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Label indication ITOVEBI, in combination with palbociclib and fulvestrant, is indicated for the treatment of adults with endocrine-resistant, PIK3CA -mutated, hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, locally advanced or metastatic breast cancer, as detected by an FDA-approved test, following recurrence on or after completing adjuvant endocrine therapy [see Clinical Studies (14.1) ] . FDA label
Also known as RO7113755, GDC-0077, Itovebi
Inavolisib · 14 trials · 9 indications
Pathological complete response (ypT0/is ypN0) is defined as no microscopic evidence of residual invasive tumor cells in all resected specimens of the breast and axilla.
Defined as the proportion of participants with a complete response or partial response, as determined by the investigator according to RECIST v1.1
| Arm | Type | Description |
|---|---|---|
| Inavolisib + Letrozole + CDK4/6i | EXPERIMENTAL | Participants will receive inavolisib, letrozole and CDK4/6i. |
| Placebo + Letrozole + CDK4/6i | PLACEBO_COMPARATOR | Participants will receive placebo, letrozole and CDK4/6i. |
| Induction Therapy: Phesgo plus Taxane-Based Chemotherapy | OTHER | Participants will be administered the treatments as outlined in the interventions section. |
| Maintenance Therapy: Inavolisib plus Phesgo | EXPERIMENTAL | Participants will be administered the treatments as outlined in the interventions section. |
| Maintenance Therapy: Placebo plus Phesgo | ACTIVE_COMPARATOR | Participants will be administered the treatments as outlined in the interventions section. |
| Inavolisib + Fulvestrant | EXPERIMENTAL | Participants will be administered the treatments as outlined in the interventions section. |
| Alpelisib + Fulvestrant | ACTIVE_COMPARATOR | Participants will be administered the treatments as outlined in the interventions section. |
| Sub-study: Inavolisib + Fulvestrant + CYP substrates | EXPERIMENTAL | Participants will be administered the treatments as outlined in the interventions section. |
| Inavolisib + Fulvestrant + Palbociclib | EXPERIMENTAL | Participants will receive inavolisib and fulvestrant (and some participants palbociclib) as outlined in the intervention section. |
| Inavolisib + Ribociclib + Fulvestrant | EXPERIMENTAL | Participants will receive inavolisib, ribociclib and fulvestrant. |
| Placebo + Ribociclib + Fulvestrant | PLACEBO_COMPARATOR | Participants will receive placebo, ribociclib and fulvestrant. |
| Arm 1 | EXPERIMENTAL | Participants will receive Inavolisib plus enzalutamide |
| Arm 2 | ACTIVE_COMPARATOR | Participants will receive either ARPi switch (enzalutamide or abiraterone) or docetaxel |
| Inavolisib Dose A plus Fulvestrant | EXPERIMENTAL | Participants will recieve an inavolisib tablet orally (PO) along with fulvestrant as an intramuscular (IM) injection. |
| Inavolisib Dose B plus Fulvestrant | EXPERIMENTAL | Participants will recieve an inavolisib tablet PO along with fulvestrant as an IM injection. |
| Arm A | EXPERIMENTAL | Participants will receive inavolisib and letrozole orally (PO) once a day (QD) from Day 1 to 28 and ribociclib PO QD from Day 1 to 21 in cycles 1-5 (each cycle=28 days). In cycle 6, inavolisib, ribociclib and letrozole will be administered PO QD on days 1-21 (each cycle=21 days). |
| Arm B | EXPERIMENTAL | Participants will receive a starting regimen of inavolisib and letrozole PO QD from Day 1 to 28 in cycle 1 (each cycle=28 days). Starting on Day 1 of Cycle 2, all participants will receive the triplet regimen inavolisib + ribociclib + letrozole as follows: inavolisib and letrozole PO QD from Day 1 to 28 and ribociclib PO QD from Day 1 to 21 in cycles 2-5 (each cycle=28 days). In cycle 6, inavolisib, ribociclib and letrozole will be administered PO QD on days 1-21 (each cycle=21 days). |
| Arm C | EXPERIMENTAL | Participants will receive a starting regimen of ribociclib PO QD from Day 1 to 21 and letrozole PO QD from Day 1 to 28 in cycle 1 (each cycle=28 days). Starting on Day 1 of Cycle 2, all participants will receive the triplet regimen inavolisib + ribociclib + letrozole as follows: inavolisib and letrozole PO QD from Day 1 to 28 and ribociclib PO QD from Day 1 to 21 in cycles 2-5 (each cycle=28 days). In cycle 6, inavolisib, ribociclib and letrozole will be administered PO QD on days 1-21 (each cycle=21 days). |
| Arm D (non-randomized) | EXPERIMENTAL | Participants will receive inavolisib and letrozole PO QD from Day 1 to 28 and ribociclib PO QD from Day 1 to 21 in cycles 1-5 (each cycle=28 days). In cycle 6, inavolisib, ribociclib and letrozole will be administered PO QD on days 1-21 (each cycle=21 days). |
| Arm E | EXPERIMENTAL | Participants will receive inavolisib and giredestrant PO QD from Day 1 to 28 and ribociclib PO QD from Day 1 to 21 in cycles 1-5 (each cycle=28 days). In cycle 6, inavolisib, ribociclib and giredestrant will be administered PO QD on days 1-21 (each cycle=21 days). |
| Arm F | EXPERIMENTAL | Participants will receive a starting regimen of inavolisib and giredestrant PO QD from Day 1 to 28 in cycle 1 (each cycle=28 days). Starting on Day 1 of Cycle 2, all participants will receive the triplet regimen inavolisib + ribociclib + giredestrant as follows: inavolisib and giredestrant PO QD from Day 1 to 28 and ribociclib PO QD from Day 1 to 21 in cycles 2-5 (each cycle=28 days). In cycle 6, inavolisib, ribociclib and giredestrant will be administered PO QD on days 1-21 (each cycle=21 days). |
| Arm G | EXPERIMENTAL | Participants will receive a starting regimen of ribociclib PO QD from Day 1 to 21 and giredestrant PO QD from Day 1 to 28 in cycle 1 (each cycle=28 days). Starting on Day 1 of Cycle 2, all participants will receive the triplet regimen inavolisib + ribociclib + giredestrant as follows: inavolisib and giredestrant PO QD from Day 1 to 28 and ribociclib PO QD from Day 1 to 21 in cycles 2-5 (each cycle=28 days). In cycle 6, inavolisib, ribociclib and giredestrant will be administered PO QD on days 1-21 (each cycle=21 days). |
| Inavolisib | EXPERIMENTAL | Inavolisib for 6 cycles (18 weeks) Neoadjuvant endocrine therapy in combination with dual anti-HER2 blockade consisting of ready-to-use fixed-dose combination of pertuzumab and trastuzumab as subcutaneous (PH-FDC SC) formulation q3w for 6 cycles (18 weeks) |
| without Inavolisib | OTHER | Neoadjuvant endocrine therapy in combination with dual anti-HER2 blockade consisting of ready-to-use fixed-dose combination of pertuzumab and trastuzumab as subcutaneous (PH-FDC SC) formulation q3w for 6 cycles (18 weeks) |
| Inavolisib + Palbociclib + Fulvestrant | EXPERIMENTAL | Participants will receive inavolisib, palbociclib, and fulvestrant. |
| Placebo + Palbociclib + Fulvestrant | PLACEBO_COMPARATOR | Participants will receive placebo, palbociclib, and fulvestrant. Participants randomized to the placebo arm who are still deriving benefit from the study treatment will be given an optional opportunity to crossover to the inavolisib arm. |
| Cohort 1 | EXPERIMENTAL | Participants with normal hepatic function will receive a single oral dose of inavolisib on Day 1 |
| Cohort 2 | EXPERIMENTAL | Participants with moderate hepatic function will receive a single oral dose of inavolisib on Day 1 |
| Cohort 3 | EXPERIMENTAL | Participants with severe hepatic function will receive a single oral dose of inavolisib on Day 1 |
| Inavolisib + Cetuximab | EXPERIMENTAL | Participants will receive 9 milligrams (mg) of inavolisib by mouth once daily (QD) on Days 8-28 of Cycle 1, then QD on Days 1-28 from Cycle 2 onwards (1 cycle=28 days). Participants will also receive cetuximab intravenous (IV) infusion 400 mg/m2 body surface area on Day 1 of Cycle 1. All subsequent weekly (QW) doses will be 250 mg/m2 each. This arm is closed. |
| Inavolisib + Bevacizumab | EXPERIMENTAL | Participants will receive 9 mg of inavolisib by mouth QD combined with bevacizumab 15 milligram/kilogram (mg/kg) IV once every three weeks (Q3W) on Day 1 of each cycle (1 cycle=21 days). This arm is closed. |
| Atezolizumab + Tiragolumab + Bevacizumab | EXPERIMENTAL | Participants in this randomized cohort will receive 1200 mg of atezolizumab by IV infusion on Day 1 of each cycle, combined with tiragolumab at a dose of 600 mg IV infusion on Day 1 of each cycle and bevacizumab IV infusion at a dose of 15 mg/kg on Day 1 of each cycle. (Cycle length=21 days) This arm is active, and not recruiting participants. |
| Atezolizumab + Tiragolumab | EXPERIMENTAL | Participants in this randomized cohort will receive 1200 mg of atezolizumab by IV infusion on Day 1 of each cycle combined with tiragolumab 600 mg IV infusion on Day 1 of each cycle. (Cycle length=21 days) This arm is active, and not recruiting participants. |
| Atezolizumab + SY-5609 | EXPERIMENTAL | Participants will receive 1680 mg of atezolizumab by IV infusion on Day 1 of each cycle Q4W in repeated 28-day cycles combined with SY-5609 at a dose of 3, 4, 5, 6, 7 or 10 mg by mouth for 7 days, followed by 7 days off. (Cycle length=28 days) This arm is closed. |
| Divarasib + Cetuximab + FOLFOX | EXPERIMENTAL | Participants will receive cetuximab IV 500 mg/m2 body surface area on Days 1 and 15 and FOLFOX on Days 1 and 15 with divarasib PO QD on Days 1-28. (Cycle length=28 days) This arm is recruiting participants. |
| Divarasib + Cetuximab | EXPERIMENTAL | Participants will receive cetuximab IV 500 mg/m2 body surface area on Days 1 and 15 with divarasib PO QD on Days 1-28. (Cycle length=28 days) This arm is active, and not recruiting participants. |
| Divarasib + Cetuximab + FOLFIRI | EXPERIMENTAL | Participants will receive cetuximab IV 500 mg/m2 body surface area on Days 1 and 15 and FOLFIRI on Days 1 and 15 with divarasib PO QD on Days 1-28. (Cycle length=28 days) This arm is active, and not recruiting participants. |
| Divarasib + Bevacizumab + FOLFOX | EXPERIMENTAL | Participants will receive Bevacizumab 5 mg/kg by IV infusion on Days 1 and 15 and FOLFOX on Days 1 and 15 with Divarasib PO QD on Days 1-28. (Cycle length=28 days) This arm is recruiting participants. |
| Divarasib + Bevacizumab + FOLFIRI | EXPERIMENTAL | Participants will receive Bevacizumab 5 mg/kg by IV infusion on Days 1 and 15 and FOLFIRI on Days 1 and 15 with Divarasib PO QD on Days 1-28. (Cycle length=28 days) This arm is recruiting participants. |
| Stage I Arm A: Inavolisib Single Agent | EXPERIMENTAL | Participants will receive inavolisib in escalating dose levels with starting dose of 6 milligrams (mg). Participants will receive single dose of inavolisib on Day 1 of Cycle 1 followed by once daily from Day 8 of Cycle 1. (Cycle length: 35 days for Cycle 1 and 28 days for all other cycles). Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. |
| Stage I Arm B: Inavolisib + Palbociclib + Letrozole | EXPERIMENTAL | Participants will receive inavolisib in escalating dose levels (starting dose 3 mg) on Days 1-28, palbociclib on Days 1-21, and letrozole on Days 1-28 of each 28-day cycle. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. |
| Stage I Arm C: Inavolisib + Letrozole | EXPERIMENTAL | Participants will receive inavolisib in escalating dose levels along with letrozole on Days 1-28 of each 28-day cycle. The starting dose of inavolisib will not exceed the starting dose in Stage I Arm A. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. |
| Stage II Arm B: Inavolisib + Palbociclib + Letrozole | EXPERIMENTAL | Participants will receive inavolisib on Days 1-28 in combination with palbociclib on Days 1-21 and letrozole on Days 1-28 of each 28-day cycle. Dose of inavolisib will be decided based on the results of Stage I Arm B. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. |
| Stage II Arm C: Inavolisib + Letrozole | EXPERIMENTAL | Participants will receive inavolisib in combination with letrozole on Days 1-28 of each 28-day cycle. Dose of inavolisib will be decided based on the results of Stage I Arm C. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. |
| Stage II Arm D: Inavolisib + Fulvestrant | EXPERIMENTAL | Participants will receive inavolisib on Days 1-28 in combination with fulvestrant on Day 1 and 15 of Cycle 1 and then on Day 1 from Cycle 2 (cycle length: 28 days). Dose of inavolisib will be decided based on the results of Stage I Arm C. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. |
| Stage II Arm E: Inavolisib + Palbociclib + Fulvestrant | EXPERIMENTAL | Participants will receive inavolisib (Days 1-28) in combination with palbociclib (Days 1-21) and fulvestrant (Days 1 and 15 of Cycle 1; Day 1 for subsequent cycles)(Cycle = 28 days). Dose of inavolisib will be determined from the results of Stage I Arm B. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. |
| Stage II Arm F: Inavolisib + Palbociclib + Fulvestrant + Metformin | EXPERIMENTAL | Participants will receive inavolisib (Days 1-28) in combination with palbociclib (Days 1-21), fulvestrant (Days 1 and 15 of Cycle 1; Day 1 for subsequent cycles) and metformin (Days 1-28)(Cycle = 28 days). Dose of inavolisib will be determined from the results of Stage I Arm B. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. |
| Stage II Arm G: Inavolisib + Trastuzumab + Pertuzumab | EXPERIMENTAL | Participants will receive inavolisib in combination with trastuzumab and pertuzumab (Days 1-21). Dose of inavolisib will be determined from the results of Stage I Arm A. Participants will continue treatment until the end of the study in the absence of unacceptable toxicities and unequivocal disease progression. |
| Name | Type | Description |
|---|---|---|
| Inavolisib | DRUG | Participants will receive oral inavolisib once daily (QD). |
| Placebo | DRUG | Participants will receive oral placebo QD. |
| CDK4/6i | DRUG | Participants will receive CDK4/6i on either Days 1-21 or Days 1-28 of each 28-day cycle. |
| Letrozole | DRUG | Participants will receive oral letrozole QD. |
| Phesgo | DRUG | Phesgo will be administered to participants subcutaneously every 3 weeks (Q3W) on D1 of each 21-day cycle. |
| Taxane-based Chemotherapy | DRUG | During the induction therapy phase, the investigator's choice of taxane-based chemotherapy will be administered after Phesgo. |
| Optional Endocrine Therapy of Investigator's Choice | DRUG | Optional endocrine therapy (ET) is allowed at the discretion of the investigator, based on the standard of care. Allowed ETs are tamoxifen, or one of the specified third-generation aromatase inhibitor (AI \[anastrozole, letrozole, or exemestane\]), or fulvestrant. The investigator will determine and supply the appropriate luteinizing hormone-releasing hormone (LHRH) agonist locally approved for use in breast cancer. The LHRH agonist will be administered according to local prescribing information. |
| Fulvestrant | DRUG | Participants will be administered 500 mg of fulvestrant on Days 1 and 15 of Cycle 1 and then on Day 1 of each subsequent 28-day cycle of main study and sub-study. |
| Alpelisib | DRUG | Alpelisib will be administered to participants at the approved dose in combination with fulvestrant: 300 mg taken PO QD and on days 1-28 of each 28-day cycle. |
| Bupropion | DRUG | Participants will be administered bupropion PO on Day -3 and Day 12 of Cycle 1 of the sub-study. |
| Omeprazole | DRUG | Participants will be administered omerprazole PO on Day -4 and Day 11 of Cycle 1 of sub-study. |
| Midazolam | DRUG | Participants will be administered midazolam PO on Day -4 and Day 11 of Cycle 1 of sub-study. |
| Palbociclib | DRUG | Some participants will receive oral palbociclib on Days 1-21 of each 28-day cycle. |
| Ribociclib | DRUG | Ribociclib will be administered as per the schedule mentioned in the protocol. |
| Enzalutamide | DRUG | Enzalutamide will be administered orally as per the schedule specified in the protocol. |
| Abiraterone | DRUG | Abiraterone will be administered orally as per the schedule specified in the protocol. |
| Docetaxel | DRUG | Docetaxel will be administered intravenously as per the schedule specified in the protocol. |
| Giredestrant | DRUG | Giredestrant will be administered as per the schedule specified in the arms |
| Endocrine therapy | DRUG | Endocrine therapy per physician´s choice with either tamoxifen 20mg or an aromatase inhibitor +/- GnRH analogue for premenopausal women and men |
| Atezolizumab | DRUG | Participants will receive atezolizumab, 1200 mg, as IV infusion Q3W on Day 1 of each 21-day cycle. |
| Bevacizumab | DRUG | Bevacizumab IV will be administered as per schedule specified in the respective arm. |
| Cetuximab | DRUG | Cetuximab IV will be administered as per schedule specified in the respective arm. |
| Tiragolumab | DRUG | Tiragolumab IV infusion will be administered as per schedule specified in the respective arm. |
| SY-5609 | DRUG | SY-5609 will be administered by mouth as per schedule specified in the respective arm. |
| Divarasib | DRUG | Divarasib will be administered orally as per schedule specified in the respective arms. |
| FOLFOX | DRUG | FOLFOX (5-fluorouracil, leucovorin, oxaliplatin) IV will be administered as per schedule specified in the respective arm. |
| FOLFIRI | DRUG | FOLFIRI (leucovorin, 5-fluorouracil, irinotecan) IV will be administered as per schedule specified in the respective arm. |
| FoundationOne®Liquid CDx | DIAGNOSTIC_TEST | FoundationOne®Liquid CDx is used to identify presence of genomic alterations for participant cohort assignment. |
| Metformin | DRUG | Participants will receive oral metformin once daily, starting on Cycle 1, Day 1, as tolerated. |
| Trastuzumab | DRUG | Participants will receive trastuzumab, administered by IV infusion on Day 1 of each 21-day cycle, at a loading dose of 8 mg/kg for Cycle 1 and a dose of 6 mg/kg for subsequent cycles, until disease progression or unacceptable toxicity. |
| Pertuzumab | DRUG | Participants will receive pertuzumab, administered by IV infusion on Day 1 of each 21-day cycle, at a loading dose of 840 mg for Cycle 1 and a dose of 420 mg for subsequent cycles, until disease progression or unacceptable toxicity. |
Inclusion Criteria: * Women or men with histologically or cytologically confirmed carcinoma of the breast * Documented ER-positive and/or progesterone receptor-positive tumor according to American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines * Documented HER2-...
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Inavolisib is an investigational medicine being studied in breast cancer, including HER2-positive and metastatic breast cancer, as well as metastatic castration-resistant prostate cancer and metastatic colorectal cancer. It is also being evaluated in patients with hepatic impairment. It is not yet approved and remains in clinical development.
Inavolisib targets PIK3CA and acts as an inhibitor of that target. Because it is directed at PIK3CA, the clinical program selects patients based on biomarker status. This targeted approach is being tested across the cancer types under study, including advanced and metastatic breast cancer.
Inavolisib is being developed by Roche Holding AG, which trades under the ticker RHHBY. Roche is running the clinical program, which includes Phase 2 and Phase 3 studies in breast cancer and other solid tumors. The drug remains investigational and has not been approved for any indication.
Inavolisib is in Phase 3 development. It is an investigational small molecule and has not been approved by the FDA or any other regulator. The overall program includes eight trials, all currently active, with a combined planned enrollment of about 1,715 participants across controlled, randomized, double-blind designs.
Inavolisib is being studied in several trials, including NCT07405801 and NCT07368998 in advanced breast cancer, NCT07287150 in metastatic castration-resistant prostate cancer, and NCT07748208 in advanced breast cancer with type 2 diabetes. These studies combine inavolisib with agents such as fulvestrant, ribociclib, and palbociclib.