Neu Direction: Testing the Efficacy of Adding HER Inhibition to Standard of Care in Metastatic MLH1-low Endocrine-resistant ER+/HER2- Breast Cancer

Trial statusNot yet recruiting
Trial phasePhase 2
Trial typeInterventional
Biological sexFemale
Age18+
SponsorUniversity of California, San Diego

About this trial

The goal of this clinical trial is to learn if neratinib, an FDA-approved oral pan-HER2/3/4 inhibitor, improves disease control for participants with metastatic endocrine-resistant ER+/HER2-negative breast cancer. Neratinib is already approved for the treatment of HER2-postive breast cancers. The study will also learn about the safety of adding this drug to standard of care treatments. The main questions it aims to answer are:

1. Does adding neratinib to standard of care systemic therapy improve disease control for patients with metastatic hormone-driven breast cancer that is resistant to endocrine therapy? 2. What side effects do participants have when adding neratinib to standard of care therapy? Researchers will compare standard of care endocrine therapy regimens with and without neratinib to see if neratinib improves control of treatment-resistant metastatic breast cancer that has continued to progress while eon first line endocrine therapy.

Participants will:

1. Take standard of care endocrine therapy for metastatic endocrine-resistant breast cancer as determined by their medical oncologist or standard of care therapy with neratinib daily 2. Visit the clinic every 3 months for checkups, tests and imaging studies

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Female over the age of 18 at the time of study enrollment

Not pregnant, planning to become pregnant or breast feeding

Metastatic ER+/HER2- breast cancer that has progressed on 1st line therapy including endocrine therapy +/- CDK4/6 inhibitors

At least one metastatic lesion visible on imaging (including FDG-PET)

Disqualifiers

History of concurrent use of other HER2-targeted therapy

Concurrent use of other targeted systemic therapy

History of other cancers other than non-melanoma skin cancer

Actionable mutations on tumor genomic sequencing will be ineligible, and those participants encouraged to proceed with the relevant targeted therapy

Trial design

Design model

Parallel

Treatments tested in this trial

  • Neratinib + endocrine therapy

    Drug

    Neratinib 120mg daily for 1 week, 160mg daily for 1 week and then 240mg daily thereafter

  • Endocrine therapy may include one of the following therapies: letrozole, anastrozole, exemestane, tamoxifen or fulvestrant

    Drug

    Endocrine therapy with out without CDK4/6 inhibitor

  • CDK4/6 + Endocrine therapy

    Drug

    Endocrine therapy with or without CDK 4/6 inhibitor

Treatment groups

150 Participants
are divided into 2 treatment groups
Group A: Standard of CareActive comparator 2 interventions
Group B: Stanard of Care + NeratinibExperimental treatment 2 interventions

Trial outcomes

Primary outcomes

1

Median Progression-Free Survival

Time frame
From enrollment through study completion, an average of 1 year.
2

Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

Adverse events will be quantified using the CTCAE v4.0 every 3 months

Time frame
From enrollment through study completion, an average of 1 year.

Secondary outcomes

Other outcomes

Sponsors and contacts

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This trial is not recruiting at the moment. You can still explore other options: