locations and contacts
53 sites in 13 countries.
53 sites in 13 countries
United States11 sites
Medical University of South Carolina
Charleston, South Carolina, 29425
Ingalls Memorial Hospital
Harvey, Illinois, 60426
Cancer Specialists of North Florida
Jacksonville, Florida, 32256-6932
Mercy Hospital, a Campus of Plantation General Hospital
Miami, Florida, 33133
Cancer Treatment Centers of America
Newnan, Georgia, 30265
Florida Hospital Cancer Inst
Orlando, Florida, 32804
Magee Womens Hospital
Pittsburgh, Pennsylvania, 15213
Florida Cancer Research Institute
Plantation, Florida, 33324
Avera Cancer Institute
Sioux Falls, South Dakota, 57105
Northwest Medical Specialties
Tacoma, Washington, 98405
Montefiore Einstein Cancer Center
The Bronx, New York, 10461
Spain7 sites
Hospital Universitario Infanta Cristina; Servicio de Oncologia
Badajoz, 06080
Organización Sanitaria Integrada Bilbao Basurto
Bilbao, Vizcaya, 48013
Hospital Universitario Ramon y Cajal
Madrid, 28034
Fundacion Jimenez Diaz; Servicio de Oncologia
Madrid, 28040
Hospital Clinico San Carlos; Servicio de Nefrologia
Madrid, 28040
Hosp. Regional Univ. de Malaga ? Hospital Materno Infantil; Hospital Materno Infantil de Malaga
Málaga, 29011
Corporacio Sanitaria Parc Tauli; Servicio de Oncologia
Sabadell, Barcelona, 8208
Italy6 sites
Centro Di Riferimento Oncologico; SOC Oncologia Medica C
Aviano, Friuli Venezia Giulia, 33081
A.O.U Policlinico S. Orsola Malpighi di Bologna U.O di Medicina Interna Borghi - Pad.2
Bologna, Emilia-Romagna, 40138
Istituto Europeo Di Oncologia
Milan, Lombardy, 20141
Azienda Ospedaliero Universitaria Seconda Università Degli Studi Di Napoli
Naples, Campania, 80131
Azienda Ospedaliero - Universitaria Pisana U.O. Oncologia Medica 2 Universitaria ? Polo Oncologico
Pisa, Tuscany, 56126
Policlinico Universitario Agostino Gemelli
Rome, Lazio, 00168
Belgium5 sites
Clinique Edith Cavell
Brussels, 1180
AZ Sint Lucas (Sint Lucas)
Ghent, 9000
Jessa Zkh (Campus Virga Jesse)
Hasselt, 3500
AZ Groeninge
Kortrijk, 8500
AZ Sint Augustinus Veurne
Veurne, 8630
Australia4 sites
Peter MacCallum Cancer Centre; Medical Oncology
Melbourne, Victoria, 3000
St John of God Murdoch Hospital; Oncology West
Murdoch, Western Australia, 6150
Mater Adult Hospital
South Brisbane, Queensland, 4101
Calvary Mater Newcastle
Waratah, New South Wales, 2298
France4 sites
Centre Oscar Lambret
Lille, 59020
Centre Régional de Lutte Contre Le Cancer Val D'aurelle Paul Lamarque
Montpellier, 34298
Hopital Tenon
Paris, 75020
Centre Eugene Marquis Centre Regional de Lutte Contre Le Cancer
Rennes, 35000
South Korea4 sites
National Cancer Center; Medical Oncology
Gyeonggi-do, 410-769
Asan Medical Center
Seoul, 05505
Korea University Guro Hospital
Seoul, 08308
Yonsei University Health System/Severance Hospital
Seoul, 120-752
United Kingdom3 sites
Nuffield Health Bournemouth Hospital
Bournemouth, BH1 1RW
Mount Vernon Hospital
Middlesex, HA6 2RN
Nottingham University Hospitals City Campus
Nottingham, NG5 1PB
Czechia2 sites
Fakultni nemocnice Hradec Kralove
Hradec Králové, 500 05
Multiscan s.r.o.
Pardubice, 532 03
Latvia2 sites
Pauls Stradins Clinical University Hospital
R?ga, LV-1002
Riga East Clinical University Hospital Latvian Oncology Centre
Riga, LV-1079
Romania2 sites
Prof. Dr. I. Chiricuta Institute of Oncology
Cluj-Napoca, 400015
Oncology Center Sf. Nectarie
Craiova, 200347
Taiwan2 sites
Chang Gung Memorial Hospital
Kaohsiung Country, 833
Koo Foundation Sun Yat-Sen Cancer Center; Hemato-Oncology
Taipei, 11259
About this study
Official title: A Multistage, Phase II Study Evaluating the Safety and Efficacy of Cobimetinib Plus Paclitaxel, Cobimetinib Plus Atezolizumab Plus Paclitaxel, or Cobimetinib Plus Atezolizumab Plus Nab-Paclitaxel as First-Line Treatment for Patients With Metastatic Triple-Negative Breast Cancer
This three-cohort, multi-stage, randomized, Phase II, multicenter trial will evaluate the safety and tolerability and estimate the efficacy of cobimetinib plus paclitaxel versus placebo plus paclitaxel in Cohort I, of cobimetinib plus atezolizumab plus paclitaxel in Cohort II, and of cobimetinib plus atezolizumab plus nab-paclitaxel in Cohort III in participants with metastatic or locally advanced, triple-negative adenocarcinoma of the breast who have not received prior systemic therapy for metastatic breast cancer (MBC). Participants may continue on study treatment until the development of progressive disease (PD) or the loss of clinical benefit, unacceptable toxicity, and/or consent withdrawal. The Cohort I target sample size is 12 participants for the safety run-in stage and approximately 90 participants in the expansion stage. Each of Cohorts II and III will consist of a safety run-in stage of approximately 15 participants followed by an expansion stage of approximately 15 participants.
- Conditions
- Breast Cancer
- Being tested
- Cobimetinib, Paclitaxel, Placebo, Atezolizumab, Nab-Paclitaxel
- Medical subject headings
- Breast Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CobimetinibDrug
Also called GDC-0973; RO5514041; XL518
Cobimetinib will be administered orally at a dose of 60 milligrams (mg) per day, once a day, on Day 3 through Day 23 of each 28-day treatment cycle.
PaclitaxelDrug
Paclitaxel will be administered at a dose of 80 milligrams per square meter (mg/m^2) by intravenous (IV) infusion on Day 1, Day 8, and Day 15 of each 28-day cycle according to prescribing information.
PlaceboDrug
Placebo matching to cobimetinib will be administered orally, once a day, on Day 3 through Day 23 of each 28 day treatment cycle.
AtezolizumabDrug
Also called MPDL3280A
Atezolizumab will be administered to Cohorts II and III at a dose of 840 mg IV every 2 weeks on Days 1 and 15 of each 28-day treatment cycle.
Nab-PaclitaxelDrug
Nab-Paclitaxel will be administered to Cohort III according to the local prescribing information at a starting dose of 100 mg/m^2 by IV infusion on Days 1, 8, and 15 of each 28 day cycle.
| Study group | Role | What they receive |
|---|---|---|
| Cohort I: Cobimetinib, Paclitaxel | Experimental | Participants will receive a combination of cobimetinib plus paclitaxel in 28-day cycles until disease progression, unacceptable toxicity, investigator decision, death, withdrawal of consent, or completion of study. Receives: Drug: Cobimetinib; Drug: Paclitaxel |
| Cohort I: Placebo, Paclitaxel | Placebo comparator | Participants will receive a combination of cobimetinib placebo plus paclitaxel in 28-day cycles until disease progression, unacceptable toxicity, investigator decision, death, withdrawal of consent, or completion of study. Receives: Drug: Paclitaxel; Drug: Placebo |
| Cohort II:Cobimetinib,Paclitaxel,Atezolizumab | Experimental | Participants will receive cobimetinib plus paclitaxel plus atezolizumab in 28-day cycles until disease progression, unacceptable toxicity, investigator decision, death, withdrawal of consent, or completion of study. Receives: Drug: Cobimetinib; Drug: Paclitaxel; Drug: Atezolizumab |
| Cohort III: Cobimetinib, Nab-Paclitaxel, Atezolizumab | Experimental | Participants will receive cobimetinib plus nab-paclitaxel plus atezolizumab until disease progression, unacceptable toxicity, investigator decision, death, withdrawal of consent, or completion of study. Receives: Drug: Cobimetinib; Drug: Atezolizumab; Drug: Nab-Paclitaxel |
What is being measured
The primary outcome is the main question the study is designed to answer.
Cohort I: Progression-Free Survival, as Determined by Investigator Using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)
PFS was defined as the time from randomization to the first occurrence of disease progression or relapse, as determined by the investigator, using RECIST v1.1. As per RECIST v1.1, progressive disease (PD) is defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (nadir), including baseline. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 millimeters (mm). The appearance of one or more new lesions is also considered progression.
Measured: Randomization up to disease progression or relapse, whichever occurs first (up to approximately 2 years)
Cohort II, III: Percentage of Participants With Confirmed Overall Response (OR) (Partial Response [PR] or Complete Response [CR]), as Determined by the Investigator Using RECIST v1.1
OR was defined as the rate of a PR or CR occurring after randomization and confirmed >=28 days later as determined by the investigator using RECIST v1.1. As per RECIST v1.1, CR is defined as the disappearance of all target lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to <10 mm. PR is defined as at least a 30% decrease in the sum of diameters of all target and new measurable lesions.
Measured: Randomization up to disease progression or relapse, whichever occurs first (up to approximately 5.25 years)
Secondary outcomes (18)
Cohort I, II, III: Overall Survival (OS)
OS was defined as the time from randomization to death from any cause
Measured: Randomization up to death from any cause (up to approximately 6.5 years)
Cohort I: Percentage of Participants With Confirmed OR (PR or CR), as Determined by the Investigator Using RECIST v1.1
OR was defined as the rate of a PR or CR occurring after randomization and confirmed >=28 days later as determined by the investigator using RECIST v1.1. As per RECIST v1.1, CR is defined as the disappearance of all target lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to <10 mm. PR is defined as at least a 30% decrease in the sum of diameters of all target and new measurable lesions.
Measured: Randomization up to disease progression or relapse, whichever occurs first (up to approximately 2 years)
Cohort I, II, III: Duration of Response (DOR), as Determined by the Investigator Using RECIST v1.1
DOR was defined as the time from the first occurrence of a documented objective response to the time of relapse, as determined by the investigator using RECIST v1.1 or death from any cause during the study, whichever occurred first.
Measured: Time from the first occurrence of documented objective response to time of relapse or death, whichever occurs first (up to approximately 6.5 years)
Cohort I, II, III: Percentage of Participants With Unconfirmed Overall Response (OR_uc) (Unconfirmed PR or CR), as Determined by the Investigator Using RECIST v1.1
ORR_uc (ORR confirmation not required) was defined as the rate of a PR or CR occurring after randomization as determined by the investigator using RECIST v1.1, confirmation not required. As per RECIST v1.1, CR is defined as the disappearance of all target lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to <10 mm. PR is defined as at least a 30% decrease in the sum of diameters of all target and new measurable lesions.
Measured: Randomization up to disease progression or relapse, whichever occurs fist (up to approximately 6.5 years)
Cohort II, III: Progression-Free Survival, as Determined by Investigator Using RECIST v1.1
PFS was defined as the time from randomization to the first occurrence of disease progression or relapse, as determined by the investigator, using RECIST v1.1. As per RECIST v1.1, PD is defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (nadir), including baseline. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered progression.
Measured: Randomization up to disease progression or relapse, whichever occurs first (up to approximately 6.5 years)
Cohort I, II, III: Percentage of Participants With Adverse Events (AEs)
Measured: Randomization up to end of study (up to approximately 6.5 years)
Cohort I, II, III: Maximum Plasma Concentration (Cmax) of Cobimetinib
Measured: Safety Run-In: Predose (Hour [Hr] 0) on Cycle (Cy) 1 Day (D) 8; predose (Hr 0), 0.5, 1, 2, 4, 6 Hr postdose (2, 4 Hr postdose for Cohorts II, III) on Cy1 D15; Expansion: predose (Hr 0), 1-4 Hr postdose on Cy1 D15; predose (Hr 0) on Cy2 D15 (Cy=28 days)
Cohort I, II, III: Minimum Plasma Concentration (Cmin) of Cobimetinib
Measured: Safety Run-In: Predose (Hr 0) on Cy 1 D8; predose (Hr 0), 0.5, 1, 2, 4, 6 Hr postdose (2, 4 Hr postdose for Cohorts II, III) on Cy1 D15; Expansion: predose (Hr 0), 1-4 Hr postdose on Cy1 D15; predose (Hr 0) on Cy2 D15 (Cy=28 days)
Cohort I: Area Under the Concentration-Time Curve From Time Zero to Dosing Interval (AUC0-tau; Total Exposure) of Cobimetinib
Measured: Safety Run-In: Predose (Hr 0) on Cy 1 D8; predose (Hr 0), 0.5, 1, 2, 4, 6 Hr postdose on Cy1 D15; Expansion: predose (Hr 0), 1-4 Hr postdose on Cy1 D15 (Cy=28 days)
Cohort I, II: Cmax of Paclitaxel
Measured: Safety Run-In: Predose (Hr 0) on Cy1 D8; predose (Hr 0), 0.5, 1, 2, 4, and 6 Hr postdose (2, 4 Hr postdose for Cohort II) (infusion duration: 1 Hr) on Cy1 D15 (Cy=28 days)
Cohort I, II: Cmin of Paclitaxel
Measured: Safety Run-In: Predose (Hr 0) on Cy1 D8; predose (Hr 0), 0.5, 1, 2, 4, and 6 Hr postdose (2, 4 Hr postdose for Cohort II) (infusion duration: 1 Hr) on Cy1 D15 (Cy=28 days)
Cohort I: AUC0-tau of Paclitaxel
Measured: Safety Run-In: Predose (Hr 0) on Cy1 D8; predose (Hr 0), 0.5, 1, 2, 4, and 6 Hr postdose (infusion duration: 1 Hr) on Cy1 D15 (Cy=28 days)
Cohort III: Cmax of Nab-Paclitaxel
Measured: Safety Run-In: Predose (Hr 0) on Cy1 D8; predose (Hr 0), 2, 4 Hr postdose (infusion duration: 30 minutes) on Cy1 D15 (Cy=28 days)
Cohort III: Cmin of Nab-Paclitaxel
Measured: Safety Run-In: Predose (Hr 0) on Cy1 D8; predose (Hr 0), 2, 4 Hr postdose (infusion duration: 30 minutes) on Cy1 D15 (Cy=28 days)
Cohort III: AUC0-tau of Nab-Paclitaxel
Measured: Safety Run-In: Predose (Hr 0) on Cy1 D8; predose (Hr 0), 2, 4 Hr postdose (infusion duration: 30 minutes) on Cy1 D15 (Cy=28 days)
Cohort II, III: Cmax (in Serum) of Atezolizumab
Measured: Safety Run-In, Expansion:Predose (Hr0), 0.5Hr postdose (infusion duration:1Hr) on D1 of Cy1, 3; predose (Hr0) on D1 of Cy2, 4, 8, every 8 Cy up to end of treatment (EOT); 120 days after EOT (approximately 5.25 years) (Cy=28 days)
Cohort II, III: Cmin (in Serum) of Atezolizumab
Measured: Safety Run-In, Expansion: Predose (Hr 0), 0.5 Hr postdose (infusion duration: 1 Hr) on D1 of Cy1, 3; predose (Hr 0) on D1 of Cy2, 4, 8, every 8 Cy up to EOT; 120 days after EOT (approximately 5.5 years) (Cy=28 days)
Cohort II, III: AUC0-tau (in Serum) of Atezolizumab
Measured: Safety Run-In, Expansion: Predose (Hr 0), 0.5 Hr postdose (infusion duration: 1 Hr) on D1 of Cy1, 3; predose (Hr 0) on D1 of Cy2, 4, 8, every 8 Cy up to EOT (approximately 5.5 years); 120 days after EOT (approximately 5.5 years) (Cy=28 days)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Dec 2014 (estimated)
- Study start12 Mar 2015
- Primary completion10 Aug 2018
- Study completion17 Sep 2021
Why it stopped: Sponsor's decision
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- More trials run by Hoffmann-La RocheThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 169 participants (actual)
Sponsor and investigators
- Lead sponsor
- Hoffmann-La Roche
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Clinical Trials, Study director, Hoffmann-La Roche
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02322814
- Sponsor's protocol ID
- WO29479
- Other IDs
- 2014-002230-32, 2014
- Status last verified
- Mar 2023
- First submitted
- 19 Dec 2014
- Last updated
- 13 Apr 2023
- Results posted
- Yes, on ClinicalTrials.gov
Publications
Barteselli G, Goodman GR, Patel Y, Caro I, Xue C, McCallum S. Characterization of Serous Retinopathy Associated with Cobimetinib: Integrated Safety Analysis of Four Studies. Drug Saf. 2022 Dec;45(12):1491-1499. doi: 10.1007/s40264-022-01248-2. Epub 2022 Oct 30.
PubMed 36310331
Study at a glance
From the registry record, last updated by the sponsor on 13 Apr 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Multistage, Phase II Study Evaluating the Safety and Efficacy of Cobimetinib Plus Paclitaxel, Cobimetinib Plus Atezolizumab Plus Paclitaxel, or Cobimetinib Plus Atezolizumab Plus Nab-Paclitaxel as First-Line Treatment for Patients With Metastatic Triple-Negative Breast Cancer
- ClinicalTrials.gov ID
- NCT02322814
- Acronym / sponsor ID
- WO29479
- Conditions
- Breast Cancer
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Sponsor's decision
- Enrolment
- 169 participants (actual)
- Lead sponsor
- Hoffmann-La RocheIndustry (pharma, biotech, devices)
- Study start
- 12 Mar 2015 (actual)
- Primary completion
- 10 Aug 2018 (actual)
- Study completion
- 17 Sep 2021 (actual)
- First posted
- 23 Dec 2014 (estimated)
- Results
- Posted 13 Nov 2019
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This three-cohort, multi-stage, randomized, Phase II, multicenter trial will evaluate the safety and tolerability and estimate the efficacy of cobimetinib plus paclitaxel versus placebo plus paclitaxel in Cohort I, of cobimetinib plus atezolizumab plus paclitaxel in Cohort II, and of cobimetinib plus atezolizumab plus nab-paclitaxel in Cohort III in participants with metastatic or locally advanced, triple-negative adenocarcinoma of the breast who have not received prior systemic therapy for metastatic breast cancer (MBC). Participants may continue on study treatment until the development of progressive disease (PD) or the loss of clinical benefit, unacceptable toxicity, and/or consent withdrawal. The Cohort I target sample size is 12 participants for the safety run-in stage and approximately 90 participants in the expansion stage. Each of Cohorts II and III will consist of a safety run-in stage of approximately 15 participants followed by an expansion stage of approximately 15 participants.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Cohort I: Cobimetinib, Paclitaxel | Experimental | Drug: Cobimetinib, Drug: PaclitaxelParticipants will receive a combination of cobimetinib plus paclitaxel in 28-day cycles until disease progression, unacceptable toxicity, investigator decision, death, withdrawal of consent, or completion of study. |
| Cohort I: Placebo, Paclitaxel | Placebo comparator | Drug: Paclitaxel, Drug: PlaceboParticipants will receive a combination of cobimetinib placebo plus paclitaxel in 28-day cycles until disease progression, unacceptable toxicity, investigator decision, death, withdrawal of consent, or completion of study. |
| Cohort II:Cobimetinib,Paclitaxel,Atezolizumab | Experimental | Drug: Cobimetinib, Drug: Paclitaxel, Drug: AtezolizumabParticipants will receive cobimetinib plus paclitaxel plus atezolizumab in 28-day cycles until disease progression, unacceptable toxicity, investigator decision, death, withdrawal of consent, or completion of study. |
| Cohort III: Cobimetinib, Nab-Paclitaxel, Atezolizumab | Experimental | Drug: Cobimetinib, Drug: Atezolizumab, Drug: Nab-PaclitaxelParticipants will receive cobimetinib plus nab-paclitaxel plus atezolizumab until disease progression, unacceptable toxicity, investigator decision, death, withdrawal of consent, or completion of study. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Histologically confirmed estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and human epidermal growth factor 2 (HER2)-negative adenocarcinoma of the breast with measurable metastatic or locally advanced disease
- Locally advanced disease must not be amenable to resection with curative intent
- Measurable disease, according to RECIST, v1.1
- Adequate hematologic and end organ function
Key exclusion criteria (34 listed)
- Disease-Specific Exclusion Criteria
- Known HER2-, ER-positive, or PR-positive breast cancer by local laboratory assessment
- Any prior chemotherapy, hormonal, or targeted therapy, for inoperable locally advanced or metastatic triple-negative breast cancer (mTNBC)
- Any systemic anticancer therapy within 3 weeks prior to Cycle 1, Day 1
- Any radiation treatment to metastatic site within 28 days of Cycle 1, Day 1
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| CobimetinibAlso: GDC-0973; RO5514041; XL518Cobimetinib will be administered orally at a dose of 60 milligrams (mg) per day, once a day, on Day 3 through Day 23 of each 28-day treatment cycle. | Drug | Cohort I: Cobimetinib, Paclitaxel, Cohort II:Cobimetinib,Paclitaxel,Atezolizumab, Cohort III: Cobimetinib, Nab-Paclitaxel, Atezolizumab |
| PaclitaxelPaclitaxel will be administered at a dose of 80 milligrams per square meter (mg/m^2) by intravenous (IV) infusion on Day 1, Day 8, and Day 15 of each 28-day cycle according to prescribing information. | Drug | Cohort I: Cobimetinib, Paclitaxel, Cohort I: Placebo, Paclitaxel, Cohort II:Cobimetinib,Paclitaxel,Atezolizumab |
| PlaceboPlacebo matching to cobimetinib will be administered orally, once a day, on Day 3 through Day 23 of each 28 day treatment cycle. | Drug | Cohort I: Placebo, Paclitaxel |
| AtezolizumabAlso: MPDL3280AAtezolizumab will be administered to Cohorts II and III at a dose of 840 mg IV every 2 weeks on Days 1 and 15 of each 28-day treatment cycle. | Drug | Cohort II:Cobimetinib,Paclitaxel,Atezolizumab, Cohort III: Cobimetinib, Nab-Paclitaxel, Atezolizumab |
| Nab-PaclitaxelNab-Paclitaxel will be administered to Cohort III according to the local prescribing information at a starting dose of 100 mg/m^2 by IV infusion on Days 1, 8, and 15 of each 28 day cycle. | Drug | Cohort III: Cobimetinib, Nab-Paclitaxel, Atezolizumab |
Primary outcome
Cohort I: Progression-Free Survival, as Determined by Investigator Using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)
Time frame: Randomization up to disease progression or relapse, whichever occurs first (up to approximately 2 years)
PFS was defined as the time from randomization to the first occurrence of disease progression or relapse, as determined by the investigator, using RECIST v1.1. As per RECIST v1.1, progressive disease (PD) is defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (nadir), including baseline. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 millimeters (mm). The appearance of one or more new lesions is also considered progression.
Cohort II, III: Percentage of Participants With Confirmed Overall Response (OR) (Partial Response [PR] or Complete Response [CR]), as Determined by the Investigator Using RECIST v1.1
Time frame: Randomization up to disease progression or relapse, whichever occurs first (up to approximately 5.25 years)
OR was defined as the rate of a PR or CR occurring after randomization and confirmed >=28 days later as determined by the investigator using RECIST v1.1. As per RECIST v1.1, CR is defined as the disappearance of all target lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to <10 mm. PR is defined as at least a 30% decrease in the sum of diameters of all target and new measurable lesions.
18 secondary outcomes
Cohort I, II, III: Overall Survival (OS)
Time frame: Randomization up to death from any cause (up to approximately 6.5 years)
Cohort I: Percentage of Participants With Confirmed OR (PR or CR), as Determined by the Investigator Using RECIST v1.1
Time frame: Randomization up to disease progression or relapse, whichever occurs first (up to approximately 2 years)
Cohort I, II, III: Duration of Response (DOR), as Determined by the Investigator Using RECIST v1.1
Time frame: Time from the first occurrence of documented objective response to time of relapse or death, whichever occurs first (up to approximately 6.5 years)
Cohort I, II, III: Percentage of Participants With Unconfirmed Overall Response (OR_uc) (Unconfirmed PR or CR), as Determined by the Investigator Using RECIST v1.1
Time frame: Randomization up to disease progression or relapse, whichever occurs fist (up to approximately 6.5 years)
Cohort II, III: Progression-Free Survival, as Determined by Investigator Using RECIST v1.1
Time frame: Randomization up to disease progression or relapse, whichever occurs first (up to approximately 6.5 years)
Cohort I, II, III: Percentage of Participants With Adverse Events (AEs)
Time frame: Randomization up to end of study (up to approximately 6.5 years)
Cohort I, II, III: Maximum Plasma Concentration (Cmax) of Cobimetinib
Time frame: Safety Run-In: Predose (Hour [Hr] 0) on Cycle (Cy) 1 Day (D) 8; predose (Hr 0), 0.5, 1, 2, 4, 6 Hr postdose (2, 4 Hr postdose for Cohorts II, III) on Cy1 D15; Expansion: predose (Hr 0), 1-4 Hr postdose on Cy1 D15; predose (Hr 0) on Cy2 D15 (Cy=28 days)
Cohort I, II, III: Minimum Plasma Concentration (Cmin) of Cobimetinib
Time frame: Safety Run-In: Predose (Hr 0) on Cy 1 D8; predose (Hr 0), 0.5, 1, 2, 4, 6 Hr postdose (2, 4 Hr postdose for Cohorts II, III) on Cy1 D15; Expansion: predose (Hr 0), 1-4 Hr postdose on Cy1 D15; predose (Hr 0) on Cy2 D15 (Cy=28 days)
Cohort I: Area Under the Concentration-Time Curve From Time Zero to Dosing Interval (AUC0-tau; Total Exposure) of Cobimetinib
Time frame: Safety Run-In: Predose (Hr 0) on Cy 1 D8; predose (Hr 0), 0.5, 1, 2, 4, 6 Hr postdose on Cy1 D15; Expansion: predose (Hr 0), 1-4 Hr postdose on Cy1 D15 (Cy=28 days)
Cohort I, II: Cmax of Paclitaxel
Time frame: Safety Run-In: Predose (Hr 0) on Cy1 D8; predose (Hr 0), 0.5, 1, 2, 4, and 6 Hr postdose (2, 4 Hr postdose for Cohort II) (infusion duration: 1 Hr) on Cy1 D15 (Cy=28 days)
Cohort I, II: Cmin of Paclitaxel
Time frame: Safety Run-In: Predose (Hr 0) on Cy1 D8; predose (Hr 0), 0.5, 1, 2, 4, and 6 Hr postdose (2, 4 Hr postdose for Cohort II) (infusion duration: 1 Hr) on Cy1 D15 (Cy=28 days)
Cohort I: AUC0-tau of Paclitaxel
Time frame: Safety Run-In: Predose (Hr 0) on Cy1 D8; predose (Hr 0), 0.5, 1, 2, 4, and 6 Hr postdose (infusion duration: 1 Hr) on Cy1 D15 (Cy=28 days)
Cohort III: Cmax of Nab-Paclitaxel
Time frame: Safety Run-In: Predose (Hr 0) on Cy1 D8; predose (Hr 0), 2, 4 Hr postdose (infusion duration: 30 minutes) on Cy1 D15 (Cy=28 days)
Cohort III: Cmin of Nab-Paclitaxel
Time frame: Safety Run-In: Predose (Hr 0) on Cy1 D8; predose (Hr 0), 2, 4 Hr postdose (infusion duration: 30 minutes) on Cy1 D15 (Cy=28 days)
Cohort III: AUC0-tau of Nab-Paclitaxel
Time frame: Safety Run-In: Predose (Hr 0) on Cy1 D8; predose (Hr 0), 2, 4 Hr postdose (infusion duration: 30 minutes) on Cy1 D15 (Cy=28 days)
Cohort II, III: Cmax (in Serum) of Atezolizumab
Time frame: Safety Run-In, Expansion:Predose (Hr0), 0.5Hr postdose (infusion duration:1Hr) on D1 of Cy1, 3; predose (Hr0) on D1 of Cy2, 4, 8, every 8 Cy up to end of treatment (EOT); 120 days after EOT (approximately 5.25 years) (Cy=28 days)
Cohort II, III: Cmin (in Serum) of Atezolizumab
Time frame: Safety Run-In, Expansion: Predose (Hr 0), 0.5 Hr postdose (infusion duration: 1 Hr) on D1 of Cy1, 3; predose (Hr 0) on D1 of Cy2, 4, 8, every 8 Cy up to EOT; 120 days after EOT (approximately 5.5 years) (Cy=28 days)
Cohort II, III: AUC0-tau (in Serum) of Atezolizumab
Time frame: Safety Run-In, Expansion: Predose (Hr 0), 0.5 Hr postdose (infusion duration: 1 Hr) on D1 of Cy1, 3; predose (Hr 0) on D1 of Cy2, 4, 8, every 8 Cy up to EOT (approximately 5.5 years); 120 days after EOT (approximately 5.5 years) (Cy=28 days)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Apr 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 36310331Barteselli G, Goodman GR, Patel Y, Caro I, Xue C, McCallum S. Characterization of Serous Retinopathy Associated with Cobimetinib: Integrated Safety Analysis of Four Studies. Drug Saf. 2022 Dec;45(12):1491-1499. doi: 10.1007/s40264-022-01248-2. Epub 2022 Oct 30.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Clinical Trials study director
Hoffmann-La Roche
53 sites in 13 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Cobimetinib, Paclitaxel and Atezolizumab in people with Breast Cancer, run by Hoffmann-La Roche at 53 sites in 13 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 34 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 13 Apr 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 53 sites in United States, Spain, Italy, Belgium, Australia and 8 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 13 Nov 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Cohort I: Progression-Free Survival, as Determined by Investigator Using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) (time frame: Randomization up to disease progression or relapse, whichever occurs first (up to approximately 2 years)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02322814, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Apr 2023.