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Hydroxychloroquine in Metastatic Estrogen Receptor-Positive Breast Cancer Progressing on Hormonal Therapy (ABC01)

Primary Purpose

Estrogen Receptor Positive Breast Cancer

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
hydroxychloroquine
Sponsored by
Western Regional Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Estrogen Receptor Positive Breast Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients ≥ 18 years of age with histologically confirmed, metastatic ER + breast cancer with clinical progression of disease (including radiographically stable disease with at least 50% increment of an elevated tumor marker by two measurements at least 2 weeks apart (this particular tumor marker will be used for disease status assessment in the study) on current hormonal therapy with PFS for at least 3 months.
  2. Karnofsky Performance Status (KPS) ≥70% and a life expectancy >3 months.
  3. Participants must have at least one target visceral lesion that allows for evaluation of tumor response or in the case of bone-only metastases, patients need to have a positive imaging study such as bone scan, magnetic resonance imaging (MRI) or positron emission tomography-computed tomography (PET-CT) or CT, and an elevated tumor marker at least twice as high as upper limit.
  4. Absolute neutrophil count > 1500 mm3, platelet count ≥ 80×109 L, hemoglobin ≥ 8.5 g/dL
  5. Creatinine clearance ≥ 30 mL/min, total bilirubin ≤ 2 mg/dL, AST/ALT ≤ 3 times the upper limit of normal range
  6. No remaining grade 2 or higher toxicity from prior cancer therapies unless judged to be clinically insignificant by the Principal Investigator
  7. At least two (2) weeks from prior major surgery
  8. Willingness to provide permission to biopsy one of the lesions if applicable before the study (All the patients are encouraged to have post-therapy biopsy upon progression of disease, but it is optional) as well as blood samples for pertinent laboratory studies
  9. Women of child-bearing potential (i.e., women who are pre-menopausal or not surgically sterile) must be willing to use an acceptable non-hormonal contraceptive method (abstinence, or double barrier method) for the duration of the study and for 30 days following the last dose of study drug, and must have a negative urine or serum pregnancy test within 2 weeks prior to beginning treatment on this trial -

Exclusion Criteria:

  1. On combination hormonal therapy with everolimus or any other investigational agent
  2. Patients have symptomatic untreated brain metastasis or leptomeningeal metastases or treated but still symptomatic requiring the use of steroid 18Jul2014 Protocol v3: ABC 01 Anti-Autophagy for Met Breast Cancer Page 4 of 16
  3. Lymphangitic carcinomatosis involving ≥ 50% of the lungs; evidence of metastases involving more than one third of the liver on sonogram or computed tomography
  4. Lactating females
  5. Uncontrolled cardiac disease, congestive heart failure, angina or hypertension
  6. Myocardial infarction or unstable angina within 2 months of treatment
  7. Known human immunodeficiency virus (HIV) infection or chronic active Hepatitis B or C (patients are NOT required to be tested for the presence of such viruses prior to therapy on this protocol)
  8. Active clinically serious infection > CTCAE (version 4.03) Grade 2
  9. Serious non-healing wound, ulcer, or bone fracture
  10. Concurrent psychiatric illness/social situations that would limit safety and compliance with study requirements
  11. Inability to complete informed consent process and adhere to the protocol treatment plan and follow-up requirements
  12. Currently receiving any other investigational therapeutic agents
  13. Patients with known glucose-6-phosphate dehydrogenase deficiency, porphyria, cirrhosis or any other conditions with potential significant known risks
  14. Patients with history of retinal damage

Sites / Locations

  • Western Regional Medical Center, Inc.

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

hydroxychloroquine plus hormonal therapy

Arm Description

Add hydroxychloroquine to the current hormonal therapy

Outcomes

Primary Outcome Measures

Number of Participants with Adverse Events as a Measure of the safety profile of orally administered hydroxychloroquine with hormonal therapy
Assess the dose-limiting side effects such as neutropenia, anemia, or thormbocytopenia, or non-hematologic side effects nausea, vomiting, diarrhea, or vision problems at the study dose

Secondary Outcome Measures

The recommended phase 2 clinical dose (RP2D) of orally administered hydroxychloroquine with hormonal therapy
orally administered hydroxychloroquine with hormonal therapy
The pharmacodynamic (PD) profile of hydroxychloroquine with hormonal therapy
microtubule-associated protein 1 light chain 3 b (LC3b) level in the biopsy, WBCs in pre- and post-treatment samples
The anti-tumor activity of hydroxychloroquine with hormonal therapy with clinical benefit rate (CBR). Clinical benefits are defined as complete remission (CR), partial remission (PR) and stable disease (SD)
The anti-tumor activity of hydroxychloroquine with hormonal therapy with clinical benefit rate (CBR). Clinical benefits are defined as complete remission (CR), partial remission (PR) and stable disease (SD)
The disease-free survival (DFS) when adding hydroxychloroquine to hormonal therapy
The disease-free survival (DFS) when adding hydroxychloroquine to hormonal therapy

Full Information

First Posted
January 19, 2015
Last Updated
September 25, 2017
Sponsor
Western Regional Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT02414776
Brief Title
Hydroxychloroquine in Metastatic Estrogen Receptor-Positive Breast Cancer Progressing on Hormonal Therapy
Acronym
ABC01
Official Title
Phase Ib/II Study of Hydroxychloroquine in Metastatic ER-Positive Breast Cancer Progressing on Hormonal Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Terminated
Why Stopped
PI Leaving Site
Study Start Date
July 2014 (undefined)
Primary Completion Date
November 2015 (Actual)
Study Completion Date
November 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Western Regional Medical Center

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To determine the safety and tolerability of orally administered hydroxychloroquine with hormonal therapy. To assess the response rate of hydroxychloroquine in combination with hormonal therapy.
Detailed Description
To determine the number of patients with adverse effects To assess the clinical response to the combination

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Estrogen Receptor Positive Breast Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
3 (Actual)

8. Arms, Groups, and Interventions

Arm Title
hydroxychloroquine plus hormonal therapy
Arm Type
Experimental
Arm Description
Add hydroxychloroquine to the current hormonal therapy
Intervention Type
Drug
Intervention Name(s)
hydroxychloroquine
Other Intervention Name(s)
Plaquenil
Intervention Description
administration of hydroxychloroquine in combination with the current hormonal therapy
Primary Outcome Measure Information:
Title
Number of Participants with Adverse Events as a Measure of the safety profile of orally administered hydroxychloroquine with hormonal therapy
Description
Assess the dose-limiting side effects such as neutropenia, anemia, or thormbocytopenia, or non-hematologic side effects nausea, vomiting, diarrhea, or vision problems at the study dose
Time Frame
18 months
Secondary Outcome Measure Information:
Title
The recommended phase 2 clinical dose (RP2D) of orally administered hydroxychloroquine with hormonal therapy
Description
orally administered hydroxychloroquine with hormonal therapy
Time Frame
18 months
Title
The pharmacodynamic (PD) profile of hydroxychloroquine with hormonal therapy
Description
microtubule-associated protein 1 light chain 3 b (LC3b) level in the biopsy, WBCs in pre- and post-treatment samples
Time Frame
18 months
Title
The anti-tumor activity of hydroxychloroquine with hormonal therapy with clinical benefit rate (CBR). Clinical benefits are defined as complete remission (CR), partial remission (PR) and stable disease (SD)
Description
The anti-tumor activity of hydroxychloroquine with hormonal therapy with clinical benefit rate (CBR). Clinical benefits are defined as complete remission (CR), partial remission (PR) and stable disease (SD)
Time Frame
18 months
Title
The disease-free survival (DFS) when adding hydroxychloroquine to hormonal therapy
Description
The disease-free survival (DFS) when adding hydroxychloroquine to hormonal therapy
Time Frame
18 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients ≥ 18 years of age with histologically confirmed, metastatic ER + breast cancer with clinical progression of disease (including radiographically stable disease with at least 50% increment of an elevated tumor marker by two measurements at least 2 weeks apart (this particular tumor marker will be used for disease status assessment in the study) on current hormonal therapy with PFS for at least 3 months. Karnofsky Performance Status (KPS) ≥70% and a life expectancy >3 months. Participants must have at least one target visceral lesion that allows for evaluation of tumor response or in the case of bone-only metastases, patients need to have a positive imaging study such as bone scan, magnetic resonance imaging (MRI) or positron emission tomography-computed tomography (PET-CT) or CT, and an elevated tumor marker at least twice as high as upper limit. Absolute neutrophil count > 1500 mm3, platelet count ≥ 80×109 L, hemoglobin ≥ 8.5 g/dL Creatinine clearance ≥ 30 mL/min, total bilirubin ≤ 2 mg/dL, AST/ALT ≤ 3 times the upper limit of normal range No remaining grade 2 or higher toxicity from prior cancer therapies unless judged to be clinically insignificant by the Principal Investigator At least two (2) weeks from prior major surgery Willingness to provide permission to biopsy one of the lesions if applicable before the study (All the patients are encouraged to have post-therapy biopsy upon progression of disease, but it is optional) as well as blood samples for pertinent laboratory studies Women of child-bearing potential (i.e., women who are pre-menopausal or not surgically sterile) must be willing to use an acceptable non-hormonal contraceptive method (abstinence, or double barrier method) for the duration of the study and for 30 days following the last dose of study drug, and must have a negative urine or serum pregnancy test within 2 weeks prior to beginning treatment on this trial - Exclusion Criteria: On combination hormonal therapy with everolimus or any other investigational agent Patients have symptomatic untreated brain metastasis or leptomeningeal metastases or treated but still symptomatic requiring the use of steroid 18Jul2014 Protocol v3: ABC 01 Anti-Autophagy for Met Breast Cancer Page 4 of 16 Lymphangitic carcinomatosis involving ≥ 50% of the lungs; evidence of metastases involving more than one third of the liver on sonogram or computed tomography Lactating females Uncontrolled cardiac disease, congestive heart failure, angina or hypertension Myocardial infarction or unstable angina within 2 months of treatment Known human immunodeficiency virus (HIV) infection or chronic active Hepatitis B or C (patients are NOT required to be tested for the presence of such viruses prior to therapy on this protocol) Active clinically serious infection > CTCAE (version 4.03) Grade 2 Serious non-healing wound, ulcer, or bone fracture Concurrent psychiatric illness/social situations that would limit safety and compliance with study requirements Inability to complete informed consent process and adhere to the protocol treatment plan and follow-up requirements Currently receiving any other investigational therapeutic agents Patients with known glucose-6-phosphate dehydrogenase deficiency, porphyria, cirrhosis or any other conditions with potential significant known risks Patients with history of retinal damage
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jiaxin Niu, MD, PhD
Organizational Affiliation
Western Regional Medical Center, Inc.
Official's Role
Principal Investigator
Facility Information:
Facility Name
Western Regional Medical Center, Inc.
City
Goodyear
State/Province
Arizona
ZIP/Postal Code
85338
Country
United States

12. IPD Sharing Statement

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Hydroxychloroquine in Metastatic Estrogen Receptor-Positive Breast Cancer Progressing on Hormonal Therapy

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