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RecruitingInterventionalPhase 3

An Open-label, Randomized, Phase 3 Study to Evaluate Patritumab Deruxtecan Monotherapy Versus Treatment of Physician's Choice in Hormone Receptor-positive, HER2-negative Unresectable Locally Advanced or Metastatic Breast Cancer (HERTHENA-Breast04)

NCT ID: NCT07060807Sponsor: Merck Sharp & Dohme LLCLast updated: 2026-06-15

Summary

Researchers are looking for other ways to treat breast cancer (BC) that is hormone receptor-positive and human epidermal growth factor receptor 2-negative (HR+/HER2-) and either unresectable locally advanced or metastatic. * HR positive (HR+) means the cancer cells have proteins that attach to estrogen or progesterone (hormones) which help the cancer to grow and spread * HER2 negative (HER2-) means the cancer cells have a low amount of a protein called HER2 * Unresectable locally advanced means the cancer cannot be completely removed by surgery and has spread into nearby tissue or muscles * Metastatic means the cancer has spread to other parts of the body Treatment for this type of breast cancer usually includes endocrine therapy (ET) and sometimes a second treatment. The main goal of this study is to learn if people who receive patritumab deruxtecan (also known as HER3-DXd and MK-1022) live longer overall or without the cancer growing/spreading, compared to people who receive chemotherapy or a different drug called trastuzumab deruxtecan.

Arms & interventions

  • BiologicalPatritumab deruxtecan

    Administered via intravenous (IV) infusion

  • DrugPaclitaxel

    Administered via IV infusion

  • DrugNab-paclitaxel

    Administered via IV infusion

  • DrugCapecitabine

    Administered via oral tablets

  • DrugLiposomal doxorubicin

    Administered via IV infusion

  • BiologicalTrastuzumab deruxtecan

    Administered via IV infusion

Outcome measures

Primary

  • Progression Free Survival (PFS)

    PFS is defined as the time from first day of study intervention to the first documented progressive disease (PD) or death due to any cause, whichever occurs first as assessed by blinded independent central review (BICR). Per Response Evaluation Criteria In Solid Tumors (RECIST) 1.1, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD. The appearance of one or more new lesions is also considered PD. PFS as assessed by BICR will be presented.

    Time frame: Up to approximately 45 months

  • Overall Survival (OS)

    OS is the length of time from when the participant starts treatment until death from any cause.

    Time frame: Up to approximately 85 months

Secondary

  • Objective Response Rate (ORR)

    Time frame: Up to approximately 85 months

  • Duration of Response (DOR)

    Time frame: Up to approximately 85 months

  • Change from Baseline in the European Organization for Research and Treatment of Cancer (EORTC)-Quality of Life Questionnaire-Core 30 (QLQ-C30) Global Health Status (Item 29) and Quality of Life (Item 30) Combined Score

    Time frame: Baseline and up to approximately 85 months

  • Change from Baseline in the EORTC-QLQ-C30 Physical Functioning (Items 1-5) Combined Score

    Time frame: Baseline and up to approximately 85 months

  • Change from Baseline in the EORTC-QLQ-C30 Emotional Functioning (Items 1-5) Combined Score

    Time frame: Baseline and up to approximately 85 months

  • Change from Baseline in the EORTC-QLQ-C30 Pain (Items 9 and 19) Combined Score

    Time frame: Baseline and up to approximately 85 months

  • Time to First Deterioration (TTD) in the European Organization for Research and Treatment of Cancer (EORTC)-Quality of Life Questionnaire-Core 30 (QLQ-C30) Global Health Status (Item 29) and Quality of Life (Item 30) Combined Score

    Time frame: Baseline and up to approximately 85 months

  • TTD in the EORTC-QLQ-C30 Physical Functioning (Items 1-5) Combined Score

    Time frame: Baseline and up to approximately 85 months

  • TTD in the EORTC-QLQ-C30 Emotional Functioning (Items 1-5) Combined Score

    Time frame: Baseline and up to approximately 85 months

  • TTD in the EORTC-QLQ-C30 Pain (Items 9 and 19) Combined Score

    Time frame: Baseline and up to approximately 85 months

  • Number of Participants Who Experience One or More Adverse Event (AEs)

    Time frame: Up to approximately 85 months

  • Number of Participants Who Discontinue Study Treatment Due to an AE

    Time frame: Up to approximately 85 months

Eligibility criteria

Sex: AllAge: 18 Years and olderHealthy volunteers: No
Inclusion Criteria: The main inclusion criteria include but are not limited to the following: * Has a diagnosis of hormone receptor positive (HR+)/human epidermal growth factor receptor 2 (HER2)- invasive breast carcinoma that is either locally advanced disease not amenable to resection with curative intent (herein called unresectable) or metastatic disease not treatable with curative intent * Has centrally-confirmed HR+ and HER2- results and human epidermal growth factor receptor 3 (HER3) evaluable results from a biopsy obtained from a distant metastatic site or a locally advanced lesion on or after the most recent line of therapy (with certain exceptions) * Must have had progression or recurrence on prior cyclin-dependent kinase (CDK)4/6 inhibitor + endocrine therapy (ET) with one of the following: * Radiographic disease progression, as assessed by the investigator, on CDK4/6 inhibitor + ET as 1L for treatment of unresectable locally advanced or metastatic HR+/HER2- breast cancer. CDK4/6 inhibitor + ET must be the only line of therapy received in the advanced setting, or * Disease recurrence, either radiographic and/or confirmed histologically via biopsy as assessed by the investigator, while on adjuvant ET in combination with a CDK4/6 inhibitor OR within 24 months from the date of last dose of adjuvant CDK4/6 inhibitor * Has measurable disease per RECIST 1.1 as assessed by the local site investigator/radiology * Human immunodeficiency virus (HIV)-infected participants must have well controlled HIV on antiretroviral therapy * Has an Eastern Cooperative Oncology Group performance status of 0 or 1 assessed within 7 days before randomization Exclusion Criteria: The main exclusion criteria include but are not limited to the following: * Has breast cancer amenable to treatment with curative intent * Is eligible to receive additional endocrine-based treatment in the advanced setting as determined by the investigator * Has a known germline breast cancer gene (BRCA) mutation (deleterious or suspected deleterious) where poly (ADP-ribose) polymerase (PARP) inhibitor(s) is a potential treatment option * Has current visceral crisis or is at risk for impending visceral crisis that has or may cause imminent organ compromise and/or other life-threatening complications * Has any of the following: a pulse oximeter reading \<92% at rest, or requires intermittent supplemental oxygen, or requires chronic supplemental oxygen * Has uncontrolled, significant cardiovascular disease or cerebrovascular disease * Has ≥Grade 2 peripheral neuropathy. * Has clinically significant corneal disease * Has received prior chemotherapy for unresectable locally advanced or metastatic breast cancer * Has received prior treatment with an anti-HER3 antibody and/or antibody-drug conjugate that consists of a topoisomerase I inhibitor (eg, T-DXd) or any other topoisomerase I inhibitor therapy * Has received prior systemic anticancer therapy within 4 weeks (or 5 half-lives, whichever is shorter) before randomization; participants previously treated with ET plus a CDK4/6 inhibitor may participate as long as at least 2 weeks have elapsed since the last dose of therapy was administered * Has received prior radiotherapy for non-central nervous system disease, or required corticosteroids for radiation-related toxicities, within 14 days of the first dose of study intervention * Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy * Has known additional malignancy that is progressing or has required active treatment within the past 3 years * Has history of (noninfectious) pneumonitis/interstitial lung disease (ILD) that required steroids, has current pneumonitis/interstitial lung disease, or has suspected ILD/pneumonitis that cannot be ruled out by imaging at Screening * Has severe hypersensitivity (≥Grade 3) to HER3-DXd and/or any of its excipients * Has severe hypersensitivity (≥Grade 3) to all the available TPC and/or any of their excipients

Study locations (33)

Southern Cancer Center (SCC) ( Site 8000)

Daphne, Alabama, 36526

Recruiting
Study Coordinator · Contact

The University of Arizona Cancer Center - North Campus ( Site 0055)

Tucson, Arizona, 85719

Recruiting
Study Coordinator · Contact

Los Angeles Hematology Oncology Medical Group ( Site 0026)

Los Angeles, California, 90017

Recruiting
Study Coordinator · Contact

Hoag Memorial Hospital Presbyterian ( Site 0025)

Newport Beach, California, 92663

Recruiting
Study Coordinator · Contact

St. Marys Hospital and Regional Medical Center-SCL Health Cancer Centers of Colorado ( Site 0021)

Grand Junction, Colorado, 81501

Recruiting
Study Coordinator · Contact

Medical Oncology Hematology Consultants (MOHC) ( Site 8002)

Newark, Delaware, 19713

Recruiting
Study Coordinator · Contact

Comprehensive Hematology Oncology ( Site 0060)

St. Petersburg, Florida, 33709

Recruiting
Study Coordinator · Contact

Baptist Health Lexington ( Site 0050)

Lexington, Kentucky, 40503

Recruiting
Study Coordinator · Contact

Baptist Health Hamburg ( Site 0071)

Lexington, Kentucky, 40509

Recruiting
Study Coordinator · Contact

John Theurer Cancer Center at Hackensack University Medical Center ( Site 0001)

Hackensack, New Jersey, 07601

Recruiting
Study Coordinator · Contact

Rutgers Cancer Institute of New Jersey ( Site 0033)

New Brunswick, New Jersey, 08903

Recruiting
Study Coordinator · Contact

Presbyterian Kaseman Hospital ( Site 0072)

Albuquerque, New Mexico, 87110

Recruiting
Study Coordinator · Contact

University of New Mexico Comprehensive Cancer Center ( Site 0047)

Albuquerque, New Mexico, 87131

Recruiting
Study Coordinator · Contact

Presbyterian Rust Jorgensen Cancer ( Site 0073)

Rio Rancho, New Mexico, 87124

Recruiting
Study Coordinator · Contact

Queens Hospital Cancer Center ( Site 0011)

Jamaica, New York, 11432

Recruiting
Study Coordinator · Contact

Optum Medical Care, PC ( Site 0009)

Westbury, New York, 11590

Recruiting
Study Coordinator · Contact

Novant Health Cancer Institute ( Site 0019)

Charlotte, North Carolina, 28204

Recruiting
Study Coordinator · Contact

Novant Health Oncology Specialists ( Site 0074)

Winston-Salem, North Carolina, 27103

Recruiting
Study Coordinator · Contact

TriHealth Cancer Institute-Good Samaritan Hospital ( Site 0020)

Cincinnati, Ohio, 45220

Recruiting
Study Coordinator · Contact

University of Pittsburgh Medical Center Magee-Womens Hospital ( Site 0058)

Pittsburgh, Pennsylvania, 15213

Recruiting
Study Coordinator · Contact

Cancer Care Associates Of York ( Site 0063)

York, Pennsylvania, 17403

Recruiting
Study Coordinator · Contact

SCRI Oncology Partners ( Site 7000)

Nashville, Tennessee, 37203

Recruiting
Study Coordinator · Contact

Tennessee Oncology, PLLC ( Site 0068)

Nashville, Tennessee, 37203

Recruiting
Study Coordinator · Contact

Texas Oncology - DFW ( Site 8003)

Dallas, Texas, 75246

Recruiting
Study Coordinator · Contact

JPS Health Network ( Site 0067)

Fort Worth, Texas, 76104

Recruiting
Study Coordinator · Contact

Texas Oncology - Gulf Coast ( Site 8006)

Houston, Texas, 77024

Recruiting
Study Coordinator · Contact

Oncology Consultants P.A. ( Site 0061)

Houston, Texas, 77030

Recruiting
Study Coordinator · Contact

Texas Oncology - Central/South Texas ( Site 8005)

McAllen, Texas, 78503

Recruiting
Study Coordinator · Contact

Mays Cancer Center ( Site 0049)

San Antonio, Texas, 78229

Recruiting
Study Coordinator · Contact

Virginia Oncology Associates (VOA) ( Site 8001)

Norfolk, Virginia, 23502

Recruiting
Study Coordinator · Contact

Shenandoah Oncology ( Site 8004)

Winchester, Virginia, 22601

Recruiting
Study Coordinator · Contact

Northwest Medical Specialties, PLLC ( Site 0062)

Tacoma, Washington, 98405

Recruiting
Study Coordinator · Contact

Circuit Clinical/SSM Health Dean Medical Group ( Site 0039)

Madison, Wisconsin, 53715

Recruiting
Study Coordinator · Contact