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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT04177108




Registration number
NCT04177108
Ethics application status
Date submitted
7/11/2019
Date registered
26/11/2019
Date last updated
27/03/2024

Titles & IDs
Public title
A Study of Ipatasertib in Combination With Atezolizumab and Paclitaxel as a Treatment for Participants With Locally Advanced or Metastatic Triple-Negative Breast Cancer
Scientific title
A Phase III, Double-blind, Placebo-controlled, Randomized Study of Ipatasertib in Combination With Atezolizumab and Paclitaxel as a Treatment for Patients With Locally Advanced Unresectable or Metastatic Triple-Negative Breast Cancer
Secondary ID [1] 0 0
2019-000810-12
Secondary ID [2] 0 0
CO41101
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Triple-Negative Breast Cancer 0 0
Condition category
Condition code
Cancer 0 0 0 0
Breast

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Atezolizumab
Treatment: Drugs - Ipatasertib
Treatment: Drugs - Paclitaxel
Treatment: Drugs - Placebo for Atezolizumab
Treatment: Drugs - Placebo for Ipatasertib

Experimental: Cohort 1 Arm A: Ipatasertib + Atezolizumab + Paclitaxel - TNBC participants with programmed death-ligand 1 (PD-L1) non-positive received a combination of paclitaxel, 80 milligrams per meter square (mg/m^2), intravenous (IV) infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib, 400 mg, orally (PO), once daily (QD), from Day 1 to Day 21 of each 28-day cycle and atezolizumab, 840 mg, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.

Experimental: Cohort 1 Arm B: Ipatasertib + Placebo + Paclitaxel - TNBC participants with PD-L1 non-positive received a combination of paclitaxel, 80 mg/m^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib, 400 mg, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab-matching placebo, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.

Experimental: Cohort 1 Arm C: Placebo + Placebo + Paclitaxel - TNBC participants with PD-L1 non-positive received a combination of paclitaxel, 80 mg/m^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib-matching placebo, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab-matching placebo, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.

Experimental: Cohort 2 Arm A: Ipatasertib + Atezolizumab + Paclitaxel - TNBC participants with PD-L1 positive received a combination of paclitaxel, 80 mg/m^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib, 400 mg, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab, 840 mg, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.

Experimental: Cohort 2 Arm B: Placebo+ Atezolizumab + Paclitaxel - TNBC participants with PD-L1 positive received a combination of paclitaxel, 80 mg/m^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib-matching placebo, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab, 840 mg, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.


Treatment: Drugs: Atezolizumab
Atezolizumab was administered as per the dosage regimen mentioned in arm descriptions.

Treatment: Drugs: Ipatasertib
Ipatasertib was administered as per the dosage regimen mentioned in arm descriptions.

Treatment: Drugs: Paclitaxel
Paclitaxel was administered as per the dosage regimen mentioned in arm descriptions.

Treatment: Drugs: Placebo for Atezolizumab
Placebo was administered as per the dosage regimen mentioned in arm descriptions.

Treatment: Drugs: Placebo for Ipatasertib
Placebo was administered as per the dosage regimen mentioned in arm descriptions.
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Progression-Free Survival (PFS) According to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1
Timepoint [1] 0 0
From Randomization to disease progression, study completion, or death (up to 39 months)
Primary outcome [2] 0 0
Overall Survival (OS)
Timepoint [2] 0 0
From randomization up to study completion or death (Up to 39 months)
Secondary outcome [1] 0 0
Number of Participants With Adverse Events (AEs)
Timepoint [1] 0 0
Up to 39 months

Eligibility
Key inclusion criteria
1. Willingness and ability to complete all study-related assessments, including
Participant-Reported Outcome (PRO) assessments, in the investigator's judgement.

2. Adequate hematologic and organ function within 14 days before the first study
treatment on Day 1 of Cycle 1.

3. Life expectancy of at least 6 months.

4. Measurable disease according to Response Evaluation Criteria in Solid Tumors, Version
1.1 (RECIST v 1.1).

5. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1.

6. For women of childbearing potential: agreement to remain abstinent (refrain from
heterosexual intercourse) or use contraception, and agreement to refrain from donating
eggs.

7. For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use
contraceptive methods, and agreement to refrain from donating sperm.

8. Appropriate candidate for paclitaxel monotherapy if tumor programmed death-ligand 1
(PD-L1) status is unknown or non-positive; appropriate candidate for paclitaxel and
atezolizumab if tumor PD-L1 status is positive.

9. Histologically documented triple-negative adenocarcinoma of the breast that is locally
advanced or metastatic and is not amenable to resection with curative intent.
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
1. Inability to comply with study and follow-up procedures.

2. History of malabsorption syndrome or other condition that would interfere with enteral
absorption or results in the inability or unwillingness to swallow pills.

3. Severe infection within 4 weeks prior to initiation of study treatment (including, but
not limited to, hospitalization for complications of infection, bacteremia, or severe
pneumonia) as well as those who have received treatment with therapeutic oral or
intravenous (IV) antibiotics within 2 weeks prior to initiation of study treatment.

4. Known human immunodeficiency virus (HIV) infection (there must be a negative HIV test
at screening).

5. Known clinically significant history of liver disease consistent with Child-Pugh Class
B or C.

6. Current treatment with anti-viral therapy for hepatitis B virus (HBV).

7. Major surgical procedure, open biopsy, or significant traumatic injury within 28 days
prior to Day 1 of Cycle 1 or anticipation of need for a major surgical procedure
during the study.

8. Pregnancy or breastfeeding, or intention to become pregnant during the study or within
28 days after the final dose of ipatasertib or (/) placebo, 5 months after the final
dose of atezolizumab/placebo, and 6 months after the final dose of paclitaxel
whichever occurs later.

9. New York Heart Association Class II, III, or IV heart failure, left ventricular
ejection fraction less than (<) 50 percent (%), or active ventricular arrhythmia
requiring medication.

10. Current unstable angina or history of myocardial infarction within 6 months prior to
Day 1 of Cycle 1.

11. Congenital long QT syndrome or screening QT interval corrected through use
Fridericia's formula (QTcF) greater than (>) 480 milliseconds (ms).

12. Current treatment with medications used at doses known to cause clinically relevant
prolongation of QT/QTc interval.

13. History or presence of an abnormal ECG that is clinically significant in the
investigator's opinion (including complete left bundle branch block, second- or
third-degree heart block, or evidence of prior myocardial infarction).

14. Requirement for chronic corticosteroid therapy of > 10 mg of prednisone per day or an
equivalent dose of other anti-inflammatory corticosteroids or immunosuppressant agents
for a chronic disease.

15. Treatment with approved or investigational cancer therapy within 14 days prior to Day
1 of Cycle 1.

16. Any other disease, metabolic dysfunction, physical examination finding, or clinical
laboratory finding that, in the investigator's opinion, gives reasonable suspicion of
a disease or condition that contraindicates the use of an investigational drug or that
may affect the interpretation of the results or renders the participant at high risk
from treatment complications.

17. History of or known presence of spinal cord metastases, as determined by computed
tomography (CT) or magnetic resonance imaging (MRI) evaluation during screening or
prior radiographic assessments.

18. Known central nervous system (CNS) disease, except for treated asymptomatic CNS
metastases.

19. Known germline breast cancer gene (BRCA)1/2 deleterious mutation, unless the
participant is not an appropriate candidate for a poly adenosine diphosphate ribose
polymerase (PARP)-inhibitor.

20. Any previous systemic therapy for inoperable locally advanced or metastatic
triple-negative adenocarcinoma of the breast.

21. Unresolved, clinically significant toxicity from prior therapy, except for alopecia
and Grade 1 peripheral neuropathy.

22. Participants who have received palliative radiotherapy to peripheral sites (e.g., bone
metastases) for pain control and whose last treatment was completed 14 days prior to
Day 1 of Cycle 1 may be enrolled in the study if they have recovered from all acute,
reversible effects (e.g., to Grade 1 or resolved by enrolment).

23. Uncontrolled pleural effusion, pericardial effusion or ascites.

24. Uncontrolled tumor-related pain.

25. Malignancies other than breast cancer within 5 years prior to Day 1 of Cycle 1, except
for appropriately treated carcinoma in situ of the cervix, non-melanoma skin
carcinoma, or Stage I uterine cancer.

26. Known hypersensitivity or contraindication to any component of the study treatments,
including the paclitaxel excipient, macrogolglycerol ricinoleate.

27. Grade greater than or equal to (=) 2 peripheral neuropathy.

28. History of Type I or Type II diabetes mellitus requiring insulin.

29. Grade = 2 uncontrolled or untreated hypercholesterolemia or hypertriglyceridemia.

30. History of or active inflammatory bowel disease (e.g., Crohn disease and ulcerative
colitis) or active bowel inflammation (e.g., diverticulitis).

31. Lung disease: pneumonitis, interstitial lung disease, idiopathic pulmonary fibrosis,
cystic fibrosis, Aspergillosis, active tuberculosis, or history of opportunistic
infections (pneumocystis pneumonia or cytomegalovirus pneumonia).

32. Treatment with strong Cytochrome P450 (CYP)3A inhibitors or strong CYP3A inducers
within 2 weeks or 5 drug-elimination half-lives, whichever is longer, prior to
initiation of study drug.

33. Prior treatment with an Protein kinase B (Akt) inhibitor.

34. Active or history of autoimmune disease or immune deficiency.

35. History of idiopathic pulmonary fibrosis, organizing pneumonia (e.g., bronchiolitis
obliterans), drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active
pneumonitis on screening chest CT scan.

36. Prior allogeneic stem cell or solid organ transplantation.

37. Treatment with a live, attenuated vaccine within 4 weeks prior to initiation of study
treatment, or anticipation of need for such a vaccine during treatment with
atezolizumab or within 5 months after the final dose of atezolizumab.

38. History of severe allergic anaphylactic reactions to chimeric or humanized antibodies
or fusion proteins.

39. Known hypersensitivity to Chinese hamster ovary cell products or recombinant human
antibodies.

40. Treatment with systemic immunostimulatory agents (including, but not limited to,
interferon and interleukin-2) within 4 weeks or 5 half-lives of the drug (whichever is
longer) prior to initiation of study treatment.

41. Treatment with systemic immunosuppressive medication (including, but not limited to
corticosteroids, cyclophosphamide, azathioprine, methotrexate, thalidomide, and
anti-tumor necrosis factor-alpha agents) within 2 weeks prior to initiation of study
treatment, or anticipation of need for systemic immunosuppressive medication during
the study.

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s


The people analysing the results/data
Intervention assignment
Parallel
Other design features
Phase
Phase 3
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
25/11/2019
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
28/02/2023
Sample size
Target
Accrual to date
Final
242
Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC,WA
Recruitment hospital [1] 0 0
Macquarie University Hospital - Macquarie Park
Recruitment hospital [2] 0 0
Mid North Coast Cancer Institute - Port Macquarie
Recruitment hospital [3] 0 0
Royal North Shore Hospital; Department of Medical Oncology - St Leonards
Recruitment hospital [4] 0 0
Calvary Mater Newcastle; Medical Oncology - Waratah
Recruitment hospital [5] 0 0
Princess Alexandra Hospital - Woolloongabba
Recruitment hospital [6] 0 0
Adelaide Cancer Centre - Kurralta Park
Recruitment hospital [7] 0 0
Monash Health Monash Medical Centre - Clayton
Recruitment hospital [8] 0 0
Peter MacCallum Cancer Centre; Medical Oncology - Melbourne
Recruitment hospital [9] 0 0
Sunshine Hospital; Oncology Research - St Albans
Recruitment hospital [10] 0 0
St John of God Hospital; Bendat Cancer Centre - Subiaco
Recruitment postcode(s) [1] 0 0
2109 - Macquarie Park
Recruitment postcode(s) [2] 0 0
2444 - Port Macquarie
Recruitment postcode(s) [3] 0 0
2065 - St Leonards
Recruitment postcode(s) [4] 0 0
2298 - Waratah
Recruitment postcode(s) [5] 0 0
4102 - Woolloongabba
Recruitment postcode(s) [6] 0 0
5037 - Kurralta Park
Recruitment postcode(s) [7] 0 0
3168 - Clayton
Recruitment postcode(s) [8] 0 0
3000 - Melbourne
Recruitment postcode(s) [9] 0 0
- St Albans
Recruitment postcode(s) [10] 0 0
6008 - Subiaco
Recruitment outside Australia
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Alabama
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Hasselt
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Rennes
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Kumamoto
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Okayama
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Loures
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Portugal
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Porto
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Madrid
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Malaga
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Valencia
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Bangkok
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Thailand
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Chiang Mai
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Thailand
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Khonkaen
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Thailand
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Songkhla
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Turkey
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Ankara
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Turkey
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Istanbul
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Turkey
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Sihhiye/Ankara
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Ukraine
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Kharkiv Governorate
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Ukraine
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Chernigiv
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Ukraine
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Dnipropetrovsk
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Ukraine
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Kryvyi Rih
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Ukraine
State/province [125] 0 0
Kyiv
Country [126] 0 0
Ukraine
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Odesa
Country [127] 0 0
Ukraine
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Sumy
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United Kingdom
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Glasgow
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United Kingdom
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London
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United Kingdom
State/province [130] 0 0
Nottingham

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
Hoffmann-La Roche
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
This study evaluated the efficacy and safety of ipatasertib in combination with atezolizumab
and paclitaxel in locally advanced or metastatic Triple-Negative Breast Cancer (TNBC)
previously untreated in this setting.
Trial website
https://clinicaltrials.gov/ct2/show/NCT04177108
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Clinical Trials
Address 0 0
Hoffmann-La Roche
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT04177108