Treatment Protocol of Tucatinib With Capecitabine and Trastuzumab in Patients With Unresectable Previously Treated HER2+ Breast Cancer

• ClinicalTrials.gov Identifier: NCT04220203
• Expanded Access Status: Approved for marketing
• First Posted: January 7, 2020
• Last Update Posted: May 7, 2020
• Sponsor: Seagen Inc.
• Collaborator: Parexel
• Information provided by (Responsible Party): Seagen Inc.

Study Description

Brief Summary:

The purpose of this program is to provide access to tucatinib in the United States before FDA approval.

Participants will receive a combination treatment of capecitabine, trastuzumab, and tucatinib. All treatments will be given on a 21 day cycle.

To learn more about this program, contact Seattle Genetics' Medical Information (medinfo@seagen.com).

Condition or disease	Intervention/treatment
HER2-positive Breast Cancer	Drug: Tucatinib; Drug: Capecitabine; Drug: Trastuzumab

Study Design

• Study Type: Expanded Access
• Expanded Access Type: Treatment IND/Protocol

See clinical trials of the intervention/treatment in this expanded access record.

• Official Title: A Multicenter, Open-label, Treatment Protocol of Tucatinib in Combination With Capecitabine and Trastuzumab in Patients With Previously Treated Unresectable Locally Advanced or Metastatic HER2+ Breast Carcinoma

Interventions

Intervention Details:

• Drug: Tucatinib
  300 mg orally two times per day
• Drug: Capecitabine
  1000 mg/m^2 orally two times per day on Days 1-14 of each 21-day cycle
• Drug: Trastuzumab
  Loading dose of 8 mg/kg into the vein (IV; intravenously), followed by 6 mg/kg IV once per 21-day cycle

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: Female

Criteria

Inclusion Criteria:

• Have histologically confirmed HER2+ breast carcinoma, with HER2+ defined by ISH or FISH or IHC methodology
• For patients WITHOUT presence or history of brain metastases, have received previous treatment with trastuzumab, pertuzumab, and T-DM1
• For patients WITH presence or history of brain metastases, have received previous treatment with trastuzumab
• Have progression of unresectable locally advanced or metastatic breast cancer after last systemic therapy (as confirmed by treating physician), or be intolerant of last systemic therapy
• Have measurable disease or non-measurable disease assessable by standard of care imaging methods
• Have ECOG PS 0 or 1
• Have a life expectancy of at least 6 months, in the opinion of the treating physician

Exclusion Criteria:

• Eligible for a tucatinib clinical trial
• Disease recurrence within 3 months of last capecitabine for metastatic disease
• History of allergic reactions to trastuzumab, capecitabine, or compounds chemically or biologically similar to tucatinib, except for Grade 1 or 2 infusion related reactions to trastuzumab that were successfully managed, or known allergy to one of the excipients in the protocol drugs
• Have received treatment with any systemic anti-cancer therapy (excluding hormonal therapy), non-CNS radiation, or experimental agent ≤ 3 weeks of first dose of protocol treatment or are currently participating in an interventional clinical trial. Have received hormonal therapies <1 week of the first dose of protocol treatment.

• Have any toxicity related to prior cancer therapies that has not resolved to ≤ Grade 1, with the following exceptions:

  • Alopecia and neuropathy, which must have resolved to ≤ Grade 2
  • CHF, which must have been ≤ Grade 1 in severity at the time of occurrence, and must have resolved completely
  • Anemia, which must have resolved to ≤ Grade 2
• Have clinically significant cardiopulmonary disease
• Have known myocardial infarction or unstable angina within 6 months prior to first dose of protocol treatment
• Are known carriers of Hepatitis B or Hepatitis C or have other known chronic liver disease with uncontrolled disease
• Are known to be positive for HIV with uncontrolled disease
• Are pregnant, breastfeeding, or planning a pregnancy
• Require therapy with warfarin or other coumarin derivatives (non-coumarin anticoagulants are allowed)
• Have inability to swallow pills or significant gastrointestinal disease which would preclude the adequate oral absorption of medications
• Have used strong CYP2C8 inhibitor within 5 half-lives of the inhibitor, or have used a CYP2C8 or CYP3A4 inducer within 5 day prior to start of tucatinib treatment.
• Have known dihydropyrimidine dehydrogenase deficiency
• Have evidence within 2 years of the start of protocol treatment of another malignancy that required systemic treatment.

CNS Exclusion - patients must not have any of the following:

• Any untreated brain lesions > 2.0 cm in size, unless discussed with medical monitor and approval for enrollment is given
• Ongoing use of systemic corticosteroids for control of symptoms of brain metastases at a total daily dose of > 2 mg of dexamethasone (or equivalent). However, patients on a chronic stable dose of ≤ 2 mg total daily of dexamethasone (or equivalent) may be eligible with discussion and approval by the medical monitor
• Any brain lesion thought to require immediate local therapy, including (but not limited to) a lesion in an anatomic site where increase in size or possible treatment-related edema may pose risk to patient (e.g. brain stem lesions).
• Known or suspected LMD as documented by the treating physician
• Have poorly controlled (> 1/week) generalized or complex partial seizures, or manifest neurologic progression due to brain metastases notwithstanding CNS-directed therapy

Contacts and Locations

No Contacts or Locations Provided

More Information

• Responsible Party: Seagen Inc.
• ClinicalTrials.gov Identifier: NCT04220203
• Other Study ID Numbers: SGNTUC-021
• First Posted: January 7, 2020
• Last Update Posted: May 7, 2020
• Last Verified: May 2020

Additional relevant MeSH terms:

Breast Neoplasms; Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Capecitabine; Trastuzumab; Tucatinib; Antimetabolites, Antineoplastic; Antimetabolites; Molecular Mechanisms of Pharmacological Action; Antineoplastic Agents; Antineoplastic Agents, Immunological; Protein Kinase Inhibitors; Enzyme Inhibitors