A study of taselisib and palbociclib for breast cancer (PIPA)

Cancer type:

Breast cancer

Status:

Results

Phase:

Phase 1

This study looked at taselisib and palbociclib for breast cancer when other treatments have stopped working. 

It was only for women with a change in a gene called PIK3CA.

This trial was open for people to join between 2015 and 2018. The team published the results in 2021.

More about this trial

Doctors use hormone therapy to treat oestrogen receptor positive Open a glossary item breast cancer (ER positive). Letrozole and fulvestrant are 2 hormone treatments. They are for women with ER positive breast cancer who have gone through the menopause (post menopausal). 

A common gene change (mutation Open a glossary item) in ER positive breast cancer is in the PIK3CA gene. This helps the cancer cells to grow. 

Taselisib is a targeted cancer drug Open a glossary item called a cancer growth blocker. It works by stopping the signals of the PIK3CA gene.

Palbociclib is also a cancer growth blocker. It works by stopping a protein that cells need to divide and grow. 

In this study researchers looked at giving:

  • taselisib and palbociclib together 
  • taselisib and palbociclib with letrozole 
  • taselisib and palbociclib with fulvestrant

They also looked at whether giving taselisib and palbociclib might help people with a solid tumour that had spread elsewhere in the body and whose: 

  • cancer had got worse despite having chemotherapy
  • cancer had a change in the PIK3CA gene

The aims of this study were to find:

  • the highest safe dose of taselisib and palbociclib to give
  • how safe taselisib and palbociclib is to give with fulvestrant
  • how safe taselisib and palbociclib is to give with letrozole
  • what the side effects are of these combinations    
  • what happens to taselisib and palbociclib in the body

Summary of results

The study team found that the side effects of having taselisib with palbociclib were tolerable and manageable. This was also the case when the people taking part had it with or without hormone therapy. 
 
Study design
This was a phase 1  Open a glossary itemstudy. There were 78 people in the study. Everyone had the PIKC3A gene change. There were 2 parts. 

In part 1 there were 20 people. The team found the best dose of taselisib and palbociclib to give. They used this for part 2. 

There were 3 groups in part 2. 

In group 1 there were 25 people with ER positive, HER2 Open a glossary item negative advanced breast cancer Open a glossary item. They had palbociclib, taselisib and fulvestrant.

In group 2 there were 26 people. Some people had ER negative advanced breast cancer and some had another type of solid tumour. They had palbociclib and taselisib.

In group 3 there were 7 people with ER positive, HER2 negative advanced breast cancer. They had palbociclib, taselisib and letrozole.

Results
The study team took blood samples to see what happened to taselisib and palbociclib in the body. They found that giving the 2 drugs together didn’t affect the amount of each drug the body absorbed.  

Side effects
The team looked at the most commonly reported side effects of the 58 people in the 3 groups in part 2. They found the most commonly reported side effects were:

  • a drop in blood cells 
  • tiredness (fatigue)
  • diarrhoea

Stopping treatment
The team looked at the reasons people stopped treatment. For this they were able to look at 77 people. Of these the number that stopped were:

  • 54 of the 77 people (70%) because a scan Open a glossary item showed their cancer was getting worse
  • 13 of the 77 people (17%) because an examination or blood test showed their cancer was getting worse
  • 3 of the 77 people (4%) because of a side effect that might be due to taking part in the trial 
  • 7 out of 77 people (9%) due to other reasons such as withdrawing their consent and not having treatment for 28 days or more

Conclusion
The study team concluded that giving taselisib and palbociclib together was safe. They also said that the side effects were manageable. This was also the case if they had it with or without hormone therapy.

The say that the combination of taselisib, palbociclib and fulvestrant showed promise. This was for people with breast cancer that had the PIKC3A gene change, was ER positive and HER2 negative.  

And that taselisib with palbociclib might benefit people who have breast cancer that:

  • has the PIKC3A gene change
  • is not hormone dependent Open a glossary item and
  • is HER2 negative 

This evidence shows that the 3 drugs together are useful and the team suggest further research to find out more. 

Where this information comes from    
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Nick Turner

Supported by

Experimental Cancer Medicine Centre (ECMC)
Institute of Cancer Research (ICR)
Pfizer
Roche
The Royal Marsden NHS Foundation Trust
The Christie NHS Foundation Trust
Beatson Institute for Cancer Research

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

14045

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Last reviewed:

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