Clinical trial NCT00828854: Study of the Effect of the Addition of SNDX-275 (Entinostat) to Continued Aromatase Inhibitor (AI) Therapy in Postmenopausal Women With ER+ Breast Cancer Whose Disease is Progressing
Official title: A Phase 2 Multicenter Study of the Effect of the Addition of SNDX-275 to Continued Aromatase Inhibitor (AI) Therapy in Postmenopausal Women With ER+ Breast Cancer Whose Disease is Progressing
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: ER+ Breast Cancer
Keywords: breast cancer
estrogen receptor positive
Lead sponsor: Syndax Pharmaceuticals
Sponsor class: INDUSTRY
First posted: 2009-01-26
Enrollment: 27
Sex: FEMALE
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The addition of entinostat to an AI will result in a maximal abrogation of estrogen receptor-α mediated activity and inhibit mechanisms of resistance to the aromatase inhibitor.

It is hypothesized that entinostat with continued AI will increase the estimated AI clinical benefit rate (CBR) from 5% to 25% with an acceptable safety profile.


Eligibility criteria: Inclusion Criteria:

1. Postmenopausal female patients.
2. Histologically or cytologically confirmed estrogen receptor-positive (ER+) breast cancer.
3. Progressive disease (PD) after at least 3 months on treatment with a 3rd generation AI in the advanced disease setting as measured by Response Evaluation Criteria in Solid Tumors (RECIST) criteria.
4. At least 1 measurable lesion ≥ 20 mm by conventional techniques or ≥ 10 mm by spiral computed tomography (CT) scan with the last imaging performed within 4 weeks prior to study entry. If there is only one measurable lesion and it is located in previously irradiated field, it must have demonstrated progression according to RECIST criteria.
5. Eastern Cooperative Oncology Group (ECOG) 0-1.
6. Laboratory parameters:

   1. Hemoglobin ≥ 9.0 g/dL; platelets ≥ 100 x10\^9/L; absolute neutrophil count (ANC) ≥ 1.5 x 10\^9/L without the use of hematopoietic growth factors.
   2. Creatinine less than 2.5 times the upper limit of normal for the institution.
   3. aspartate aminotransferase (AST) and alanine aminotransferase (ALT) less than 2.5 times the upper limit of normal for the institution.
7. Able to understand and give written informed consent and comply with study procedures.

Exclusion Criteria:

1. Discontinuation of AI therapy prior to study entry.
2. Less than 3 months treatment with most recent AI.
3. Rapidly progressive, life-threatening metastases, including any of the following:

   1. Symptomatic lymphangitic metastases.
   2. Patients with known active brain or leptomeningeal involvement.
4. More than one prior chemotherapy for metastatic disease.
5. Any chemotherapy within 3 months prior to study.
6. Radiotherapy to measurable lesion within 2 months prior to study.
7. Bisphosphonates initiated within 4 weeks prior to study start.
8. Allergy to benzamides or inactive components of study drug.
9. Previous treatment with entinostat or any other histone deacetylase (HDAC) inhibitor including valproic acid.
10. Patient is currently receiving treatment with any agent listed on the prohibited medication list such as valproic acid or other systemic cancer agents
11. Any concomitant medical condition that precludes adequate study treatment compliance or assessment, or increases patient risk in the opinion of the investigator:

    1. Myocardial infarction or arterial thromboembolic events within 6 months, or experiencing severe or unstable angina, New York Heart Association (NYHA) Class III or IV disease and a QTc interval \>0.47 second.
    2. Uncontrolled heart failure or hypertension, uncontrolled diabetes mellitus, uncontrolled systemic infection,
    3. Other active malignancy within 5 years excluding basal cell carcinoma or cervical intraepithelial neoplasia \[CIN / cervical carcinoma in situ\] or melanoma in situ).
12. Patient currently is enrolled in (or completed within 30 days before study drug administration) another investigational drug study.

Primary outcomes:
measure: Clinical Benefit Rate (CBR)
timeFrame: 6 months
Secondary outcomes:
measure: Progression-Free Survival (PFS)
timeFrame: Up to 6, 28-day cycles
measure: Objective Response Rate (ORR) During the First 6 Cycles of Study Treatment
timeFrame: Up to 6, 28-day cycles
measure: Number of Participants With Adverse Events (AEs)
timeFrame: Up to 6, 28-day cycles + 30 days
Other outcomes:
Locations:
city: Dublin
country: Ireland
facility: St. Vincent's University Hospital
city: Birmingham
country: United Kingdom
facility: The University of Birmingham
city: Cardiff
country: United Kingdom
facility: Velindre Hospital - Whitchurch
city: Liverpool
country: United Kingdom
facility: Whiston Hospital; Clatterbridge Centre for Oncology
city: London
country: United Kingdom
facility: University College London Hospitals
city: Manchester
country: United Kingdom
facility: Christie Hospital, Manchester Breast Centre
Study officials:
References: