A Randomized Trial of Neratinib, A Pan-ERBB Inhibitor, Alone or in Combination With Palbociclib, a CDK4/6 Inhibitor, in Patients With HER2+ Gynecologic Cancers and Other Solid Tumors: A ComboMATCH Treatment Trial
Summary
This phase II ComboMATCH treatment trial compares the effect of neratinib to the combination of neratinib and palbociclib in treating patients with HER2 positive solid tumors. Neratinib and palbociclib are in a class of medications called kinase inhibitors. They work by blocking the action of an abnormal protein that signals cancer cells to multiply. This helps slow or stop the spread of tumor cells. Giving neratinib and palbociclib in combination may shrink or stabilize cancers that over-express a specific biomarker called HER2.
Detailed description
PRIMARY OBJECTIVE: I. To investigate the efficacy of neratinib plus palbociclib (PD-0332991) compared to neratinib maleate (neratinib) alone in patients with HER2+ gynecologic cancers and HER2+ solid tumors by evaluating progression-free survival (PFS). SECONDARY OBJECTIVES: I. To investigate outcome in terms of objective response rate (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. II. To investigate clinical benefit rate (ORR + stable disease at 16 weeks). III. To evaluate overall (OS) survival. IV. To evaluate the ORR of patients who crossed over from neratinib monotherapy to neratinib-palbociclib combination. V. To investigate adverse events especially grade 3 and 4 toxicities by Common Terminology Criteria for Adverse Events (CTCAE) version (v) 5.0. VI. Collect tissue and provide it to the ComboMATCH Registration Protocol to assess concordance between the diagnostic tumor mutation profile generated by the Designated Laboratories, the pre-treatment biopsy mutation profile, and the pre-treatment circulating tumor-derived deoxyribonucleic acid (ctDNA) mutation profile from plasma, as described in ComboMATCH Registration Protocol. EXPLORATORY TRANSLATIONAL OBJECTIVES: I. To investigate the role of ctDNA-HER2 status at baseline and during follow up to assess if it predicts response to therapy and disease progression and if it does correlate with tumor tissue based HER2 status. II. To investigate if activation of the pathways of interest (PI3K/mTOR and RB1, CCND1-CDK4/6 CDK and RAS/RAF/MAPK) in tumor tissue as well as blood/ctDNA correlate with response or resistance to therapy. III. To correlate extent of HER2 amplification with response to treatment and with HER2 expression by immunohistochemistry or fluorescence in situ hybridization (FISH). IV. To correlate the extent of HER2 amplification with HER2 expression by RNA and protein immunohistochemistry (IHC) analyses and FISH. V. To correlate expression of Rb1, CCND1, CCNE1, CDK4/6 protein expression with response to treatment. VI. Assess alteration in RB1-CDK pathway in neratinib resistant patients at time of progression on monotherapy compared to combination neratinib-palbociclib. OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients receive neratinib maleate orally (PO) once daily (QD) on days 1-14 of cycle 0 in the absence of disease progression or unacceptable toxicity. Patients then receive neratinib maleate PO QD on days 1-28 of each subsequent cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients who experience progression may crossover to Arm II. Patients undergo echocardiogram (ECHO) or multi-gated acquisition scan (MUGA) during screening and on study, and computed tomography (CT) or magnetic resonance imaging (MRI) and collection of blood samples throughout the trial. Patients may also undergo tumor biopsy during screening and on study. ARM II: Patients receive neratinib maleate PO QD on days 1-14 of cycle 0 in the absence of disease progression or unacceptable toxicity. Patients then receive neratinib maleate PO QD on days 1-28 and palbociclib PO QD on days 1-21 of each subsequent cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO or MUGA during screening and on study, and CT or MRI and collection of blood samples throughout the trial. Patients may also undergo tumor biopsy during screening and on study. After completion of study treatment, patients are followed up every 3 months for 2 years.
Arms & interventions
- ProcedureBiopsy Procedure
Undergo tumor biopsy
- ProcedureBiospecimen Collection
Undergo collection of blood samples
- ProcedureComputed Tomography
Undergo CT scan
- ProcedureEchocardiography Test
Undergo ECHO
- ProcedureMagnetic Resonance Imaging
Undergo MRI
- ProcedureMultigated Acquisition Scan
Undergo MUGA
- DrugNeratinib Maleate
Given PO
- DrugPalbociclib
Given PO
Outcome measures
Primary
Progression free survival
The stratified log-rank statistic will be used to draw inferences about the relative activity of the two regimens. Characterized by medians and Kaplan-Meier (KM) curves.
Time frame: From study entry to time of progression or death, whichever occurs first, or date of last contact if neither progression nor death has occurred, assessed up to 2 years
Secondary
Overall survival
Time frame: Up to 2 years
Eligibility criteria
Study locations (186)
University of Alabama at Birmingham Cancer Center
Birmingham, Alabama, 35233
University of South Alabama Mitchell Cancer Institute
Mobile, Alabama, 36688
Alaska Women's Cancer Care
Anchorage, Alaska, 99508
UC San Diego Health System - Encinitas
Encinitas, California, 92024
UC San Diego Moores Cancer Center
La Jolla, California, 92093
The Angeles Clinic and Research Institute - West Los Angeles Office
Los Angeles, California, 90025
Cedars-Sinai Medical Center
Los Angeles, California, 90048
UC San Diego Medical Center - Hillcrest
San Diego, California, 92103
UM Sylvester Comprehensive Cancer Center at Aventura
Aventura, Florida, 33180
UM Sylvester Comprehensive Cancer Center at Coral Gables
Coral Gables, Florida, 33146
UM Sylvester Comprehensive Cancer Center at Coral Springs
Coral Springs, Florida, 33065
UM Sylvester Comprehensive Cancer Center at Deerfield Beach
Deerfield Beach, Florida, 33442
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami, Florida, 33136
UM Sylvester Comprehensive Cancer Center at Kendall
Miami, Florida, 33176
University of Miami Sylvester Comprehensive Cancer Center at Sole Mia
North Miami, Florida, 33181
UM Sylvester Comprehensive Cancer Center at Plantation
Plantation, Florida, 33324
Saint Alphonsus Cancer Care Center-Boise
Boise, Idaho, 83706
Saint Luke's Cancer Institute - Boise
Boise, Idaho, 83712
Saint Alphonsus Cancer Care Center-Caldwell
Caldwell, Idaho, 83605
Kootenai Health - Coeur d'Alene
Coeur d'Alene, Idaho, 83814
Saint Luke's Cancer Institute - Fruitland
Fruitland, Idaho, 83619
Saint Luke's Cancer Institute - Meridian
Meridian, Idaho, 83642
Saint Alphonsus Cancer Care Center-Nampa
Nampa, Idaho, 83687
Saint Luke's Cancer Institute - Nampa
Nampa, Idaho, 83687
Kootenai Clinic Cancer Services - Post Falls
Post Falls, Idaho, 83854
Kootenai Clinic Cancer Services - Sandpoint
Sandpoint, Idaho, 83864
SIH Cancer Institute
Carterville, Illinois, 62918
John H Stroger Jr Hospital of Cook County
Chicago, Illinois, 60612
University of Illinois
Chicago, Illinois, 60612
Carle at The Riverfront
Danville, Illinois, 61832
Cancer Care Specialists of Illinois - Decatur
Decatur, Illinois, 62526
Decatur Memorial Hospital
Decatur, Illinois, 62526
Carle Physician Group-Effingham
Effingham, Illinois, 62401
Crossroads Cancer Center
Effingham, Illinois, 62401
NorthShore University HealthSystem-Evanston Hospital
Evanston, Illinois, 60201
NorthShore University HealthSystem-Glenbrook Hospital
Glenview, Illinois, 60026
NorthShore University HealthSystem-Highland Park Hospital
Highland Park, Illinois, 60035
Carle Physician Group-Mattoon/Charleston
Mattoon, Illinois, 61938
Carle BroMenn Medical Center
Normal, Illinois, 61761
Carle Cancer Institute Normal
Normal, Illinois, 61761
Cancer Care Center of O'Fallon
O'Fallon, Illinois, 62269
Mercyhealth Cancer Institute - Rockford
Rockford, Illinois, 61114
Southern Illinois University School of Medicine
Springfield, Illinois, 62702
Springfield Clinic
Springfield, Illinois, 62702
Springfield Memorial Hospital
Springfield, Illinois, 62781
Carle Cancer Center
Urbana, Illinois, 61801
Woodland Cancer Care Center
Michigan City, Indiana, 46360
UI Health Care Mission Cancer and Blood - Ankeny Clinic
Ankeny, Iowa, 50023
UI Health Care Mission Cancer and Blood - Des Moines Clinic
Des Moines, Iowa, 50309
UI Health Care Mission Cancer and Blood - Laurel Clinic
Des Moines, Iowa, 50314
UI Health Care Mission Cancer and Blood - Waukee Clinic
Waukee, Iowa, 50263
Saint Joseph Hospital East
Lexington, Kentucky, 40509
University of Kentucky/Markey Cancer Center
Lexington, Kentucky, 40536
Harold Alfond Center for Cancer Care
Augusta, Maine, 04330
Lafayette Family Cancer Center-EMMC
Brewer, Maine, 04412
MaineHealth Maine Medical Center- Scarborough
Scarborough, Maine, 04074
University of Maryland/Greenebaum Cancer Center
Baltimore, Maryland, 21201
Walter Reed National Military Medical Center
Bethesda, Maryland, 20889-5600
National Institutes of Health Clinical Center
Bethesda, Maryland, 20892
UPMC Western Maryland
Cumberland, Maryland, 21502
Trinity Health Saint Joseph Mercy Hospital Ann Arbor
Ann Arbor, Michigan, 48106
Trinity Health IHA Medical Group Hematology Oncology - Brighton
Brighton, Michigan, 48114
Trinity Health IHA Medical Group Hematology Oncology - Canton
Canton, Michigan, 48188
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
Chelsea, Michigan, 48118
Corewell Health Dearborn Hospital
Dearborn, Michigan, 48124
OSF Saint Francis Hospital and Medical Group
Escanaba, Michigan, 49829
Corewell Health Farmington Hills Hospital
Farmington Hills, Michigan, 48336
Cancer Hematology Centers - Flint
Flint, Michigan, 48503
Genesee Hematology Oncology PC
Flint, Michigan, 48503
Genesys Hurley Cancer Institute
Flint, Michigan, 48503
Hurley Medical Center
Flint, Michigan, 48503
University of Michigan Health - Sparrow Lansing
Lansing, Michigan, 48912
Trinity Health Saint Mary Mercy Livonia Hospital
Livonia, Michigan, 48154
Trinity Health Saint Joseph Mercy Oakland Hospital
Pontiac, Michigan, 48341
Corewell Health William Beaumont University Hospital
Royal Oak, Michigan, 48073
Corewell Health Beaumont Troy Hospital
Troy, Michigan, 48085
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
Ypsilanti, Michigan, 48197
Sanford Joe Lueken Cancer Center
Bemidji, Minnesota, 56601
Essentia Health - Deer River Clinic
Deer River, Minnesota, 56636
Essentia Health Cancer Center
Duluth, Minnesota, 55805
Essentia Health Hibbing Clinic
Hibbing, Minnesota, 55746
Saint John's Hospital - Healtheast
Maplewood, Minnesota, 55109
Mayo Clinic in Rochester
Rochester, Minnesota, 55905
Essentia Health Sandstone
Sandstone, Minnesota, 55072
Essentia Health Virginia Clinic
Virginia, Minnesota, 55792
Saint Francis Medical Center
Cape Girardeau, Missouri, 63703
Community Hospital of Anaconda
Anaconda, Montana, 59711
Billings Clinic Cancer Center
Billings, Montana, 59101
Bozeman Health Deaconess Hospital
Bozeman, Montana, 59715
Benefis Sletten Cancer Institute
Great Falls, Montana, 59405
Logan Health Medical Center
Kalispell, Montana, 59901
Community Medical Center
Missoula, Montana, 59804
OptumCare Cancer Care at Charleston
Las Vegas, Nevada, 89102
OptumCare Cancer Care at Fort Apache
Las Vegas, Nevada, 89183
Jersey City Medical Center
Jersey City, New Jersey, 07302
Monmouth Medical Center Southern Campus
Lakewood, New Jersey, 08701
Monmouth Medical Center
Long Branch, New Jersey, 07740
Rutgers Cancer Institute of New Jersey
New Brunswick, New Jersey, 08903
Community Medical Center
Toms River, New Jersey, 08755
Roswell Park Cancer Institute
Buffalo, New York, 14263
State University of New York Upstate Medical University
Syracuse, New York, 13210
Cone Health MedCenter Asheboro
Asheboro, North Carolina, 27205
Cone Health Cancer Center at Alamance Regional
Burlington, North Carolina, 27215
Southeastern Medical Oncology Center-Clinton
Clinton, North Carolina, 28328
Duke University Medical Center
Durham, North Carolina, 27710
Southeastern Medical Oncology Center-Goldsboro
Goldsboro, North Carolina, 27534
Cone Health Cancer Center
Greensboro, North Carolina, 27403
Cone Health Cancer Center at Drawbridge Parkway
Greensboro, North Carolina, 27410
Southeastern Medical Oncology Center-Jacksonville
Jacksonville, North Carolina, 28546
Duke Women's Cancer Care Raleigh
Raleigh, North Carolina, 27607
Annie Penn Memorial Hospital
Reidsville, North Carolina, 27320
Sanford Bismarck Medical Center
Bismarck, North Dakota, 58501
Sanford Broadway Medical Center
Fargo, North Dakota, 58122
Sanford Roger Maris Cancer Center
Fargo, North Dakota, 58122
OhioHealth O'Bleness Hospital
Athens, Ohio, 45701
Miami Valley Hospital South
Centerville, Ohio, 45459
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210
Columbus Oncology and Hematology Associates Inc
Columbus, Ohio, 43214
Riverside Methodist Hospital
Columbus, Ohio, 43214
Grant Medical Center
Columbus, Ohio, 43215
Doctors Hospital
Columbus, Ohio, 43228
Miami Valley Hospital
Dayton, Ohio, 45409
Premier Blood and Cancer Center
Dayton, Ohio, 45409
Dayton Physician LLC - Englewood
Dayton, Ohio, 45415
Miami Valley Hospital North
Dayton, Ohio, 45415
Delaware Health Center-Grady Cancer Center
Delaware, Ohio, 43015
Grady Memorial Hospital
Delaware, Ohio, 43015
Columbus Oncology and Hematology Associates
Dublin, Ohio, 43016
Dublin Methodist Hospital
Dublin, Ohio, 43016
Atrium Medical Center-Middletown Regional Hospital
Franklin, Ohio, 45005-1066
Miami Valley Cancer Care and Infusion
Greenville, Ohio, 45331
Kettering Medical Center
Kettering, Ohio, 45429
OhioHealth Mansfield Hospital
Mansfield, Ohio, 44903
OhioHealth Marion General Hospital
Marion, Ohio, 43302
OhioHealth Pickerington Methodist Hospital
Pickerington, Ohio, 43147
Upper Valley Medical Center
Troy, Ohio, 45373
OhioHealth Westerville Medical Campus/Westerville Cancer Center
Westerville, Ohio, 43082
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Saint Alphonsus Cancer Care Center-Ontario
Ontario, Oregon, 97914
Providence Portland Medical Center
Portland, Oregon, 97213
Providence Saint Vincent Medical Center
Portland, Oregon, 97225
UPMC Altoona
Altoona, Pennsylvania, 16601
UPMC Hillman Cancer Center Erie
Erie, Pennsylvania, 16505
UPMC Cancer Centers - Arnold Palmer Pavilion
Greensburg, Pennsylvania, 15601
UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion
Mechanicsburg, Pennsylvania, 17050
UPMC Hillman Cancer Center - Monroeville
Monroeville, Pennsylvania, 15146
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, 19107
UPMC-Magee Womens Hospital
Pittsburgh, Pennsylvania, 15213
University of Pittsburgh Cancer Institute (UPCI)
Pittsburgh, Pennsylvania, 15232
UPMC-Passavant Hospital
Pittsburgh, Pennsylvania, 15237
Asplundh Cancer Pavilion
Willow Grove, Pennsylvania, 19090
Women and Infants Hospital
Providence, Rhode Island, 02905
Sanford Cancer Center Oncology Clinic
Sioux Falls, South Dakota, 57104
Sanford USD Medical Center - Sioux Falls
Sioux Falls, South Dakota, 57117-5134
Bristol Regional Medical Center
Bristol, Tennessee, 37620
Regional Cancer Center at Johnson City Medical Center
Johnson City, Tennessee, 37604
Ballad Health Cancer Care - Kingsport
Kingsport, Tennessee, 37660
Wellmont Holston Valley Hospital and Medical Center
Kingsport, Tennessee, 37660
Vanderbilt University/Ingram Cancer Center
Nashville, Tennessee, 37232
UT Southwestern/Simmons Cancer Center-Dallas
Dallas, Texas, 75390
UT MD Anderson Cancer Center
Houston, Texas, 77030
Scott and White Memorial Hospital
Temple, Texas, 76508
Ballad Health Cancer Care - Bristol
Bristol, Virginia, 24201
University of Virginia Cancer Center
Charlottesville, Virginia, 22908
Inova Schar Cancer Institute
Fairfax, Virginia, 22031
Inova Fairfax Hospital
Falls Church, Virginia, 22042
VCU Massey Comprehensive Cancer Center
Richmond, Virginia, 23298
Carilion Roanoke Memorial Hospital
Roanoke, Virginia, 24033
Swedish Cancer Institute-Edmonds
Edmonds, Washington, 98026
Swedish Cancer Institute-Issaquah
Issaquah, Washington, 98029
Swedish Medical Center-First Hill
Seattle, Washington, 98122
West Virginia University Healthcare
Morgantown, West Virginia, 26506
Duluth Clinic Ashland
Ashland, Wisconsin, 54806
Marshfield Medical Center-EC Cancer Center
Eau Claire, Wisconsin, 54701
Saint Vincent Hospital Cancer Center Green Bay
Green Bay, Wisconsin, 54301
Saint Vincent Hospital Cancer Center at Saint Mary's
Green Bay, Wisconsin, 54303
Gundersen Lutheran Medical Center
La Crosse, Wisconsin, 54601
Marshfield Medical Center-Marshfield
Marshfield, Wisconsin, 54449
Marshfield Medical Center - Minocqua
Minocqua, Wisconsin, 54548
Cancer Center of Western Wisconsin
New Richmond, Wisconsin, 54017
Saint Vincent Hospital Cancer Center at Oconto Falls
Oconto Falls, Wisconsin, 54154
Marshfield Medical Center-Rice Lake
Rice Lake, Wisconsin, 54868
Saint Vincent Hospital Cancer Center at Sheboygan
Sheboygan, Wisconsin, 53081
Marshfield Medical Center-River Region at Stevens Point
Stevens Point, Wisconsin, 54482
Saint Vincent Hospital Cancer Center at Sturgeon Bay
Sturgeon Bay, Wisconsin, 54235-1495
Marshfield Medical Center - Weston
Weston, Wisconsin, 54476