Final Overall Survival Analysis of the Phase II SAKK 21/12 Trial of Transdermal CR1447 in Patients With Metastatic Breast Cancer.

Objective CR1447 is a transdermal formulation of 4-hydroxytestosterone with aromatase-inhibiting and androgen receptor (AR)-modulating activity. This multicenter, phase II study assessed the efficacy and safety of CR1447 in patients with metastatic breast cancer. The primary endpoint, the disease control rate at week 24, was published in 2019. Here, we report the final overall survival (OS) data of this study. Patients And Methods This study enrolled patients with estrogen receptor (ER)-positive, HER2-negative breast cancer pretreated with a maximum of 1 line of prior endocrine therapy (ET) without progression for at least 6 months (cohort A) (n = 29) and patients with AR-positive triple-negative metastatic breast cancer treated with a maximum of 2 prior lines of chemotherapy (cohort B) (n = 8). The intention-to-treat (ITT) population included eligible patients who received at least 1 dose of the study drug. The non-ITT population in cohort A comprised patients with more than 1 line of prior ET. Accrual was stopped in 2018 due to futility in cohort A and slow accrual in cohort B. Results At the data cut-off, 92% of patients had died. The median OS in cohort A was 35.4 months (95% CI: 24.6-49.1) in the ITT population (n = 21) and 19.4 months (95% CI: 2.3-36.8) in the non-ITT population (n = 8). In cohort B, the median OS was 10.8 months (95% CI: 3.3-28.6). Most adverse events were grade 1 - 2 and most frequently included hypertriglyceridemia, increased levels of aspartate aminotransferase and dry skin. Conclusions In this final OS analysis, CR1447 was associated with an OS in line with other ET agents in patients with metastatic ER-positive, HER2-negative breast cancer who had received no more than 1 prior line of ET. Therapy was well tolerated with no treatment-related grade 3 to 5 toxicities.