Efficacy and Safety Comparison of Niraparib to Placebo in Participants With Human Epidermal Growth Factor 2 Negative (HER2-) Breast Cancer Susceptibility Gene Mutation (BRCAmut) or Triple-Negative Breast Cancer (TNBC) With Molecular Disease

Not Recruiting

Trial ID: NCT04915755

Purpose

This study will assess the efficacy and safety of Niraparib in participants with either tumor mutation in the BRCA gene (tBRCAmut) HER2- breast cancer (Independent of hormone receptor [HR] status, including HR positive [+] and TNBC) or tumor BRCA wild type (tBRCAwt) TNBC with molecular disease based on the presence of circulating tumor Deoxyribonucleic acid (ctDNA) following surgery or completion of adjuvant therapy.

Official Title

A Randomized Phase 3 Double-Blinded Study Comparing the Efficacy and Safety of Niraparib to Placebo in Participants With Either HER2-Negative BRCA-Mutated or Triple-Negative Breast Cancer With Molecular Disease Based on Presence of Circulating Tumor DNA After Definitive Therapy (ZEST)

Stanford Investigator(s)

Melinda L. Telli, M.D.
Melinda L. Telli, M.D.

Professor of Medicine (Oncology)

Eligibility


Inclusion Criteria:

   - Stage I to III breast cancer with surgical resection of the primary tumor that is
   confirmed to be either: TNBC, irrespective of BRCA status or HR+/HER2- breast cancer
   with a known and documented deleterious or suspected deleterious tBRCA mutation.

   - Estrogen receptor (ER) and/or progesterone receptor (PgR) negativity is defined as
   immunohistochemistry (IHC) nuclear staining less than (<) 1 percentage (%), or by
   Allred scoring system where TNBC is defined to be 0 out of 8 or 2 out of 8, or
   staining in <1 % of cancer cells.

   - Completed prior standard therapy for curative intent.

   - Participants with HR+ breast cancer must be on a stable regimen of endocrine therapy.

   - Detectable ctDNA as measured by central testing.

   - An archival tumor tissue specimen of the primary tumor sufficient in quality and
   quantity for ctDNA assay design and tBRCA and Homologous recombination deficiency
   (HRD) testing is required.

   - An Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

Exclusion Criteria:

   - Prior treatment with a Poly Adenosine-diphosphate Ribose Polymerase (PARP) inhibitor.

   - Current treatment with a Cyclin-dependent kinase (CDK)4/6 inhibitor or endocrine
   therapy other than anastrozole, letrozole, exemestane, and tamoxifen with or without
   ovarian suppression.

   - Participants have any sign of metastasis or local recurrence after comprehensive
   assessment conducted per protocol.

   - Participants have shown no definitive response to preoperative chemotherapy by
   pathologic, radiographic or clinical evaluation, in cases where preoperative
   chemotherapy was administered.

   - Participants have inadequately treated or controlled hypertension.

   - Participants have received live vaccine within 30 days of planned start of study
   randomization.

   - Participants have a second primary malignancy.

   - Exceptions are the following: (a) Adequately treated non-melanoma skin cancer,
   curatively treated in situ cancer of the cervix, Ductal carcinoma in situ (DCIS) of
   the breast, Stage I Grade 1 endometrial carcinoma. (b) Other solid tumors and
   lymphomas (without bone marrow involvement) diagnosed >=5 years prior to randomization
   and treated with no evidence of disease recurrence and for whom no more than 1 line of
   chemotherapy was applied.

   - Participant is pregnant, breastfeeding, or expecting to conceive children while
   receiving study treatment and/or for up to 180 days after the last dose of study
   treatment (except France).

   - Participant is immunocompromised. Participants with splenectomy are allowed.
   Participants with known human immunodeficiency virus (HIV) are allowed if they meet
   protocol-defined criteria.

   - Participants have a known history of myelodysplastic syndrome (MDS) or acute myeloid
   leukemia (AML).

Intervention(s):

drug: Niraparib

drug: Placebo

Not Recruiting

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Kaushali Anant Thakore-Shah
+1 650-721-6977

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