Breast cancer: CLEOPATRA trial

Abbreviations

No EU-CTR

  • CLEOPATRA references
    2015-02-19
    Sandra M. Swain
    Pertuzumab, Trastuzumab, and Docetaxel in HER2-Positive Metastatic Breast Cancer
Investigated (inv)
Comparator (comp)

PERT+TRAS+doce

PLB+TRAS+doce

402

406

Phase:

3

Randomisation:

Double blind

Primary tumour:

Breast

Subtype (biomarker):

HER2 poz.

Stage:

meta

Line of therapy:

L1

Primary
PERT+TRAS+doce
PLB+TRAS+doce
HR
p
PFS
18.5 mo
12.4 mo
0.62 (0.51-0.75)
<0.001
Secondaries
PERT+TRAS+doce
PLB+TRAS+doce
HR
p
OS
56.5 mo
40.8 mo
0.68 (0.56-0.84)
<0.001
DoR
20.2 mo
12.5 mo
na
na
PFS
18.5 mo
12.4 mo
0.62 (0.51-0.75)
<0.001
ORR
80.2%
69.3%
na
na
(all grades, %)
PERT+TRAS+doce
PLB+TRAS+doce
p
Neutropenia (gr.≥3)
48.9
45.8
NA
Febrile neutropenia (gr.≥3)
13.8
7.6
NA
Leukopenia (gr.≥3)
12.3
14.6
NA
Diarrhea (gr.≥3)
7.9
5.0
NA
Peripheral neuropathy (gr.≥3)
2.7
1.8
NA
Anemia (gr.≥3)
2.5
3.5
NA
Asthenia (gr.≥3)
2.5
1.5
NA
Fatigue (gr.≥3)
2.2
3.3
NA
Granulocytopenia (gr.≥3)
1.5
2.3
NA
Left ventricular systolic dysfunction (gr.≥3)
1.2
2.8
NA
  • Inclusion
  • Exclusion

- 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) - Human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (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 and men with partners of childbearing potential, agreement to use a highly effective form of contraception and to continue its use for the duration of study treatment and for at least 7 months after the last dose of study treatment

- History of anti-cancer therapy for MBC (with the exception of one prior hormonal regimen for MBC, which must be stopped prior to randomization) - 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, basal cell carcinoma or squamous cell carcinoma

Characteristics
PERT+TRAS+doce
PLB+TRAS+doce
Agedc-comma sex
Median age (range) yr
54 (22-82)
54 (27-89)
Female - no.(%)
402 (100.0)
404 (99.5)
Race or ethnic group - no.(%)
Asian
128 (31.8)
133 (32.8)
Black
10 (2.5)
20 (4.9)
White
245 (60.9)
235 (57.9)
Other
19 (4.7)
18 (4.4)
Region - no.(%)
Asia
125 (31.1)
128 (31.5)
Europe
154 (38.3)
152 (37.4)
North America
67 (16.7)
68 (16.7)
South America
56 (13.9)
58 (14.3)
ECOG performance status - no.(%)
0
274 (68.2)
248 (61.1)
1
125 (31.1)
157 (38.7)
≥2
3 (0.7)
1 (0.2)
Disease type at screening - no.(%)
Visceral
314 (78.1)
316 (77.8)
Nonvisceral
88 (21.9)
90 (22.2)
Hormone-receptor status - no.(%)
ERdc-plusdc-comma PgRdc-plusdc-comma or both
189 (47.0)
199 (49.0)
ER-dc-comma PgR-
212 (52.7)
196 (48.3)
Unknown
1 (0.2)
11 (2.7)
HER2 statusdc-comma assessed by IHC - no.(%)
0 or 1dc-plus
4 (1.0)
2 (0.5)
2dc-plus
47 (11.7)
32 (7.9)
3+
350 (87.1)
371 (91.4)
Data not available
1 (0.2)
1 (0.2)
HER2 statusdc-comma assessed by
Positive
384 (95.5)
383 (94.3)
Negative
1 (0.2)
4 (1.0)
Data not available
17 (4.2)
19 (4.7)
Prior adjuvant or neoadjuvant ch
Yes
184 (45.8)
192 (47.3)
No
218 (54.2)
214 (52.7)
Prior adjuvant or neoadjuvant chemotherapy - no.(%)
Anthracycline
150 (37.3)
164 (40.4)
Hormone
106 (26.4)
97 (23.9)
Taxane
91 (22.6)
94 (23.2)
Trastuzumab
47 (11.7)
41 (10.1)
Ad-hoc:
no.pts inv.
no.pts comp.
PERT+TRAS+doce
PLB+TRAS+doce
HR
p
  • PFS
analisys of PFS
PERT+TRAS+doce
PLB+TRAS+doce
HR (95% CI)
Age (n)
<65 yr (681)
0.65 (0.53–0.80)
≥65 yr (127)
0.52 (0.31–0.86)
Race or ethnic group (n)
White (480)
0.62 (0.49–0.80)
Asian (261)
0.68 (0.49–0.95)
Geographic region (n)
Europe (306)
0.72 (0.53–0.97)
Asia (253)
0.68 (0.48–0.95)
Previous neoadj. or adj. chemotherapy (n)
Yes (376)
0.61 (0.46–0.81)
No (432)
0.63 (0.49–0.82)
Disease type (n)
Visceral (630)
0.55 (0.45–0.68)
Nonvisceral (178)
0.96 (0.61–1.52)
Hormone-receptor status (n)
ERdc-plusdc-comma PgRdc-plusdc-comma or both (388)
0.72 (0.55–0.95)
ER-dc-comma PgR- (408)
0.55 (0.42–0.72)
HER2 status (n)
IHC 3dc-plus (721)
0.60 (0.49–0.74)
FISH-positive (767)
0.64 (0.53–0.78)
analisys of
PERT+TRAS+doce
PLB+TRAS+doce
HR (95% CI)