A Phase III, Open-label, Randomised Study of Datopotamab Deruxtecan (Dato-DXd) With or Without Durvalumab Compared With Investigator's Choice of Chemotherapy (Paclitaxel, Nab-paclitaxel or Gemcitabine + Carboplatin) in Combination With Pembrolizumab in Patients With PD-L1 Positive Locally Recurrent Inoperable or Metastatic Triple-negative Breast Cancer (TROPION-Breast05)
Summary
This is a Phase III, randomised, open-label, 3-arm, multicentre, international study assessing the efficacy and safety of Dato-DXd with or without durvalumab compared with investigator's choice chemotherapy in combination with pembrolizumab in participants with PD-L1 positive locally recurrent inoperable or metastatic TNBC.
Detailed description
The primary objective of the study is to demonstrate superiority of Dato-DXd + durvalumab relative to ICC + pembrolizumab by assessment of PFS as assessed by BICR in participants with PD-L1 positive locally recurrent inoperable or metastatic TNBC. The study will be stratified based on geographic location (US/Canada/Europe vs. Dato-DXd monotherapy enrolling countries vs. rest of world), disease-free interval (DFI) history (de novo vs. prior DFI 6 to 12 months vs. prior DFI \> 12 months), and prior PD-1/PD-L1 treatment for early stage TNBC (yes vs. no). This study aims to see if Dato-DXd with durvalumab allows patients to live longer without their breast cancer getting worse, or simply to live longer, compared to patients receiving standard of care chemotherapy and pembrolizumab. This study is also looking to see how the treatment and the breast cancer affects patients' quality of life.
Arms & interventions
- DrugDato-DXd
Provided in 100mg vials. IV infusion. Experimental drug.
- DrugDurvalumab
Provided in 500mg vials. IV infusion. Experimental drug.
- DrugPaclitaxel
IV infusion. Active comparator.
- DrugNab-paclitaxel
IV infusion. Active comparator.
- DrugGemcitabine
IV infusion. Active comparator.
- DrugCarboplatin
IV infusion. Active comparator.
- DrugPembrolizumab
IV infusion. Active comparator.
Outcome measures
Primary
Progression Free Survival (PFS)
PFS is defined as time from randomisation until progression per RECIST 1.1 as assessed by BICR, or death due to any cause. The comparison will include all randomised participants, as randomised, regardless of whether the participant withdraws from randomised therapy, receives another anticancer therapy or clinically progresses prior to RECIST 1.1 progression. However, if the participant progresses or dies immediately after 2 or more consecutive missed visits, the participant will be censored at the time of the latest evaluable assessment prior to the 2 missed visits. The measure of interest is the HR of PFS.
Time frame: From randomisation until progression per RECIST 1.1 as assessed by BICR, or death due to any cause (anticipated to be up to 33 months).
Secondary
Overall Survival (OS)
Time frame: From randomisation until the date of death due to any cause (anticipated to be up to 64 months).
Objective Response Rate (ORR)
Time frame: From randomisation up until progression (anticipated to be up to 33 months).
Duration of Response (DoR)
Time frame: From the date of first documented response until date of documented progression per RECIST 1.1, as assessed by BICR/investigator assessment or death due to any cause (anticipated to be up to 33 months).
Progression-Free Survival (PFS) by Investigator assessment
Time frame: From randomisation until progression per RECIST 1.1 as assessed by the investigator, or death due to any cause (anticipated to be up to 33 months).
Clinical Benefit Rate (CBR) at 24 weeks
Time frame: From randomisation up until progression, or the last evaluable assessment in the absence of progression (anticipated to be up to 33 months).
Time to deterioration (TTD) in breast and arm symptoms in participants treated with Dato-DXd + durvalumab compared with ICC + pembrolizumab
Time frame: From the date of randomisation to the date of deterioration (from randomization to 18 weeks post-progression).
Time to deterioration (TTD) in pain in participants treated with Dato-DXd + durvalumab compared with ICC + pembrolizumab
Time frame: Time from the date of randomisation to the date of deterioration (from randomization to 18 weeks post-progression).
Time to deterioration (TTD) in physical functioning in participants treated with Dato-DXd + durvalumab compared with ICC + pembrolizumab
Time frame: From the date of randomisation to the date of deterioration (from randomization to 18 weeks post-progression).
Time to deterioration (TTD) in GHS/QoL in participants treated with Dato-DXd + durvalumab compared with ICC + pembrolizumab
Time frame: From the date of randomisation to the date of deterioration (from randomization to 18 weeks post-progression).
Time to First Subsequent Therapy (TFST)
Time frame: From randomisation until the start date of the first subsequent anticancer therapy after discontinuation of randomised treatment, or death due to any cause (anticipated to be up to 64 months).
Time to Second Subsequent Therapy (TSST)
Time frame: From randomisation until the start date of the second subsequent anti cancer therapy after discontinuation of first subsequent treatment, or death due to any cause (anticipated to be up to 64 months).
Progression Free Survival 2 (PFS2)
Time frame: From the randomisation to the earliest of the progression event (following the initial progression), subsequent to first subsequent therapy, or death (anticipated to be up to 64 months).
Pharmacokinetics of Dato-DXd in combination with durvalumab
Time frame: From first dose to end of treatment (anticipated to be up to 33 months).
Immunogenicity of Dato-DXd in combination with durvalumab
Time frame: From first dose to end of treatment safety follow-up (anticipated to be up to 33 months).
Safety and tolerability of Dato-DXd + durvalumab as compared with ICC + pembrolizumab
Time frame: From first dose to end of treatment safety follow-up (anticipated to be up to 33 months).
Eligibility criteria
Study locations (64)
Research Site
Daphne, Alabama, 36526
Research Site
Springdale, Arkansas, 72762
Research Site
Duarte, California, 91010
Research Site
Glendale, California, 91204
Research Site
Sacramento, California, 95817
Research Site
Santa Rosa, California, 95403
Research Site
Aurora, Colorado, 80012
Research Site
New Haven, Connecticut, 06510
Research Site
Jacksonville, Florida, 32256
Research Site
Miami, Florida, 33176
Research Site
Palm Bay, Florida, 32909
Research Site
Plantation, Florida, 33324
Research Site
Atlanta, Georgia, 30318
Research Site
Honolulu, Hawaii, 96819
Research Site
Chicago, Illinois, 60637
Research Site
Decatur, Illinois, 62526
Research Site
Elmhurst, Illinois, 60126
Research Site
Naperville, Illinois, 60540
Research Site
New Albany, Indiana, 47150
Research Site
Des Moines, Iowa, 50309
Research Site
Lexington, Kentucky, 40503
Research Site
Louisville, Kentucky, 40202
Research Site
Louisville, Kentucky, 40207
Research Site
Baton Rouge, Louisiana, 70808
Research Site
Baton Rouge, Louisiana, 70809
Research Site
Baltimore, Maryland, 21215
Research Site
Columbia, Maryland, 21044
Research Site
Boston, Massachusetts, 02111
Research Site
Worcester, Massachusetts, 01655
Research Site
Detroit, Michigan, 48201
Research Site
Grand Rapids, Michigan, 49503
Research Site
Saint Paul, Minnesota, 55109
Research Site
Hattiesburg, Mississippi, 39401
Research Site
St Louis, Missouri, 63129
Research Site
Albuquerque, New Mexico, 87109
Research Site
Albany, New York, 12206
Research Site
New York, New York, 10065
Research Site
Stony Brook, New York, 11794-7263
Research Site
Cincinnati, Ohio, 45219
Research Site
Cincinnati, Ohio, 45245
Research Site
Cleveland, Ohio, 44195
Research Site
York, Pennsylvania, 17403
Research Site
Providence, Rhode Island, 02903
Research Site
Chattanooga, Tennessee, 37404
Research Site
Nashville, Tennessee, 37203
Research Site
Dallas, Texas, 75230
Research Site
Dallas, Texas, 75246
Research Site
Dallas, Texas, 75246
Research Site
El Paso, Texas, 79902
Research Site
Flower Mound, Texas, 75028
Research Site
Fort Worth, Texas, 76104
Research Site
Houston, Texas, 77054
Research Site
Houston, Texas, 77090
Research Site
Houston, Texas, 77098
Research Site
Kingwood, Texas, 77339
Research Site
McKinney, Texas, 75071
Research Site
Sugar Land, Texas, 77479
Research Site
Charlottesville, Virginia, 22903
Research Site
Fairfax, Virginia, 22031
Research Site
Midlothian, Virginia, 23114
Research Site
Norfolk, Virginia, 23502
Research Site
Roanoke, Virginia, 24014
Research Site
Tacoma, Washington, 98405
Research Site
Madison, Wisconsin, 53792
References
- Schmid P, Oliveira M, O'Shaughnessy J, Cristofanilli M, Graff SL, Im SA, Loi S, Saji S, Wang S, Cescon DW, Hovey T, Nawrot A, Tse K, Vukovic P, Curigliano G. TROPION-Breast05: a randomized phase III study of Dato-DXd with or without durvalumab versus chemotherapy plus pembrolizumab in patients with PD-L1-high locally recurrent inoperable or metastatic triple-negative breast cancer. Ther Adv Med Oncol. 2025 Apr 17;17:17588359251327992. doi: 10.1177/17588359251327992. eCollection 2025.(PubMed)