| NCT ID | Title | Phase | Status | Enrollment | Velocity | Design | Start | Completion | Last Updated | Sites | Countries |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NCT00878709 | Study Evaluating The Effects Of Neratinib After Adjuvant Trastuzumab In Women With Early Stage Breast Cancer | PHASE3 | COMPLETED | 2,840 | — | — | Jul 9, 2009 | Oct 4, 2019 | Jun 11, 2021 | 494 | United States, Australia +38 |
| NCT01008150 | Phase II Randomized Trial Evaluating Neoadjuvant Therapy With Neratinib and/or Trastuzumab Followed by Postoperative Trastuzumab in Women With Locally Advanced HER2-positive Breast Cancer | PHASE2 | COMPLETED | 141 | — | — | Oct 1, 2010 | Nov 25, 2016 | Oct 25, 2021 | 42 | United States, Canada +3 |
| NCT04886531 | Trial of Pre-operative Neratinib and Endocrine Therapy With Trastuzumab in ER-Positive, HER-2 Positive Breast Cancers | PHASE2 | RECRUITING | 30 | — | — | Jul 21, 2022 | Jul 21, 2027 | Apr 8, 2026 | 4 | United States |
| NCT00915018 | Study Evaluating Neratinib Plus Paclitaxel VS Trastuzumab Plus Paclitaxel In ErbB-2 Positive Advanced Breast Cancer | PHASE2 | COMPLETED | 479 | — | — | Aug 21, 2009 | Jun 28, 2018 | Aug 22, 2018 | 195 | United States, Australia +33 |
| NCT02236000 | A Dose-Escalation Study Evaluating the Combination of Trastuzumab Emtansine (T-DM1) With Neratinib in Women With Metastatic HER2-Positive Breast Cancer | PHASE1 | COMPLETED | 49 | — | — | Aug 1, 2014 | Aug 1, 2021 | Jan 26, 2023 | 15 | United States |
| NCT03377387 | Capecitabine 7/7 Schedule With Neratinib in Patients With Metastatic HER2-Positive Breast Cancer | PHASE1 | ACTIVE NOT_RECRUITING | 34 | — | — | Dec 13, 2017 | Dec 1, 2026 | Apr 16, 2026 | 10 | United States |
| NCT01111825 | Temsirolimus Plus Neratinib for Patients With Metastatic HER2-Amplified or Triple Negative Breast Cancer | PHASE1 | COMPLETED | 99 | — | — | Apr 1, 2010 | Jul 1, 2016 | Sep 26, 2018 | 12 | United States, Denmark +4 |
| NCT00741260 | Study Evaluating The Combination Of Neratinib And Capecitabine In Solid Tumors And Breast Cancer | PHASE1 | COMPLETED | 105 | — | — | Dec 9, 2008 | Jun 1, 2018 | Sep 5, 2018 | 37 | United States, Australia +9 |
| NCT00708903 | Study to Examine the Effect of HKI-272 on Rhythms of the Heart (Cardiac Repolarization) | PHASE1 | COMPLETED | 60 | — | — | May 1, 2008 | Jul 1, 2008 | May 14, 2012 | 1 | United States |
| NCT00706030 | Study Evaluating Neratinib (HKI-272) In Combination With Vinorelbine In Subjects With Solid Tumors And Metastatic Breast Cancer | PHASE1 | COMPLETED | 92 | — | — | Apr 29, 2008 | Jun 7, 2018 | Aug 9, 2018 | 35 | United States, Belgium +9 |
Invasive disease-free survival time is defined as the time from date of randomization until the first disease recurrence of the following events: invasive ipsilateral breast tumor recurrence, invasive contralateral breast cancer, local/regional invasive recurrence, distant recurrence and death from any cause.
Number of participants with no histologic evidence of invasive tumor cells in the surgical breast specimen, axillary nodes after neoadjuvant chemotherapy
pCR is defined as the lack of all signs of invasive cancer in the breast removed during surgery
Defined as the interval from the date of randomization until the first date on which recurrence or progression, or death due to any cause, is documented, censored at the last assessable evaluation or at the initiation of new anticancer therapy.
If 1 of 3 patients in this cohort experiences a dose limiting toxicity (DLT), 3 more patients will be added at the same dose level. If 0 of 3 initial patients or 1 of 6 patients in an expanded cohort experiences a DLT, the dose for the next cohort will be escalated to dose level 2; otherwise, the combination will be considered too toxic.
Per Response Evaluation Criteria in Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.
If 0 of the 3 patients entered at a dose level experiences a DLT, another 3 patients will be treated at the next higher dose level. If 1 of 3 patients in a cohort experiences a DLT, then up to 3 additional patients will be treated at the same dose level. If none of these 3 additional patients experience a DLT, then the dose will be escalated to the next higher dose level. If \> 2 of the initial 3 or 6 patients at a dose level experience a DLT, then the MTD will have been exceeded, and de-escalation is warranted. De-escalation will continue if \> 2 of the initial 3 or 6 patients in a dose level cohort experience a DLT. There will be 2 dose de-escalation levels (dose levels -1 and -2) and one dose escalation (dose level +1) as shown in the table below. If \< 1 of 6 patients, at that dose level, experience a DLT, then that dose level will be confirmed as the MTD.
ORR is defined as proportion of subjects who achieved confirmed complete response (CR) or partial response (PR) per Response Evaluation Criteria In Solid Tumors Criteria (RECIST) v1.1: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR. A complete or partial response must be confirmed no less than 4-weeks after the criteria for response are initially met.
Number of participants reporting Adverse Events Causing Dose Limiting Toxicities (DLT).
MTD reflects the highest dose of neratinib plus capeciteabine that did not cause a selected Grade 3 toxicity in \>= 2 participants, which is any of 1) Grade 3 or 4 non-hematologic toxicity (Grade 3 asthenia was not considered a DLT unless lasting \>3 days, 2) Grade 3 diarrhea lasting \>2 days on optimal medical therapy or associated with fever or dehydration. 3) Grade 4 neutropenia lasting ≥ 3 days or Grade 4 febrile neutropenia, 4) Grade 4 thrombocytopenia lasting ≥3 days or associated with bleeding or requiring platelet transfusion, 5) Delayed recovery \[to ≥ National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) Grade 1 or baseline\] from one of the above listed toxicities that were related to neratinib and/or capecitabine that delayed the initiation of the next dose by more than 3 weeks.
MTD reflects the highest dose of capecitabine in combination with neratinib that did not cause a selected Grade 3 toxicity in \>= 2 participants, which is any of 1) Grade 3 or 4 non-hematologic toxicity (Grade 3 asthenia was not considered a DLT unless lasting \>3 days, 2) Grade 3 diarrhea lasting \>2 days on optimal medical therapy or associated with fever or dehydration. 3) Grade 4 neutropenia lasting ≥ 3 days or Grade 4 febrile neutropenia, 4) Grade 4 thrombocytopenia lasting ≥3 days or associated with bleeding or requiring platelet transfusion, 5) Delayed recovery \[to ≥ National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) Grade 1 or baseline\] from one of the above listed toxicities that were related to neratinib and/or capecitabine that delayed the initiation of the next dose by more than 3 weeks.
Overall Response Rate (ORR), subjects with CR or PR by independent review in subjects with ErbB-2-positive breast cancer treated at the MTD of neratinib in combination with vinorelbine per Response Evaluation Criteria In Solid Tumors Criteria (RECIST) v1.0: Complete Response (CR), disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; and Non-PD for non-target lesions, and no new lesions.
Maximum Tolerated Dose (MTD) of Neratinib in combination with vinorelbine in subjects with advanced solid tumors.
| Arm | Type | Description |
|---|---|---|
| Neratinib | EXPERIMENTAL | 240 mg orally daily for one year |
| Placebo | PLACEBO_COMPARATOR | orally daily for one year |
| Arm 1: paclitaxel + trastuzumab then A C | ACTIVE_COMPARATOR | 4 cycles of paclitaxel 80 mg/m2 on Days 1, 8, and 15 of a 28-day cycle. Trastuzumab concurrently with paclitaxel weekly for a total of 16 doses (4 mg/kg loading dose, then 2 mg/kg weekly). Following paclitaxel/trastuzumab, standard AC every 21 days for 4 cycles. Following surgery, trastuzumab (8 mg/kg loading dose, then 6 mg/kg) every 3 weeks to complete 1 year of targeted therapy (either preoperative trastuzumab therapy or neratinib therapy) |
| Arm 2: paclitaxel + neratinib then A C | EXPERIMENTAL | 4 cycles of paclitaxel 80 mg/m2 on Days 1, 8, and 15 of a 28-day cycle. Neratinib 240 mg orally once daily beginning on Day 1 of paclitaxel and continuing through Day 28 of the final cycle of paclitaxel. Following paclitaxel/neratinib therapy, standard AC every 21 days for 4 cycles. Following surgery, trastuzumab (8 mg/kg loading dose, then 6 mg/kg) every 3 weeks to complete 1 year of targeted therapy (either preoperative trastuzumab therapy or neratinib therapy) |
| Arm 3: paclitaxel + trastuzumab + neratinib then A C | EXPERIMENTAL | 4 cycles of paclitaxel 80 mg/m2 on days 1, 8, and 15 of a 28 day cycle. Trastuzumab concurrently with paclitaxel, weekly for a total of 16 doses (4 mg/kg loading dose, then 2 mg/kg weekly). Neratinib 200 mg orally once daily beginning on Day 1 of paclitaxel and continuing through Day 28 of the final cycle of paclitaxel. Following paclitaxel/trastuzumab/neratinib therapy, standard AC every 21 days for 4 cycles. Following surgery, trastuzumab (8 mg/kg loading dose, then 6 mg/kg) every 3 weeks to complete 1 year of targeted therapy (either preoperative trastuzumab therapy or neratinib therapy) |
| Arm 3 NR: paclitaxel+trastuzumab+neratinib | EXPERIMENTAL | Non-randomized: 4 cycles of paclitaxel 80 mg/m2 on days 1, 8, and 15 of a 28 day cycle. Trastuzumab concurrently with paclitaxel, weekly for a total of 16 doses (4 mg/kg loading dose, then 2 mg/kg weekly). Neratinib 200 mg orally once daily beginning on Day 1 of paclitaxel and continuing through Day 28 of the final cycle of paclitaxel. Following paclitaxel/trastuzumab/neratinib therapy, standard AC every 21 days for 4 cycles. Following surgery, trastuzumab (8 mg/kg loading dose, then 6 mg/kg) every 3 weeks to complete 1 year of targeted therapy (either preoperative trastuzumab therapy or neratinib therapy) |
| A | EXPERIMENTAL | Weeks 1-3\* patients receive either (a) Neratinib, (b) Letrozole or Anastrozole or (c) Neratinib + Letrozole or Anastrozole Weeks 4-24 patients receive Neratinib + Letrozole or Anastrozole and Trastuzumab \*Starting drug intervention varies for the first 3 weeks depending on arms: a, b, and c by randomization. |
| neratinib plus paclitaxel | EXPERIMENTAL | - |
| trastuzumab plus paclitaxel | ACTIVE_COMPARATOR | - |
| Neratinib and T-DM1 | EXPERIMENTAL | - |
| capecitabine 7/7 with neratinib | EXPERIMENTAL | In the phase I portion of the study, a 3+3 design will be used. Once the MTD is reached, the phase II portion will enroll up to 24 patients. Capecitabine will be taken orally in AM and PM (at the assigned dose per cohort) 7 days on and 7 days off. Neratinib is given as 240 mg daily continuously without stopping. A cycle is 28 days. Patients will be seen on Day 1 of each cycle (+/- 3 days). The MD has been determined as 240mg of neratinib and 1000mg BID of capecitabine. |
| Temsirolimus plus Neratinib | EXPERIMENTAL | This is an open-label, single arm, dose-escalation phase I-II study to determine the maximum tolerated dose (MTD) of temsirolimus with daily neratinib, and to determine the safety and efficacy of this combination when given to patients with advanced breast carcinoma. Patients with trastuzumab-refractory HER2-amplified disease or triple negative disease will be enrolled in both phases of this clinical trial. |
| Neratinib and Capecitabine (Dose Level 1) | EXPERIMENTAL | Neratinib 160 mg and Capecitabine 1500 mg/m\^2 |
| Neratinib and Capecitabine (Dose Group 2) | EXPERIMENTAL | Neratinib 240 mg and Capecitabine 1500 mg/m\^2 |
| Neratinib and Capecitabine (Dose Group 3) | EXPERIMENTAL | Neratinib 240 mg and Capecitabine 2000 mg/m\^2 |
| Neratinib and Capecitabine (Dose Group 4) | EXPERIMENTAL | Neratinib 200 mg and Capecitabine 2000 mg/m\^2 |
| Neratinib and Capecitabine (Dose Group 5) | EXPERIMENTAL | Neratinib 160 mg and Capecitabine 2000 mg/m\^2 |
| Neratinib and Capecitabine MTD (Dose Group 6) | EXPERIMENTAL | Neratinib and Capecitabine Maximum Tolerated Dose without prior lapatinib |
| Neratinib and Capecitabine MTD (Dose Group 7) | EXPERIMENTAL | Neratinib and Capecitabine Maximum Tolerated Dose with prior lapatinib |
| 1 | EXPERIMENTAL | HKI-272 |
| 2 | PLACEBO_COMPARATOR | Placebo |
| 3 | ACTIVE_COMPARATOR | Moxifloxacin |
| neratinib 160 mg + vinorelbine | EXPERIMENTAL | neratinib 160 mg tablets administered daily by mouth, vinorelbine 25 mg/m\^2 administered IV on day 1 and day 8 of 21 day cycle |
| neratinib 240 mg + vinorelbine | EXPERIMENTAL | neratinib 240 mg tablets administered daily by mouth, vinorelbine 25 mg/m\^2 administered IV on day 1 and day 8 of 21 day cycle |
| neratinib 240 mg + vinorelbine, No Prior Lapatinib | EXPERIMENTAL | neratinib 240 mg tablets administered daily by mouth, vinorelbine 25 mg/m\^2 administered IV on day 1 and day 8 of 21 day cycle |
| neratinib 240 mg + vinorelbine, Prior Lapatinib | EXPERIMENTAL | neratinib 240 mg tablets administered daily by mouth, vinorelbine 25 mg/m\^2 administered IV on day 1 and day 8 of 21 day cycle |
| Name | Type | Description |
|---|---|---|
| neratinib | DRUG | - |
| placebo | OTHER | - |
| Paclitaxel | DRUG | - |
| Trastuzumab | DRUG | - |
| Doxorubicin | DRUG | - |
| Cyclophosphamide | DRUG | - |
| Letrozole (L) or Anastrozole (A) | DRUG | L: (2.5 mg) OR A: (1 mg) orally daily (up to a maximum of 24 weeks)\* |
| T-DM1 | DRUG | Dose-Escalation Phase (Part 1) - Trastuzumab emtansine (T-DM1) will be given at 3.6 mg/kg IV Day 1 every 21 days. Dose-evaluation Phase (Part 2) - Trastuzumab emtansine (T-DM1) will be given at 3.6 mg/kg IV Day 1 every 21 days. |
| Capecitabine | DRUG | Capecitabine will be taken orally in AM and PM (at the assigned dose per cohort) 7 days on and 7 days off. Phase II MD 1000mg BID of capecitabine. |
| EORTC QLQ - BR23, EQ-5D-5L, EORTC QLQ-C30 | BEHAVIORAL | Questionnaires Every Cycle (+/- 3 days) (For phase II) |
| Temsirolimus | DRUG | 28 day treatment cycle Phase 1 * Weekly intravenously (IV) on days 1, 8, 15, and 22 * Starting dose 8 mg IV weekly (dose level 1). Three patients initially enrolled in each cohort Phase 2 * Dose escalation cohort - 8 mg IV weekly on Days 1, 8, 15, and 22, and then 15 mg IV weekly starting on Day 29 * HER2-amplified and Triple negative - 8 mg IV weekly on Days 1, 8, 15, and 22 |
| Moxifloxacin | DRUG | - |
| vinorelbine | DRUG | - |
Inclusion Criteria: * Stage II through IIIC HER-2/erbB-2 positive breast cancer with node positive disease. * Been treated for early breast cancer with standard of care duration of trastuzumab. * Could have been treated neoadjuvantly but have not reached pathologic complete response. Exclusion Cri...