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Trastuzumab and Interleukin-2 in Treating Patients With Metastatic Breast Cancer

Primary Purpose

HER2-positive Breast Cancer, Male Breast Cancer, Recurrent Breast Cancer

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
trastuzumab
aldesleukin
laboratory biomarker analysis
pharmacological study
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HER2-positive Breast Cancer

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Histologically or cytologically confirmed breast cancer Primary and/or metastatic disease HER2 overexpression 3+ by immunohistochemistry (IHC) or fluorescence in situ hybridization (FISH) Tumors with HER2 2+ overexpression by IHC allowed if confirmed by FISH Progressive disease during or within 12 months of receiving prior regimen containing trastuzumab (Herceptin) Unidimensionally measurable disease At least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan The following are not considered measurable: Bone metastases Pleural or peritoneal effusion Ascites Leptomeningeal disease Lymphangitic disease Inflammatory breast cancer Cystic lesions CNS lesions CNS metastases allowed if all of the following conditions are met: Asymptomatic At least 3 months since prior surgery and/or cranial irradiation At least 3 weeks since prior steroids Hormone receptor status: Not specified Male or female Performance status - ECOG 0-2 Granulocyte count at least 1,000/mm^3 Platelet count at least 100,000/mm^3 Bilirubin no greater than 1.5 times upper limit of normal (ULN) SGOT and SGPT no greater than 2 times ULN (5 times ULN for liver metastases) Alkaline phosphatase no greater than 2 times ULN (5 times ULN for liver metastases) Creatinine no greater than 1.5 times ULN LVEF at least lower limit of normal by MUGA or echocardiogram No congestive heart failure or active ischemic heart disease Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No psychiatric illness, medical condition, or uncontrolled infection that would preclude study No underlying immunodeficiency (e.g., HIV or autoimmune disease) No other prior malignancy within the past 5 years except nonmelanoma skin cancer or carcinoma in situ of the cervix See Disease Characteristics Prior cumulative doxorubicin dose no greater than 360 mg/m^2 At least 3 weeks since prior chemotherapy No more than 2 prior chemotherapy regimens for metastatic disease No concurrent chemotherapy See Disease Characteristics At least 3 weeks since prior endocrine therapy No concurrent corticosteroids or dexamethasone Concurrent hormones allowed for conditions unrelated to disease (e.g., insulin for diabetes) See Disease Characteristics At least 3 weeks since prior radiotherapy No prior radiotherapy to study lesion, unless evidence of disease progression No concurrent palliative radiotherapy See Disease Characteristics At least 4 weeks since prior major surgery No concurrent immunosuppressive drugs

Sites / Locations

  • Ohio State University Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (trastuzumab and aldesleukin)

Arm Description

Patients receive trastuzumab IV over 30-90 minutes on days 1 and 8 and aldesleukin SC on days 2-7 and 9-21. Beginning on day 22, patients receive trastuzumab IV over 30 minutes every 14 days. Patients also receive aldesleukin SC daily on days 1-14. Treatment continues for 1 year in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Response rate using Response Evaluation Criteria in Solid Tumors (RECIST)
Toxicity assessed using Common Toxicity Criteria (CTC) version 2.0

Secondary Outcome Measures

Degree of NK cell expansion
Effectiveness of patients' PBMCs in a standard ADCC assay directed against HER2 target cells

Full Information

First Posted
September 11, 2000
Last Updated
October 7, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00006228
Brief Title
Trastuzumab and Interleukin-2 in Treating Patients With Metastatic Breast Cancer
Official Title
Phase II Trial of Anti-HER-2 Monoclonal Antibody Trastuzumab (Herceptin) in Combination With Low Dose Interleukin-2 (Proleukin) in Metastatic Breast Cancer Patients Who Have Previously Failed Trastuzumab
Study Type
Interventional

2. Study Status

Record Verification Date
October 2013
Overall Recruitment Status
Completed
Study Start Date
July 2000 (undefined)
Primary Completion Date
July 2003 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
Monoclonal antibodies such as trastuzumab can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. Interleukin-2 may stimulate a person's white blood cells to kill breast cancer cells. Phase II trial to study the effectiveness of trastuzumab plus interleukin-2 in treating patients who have metastatic breast cancer that has not responded to previous trastuzumab therapy.
Detailed Description
PRIMARY OBJECTIVES: I. To estimate the response rate and toxicity to low-dose IL-2 with intermediate-"pulse" dose interleukin 2 (IL-2) and trastuzumab in patients with uni-dimensional measurable metastatic breast cancer and human epidermal growth factor receptor 2 (HER2) positive (3+ overexpression by immunohistochemistry [IHC] method or positive by fluorescent in situ hybridization [FISH]) who either have had evidence of progressive disease while receiving a trastuzumab-containing regimen, or have had progressive disease within 12 months of receiving a trastuzumab-containing regimen. SECONDARY OBJECTIVES: I. To perform correlative immunologic assays to determine the degree of natural killer (NK) cell expansion in response to low-dose IL-2, and the effectiveness of patients' peripheral blood mononuclear cells (PBMC) in a standard antibody-dependent cell-mediated cytotoxicity (ADCC) assay directed against a HER2 target cell. II. To determine the pharmacokinetics of trastuzumab using an every 2-week schedule. III. To determine Fc-gamma receptor polymorphisms from study patients. OUTLINE: This is a multicenter study. Patients receive trastuzumab intravenously (IV) over 30-90 minutes on days 1 and 8 and aldesleukin subcutaneously (SC) on days 2-7 and 9-21. Beginning on day 22, patients receive trastuzumab IV over 30 minutes every 14 days. Patients also receive aldesleukin SC daily on days 1-14. Treatment continues for 1 year in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up for at least 30 days. PROJECTED ACCRUAL: A total of 17-37 patients will be accrued for this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HER2-positive Breast Cancer, Male Breast Cancer, Recurrent Breast Cancer, Stage IV Breast Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
37 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment (trastuzumab and aldesleukin)
Arm Type
Experimental
Arm Description
Patients receive trastuzumab IV over 30-90 minutes on days 1 and 8 and aldesleukin SC on days 2-7 and 9-21. Beginning on day 22, patients receive trastuzumab IV over 30 minutes every 14 days. Patients also receive aldesleukin SC daily on days 1-14. Treatment continues for 1 year in the absence of disease progression or unacceptable toxicity.
Intervention Type
Biological
Intervention Name(s)
trastuzumab
Intervention Description
Given IV
Intervention Type
Biological
Intervention Name(s)
aldesleukin
Intervention Description
Given SC
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
pharmacological study
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Response rate using Response Evaluation Criteria in Solid Tumors (RECIST)
Time Frame
Up to 12 months
Title
Toxicity assessed using Common Toxicity Criteria (CTC) version 2.0
Time Frame
Up to 12 months
Secondary Outcome Measure Information:
Title
Degree of NK cell expansion
Time Frame
Up to 12 months
Title
Effectiveness of patients' PBMCs in a standard ADCC assay directed against HER2 target cells
Time Frame
Up to 12 months

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed breast cancer Primary and/or metastatic disease HER2 overexpression 3+ by immunohistochemistry (IHC) or fluorescence in situ hybridization (FISH) Tumors with HER2 2+ overexpression by IHC allowed if confirmed by FISH Progressive disease during or within 12 months of receiving prior regimen containing trastuzumab (Herceptin) Unidimensionally measurable disease At least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan The following are not considered measurable: Bone metastases Pleural or peritoneal effusion Ascites Leptomeningeal disease Lymphangitic disease Inflammatory breast cancer Cystic lesions CNS lesions CNS metastases allowed if all of the following conditions are met: Asymptomatic At least 3 months since prior surgery and/or cranial irradiation At least 3 weeks since prior steroids Hormone receptor status: Not specified Male or female Performance status - ECOG 0-2 Granulocyte count at least 1,000/mm^3 Platelet count at least 100,000/mm^3 Bilirubin no greater than 1.5 times upper limit of normal (ULN) SGOT and SGPT no greater than 2 times ULN (5 times ULN for liver metastases) Alkaline phosphatase no greater than 2 times ULN (5 times ULN for liver metastases) Creatinine no greater than 1.5 times ULN LVEF at least lower limit of normal by MUGA or echocardiogram No congestive heart failure or active ischemic heart disease Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No psychiatric illness, medical condition, or uncontrolled infection that would preclude study No underlying immunodeficiency (e.g., HIV or autoimmune disease) No other prior malignancy within the past 5 years except nonmelanoma skin cancer or carcinoma in situ of the cervix See Disease Characteristics Prior cumulative doxorubicin dose no greater than 360 mg/m^2 At least 3 weeks since prior chemotherapy No more than 2 prior chemotherapy regimens for metastatic disease No concurrent chemotherapy See Disease Characteristics At least 3 weeks since prior endocrine therapy No concurrent corticosteroids or dexamethasone Concurrent hormones allowed for conditions unrelated to disease (e.g., insulin for diabetes) See Disease Characteristics At least 3 weeks since prior radiotherapy No prior radiotherapy to study lesion, unless evidence of disease progression No concurrent palliative radiotherapy See Disease Characteristics At least 4 weeks since prior major surgery No concurrent immunosuppressive drugs
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Charles Shapiro
Organizational Affiliation
Ohio State University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ohio State University Medical Center
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States

12. IPD Sharing Statement

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Trastuzumab and Interleukin-2 in Treating Patients With Metastatic Breast Cancer

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