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A Phase II Trial of Camrelizumab in Combination With Apatinib and Eribulin in Patients With Advanced TNBC

Primary Purpose

Breast Cancer

Status
Active
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Camrelizumab
Apatinib
Eribulin
Sponsored by
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. The patients sign the written informed consent.
  2. Women aged 18-70.
  3. The pathologic diagnosis of unresectable recurrent or metastatic triple-negative breast cancer [ER-negative(IHC<1%), PR-negative(IHC<1%), HER2-negative(IHC-/+ or IHC++ and FISH/CISH-)]. Patients with at least one measuring lesion that was conformed to RECIST v1.1 standard.
  4. Prior therapy (adjuvant/neoadjuvant/advanced) must have included an anthracycline and a taxane in any combination or order and either in the early or metastatic disease setting unless contraindicated for a given patient.
  5. The patient can swallow pills.
  6. Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 1.
  7. With a life expectancy of at least 12 weeks.
  8. The results of patient's blood tests are as follows:

    • Hb≥90g/L; • Plt≥100^9/L; • Serum albumin ≥3g/dL;• Neutrophils≥1.5^9/L; TSH≤ normal upper limit (ULN);• ALT and AST ≤1.5 ULN (liver metastases ≤3 ULN); • TBIL ≤ULN (total bilirubin ≤1.5 ULN in Gilbert's syndrome or liver metastasis subjects);• ALT and AST ≤1.5 ULN (liver metastases ≤3 ULN);• AKP≤ 2.5 ULN; • Renal function within 7 days before the first administration: serum creatinine ≤1.5 ULN or creatinine clearance ≥60mL/min

  9. Female subjects of childbearing potential must have a negative serum pregnancy test within 7 days before the first dose and must be willing to use very efficient barrier methods of contraception for the course of the study through 6 months after the last dose of study treatment.

Exclusion Criteria:

  1. The subjects had a central nervous system metastases with clinical symptoms.
  2. Other clinical trials of drugs were used in the first four weeks before the first dose.
  3. Subjects with severe allergic reactions to other monoclonal antibodies.
  4. Received other anti-tumor treatments within 28 days before the first dose.
  5. A heart condition or disease that is not well controlled.
  6. Subjects with treatment history of anti-angiogenesis drugs, or immunotherapy (previous use of anti-PD-1/PD-L1 antibodies was allowed) or eribulin.
  7. The subjects had any history of autoimmune disease or any use of systemic glucocorticoid or immunosuppressive medications.
  8. Subjects had history of hypertension and poor control with antihypertensive medication (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg).
  9. Urine routine indicated that urine protein ≥ ++, or the 24-hour urine protein quantity ≥ 1.0g.
  10. Hereditary or acquired bleeding and thrombotic tendencies (such as hemophilia, coagulation dysfunction, thrombocytopenia, hypersplenism, etc.).
  11. Congenital or acquired immune deficiency (such as HIV infection);
  12. Receive live vaccine within 4 weeks before or during the study period;
  13. Patients who are allergic to or contraindicated to the experimental drugs.

Sites / Locations

  • The First Affiliated Hospital, Sun Yat-Sen University
  • Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
  • Changhai Hospital, Navy Medical University (Second Military Medical University)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Camrelizumab +Apatinib+Eribulin

Arm Description

Camrelizumab 200mg(3mg/kg for patient whose weight is below 50kg) iv Q3W combination with Apatinib 250mg, po, daily (d1-d21)and Eribulin1.4mg/m2 iv d1, d8 Q3W

Outcomes

Primary Outcome Measures

Overall response rate (ORR)
The propotion of subjects with CR or PR.

Secondary Outcome Measures

Incidence of Treatment-Emergent Adverse Events
Adverse events/serious adverse events
Disease Control Rate (DCR)
The propotion of subjects with CR, PR, or SD.
DOR
Duration of response
PFS
Progression-Free-Survival
One year-OS rate
One year-Overall survival rate
Clinical benefit rate (CBR)
The propotion of subjects with CR, PR, or SD for >=6 months during the study.
TTR
Time to response
Frequencies of Biomarkers
Biomarkers (including tumor/stromal PD-L1, stromal PD-1, tumor-infiltrating lymphocytes and tumor-infiltrating B cells, eg)

Full Information

First Posted
March 7, 2020
Last Updated
April 10, 2023
Sponsor
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
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1. Study Identification

Unique Protocol Identification Number
NCT04303741
Brief Title
A Phase II Trial of Camrelizumab in Combination With Apatinib and Eribulin in Patients With Advanced TNBC
Official Title
An Open-labeled, Single-arm, Investigator-initiated Phase II Trial of Camrelizumab (Anti-PD-1 Antibody) in Combination With Apatinib and Eribulin in Patients With Advanced Triple-Negative Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
March 25, 2020 (Actual)
Primary Completion Date
November 30, 2022 (Actual)
Study Completion Date
August 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University

4. Oversight

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

5. Study Description

Brief Summary
This is a phase II, open-labeled, multi-centered,single-arm, Investigator-initiated clinical trial of camrelizumab (an anti-PD-1 antibody) in combination with apatinib (a VEGFR2 TKI) and eribulin mesylate in patients with advanced triple-negative breast cancer. We will enroll 46 subjects (Simons two stage design). This study aims to evaluate the efficacy and safety of camrelizumab combined with apatinib and eribulin in the treatment of advanced TNBC.
Detailed Description
This a phase II, open-labeled, multi-centered, single-arm, investigator-initiated clinical trial to assess the efficacy and safety of camrelizumab combination with apatinib and eribulin in female patients age of 18 to 70 with advanced TNBC, and previously treated with at least one line of systemic therapy in the advanced setting. Prior therapy (adjuvant/neoadjuvant/advanced) must have included an anthracycline and a taxane. The number of patients to be included is 46 patients (Simons two stage design). The primary objective is to assess the overall response rate (ORR). All enrolled patients will be treated with camrelizumab 200mg (iv. 3mg/kg for patient whose weight is below 50kg) on day 1 of each 21-day cycle, and apatinib 250mg daily (po, d1-d21), in combination with eribulin mesylate at 1.4 mg/m2 (iv.) on day 1 and day 8 of every 21-day cycle.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
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
46 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Camrelizumab +Apatinib+Eribulin
Arm Type
Experimental
Arm Description
Camrelizumab 200mg(3mg/kg for patient whose weight is below 50kg) iv Q3W combination with Apatinib 250mg, po, daily (d1-d21)and Eribulin1.4mg/m2 iv d1, d8 Q3W
Intervention Type
Drug
Intervention Name(s)
Camrelizumab
Intervention Description
Camrelizumab 200mg (3mg/kg for patient whose weight is below 50kg) will be administered as an intravenous infusion over 30 minutes every three weeks until unacceptable toxic effects or disease progression or other termination criteria appeared. Patients received up to two years of treatment.
Intervention Type
Drug
Intervention Name(s)
Apatinib
Intervention Description
Apatinib 250mg will be administered daily until unacceptable toxic effects or disease progression or other termination criteria appeared. Patients received up to two years of treatment.
Intervention Type
Drug
Intervention Name(s)
Eribulin
Other Intervention Name(s)
Eribulin Mesylate
Intervention Description
Eribulin Mesylate will be administered as a 1.4 mg/m2 intravenous (IV) injection over 2 to 5 minutes on day 1 and day 8 of each 21-day cycle until unacceptable toxic effects or disease progression or other termination criteria appeared. Patients received up to two years of treatment.
Primary Outcome Measure Information:
Title
Overall response rate (ORR)
Description
The propotion of subjects with CR or PR.
Time Frame
from the first drug administration up to the first occurrence of progression or death (up to 24 months)
Secondary Outcome Measure Information:
Title
Incidence of Treatment-Emergent Adverse Events
Description
Adverse events/serious adverse events
Time Frame
from the first drug administration to within 90 days for the last dose
Title
Disease Control Rate (DCR)
Description
The propotion of subjects with CR, PR, or SD.
Time Frame
from the first drug administration up to the first occurrence of progression or death(up to 24 months)
Title
DOR
Description
Duration of response
Time Frame
from the first drug administration up to the first occurrence of progression or death(up to 24 months)
Title
PFS
Description
Progression-Free-Survival
Time Frame
from the first drug administration up to the first occurrence of progression or death (up to 24 months)
Title
One year-OS rate
Description
One year-Overall survival rate
Time Frame
12 months after the first drug administration
Title
Clinical benefit rate (CBR)
Description
The propotion of subjects with CR, PR, or SD for >=6 months during the study.
Time Frame
from the first drug administration up to the first occurrence of progression or death(up to 24 months)
Title
TTR
Description
Time to response
Time Frame
from the first drug administration up to one year
Title
Frequencies of Biomarkers
Description
Biomarkers (including tumor/stromal PD-L1, stromal PD-1, tumor-infiltrating lymphocytes and tumor-infiltrating B cells, eg)
Time Frame
pre-treatment, up to 24 months

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: The patients sign the written informed consent. Women aged 18-70. The pathologic diagnosis of unresectable recurrent or metastatic triple-negative breast cancer [ER-negative(IHC<1%), PR-negative(IHC<1%), HER2-negative(IHC-/+ or IHC++ and FISH/CISH-)]. Patients with at least one measuring lesion that was conformed to RECIST v1.1 standard. Prior therapy (adjuvant/neoadjuvant/advanced) must have included an anthracycline and a taxane in any combination or order and either in the early or metastatic disease setting unless contraindicated for a given patient. The patient can swallow pills. Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 1. With a life expectancy of at least 12 weeks. The results of patient's blood tests are as follows: • Hb≥90g/L; • Plt≥100^9/L; • Serum albumin ≥3g/dL;• Neutrophils≥1.5^9/L; TSH≤ normal upper limit (ULN);• ALT and AST ≤1.5 ULN (liver metastases ≤3 ULN); • TBIL ≤ULN (total bilirubin ≤1.5 ULN in Gilbert's syndrome or liver metastasis subjects);• ALT and AST ≤1.5 ULN (liver metastases ≤3 ULN);• AKP≤ 2.5 ULN; • Renal function within 7 days before the first administration: serum creatinine ≤1.5 ULN or creatinine clearance ≥60mL/min Female subjects of childbearing potential must have a negative serum pregnancy test within 7 days before the first dose and must be willing to use very efficient barrier methods of contraception for the course of the study through 6 months after the last dose of study treatment. Exclusion Criteria: The subjects had a central nervous system metastases with clinical symptoms. Other clinical trials of drugs were used in the first four weeks before the first dose. Subjects with severe allergic reactions to other monoclonal antibodies. Received other anti-tumor treatments within 28 days before the first dose. A heart condition or disease that is not well controlled. Subjects with treatment history of anti-angiogenesis drugs, or immunotherapy (previous use of anti-PD-1/PD-L1 antibodies was allowed) or eribulin. The subjects had any history of autoimmune disease or any use of systemic glucocorticoid or immunosuppressive medications. Subjects had history of hypertension and poor control with antihypertensive medication (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg). Urine routine indicated that urine protein ≥ ++, or the 24-hour urine protein quantity ≥ 1.0g. Hereditary or acquired bleeding and thrombotic tendencies (such as hemophilia, coagulation dysfunction, thrombocytopenia, hypersplenism, etc.). Congenital or acquired immune deficiency (such as HIV infection); Receive live vaccine within 4 weeks before or during the study period; Patients who are allergic to or contraindicated to the experimental drugs.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jieqiong Liu
Organizational Affiliation
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Official's Role
Principal Investigator
Facility Information:
Facility Name
The First Affiliated Hospital, Sun Yat-Sen University
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510000
Country
China
Facility Name
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510120
Country
China
Facility Name
Changhai Hospital, Navy Medical University (Second Military Medical University)
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200433
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
35641481
Citation
Liu J, Wang Y, Tian Z, Lin Y, Li H, Zhu Z, Liu Q, Su S, Zeng Y, Jia W, Yang Y, Xu S, Yao H, Jiang W, Song E. Multicenter phase II trial of Camrelizumab combined with Apatinib and Eribulin in heavily pretreated patients with advanced triple-negative breast cancer. Nat Commun. 2022 May 31;13(1):3011. doi: 10.1038/s41467-022-30569-0.
Results Reference
derived

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A Phase II Trial of Camrelizumab in Combination With Apatinib and Eribulin in Patients With Advanced TNBC

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