Patient case: 45-year-old female with cervical cancer; genetic feature: ERBB2 (S310Y)

Clinical trial: A Study to Evaluate Pertuzumab + Trastuzumab + Docetaxel vs. Placebo + Trastuzumab + Docetaxel in Previously Untreated HER2-positive Metastatic Breast Cancer

Summary: This study is a Phase III, randomized, double-blind, placebo-controlled, multicenter international clinical trial. Participants who have HER2-positive metastatic breast cancer (MBC) and have not received chemotherapy or biological therapy (including approved or investigational tyrosine kinase/HER inhibitors or vaccines) for their metastatic disease are eligible for study. Participants could have received one prior hormonal treatment for MBC. Participants may have received systemic breast cancer treatment in the neo-adjuvant or adjuvant setting, provided that the participant has experienced a disease-free interval (DFI) of greater than or equal to (>/=) 12 months from completion of adjuvant systemic treatment (excluding hormonal therapy) to metastatic diagnosis. Participants may have received trastuzumab and/or a taxane during the neo-adjuvant or adjuvant treatment.

Detailed description: Participants will be randomized in 1:1 ratio to receive pertuzumab or placebo along with trastuzumab and docetaxel every 3 weeks (Q3W) in the treatment phase of the study until investigator-assessed radiographic or clinical progressive disease, unmanageable toxicity, or study termination. Participants who were on placebo arm will be offered to receive after completion of treatment phase but participants who discontinue from the study, will not receive pertuzumab during open-label phase.

Eligibility: Inclusion Criteria:
  -  Histologically or cytologically confirmed adenocarcinoma of the breast with locally recurrent or metastatic disease, and candidate for chemotherapy. Participants with measurable and non-measurable disease are eligible (locally recurrent disease must not be amenable to resection with curative intent; participants with de novo Stage IV disease are eligible)
  -  HER2-positive MBC
  -  Left ventricular ejection fraction (LVEF) >/=50 percent (%) at baseline (within 42 days of randomization)
  -  Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or 1
  -  For women of childbearing potential, agreement to use an effective form of contraception and to continue its use for the duration of study treatment and for 6 months after the last dose of study treatment
  Exclusion Criteria:
  -  History of anti-cancer therapy for MBC (with the exception of one prior hormonal regimen for MBC)
  -  History of approved or investigative tyrosine kinase/HER inhibitors for breast cancer in any treatment setting, except trastuzumab used in the neoadjuvant or adjuvant setting
  -  History of systemic breast cancer treatment in the neo-adjuvant or adjuvant setting with a disease-free interval from completion of the systemic treatment (excluding hormonal therapy) to metastatic diagnosis of less than (<) 12 months
  -  History of persistent Grade >/=2 hematologic toxicity resulting from previous adjuvant therapy
  -  Current peripheral neuropathy of National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 3.0, Grade >/=3 at randomization
  -  History of other malignancy within the last 5 years, except for carcinoma in situ of the cervix or basal cell carcinoma
  -  Current clinical or radiographic evidence of central nervous system (CNS) metastases
  -  Computed tomography (CT) or magnetic resonance imaging (MRI) scan of the brain is mandatory in cases of clinical suspicion of brain metastases
  -  History of exposure to cumulative doses of anthracyclines
  -  Current uncontrolled hypertension or unstable angina
  -  History of congestive heart failure (CHF) of any New York Heart Association (NYHA) criteria, or serious cardiac arrhythmia requiring treatment
  -  History of myocardial infarction within 6 months of randomization
  -  History of LVEF decline to below 50% during or after prior trastuzumab neo-adjuvant or adjuvant therapy
  -  Current dyspnea at rest due to complications of advanced malignancy, or other diseases that require continuous oxygen therapy
  -  Inadequate organ function within 28 days prior to randomization
  -  Current severe, uncontrolled systemic disease
  -  Major surgical procedure or significant traumatic injury within 28 days prior to study treatment start or anticipation of the need for major surgery during the course of study treatment
  -  Pregnant or lactating women
  -  History of receiving any investigational treatment within 28 days of randomization
  -  Current known infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV)
  -  Receipt of IV antibiotics for infection within 14 days of randomization
  -  Current chronic daily treatment with corticosteroids (excluding inhaled steroids)
  -  Known hypersensitivity to any of the study drugs
  -  Assessed by the investigator to be unable or unwilling to comply with the requirements of the protocol

Relevance to patient case: not relevant