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Phase II / Phase III: ZN-1041 in HER2-Positive Breast Cancer (BREnnA)

Clinical Trial Overview

Clinical Trial Overview

Recruiting

A Two-part, Seamless, Multicenter, Randomized, Open-label, Adaptive Phase II/III Study of the Blood-brain Barrier Penetrant RO7771950 Versus Tucatinib, Both in Combination With Trastuzumab and Capecitabine, in Patients With Pretreated Unresectable Locally Advanced or Metastatic HER2-Positive Breast Cancer, With or Without Central Nervous System Metastases

Objective

The purpose of this study is to assess the efficacy and safety of RO7771950 in combination with trastuzumab and capecitabine, compared to tucatinib in combination with trastuzumab and capecitabine.

Primary Endpoints

  • Progression-free Survival (PFS) as Determined by Blinded Independent Central Review (BICR)

Secondary Endpoints

  • Progression-free Survival in Participants with Central Nervous System Metastases (PFS-CNS) by BICR
  • Overall Survival in Full Analysis Set (OS-FAS)
  • Objective Response Rate (ORR) by BICR
  • Duration of Response (DOR) as per BICR
  • Clinical Benefit Rate (CBR) as per BICR
  • ORR in Participants with CNS Metastases (ORR-CNS)
  • DOR in Participants with CNS Metastases (DOR-CNS)
  • CBR in Participants with CNS Metastases (CBR-CNS)
  • Changes from Baseline in Symptoms Burden in Participants With Brain Tumors
  • Changes from Baseline in Function and Health-related Quality of Life (HRQoL)
  • Incidence of Adverse Events (AEs)
  • Severity of AEs
  • Change from Baseline in Echocardiogram (ECHO)/Multiple-gated Acquisition (MUGA)
  • Change from Baseline in the Columbia-suicide Severity Rating Scale (C-SSRS)
  • Number of Participants Reporting Presence, Frequency of Occurrence, Severity, and/or Degree of Interference With Daily Activities of Symptomatic Treatment Toxicities as Assessed Through Use of the Patient-reported Outcome (PRO)-CTCAE
  • Proportion of Participants Reporting Each Response Option at Each Assessment Timepoint by Treatment Arm for Treatment Side-effect Bother Single-item Functional Assessment of Cancer Therapy (FACT-GP5)
  • Change from Baseline/Worsening in Symptomatic Treatment Toxicities as Assessed Through Use of the PRO-CTCAE
  • Change from Baseline/Worsening in Symptomatic Treatment Side-effect Bother FACT-GP5
  • Health Utility Scores of the European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L)
  • Plasma Concentration of RO7771950 and its Metabolite(s) at Specified Timepoints

ZN-1041

Other names: RG6596; RO7771950

Modality: Tyrosine Kinase Inhibitor (TKI)

Disease/Condition: HER2-Positive Breast Cancer


ADDITIONAL RESOURCES

Inclusion and Exclusion Criteria

Inclusion and Exclusion Criteria

Inclusion Criteria
  • Pathologically documented locally advanced inoperable (LAI) or metastatic breast cancer (MBC) with confirmed HER2-positive status by central laboratory.
  • Measurable disease as per by RECIST v1.1 in stage 1. Non-measurable disease allowed in stage 2.
  • Previously treated (stable or progressive) or previously untreated CNS metastases, or leptomeningeal metastases.
  • At least one prior line of anti-HER2-based therapy for LAI or metastatic disease.
  • Prior anti-HER2 antibody-drug conjugate (ADC), such as trastuzumab-deruxtecan (T-DXd) or trastuzumab emtansine (T-DM1), in any treatment setting. Participants without prior ADC therapy may only be enrolled if approved standard-of-care (SOC) anti-HER2 ADC is not locally accessible at screening, or if there is a prospectively documented clinical contraindication.
  • Prior tyrosine kinase inhibitor (TKI) in the (neo)adjuvant setting provided completion is > 12 months ahead of LAI occurrence. Prior treatment with TKIs for LAI/MBC is not permitted.
  • Has protocol-defined adequate organ and bone marrow function.
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
  • Baseline left ventricular ejection fraction (LVEF) ≥ 50%.
Exclusion Criteria
  • Concurrent anti-cancer treatment, or treatment with investigational therapy within 28 days prior to initiation of study treatment.
  • Known active/untreated hepatitis B or C or chronic liver disease.
  • Clinically significant cardiovascular disease or risk, including heart failure (New York Heart Association (NYHA) ≥ II), ischemic heart disease or recent coronary events/interventions, clinically significant arrhythmias or electrocardiogram (ECG) abnormalities, QT prolongation or risk of ventricular dysrhythmias, poorly controlled hypertension, peripheral arterial disease, dilated cardiomyopathy, or unstable angina.
  • Clinically significant electrolyte abnormalities (e.g., hypokalemia, hypomagnesemia, hypocalcemia), or family history of sudden unexplained death or long QT syndrome.
  • Concomitant use of any drug or herbal medicine known to strongly inhibit or induce CYP3A4 or CYP2C8 activity, oral coumarin-derivative anticoagulants.
Study Site Locations

14 Results

    Enrollment and Resources

    Enrollment & Resources

    Enrollment

    For more information on eligibility criteria, view the study or reach out to our team.

    Call icon

    Phone

    1-888-662-6728
    (US and Canada)

    Resources

    ClinicalTrials.gov

    Learn more about this trial (NCT07413939) on ClinicalTrials.gov.

    Patient Resources

    Genentech offers a place for patients, relatives, and caregivers to learn more about clinical trials.

    Information is consistent with ClinicalTrials.gov as of October 06, 2026. Products under investigation have not been approved for use outside of the clinical trial setting. This information is presented only for the purposes of providing an overview of clinical trials and should not be construed as a recommendation for use of any product for unapproved purposes.

    Looking for more information?

    Reach out to a Genentech Medical Science Liaison near you, or connect with the contact center.

    Call the Trial Information Support Team: 1-888-662-6728 Hours: Monday-Friday, 5am-5pm PT

    • AD
      Alzheimer's disease

    • ABC
      advanced breast cancer

    • bADLs
      Basic activities of daily living

    • ISLT
      International Shopping List Test

    • MCI
      Mild cognitive impairment

    • CV
      coefficient of variation

    • HEX
      cell hexagonality

    • PDS
      Port Delivery System

    • Q24W
      once every 24 weeks

    • BMI
      Body mass index

    • HbA1c
      hemoglobin A1C

    • HOMA-IR
      Homeostasis Model Assessment of Insulin Resistance

    • NLM
      National Library of Medicine

    • QUICKI
      Quantitative Insulin Sensitivity Check Index

    • SGLT-2
      sodium-glucose cotransporter-2

    • SMBG
      Self-Monitored Blood Glucose

    • T1DM
      Type 1 Diabetes Mellitus

    • T2DM
      Type 2 diabetes mellitus

    • AE
      adverse events

    • AESI
      Adverse Events of Special Interest

    • MDD
      major depressive disorder

    • PHQ-9
      Patient Health Questionnaire-9

    • SAE
      serious adverse events

    • ABR
      Annualized Bleed Rate

    • CBR
      clinical benefit rate

    • CDK4/6i
      cyclin-dependent kinase 4 and 6 inhibitor

    • CNS
      central nervous system

    • CR
      complete response

    • DoR
      duration of response

    • ER
      estrogen receptor

    • HER2
      human epidermal growth factor receptor 2

    • HER2-
      human epidermal growth factor receptor 2-negative

    • HR
      hormone receptor

    • HR+
      hormone receptor-positive

    • mut
      mutated

    • NIS
      non-interventional study

    • ORR
      objective response rate

    • OS
      overall survival

    • PFS
      progression-free-survival

    • PIK3CA
      phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha

    • PIK3CAm
      PIK3CA-mutated

    • PK
      pharmacokinetics

    • PROs
      patient-reported outcomes

    • SD
      stable disease

    • SoC
      standard of care

    • VWD
      von Willebrand disease

    • WHO
      World Health Organization

    • T2D
      Type 2 diabetes

    • T1D
      Type 1 Diabetes

    • ADA
      anti-drug antibody

    • DXA
      Dual-energy X-ray Absorptiometry

    • ASCVD
      atherosclerotic cardiovascular disease

    • FGF21
      fibroblast growth factor 21

    • SHTG
      severe hypertriglyceridemia

    • TG
      triglycerides

    • MASH
      metabolic dysfunction-associated steatohepatitis

    • NAFLD
      non-alcoholic fatty liver disease

    • NAS
      NAFLD Activity Score

    • NASH
      nonalcoholic steatohepatitis

    • pmMS
      partial modified Mayo

    • CD
      Crohn's disease

    • CMV
      cytomegalovirus

    • HIV
      human immunodeficiency virus

    • HBV
      Hepatitis B

    • HCV
      Hepatitis C

    • TB
      tuberculosis

    • UC
      ulcerative colitis

    • TL1A
      tumor necrosis factor-like ligand 1A

    • mMS
      modified Mayo Score

    • APS
      average daily abdominal pain scores in the past week

    • CDAI
      Crohn’s Disease Activity Index

    • IBDQ
      Inflammatory Bowel Disease Questionnaire

    • SF
      stool frequency subscore

    • PBO
      Placebo

    • EASI
      Eczema Area and Severity Index

    • IGA
      Investigator Global Assessment

    • NRS
      Numerical Rating Scale

    • IM
      intramuscular

    • IL
      intralesional

    • PDE-4
      Phosphodiesterase-4

    • ACE
      angiotensin-converting enzyme

    • ARBs
      angiotensin II receptor blockers

    • ASO
      Antisense Oligonucleotide

    • CKD-EPI
      Chronic Kidney Disease Epidemiology Collaboration

    • eGFR
      Estimated Glomerular Filtration Rate

    • FACIT-F
      Functional Assessment of Chronic Illness Therapy-Fatigue subscale

    • g/day
      gram per day

    • g/g
      gram per gram

    • GIP
      Glucose-dependent Insulinotropic Polypeptide

    • GLP-1
      Glucagon-like Peptide-1

    • IgAN
      IgA nephropathy

    • mg/day
      milligrams per day

    • TEAEs
      Treatment-Emergent Adverse Events

    • UPCR
      Urine Protein-to-Creatinine Ratio

    • AEs
      Adverse events

    • ALT
      Alanine aminotransferase

    • AST
      Aspartate aminotransferase

    • C-SSRS
      Columbia-Suicide Severity Rating Scale

    • DMT
      Disease-modifying therapy

    • ECG
      Electrocardiogram

    • EDSS
      Expanded Disability Status Scale

    • Gd
      Gadolinium

    • IPMSSG
      International Pediatric Multiple Sclerosis Study Group

    • MRI
      Magnetic resonance imaging

    • MS
      Multiple sclerosis

    • PD
      Pharmacodynamic

    • PPMS
      Primary progressive multiple sclerosis

    • RMS
      Relapsing multiple sclerosis

    • SI
      Suicidal ideation

    • SPMS
      Secondary progressive multiple sclerosis

    • CYP3A4
      cytochrome-p450-3a4

    • ADAS-Cog-13
      Alzheimer's Disease Assessment Scale-Cognition 13

    • ADAs
      Anti-drug antibodies

    • ADCS-ADL
      Alzheimer's Disease Cooperative Study Activities of Daily Living Inventory

    • CDR-GS
      Clinical Dementia Rating, Global Score

    • CDR-SB
      Clinical Dementia Rating, Sum of Boxes

    • CSF
      Cerebrospinal fluid

    • GFAP
      Glial fibrillar acidic protein

    • iADRS
      Integrated Alzheimer's Disease Rating Scale

    • MMSE
      Mini-Mental State Examination

    • PET
      Positron emission tomography

    • RBANS DMI
      Repeatable Battery for the Assessment of Neuropsychological Status Delayed Memory Index

    • EORTC QLQ-C30
      European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire

    • PRO-CTCAE
      Patient-Reported Outcomes Common Terminology Criteria for Adverse Events

    • TTCD
      Time to Confirmed Deterioration

    • AJCC
      American Joint Committee on Cancer Staging System

    • ECOG
      Eastern Cooperative Oncology Group

    • FFPE
      formalin-fixed, paraffin-embedded

    • RECIST
      Response Evaluation Criteria in Solid Tumors

    • NSCLC
      non-small cell lung cancer

    • BICR
      blinded independent central review

    • CD137
      Cluster of Differentiation 137

    • EORTC QLQ-LC13
      European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-Supplemental Lung Cancer Module

    • KRAS G12C
      Kirsten rat sarcoma viral oncogene homolog G12C

    • PD-L1
      Programmed death-ligand 1

    • RAS
      RAt Sarcoma

    • RT
      Radiation therapy

    • DOCR
      duration of complete response

    • DFS
      disease-free survival

    • EFSeff
      event-free survival efficacy causes

    • FACT-Lym LymS
      lymphoma subscale within the functional assessment of cancer therapy-Lymphoma questionnaire

    • IPI
      international prognostic index

    • IRF
      Independent Review Facility

    • Pola-R-CHP
      polatuzumab vedotin plus rituximab, cyclophosphamide, doxorubicin, and prednisone

    • LBCL
      large B-cell lymphoma

    • PROMIS-29
      Patient-Reported Outcomes Measurement Information System-29

    • ESR1nmd
      ESR1 no-mutation-detected

    • IV
      intravenous

    • II
      2

    • ECD
      endothelial cell density

    • III
      3

    • SC
      Subcutaneous

    +