Resumen

El objetivo de este ensayo clínico es evaluar si sacituzumab govitecan-hziy (SG) puede prolongar la supervivencia de personas con cáncer de mama metastásico HR+/HER2- y si el tumor no crece ni se disemina, en comparación con los tratamientos estándar disponibles actualmente, como paclitaxel, nab-paclitaxel o capecitabina. El objetivo primario es comparar el efecto de SG respecto al tratamiento a elección del médico (TPC) sobre la supervivencia libre de progresión (SLP).

Elegibilidad

Edad mínima: 18 YearsSexo: ALL

Criterios de inclusión

Able to understand and give written informed consent.
Must have adequate tumor tissue sample preferably from locally recurrent or metastatic site.
Documented evidence of HR+ metastatic breast cancer (mBC) confirmed with the most recently available tumor biopsy preferably from a locally recurrent or metastatic site.
Documented evidence of HER2- status.
Documented PD by computed tomography (CT) or magnetic resonance imaging during or after the most recent therapy per RECIST v1.1 criteria.
Candidate for the first chemotherapy in the locally advanced or metastatic setting.
Eligible for capecitabine, nab-paclitaxel, or paclitaxel.
Individuals must have at least one of the following:
Disease progression on at least 2 or more previous lines of endocrine therapy (ET) with or without a targeted therapy in the metastatic setting.
Disease recurrence while on the first 24 months of starting adjuvant ET will be considered a line of therapy; these individuals will only require 1 line of ET in the metastatic setting.
Disease progression within 6 months of starting first-line ET with or without a cyclin-dependent kinase (CDK) 4/6 inhibitor (if ineligible or if unable to access a CDK 4/6 inhibitor) in the metastatic setting.
Disease recurrence while on the first 24 months of starting adjuvant ET with CDK 4/6 inhibitor and if the individual is no longer a candidate for additional ET in the metastatic setting.
Individuals may have received prior targeted therapies, including but not limited to PARP inhibitors (for those with germline BRCA1 or BRCA2 mutations), phosphatidylinositol 3-kinase (PI3K) inhibitors (for those with PIK3CA mutations), or mammalian target of rapamycin (mTOR) inhibitors. However, individuals can no longer be candidates for additional endocrine treatment with or without targeted therapies.
Individuals with HIV must be on antiretroviral therapy (ART) and have a well-controlled HIV infection/disease.
Demonstrates adequate organ function.
Male individuals and female individuals of childbearing potential who engage in heterosexual intercourse must agree to use protocol-specified method(s) of contraception.
Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

Criterios de exclusión

Progressive disease within 6 months of completing (neo)adjuvant chemotherapy.
Locally advanced metastatic breast cancer (mBC) (Stage IIIc) in individuals who are candidates for curative intent therapy at the time of study enrollment.
Current enrollment in another clinical study and use of any investigational device or drug (drugs not marketed for any indication) either within 5 half-lives or 28 days prior to randomization, whichever is longer.
Use of investigational drugs in the category of Selective Estrogen Receptor Degraders are acceptable if last dose was longer than 14 days prior to randomization.
Received any prior treatment (including antibody-drug conjugate (ADC)) containing a chemotherapeutic agent targeting topoisomerase I.
Received any prior treatment with a trophoblast cell-surface antigen 2 (Trop-2)-directed ADC.
Have an active second malignancy.
Have an active serious infection requiring antibiotics.
Have active hepatitis B virus (HBV) or hepatitis C virus (HCV).
Individuals positive for human immunodeficiency virus type 1/2 (HIV-1 or -2) with a history of Kaposi sarcoma and/or Multicentric Castleman Disease.
Have a positive serum pregnancy test or are breastfeeding for individuals who are assigned female at birth.

Ubicaciones

Hospital Britanico de Buenos Aires

Buenos Aires, Argentina

Instituto de Investigaciones Clinicas de Mar del Plata

Buenos Aires, Argentina

Instituto Alexander Fleming

C.a.b.a., Argentina

Hospital Alemán

CABA, Argentina

Centro Privado de RMI Rio Cuarto S.A.

Córdoba, Argentina

Instituto de Oncología de Rosario

Rosario, Argentina

CER San Juan Centro Polivalente de Asistencia e Investigación Clínica

San Juan, Argentina

Resumen

Elegibilidad

Criterios de inclusión

Criterios de exclusión

Intervenciones

Sacituzumab Govitecan-hziy

Paclitaxel

Nab-paclitaxel

Capecitabine