A Phase 3 interventional study of neratinib and placebo in Breast Cancer, sponsored by Puma Biotechnology, Inc.. Completed at 494 sites in 40 countries. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-06-11.
Sponsored by Puma Biotechnology, Inc. · Phase 3, Interventional, and Treatment
The purpose of this study is to investigate whether neratinib can further reduce the risk of recurrence from previously diagnosed HER-2 positive breast cancer after adjuvant treatment with trastuzumab.
Exclusion Criteria:
240 mg orally daily for one year
Drug: neratinib
orally daily for one year
Other: placebo
Also known as: HKI-272, Nerlynx
Invasive Disease-free Survival (iDFS) in Neratinib Arm Compared to Placebo Arm at Year 2
Invasive disease-free survival time is defined as the time from date of randomization until the first disease recurrence of the following events: invasive ipsilateral breast tumor recurrence, invasive contralateral breast cancer, local/regional invasive recurrence, distant recurrence and death from any cause.
Time frame: From randomization until time of event up to 2 years
Kaplan-Meier Estimates of Invasive Disease-free Survival (iDFS) at Year 2 by Treatment Arms
Time frame: From randomization until time of event up to 2 years
Overall Survival (OS)
OS was defined as the time from randomization to death due to any cause, censored at the last date known alive.
Time frame: Randomization until death due to any cause (up to 119 Months)
Disease-free Survival Including Ductal Carcinoma in Situ (DFS-DCIS) in Neratinib Arm Compared to Placebo Arm at Year 2
Disease-free survival including DCIS time is defined as the time from date of randomization until the first occurrence of DCIS or an iDFS event (an iDFS event including invasive ipsilateral breast tumor recurrence, invasive contralateral breast cancer, local/regional invasive recurrence, or distant recurrence and death from any.
Time frame: From randomization until time of event up to 2 years
Kaplan-Meier Estimates of Disease-free Survival Including Ductal Carcinoma in Situ (DFS-DCIS) at Year 2 by Treatment Arms
Time frame: From randomization until time of event up to 2 years
Distant Disease-free Survival (DDFS) in Neratinib Arm Compared to Placebo Arm at Year 2
Distant disease-free survival time is defined as the time from date of randomization until the first occurrence of distant recurrence or death from any cause.
Time frame: From randomization until time of event up to 2 years
Kaplan-Meier Estimates of Distant Disease-free Survival (DDFS) at Year 2 by Treatment Arms
Time frame: From randomization until time of event up to 2 years
Percentage of Participants With Time to Distant Recurrence (TTDR) Event in Neratinib Arm Compared to Placebo Arm at Year 2
Percentage of Participants with TTDR events is reported. TTDR is defined as the time from date of randomization until the first occurrence of distant recurrence or death from breast cancer.
Time frame: From randomization until time of event up to 2 years
Kaplan-Meier Estimates of Time to Distant Recurrence (TTDR) Survival at Year 2 by Treatment Arms
Time frame: From randomization until time of event up to 2 years
Central Nervous System Recurrence in Neratinib Arm Compared to Placebo Arm at Year 2
CNS recurrence is defined as the time from randomization to CNS as the first distant recurrence. Competing events include distant recurrence at other sites as the first distant recurrence and death from any cause prior to distant recurrence.
Time frame: From randomization until time of event up to 2 years
Cumulative Incidence of Central Nervous System Recurrence (CNS) at Year 2
Cumulative incidence of Central Nervous System Recurrence (CNS) is estimated by Gray's method (Gray,1988).
Time frame: From randomization until time of event up to 2 years
Invasive Disease-free Survival (iDFS) in Neratinib Arm Compared to Placebo Arm at Year 5
Invasive disease-free survival time is defined as the time from date of randomization until the first disease recurrence of the following events: invasive ipsilateral breast tumor recurrence, invasive contralateral breast cancer, local/regional invasive recurrence, distant recurrence and death from any cause.
Time frame: From randomization until time of event up to 5 years
Kaplan-Meier Estimates of Invasive Disease-free Survival (iDFS) at Year 5 by Treatment Arms
Time frame: From randomization until time of event up to 5 years
Disease-free Survival Including Ductal Carcinoma in Situ (DFS-DCIS) in Neratinib Arm Compared to Placebo Arm at Year 5
Disease-free survival including DCIS time is defined as the time from date of randomization until the first occurrence of DCIS or an iDFS event (an iDFS event including invasive ipsilateral breast tumor recurrence, invasive contralateral breast cancer, local/regional invasive recurrence, or distant recurrence and death from any.
Time frame: From randomization until time of event up to 5 years
Distant Disease-free Survival (DDFS) in Neratinib Arm Compared to Placebo Arm at Year 5
Distant disease-free survival time is defined as the time from date of randomization until the first occurrence of distant recurrence or death from any cause.
Time frame: From randomization until time of event up to 5 years
Percentage of Participants With Time to Distant Recurrence (TTDR) Event in Neratinib Arm Compared to Placebo Arm at Year 5
Percentage of Participants with TTDR events is reported. TTDR is defined as the time from date of randomization until the first occurrence of distant recurrence or death from breast cancer.
Time frame: From randomization until time of event up to 5 years
Cumulative Incidence of Central Nervous System Recurrence (CNS) at Year 5
Cumulative incidence of Central Nervous System Recurrence (CNS) is estimated by Gray's method (Gray,1988).
Time frame: From randomization until time of event up to 5 years
| Milestone | Neratinib | Placebo |
|---|---|---|
| Started | 1420 | 1420 |
| Completed | 1095 | 1183 |
| Not completed | 325 | 237 |
| Withdrew: Withdrawal by subject | 197 | 120 |
| Withdrew: Lost to follow-up | 35 | 33 |
| Withdrew: Other reasons | 93 | 84 |
Invasive disease-free survival time is defined as the time from date of randomization until the first disease recurrence of the following events: invasive ipsilateral breast tumor recurrence, invasive contralateral breast cancer, local/regional invasive recurrence, distant recurrence and death from any cause.
| percentage of participants with events | Neratinib | Placebo |
|---|---|---|
| Invasive Disease-free Survival (iDFS) in Neratinib Arm Compared to Placebo Arm at Year 2 | 4.7 | 7.5 |
| percentage of participants | Neratinib | Placebo |
|---|---|---|
| Kaplan-Meier Estimates of Invasive Disease-free Survival (iDFS) at Year 2 by Treatment Arms | 94.2 (92.6 to 95.4) | 91.9 (90.2 to 93.2) |
OS was defined as the time from randomization to death due to any cause, censored at the last date known alive.
| percentage of participants | Neratinib | Placebo |
|---|---|---|
| 1 Year Kaplan-Meier Estimate | 99.64 (99.13 to 99.85) | 99.43 (98.86 to 99.71) |
| 3 Year Kaplan-Meier Estimate | 96.74 (95.62 to 97.57) | 96.44 (95.30 to 97.31) |
| 5 Year Kaplan-Meier Estimate | 94.09 (92.65 to 95.25) | 93.26 (91.77 to 94.49) |
| 7 Year Kaplan-Meier Estimate | 91.36 (89.66 to 92.79) | 91.29 (89.62 to 92.70) |
| 9 Year Kaplan-Meier Estimate | 89.06 (86.97 to 90.84) | 88.65 (88.58 to 90.43) |
Disease-free survival including DCIS time is defined as the time from date of randomization until the first occurrence of DCIS or an iDFS event (an iDFS event including invasive ipsilateral breast tumor recurrence, invasive contralateral breast cancer, local/regional invasive recurrence, or distant recurrence and death from any.
| percentage of participants with events | Neratinib | Placebo |
|---|---|---|
| Disease-free Survival Including Ductal Carcinoma in Situ (DFS-DCIS) in Neratinib Arm Compared to Placebo Arm at Year 2 | 4.7 | 8.0 |
| percentage of participants | Neratinib | Placebo |
|---|---|---|
| Kaplan-Meier Estimates of Disease-free Survival Including Ductal Carcinoma in Situ (DFS-DCIS) at Year 2 by Treatment Arms | 94.2 (92.6 to 95.4) | 91.3 (89.6 to 92.7) |
Distant disease-free survival time is defined as the time from date of randomization until the first occurrence of distant recurrence or death from any cause.
| percentage of participants with events | Neratinib | Placebo |
|---|---|---|
| Distant Disease-free Survival (DDFS) in Neratinib Arm Compared to Placebo Arm at Year 2 | 3.8 | 5.4 |
| percentage of participants | Neratinib | Placebo |
|---|---|---|
| Kaplan-Meier Estimates of Distant Disease-free Survival (DDFS) at Year 2 by Treatment Arms | 95.3 (93.9 to 96.4) | 94.0 (92.6 to 95.2) |
Percentage of Participants with TTDR events is reported. TTDR is defined as the time from date of randomization until the first occurrence of distant recurrence or death from breast cancer.
| percentage of participants with events | Neratinib | Placebo |
|---|---|---|
| Percentage of Participants With Time to Distant Recurrence (TTDR) Event in Neratinib Arm Compared to Placebo Arm at Year 2 | 3.7 | 5.3 |
| percentage of participants | Neratinib | Placebo |
|---|---|---|
| Kaplan-Meier Estimates of Time to Distant Recurrence (TTDR) Survival at Year 2 by Treatment Arms | 95.5 (94.1 to 96.6) | 94.2 (92.8 to 95.3) |
CNS recurrence is defined as the time from randomization to CNS as the first distant recurrence. Competing events include distant recurrence at other sites as the first distant recurrence and death from any cause prior to distant recurrence.
| percentage of participants with events | Neratinib | Placebo |
|---|---|---|
| Central Nervous System Recurrence in Neratinib Arm Compared to Placebo Arm at Year 2 | 0.8 | 1.1 |
Cumulative incidence of Central Nervous System Recurrence (CNS) is estimated by Gray's method (Gray,1988).
| percentage of participants | Neratinib | Placebo |
|---|---|---|
| Cumulative Incidence of Central Nervous System Recurrence (CNS) at Year 2 | 0.92 (0.49 to 1.59) | 1.16 (0.68 to 1.87) |
Invasive disease-free survival time is defined as the time from date of randomization until the first disease recurrence of the following events: invasive ipsilateral breast tumor recurrence, invasive contralateral breast cancer, local/regional invasive recurrence, distant recurrence and death from any cause.
| percentage of participants with events | Neratinib | Placebo |
|---|---|---|
| Invasive Disease-free Survival (iDFS) in Neratinib Arm Compared to Placebo Arm at Year 5 | 8.2 | 11.5 |
| percentage of participants | Neratinib | Placebo |
|---|---|---|
| Kaplan-Meier Estimates of Invasive Disease-free Survival (iDFS) at Year 5 by Treatment Arms | 90.2 (88.3 to 91.8) | 87.7 (85.7 to 89.4) |
Disease-free survival including DCIS time is defined as the time from date of randomization until the first occurrence of DCIS or an iDFS event (an iDFS event including invasive ipsilateral breast tumor recurrence, invasive contralateral breast cancer, local/regional invasive recurrence, or distant recurrence and death from any.
| percentage of participants with events | Neratinib | Placebo |
|---|---|---|
| Disease-free Survival Including Ductal Carcinoma in Situ (DFS-DCIS) in Neratinib Arm Compared to Placebo Arm at Year 5 | 8.5 | 12.3 |
Distant disease-free survival time is defined as the time from date of randomization until the first occurrence of distant recurrence or death from any cause.
| percentage of participants with events | Neratinib | Placebo |
|---|---|---|
| Distant Disease-free Survival (DDFS) in Neratinib Arm Compared to Placebo Arm at Year 5 | 7.0 | 9.2 |
Percentage of Participants with TTDR events is reported. TTDR is defined as the time from date of randomization until the first occurrence of distant recurrence or death from breast cancer.
| percentage of participants with events | Neratinib | Placebo |
|---|---|---|
| Percentage of Participants With Time to Distant Recurrence (TTDR) Event in Neratinib Arm Compared to Placebo Arm at Year 5 | 6.8 | 8.9 |
Cumulative incidence of Central Nervous System Recurrence (CNS) is estimated by Gray's method (Gray,1988).
| percentage of participants | Neratinib | Placebo |
|---|---|---|
| Cumulative Incidence of Central Nervous System Recurrence (CNS) at Year 5 | 1.3 (0.77 to 2.06) | 1.82 (1.19 to 2.68) |
Collected over From first dose through 28 days after the last dose, up to two years.. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Neratinib | — | 103/1,408 (7.3%) | 1,386/1,408 (98.4%) |
| Placebo | — | 85/1,408 (6%) | 1,234/1,408 (87.6%) |
| Event | Neratinib | Placebo |
|---|---|---|
| DiarrhoeaGastrointestinal disorders | 22/1408 | 1/1408 |
| VomitingGastrointestinal disorders | 12/1408 | 1/1408 |
| DehydrationMetabolism and nutrition disorders | 9/1408 | 1/1408 |
| CellulitisInfections and infestations | 6/1408 | 4/1408 |
| ErysipelasInfections and infestations | 5/1408 | 0/1408 |
| NauseaGastrointestinal disorders | 4/1408 | 1/1408 |
| PneumoniaInfections and infestations | 1/1408 | 4/1408 |
| Alanine aminotransferase increasedInvestigations | 4/1408 | 0/1408 |
| Aspartate aminotransferase increasedInvestigations | 4/1408 | 0/1408 |
| FatigueGeneral disorders | 3/1408 | 0/1408 |
| Event | Neratinib | Placebo |
|---|---|---|
| DiarrhoeaGastrointestinal disorders | 1341/1408 | 499/1408 |
| NauseaGastrointestinal disorders | 605/1408 | 303/1408 |
| FatigueGeneral disorders | 381/1408 | 283/1408 |
| VomitingGastrointestinal disorders | 364/1408 | 113/1408 |
| Abdominal painGastrointestinal disorders | 339/1408 | 144/1408 |
| HeadacheNervous system disorders | 278/1408 | 275/1408 |
| Abdominal pain upperGastrointestinal disorders | 212/1408 | 96/1408 |
| RashSkin and subcutaneous tissue disorders | 211/1408 | 100/1408 |
| Decreased appetiteMetabolism and nutrition disorders | 170/1408 | 40/1408 |
| ArthralgiaMusculoskeletal and connective tissue disorders | 86/1408 | 162/1408 |
Intent to treat (ITT) population included all participants who were randomized regardless of whether they received any study treatment.
| Age, Continuous(years) | Neratinib | Placebo | Total |
|---|---|---|---|
| Mean | 52.3 ± 10.08 | 52.3 ± 10.28 | 52.3 ± 10.18 |
| Sex: Female, Male(Participants) | Neratinib | Placebo | Total |
|---|---|---|---|
| Female | 1420 | 1420 | 2840 |
| Male | 0 | 0 | 0 |
| Race/Ethnicity, Customized(Participants) | Neratinib | Placebo | Total |
|---|---|---|---|
| Asian | 188 | 197 | 385 |
| Black or African American | 27 | 47 | 74 |
| White | 1165 | 1135 | 2300 |
| Other | 40 | 41 | 81 |
Showing the first 100 of 494 sites across 40 countries.
Plan to share: Yes — Puma Biotechnology is committed to sharing clinical trial data and information to help physicians and patients make informed treatment decisions, and to help qualified researchers advance scientific knowledge. In accordance with legal and regulatory requirements, Puma publishes study protocol information and clinical study results on clinical trial registries, including ClinicalTrials.gov and EU Clinical Trials Register. Puma also publishes information about clinical studies in peer-reviewed scientific journals and shares data in scientific meetings. Puma commits to safeguarding confidentiality and patient privacy throughout the clinical trial data and information sharing process. Any patient-level data will be anonymized to protect personally identifiable information. Qualified researchers and study participants may submit requests for other study documentation and clinical trial data to clinicaltrials@pumabiotechnology.com for consideration.
Supporting information: Study protocol, Sap, Icf, Csr
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