A Study of Patritumab Deruxtecan (HER3-DXd) in Combination With Trastuzumab Deruxtecan (T-DXd) in Participants With HR-Positive, HER2-Low or HER2-Ultralow Unresectable or Metastatic Breast Cancer

NCT07701941 | Not Yet Recruiting Phase 1 FDA Drug

• 2 other identifiers: U31402-2872024-517541-14-00
• Study Type: interventional
• Target: 220
• Locations: 0 countries
• Sites: N/A

Brief Summary

The primary purpose of the study is to assess the safety, tolerability, and anti-tumor activity of HER3-DXd and T-DXd in the combination dosing regimens in participants with hormone receptor positive, HER2-low or HER2-ultralow, unresectable, or metastatic breast cancer.

Conditions

Hormone Receptor Positive; HER2-low or HER2-ultralow; Unresectable or Metastatic Breast Cancer

Outcome Measures

Primary Outcomes (2)

• Part 1: Number of Participants With at Least One Treatment-emergent Adverse Event (TEAE) and Serious Adverse Event (SAE)

  Adverse event(AE): any untoward medical occurrence in a participant administered pharmaceutical product (PP) and which does not necessarily have a causal relationship with the treatment.AE can therefore be any unfavorable and unintended sign(including an abnormal laboratory finding, for example),symptom,or disease temporally associated with the use of PP, whether or not considered related to the PP.Pre-existing conditions which worsen during study are also considered as AEs.SAE:any AE that fulfilled any of following criteria:fatal,life-threatening,required inpatient hospitalisation or prolongation of existing hospitalization,resulted in persistent or significant disability/incapacity,was congenital anomaly/birth defect, medically significant or required intervention to prevent any of the other outcomes listed here. TEAEs:AEs with start or worsening date during the on-treatment period(from 1st dose date of trial intervention to 47 days after the last dose date of trial intervention).

  Up to approximately 4.5 years

• Part 2: Objective Response Per Response Evaluation Criteria in Solid Tumours Version 1.1 (RECIST v.1.1) as Assessed by the Investigator

  Objective response is defined as participants with a best overall response (BOR) of confirmed complete response (CR) or confirmed partial response (PR), as assessed by investigator per RECIST v1.1.

  Up to approximately 4.5 years

Secondary Outcomes (25)

• Part 1: Objective Response Per RECIST v.1.1 as Assessed by the Investigator

  Up to approximately 6 years

• Part 2: Number of Participants With at Least One TEAE and SAE

  Up to approximately 6 years

• Parts 1 and 2: Disease Control Per RECIST v.1.1 as Assessed by the Investigator

  Up to approximately 6 years

• Parts 1 and 2: Duration of Response (DoR) Per RECIST v.1.1 as Assessed by the Investigator

  Up to approximately 6 years

• Parts 1 and 2: Clinical Benefit Per RECIST v.1.1 as Assessed by Investigator

  Up to approximately 6 years

Study Arms (4)

Part 1: Arm 1: Dose Regimen Determination

EXPERIMENTAL

Participants with unresectable or metastatic breast cancer (mBC) will receive T-DXd and HER3-DXd in combination regimen A until disease progression, death, unacceptable toxicity, or trial close.

Drug: Patritumab deruxtecan; Drug: Trastuzumab deruxtecan

Part 1: Arm 2: Dose Regimen Determination

EXPERIMENTAL

Participants with unresectable or mBC will receive T-DXd and HER3-DXd in combination regimen B until disease progression, death, unacceptable toxicity, or trial close.

Drug: Patritumab deruxtecan; Drug: Trastuzumab deruxtecan

Part 2: Arm 3: Dose Expansion

EXPERIMENTAL

Participants with unresectable or mBC will receive T-DXd and HER3-DXd in a combination regimen based on the available Part 1 data until disease progression, death, unacceptable toxicity, or trial close.

Drug: Patritumab deruxtecan; Drug: Trastuzumab deruxtecan

Part 2: Arm 4: Monotherapy

ACTIVE COMPARATOR

Participants with unresectable or mBC will receive T-DXd monotherapy until disease progression, death, unacceptable toxicity, or trial close.

Drug: Trastuzumab deruxtecan

Interventions

Patritumab deruxtecan DRUG

Intravenous administration as determined by treatment arm.

Also known as: U31402, HER3-DXd

Part 1: Arm 1: Dose Regimen Determination; Part 1: Arm 2: Dose Regimen Determination; Part 2: Arm 3: Dose Expansion

Trastuzumab deruxtecan DRUG

Intravenous administration as determined by treatment arm.

Also known as: DS8201a, T-DXd

Part 1: Arm 1: Dose Regimen Determination; Part 1: Arm 2: Dose Regimen Determination; Part 2: Arm 3: Dose Expansion; Part 2: Arm 4: Monotherapy

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Pathologically documented breast cancer that meets the following:
• Unresectable or metastatic.
• HR+ based on testing performed locally. HR+ (estrogen receptor \[ER\] and/or progesterone receptor \[PgR\] positive \[ER or PgR greater than equal to (≥)1 percent (%)\] per American Society of Clinical Oncology \[ASCO\]/College of American Pathologists \[CAP\] 2020 guidelines) in the unresectable or metastatic setting.
• Assessed as HER2-low (defined as Immunohistochemistry (IHC)2+/In-situ hybridization (ISH)- or IHC1+) or HER2-ultralow (defined as IHC 0 with any membrane staining in greater than (\>) 0 and lesser than equal to (≤)10% of the cancer cells) locally for Part 1 and centrally for Part 2. The HER2 result must be from a tumor sample obtained in the unresectable or metastatic setting.
• For Dose Regimen Determination (Part 1), HER2 status used for eligibility assessment must be determined locally (according to applicable regulations) using the PATHWAY anti-HER2/neu (4B5) Rabbit Monoclonal Primary Antibody (Ventana Medical Systems, Inc.). Additional HER2 testing will be performed locally and according to applicable regulations using the prescribed test during Screening only if prior results obtained with this test are not available for eligibility assessment.
• For Dose Expansion (Part 2), HER2 testing will be performed prospectively at a central laboratory using the pretreatment tumor tissue sample.
• Provides a pretreatment tumor tissue sample that meets one of the following collection requirements:
• Tissue biopsy collected from ≥1 lesion not previously irradiated and performed since progression with the most recent systemic cancer therapy regimen and prior to signature of the Tissue Screening informed consent form (ICF) (ARCHIVAL PRETREATMENT sample).
• Newly obtained pretreatment tumor biopsy from ≥1 lesion not previously irradiated and amenable to sampling, after signature of the Tissue Screening ICF (FRESH PRETREATMENT sample).
• Documented radiologic disease progression as per investigator assessment per RECIST v1.1 criteria (during or after most recent treatment).
• Documented refractoriness to endocrine therapy, defined as disease progression on one or more line of endocrine therapy in the unresectable or metastatic setting and determined by the investigator that participant would no longer benefit from further treatment with endocrine therapy.
• Prior treatment with a Cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor in any setting. Subsequent endocrine therapies administered after progression on CDK4/6 inhibitor are allowed.
• Participants with genomic alterations/mutations (Phosphatidylinositol-4,5-Bisphosphate 3-Kinase Catalytic Subunit Alpha (PIK3CA), phosphatase and tensin homolog (PTEN), AKT, or Breast Cancer gene (BRCA)1/2) who are eligible for approved targeted therapies in combination with endocrine therapy or as monotherapy (according to local label and availability) must have received the corresponding therapy prior to enrollment, unless contraindicated or not accessible in their country/region.
• No prior chemotherapy for unresectable or metastatic breast cancer. Participants who have received chemotherapy in the neoadjuvant or adjuvant setting are eligible.
• ECOG performance status 0 or 1 at the time of Screening.

You may not qualify if:

• Prior treatment with an anti-HER3 antibody and/or antibody-drug conjugate (ADC) that consists of a topoisomerase I inhibitor (e.g., T-DXd) or any other topoisomerase I inhibitor therapy.
• Has any history of interstitial lung disease (ILD)/pneumonitis irrespective of steroid use, or current ILD, or suspected ILD, or ILD that cannot be ruled out by imaging at Screening. Examples of suspected ILD/pneumonitis by imaging include the presence of lung parenchymal fibrosis, such as CPFE, and any radiographic features consistent with ILA, including but not limited to, extensive ground glass opacities, reticular opacities, traction bronchiectasis, and honeycombing. Participants may be eligible if they had history of radiation pneumonitis that did not require steroids.
• Is receiving chronic systemic corticosteroids dosed at \>10 mg prednisone daily or equivalent anti-inflammatory activity or any form of immunosuppressive therapy prior to randomization. Participants who require use of bronchodilators, inhaled or topical steroids, or local steroid injections may be included in the trial.
• Evidence of spinal cord compression or brain metastases, defined as being clinically active and symptomatic, or requiring therapy with corticosteroids or anticonvulsants to control associated symptoms. Participants with clinically inactive or treated brain metastases who are asymptomatic (i.e., without neurologic signs or symptoms and do not require treatment with corticosteroids or anticonvulsants) may be included in the trial but must have a stable neurologic status for ≥4 weeks prior to Cycle 1 Day 1. Participants with asymptomatic brain metastases and treated with anticonvulsants as prophylaxis can enroll.
• Inadequate washout period of prior treatment before randomization:
• Whole brain radiation therapy less than (\<)28 days.
• Monoclonal antibodies other than immune checkpoint inhibitors, such as anti-vascular endothelial growth factor (VEGF) (e.g., bevacizumab) and anti-epidermal growth factor receptor (EGFR) (e.g., cetuximab) \< 28 days.
• Immune checkpoint inhibitor therapy \<21 days.
• Major surgery (excluding placement of vascular access) \<28 days.
• Radiotherapy treatment to more than 30% of the bone marrow or wide field radiation or palliative stereotactic radiation to chest \<28 days or palliative stereotactic radiation therapy to other anatomic areas \<14 days.
• Chloroquine or hydroxychloroquine ≤14 days.
• Hormonal therapy \<21 days prior to first dose of HER3-DXd.
• Live or live attenuated virus vaccination \<30 days.
• Uncontrolled or significant cardiovascular disease, including any of the following:
• QTcF prolongation interval \>450 milliseconds (ms) (average of triplicate determinations at screening).

Sponsors & Collaborators

• Daiichi Sankyo: lead
• Merck Sharp & Dohme LLC: collaborator

MeSH Terms

Conditions

Breast Neoplasms

Interventions

patritumab deruxtecan; trastuzumab deruxtecan

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases

Central Study Contacts

Daiichi Sankyo Contact for Clinical Trial Information

CONTACT

9089926400; CTRinfo_us@daiichisankyo.com

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 8, 2026
• First Posted: July 14, 2026
• Study Start (Estimated): August 3, 2026
• Primary Completion (Estimated): January 1, 2031
• Study Completion (Estimated): May 1, 2032
• Last Updated: July 14, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: Completed studies that has reached a global end or completion with all data set collected and analyzed, and for which the medicine and indication have received European Union (EU) and United States (US), and/or Japan (JP) marketing approval on or after 01 January 2014 or by the US or EU or JP Health Authorities when regulatory submissions in all regions are not planned and after the primary study results have been accepted for publication.
• Access Criteria: Formal request from qualified scientific and medical researchers on IPD and clinical study documents on completed clinical trials supporting products submitted and licensed in the United States, the European Union and/or Japan from 01 January 2014 and beyond for the purpose of conducting legitimate research. This must be consistent with the principle of safeguarding study participants' privacy and consistent with provision of informed consent.