A Phase II Clinical Trial of PM01183 in BRCA 1/2-Associated or Unselected Metastatic Breast Cancer

A Clinical Trial of PM01183 in Metastatic Breast Cancer to assess the antitumor activity of PM01183 ,to evaluate whether the presence of a known germline mutation in BRCA 1/2 predicts response to PM01183 in Metastatic Breast Cancer (MBC) patients, to evaluate the safety profile of this PM01183 to analyze the pharmacokinetics (PK) and PK/PD (pharmacokinetic/pharmacodynamic) correlations and to evaluate the pharmacogenomic (PGx) expression profile in tumor samples.

A Multicenter Phase II Clinical Trial of PM01183 in BRCA 1/2-Associated or Unselected Metastatic Breast Cancer to assess the antitumor activity of PM01183 in terms of overall response rate (ORR), duration of response (DR),clinical benefit \[ORR or stable disease lasting over three months (SD \> 3 months)\], progression free survival (PFS), and one-year overall survival (1y-OS) and to evaluate whether the presence of a known germline mutation in BRCA 1/2 predicts response to PM01183 in MBC patients, to explore the activity of PM01183 in specific breast cancer subpopulations according to hormonal receptor status, HER-2 overexpression, number and/or type of prior therapies, or according to other available histological/molecular classifications, to evaluate the safety profile of this PM01183 administration schedule \[Day 1 every three weeks (q3wk)\] in this patient population, to analyze the pharmacokinetics (PK) of PM01183 in this patient population, to explore PK/PD (pharmacokinetic/ pharmacodynamic) correlations, if applicable and to evaluate the pharmacogenomic (PGx) expression profile of selected putative markers potentially predictive of response to PM01183, in tissues from tumor samples.

Eligibility Criteria:
Inclusion Criteria:

* Women ≥ 18 and ≤ 75 years of age.
* Voluntary signed informed consent form (ICF).
* Proven diagnosis of metastatic breast cancer (MBC).
* At least one, but no more than three, prior chemotherapy regimens for MBC.
* Patients with known HER-2 overexpressing MBC must have failed at least one prior trastuzumab-containing regimen for metastatic disease.
* Disease evaluable for response by specific appropriate criteria.
* No or minimal disease-related symptoms not affecting patient daily activities.
* Adequate major organ function (normal or minimal alteration in liver, kidney, hematological, metabolic and cardiac function)
* Wash out periods prior to Day 1 of Cycle 1:

At least three weeks since the last chemotherapy (six weeks in some particular cases) and At least four weeks since the last radiotherapy (RT) \> 30 Gy) and At least one week since the last hormonal therapy and At least two weeks since the last biological/investigational therapy

* Minimal or no ongoing toxicity from immediately prior therapy according to specific appropriate criteria. Mild ongoing toxicity is allowed in case of alopecia, skin toxicity, fatigue and/or finger numbness or tumbling.
* Patients of child-bearing potential must agree to use a medically approved contraception method until at least six weeks after the last study drug administration.
* Known deleterious germline mutation of BRCA1/2 (Patients in Cohorts A and A1)
* Prior treatment with PARP inhibitors (Patients in Cohort A1)

Exclusion Criteria:

* Prior treatment with PM01183 or trabectedin.
* Extensive prior RT.
* Prior or concurrent malignant disease unless cured for more than five years.
* Exceptions are breast cancer in the other breast.
* Uncommon or rare subtypes of breast cancer.
* Symptomatic or progressive brain metastases.
* Bone-limited and exclusively metastases.
* Relevant diseases or clinical situations which may increase patient's risk:

History of cardiac disease. Moderate breathing difficulties or oxygen requirement Active uncontrolled infection. Unhealed wound or presence of any external drainage. Chronically active viral hepatitis. Immunocompromised patients, including those known to be infected by human immunodeficiency virus (HIV).

Known muscular disease or functional alteration

* Pregnant or breastfeeding women.
* Impending need for immediate RT for symptomatic relief.
* Limitation of the patient's ability to comply with the treatment or to follow-up the protocol.