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Study of Safety and Efficacy of Novel Immunotherapy Combinations in Patients With Triple Negative Breast Cancer (TNBC).

Primary Purpose

Triple Negative Breast Cancer (TNBC)

Status
Terminated
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
spartalizumab
LAG525
NIR178
capmatinib
MCS110
canakinumab
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Triple Negative Breast Cancer (TNBC) focused on measuring Phase Ib, TNBC, advanced, metastatic, immunotherapy, PDR001,, LAG525, NIR178, INC280, MCS110, ACZ885

Eligibility Criteria

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

Main Inclusion Criteria:

  • Patients with advanced/metastatic TNBC (defined as HER-2 negative with <1% of tumor cell nuclei immunoreactive for estrogen receptor (ER) and progesterone receptor (PR)), with measurable disease as determined by RECIST version 1.1 (refer to Appendix 16.1). Tumor lesions previously irradiated or subjected to other loco-regional therapy will only be considered measurable if there is documented disease progression at the treated site prior to study entry.
  • Patients should have received standard chemotherapy for advanced or metastatic disease but should not have received more than 2 prior lines of chemotherapy. Neoadjuvant or adjuvant chemotherapy will count as one prior line.
  • Patients must have received prior systemic treatment that included taxane-based chemotherapy for neoadjuvant or metastatic disease.
  • Patients must have a site of disease amenable to core needle biopsy, and be a candidate for tumor biopsy according to the treating institution's guidelines. Patients must be willing to undergo a new tumor biopsy at screening, and during therapy on the study. Exceptions may be considered after documented discussion with Novartis. Patients with available archival tumor tissue obtained ≤6 months prior to study treatment initiation do not need to undergo a new tumor biopsy at screening, if the patient has not received any anti-cancer therapy since the biopsy was taken, and if adequate tissue is available.

Main exclusion criteria applicable to all treatment arms:

  • Patient has received prior treatment with anti-LAG-3, anti-PD-1, anti-PD-L1, or anti-PD-L2 antibody (any line of therapy).
  • Presence of symptomatic central nervous system (CNS) metastases, or CNS metastases that require local CNS-directed therapy (such as radiotherapy or surgery), or increasing doses of corticosteroids within 2 weeks prior to initiating study treatment.
  • History of severe hypersensitivity reactions to any ingredient of study drug(s) and other mAbs and/or their excipients.
  • Impaired cardiac function or clinically significant cardiac disease.
  • HIV infection.
  • Patients with active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, including those with inactive disease for patients receiving either capmatinib, MCS110 or canakinumab.
  • Active, known or suspected autoimmune disease.
  • History of or current interstitial lung disease or pneumonitis grade ≥ 2.
  • Subjects with tuberculosis (TB), for patients receiving either MCS110 or canakinumab.

Other eligibility criteria apply.

Sites / Locations

  • Columbia University Medical Center- New York Presbyterian Columbia
  • Sarah Cannon Research Institute Sarah Cannon Research
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

1: spartalizumab + LAG525 + NIR178

2: spartalizumab +LAG525 +capmatinib

3: spartalizumab + LAG525 + MCS110

4: spartalizumab +LAG525 +canakinumab

Arm Description

phase Ib (escalation and expansion)

phase Ib (escalation and expansion)

phase Ib (escalation and expansion)

phase Ib (escalation and expansion)

Outcomes

Primary Outcome Measures

Incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs) as a measure of safety
Month 18 is assumed to be study end
Severity of Adverse Events (AEs) and Serious Adverse Events (SAEs) as a measure of safety
Month 18 is assumed to be study end
Incidence of dose limiting toxicities (DLTs) of treatment (Escalation only)
end of first cycle
Frequency of dose interuptions
Month 18 is assumed to be study end
Frequency of dose reductions
Month 18 is assumed to be study end
Dose intensities
Month 18 is assumed to be study end

Secondary Outcome Measures

Best overall response (BOR)
Month 18 is assumed to be study end
Progression free survival (PFS) per RECIST v1.1 and iRECIST
Month 18 is assumed to be study end
Presence of anti-spartalizumab antibodies
Presence of anti-LAG525 antibodies
Presence of anti-MCS110 antibodies
Presence of anti-canakinumab antibodies
Serum concentration of spartalizumab, LAG525, MCS110, canakinumab
Plasma concentration of NIR178, NJI675, capmatinib
PK parameter (Tmax) of spartalizumab
cycle 12
PK parameter (Cmax) of spartalizumab
cycle 12
PK parameter (AUC) of spartalizumab
cycle 12
PK parameter (Tmax) of LAG525
cycle 12
PK parameter (Cmax) of LAG525
cycle 12
PK parameter (AUC) of LAG525
cycle 12
PK parameter (Tmax) of NIR178
cycle 12
PK parameter (Cmax) of NIR178
cycle 12
PK parameter (AUC) of NIR178
cycle 12
PK parameter (Tmax) of capmatinib
cycle 12
PK parameter (Cmax) of capmatinib
cycle 12
PK parameter (AUC) of capmatinib
cycle 12
PK parameter (Tmax) of MCS110
cycle 12
PK parameter (Cmax) of MCS110
cycle 12
PK parameter (AUC) of MCS110
cycle 12
PK parameter (Tmax) of canakinumab
cycle 12
PK parameter (Cmax) of canakinumab
cycle 12
PK parameter (AUC) of canakinumab
cycle 12
Changes from baseline of PD markers in tumor tissue (TILs, CD8, PD-L1, LAG-3)

Full Information

First Posted
November 12, 2018
Last Updated
February 22, 2023
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT03742349
Brief Title
Study of Safety and Efficacy of Novel Immunotherapy Combinations in Patients With Triple Negative Breast Cancer (TNBC).
Official Title
A Phase Ib, Multicenter, Open-label Dose Escalation and Expansion Platform Study of Select Immunotherapy Combinations in Adult Patients With Triple-negative Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Terminated
Why Stopped
This was a sponsor decision and was not a consequence of any safety concern
Study Start Date
January 31, 2019 (Actual)
Primary Completion Date
February 6, 2023 (Actual)
Study Completion Date
February 6, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a Phase Ib, open label, dose escalation study of spartalizumab + LAG525 in combination with NIR178, capmatinib, MCS110, or canakinumab, followed by a dose expansion in adult patients with advanced or metastatic TNBC. During the dose-escalation part of each treatment arm, patients will be treated with fixed doses of spartalizumab + LAG525 in combination with partner investigational drugs to be escalated until the MTD is reached or a lower RDE is established: NIR178, capmatinib, MCS110, or canakinumab. It is anticipated that other partner study drugs may be added in the future by protocol amendment. After the determination of the MTD/RDE for a particular treatment arm, dose expansion may begin in that arm in order to further assess safety, tolerability, PK/PD, and anti-tumor activity of each combination at the MTD/RDE. Dose expansion arms may initiate only after consideration by the Investigators and Novartis of all available toxicity information, the assessment of risk to future patients from the BLRM, and the available PK, preliminary efficacy, and PD information. There is no requirement for dose-escalation treatment arms reaching an MTD/RDE to proceed to dose expansion.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Triple Negative Breast Cancer (TNBC)
Keywords
Phase Ib, TNBC, advanced, metastatic, immunotherapy, PDR001,, LAG525, NIR178, INC280, MCS110, ACZ885

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
64 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1: spartalizumab + LAG525 + NIR178
Arm Type
Experimental
Arm Description
phase Ib (escalation and expansion)
Arm Title
2: spartalizumab +LAG525 +capmatinib
Arm Type
Experimental
Arm Description
phase Ib (escalation and expansion)
Arm Title
3: spartalizumab + LAG525 + MCS110
Arm Type
Experimental
Arm Description
phase Ib (escalation and expansion)
Arm Title
4: spartalizumab +LAG525 +canakinumab
Arm Type
Experimental
Arm Description
phase Ib (escalation and expansion)
Intervention Type
Biological
Intervention Name(s)
spartalizumab
Other Intervention Name(s)
PDR001
Intervention Description
LIVI (Liquid in vial) Concentrate for Solution for infusion
Intervention Type
Biological
Intervention Name(s)
LAG525
Intervention Description
LAG525 LIVI (Liquid in vial) Concentrate for Solution for infusion
Intervention Type
Drug
Intervention Name(s)
NIR178
Intervention Description
Capsule
Intervention Type
Drug
Intervention Name(s)
capmatinib
Other Intervention Name(s)
INC280
Intervention Description
Tablet
Intervention Type
Biological
Intervention Name(s)
MCS110
Intervention Description
LIVI (Liquid in vial) Concentrate for Solution for infusion
Intervention Type
Biological
Intervention Name(s)
canakinumab
Other Intervention Name(s)
ACZ885
Intervention Description
LIVI (Liquid in vial) Solution for injection
Primary Outcome Measure Information:
Title
Incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs) as a measure of safety
Description
Month 18 is assumed to be study end
Time Frame
at month 18
Title
Severity of Adverse Events (AEs) and Serious Adverse Events (SAEs) as a measure of safety
Description
Month 18 is assumed to be study end
Time Frame
at month 18
Title
Incidence of dose limiting toxicities (DLTs) of treatment (Escalation only)
Description
end of first cycle
Time Frame
at Day 28
Title
Frequency of dose interuptions
Description
Month 18 is assumed to be study end
Time Frame
at month 18
Title
Frequency of dose reductions
Description
Month 18 is assumed to be study end
Time Frame
at month 18
Title
Dose intensities
Description
Month 18 is assumed to be study end
Time Frame
at month 18
Secondary Outcome Measure Information:
Title
Best overall response (BOR)
Description
Month 18 is assumed to be study end
Time Frame
at month 18
Title
Progression free survival (PFS) per RECIST v1.1 and iRECIST
Description
Month 18 is assumed to be study end
Time Frame
at month 18
Title
Presence of anti-spartalizumab antibodies
Time Frame
at Day 1, Day 29, Day 57, Day 85, Day 113, Day 141, Day 197, Day 253, Day 309 and EOT
Title
Presence of anti-LAG525 antibodies
Time Frame
at Day 1, Day 29, Day 57, Day 85, Day 113, Day 141, Day 197, Day 253, Day 309 and EOT
Title
Presence of anti-MCS110 antibodies
Time Frame
at Day 1, Day 29, Day 57, Day 85, Day 113, Day 141, Day 197, Day 253, Day 309 and EOT
Title
Presence of anti-canakinumab antibodies
Time Frame
at Day 1, Day 29, Day 57, Day 85, Day 113, Day 141, Day 197, Day 253, Day 309 and EOT
Title
Serum concentration of spartalizumab, LAG525, MCS110, canakinumab
Time Frame
at Day 1, Day 8, Day 15, Day 29, Day 57, Day 65, Day 70, Day 85, Day 113, Day 141, Day 197, Day 253, Day 309 and EOT
Title
Plasma concentration of NIR178, NJI675, capmatinib
Time Frame
at Day 1, Day 29, Day 57, Day 85, Day 113, Day 141, Day 197, Day 253, Day 309 and EOT
Title
PK parameter (Tmax) of spartalizumab
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (Cmax) of spartalizumab
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (AUC) of spartalizumab
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (Tmax) of LAG525
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (Cmax) of LAG525
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (AUC) of LAG525
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (Tmax) of NIR178
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (Cmax) of NIR178
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (AUC) of NIR178
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (Tmax) of capmatinib
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (Cmax) of capmatinib
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (AUC) of capmatinib
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (Tmax) of MCS110
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (Cmax) of MCS110
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (AUC) of MCS110
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (Tmax) of canakinumab
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (Cmax) of canakinumab
Description
cycle 12
Time Frame
at month 12
Title
PK parameter (AUC) of canakinumab
Description
cycle 12
Time Frame
at month 12
Title
Changes from baseline of PD markers in tumor tissue (TILs, CD8, PD-L1, LAG-3)
Time Frame
at baseline and at Day 43

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Main Inclusion Criteria: Patients with advanced/metastatic TNBC (defined as HER-2 negative with <1% of tumor cell nuclei immunoreactive for estrogen receptor (ER) and progesterone receptor (PR)), with measurable disease as determined by RECIST version 1.1 (refer to Appendix 16.1). Tumor lesions previously irradiated or subjected to other loco-regional therapy will only be considered measurable if there is documented disease progression at the treated site prior to study entry. Patients should have received standard chemotherapy for advanced or metastatic disease but should not have received more than 2 prior lines of chemotherapy. Neoadjuvant or adjuvant chemotherapy will count as one prior line. Patients must have received prior systemic treatment that included taxane-based chemotherapy for neoadjuvant or metastatic disease. Patients must have a site of disease amenable to core needle biopsy, and be a candidate for tumor biopsy according to the treating institution's guidelines. Patients must be willing to undergo a new tumor biopsy at screening, and during therapy on the study. Exceptions may be considered after documented discussion with Novartis. Patients with available archival tumor tissue obtained ≤6 months prior to study treatment initiation do not need to undergo a new tumor biopsy at screening, if the patient has not received any anti-cancer therapy since the biopsy was taken, and if adequate tissue is available. Main exclusion criteria applicable to all treatment arms: Patient has received prior treatment with anti-LAG-3, anti-PD-1, anti-PD-L1, or anti-PD-L2 antibody (any line of therapy). Presence of symptomatic central nervous system (CNS) metastases, or CNS metastases that require local CNS-directed therapy (such as radiotherapy or surgery), or increasing doses of corticosteroids within 2 weeks prior to initiating study treatment. History of severe hypersensitivity reactions to any ingredient of study drug(s) and other mAbs and/or their excipients. Impaired cardiac function or clinically significant cardiac disease. HIV infection. Patients with active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, including those with inactive disease for patients receiving either capmatinib, MCS110 or canakinumab. Active, known or suspected autoimmune disease. History of or current interstitial lung disease or pneumonitis grade ≥ 2. Subjects with tuberculosis (TB), for patients receiving either MCS110 or canakinumab. Other eligibility criteria apply.
Facility Information:
Facility Name
Columbia University Medical Center- New York Presbyterian Columbia
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Sarah Cannon Research Institute Sarah Cannon Research
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
Novartis Investigative Site
City
Westmead
State/Province
New South Wales
ZIP/Postal Code
2145
Country
Australia
Facility Name
Novartis Investigative Site
City
Shatin, New Territories
Country
Hong Kong
Facility Name
Novartis Investigative Site
City
Tel Aviv
ZIP/Postal Code
6423906
Country
Israel
Facility Name
Novartis Investigative Site
City
Milano
State/Province
MI
ZIP/Postal Code
20133
Country
Italy
Facility Name
Novartis Investigative Site
City
Milano
State/Province
MI
ZIP/Postal Code
20141
Country
Italy
Facility Name
Novartis Investigative Site
City
Kashiwa
State/Province
Chiba
ZIP/Postal Code
277 8577
Country
Japan
Facility Name
Novartis Investigative Site
City
Amsterdam
ZIP/Postal Code
1066 CX
Country
Netherlands
Facility Name
Novartis Investigative Site
City
Singapore
ZIP/Postal Code
119074
Country
Singapore
Facility Name
Novartis Investigative Site
City
Singapore
ZIP/Postal Code
169610
Country
Singapore
Facility Name
Novartis Investigative Site
City
Barcelona
State/Province
Catalunya
ZIP/Postal Code
08035
Country
Spain
Facility Name
Novartis Investigative Site
City
Valencia
State/Province
Comunidad Valenciana
ZIP/Postal Code
46010
Country
Spain

12. IPD Sharing Statement

Learn more about this trial

Study of Safety and Efficacy of Novel Immunotherapy Combinations in Patients With Triple Negative Breast Cancer (TNBC).

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