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OncoMatch/Clinical Trials/NCT07137416

Testing the Safety of the Combination of Anti-Cancer Drugs CX-5461 (Pidnarulex) and Trastuzumab Deruxtecan (T-DXd) for Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Solid Tumors and Breast Cancer

Is NCT07137416 recruiting? Yes, currently enrolling (May 2026). This Phase 1 trial studies multiple treatments including Trastuzumab Deruxtecan and Pidnarulex for anatomic stage iii breast cancer ajcc v8.

Phase 1RecruitingNational Cancer Institute (NCI)NCT07137416Data as of May 2026

Treatment: Pidnarulex · Trastuzumab DeruxtecanThis phase I trial tests the safety, side effects, and best dose of pidnarulex in combination with trastuzumab deruxtecan in treating patients with breast cancer and other solid tumors that express varying levels of a protein called HER2 and that has spread from where it first started (primary site) to other places in the body (metastatic), that cannot be removed by surgery (unresectable), or that has spread to nearby tissue or lymph nodes (locally advanced). Pidnarulex is an enzyme inhibitor that causes cell death and prevents tumor cell growth. Trastuzumab deruxtecan is in a class of medications called antibody-drug conjugates. It is composed of a monoclonal antibody, called trastuzumab, linked to a chemotherapy drug, called deruxtecan. Trastuzumab attaches to HER2 positive tumor cells in a targeted way and delivers deruxtecan to kill them. Giving pidnarulex in combination with trastuzumab deruxtecan may be safe, tolerable and/or effective in treating patients with metastatic, unresectable, or locally advanced HER2-expressing breast cancer or other solid tumors.

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Extracted eligibility criteria

Cancer type

Breast Carcinoma

Tumor Agnostic

Triple-Negative Breast Cancer

Biomarker criteria

Required: HER2 (ERBB2) overexpression (IHC 3+)

HER2-positive (IHC 3+) solid cancers

Required: HER2 (ERBB2) low expression (IHC 2+/ISH-, IHC 1+/ISH-, or IHC 1+/ISH untested)

HER2-low, with HER2-low defined as IHC 2+/ISH-, IHC 1+/ISH-, or IHC 1+/ISH untested

Required: HER2 (ERBB2) ultralow expression (IHC 0 with membrane staining)

HER2-ultralow defined as IHC 0 with membrane staining

Allowed: ESR1 expression

Any estrogen receptor (ER) and progesterone receptor (PR) expression is permitted but must be known

Allowed: PR (PGR) expression

Any estrogen receptor (ER) and progesterone receptor (PR) expression is permitted but must be known

Disease stage

Required: Stage III, IV (AJCC v8)

Metastatic disease required

locally advanced or metastatic disease; unresectable

Performance status

ECOG 0–2(Ambulatory, capable of self-care)

Prior therapy

Min 1 prior line

Must have received: cytotoxic chemotherapy

Patients must have had at least one prior line of cytotoxic chemotherapy

Cannot have received: anthracycline

Exception: Receipt of anthracycline in the (neo)adjuvant setting is allowed, provided that disease recurrence occurred later than 6 months after the completion of treatment

Patients must not have progressed on a prior anthracycline in the metastatic setting

Lab requirements

Blood counts

ANC ≥ 1,500/mcL (no G-CSF within 1 week prior to screening); Platelets ≥ 100,000/mcL (no transfusions within 1 week prior to screening)

Kidney function

Glomerular filtration rate (GFR) ≥ 60 mL/min/1.73 m^2 (using Cockcroft-Gault equation for participants with creatinine levels above institutional ULN)

Liver function

Total bilirubin ≤ 1.5 × institutional ULN (or ≤ 2 × institutional ULN in patients with documented Gilbert's syndrome); AST/ALT ≤ 3 × institutional ULN (or ≤ 5 × ULN in patients with liver metastases)

Cardiac function

LVEF ≥ 50% by ECHO or MUGA within 28 days before enrollment; NYHA class II or better

ANC ≥ 1,500/mcL; Platelets ≥ 100,000/mcL; Total bilirubin ≤ 1.5 × institutional ULN (or ≤ 2 × institutional ULN in patients with documented Gilbert's syndrome); AST/ALT ≤ 3 × institutional ULN (or ≤ 5 × ULN in patients with liver metastases); INR/PT and aPTT ≤ 1.5 × ULN; GFR ≥ 60 mL/min/1.73 m^2; LVEF ≥ 50% by ECHO or MUGA; NYHA class II or better

Structured fields extracted by AI. May contain errors — verify against the official protocol.

US trial sites

  • Dana-Farber - Harvard Cancer Center LAO · Boston, Massachusetts

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