Neoadjuvant Study of Camrelizumab Plus Chemotherapy in Triple Negative Breast Cancer (TNBC)
Primary Purpose
Triple Negative Breast Cancer
Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Camrelizumab
Nab paclitaxel
Epirubicin
Cyclophosphamide
Sponsored by
About this trial
This is an interventional treatment trial for Triple Negative Breast Cancer focused on measuring Neoadjuvant, PD-1
Eligibility Criteria
Inclusion Criteria:
- Newly diagnosed breast cancer
- 18-70 Years, female;
- life expectancy is not less than 3 months
- Histologically documented TNBC (negative human epidermal growth factor receptor 2 [HER2], estrogen receptor [ER], and progesterone receptor [PgR] status);
- Stage at presentation: T1c N1-2 or T2-4 N0-2;
- at least one measurable lesion according to RECIST 1.1;
Adequate function of major organs meets the following requirements:
- Neutrophils ≥ 1.5×10^9/L
- Platelets ≥ 100×10^9/L
- Hemoglobin ≥ 90g/L
- lymphocyte≥0.5×10^9/L
- Total bilirubin≤ 1.5 × the upper limit of normal (ULN)
- ALT and AST ≤ 3 × ULN
- ALP≤ 2.5 × ULN
- BUN and Cr ≤ 1.5 × ULN
- TSH≤ ULN
- Left ventricular ejection fraction (LVEF) ≥ 50%
- QTcF ≤ 470 ms
- Provides tumor tissue specimen to assess tumor programmed death-ligand 1 (PD-L1);
- For women of childbearing potential: agreement to use contraceptive methods. Women who are not postmenopausal or have undergone a sterilization procedure must have a negative serum pregnancy test result within 72 hours prior to initiation of study drug.
Exclusion Criteria:
- Stage Ⅳ (metastatic) breast cancer or bilateral breast cancer
- Inflammatory breast cancer
- patients who received chemotherapy, endocrine therapy, immunotherapy, biotherapy or TACE within 4 weeks before admission
- Has participated in an interventional clinical study with an investigational compound within 4 weeks prior to initiation of study treatment
- Prior treatment with anti-cytotoxic T-lymphocyte-associated protein 4 (anti-CTLA-4), anti-programmed death-1 (anti-PD-1), and anti-PD-L1 therapeutic antibodies
- Has a history of invasive malignancy ≤5 years prior to signing informed consent except for adequately treated basal cell or squamous cell skin cancer or in situ cervical cancer.
- Major surgical procedure within 4 weeks prior to initiation of study treatment
- Active or history of autoimmune disease or immune deficiency diseases except history of autoimmune-related hypothyroidism, controlled Type 1 diabetes mellitus
- Has a history of (non-infectious) pneumonitis, interstitial lung disease or uncontrollable systematicness diseases
- Administration of a live attenuated vaccine within 28 days prior to initiation of study treatment or anticipation of need for such a vaccine during the study
- Has a known history of Human Immunodeficiency Virus (HIV).
- Has known active Hepatitis B, Hepatitis C or Autoimmune hepatitis
- Severe infections within 4 weeks prior to initiation of study treatment, including but not limited to hospitalization for complications of infection, bacteremia, or severe pneumonia
- Has active infection (CTCAE≥2) needed the treatment of antibiotic within 2 weeks prior to initiation of study treatment
- Has evidence of active tuberculosis within 1year prior to initiation of study treatment
- Prior allogeneic stem cell or solid organ transplantation
- Pre-existing motor or sensory neuropathy of a severity≥grade 2
- Has significant cardiovascular disease
- Treatment with systemic immunostimulatory agents within 4 weeks prior to initiation of study treatment
- Treatment with systemic immunosuppressive medications within 2 weeks prior to initiation of study treatment
- Has a known hypersensitivity to the components of the study treatment or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins
- Female patients during pregnancy and lactation, fertile women with positive baseline pregnancy tests or women of childbearing age who are unwilling to take effective contraceptive measures throughout the trial
- History of neurological or psychiatric disorders, including epilepsy or dementia.
- any other situation evaluated by researchers
Sites / Locations
- Breast Cancer Center, Shandong Cancer Hospital Affiliated to Shandong University RecruitingRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Camrelizumab+Chemotherapy
Arm Description
Participants receive Camrelizumab d1,15 (Q2W) + nab-paclitaxel d1,8,15(QW 3/4) x 4 cycles, followed by Camrelizumab Q2W + epirubicin + cyclophosphamide Q2W x 4 cycles as neoadjuvant therapy prior to surgery
Outcomes
Primary Outcome Measures
pCR rate using the definition of ypT0/Tis ypN0 (i.e., no invasive residual in breast or nodes; noninvasive breast residuals allowed) at the time of definitive surgery
pCR rate (ypT0/Tis ypN0) is defined as the percentage of participants without residual invasive tumor on hematoxylin and eosin evaluation of breast specimen and all sampled regional lymph nodes following completion of neoadjuvant systemic therapy by current AJCC staging criteria assessed by the local pathologist at the time of definitive surgery in all participants.
Secondary Outcome Measures
pCR rate using the definition of ypT0/Tis (i.e., absence of invasive cancer in the breast irrespective of ductal carcinoma in situ or nodal involvement) at the time of definitive surgery
pCR rate (ypT0/Tis) is defined as the percentage of participants without invasive cancer in the breast irrespective of ductal carcinoma in situ or nodal involvement following completion of neoadjuvant systemic therapy by current AJCC staging criteria assessed by the local pathologist at the time of definitive surgery in all participants
Event-Free Survival (EFS) in all participants
EFS is defined as the time from start of study treatment to any of the following events: progression of disease that precludes surgery, local or distant recurrence, second primary malignancy (breast or other cancers) or death due to any cause.
Objective Overall Response Rate (ORR)
ORR was defined as percentage of participants with best (confirmed) overall response (BOR) of either CR or PR. ORR was assessed by the investigator according to RECIST version 1.1 and is based on BOR, which is defined as best response recorded from start of study treatment until definitive surgery or disease progression.
Adverse events (AEs)
AEs were graded according to the National Cancer Institute's Common Toxicity Criteria for Adverse Events (CTCAE) version 5.0.
In general, AEs are graded according to the following: Grade 1 Mild AE Grade 2 Moderate AE Grade 3 Severe AE Grade 4 Life-threatening or disabling AE Grade 5 Death related to AE.
The type, grade and frequency of AEs will be reported.
Full Information
NCT ID
NCT04676997
First Posted
November 30, 2020
Last Updated
December 18, 2020
Sponsor
Shandong Cancer Hospital and Institute
Collaborators
Jiangsu HengRui Medicine Co., Ltd.
1. Study Identification
Unique Protocol Identification Number
NCT04676997
Brief Title
Neoadjuvant Study of Camrelizumab Plus Chemotherapy in Triple Negative Breast Cancer (TNBC)
Official Title
A Phase Ⅱ Study to Evaluate Efficacy and Safety of Camrelizumab Plus Chemotherapy as Neoadjuvant Therapy in Participants With Triple Negative Breast Cancer (TNBC)
Study Type
Interventional
2. Study Status
Record Verification Date
December 2020
Overall Recruitment Status
Recruiting
Study Start Date
May 20, 2020 (Actual)
Primary Completion Date
July 30, 2021 (Anticipated)
Study Completion Date
February 28, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Shandong Cancer Hospital and Institute
Collaborators
Jiangsu HengRui Medicine Co., Ltd.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The study is being conducted to evaluate the efficacy, safety and tolerability of Camrelizumab Combination With Nab-Paclitaxel and Epirubicin as Neoadjuvant Therapy in Participants With Triple Negative Breast Cancer (TNBC)
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Triple Negative Breast Cancer
Keywords
Neoadjuvant, PD-1
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Camrelizumab+Chemotherapy
Arm Type
Experimental
Arm Description
Participants receive Camrelizumab d1,15 (Q2W) + nab-paclitaxel d1,8,15(QW 3/4) x 4 cycles, followed by Camrelizumab Q2W + epirubicin + cyclophosphamide Q2W x 4 cycles as neoadjuvant therapy prior to surgery
Intervention Type
Biological
Intervention Name(s)
Camrelizumab
Intervention Description
200mg on days1,15 of Cycles 1-4 (Q2W); IV infusion. 200mg on day 1 of Cycles 5-8 (Q2W); IV infusion.
Intervention Type
Drug
Intervention Name(s)
Nab paclitaxel
Intervention Description
125 mg/m² on day 1, 8 and 15 of Cycles 1-4 (QW 3/4); IV infusion.
Intervention Type
Drug
Intervention Name(s)
Epirubicin
Intervention Description
90 mg/m² on day 1 of Cycles 5-8 (Q2W); IV infusion.
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Intervention Description
600 mg/m² on day 1 of Cycles 5-8 (Q2W); IV infusion.
Primary Outcome Measure Information:
Title
pCR rate using the definition of ypT0/Tis ypN0 (i.e., no invasive residual in breast or nodes; noninvasive breast residuals allowed) at the time of definitive surgery
Description
pCR rate (ypT0/Tis ypN0) is defined as the percentage of participants without residual invasive tumor on hematoxylin and eosin evaluation of breast specimen and all sampled regional lymph nodes following completion of neoadjuvant systemic therapy by current AJCC staging criteria assessed by the local pathologist at the time of definitive surgery in all participants.
Time Frame
Up to approximately 27-30 weeks
Secondary Outcome Measure Information:
Title
pCR rate using the definition of ypT0/Tis (i.e., absence of invasive cancer in the breast irrespective of ductal carcinoma in situ or nodal involvement) at the time of definitive surgery
Description
pCR rate (ypT0/Tis) is defined as the percentage of participants without invasive cancer in the breast irrespective of ductal carcinoma in situ or nodal involvement following completion of neoadjuvant systemic therapy by current AJCC staging criteria assessed by the local pathologist at the time of definitive surgery in all participants
Time Frame
Up to approximately 27-30 weeks
Title
Event-Free Survival (EFS) in all participants
Description
EFS is defined as the time from start of study treatment to any of the following events: progression of disease that precludes surgery, local or distant recurrence, second primary malignancy (breast or other cancers) or death due to any cause.
Time Frame
Up to approximately 5 years
Title
Objective Overall Response Rate (ORR)
Description
ORR was defined as percentage of participants with best (confirmed) overall response (BOR) of either CR or PR. ORR was assessed by the investigator according to RECIST version 1.1 and is based on BOR, which is defined as best response recorded from start of study treatment until definitive surgery or disease progression.
Time Frame
Up to approximately 25-30 weeks
Title
Adverse events (AEs)
Description
AEs were graded according to the National Cancer Institute's Common Toxicity Criteria for Adverse Events (CTCAE) version 5.0.
In general, AEs are graded according to the following: Grade 1 Mild AE Grade 2 Moderate AE Grade 3 Severe AE Grade 4 Life-threatening or disabling AE Grade 5 Death related to AE.
The type, grade and frequency of AEs will be reported.
Time Frame
Up to approximately 35 weeks
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:
Newly diagnosed breast cancer
18-70 Years, female;
life expectancy is not less than 3 months
Histologically documented TNBC (negative human epidermal growth factor receptor 2 [HER2], estrogen receptor [ER], and progesterone receptor [PgR] status);
Stage at presentation: T1c N1-2 or T2-4 N0-2;
at least one measurable lesion according to RECIST 1.1;
Adequate function of major organs meets the following requirements:
Neutrophils ≥ 1.5×10^9/L
Platelets ≥ 100×10^9/L
Hemoglobin ≥ 90g/L
lymphocyte≥0.5×10^9/L
Total bilirubin≤ 1.5 × the upper limit of normal (ULN)
ALT and AST ≤ 3 × ULN
ALP≤ 2.5 × ULN
BUN and Cr ≤ 1.5 × ULN
TSH≤ ULN
Left ventricular ejection fraction (LVEF) ≥ 50%
QTcF ≤ 470 ms
Provides tumor tissue specimen to assess tumor programmed death-ligand 1 (PD-L1);
For women of childbearing potential: agreement to use contraceptive methods. Women who are not postmenopausal or have undergone a sterilization procedure must have a negative serum pregnancy test result within 72 hours prior to initiation of study drug.
Exclusion Criteria:
Stage Ⅳ (metastatic) breast cancer or bilateral breast cancer
Inflammatory breast cancer
patients who received chemotherapy, endocrine therapy, immunotherapy, biotherapy or TACE within 4 weeks before admission
Has participated in an interventional clinical study with an investigational compound within 4 weeks prior to initiation of study treatment
Prior treatment with anti-cytotoxic T-lymphocyte-associated protein 4 (anti-CTLA-4), anti-programmed death-1 (anti-PD-1), and anti-PD-L1 therapeutic antibodies
Has a history of invasive malignancy ≤5 years prior to signing informed consent except for adequately treated basal cell or squamous cell skin cancer or in situ cervical cancer.
Major surgical procedure within 4 weeks prior to initiation of study treatment
Active or history of autoimmune disease or immune deficiency diseases except history of autoimmune-related hypothyroidism, controlled Type 1 diabetes mellitus
Has a history of (non-infectious) pneumonitis, interstitial lung disease or uncontrollable systematicness diseases
Administration of a live attenuated vaccine within 28 days prior to initiation of study treatment or anticipation of need for such a vaccine during the study
Has a known history of Human Immunodeficiency Virus (HIV).
Has known active Hepatitis B, Hepatitis C or Autoimmune hepatitis
Severe infections within 4 weeks prior to initiation of study treatment, including but not limited to hospitalization for complications of infection, bacteremia, or severe pneumonia
Has active infection (CTCAE≥2) needed the treatment of antibiotic within 2 weeks prior to initiation of study treatment
Has evidence of active tuberculosis within 1year prior to initiation of study treatment
Prior allogeneic stem cell or solid organ transplantation
Pre-existing motor or sensory neuropathy of a severity≥grade 2
Has significant cardiovascular disease
Treatment with systemic immunostimulatory agents within 4 weeks prior to initiation of study treatment
Treatment with systemic immunosuppressive medications within 2 weeks prior to initiation of study treatment
Has a known hypersensitivity to the components of the study treatment or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins
Female patients during pregnancy and lactation, fertile women with positive baseline pregnancy tests or women of childbearing age who are unwilling to take effective contraceptive measures throughout the trial
History of neurological or psychiatric disorders, including epilepsy or dementia.
any other situation evaluated by researchers
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jinming Yu, MD
Phone
+8613806406293
Email
jn7984729@public.jn.sd.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Yongsheng Wang, MD
Phone
+8613505409989
Email
wangysh2008@aliyun.com
Facility Information:
Facility Name
Breast Cancer Center, Shandong Cancer Hospital Affiliated to Shandong University Recruiting
City
Jinan
State/Province
Shandong
ZIP/Postal Code
250117
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jinming Yu, MD
Phone
+8613806406293
Email
jn7984729@public.jn.sd.cn
First Name & Middle Initial & Last Name & Degree
Yongsheng Wang, MD
Phone
+8613505409989
Email
wangysh2008@aliyun.com
First Name & Middle Initial & Last Name & Degree
Jinming Yu, MD
First Name & Middle Initial & Last Name & Degree
Yongsheng Wang, MD
12. IPD Sharing Statement
Learn more about this trial
Neoadjuvant Study of Camrelizumab Plus Chemotherapy in Triple Negative Breast Cancer (TNBC)
We'll reach out to this number within 24 hrs