RecruitingNot ApplicableNCT05378204

Study Evaluating DNA Double-strand Breaks (DSBs) REpair Factors (POLQ, Shieldin Complex and 53BP1) Expression as Biomarker of PARP Inhibitor Resistance in Patients With Deleterious Germline Mutation in BRCA 1/2 and HER2-negative, Metastatic or Locally Advanced Breast Cancer.

Prospective and Multicentric Study Evaluating DNA Double-strand Breaks (DSBs) REpair Factors (POLQ, Shieldin Complex and 53BP1) Expression as Biomarker of PARP Inhibitor Resistance in Patients With Deleterious Germline Mutation in BRCA 1/2 and HER2-negative, Metastatic or Locally Advanced Breast Cancer.


Sponsor

Institut Claudius Regaud

Enrollment

120 participants

Start Date

Jun 23, 2022

Study Type

INTERVENTIONAL

Conditions

Summary

The purpose of this study is to assess whether expression of not only POLQ/Polθ, but also Shieldin complex and/or 53BP1 are correlated with primary and/or acquired resistance to PARPi (Poly(ADP-Ribose) Polymerases inhibitors) in a sub-population of locally advanced or metastatic breast cancer patients and vary regarding type and location of gBRCA1/2 mutations. This translational research program is composed of two multicentric, non-randomized prospective studies in patients with HER2-negative locally advanced or metastatic breast cancer: * The main study concerns 80 patients eligible for PARPi (according to the investigators).PARPi treatments (talazoparib or olaparib) will be administered and dosed according to the standard of care administration. * The sub-study concerns 40 patients in progression disease under PARPi alone. For each included patient in the main study or sub-study, tumor biopsy specimen and blood samples will be collected at different times during the study.


Eligibility

Min Age: 18 Years

Inclusion Criteria43

  • MAIN STUDY
  • Women (or men) aged ≥ 18 years with histologically proven breast cancer
  • Metastatic relapse or locally advanced breast cancer
  • No-HER2 overexpression or amplification
  • Triple-negative (defines as ER\<1%, PR\<1% and HER2-negative as per ASCO CAP guidelines) or hormone receptor positive (defines as ER and/or PR ≥ 1%) breast cancer
  • Patients with metastases that can be biopsied except bone metastases. At baseline, if patients already have an archived biopsy from a secondary or a primary site (if stage IV) of their current disease, this material can be used for the study, provided that, it was collected within 3 months prior enrollment and a frozen and a FFPE sample are both available for research
  • ECOG Performance Status ≤ 2
  • Patients must have measurable or evaluable disease according to RECIST v1.1
  • Patient with deleterious germline BRCA 1 and/or 2 mutation, eligible for PARP inhibitor therapy (olaparib or talazoparib), according each investigator
  • Any number of prior lines therapy are allowed
  • Current treatment with PARP inhibitor not yet started
  • Women should be post-menopaused or willing to accept the use of an effective contraceptive regimen during the treatment period by PARP inhibitor
  • Patient able to participate and willing to give informed consent prior performance of any study-related procedures and to comply with the study protocol
  • Patient affiliated to a Social Health Insurance in France
  • Abnormal coagulation contraindicating biopsy
  • Bone metastases when this is the only site of biopsiable disease
  • Patients with all target in a previously irradiated region, except if clear progression has been observed prior to study in at least one of them
  • Patients with known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer
  • Patients with known untreated CNS metastases and/or carcinomatous meningitis
  • Patients with a known history of Human Immunodeficiency Virus (HIV)
  • Patients with known active Hepatitis B or C
  • Patients should not be on any other anti-cancer therapy (chemotherapy, endocrine therapy, immunotherapy, tailored therapy or alternative investigational therapy)
  • Patient pregnant, or breast-feeding
  • Any psychological, familial, geographic or social situation, according to the judgment of investigator, potentially preventing the provision of informed consent or compliance to study procedure
  • Patient who has forfeited his/her freedom by administrative or legal award or who is under legal protection (curatorship and guardianship, protection of justice)
  • SUB-STUDY
  • Women (or men) aged ≥ 18 years with histologically proven breast cancer
  • Metastatic relapse or locally advanced breast cancer
  • No-HER2 overexpression or amplification
  • Triple-negative (defines as ER\<1%, PR\<1% and HER2-negative as per ASCO CAP guidelines) or hormone receptor positive (defines as ER and or PR ≥ 1%) breast cancer
  • Patients with metastases that can be biopsied except bone metastases
  • ECOG Performance Status ≤ 2
  • Patients, with deleterious germline BRCA 1 and/or 2, in progression under PARPi alone (talazoparib or olaparib)
  • Patient able to participate and willing to give informed consent prior performance of any study-related procedures and to comply with the study protocol
  • Patient affiliated to a Social Health Insurance in France
  • Abnormal coagulation contraindicating biopsy
  • Bone metastases when this is the only site of biopsiable disease
  • Patient pregnant, or breast-feeding
  • Patients with a known history of Human Immunodeficiency Virus (HIV)
  • Patients with known active Hepatitis B or C
  • Any psychological, familial, geographic or social situation, according to the judgment of investigator, potentially preventing the provision of informed consent or compliance to study procedure
  • Patients already participating in the main REPARP study
  • Patient who has forfeited his/her freedom by administrative or legal award or who is under legal protection (curatorship and guardianship, protection of justice)

Interventions

OTHERMain study:

For each included patient, tumor biopsy specimen and blood samples will be collected at baseline visit (before the first dose of PARPi treatment). During the treatment period: blood samples will be scheduled every 8 weeks (i.e. 2 cycles). At the time of progression: tumor biopsy and blood samples will be collected.

OTHERSub-study:

For each included patient, tumor biopsy specimen and blood samples will be collected as soon as possible after progression (before initiation of the post PARPi anti-tumoral treatment).


Locations(25)

Institut Bergonie

Bordeaux, France

Centre Francois Baclesse

Caen, France

Centre Jean Perrin

Clermont-Ferrand, France

Centre Georges Francois Leclerc

Dijon, France

Centre Hospitalier Départemental Vendée

La Roche-sur-Yon, France

Centre Oscar Lambret

Lille, France

CHU de LIMOGES

Limoges, France

Centre Leon Berard

Lyon, France

Institut Paoli Calmettes

Marseille, France

Centre de Cancerologie Du Grand Montpellier

Montpellier, France

Institut Regional Du Cancer de Montpellier

Montpellier, France

CHU de Nimes

Nîmes, France

Hopital Pitie Salpetriere

Paris, France

Hopital Saint Louis

Paris, France

Hopital Tenon

Paris, France

INSTITUT CURIE - Site de Paris

Paris, France

CENTRE ARMORICAIN DE RADIOTHERAPIE, IMAGERIE MEDICALE ET ONCOLOGIE - Hôpital privé des Côtes d'Armor

Plérin, France

Chu de Poitiers

Poitiers, France

Centre Eugene Marquis

Rennes, France

Chu Saint Etienne

Saint-Etienne, France

INSTITUT DE CANCEROLOGIE DE L'OUEST St-Herblain

Saint-Herblain, France

IUCT-O

Toulouse, France

Chru de Tours

Tours, France

Institut de Cancerologie de Lorraine

Vandœuvre-lès-Nancy, France

Institut Gustave Roussy

Villejuif, France

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NCT05378204


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