NCT05967286

Brief Summary

This phase II ComboMATCH treatment trial studies the effect of adding a drug called BYL719 (alpelisib) to the usual treatment of olaparib in patients with breast cancer that has spread from where it first started (breast) to other places in the body (metastatic). Olaparib is an inhibitor of PARP, an enzyme that helps repair DNA when it becomes damaged. Blocking PARP may help keep tumor cells from repairing their damaged DNA, causing them to die. PARP inhibitors are a type of targeted therapy. Alpelisib blocks certain proteins, which may help keep tumor cells from growing and may kill them. It is a type of kinase inhibitor. Giving alpelisib in combination with olaparib may be able to improve treatment results for patients with metastatic breast cancer.

Trial Health

15
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Timeline
Completed

Started Oct 2023

Status
withdrawn

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

July 28, 2023

Completed
4 days until next milestone

First Posted

Study publicly available on registry

August 1, 2023

Completed
3 months until next milestone

Study Start

First participant enrolled

October 23, 2023

Completed
1.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 30, 2025

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 30, 2025

Completed
Last Updated

March 20, 2024

Status Verified

March 1, 2024

Enrollment Period

1.5 years

First QC Date

July 28, 2023

Last Update Submit

March 19, 2024

Conditions

Outcome Measures

Primary Outcomes (2)

  • Progression-free survival (PFS) (Cohort 2)

    Will compare the PFS distributions between those treated with BYL719 (alpelisib) and olaparib versus (vs) olaparib. Despite this being a randomized phase II trial, we will utilize an intent to treat approach such that patients will be analyzed based on the treatment arm to which they were randomized. Will be compared between the two treatment arms using Kaplan-Meier methods. The hazard ratio, median PFS, and estimated PFS rates at 6, 12, 18, 24, and 30 months will be estimated along with corresponding 95% confidence intervals.

    From randomization date until the time of disease progression or death due to any cause, assessed up to 5 years

  • Objective response rate (ORR) (Cohort 3)

    Defined as the proportion of patients who documented a complete response (CR) or partial response (PR) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 divided by the total number of evaluable patients in a cohort.

    Up to 5 years

Secondary Outcomes (6)

  • ORR (Cohort 2)

    Up to 5 years

  • PFS (Cohort 3)

    From study entry to the first of either disease progression or death from any cause, assessed up to 5 years

  • Overall survival (OS) (Cohorts 2 and 3)

    From registration until death due to any cause, assessed up to 5 years

  • Clinical benefit rate (CBR) (Cohorts 2 and 3)

    From registration until death due to any cause, assessed up to 5 years

  • Incidence of adverse events (Cohorts 2 and 3)

    Up to 5 years

  • +1 more secondary outcomes

Study Arms (4)

Cohort 1, Arm A (olaparib, alpelisib)

EXPERIMENTAL

Patients receive olaparib PO BID and alpelisib PO daily on days 1-28 of each cycle. Cycles repeat every 28 days for up to 5 years in the absence of disease progression, unacceptable toxicity, or bone marrow findings consistent with MDS or AML. Patients also undergo MRI, CT, and/or PET scans throughout the trial and a biopsy prior to treatment start. Patients may also undergo bone scans on study as clinically indicated. Patients have the option to also undergo blood collection throughout the trial and a second biopsy at time of disease progression.

Drug: AlpelisibProcedure: BiopsyProcedure: Biospecimen CollectionProcedure: Bone ScanProcedure: Magnetic Resonance ImagingDrug: Olaparib

Cohort 2, Arm B (olaparib, alpelisib)

EXPERIMENTAL

Patients receive olaparib PO BID and alpelisib PO daily on days 1-28 of each cycle. Cycles repeat every 28 days for up to 5 years in the absence of disease progression, unacceptable toxicity, or bone marrow findings consistent with MDS or AML. Patients also undergo MRI, CT, and/or PET scans throughout the trial and a biopsy prior to treatment start. Patients may also undergo bone scans on study as clinically indicated. Patients have the option to also undergo blood collection throughout the trial and a second biopsy at time of disease progression.

Drug: AlpelisibProcedure: BiopsyProcedure: Biospecimen CollectionProcedure: Computed TomographyProcedure: Magnetic Resonance ImagingDrug: OlaparibProcedure: Positron Emission Tomography

Cohort 2, Arm C (olaparib)

ACTIVE COMPARATOR

Patients receive olaparib PO BID on days 1-28 of each cycle. Cycles repeat every 28 days for up to 5 years in the absence of disease progression, unacceptable toxicity, or bone marrow findings consistent with MDS or AML. Patients experiencing disease progression have the option to migrate to Cohort 3, Arm D. Patients also undergo MRI, CT, and/or PET scans throughout the trial and a biopsy prior to treatment start. Patients may also undergo bone scans on study as clinically indicated. Patients have the option to also undergo blood collection throughout the trial and a second biopsy at time of disease progression.

Procedure: BiopsyProcedure: Biospecimen CollectionProcedure: Bone ScanProcedure: Computed TomographyProcedure: Magnetic Resonance ImagingDrug: Olaparib

Cohort 3, Arm D (olaparib, alpelisib)

EXPERIMENTAL

Patients receive olaparib PO BID and alpelisib PO daily on days 1-28 of each cycle. Cycles repeat every 28 days for up to 5 years in the absence of disease progression, unacceptable toxicity, or bone marrow findings consistent with MDS or AML. Patients also undergo MRI, CT, and/or PET scans throughout the trial and a biopsy prior to treatment start. Patients may also undergo bone scans on study as clinically indicated. Patients have the option to also undergo blood collection throughout the trial and a second biopsy at time of disease progression.

Drug: AlpelisibProcedure: BiopsyProcedure: Biospecimen CollectionProcedure: Bone ScanProcedure: Computed TomographyProcedure: Magnetic Resonance ImagingDrug: OlaparibProcedure: Positron Emission Tomography

Interventions

Given PO

Also known as: BYL719, Phosphoinositide 3-kinase Inhibitor BYL719, Piqray, VIJOICE
Cohort 1, Arm A (olaparib, alpelisib)Cohort 2, Arm B (olaparib, alpelisib)Cohort 3, Arm D (olaparib, alpelisib)
BiopsyPROCEDURE

Undergo biopsy

Also known as: BIOPSY_TYPE, Bx
Cohort 1, Arm A (olaparib, alpelisib)Cohort 2, Arm B (olaparib, alpelisib)Cohort 2, Arm C (olaparib)Cohort 3, Arm D (olaparib, alpelisib)

Undergo collection of blood

Also known as: Biological Sample Collection, Biospecimen Collected, Specimen Collection
Cohort 1, Arm A (olaparib, alpelisib)Cohort 2, Arm B (olaparib, alpelisib)Cohort 2, Arm C (olaparib)Cohort 3, Arm D (olaparib, alpelisib)
Bone ScanPROCEDURE

Undergo bone scans

Also known as: Bone Scintigraphy
Cohort 1, Arm A (olaparib, alpelisib)Cohort 2, Arm C (olaparib)Cohort 3, Arm D (olaparib, alpelisib)

Undergo CT

Also known as: CAT, CAT Scan, Computed Axial Tomography, Computerized Axial Tomography, Computerized axial tomography (procedure), Computerized Tomography, CT, CT Scan, tomography
Cohort 2, Arm B (olaparib, alpelisib)Cohort 2, Arm C (olaparib)Cohort 3, Arm D (olaparib, alpelisib)

Undergo MRI

Also known as: Magnetic Resonance, Magnetic resonance imaging (procedure), Magnetic Resonance Imaging Scan, Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance, MR, MR Imaging, MRI, MRI Scan, NMR Imaging, NMRI, Nuclear Magnetic Resonance Imaging
Cohort 1, Arm A (olaparib, alpelisib)Cohort 2, Arm B (olaparib, alpelisib)Cohort 2, Arm C (olaparib)Cohort 3, Arm D (olaparib, alpelisib)

Given PO

Also known as: AZD 2281, AZD-2281, AZD2281, KU-0059436, Lynparza, PARP Inhibitor AZD2281
Cohort 1, Arm A (olaparib, alpelisib)Cohort 2, Arm B (olaparib, alpelisib)Cohort 2, Arm C (olaparib)Cohort 3, Arm D (olaparib, alpelisib)

Undergo PET

Also known as: Medical Imaging, Positron Emission Tomography, PET, PET Scan, Positron emission tomography (procedure), Positron Emission Tomography Scan, Positron-Emission Tomography, proton magnetic resonance spectroscopic imaging, PT
Cohort 2, Arm B (olaparib, alpelisib)Cohort 3, Arm D (olaparib, alpelisib)

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patient must have enrolled onto EAY191 and must have been given a treatment assignment to ComboMATCH to EAY191-A2 based on the presence of an actionable mutation as defined in EAY191
  • Metastatic or unresectable breast cancer that is HER2-negative (by American Society of Clinical Oncology-College of American Pathologists \[ASCO-CAP\] guidelines)
  • Patients with estrogen receptor positive (ER+) or ER-negative disease are eligible
  • Germline or deleterious somatic mutation in at least one of: BAP1, BARD1, BRCA1, BRCA2, BRIP1 (FANCJ), FANCA, FANCC, FANCD2, FANCE, FANCF, FANCM, MRE11,PALB2, RAD50, RAD51B, RAD51C, RAD51D
  • COHORTS 1 AND 2 (PARP-INHIBITOR NAIVE): No prior PARP-inhibitor is allowed. Prior mTOR- or AKT-inhibitor is allowed
  • COHORTS 1 AND 2 (PARP-INHIBITOR NAIVE): PIK3CA mutation status
  • COHORT 3 (PRIOR PARP-INHIBITOR): Patient must have received and progressed on prior PARP inhibitor therapy in any setting; intervening lines of therapy are allowed
  • At least one measurable lesion that can be accurately assessed at baseline by CT (MRI where CT is contraindicated) and is suitable for repeated assessment as per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
  • Prior PI3K inhibitor therapy is allowed
  • Patients with estrogen receptor positive (ER+) disease are eligible after progression on at least 1 prior endocrine treatment in the metastatic setting
  • No treatment within 4 weeks of registration which includes: investigational medicinal product (IMP), systemic anti-cancer treatment (cytotoxic chemotherapy, immunotherapy, targeted therapy except for PI3K inhibitors, biologics, tumor embolization, or monoclonal antibodies). If there is a period needed for the IMP or systemic treatment to be cleared from the body that may take longer than 4 weeks (i.e. period of 5 half lives), the longer time period should be utilized
  • No major surgery done =\< 14 days prior to registration, or patients must have recovered from any effects from any major surgery that occurred \> 14 days prior to registration
  • Not pregnant and not nursing, because this study involves an investigational agent whose genotoxic, mutagenic and teratogenic effects on the developing fetus and newborn are unknown and an agent that has known genotoxic, mutagenic and teratogenic effects
  • Therefore, for women of childbearing potential only, a negative pregnancy test done =\< 7 days prior to registration is required
  • Age \>= 18 years
  • +24 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Interventions

AlpelisibBiopsySpecimen HandlingMagnetic Resonance Spectroscopyolaparib

Intervention Hierarchy (Ancestors)

CytodiagnosisCytological TechniquesClinical Laboratory TechniquesDiagnostic Techniques and ProceduresDiagnosisDiagnostic Techniques, SurgicalSurgical Procedures, OperativeInvestigative TechniquesSpectrum AnalysisChemistry Techniques, Analytical

Study Officials

  • Gerburg M Wulf

    Alliance for Clinical Trials in Oncology

    PRINCIPAL INVESTIGATOR
0

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
SEQUENTIAL
Sponsor Type
NIH
Responsible Party
SPONSOR

Study Record Dates

First Submitted

July 28, 2023

First Posted

August 1, 2023

Study Start

October 23, 2023

Primary Completion

April 30, 2025

Study Completion

April 30, 2025

Last Updated

March 20, 2024

Record last verified: 2024-03

Data Sharing

IPD Sharing
Will share

NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.

More information