Clareo Health | SAFIR02_Breast - Efficacy of Genome Analysis as a Therapeutic Decision Tool for Patients With Metastatic Breast Cancer

Spinal cord compression and/or symptomatic or progressive brain metastases

Bone metastases when this is the only site of biopsiable disease

Patients with all target lesions in a previously irradiated region, except if clear progression has been observed prior to study in at least one of them

Patient who received more than 2 lines of chemotherapy at the time of the biopsy

Tumor progression observed with the current line of treatment when under 2nd line

Patients who already had a genomic profile (both CGH and NGS analysis) in which no SAFIR02 targetable alterations have been identified

Abnormal coagulation contraindicating biopsy

Inability to swallow

Major problem with intestinal absorption Any clinically important abnormalities in rhythm, conduction or morphology of resting ECG Any factors increasing the risk of QTc prolongation or arrhythmic events Experience of any of the following in the preceding 12 months: coronary artery bypass graft, angioplasty, vascular stent, myocardial infarction, past or current uncontrolled angina pectoris, congestive heart failure NYHA Grade ≥2, torsades de pointes, current uncontrolled hypertension, cardiomyopathy Past medical history of interstitial lung disease, drug-induced interstitial disease, radiation pneumonitis which requires steroid treatment or any evidence of clinically interstitial lung disease Previous or current malignancies of other histologies within the last 5 years, Evidence of severe or uncontrolled systemic disease (active bleeding diatheses, or active Hepatitis B, C and HIV)

diagnosis of acne rosacea, severe psoriasis and severe atopic eczema

Prior exposure to anthracyclines or mitoxantrone with cumulative exposure in excess of 360 mg/m² for doxorubicin, 720 mg/m² for epirubicin, or 72 mg/m² for mitoxantrone

Previous treatment with the same agent or in the same class as one of those used in the SAFIR02 trial (patients who received this previous targeted agent without the target prescreening are eligible but may not be eligible for randomisation in substudy 1 if the treatment allocated by the MTB is in the same class) History of retinal degenerative disease, eye injury or corneal surgery in the previous 3 months, past history of central serous retinopathy or retinal vein occlusion, intraocular pressure \>21 mmHg, or uncontrolled glaucoma.

History of hemorrhagic or thrombotic stroke, TIA or other CNS bleeds

Renal disease including glomerulonephritis, nephritic syndrome, Fanconi syndrome, renal tubular acidosis

Patients using drugs that are known potent inhibitors or potent inducers or substrates of cytochrome P450

Randomized phase:

Substudy 1:

More than 2 previous lines of chemotherapy for metastatic disease before randomization

Life expectancy \<3 months

Disease progression occuring at any time during chemotherapy and before randomization or toxicity that led to the discontinuation of the last chemotherapy before 4 full cycles have been delivered

Less than 28 days from radiotherapy, less than 2 weeks from palliative radiation

Patients previously treated with a targeted agent in the same class as the agent to be given to the patient in substudy 1

Toxicities of grade ≥2 from any previous anti-cancer therapy

Altered haematopoietic or organ function

Mean resting corrected QT interval (QTc) \>480 msec (or QTcF \>450 msec) obtained from 3 consecutive ECGs

Left ventricular ejection fraction (LVEF) \<55% (MUGA scan or Echocardiogram)

Altered ophthalmic conditions confirmed by an ophthalmology specialist for patients likely to be treated with AZD4547 orAZD8931 or Selumetinib

Patients using non-substitutable drugs, that are known to prolong QT interval or induce Torsades de Pointes, when they are supposed to be treated with vandetanib, AZD5363 or AZD8931

Substudy 2:

wash-out period of at least 15 days for weekly (except monoclonal antibodies) or daily chemotherapies or 28 days for other chemotherapies from last chemotherapy administration prior to randomization and grade ≤1 residual toxicities

More than 2 previous lines of chemotherapy for metastatic disease before randomization

Life expectancy \<3 months

Disease progression occuring at any time during chemotherapy and before randomization or toxicity that led to the discontinuation of the last chemotherapy before 4 full cycles have been delivered

Any previous treatment with a PD1 or PD-L1 inhibitor, including MEDI4736

Toxicities of grade ≥2 from any previous anti-cancer therapy

Altered haematopoietic or organ function

Mean resting QT interval corrected for heart rate (QTc) ≥470 ms calculated from 3 consecutive ECGs using Bazett's Correction

Current or prior use of immunosuppressive medication within 28 days before the first dose of MEDI4736, with the exceptions of intranasal and inhaled corticosteroids or systemic corticosteroids at physiological doses, which are not to exceed 10 mg/day of prednisone, or an equivalent corticosteroid

Active or prior documented autoimmune disease within the past 2 years NOTE: Subjects with vitiligo, Grave's disease, or psoriasis not requiring systemic treatment (within the past 2 years) are not excluded

History of primary immunodeficiency

What this study is about