BGB-21447 (Bcl-2 Inhibitor) Combinations for Adults With Hormone-Receptor Positive (HR+)/Human Epidermal Growth Factor Receptor 2 Negative (HER2-) Metastatic Breast Cancer

Last updated: November 7, 2025
Sponsor: BeOne Medicines
Overall Status: Active - Recruiting

Phase

1

Condition

Metastatic Cancer

Breast Cancer

Treatment

BGB-43395

BGB-21447

Fulvestrant

Clinical Study ID

NCT06756932
BGB-21447-102
CTR20250114
  • Ages > 18
  • All Genders

Study Summary

This is a dose escalation and dose expansion study to assess the safety and tolerability of BGB-21447 (a B-cell leukemia/lymphoma 2 inhibitor, Bcl-2i) in combination with fulvestrant, with or without BGB-43395 (cyclin-dependent kinase 4 inhibitor, CDK4i), in adults with HR+/HER2- metastatic breast cancer.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Histologically or cytologically confirmed HR+/HER2- metastatic breast cancer. Part 1A and 1B: Participants must have received ≥ 1 prior line(s) of treatment foradvanced/metastatic disease, including prior endocrine therapy and CDK4/6 inhibitorin either the adjuvant or advanced/metastatic setting. Part 2: Participants musthave received 1-3 prior line(s) of treatment for advanced/metastatic disease,including prior endocrine therapy and CDK4/6 inhibitor in either the adjuvant oradvanced/metastatic setting.

  • Female participants will be required (either continue ongoing or initiate as soon asfeasible) to have ovarian function suppression using gonadotropin-releasing hormone (GnRH) agonists (such as goserelin) or be postmenopausal.

  • Male participants may be required to use GnRH agonists when being treated withfulvestrant at the discretion of the investigator.

  • Participants must have a stable Eastern Cooperative Oncology Group (ECOG)Performance Status of ≤ 1.

  • Adequate organ function.

  • Female participants of childbearing potential and nonsterile male participants withfemale partners of childbearing potential must be willing to use a highly effectivemethod of birth control for the duration of the study and for 7 days after the lastdose of BGB-21447, 6 months after the last dose of BGB-43395, and 2 years after thelast dose of fulvestrant.

  • Food effect substudy only: Participants who are able and willing to fast overnight (≥ 10 hours) and consume a high-fat meal.

Exclusion

Exclusion Criteria:

  • Prior Bcl-2 inhibitor exposure. For triplet combination cohorts only: Prior therapyselectively targeting CDK4.

  • Known leptomeningeal disease or uncontrolled, untreated brain metastases.

  • Any malignancy ≤ 3 years before the first dose of study treatment(s) except for thespecific cancer under investigation in this study and any locally recurring cancerthat has been treated with curative intent (eg, treated papillary thyroid carcinoma,resected basal or squamous cell skin cancer, superficial bladder cancer, orcarcinoma in situ of the cervix or breast).

  • For Part 1B: Uncontrolled diabetes.

  • History of hepatitis B or active Hepatitis C infection

  • China Only: Untreated chronic hepatitis B or chronic hepatitis B virus (HBV)carriers with HBV DNA > 500 IU/ml (or > 2500 copies/ml) at screening.

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Study Design

Total Participants: 120
Treatment Group(s): 3
Primary Treatment: BGB-43395
Phase: 1
Study Start date:
February 04, 2025
Estimated Completion Date:
July 30, 2027

Study Description

This new study will check how safe and helpful a potential anticancer drug called BGB-21447 (Bcl-2i) is. This drug will be tested in combination with fulvestrant, with or without BGB-43395 (CDK4i), in adults with metastatic breast cancer.

HR+/HER2- tumors account for approximately 70% of all breast cancers and are responsible for most breast cancer-related deaths. While CDK4/6 inhibitors combined with endocrine therapy have improved outcomes for patients with HR+/HER2- metastatic breast cancer, patients eventually develop progressive disease on these therapies and require new treatments.

BGB-21447 is an oral drug that is highly potent and selectively stops a protein called B-cell lymphoma-2 (Bcl-2). Bcl-2 proteins are often overexpressed in some cancers (like HR+ breast cancer) by keeping the cancer cells from dying. Disrupting this pathway is believed to lead to cell death.

BGB-43395 is an oral drug that selectively stops a protein called cyclin-dependent kinase 4 (CDK4). CDK4 is a type of protein that regulates cell growth and division in your body.

Fulvestrant is a treatment that blocks estrogen receptors and reduces estrogen production. Fulvestrant has been approved to treat hormone receptor positive metastatic breast cancer to help stop the cancer cells from growing.

This combination might be a good way to fight cancer, aiming to give patients the best possible treatment. The study is designed to see if this combination is safe and works well.

Connect with a study center

  • Saint Vincents Hospital Sydney

    Darlinghurst, New South Wales NSW 2010
    Australia

    Site Not Available

  • Calvary Mater Newcastle

    Waratah, New South Wales NSW 2298
    Australia

    Site Not Available

  • Saint Vincents Hospital Sydney

    Darlinghurst 2169378, New South Wales 2155400 NSW 2010
    Australia

    Active - Recruiting

  • Calvary Mater Newcastle

    Waratah 10103871, New South Wales 2155400 NSW 2298
    Australia

    Active - Recruiting

  • Sunshine Coast University Private Hospital

    Birtinya, Queensland QLD 4575
    Australia

    Site Not Available

  • Sunshine Coast University Private Hospital

    Birtinya 8348723, Queensland 2152274 QLD 4575
    Australia

    Active - Recruiting

  • Peter Maccallum Cancer Centre

    Melbourne, Victoria VIC 3000
    Australia

    Site Not Available

  • Western Health - Sunshine Hospital

    Saint Albans, Victoria 3021
    Australia

    Site Not Available

  • Western Health Sunshine Hospital

    St Albans, Victoria VIC 3021
    Australia

    Site Not Available

  • Peter Maccallum Cancer Centre

    Melbourne 2158177, Victoria 2145234 VIC 3000
    Australia

    Active - Recruiting

  • Western Health Sunshine Hospital

    St Albans 8015209, Victoria 2145234 VIC 3021
    Australia

    Active - Recruiting

  • Linear Clinical Research

    Nedlands, Western Australia WA 6009
    Australia

    Site Not Available

  • Linear Clinical Research

    Nedlands 2064874, Western Australia 2058645 WA 6009
    Australia

    Active - Recruiting

  • Sun Yat Sen Memorial Hospital, Sun Yat Sen University (South)

    Guangzhou, Guangdong 510245
    China

    Site Not Available

  • Sun Yat Sen Memorial Hospital, Sun Yat Sen University (South)

    Guangzhou 1809858, Guangdong 1809935 510245
    China

    Active - Recruiting

  • The First Affiliated Hospital of Zhengzhou University

    Zhengzhou, Henan 450052
    China

    Site Not Available

  • The First Affiliated Hospital of Zhengzhou University

    Zhengzhou 1784658, Henan 1808520 450052
    China

    Active - Recruiting

  • The First Affiliated Hospital of Nanchang University Branch Donghu

    Nanchang, Jiangxi 330006
    China

    Site Not Available

  • The First Affiliated Hospital of Nanchang University Branch Donghu

    Nanchang 1800163, Jiangxi 1806222 330006
    China

    Active - Recruiting

  • Fudan University Shanghai Cancer Centerpudong

    Shanghai, Shanghai 201321
    China

    Site Not Available

  • Fudan University Shanghai Cancer Centerpudong

    Shanghai 1796236, Shanghai Municipality 1796231 201321
    China

    Active - Recruiting

  • Tianjin Medical University Cancer Institute and Hospital

    Tianjin, Tianjin 300060
    China

    Site Not Available

  • Tianjin Medical University Cancer Institute and Hospital

    Tianjin 1792947, Tianjin Municipality 1792943 300060
    China

    Active - Recruiting

  • Sir Run Run Shaw Hospital, Zhejiang University School of Medicine

    Hangzhou, Zhejiang 310016
    China

    Site Not Available

  • Sir Run Run Shaw Hospital, Zhejiang University School of Medicine

    Hangzhou 1808926, Zhejiang 1784764 310016
    China

    Active - Recruiting

  • Hoag Memorial Presbyterian

    Newport, California 92663
    United States

    Site Not Available

  • Hoag Memorial Presbyterian

    Newport Beach, California 92663-4162
    United States

    Site Not Available

  • Hoag Memorial Presbyterian

    Newport Beach 5376890, California 5332921 92663-4162
    United States

    Active - Recruiting

  • University of Iowa Hospitals and Clinics

    Iowa City, Iowa 52242-1009
    United States

    Site Not Available

  • University of Iowa Hospitals and Clinics

    Iowa City 4862034, Iowa 4862182 52242-1009
    United States

    Active - Recruiting

  • Md Anderson Cancer Center

    Houston, Texas 77030-3907
    United States

    Site Not Available

  • Md Anderson Cancer Center

    Houston 4699066, Texas 4736286 77030-3907
    United States

    Active - Recruiting

  • Fred Hutchinson Cancer Research Center

    Seattle, Washington 98109-4433
    United States

    Site Not Available

  • Fred Hutchinson Cancer Research Center

    Seattle 5809844, Washington 5815135 98109-4433
    United States

    Active - Recruiting

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