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NeoplasmsPhase 1NCT02964507

Dose Escalation and Expansion Study of GSK525762 in Combination With Fulvestrant in Participants With Hormone Receptor-positive (HR+)/Human Epidermal Growth Factor Receptor 2 Negative (HER2-) Advanced or Metastatic Breast Cancer

A Phase 1 study testing GSK525762 and Fulvestrant in people with Neoplasms, run by GlaxoSmithKline at 38 sites in 7 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This is a combination Phase I and Phase II study, with an aim to evaluate the combination of GSK525762 and fulvestrant in women with HR+/HER2- advanced or metastatic breast cancer, who have disease that has progressed after prior treatment with at least one line of endocrine therapy. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Neoplasms
What is being tested?
GSK525762 and Fulvestrant
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
124 participants
Where
38 sitesin 7 countries
Study dates
26 Sep 2019to 19 Jul 2021
Phase
Phase 1
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
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Written informed consent provided.
  • Females 18 years old and greater (at the time of written consent)
  • Histologically or cytologically confirmed diagnosis of advanced or metastatic adenocarcinoma of the breast.
  • Documentation of estrogen receptor (ER)-positive and/or progesterone receptor (PR)-positive tumor (>=1% positive stained tumor cell nuclei) based on local testing of the most recent tumor biopsy, using an assay consistent with local standards.
  • Documentation of HER2-negative tumor based on local testing of the most recent tumor biopsy as per most recent American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines. At the time of writing, HER2-negative tumor is defined as immunohistochemistry (IHC) score of 0 or 1+, or negative by in situ hybridization defined as a HER2/chromosome enumeration probe 17 (CEP17) ratio <2 or for single probe assessment of an average HER2 copy number <4.
  • Provision of mandatory screening fresh tumor biopsy sample during the screening period: a. Screening biopsy can be waived if a biopsy was collected within 3 months prior to first dose of study drug and was collected after the last anti-cancer treatment before coming into this study; b. Participants with inaccessible site of biopsy or who have a significant medical risk of obtaining the biopsy should be discussed with the Medical Monitor if they can qualify; c. Bone biopsies are not acceptable. Biopsies should be obtained from bone with metastatic soft-tissue component. Participants with bone only disease may be enrolled upon review by Medical Monitor.
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  • History of prior therapy that satisfies one of the following criteria: a. Aromatase inhibitor (AI) failures: Disease that relapsed during treatment or within 12 months of completion of adjuvant therapy with an AI, OR disease that progressed during treatment with an AI for advanced/metastatic disease. Prior ovarian suppression and/or tamoxifen are allowed as long as other criteria are met; b. Cyclin-dependent kinase 4/6 (CDK4/6) inhibitor plus AI failures: Disease that progressed on a CDK4/6 inhibitor plus AI, for advanced/metastatic disease with a minimum duration of treatment of 12 months (>=12 months) with CDK4/6 inhibitor plus AI. Participants with either measurable disease or bone only disease are allowed. Prior ovarian suppression and/or tamoxifen are allowed as long as other criteria are met.
  • Documented progression on last line of systemic anti-cancer therapy with CDK4/6 inhibitor plus AI is required.
  • Any menopausal status.
  • Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria is required except for participants with bone only disease.
  • All prior treatment- related toxicities must be National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 4 <=Grade 1 (except alopecia (permitted at any grade) and peripheral neuropathy (permitted at <=Grade 2) at the time of treatment allocation.
  • Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0 to 1.
  • Adequate organ function.
  • Able to swallow and retain orally administered medication.
  • A female participant is eligible to participate if she is of: i) Non-childbearing potential. ii) Child-bearing potential and agrees to use one of the contraception methods. iii) Negative serum pregnancy test <=7 days prior to first study drug dose. iv) Female participants who are lactating must discontinue nursing prior to the first dose of study treatment and must refrain from nursing throughout the treatment period and for at least 28 days following the last dose of study treatment.

Who cannot join

  • Prior therapy with any Bromodomain and extra-terminal (BET) inhibitor, any selective estrogen receptor degrader (SERD) including fulvestrant, or inhibitors of the Phosphoinositide-3-kinase (PI3K)/ serine/threonine-specific protein kinase (AKT)/Mammalian Target of Rapamycin (mTOR) pathway.
  • Prior therapy with more than one line of cytotoxic chemotherapy following diagnosis of advanced/metastatic disease.
  • More than or equal to 3 lines of systemic anti-cancer therapy in the advanced or metastatic setting.
  • Recent prior therapy, defined as: a. Any investigational or approved non-biologic anti-cancer drug within 14 days or five half-life (whichever is greater) prior to the first dose of GSK525762 and fulvestrant. b. Any nitrosoureas or mitomycin C within 42 days prior to the first dose of GSK525762 and fulvestrant c. Any anti-cancer biologic agents within 42 days prior to the first dose of GSK525762 and fulvestrant. d. Any radiotherapy within 14 days prior to the first dose of GSK525762 and fulvestrant. If the participant received radiotherapy <90 days prior to study treatment, the irradiated lesion cannot be the only lesion used for evaluating response.
  • Any major surgery within 28 days prior to the first dose of GSK525762 and fulvestrant
  • Concomitant active malignancy other than HR+/HER2- breast cancer
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  • Therapeutic-dose anticoagulation (e.g., warfarin, low-molecular weight heparin [LMWH], or novel oral anticoagulants) must be discontinued and coagulation parameters must be normalized prior to the first dose of GSK525762 and fulvestrant. Prophylactic anticoagulation, with low doses (per standard practice) of agents such as LMWH, direct thrombin inhibitors, or factor Xa inhibitors is permitted.
  • Current use of a prohibited medication or planned use of any forbidden medications during treatment with GSK525762 and fulvestrant. This includes medications with significant risk of Torsades de pointes as well as those that are potent inducers or inhibitors of Cytochrome P3A4 (CYP3A4) enzymes.
  • Evidence of severe or uncontrolled systemic diseases (e.g., unstable or uncompensated respiratory, hepatic, renal, cardiac disease, or clinically significant bleeding episodes). Any serious and/or unstable pre-existing medical (aside from malignancy), psychiatric disorder, or other conditions that could interfere with participant's safety, obtaining informed consent or compliance to the study procedures, in the opinion of the Investigator. a) Systolic blood pressure higher than 150 millimeters of mercury (mmHg) or diastolic blood pressure higher than 90 mmHg found on 2 separate occasions separated by 1 week, despite adequate therapy, will be defined as uncontrolled hypertension. b) Uncontrolled diabetes mellitus (despite therapeutic; compliance to intervention) as defined by a hemoglobin A1c (HbA1c) level more than 8% and/or occurrence of more than two episodes of ketoacidosis in the 12 months prior to the first dose of study drug.
  • Participants with advanced/metastatic, symptomatic, visceral spread, that are at risk of life-threatening complications in the short term including participants with massive uncontrolled effusions (pleural, pericardial, peritoneal), pulmonary lymphangitis, and over 50 percent (%) of liver involvement in metastases.
  • Symptomatic or untreated leptomeningeal or brain metastases or spinal cord compression.
  • Cardiac abnormalities as evidenced by any of the following: Baseline QT interval corrected by Fridericia's formula (QTcF) interval >=480 milliseconds (msec); Clinically significant conduction abnormalities or arrhythmias; Presence of cardiac pacemaker or defibrillator with a paced ventricular rhythm limiting electrocardiogram analysis; History or evidence of current >=Class II congestive heart failure as defined by New York Heart Association (NYHA); History of acute coronary syndromes (including unstable angina and myocardial infarction), coronary angioplasty, or stenting within the past 3 months. Participants with a history of stent placement requiring ongoing antithrombotic therapy (e.g., clopidogrel, prasugrel) will not be permitted to enroll; Clinically significant cardiomegaly, ventricular hypertrophy, or cardiomyopathy.
  • Current active liver or biliary disease (with the exception of Gilbert's syndrome or asymptomatic gallstones, liver metastases or otherwise stable chronic liver disease per investigator assessment).
  • Presence of hepatitis B surface antigen (HBsAg) or positive hepatitis C antibody test result at screening.
  • History of known human immunodeficiency virus (HIV) infection.
  • Any serious known immediate or delayed hypersensitivity reaction(s) to GSK525762 or fulvestrant, or idiosyncrasy to drugs chemically related to the investigational drugs.
  • Hemoptysis >1 teaspoon in 24 hours within the last 28 days.
  • Concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs) (except for cases where NSAIDs provide benefit over other analgesics and in these cases, consideration should be given to the prophylactic administration of a proton pump inhibitor) and high dose aspirin (allowed up to <=100 milligrams orally daily).
  • Participants with history of known bleeding disorder(s) including clinically significant hemorrhage (e.g., gastrointestinal, neurologic), within the past 6 months.
  • Any clinically significant gastrointestinal abnormalities that may alter absorption, such as malabsorption syndrome, chronic gastrointestinal disease, or major resection of the stomach and/or bowels that could preclude adequate absorption of the study medication.

Trial locations and contacts

38 sites in 7 countries.

38 sites in 7 countries

United States15 sites
  • GSK Investigational Site

    Birmingham, Alabama, 35249

  • GSK Investigational Site

    Chicago, Illinois, 60611

  • GSK Investigational Site

    Gilbert, Arizona, 85234

  • GSK Investigational Site

    Houston, Texas, 77030

  • GSK Investigational Site

    Kansas City, Missouri, 64111

  • GSK Investigational Site

    New Orleans, Louisiana, 70121

  • GSK Investigational Site

    Plantation, Florida, 33324

  • GSK Investigational Site

    Providence, Rhode Island, 02903

  • GSK Investigational Site

    Rochester, Minnesota, 55905

  • GSK Investigational Site

    San Diego, California, 92123

  • GSK Investigational Site

    Scottsdale, Arizona, 85259

  • GSK Investigational Site

    Seattle, Washington, 98101

  • GSK Investigational Site

    St Louis, Missouri, 63110

  • GSK Investigational Site

    The Bronx, New York, 10461

  • GSK Investigational Site

    White Plains, New York, 10601

Other trials in United States

United Kingdom6 sites
  • GSK Investigational Site

    Glasgow, G12 OYN

  • GSK Investigational Site

    London, EC1M 6BQ

  • GSK Investigational Site

    London, NW1 2PG

  • GSK Investigational Site

    Manchester, Lancashire, M20 4BX

  • GSK Investigational Site

    Northwood, Middlesex, HA6 2RN

  • GSK Investigational Site

    Nottingham, Nottinghamshire, NG5 1PB

Other trials in United Kingdom

Canada5 sites
  • GSK Investigational Site

    Montreal, Quebec, H2L 4M1

  • GSK Investigational Site

    Montreal, Quebec, H3T 1E2

  • GSK Investigational Site

    Ottawa, Ontario, K1H 8L6

  • GSK Investigational Site

    Québec, Quebec, G1S 4L8

  • GSK Investigational Site

    Toronto, Ontario, M5G 2M9

Other trials in Canada

South Korea4 sites
  • GSK Investigational Site

    Gyeonggi-do, 410-769

  • GSK Investigational Site

    Seoul, 120-752

  • GSK Investigational Site

    Seoul, 135-710

  • GSK Investigational Site

    Seoul, 138-736

Other trials in South Korea

Australia3 sites
  • GSK Investigational Site

    Bedford Park, South Australia, 5042

  • GSK Investigational Site

    Heidelberg, Victoria, 3084

  • GSK Investigational Site

    Port Macquarie, New South Wales, 2444

Other trials in Australia

Spain3 sites
  • GSK Investigational Site

    A Coruña, 15006

  • GSK Investigational Site

    Barcelona, 8035

  • GSK Investigational Site

    Lleida, 25198

Other trials in Spain

France2 sites
  • GSK Investigational Site

    Bordeaux, 33076

  • GSK Investigational Site

    Saint-Herblain, 44805

Other trials in France

About this study

Official title: A Phase I/II Dose Escalation and Expansion Study to Investigate the Safety, Pharmacokinetics, Pharmacodynamics and Clinical Activity of GSK525762 in Combination With Fulvestrant in Subjects With Hormone Receptor-positive/HER2-negative (HR+/HER2-) Advanced or Metastatic Breast Cancer

This is a combination Phase I and Phase II study, with an aim to evaluate the combination of GSK525762 and fulvestrant in women with HR+/HER2- advanced or metastatic breast cancer, who have disease that has progressed after prior treatment with at least one line of endocrine therapy. The objectives of the study are to first identify, in open-label single-arm Phase I, a recommended Phase II dose of GSK525762 that may be combined safely with fulvestrant. Phase I will follow a modified toxicity probability interval (mTPI) design, and a sentinel group will be evaluated first for dose-limiting toxicity and further expanded to collect additional safety data. This will be followed by a double-blind, randomized controlled Phase II, to identify the clinical activity of the two study treatments when given in combination. The composition of Phase II will be selected at the end of Phase I.

Conditions
Neoplasms
Being tested
GSK525762, Placebo, Fulvestrant
Keywords
GSK525762, HR+/HER2- advanced or metastatic breast cancer, mTPI
Medical subject headings
Neoplasms, Breast Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • GSK525762Drug

    GSK525762 will be administered.

  • PlaceboDrug

    Placebo will be administered.

  • FulvestrantDrug

    Fulvestrant will be administered.

Study groups in NCT02964507
Study groupRoleWhat they receive
GSK525762 + Fulvestrant (Phase I)ExperimentalNot described
Receives: Drug: GSK525762; Drug: Fulvestrant
GSK525762 + Fulvestrant (Phase II)ExperimentalNot described
Receives: Drug: GSK525762; Drug: Fulvestrant
Placebo + Fulvestrant (Phase II)Placebo comparatorNot described
Receives: Drug: Placebo; Drug: Fulvestrant

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Phase I: Number of Participants With Non-serious Adverse Events (AEs) and Serious Adverse Events (SAEs)

    An AE is defined as any untoward medical occurrence in a participant or clinical investigation participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. A SAE is defined as any untoward medical occurrence that, at any dose results in death, is life-threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, is a congenital anomaly/birth defect, any other situation such as important medical events according to medical or scientific judgement or is associated with liver injury and impaired liver function. Any other adverse event apart from SAE is considered as non-SAE.

    Measured: Up to 3 year and 8 months

  2. Phase I: Number of Participants With Dose Limiting Toxicities (DLTs)

    An event was considered DLT if it occurred within first 28 days of treatment and met one of following DLT criteria: Grade3 or greater neutropenia for >=5 days, febrile neutropenia, Grade4 anemia of any duration, Grade4 thrombocytopenia of any duration or Grade3 thrombocytopenia with bleeding, alanine aminotransferase (ALT) >3 times (x) upper limit of normal (ULN)+bilirubin >=2x ULN (>35 % direct) or ALT between 3-5xULN with bilirubin <2xULN but with hepatitis symptoms or rash, Grade3 nausea,vomiting or diarrhea that did not improve within 72hour despite appropriate supportive treatment(s), Grade4 nausea,vomiting,or diarrhea, Grade3 hypertension (uncontrolled despite addition of upto 2 antihypertensive medications), Grade4 hypertension, other Grade3 or greater clinically significant non-hematologic toxicity (including QT duration corrected for heart rate by Fridericia's formula (QTcF), ejection fraction <lower limit of normal (LLN) with an absolute decrease of >10% from Baseline.

    Measured: Up to 28 days

  3. Phase I: Number of Participants With Dose Reductions and Dose Interruption/Delays

    Number of participants with dose reductions and dose interruption or delay due to any reason is presented.

    Measured: Up to 3 year and 8 months

  4. Phase I: Objective Response Rate-Investigator Assessment

    Objective Response Rate is defined as the percentage of participants who demonstrate a Best Response of confirmed complete response (CR) or partial response (PR), as assessed by the investigator per response evaluation criteria in solid tumors (RECIST) version (v) 1.1 criteria.

    Measured: Up to 3 year and 8 months

  5. Phase I: Plasma Concentration of GSK525762

    Blood samples were collected at indicated time points for pharmacokinetic (PK) analysis of GSK525762.

    Measured: Day 1: Pre-dose, 0.5, 1, 3 hours on Weeks 1 and 3; Day 1: Pre-dose, 0.5-1, 4-8 hours on Week 5; Day 1: Pre-dose, 0.5-1 hour on Weeks 9, 17, 25

  6. Phase II: Progression Free Survival (PFS)

    PFS is defined as the time (in months) from the date of first dose until the date of first documented progressive disease (PD), as assessed by the investigator per RECIST v1.1 criteria, or date of death due to any cause, whichever occurs first. PD is defined as at least a 20% increase in the sum of the diameters of target lesions taking as a reference the smallest sum of diameters for this study.

    Measured: Up to 3 year and 8 months

Secondary outcomes (11)
  1. Phase I: Number of Participants Who Withdrew Due to Toxicity and Changes in Safety Assessment

    Number of participants who withdrew due to toxicity and changes in safety assessment including laboratory parameters and vital signs have been presented.

    Measured: Up to 4 year and 4 months

  2. Phase I: Disease Control Rate (DCR)

    DCR is defined as the percentage of participants in the population with a confirmed complete response (CR), confirmed partial response (PR), or stable disease (SD) lasting >=6 months, as assessed by the investigator per RECIST v1.1 criteria.

    Measured: Up to 3 year and 8 months

  3. Phase I: Duration of Response (DoR)

    DoR is defined as the time (in months) from date of first documented evidence of confirmed CR or PR to the date of first documented PD, as assessed by the investigator per RECIST v1.1 criteria, or to the date of death due to any cause among participants with a Best overall response (BOR) of confirmed CR or PR.

    Measured: Up to 3 year and 8 months

  4. Phase I: Progression-free Survival (PFS)

    PFS is defined as the time (in months) from the date of first dose until the date of first documented PD, as assessed by the investigator per RECIST v1.1 criteria, or date of death due to any cause, whichever occurs first. PD is defined as at least a 20% increase in the sum of the diameters of target lesions taking as a reference the smallest sum of diameters for this study.

    Measured: Up to 3 year and 8 months

  5. Phase I: Plasma Concentration of GSK3529246

    Blood samples were collected at indicated time points for PK analysis of GSK3529246. GSK3529246 is an active metabolite of GSK525762.

    Measured: Day 1: Pre-dose, 0.5, 1, 3 hours on Weeks 1 and 3; Day 1: Pre-dose, 0.5-1, 4-8 hours on Week 5, Day 1: pre-dose, 0.5-1 hour on Weeks 9, 17, 25

  6. Phase I: Plasma Concentration of Fulvestrant

    Blood samples were collected at indicated time points for PK analysis of Fulvestrant.

    Measured: Day 1: Pre-dose on Weeks 1, 3, 5, 9, 17, 25

  7. Phase II: Overall Survival (OS)

    OS is defined as the interval of time (in months) between the date of first dose and the date of death due to any cause.

    Measured: Up to 3 year and 8 months

  8. Phase II: Overall Response Rate (ORR)

    ORR is defined as the percentage of participants in the population who demonstrate a BOR of confirmed CR or PR, as assessed by the investigator per RECIST v1.1 criteria.

    Measured: Up to 3 year and 8 months

  9. Phase II: Disease Control Rate (DCR)

    DCR is defined as the percentage of participants in the population with a confirmed CR, confirmed PR, or SD lasting >=6 months, as assessed by the investigator per RECIST v1.1 criteria.

    Measured: Up to 3 year and 8 months

  10. Phase II: Plasma Concentration of GSK525762 and GSK3529246

    Blood samples were planned to be collected for PK analysis of GSK525762 and GSK3529246. GSK3529246 is metabolite of GSK525762.

    Measured: Day 1: Pre-dose, 0.5, 1, 3 hours on Weeks 1 and 3; Day 1: Pre-dose, 0.5-1, 4-8 hours on Week 5, Day 1: Pre-dose, 0.5-1 hour on Weeks 9, 17, 25

  11. Phase II: Plasma Concentration of Fulvestrant

    Blood samples were planned to be collected for PK analysis of fulvestrant.

    Measured: Day 1: Pre-dose on Weeks 1, 3, 5, 9, 17, 25

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Nov 2016 (estimated)
  2. Study start26 Sep 2019
  3. Primary completion29 Sep 2020
  4. Study completion19 Jul 2021

Why it stopped: This study has been terminated due to meeting protocol defined futility.

Resources

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 1
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
124 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02964507
Sponsor's protocol ID
201973
Other IDs
2016-003074-40, 2016
Status last verified
Aug 2024
First submitted
12 Nov 2016
Last updated
29 Aug 2024
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: GSK will assess requests from qualified researchers for anonymized individual patient-level data (IPD) and related study documents. Data sharing is subject to certain criteria, conditions, and exceptions. For further information, refer to https://www.gsk-studyregister.com/About\_GSK\_Patient\_Level\_Data\_Sharing\_Final\_13July2023.pdf

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing GSK525762 and Fulvestrant in people with Neoplasms, run by GlaxoSmithKline at 38 sites in 7 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 15 inclusion and 20 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 29 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 38 sites in United States, United Kingdom, Canada, South Korea, Australia and 2 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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 27 Jan 2022). 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?

Phase I: Number of Participants With Non-serious Adverse Events (AEs) and Serious Adverse Events (SAEs) (time frame: Up to 3 year and 8 months). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 29 Aug 2024.

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