BYL719 + T-DM1 in HER2(+) Metastatic Breast Cancer Pts Who Progress on Prior Trastuzumab & Taxane Tx

Sponsor
Northwestern University (Other)
Overall Status
Completed
CT.gov ID
NCT02038010
Collaborator
Novartis (Industry), National Cancer Institute (NCI) (NIH)
17
1
1
36
0.5

Study Details

Study Description

Brief Summary

The purpose of this study is to see whether a combination of two different drugs - trastuzumab-MCC-DM1 (T-DM1) and BYL719 is safe, and if it might be effective in treating metastatic breast cancer. T-DM1 is a type of drug that contains an antibody (trastuzumab) linked to chemotherapy. The antibody in T-DM1 targets a marker on breast cancer cells called HER2, which allows the drug to go directly to the cancer cells. The use of T-DM1 in this study is considered standard treatment for the type of cancer in this study. Participants in this study have already been treated with trastuzumab and chemotherapy in the past, and their cancer has gotten worse in spite of those treatments. BYL719 is an oral drug (taken by mouth) that the researchers think may help T-DM1 to work better.

Condition or Disease Intervention/Treatment Phase
  • Drug: PI3K inhibitor BYL719
  • Biological: ado-trastuzumab emtansine
  • Other: pharmacological study
  • Other: laboratory biomarker analysis
Phase 1

Detailed Description

PRIMARY OBJECTIVES:
  1. Determine safety, tolerability, feasibility, and the maximum-tolerated dose (MTD) of dose-escalating BYL719 in combination with ado-trastuzumab emtansine (T-DM1) in patients with HER2-positive metastatic breast cancer (MBC) after progression on trastuzumab and taxane-based therapy.
SECONDARY OBJECTIVES:
  1. Evaluate pharmacokinetics (PK) of BYL719 administered in combination with T-DM1.

  2. Assess any preliminary evidence of efficacy of BYL719 and T-DM1 in combination in patients with HER2-positive MBC.

TERTIARY OBJECTIVES:
  1. Explore efficacy in patients whose tumors have an alteration (mutation or amplification) of the PIK3CA gene and decrease of phosphatase and tensin homolog gene (PTEN) expression. (Optional) II. Examine other v-akt murine thymoma viral oncogene homolog 1 (Akt)/mechanistic target of rapamycin (mTOR) downstream markers by immunohistochemistry. (Optional)

OUTLINE: This is a dose-escalation study of PI3K inhibitor BYL719.

Patients receive PI3K inhibitor BYL719 orally (PO) daily on days 1-21 and ado-trastuzumab emtansine (T-DM1) intravenously (IV) over 30-90 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity, or at the discretion of the treating physician.

After completion of study treatment, patients are followed up every 3 months.

Study Design

Study Type:
Interventional
Actual Enrollment :
17 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Phase I Study of BYL719 and Trastuzumab-MCC-DM1 in HER2-Positive Metastatic Breast Cancer Patients With Progression on Prior Trastuzumab and Taxane-Based Therapy
Actual Study Start Date :
May 21, 2014
Actual Primary Completion Date :
Apr 15, 2015
Actual Study Completion Date :
May 20, 2017

Arms and Interventions

Arm Intervention/Treatment
Experimental: Treatment (PI3K inhibitor BYL719, ado-trastuzumab emtansine)

Patients receive PI3K inhibitor BYL719 PO daily on days 1-21 and ado-trastuzumab emtansine IV over 30-90 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

Drug: PI3K inhibitor BYL719
Given PO
Other Names:
  • BYL719
  • phosphoinositide 3-kinase inhibitor BYL719
  • Biological: ado-trastuzumab emtansine
    Given IV
    Other Names:
  • Kadcyla
  • T-DM1
  • trastuzumab-DM1
  • trastuzumab-MCC-DM1
  • trastuzumab-MCC-DM1 antibody-drug conjugate
  • Other: pharmacological study
    Correlative studies
    Other Names:
  • pharmacological studies
  • Other: laboratory biomarker analysis
    Optional correlative studies

    Outcome Measures

    Primary Outcome Measures

    1. Dose Limiting Toxicity (DLT) of Dose-escalating BYL719 in Combination With T-DM1 [The 1st 21 days (Cycle 1) of treatment]

      DLTs of BYL719 in combination with T-DM1 will be assessed using National Cancer Institute's Common Toxicity Criteria for adverse events version 4.0 (except for hyperglycemia). A DLT is described any grade 3 or higher, clinically significant toxicity (excluding alopecia) experienced during the first 21 days following first dose of BYL719 that is determined to be at least possibly related to study medication. Lower grades may also be considered DLTs if they lead to a dose interruption of more than 7 consecutive days of BYL719. In general adverse events (AEs) will be graded according to the following: Grade 1 Mild AE Grade 2 Moderate AE Grade 3 Severe AE Grade 4 Life-threatening or disabling AE Grade 5 Death related to AE

    2. Maximum Tolerated Dose (MTD) of BYL719 in Combination With T-DM1. [The 1st 21 days (Cycle 1) of treatment]

      Safety of BYL719 in combination with T-DM1 will be assessed during the first 21 days (1 cycle=21 days) which will assist in providing the MTD. Adverse Events including dose limiting toxicities (DLT), changes in physical findings, or clinical laboratory results as well as cardiac toxicity (changes in cardiac function, which will be measured by use of echocardiogram or MUGA scan) will be evaluated. For each dose level, 3 patients will be treated. If none (0 of 3) show a DLT, dose will be escalated for the next cohort of patients. If 2 or 3 have a DLT, then the previous dose will be considered the MTD. If 2 or 3 in cohort 1 (starting dose) experience a DLT, then the dose in -1 cohort will be used. If 1 of 3 patients has a DLT, then an additional 3 patients will be added to that dose level. If 1 of 6 has a DLT, then the dose will be escalated. If 2 of 6 have a DLT, then this dose will be considered the MTD. If 3 or more of 6 have a DLT, then the previous dose will be the MTD.

    Secondary Outcome Measures

    1. Pharmacokinetics (PK) of BYL719 Administered in Combination With T-DM1. [Day 1, 8, and 15 of Cycles 1, 2, and 3, then every 3 Cycles (1 Cycle =21 days) while on treatment where the median number of cycles is 11 and range is 3-19 cycles.]

      To assess the pharmacokinetics (PK)of BYL719, blood will be drawn from patients on Day 1, 8, and 15 of Cycles 1, 2 and 3 where 1 Cycle = 21 days. After that blood will be drawn once every 3 cycles. PK parameters of BYL719 including peak and trough concentrations as an estimate of the steady-state concentration, elimination clearance, interindividual variability of the elimination clearance, and the effect of PK parameters with prolonged administration of BYL719 will be obtained. Steady state concentration will be analyzed to see if there is any relationship with efficacy or toxicity.

    2. Progression-Free Survival (PFS) of BYL719 Administered in Combination With T-DM1 for All Patients Treated on Study. [From the start of treatment and every 3 months up to 1 year after discontinuation of treatment. 1 Cycle = 21 days. Median number of cycles is 11 and range is 3-19 cycles.]

      Progression-Free Survival (PFS) for patients treated with BYL719 and T-DM1 in combination is measured for all patients from the time of treatment initiation until the first documentation of progressive disease or death from any cause. It will be assessed every 3 months up to 1 year after discontinuation of the study drugs. Patients that completed at least 3 cycles of treatment and had imaging at 1st response time point were considered evaluable for this objective.

    3. Objective Response Rate (ORR) of BYL719 Administered in Combination With T-DM1 by Cohort [From the start of treatment and every 3 cycles during treatment where 1 cycle =21 days, median number of cycles is 11 and range of cycles is 3-19.]

      ORR for patients treated with BYL719 in combination with T-DM1 assessed every 3 cycles (every 9 weeks) with imaging and Best Response defined by RECIST v1.1. ORR is defined as number of patients with Complete Response (CR)+Partial Response (PR) documented as their Best Response (confirmed 4 weeks later). Response is based on evaluation of target and non-target lesions. Clinical lesions will only be considered measurable when they are superficial. Patients that completed at least 3 cycles of treatment and had imaging at 1st response time point were considered evaluable for this objective. Target Lesions: CR: Disappearance of all target lesions. PR: At least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum of LD. For Non-Target Lesions: CR: Disappearance of all non-target lesions and normalization of tumor marker level Non-complete Response (Non-CR): Persistence of one or more non-target lesion(s)

    Other Outcome Measures

    1. Number of Patients With Changes in PIK3CA Gene, PTEN Expression and Akt/mTOR Downstream Markers [Baseline]

      Patients tumor tissue collected during biopsy will be evaluated by immunohitochemistry (IHC) and Next Generation Sequencing (NGS) to see if the study drugs are efficacious on patients who have this alteration.

    2. Clinical Benefit Rate (CBR) of BYL719 Administered in Combination With T-DM1 by Cohort [From the start of treatment and every 3 cycles (1 cycle =21 days) while on treatment where the median number of cycles is 11 and range is 3-19 cycles.]

      Clinical Benefit Rate (CBR) patients treated BYL719 and T-DM1 combination treatment is defined as the number of patients with Complete Response + Partial Response + Stable Disease for over 6 months documented as their best response, assessed every 3 cycles (every 9 weeks) with physical exam and imaging (CT chest/abdomen/pelvis and bone scan, or PET/CT) and defined by RECIST guidelines. Patients that completed at least 3 cycles of treatment and had imaging at 1st response time point were considered evaluable for this objective.

    3. Best Response of BYL719 Administered in Combination With T-DM1 by Cohort [From the start of treatment and every 3 cycles during treatment where 1 cycle =21 days, median number of cycles is 11 and range of cycles is 3-19.]

      Best Response (BR) of patients treated with BYL719 and T-DM1 combination treatment is assessed every 9 weeks with physical exam and imaging and defined by Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0). BR is based on evaluation of target and non-target lesions. Clinical lesions will only be considered measurable when they are superficial. Patients that completed at least 3 cycles of treatment and had imaging at 1st response time point were considered evaluable for this objective. Complete Response (CR): Disappearance of all target lesions Partial Response (PR): >=30% decrease in the sum of the longest diameter (LD) of target lesions Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD Progressive Disease (PD): At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum of LD recorded since the treatment started or the appearance of one or more new lesions

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    Female
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Patients must have histologically-confirmed HER2-positive breast cancer that is locally advanced or metastatic (stage 4); ideally this should be from biopsy of the metastatic disease; however if this is not available, histologic confirmation from the primary tumor is acceptable

    • Patients must have had progression on a trastuzumab and taxane-based chemotherapy regimen during or after treatment for locally advanced or metastatic disease or within 6 months after treatment for early-stage HER2-positive disease documented by one of the following results using Food and Drug Administration (FDA)-approved testing methods:

    • Fluorescence in situ hybridization (FISH)-positive (with an amplification ratio

    = 2.0 indicating positive status) and/or

    • Immunohistochemistry (IHC) 3 + by local laboratory assessment

    • Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status =< 2

    • Patients must have a life expectancy >= 90 days

    • Patients must have baseline laboratory tests within the following parameters at least 4 weeks (28 days) prior to registration:

    • Hemoglobin > 8 g/dL (which may be reached by transfusion)

    • Platelet count >= 100 x 10^9/L (no transfusion allowed within 2 weeks)

    • Absolute neutrophil count (ANC) >= 1.5 x 10^9/L without growth factor support

    • Serum bilirubin =< 1.5 x upper limit of normal (ULN)

    • Aspartate aminotransferase (AST)/serum glutamic oxaloacetic transaminase (SGOT) and/or alanine aminotransferase (ALT)/serum glutamate pyruvate transaminase (SGPT) =< 2.5 x upper limit of normal (ULN) or =< 5 x ULN if liver metastases are present

    • Serum creatinine =< 1.5 x ULN or calculated or directly measured creatinine clearance (CrCl) >= 50% LLN (lower limit of normal)

    • Fasting plasma glucose (FPG) < 140 mg/dL/7.8 mmol/L

    • Patients with child-bearing potential must have a negative urine pregnancy test within 7 days prior to registration

    • Patients must have a baseline electrocardiogram (ECG) showing QT interval =< 460 msec within 14 days prior to registration

    • Patients must provide written informed consent prior to any registration on study

    • Patients must be willing and able to comply with scheduled visits, treatment plan and laboratory tests

    • Patient must be able to swallow and retain oral medication

    Exclusion Criteria:
    • Patients with prior sensitivity or intolerance to PI3K inhibitors are not eligible for participation

    • Patients with a history of grade >= 3 hypersensitivity reaction to trastuzumab, OR grade >= 1 with the most recent trastuzumab infusion before study entry, OR continued requirement for prolonged trastuzumab infusions to prevent hypersensitivity reactions are not eligible for participation

    • Patients with a history of intolerance to trastuzumab and/or adverse events related to trastuzumab that resulted in trastuzumab being permanently discontinued are not eligible for participation

    • Patients who have received prior treatment with T-DM1 are not eligible for participation

    • Patients who have received prior anti-cancer therapy (e.g., biologic or other targeted therapy, chemotherapy, hormonal therapy) within 2 weeks prior to registration are not eligible for participation

    • Patients with central nervous system (CNS) involvement may participate if the patient meets all of the following criteria:

    • At least 4 weeks from prior therapy completion (including radiation and/or surgery) to starting the study treatment

    • Clinically stable with respect to the CNS tumor at the time of screening

    • Not receiving steroid therapy

    • Not receiving enzyme inducing anti-epileptic medications that were started for brain metastases

    • Patients who have received radiotherapy =< 4 weeks prior to registration, with the exception of palliative radiotherapy, who have not recovered from side effects of such therapy to baseline or grade =< 1 and/or from whom >= 30% of the bone marrow was irradiated are not eligible for participation

    • Patients who have undergone major surgery =< 4 weeks prior to registration or who have not recovered from side effects of such procedure are not eligible for participation

    • Patients with clinically significant cardiac disease or impaired cardiac function are not eligible for participation; this includes patients with:

    • Congestive heart failure (CHF) requiring treatment (New York Heart Association [NYHA] grade >= 2)

    • Left ventricular ejection fraction (LVEF) < 50% as determined by multi-gated acquisition (MUGA) scan or echocardiogram (ECHO)

    • Uncontrolled arterial hypertension defined by blood pressure > 140/100 mm Hg at rest (average of 3 consecutive readings)

    • History or current evidence of unstable, clinically significant cardiac arrhythmias or patients that require medications with a narrow therapeutic window, atrial fibrillation and/or conduction abnormality (e.g. congenital long QT syndrome, high-grade/complete atrioventricular [AV]-blockage)

    • Acute coronary syndromes (including myocardial infarction, unstable angina, coronary artery bypass graft [CABG], coronary angioplasty, or stenting), < 3 months prior to screening

    • QT interval adjusted according to Fridericia (QTcF) > 460 msec on screening ECG

    • Patients with diabetes mellitus requiring insulin treatment and/or with clinical signs or with fasting plasma glucose (FPG) >= 140 mg/dL/7.8 mmol/L, or history of documented steroid-induced diabetes mellitus are not eligible for participation

    • Patients exhibiting any other condition that would, in the Investigator's judgment, preclude patient's participation in the clinical study due to safety concerns or compliance with clinical study procedures are not eligible for participation; this might include, but is not limited to, infection/inflammation, intestinal obstruction, and/or social/psychological complications

    • Patients with impaired gastrointestinal (GI) function or GI disease that may significantly alter the absorption of oral BYL719 (e.g. ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection) are not eligible for participation

    • Patients who are currently receiving medication with a known risk of prolonging the QT interval or inducing Torsades de Pointes (TdP) AND are unable to discontinue this medication or switch to a different medication prior to beginning study treatment are not eligible for participation

    • Patients with a history of another malignancy within 2 years prior to registration are not eligible for participation; NOTE: the exceptions to this include cured basal cell carcinoma of the skin or excised carcinoma in situ of the cervix

    • Patients receiving therapeutic doses of warfarin are not eligible for participation; NOTE: Patients with a need for therapeutic anticoagulation should be given low molecular weight heparin or other non-warfarin product

    • Pregnant or nursing (lactating) women are not eligible for participation; NOTE: Pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive human chorionic gonadotropin (hCG) laboratory test (> 5 mIU/mL)

    • Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, are not eligible for participation UNLESS they agree to use highly effective methods of contraception during dosing and for 5 weeks after study drugs discontinuation; highly effective contraception methods include:

    • Total abstinence (when this is in line with the preferred and usual lifestyle of the subject); periodic abstinence (e.g. calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception

    • Female sterilization (have had surgical bilateral oophorectomy with or without hysterectomy) or tubal ligation at least 5 weeks before receiving study treatment. In case of oophorectomy alone, the reproductive status of the woman must have been confirmed by follow up hormone level assessment

    • Male sterilization (at least 6 months prior to screening); for female subjects on the study the vasectomized male partner should be the sole partner for that subject

    • Combination of the following:

    • Placement of an intrauterine device (IUD) or intrauterine system (IUS)

    • Barrier methods of contraception: condom or occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam/gel/film/cream/vaginal suppository

    • NOTE: Oral contraceptives (OC), injected or implanted hormonal methods are not allowed as the sole method of contraception, as BYL719 has not been characterized with respect to its potential to interfere with the PK and/or the effectiveness of OCs

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Northwestern University Chicago Illinois United States 60611

    Sponsors and Collaborators

    • Northwestern University
    • Novartis
    • National Cancer Institute (NCI)

    Investigators

    • Principal Investigator: Sarika Jain, Northwestern University

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    William Gradishar, Principal Investigator, Northwestern University
    ClinicalTrials.gov Identifier:
    NCT02038010
    Other Study ID Numbers:
    • NU 13B06
    • NCI-2013-02224
    • NU 13B06
    • P30CA060553
    • STU00087202
    First Posted:
    Jan 16, 2014
    Last Update Posted:
    Jun 29, 2020
    Last Verified:
    Jun 1, 2020

    Study Results

    Participant Flow

    Recruitment Details The study opened for accrual on February 26, 2014 with an accrual goal of up to 28 patients. The first patient started treatment May 21 2014. The study was designed as a 3 + 3 escalation. 6 patients were enrolled in Cohort 1 and 11 patients enrolled in Cohort -1. The study closed February 12, 2016 with accrual for the study design having been met.
    Pre-assignment Detail
    Arm/Group Title Cohort -1 (250mg BYL719, 3.6mg/kg T-DM1) Cohort 1 (300mg BYL719, 3.6mg/kg T-DM1) Cohort 2 (350mg BYL719, 3.6mg/kg T-DM1) Cohort 3 (400mg BYL719, 3.6mg/kg T-DM1)
    Arm/Group Description Patients receive 250 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies Patients receive 300 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies Patients receive 350 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies Patients receive 400 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies
    Period Title: Completed 1st Cycle and Started Cycle 2
    STARTED 11 6 0 0
    Completed 1st Cycle 11 5 0 0
    Continued on to Cycle 2 10 4 0 0
    COMPLETED 10 4 0 0
    NOT COMPLETED 1 2 0 0
    Period Title: Completed 1st Cycle and Started Cycle 2
    STARTED 10 4 0 0
    Completed 3 Cycles 10 4 0 0
    Continued to Cycle 4 9 3 0 0
    COMPLETED 9 3 0 0
    NOT COMPLETED 1 1 0 0
    Period Title: Completed 1st Cycle and Started Cycle 2
    STARTED 11 6 0 0
    COMPLETED 4 3 0 0
    NOT COMPLETED 7 3 0 0

    Baseline Characteristics

    Arm/Group Title BYL719 and T-DM1 Treatment
    Arm/Group Description Patients receive either 250 mg (Cohort -1) or 300 mg (Cohort 1) PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies
    Overall Participants 17
    Age (Count of Participants)
    <=18 years
    0
    0%
    Between 18 and 65 years
    14
    82.4%
    >=65 years
    3
    17.6%
    Sex: Female, Male (Count of Participants)
    Female
    17
    100%
    Male
    0
    0%
    Ethnicity (NIH/OMB) (Count of Participants)
    Hispanic or Latino
    3
    17.6%
    Not Hispanic or Latino
    14
    82.4%
    Unknown or Not Reported
    0
    0%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    0
    0%
    Asian
    0
    0%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    Black or African American
    0
    0%
    White
    17
    100%
    More than one race
    0
    0%
    Unknown or Not Reported
    0
    0%
    Region of Enrollment (Count of Participants)
    United States
    17
    100%
    T-DM1 Systemic Therapy in Metastatic Setting (Count of Participants)
    Patients had prior T-DM1 therapy
    10
    58.8%
    Patients had not had prior TDM1 therapy
    7
    41.2%
    Hormone Receptor Status (Count of Participants)
    Positive
    8
    47.1%
    Negative
    9
    52.9%

    Outcome Measures

    1. Primary Outcome
    Title Dose Limiting Toxicity (DLT) of Dose-escalating BYL719 in Combination With T-DM1
    Description DLTs of BYL719 in combination with T-DM1 will be assessed using National Cancer Institute's Common Toxicity Criteria for adverse events version 4.0 (except for hyperglycemia). A DLT is described any grade 3 or higher, clinically significant toxicity (excluding alopecia) experienced during the first 21 days following first dose of BYL719 that is determined to be at least possibly related to study medication. Lower grades may also be considered DLTs if they lead to a dose interruption of more than 7 consecutive days of BYL719. In general adverse events (AEs) will be graded according to the following: Grade 1 Mild AE Grade 2 Moderate AE Grade 3 Severe AE Grade 4 Life-threatening or disabling AE Grade 5 Death related to AE
    Time Frame The 1st 21 days (Cycle 1) of treatment

    Outcome Measure Data

    Analysis Population Description
    5 patients enrolled into Cohort 1 were assess for DLTs, one patient in Cohort 1 was determined not to be evaluable after review; the patient only received one dose of treatment total. Only the first 3 patients in Cohort -1 were assessed for DLTs due to 3+3 design.
    Arm/Group Title Cohort -1 (250mg BYL719, 3.6mg/kg T-DM1) Cohort 1 (300mg BYL719, 3.6mg/kg T-DM1)
    Arm/Group Description Patients receive 250 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies Patients receive 300 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies
    Measure Participants 3 5
    Thrombocytopenia
    0
    0%
    1
    NaN
    Rash Maculopapular
    0
    0%
    2
    NaN
    2. Primary Outcome
    Title Maximum Tolerated Dose (MTD) of BYL719 in Combination With T-DM1.
    Description Safety of BYL719 in combination with T-DM1 will be assessed during the first 21 days (1 cycle=21 days) which will assist in providing the MTD. Adverse Events including dose limiting toxicities (DLT), changes in physical findings, or clinical laboratory results as well as cardiac toxicity (changes in cardiac function, which will be measured by use of echocardiogram or MUGA scan) will be evaluated. For each dose level, 3 patients will be treated. If none (0 of 3) show a DLT, dose will be escalated for the next cohort of patients. If 2 or 3 have a DLT, then the previous dose will be considered the MTD. If 2 or 3 in cohort 1 (starting dose) experience a DLT, then the dose in -1 cohort will be used. If 1 of 3 patients has a DLT, then an additional 3 patients will be added to that dose level. If 1 of 6 has a DLT, then the dose will be escalated. If 2 of 6 have a DLT, then this dose will be considered the MTD. If 3 or more of 6 have a DLT, then the previous dose will be the MTD.
    Time Frame The 1st 21 days (Cycle 1) of treatment

    Outcome Measure Data

    Analysis Population Description
    5 patients enrolled into Cohort 1 were assess for DLTs, one patient in Cohort 1 was determined not to be evaluable after review; the patient only received one dose of treatment total. Only the first 3 patients in Cohort -1 were assessed for DLTs due to 3+3 design in assessing for DLTs and determining the MTD.
    Arm/Group Title 250mg or 300mg BYL719, 3.6mg/kg T-DM1
    Arm/Group Description Patients receive 250 mg PO daily PI3K inhibitor BYL719 on days 1-21 in Cohort -1 and 300 mg PO daily PI3K inhibitor BYL719 on days 1-21 in Cohort 1 All patients also received 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies
    Measure Participants 8
    Number [mg per day]
    250
    3. Secondary Outcome
    Title Pharmacokinetics (PK) of BYL719 Administered in Combination With T-DM1.
    Description To assess the pharmacokinetics (PK)of BYL719, blood will be drawn from patients on Day 1, 8, and 15 of Cycles 1, 2 and 3 where 1 Cycle = 21 days. After that blood will be drawn once every 3 cycles. PK parameters of BYL719 including peak and trough concentrations as an estimate of the steady-state concentration, elimination clearance, interindividual variability of the elimination clearance, and the effect of PK parameters with prolonged administration of BYL719 will be obtained. Steady state concentration will be analyzed to see if there is any relationship with efficacy or toxicity.
    Time Frame Day 1, 8, and 15 of Cycles 1, 2, and 3, then every 3 Cycles (1 Cycle =21 days) while on treatment where the median number of cycles is 11 and range is 3-19 cycles.

    Outcome Measure Data

    Analysis Population Description
    No data from the blood draws was collected or analyzed for this objective.
    Arm/Group Title Cohort -1 (250mg BYL719, 3.6mg/kg T-DM1) Cohort 1 (300mg BYL719, 3.6mg/kg T-DM1)
    Arm/Group Description Patients receive 250 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies Patients receive 300 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies
    Measure Participants 0 0
    4. Secondary Outcome
    Title Progression-Free Survival (PFS) of BYL719 Administered in Combination With T-DM1 for All Patients Treated on Study.
    Description Progression-Free Survival (PFS) for patients treated with BYL719 and T-DM1 in combination is measured for all patients from the time of treatment initiation until the first documentation of progressive disease or death from any cause. It will be assessed every 3 months up to 1 year after discontinuation of the study drugs. Patients that completed at least 3 cycles of treatment and had imaging at 1st response time point were considered evaluable for this objective.
    Time Frame From the start of treatment and every 3 months up to 1 year after discontinuation of treatment. 1 Cycle = 21 days. Median number of cycles is 11 and range is 3-19 cycles.

    Outcome Measure Data

    Analysis Population Description
    The sample size was so small for each cohort that it was decided that there wouldn't any merit to separating out the dose cohorts and Kaplan Meier curves were completed on all patients combined and patients with or without prior T-DM1 treatment. No data was collected and no analysis was completed on each dose cohort separately.
    Arm/Group Title BYL719 and T-DM1 Treatment
    Arm/Group Description Patients receive either 250 mg (Cohort -1) or 300 mg (Cohort 1) PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies
    Measure Participants 14
    All Patients
    8.1
    Patients without Prior TDM1 Exposure
    10.8
    Patients with Prior TDM1 Exposure
    6.2
    5. Secondary Outcome
    Title Objective Response Rate (ORR) of BYL719 Administered in Combination With T-DM1 by Cohort
    Description ORR for patients treated with BYL719 in combination with T-DM1 assessed every 3 cycles (every 9 weeks) with imaging and Best Response defined by RECIST v1.1. ORR is defined as number of patients with Complete Response (CR)+Partial Response (PR) documented as their Best Response (confirmed 4 weeks later). Response is based on evaluation of target and non-target lesions. Clinical lesions will only be considered measurable when they are superficial. Patients that completed at least 3 cycles of treatment and had imaging at 1st response time point were considered evaluable for this objective. Target Lesions: CR: Disappearance of all target lesions. PR: At least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum of LD. For Non-Target Lesions: CR: Disappearance of all non-target lesions and normalization of tumor marker level Non-complete Response (Non-CR): Persistence of one or more non-target lesion(s)
    Time Frame From the start of treatment and every 3 cycles during treatment where 1 cycle =21 days, median number of cycles is 11 and range of cycles is 3-19.

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Cohort -1 (250mg BYL719, 3.6mg/kg T-DM1) Cohort 1 (300mg BYL719, 3.6mg/kg T-DM1)
    Arm/Group Description Patients receive 250 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies Patients receive 300 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies
    Measure Participants 10 4
    Number [participants]
    4
    23.5%
    2
    NaN
    6. Other Pre-specified Outcome
    Title Number of Patients With Changes in PIK3CA Gene, PTEN Expression and Akt/mTOR Downstream Markers
    Description Patients tumor tissue collected during biopsy will be evaluated by immunohitochemistry (IHC) and Next Generation Sequencing (NGS) to see if the study drugs are efficacious on patients who have this alteration.
    Time Frame Baseline

    Outcome Measure Data

    Analysis Population Description
    The sample size was so small for each cohort and due to the exploratory nature of outcome measure, there wouldn't any merit to separating out dose cohorts. Mutations were collected for patients combined, reported on and correlated with response descriptively. No data was collected/no analysis was completed on each dose cohort separately.
    Arm/Group Title 250mg or 300mg BYL719, 3.6mg/kg T-DM1
    Arm/Group Description Patients receive 250 mg PO daily PI3K inhibitor BYL719 on days 1-21 in Cohort -1 and 300 mg PO daily PI3K inhibitor BYL719 on days 1-21 in Cohort 1 All patients also received 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies
    Measure Participants 11
    PTEN Loss (IHC)
    2
    11.8%
    AKT Increased Expression (IHC)
    3
    17.6%
    PIK3CA Mutation (NGS)
    4
    23.5%
    PI3K Pathway Aberration
    9
    52.9%
    Patients with Response and PTEN Loss
    1
    5.9%
    Patient with Response and AKT Increased Expression
    1
    5.9%
    Patient with Response and P13K Pathway Aberration
    2
    11.8%
    Patients with SD and PTEN Loss
    1
    5.9%
    Patient with SD and AKT Increased Expression
    1
    5.9%
    Patients with SD and PIK3CA Mutation
    1
    5.9%
    Patients with SD and P13K Pathway Aberration
    5
    29.4%
    Patients with PD and PTEN Loss
    0
    0%
    Patients with PD and AKT Increased Expression
    0
    0%
    Patients with PD and PIK3CA Mutation
    1
    5.9%
    Patients with PD and P13K Pathway Aberration
    1
    5.9%
    7. Other Pre-specified Outcome
    Title Clinical Benefit Rate (CBR) of BYL719 Administered in Combination With T-DM1 by Cohort
    Description Clinical Benefit Rate (CBR) patients treated BYL719 and T-DM1 combination treatment is defined as the number of patients with Complete Response + Partial Response + Stable Disease for over 6 months documented as their best response, assessed every 3 cycles (every 9 weeks) with physical exam and imaging (CT chest/abdomen/pelvis and bone scan, or PET/CT) and defined by RECIST guidelines. Patients that completed at least 3 cycles of treatment and had imaging at 1st response time point were considered evaluable for this objective.
    Time Frame From the start of treatment and every 3 cycles (1 cycle =21 days) while on treatment where the median number of cycles is 11 and range is 3-19 cycles.

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Cohort -1 (250mg BYL719, 3.6mg/kg T-DM1) Cohort 1 (300mg BYL719, 3.6mg/kg T-DM1)
    Arm/Group Description Patients receive 250 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies Patients receive 300 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies
    Measure Participants 10 4
    Number [participants]
    7
    41.2%
    3
    NaN
    8. Other Pre-specified Outcome
    Title Best Response of BYL719 Administered in Combination With T-DM1 by Cohort
    Description Best Response (BR) of patients treated with BYL719 and T-DM1 combination treatment is assessed every 9 weeks with physical exam and imaging and defined by Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0). BR is based on evaluation of target and non-target lesions. Clinical lesions will only be considered measurable when they are superficial. Patients that completed at least 3 cycles of treatment and had imaging at 1st response time point were considered evaluable for this objective. Complete Response (CR): Disappearance of all target lesions Partial Response (PR): >=30% decrease in the sum of the longest diameter (LD) of target lesions Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD Progressive Disease (PD): At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum of LD recorded since the treatment started or the appearance of one or more new lesions
    Time Frame From the start of treatment and every 3 cycles during treatment where 1 cycle =21 days, median number of cycles is 11 and range of cycles is 3-19.

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Cohort -1 (250mg BYL719, 3.6mg/kg T-DM1) Cohort 1 (300mg BYL719, 3.6mg/kg T-DM1)
    Arm/Group Description Patients receive 250 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies Patients receive 300 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies
    Measure Participants 10 4
    Complete Response
    0
    0%
    1
    NaN
    Partial Response
    4
    23.5%
    1
    NaN
    Stable Disease
    5
    29.4%
    1
    NaN
    Progressive Disease
    1
    5.9%
    1
    NaN
    9. Post-Hoc Outcome
    Title Toxicity of the Combination of BYL719 and T-DM1 Treatment by Cohort
    Description Toxicity profile of BYL719 in combination with T-DM1 will be assessed using National Cancer Institute's Common Toxicity Criteria for Adverse Events version 4.0 (CTCAEv4.0). Toxicity is defined as an AE that is determined to be at least possibly related to at least one of the study drugs: BYL719 and T-DM1. In general adverse events (AEs) will be graded according to the following: Grade 1 Mild AE Grade 2 Moderate AE Grade 3 Severe AE Grade 4 Life-threatening or disabling AE Grade 5 Death related to AE
    Time Frame From the time of treatment initiation thoughout treatment until 30 days post last dose. Range of cycles completed =1 to 19 where 1 cycle =21 days

    Outcome Measure Data

    Analysis Population Description
    Any patient that received a dose of study drug was evaluable for this outcome measure
    Arm/Group Title Cohort -1 (250mg BYL719, 3.6mg/kg T-DM1) Cohort 1 (300mg BYL719, 3.6mg/kg T-DM1)
    Arm/Group Description Patients receive 250 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies Patients receive 300 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies
    Measure Participants 11 6
    Anemia
    0
    0%
    1
    NaN
    Pancreatitis
    0
    0%
    1
    NaN
    Electrocardiogram QT corrected interval prolonged
    0
    0%
    1
    NaN
    Lymphocyte Count Decreased
    0
    0%
    1
    NaN
    Platelet Count Decreased
    1
    5.9%
    2
    NaN
    Weight Loss
    1
    5.9%
    0
    NaN
    Anorexia
    2
    11.8%
    0
    NaN
    Hyperglycemia
    2
    11.8%
    2
    NaN
    Abnormal Uterine Bleeding
    0
    0%
    1
    NaN
    Rash Maculo-papular
    3
    17.6%
    4
    NaN
    Hypertension
    1
    5.9%
    1
    NaN

    Adverse Events

    Time Frame Adverse Events (AEs) were collected over 2 and half year period for all patients. Each patient was followed from the time of consent, during treatment at the beginning of each cycle through 30 days post last treatment, where 1 Cycle = 21 days the range of cycles attempted was 1-19.
    Adverse Event Reporting Description
    Arm/Group Title Cohort -1 (250mg BYL719, 3.6mg/kg T-DM1) Cohort 1 (300mg BYL719, 3.6mg/kg T-DM1)
    Arm/Group Description Patients receive 250 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies Patients receive 300 mg PO daily PI3K inhibitor BYL719 on days 1-21 and 3.6mg/kg IV over 30-90 minutes on day 1 ado-trastuzumab emtansine (T-DM1). Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. PI3K inhibitor BYL719: Given PO Ado-trastuzumab emtansine: Given IV Pharmacological study: Correlative studies Laboratory biomarker analysis: Optional correlative studies
    All Cause Mortality
    Cohort -1 (250mg BYL719, 3.6mg/kg T-DM1) Cohort 1 (300mg BYL719, 3.6mg/kg T-DM1)
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 4/11 (36.4%) 3/6 (50%)
    Serious Adverse Events
    Cohort -1 (250mg BYL719, 3.6mg/kg T-DM1) Cohort 1 (300mg BYL719, 3.6mg/kg T-DM1)
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 3/11 (27.3%) 3/6 (50%)
    Gastrointestinal disorders
    Acute pancreatitis 1/11 (9.1%) 0/6 (0%)
    Infections and infestations
    Wound Infection 0/11 (0%) 1/6 (16.7%)
    Metabolism and nutrition disorders
    Elevated Fasting Plasma 1/11 (9.1%) 0/6 (0%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Tumor pain 0/11 (0%) 1/6 (16.7%)
    Psychiatric disorders
    Delirium 0/11 (0%) 1/6 (16.7%)
    Respiratory, thoracic and mediastinal disorders
    Death due to Respiratory Failure 0/11 (0%) 1/6 (16.7%)
    Epistaxis 1/11 (9.1%) 0/6 (0%)
    Hypoxemia 1/11 (9.1%) 0/6 (0%)
    Skin and subcutaneous tissue disorders
    Pain of skin 0/11 (0%) 1/6 (16.7%)
    Other (Not Including Serious) Adverse Events
    Cohort -1 (250mg BYL719, 3.6mg/kg T-DM1) Cohort 1 (300mg BYL719, 3.6mg/kg T-DM1)
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 11/11 (100%) 6/6 (100%)
    Blood and lymphatic system disorders
    Anemia 8/11 (72.7%) 4/6 (66.7%)
    Cardiac disorders
    Left Ventricular Systolic Dysfunction 1/11 (9.1%) 0/6 (0%)
    Palpitations 1/11 (9.1%) 0/6 (0%)
    Sinus Bradycardia 1/11 (9.1%) 0/6 (0%)
    Sinus Tachycardia 5/11 (45.5%) 2/6 (33.3%)
    Nonspecific T Wave Abnormality on ECG 0/11 (0%) 1/6 (16.7%)
    Right Bundle Block 1/11 (9.1%) 0/6 (0%)
    Ear and labyrinth disorders
    Ear Pain 1/11 (9.1%) 0/6 (0%)
    Eye disorders
    Blurred Vision 3/11 (27.3%) 1/6 (16.7%)
    Dry Eye 1/11 (9.1%) 0/6 (0%)
    Floaters 1/11 (9.1%) 0/6 (0%)
    Gastrointestinal disorders
    Abdominal Pain 1/11 (9.1%) 0/6 (0%)
    Ascites 1/11 (9.1%) 0/6 (0%)
    Bloating 1/11 (9.1%) 0/6 (0%)
    Constipation 2/11 (18.2%) 3/6 (50%)
    Diarrhea 3/11 (27.3%) 3/6 (50%)
    Dry Mouth 4/11 (36.4%) 0/6 (0%)
    Gastroesophageal Reflux Disease 1/11 (9.1%) 0/6 (0%)
    Mucositis Oral 1/11 (9.1%) 1/6 (16.7%)
    Nausea 4/11 (36.4%) 5/6 (83.3%)
    Pancreatitis 1/11 (9.1%) 0/6 (0%)
    Vomiting 0/11 (0%) 1/6 (16.7%)
    Chills 1/11 (9.1%) 0/6 (0%)
    General disorders
    Edema Limbs 2/11 (18.2%) 1/6 (16.7%)
    Fatigue 8/11 (72.7%) 5/6 (83.3%)
    Fever 1/11 (9.1%) 0/6 (0%)
    Non-Cardiac Chest Pain 1/11 (9.1%) 0/6 (0%)
    Pain 2/11 (18.2%) 2/6 (33.3%)
    Pancreatic Insufficiency 1/11 (9.1%) 0/6 (0%)
    Infections and infestations
    Breast Infection 0/11 (0%) 1/6 (16.7%)
    Lung Infection 0/11 (0%) 1/6 (16.7%)
    Mucosal Infection 1/11 (9.1%) 0/6 (0%)
    Skin Infection 0/11 (0%) 1/6 (16.7%)
    Urinary Tract Infection 3/11 (27.3%) 0/6 (0%)
    Wound Infection 0/11 (0%) 1/6 (16.7%)
    Injury, poisoning and procedural complications
    Fall 0/11 (0%) 1/6 (16.7%)
    Radiation Recall Reaction (Dermatologic) 1/11 (9.1%) 0/6 (0%)
    Investigations
    Activated Partial Thromboplastin Time Prolonged 2/11 (18.2%) 1/6 (16.7%)
    Alanine Aminotransferase Increased 5/11 (45.5%) 2/6 (33.3%)
    Alkaline Phosphatase Increased 7/11 (63.6%) 4/6 (66.7%)
    Aspartate Aminotransferase Increased 10/11 (90.9%) 5/6 (83.3%)
    Blood Bilirubin Increased 5/11 (45.5%) 0/6 (0%)
    Creatinine Increased 0/11 (0%) 1/6 (16.7%)
    Electrocardiogram QT Corrected Interval Prolonged 2/11 (18.2%) 1/6 (16.7%)
    Lymphocyte Count Decrease 6/11 (54.5%) 5/6 (83.3%)
    Lymphocyte Count Increase 1/11 (9.1%) 0/6 (0%)
    Neutrophil Count Decrease 3/11 (27.3%) 2/6 (33.3%)
    Platelet Count Decrease 6/11 (54.5%) 3/6 (50%)
    Weight Loss 2/11 (18.2%) 2/6 (33.3%)
    White Blood Cell Decrease 3/11 (27.3%) 2/6 (33.3%)
    Elevated Hemoglobin A1C 4/11 (36.4%) 0/6 (0%)
    Metabolism and nutrition disorders
    Anorexia 2/11 (18.2%) 3/6 (50%)
    Hypercalcemia 1/11 (9.1%) 0/6 (0%)
    Hyperglycemia 9/11 (81.8%) 3/6 (50%)
    Hyperkalemia 0/11 (0%) 1/6 (16.7%)
    Hypernatremia 1/11 (9.1%) 0/6 (0%)
    Hypoalbuminemia 7/11 (63.6%) 5/6 (83.3%)
    Hypocalcemia 3/11 (27.3%) 3/6 (50%)
    Hypoglycemia 1/11 (9.1%) 1/6 (16.7%)
    Hypokalemia 7/11 (63.6%) 3/6 (50%)
    Hyponatremia 0/11 (0%) 2/6 (33.3%)
    Musculoskeletal and connective tissue disorders
    Arthralgia 1/11 (9.1%) 0/6 (0%)
    Back Pain 1/11 (9.1%) 0/6 (0%)
    Chest Wall Pain 1/11 (9.1%) 0/6 (0%)
    Fractured Rib 1/11 (9.1%) 0/6 (0%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Sebaceous Cyst 1/11 (9.1%) 0/6 (0%)
    Nervous system disorders
    Dizziness 2/11 (18.2%) 0/6 (0%)
    Headache 4/11 (36.4%) 0/6 (0%)
    Peripheral Sensory Neuropathy 9/11 (81.8%) 2/6 (33.3%)
    Sinus Pain 1/11 (9.1%) 0/6 (0%)
    Psychiatric disorders
    Anxiety 1/11 (9.1%) 0/6 (0%)
    Delirium 0/11 (0%) 1/6 (16.7%)
    Depression 0/11 (0%) 2/6 (33.3%)
    Insomnia 1/11 (9.1%) 0/6 (0%)
    Renal and urinary disorders
    Hematuria 1/11 (9.1%) 0/6 (0%)
    Urinary Incontinence 1/11 (9.1%) 0/6 (0%)
    Reproductive system and breast disorders
    Post- Menopausal Bleeding 1/11 (9.1%) 0/6 (0%)
    Respiratory, thoracic and mediastinal disorders
    Cough 6/11 (54.5%) 2/6 (33.3%)
    Dyspnea 2/11 (18.2%) 1/6 (16.7%)
    Epistaxis 3/11 (27.3%) 0/6 (0%)
    Hoarseness 1/11 (9.1%) 0/6 (0%)
    Hypoxia 0/11 (0%) 1/6 (16.7%)
    Pleural Effusion 0/11 (0%) 1/6 (16.7%)
    Pneumonitis 1/11 (9.1%) 0/6 (0%)
    Respiratory Failure 0/11 (0%) 1/6 (16.7%)
    Respiratory, thoracic and mediastinal disorder NOS 0/11 (0%) 1/6 (16.7%)
    Skin and subcutaneous tissue disorders
    Alopecia 1/11 (9.1%) 2/6 (33.3%)
    Bullous Dermatitis 1/11 (9.1%) 0/6 (0%)
    Palmar-plantar Erythrodysesthesia Syndrome 1/11 (9.1%) 0/6 (0%)
    Pruritus 1/11 (9.1%) 2/6 (33.3%)
    Rash Acneiform 0/11 (0%) 1/6 (16.7%)
    Rash Maculo-papular 6/11 (54.5%) 3/6 (50%)
    Vascular disorders
    Hypertension 2/11 (18.2%) 2/6 (33.3%)
    Lymphedema 1/11 (9.1%) 2/6 (33.3%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    All Principal Investigators ARE employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title William Gradishar, MD
    Organization Northwestern University
    Phone 312 695 4541
    Email w-gradishar@northwestern.edu
    Responsible Party:
    William Gradishar, Principal Investigator, Northwestern University
    ClinicalTrials.gov Identifier:
    NCT02038010
    Other Study ID Numbers:
    • NU 13B06
    • NCI-2013-02224
    • NU 13B06
    • P30CA060553
    • STU00087202
    First Posted:
    Jan 16, 2014
    Last Update Posted:
    Jun 29, 2020
    Last Verified:
    Jun 1, 2020