RECRUITING

A Study Evaluating the Efficacy and Safety of Multiple Treatment Combinations in Participants With Breast Cancer

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This is a Phase Ib/II, open-label, multicenter, randomized umbrella study in participants with breast cancer. The study is designed with the flexibility to open new treatment arms as new treatments become available, close existing treatment arms that demonstrate minimal clinical activity or unacceptable toxicity, or modify the patient population. Cohort 1 will focus on participants with inoperable, locally advanced or metastatic, estrogen receptor-positive (ER+), HER2-negative breast cancer who had disease progression during or following treatment with a cyclin-dependent kinase 4/6 inhibitor (CDK4/6i; e.g., palbociclib, ribociclib, abemaciclib) in the first- or second-line setting. Cohort 2 will focus on inoperable, locally advanced or metastatic, ER+, HER2-positive breast cancer with previous progression to standard-of-care anti-HER2 therapies, of which one was a trastuzumab-and-taxane-based systemic therapy (including in the early setting if recurrence occurred within 6 months of finishing adjuvant therapy) and one was a HER2-targeting antibody-drug conjugate (ADC; e.g., ado-trastuzumab emtansine or trastuzumab-deruxtecan) or a HER2-targeting tyrosine kinase inhibitor (TKI; e.g., tucatinib, lapatinib, pyrotinib, or neratinib). Cohort 3 will focus on inoperable, locally advanced or metastatic, ER+, HER2-negative, PIK3CA-mutated breast cancer with resistance to adjuvant endocrine therapy.

Official Title

A Phase Ib/II, Open-Label, Multicenter, Randomized Umbrella Study Evaluating the Efficacy and Safety of Multiple Treatment Combinations in Patients With Breast Cancer (MORPHEUS-BREAST CANCER)

Quick Facts

Study Start:2021-06-22
Study Completion:2027-11-30
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT04802759

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years
Sexes Eligible for Study:FEMALE
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
  2. * Documented estrogen receptor-positive (ER+) tumor
  3. * Patients for whom endocrine therapy is recommended and treatment with cytotoxic chemotherapy is not indicated at time of entry into the study, as per national or local treatment guidelines
  4. * Radiologic/objective evidence of recurrence or progression after the most recent systemic therapy for breast cancer
  5. * Disease progression during or after first- or second-line hormonal therapy for locally advanced or metastatic disease (note: at least one line of therapy must have contained a CDK4/6i administered for a minimum of 8 weeks prior to disease progression.)
  6. * Postmenopausal status for women
  7. * Life expectancy ≥3 months
  8. * Availability of a representative tumor specimen that is suitable for biomarker evaluation via central testing
  9. * Prior fulvestrant therapy is allowed
  10. * Stages 1 and 2: Measurable disease (at least one target lesion) according to RECIST v1.1
  11. * Stages 1 and 2: Adequate hematologic and end-organ function
  12. * Stages 1 and 2: Stable anticoagulant regimen for patients receiving therapeutic anticoagulation
  13. * ECOG Performance Status of 0 or 1
  14. * Histologically or cytologically confirmed and documented adenocarcinoma of the breast with metastatic or locally advanced disease not amenable to curative resection
  15. * ER+, HER2-positive breast cancer
  16. * Postmenopausal status for women
  17. * Life expectancy ≥3 months
  18. * Willingness to have a representative tumor specimen that is suitable for biomarker evaluation via central testing submitted, if available
  19. * Prior endocrine therapy in the advanced setting allowed, including fulvestrant if given more than 28 days prior to randomization, but excluding other selective estrogen receptor degraders (SERDs)
  20. * Stages 1 and 2: Measurable disease (at least one target lesion) according to RECIST v1.1
  21. * Stages 1 and 2: Baseline left ventricular ejection fraction (LVEF) ≥50% as measured by ECHO or MUGA scans
  22. * Stages 1 and 2: Adequate hematologic and end-organ function
  23. * Stages 1 and 2: Stable anticoagulant regimen for patients receiving therapeutic anticoagulation
  24. * Ability to initiate Stage 2 treatment within 3 months after experiencing unacceptable toxicity, disease progression as determined by the investigator according to RECIST v1.1, or loss of clinical benefit as determined by the investigator, provided that a Stage 2 slot is available and patient meets eligibility criteria for Stage 2
  25. * Availability of a tumor specimen from a biopsy performed upon discontinuation of Stage 1 because of unacceptable toxicity to drugs, disease progression as determined by the investigator according to RECIST v1.1, or loss of clinical benefit as determined by the investigator
  26. * Measurable disease (at least one target lesion) according to RECIST v1.1
  27. * ECOG Performance Status of 0 or 1
  28. * Documented ER+ tumor
  29. * Patients for whom endocrine therapy is recommended and treatment with cytotoxic chemotherapy is not indicated at time of entry into the study, as per national or local treatment guidelines
  30. * Histologically or cytologically confirmed and documented adenocarcinoma of the breast that is locally advanced or metastatic and is not amenable to surgical or radiation therapy with curative intent
  31. * Patients must have progressed during adjuvant endocrine treatment or within 12 months of completing adjuvant endocrine therapy with an aromatase inhibitor or tamoxifen. If a CDK4/6i was included as part of neoadjuvant or adjuvant therapy, progression event must be \>12 months since completion of CDK4/6i portion of neoadjuvant or adjuvant therapy.
  32. * Postmenopausal status for women (including women on or starting luteinizing hormone-releasing hormone \[LHRH\] agonist for ovarian suppression prior to randomization)
  33. * Life expectancy ≥6 months
  34. * Adequate hematologic and end-organ function
  35. * Evidence of an eligible PIK3CA mutation based on pre-existing test results (i.e., previously obtained as part of clinical practice) from blood or tumor tissue. If pre-existing test results are not available, submission of a freshly collected pretreatment blood sample to determine PIK3CA mutation status at a central testing site with the FoundationOne Liquid® CDx assay is required.
  1. * Prior treatment with any of the protocol-specified study treatments
  2. * Treatment with investigational therapy within 28 days prior to initiation of study treatment
  3. * Systemic treatment for breast cancer within 2 weeks of Cycle 1, Day 1 or 5 half-lives of the drug prior to Cycle 1, Day 1
  4. * Treatment with strong CYP3A4 inhibitors or inducers within 14 days or 5 drug elimination half-lives (whichever is longer) prior to randomization
  5. * Adverse events from prior anti-cancer therapy that have not resolved to Grade ≤1 or better, with the exception of alopecia of any grade and Grade ≤2 peripheral neuropathy
  6. * Eligible only for the control arm
  7. * Prior allogeneic stem cell or solid organ transplantation
  8. * Major surgical procedure other than for diagnosis within 4 weeks prior to initiation of study treatment or anticipation of need for a major surgical procedure during the course of the study
  9. * History of malignancy other than breast cancer within 2 years prior to screening, with the exception of those with a negligible risk of metastasis or death
  10. * Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures
  11. * Uncontrolled tumor-related pain
  12. * Uncontrolled or symptomatic hypercalcemia
  13. * Symptomatic, untreated, or actively progressing central nervous system (CNS) metastases
  14. * History of leptomeningeal disease
  15. * Active tuberculosis
  16. * Severe infection within 4 weeks prior to initiation of study treatment
  17. * Treatment with therapeutic oral or IV antibiotics within 2 weeks prior to initiation of study treatment
  18. * History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography scan
  19. * Active cardiac disease or history of cardiac dysfunction
  20. * Positive HIV test at screening or at any time prior to screening
  21. * Active Hepatitis B or Hepatitis C virus infection
  22. * Active inflammatory bowel disease, chronic diarrhea, short bowel syndrome, or major upper gastrointestinal (GI) surgery, including gastric resection, potentially affecting enteral absorption
  23. * Known allergy or hypersensitivity to any of the study drugs or any of their excipients
  24. * Cohort 1 only: Known HER2-positive breast cancer
  25. * Cohort 1 only: Concurrent hormone replacement therapy
  26. * Cohort 1 only: Prior treatment with cytotoxic chemotherapy for metastatic breast cancer (with the exception of single agent capecitabine, which will count as a single line of therapy)
  27. * Cohort 2 only: Dyspnea at rest due to complications of advanced malignancy, or other disease requiring continuous oxygen therapy
  28. * Cohort 2 only: Current chronic daily treatment (continuous for \>3 months) with corticosteroids (dose of 10 mg/day methylprednisolone equivalent), excluding inhaled steroids
  29. * Interstitial lung disease or severe dyspnea at rest or requiring oxygen therapy
  30. * History of major surgical resection involving the stomach or small bowel, or a preexisting chronic condition resulting in baseline Grade 2 or higher diarrhea
  31. * History of syncope of cardiovascular etiology, ventricular arrhythmia, or sudden cardiac arrest
  32. * Prior treatment with an Akt inhibitor
  33. * Inability to swallow medication or malabsorption condition that would alter the absorption of orally administered medications
  34. * Grade ≥2 uncontrolled or untreated hypercholesterolemia or hypertriglyceremia
  35. * History of Type 1 or Type 2 diabetes mellitus requiring insulin
  36. * History or presence of an abnormal electrocardiogram (ECG) that is clinically significant in the investigator's opinion
  37. * Prior treatment with any PI3K, Akt, or mTOR inhibitor, or any agent whose mechanism of action is to inhibit the PI3K/Akt/mTOR pathway
  38. * Type 2 diabetes requiring ongoing systemic treatment at the time of study entry; or any history of Type 1 diabetes
  39. * Fasting glucose ≥126 mg/dL or ≥7.0 mmol/L and HbA1c ≥5.7% (or HbA1c ≥6.4% for the ESR1m enriched Arm only)
  40. * Any concurrent ocular or intraocular condition, excluding baseline cataracts, that, in the opinion of the investigator, would require medical or surgical intervention during the study period to prevent or treat vision loss
  41. * Active inflammatory or infectious conditions in either eye or history of idiopathic or autoimmune-associated uveitis in either eye
  42. * Symptomatic active lung disease, including pneumonitis
  43. * Inability to confirm biomarker eligibility based on valid results from either central testing of blood or local testing of blood or tumor tissue that documents one of the protocol-defined PIK3CA mutations
  44. * ESR1m enriched Arm only: Inability to determine ESR1 mutation status based on valid results from either central testing of blood or from pre-existing test results (from blood or tumor tissue) that confirm the presence of an ESR1 mutation. While patients who have tumors without detectable ESR1 mutation may be enrolled in this arm, a pre-existing test with no detectable ESR1m result is not acceptable for enrollment, and the participant in this case must submit a sample for central testing.
  45. * Currently receiving or has received systemic corticosteroids ≤2 weeks prior to starting trial treatment
  46. * Impairment of GI function or GI disease that may significantly alter the absorption of the oral trial treatments
  47. * Prior treatment with mTOR inhibitor
  48. * Receipt of systemic corticosteroids (at a dose \>10 mg prednisone/day or equivalent) within 14 days before the first dose of samuraciclib
  49. * Active bleeding diatheses
  50. * History of hemolytic anemia or marrow aplasia
  51. * Receipt of a live-virus vaccination within 28 days or less of planned treatment start
  52. * Active or history of autoimmune disease or immune deficiency
  53. * Significant cardiovascular disease (such as New York Heart Association Class II or greater cardiac disease, myocardial infarction, or cerebrovascular accident) within 3 months prior to initiation of study treatment, unstable arrhythmia, or unstable angina
  54. * Treatment with a live, attenuated vaccine within 4 weeks prior to initiation of study treatment, or anticipation of need for such a vaccine during atezolizumab treatment or within 5 months after the final dose of atezolizumab
  55. * Treatment with systemic immunostimulatory agents within 4 weeks or 5 drug-elimination half-lives (whichever is longer) prior to initiation of study treatment
  56. * Treatment with systemic immunosuppressive medication within 2 weeks prior to initiation of study treatment, or anticipation of need for systemic immunosuppressive medication during study treatment
  57. * History of severe allergic anaphylactic reactions to chimeric or humanized antibodies or fusion proteins
  58. * Known hypersensitivity to Chinese hamster ovary cell products or recombinant human antibodies
  59. * Prior treatment with CD137 agonists or immune checkpoint blockade therapies, including anti-CTLA-4, anti-PD-1, and anti-PD-L1 therapeutic antibodies
  60. * Pregnant or breastfeeding, or intending to become pregnant during study treatment or within 5 months for atezolizumab
  61. * Interstitial lung disease or severe dyspnea
  62. * History of major surgical resection involving the stomach or small bowel, preexisting chronic condition resulting in baseline Grade 2 or higher diarrhea, or a condition that may significantly alter the absorption of the oral trial treatments
  63. * History of syncope of cardiovascular etiology, ventricular arrhythmia, or sudden cardiac arrest
  64. * History of major surgical resection involving the stomach or small bowel, preexisting chronic condition resulting in baseline Grade 2 or higher diarrhea, or a condition that may significantly alter the absorption of the oral trial treatments
  65. * Interstitial lung disease or severe dyspnea
  66. * Known HER2-positive breast cancer
  67. * Prior treatment with any SERD (e.g., fulvestrant, novel oral), proteolysis targeting chimera, complete ER antagonist (CERAN), or novel SERM (other than tamoxifen, toremifene)
  68. * Prior treatment with any PI3Kalpha (PIK3CA gene product), AKT or mTOR inhibitor
  69. * Treatment with investigational therapy within 28 days prior to initiation of study treatment
  70. * Treatment with strong CYP3A4 inhibitors or inducers within 14 days or 5 drug elimination half-lives (whichever is longer) prior to randomization
  71. * Adverse events from prior anti-cancer therapy that have not resolved to Grade ≤1 or better, with the exception of alopecia of any grade and Grade ≤2 peripheral neuropathy
  72. * Major surgical procedure within 4 weeks prior to initiation of study treatment or anticipation of need for a major surgical procedure during the course of the study
  73. * History of malignancy other than breast cancer within 2 years prior to screening, with the exception of those with a negligible risk of metastasis or death
  74. * Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures
  75. * Uncontrolled tumor-related pain
  76. * Uncontrolled or symptomatic hypercalcemia
  77. * Symptomatic, untreated, or actively progressing central nervous system (CNS) metastases
  78. * History of leptomeningeal disease
  79. * Severe infection within 4 weeks prior to initiation of study treatment
  80. * Treatment for clinically significant infection with therapeutic oral or IV antibiotics within 2 weeks prior to initiation of study treatment
  81. * History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography scan
  82. * Active cardiac disease or history of cardiac dysfunction
  83. * Positive HIV test at screening or at any time prior to screening
  84. * Active Hepatitis B or Hepatitis C virus infection
  85. * Active inflammatory bowel disease, chronic diarrhea, short bowel syndrome, or major upper gastrointestinal (GI) surgery, including gastric resection, potentially affecting enteral absorption
  86. * Known allergy or hypersensitivity to any of the study drugs or any of their excipients

Contacts and Locations

Study Contact

Reference Study ID Number: CO42867 https://forpatients.roche.com/
CONTACT
888-662-6728 (U.S. Only)
global-roche-genentech-trials@gene.com

Principal Investigator

Clinical Trials
STUDY_DIRECTOR
Hoffmann-La Roche

Study Locations (Sites)

City of Hope
Duarte, California, 91010
United States
University of California, San Francisco (UCSF)
San Francisco, California, 94143
United States
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center
Santa Monica, California, 90404
United States
Stanford Cancer Institute (SCI)
Stanford, California, 94305
United States
Massachusetts General Hospital
Boston, Massachusetts, 02114
United States
Regional Cancer Care Associates LLC (RCCA) - Freehold Location
Freehold, New Jersey, 07728
United States
Regional Cancer Care Associates LLC ? Howell Division
Howell Township, New Jersey, 07731
United States
Levine Cancer Institute
Charlotte, North Carolina, 28204
United States
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, 19107
United States
University of Pittsburgh Cancer Institute
Pittsburgh, Pennsylvania, 15219
United States
West Cancer Center
Germantown, Tennessee, 38138
United States

Collaborators and Investigators

Sponsor: Hoffmann-La Roche

  • Clinical Trials, STUDY_DIRECTOR, Hoffmann-La Roche

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2021-06-22
Study Completion Date2027-11-30

Study Record Updates

Study Start Date2021-06-22
Study Completion Date2027-11-30

Terms related to this study

Additional Relevant MeSH Terms

  • Inoperable, Locally Advanced or Metastatic, ER-positive Breast Cancer