PD-1(Programmed Death-1) Antibody +GP as First Line Treatment for Triple Negative Breast Cancer(TNBC) Patients
Primary Purpose
Triple Negative Breast Cancer
Status
Active
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
JS001 120mg+GP
JS001 240mg+GP
JS001 480mg+GP
GP followed by JS001
Sponsored by
About this trial
This is an interventional treatment trial for Triple Negative Breast Cancer
Eligibility Criteria
Inclusion Criteria:
- Histologically confirmed relapsed or metastatic triple negative breast cancer
- Subjects must have normal organ and marrow function as defined below:
- White blood cell ≥ 3,000/μL, Absolute neutrophil count ≥ 1,500/μL, Hemoglobin ≥ 9.0 g/dl, Platelet count ≥ 100,000/μL
- Total bilirubin ≤1.25 X institutional upper limit of normal , aspartate aminotransferase(AST) ≤ 2.5 X institutional upper limit of normal, alanine transaminase(ALT) ≤ 2.5 X institutional upper limit of normal (For patients with liver metastasis, Total bilirubin ≤1.5 X institutional upper limit of normal , AST ≤5 X institutional upper limit of normal, ALT ≤5 X institutional upper limit of normal)
- Serum creatinine within normal institutional limits
- thyroid-stimulating hormone ,FT3(free triiodothyronine),FT4(Free thyroid hormone) within 0.9 X institutional lower limit of normal to 1.1 X institutional upper limit of normal (Except for patients who had thyroid ectomy)
- Basically normal EKG and left ventricular ejection fraction(LVEF)>50%
- Life expectancy of 6 months or more
- Performance Status 0-1
- Subjects must have at least one measurable disease per RECIST v1.1
- Weight more than 45 Kilogram
- Subjects must have not received chemotherapy in metastatic setting, subjects relapsed 6 months after the completion of adjuvant therapy are eligible
- Subjects must be willing to supply fresh or archive tumor tissue for research purposes
- Subjects must have stopped receiving any anti-cancer treatment (including chemotherapy, curative radiotherapy, and surgery or targeting therapy) for at least 4 weeks.
- Subjects must have stopped receiving systemic immunosuppressive agents for at least 2 weeks.
- Subjects must have the ability to understand and the willingness to sign a written informed consent document
Exclusion Criteria:
- Subjects with radiographically stable treated brain metastases are eligible but must not have been on steroid therapy for at least 4 weeks
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to Gemcitabine, cisplatin or JS001
- Patients who have adjuvant chemotherapy and relapsed within 6 months.
- Pregnant or breastfeeding women are excluded from this study
- Patients with HIV infection, patients with positive HbsAg or HCV(hepatitis C virus)-RNA
- Patients with chronic autoimmune disease
- Patients with prior therapy with antibodies that modulate T-cell function (e.g., anti-PD-1, anti-PD-L1, anti-CTLA-4(Cytotoxic T-lymphocyte-associated protein 4))
- Patients with evidence of active, non-infectious pneumonia
- Patients with a history of tuberculosis
- Patients active infection requiring intravenous systemic therapy
- Severe cardiovascular disease
- Severe gastrointestinal dysfunction (bleeding, infection, obstruction or ≥ grade 1 diarrhea)
- Patients with severe coagulation dysfunction or bleeding tendency, patients who are receiving thrombolysis or anticoagulation therapy
- Subjects with uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, severe hyper blood pressure, severe diabetes or severe thyroid disease that would limit compliance with study requirements
- Patients with known psychiatric disorders that would interfere with cooperation with requirements of the trial
- Patients who have received a vaccine within 4 weeks prior to the first dose of JS001
- Patients with a known additional malignancy that is progressing or requires active treatment (within the last 5 years). Exceptions: basal cell carcinoma of the skin, squamous cell carcinoma of the skin or in situ cancers that has undergone potentially curative therapy
Sites / Locations
- Fudan University Shanghai Cancer Center
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Experimental
Experimental
Experimental
Experimental
Arm Label
JS001 120mg+GP
JS001 240mg+GP
JS001 480mg +GP
GP followed by JS001
Arm Description
Level 1: JS001 120mg +GP q3w,*6 cycles, then JS001 120mg q3w for maintenance therapy for up to approximately 2 years.
Level 2: JS001 240mg +GP q3w,*6 cycles, then JS001 240mg q3w for maintenance therapy for up to approximately 2 years.
Level 3: JS001 480mg+GP q3w,*6 cycles, then JS001 480mg q3w for maintenance therapy for up to approximately 2 years.
sequential treatment: Patients receive 6 cycles of GP without JS001 and then receive JS001 maintenance therapy for up to approximately 2 years. JS001 will be given at RP2D.
Outcomes
Primary Outcome Measures
Maximum Tolerated Dose (MTD) of JS001 when combined with GP
If 1/6 patients has grade 3 or higher toxicity then escalation proceeds, if 2/6 has grade 3 or greater toxicity then this is declared MTD.
Secondary Outcome Measures
Peak Plasma Concentration (Cmax)
Cmax of JS001
Area under the plasma concentration versus time curve (AUC)
AUC of JS001
other pharmacokinetics(PK) characteristics of JS001+GP
half life of JS001
Incidence of Treatment-Emergent Adverse Events
Incidence of Adverse Events that need to be treated immediately
Incidence of Severe Adverse Events
Incidence of Adverse Events that cause hospitalization, inability, death, etc
objective response rate of JS001+GP
objective response rate(%) is the sum of CR(complete remission) rate and PR(partial remission) rate
disease control rate of JS001+GP
disease control rate(%) is the sum of CR rate and PR rate and SD(stable disease) rate for more than 6 weeks
duration of regression of JS001+GP
duration of regression(months) is the time interval from randomization to disease progression
time to regression of JS001+GP
time to regression(months) is the time interval from randomization to disease regressin
progression free survival of JS001+GP
progression free survival(months) is the time interval from randomization to disease progression or death from any reason
overall survival of JS001+GP
overall survival(months) is the time interval between randomization and death from any reason
best combination regimen
Is JS001 combined with GP or GP followed by JS001 better in safety (incidence of grade 3-4 toxicity) and efficacy(Response Rate and PFS)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03251313
Brief Title
PD-1(Programmed Death-1) Antibody +GP as First Line Treatment for Triple Negative Breast Cancer(TNBC) Patients
Official Title
Recombinant Humanized PD-1 Monoclonal Antibody (JS001) Combined With Gemcitabine and Cisplatin (GP) as First Line Treatment for Triple Negative Breast Cancer patients-a Phase 1 Clinical Trial
Study Type
Interventional
2. Study Status
Record Verification Date
April 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 15, 2019 (Actual)
Primary Completion Date
December 30, 2022 (Anticipated)
Study Completion Date
December 30, 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Fudan University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a Phase I dose escalation trial to assess dose-limiting toxicity (DLT) and MTD of JS001+GP in advanced/metastatic TNBC patients, and to determine the recommended Phase II dose and the best combination regimen.
Detailed Description
There will be 3 stages in this trial. Stage 1 is the dose escalation stage. JS001 will be tested in combination with GP in 3 dose levels.
Level 1: 120mg Level 2: 240mg Level 3: 480mg Patients will receive JS001+GP for 6 cycles and JS001 maintenance therapy for up to approximately 2 years.
JS001 will be given on d1 every 3 weeks with GP and every 2 weeks in maintenance therapy.
The first group of participants will receive the lowest dose level of JS001 at 120mg. Each new group will receive a higher dose of JS001 than the group before it until 480mg.
Stage 2 is the dose expansion stage. Dose expansion will be carried out to expand to 12 patients in the highest dose level at which the patient can tolerate well. This dose will also be recommended as phase 2 dose(RP2D).
Stage 3 is the sequential treatment stage. Patients receive 6 cycles of GP without JS001 and then receive JS001 maintenance therapy for up to approximately 2 years.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Triple Negative Breast Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
31 (Actual)
8. Arms, Groups, and Interventions
Arm Title
JS001 120mg+GP
Arm Type
Experimental
Arm Description
Level 1: JS001 120mg +GP q3w,*6 cycles, then JS001 120mg q3w for maintenance therapy for up to approximately 2 years.
Arm Title
JS001 240mg+GP
Arm Type
Experimental
Arm Description
Level 2: JS001 240mg +GP q3w,*6 cycles, then JS001 240mg q3w for maintenance therapy for up to approximately 2 years.
Arm Title
JS001 480mg +GP
Arm Type
Experimental
Arm Description
Level 3: JS001 480mg+GP q3w,*6 cycles, then JS001 480mg q3w for maintenance therapy for up to approximately 2 years.
Arm Title
GP followed by JS001
Arm Type
Experimental
Arm Description
sequential treatment: Patients receive 6 cycles of GP without JS001 and then receive JS001 maintenance therapy for up to approximately 2 years. JS001 will be given at RP2D.
Intervention Type
Combination Product
Intervention Name(s)
JS001 120mg+GP
Intervention Description
In this arm, JS001 120mg will be given at d1; Gem 1000mg/m2 d2,9; DDP(cisplatin) 75mg/m2 d2
Intervention Type
Combination Product
Intervention Name(s)
JS001 240mg+GP
Intervention Description
In this arm, JS001 240mg will be given at d1; Gem 1000mg/m2 d2,9; DDP 75mg/m2 d2
Intervention Type
Combination Product
Intervention Name(s)
JS001 480mg+GP
Intervention Description
In this arm, JS001 480mg will be given at d1; Gem 1000mg/m2 d2,9; DDP 75mg/m2 d2
Intervention Type
Combination Product
Intervention Name(s)
GP followed by JS001
Intervention Description
In this arm,Patients receive 6 cycles of GP without JS001 and then receive JS001 maintenance therapy for up to approximately 2 years. JS001 will be given at RP2D.
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD) of JS001 when combined with GP
Description
If 1/6 patients has grade 3 or higher toxicity then escalation proceeds, if 2/6 has grade 3 or greater toxicity then this is declared MTD.
Time Frame
3 weeks
Secondary Outcome Measure Information:
Title
Peak Plasma Concentration (Cmax)
Description
Cmax of JS001
Time Frame
85 days
Title
Area under the plasma concentration versus time curve (AUC)
Description
AUC of JS001
Time Frame
85 days
Title
other pharmacokinetics(PK) characteristics of JS001+GP
Description
half life of JS001
Time Frame
85 days
Title
Incidence of Treatment-Emergent Adverse Events
Description
Incidence of Adverse Events that need to be treated immediately
Time Frame
85 days
Title
Incidence of Severe Adverse Events
Description
Incidence of Adverse Events that cause hospitalization, inability, death, etc
Time Frame
85 days
Title
objective response rate of JS001+GP
Description
objective response rate(%) is the sum of CR(complete remission) rate and PR(partial remission) rate
Time Frame
1 year
Title
disease control rate of JS001+GP
Description
disease control rate(%) is the sum of CR rate and PR rate and SD(stable disease) rate for more than 6 weeks
Time Frame
1 year
Title
duration of regression of JS001+GP
Description
duration of regression(months) is the time interval from randomization to disease progression
Time Frame
1 year
Title
time to regression of JS001+GP
Description
time to regression(months) is the time interval from randomization to disease regressin
Time Frame
1 year
Title
progression free survival of JS001+GP
Description
progression free survival(months) is the time interval from randomization to disease progression or death from any reason
Time Frame
1 year
Title
overall survival of JS001+GP
Description
overall survival(months) is the time interval between randomization and death from any reason
Time Frame
1 year
Title
best combination regimen
Description
Is JS001 combined with GP or GP followed by JS001 better in safety (incidence of grade 3-4 toxicity) and efficacy(Response Rate and PFS)
Time Frame
1 year
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically confirmed relapsed or metastatic triple negative breast cancer
Subjects must have normal organ and marrow function as defined below:
White blood cell ≥ 3,000/μL, Absolute neutrophil count ≥ 1,500/μL, Hemoglobin ≥ 9.0 g/dl, Platelet count ≥ 100,000/μL
Total bilirubin ≤1.25 X institutional upper limit of normal , aspartate aminotransferase(AST) ≤ 2.5 X institutional upper limit of normal, alanine transaminase(ALT) ≤ 2.5 X institutional upper limit of normal (For patients with liver metastasis, Total bilirubin ≤1.5 X institutional upper limit of normal , AST ≤5 X institutional upper limit of normal, ALT ≤5 X institutional upper limit of normal)
Serum creatinine within normal institutional limits
thyroid-stimulating hormone ,FT3(free triiodothyronine),FT4(Free thyroid hormone) within 0.9 X institutional lower limit of normal to 1.1 X institutional upper limit of normal (Except for patients who had thyroid ectomy)
Basically normal EKG and left ventricular ejection fraction(LVEF)>50%
Life expectancy of 6 months or more
Performance Status 0-1
Subjects must have at least one measurable disease per RECIST v1.1
Weight more than 45 Kilogram
Subjects must have not received chemotherapy in metastatic setting, subjects relapsed 6 months after the completion of adjuvant therapy are eligible
Subjects must be willing to supply fresh or archive tumor tissue for research purposes
Subjects must have stopped receiving any anti-cancer treatment (including chemotherapy, curative radiotherapy, and surgery or targeting therapy) for at least 4 weeks.
Subjects must have stopped receiving systemic immunosuppressive agents for at least 2 weeks.
Subjects must have the ability to understand and the willingness to sign a written informed consent document
Exclusion Criteria:
Subjects with radiographically stable treated brain metastases are eligible but must not have been on steroid therapy for at least 4 weeks
History of allergic reactions attributed to compounds of similar chemical or biologic composition to Gemcitabine, cisplatin or JS001
Patients who have adjuvant chemotherapy and relapsed within 6 months.
Pregnant or breastfeeding women are excluded from this study
Patients with HIV infection, patients with positive HbsAg or HCV(hepatitis C virus)-RNA
Patients with chronic autoimmune disease
Patients with prior therapy with antibodies that modulate T-cell function (e.g., anti-PD-1, anti-PD-L1, anti-CTLA-4(Cytotoxic T-lymphocyte-associated protein 4))
Patients with evidence of active, non-infectious pneumonia
Patients with a history of tuberculosis
Patients active infection requiring intravenous systemic therapy
Severe cardiovascular disease
Severe gastrointestinal dysfunction (bleeding, infection, obstruction or ≥ grade 1 diarrhea)
Patients with severe coagulation dysfunction or bleeding tendency, patients who are receiving thrombolysis or anticoagulation therapy
Subjects with uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, severe hyper blood pressure, severe diabetes or severe thyroid disease that would limit compliance with study requirements
Patients with known psychiatric disorders that would interfere with cooperation with requirements of the trial
Patients who have received a vaccine within 4 weeks prior to the first dose of JS001
Patients with a known additional malignancy that is progressing or requires active treatment (within the last 5 years). Exceptions: basal cell carcinoma of the skin, squamous cell carcinoma of the skin or in situ cancers that has undergone potentially curative therapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Xichun Hu, MD& PhD
Organizational Affiliation
Fudan University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fudan University Shanghai Cancer Center
City
Shanghai
ZIP/Postal Code
200032
Country
China
12. IPD Sharing Statement
Plan to Share IPD
Undecided
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PD-1(Programmed Death-1) Antibody +GP as First Line Treatment for Triple Negative Breast Cancer(TNBC) Patients
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