Study With Atezolizumab in Combination With Trastuzumab and Vinorelbine in HER2-positive Advanced/Metastatic Breast Cancer (ATREZZO)
Primary Purpose
Breast Cancer
Status
Recruiting
Phase
Phase 2
Locations
Spain
Study Type
Interventional
Intervention
Atezolizumab + Trastuzumab + Vinorelbine
Sponsored by
About this trial
This is an interventional treatment trial for Breast Cancer focused on measuring cancer, breast cancer
Eligibility Criteria
Inclusion Criteria:
- Male or female (Premenopausal or postmenopausal women)
- ECOG 0 to 2
- Histologically confirmed adenocarcinoma of the breast, metastatic or unresectable locally advanced.
- All patients must have received at least pertuzumab/trastuzumab and T-DM1
- Measurable disease according to RECIST 1.1 criteria.
- Adequate organ function
- Baseline LVEF ≥50%
- Participants with asymptomatic brain metastases are eligible.
Exclusion Criteria:
- Treatment with any investigational anticancer drug within 14 days of the start of study treatment.
- Patient has received Vinorelbine or any other vinca alkaloids previously immediately prior to initiate study treatment.
- History of other malignant tumors in the past 3 years
- Known or suspected leptomeningeal disease (LMD)/ poorly controlled (> 1/week) generalized or complex partial seizures, or manifest neurologic progression due to brain metastases.
- Symptomatic hypercalcemia requiring treatment with bisphosphonates in the 14 days prior to inclusion
- Cardiopulmonary dysfunction
- Any other severe, uncontrolled
- Major surgery in the 28 days prior to enrolment
- Infection with HIV or active Hepatitis B and/or Hepatitis C.
- History of trastuzumab intolerance, including grade 3-4 infusion reaction or hypersensitivity.
- Known hypersensitivity or allergy to biopharmaceuticals produced in Chinese hamster ovary cells or any component of the atezolizumab formulation
- History of autoimmune disease,
- Prior allogeneic stem cell or solid organ transplantation
- History of idiopathic pulmonary fibrosis, drug-induced pneumonitis, organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia), or evidence of active pneumonitis on screening chest CT scan. (Note: History of radiation pneumonitis in the radiation field [fibrosis] is permitted.)
- Active tuberculosis
- Receipt of a live, attenuated vaccine within 4 weeks prior to enrollment
- Prior treatment with CD137 agonists, anti-PD-1, or anti-PD-L1 therapeutic antibody or immune checkpoint targeting agents
- Treatment with systemic immunostimulatory agents (including but not limited to interferons or interleukin [IL]-2) within 4 weeks or five half-lives of the drug prior to enrolment
- Treatment with systemic immunosuppressive medications within 2 weeks prior to enrolment, or anticipated requirement for systemic immunosuppressive medications during the trial.
Sites / Locations
- H. Clínico San Cecilio de GranadaRecruiting
- Institut Català d'Oncologia HospitaletRecruiting
- Hospital Universitario de CanariasRecruiting
- Complejo Hospitalario Universitario A Coruña (CHUAC)Recruiting
- Hospital General Universitario de AlicanteRecruiting
- Hospital del MarRecruiting
- Hospital Clinic de BarcelonaRecruiting
- Hospital Universitari Vall d' HebronRecruiting
- Hospital San Pedro de AlcántaraRecruiting
- Hospital de LeónRecruiting
- Hospital Universitario 12 de octubreRecruiting
- Hospital Son EspasesRecruiting
- Hospital Universitari Sant Joan de ReusRecruiting
- Hospital Universitario Virgen del RocioRecruiting
- Hospital Clinico Universitario de ValenciaRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Atezolizumab in combination with Trastuzumab and Vinorelbine
Arm Description
Outcomes
Primary Outcome Measures
Overall Response rate
the proportion of patients with best overall response of complete response (CR) or partial response (PR), as per local investigator´s assessment and according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria
Secondary Outcome Measures
Overall Response rate in PD-L1+ patients
the proportion of patients with best overall response of complete response (CR) or partial response (PR), as per local investigator´s assessment and according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria
Clinical Benefit
Clinical Benefit Rate at 24 weeks
Overal survival
Time from the date of allocation to the date of death due to any cause.
Progression free survival
Survival witouth observed progression
Duration of response
time from first documented response until progression
Time to response
time until first documented response
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
AEs according to CTCAE v 5.0.
Overall Response rate in patients with brain metastases at baseline
Patients with a history of brain metastases, current brain metastases, or equivocal brain lesions at baseline
Clinical Benefit in patients with brain metastases at baseline
Clinical Benefit Rate at 24 weeks in patients with a history of brain metastases, current brain metastases, or equivocal brain lesions at baseline
Progression free survival in patients with brain metastases at baseline
Survival without observed progression in patients with a history of brain metastases, current brain metastases, or equivocal brain lesions at baseline
Overal survival in patients with brain metastases at baseline
Time from the date of allocation to the date of death due to any cause.
Full Information
NCT ID
NCT04759248
First Posted
January 28, 2021
Last Updated
April 11, 2023
Sponsor
SOLTI Breast Cancer Research Group
Collaborators
Roche Pharma AG
1. Study Identification
Unique Protocol Identification Number
NCT04759248
Brief Title
Study With Atezolizumab in Combination With Trastuzumab and Vinorelbine in HER2-positive Advanced/Metastatic Breast Cancer
Acronym
ATREZZO
Official Title
A Phase II With 2 Parallel Cohorts Clinical Trial Targeting Estrogen Receptor Negative or PAM50 Non-luminal Disease With Atezolizumab in Combination With Trastuzumab and Vinorelbine in HER2-positive Advanced/Metastatic Breast Cancer - ATREZZO Study
Study Type
Interventional
2. Study Status
Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 15, 2021 (Actual)
Primary Completion Date
December 24, 2023 (Anticipated)
Study Completion Date
February 24, 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
SOLTI Breast Cancer Research Group
Collaborators
Roche Pharma AG
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
Immune checkpoint inhibitors given in monotherapy in advanced breast cancer have shown modest benefit in first-line, but very limited efficacy in later lines. Thus, combination therapies are needed.
Response following anti-PD1/PD-L1 monotherapy is associated with large survival benefit in the advanced setting.
Previous studies of the intrinsic subtypes have shown that Basal-like and HER2-E are associated with higher expression of immune-related genes or higher infiltration of stromal tumor infiltrating lymphocytes compared to the luminal subtypes. Immune infiltration in BC is associated with chemo/antiHER2 responsiveness and potentially benefit from anti-PD-1/PD-L1 inhibitors.
In addition, one emerging biomarker of response to anti-PD-1 therapy is the tumor mutational burden (I.e. the total number of mutations per coding area of a tumor genome). The HER2-E and Basal-like profiles have been associated with high mutational burden.
A range of studies have been initiated including several phase II/III studies evaluating atezolizumab in combination with different chemotherapeutic compounds routinely used in breast cancer, but none with predefined biomarker beyond the expression of PD-L1 by IHC
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
cancer, breast cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
This is an open-label, single arm, Simon 2-stage, multicenter phase II study evaluating treatment with atezolizumab in combination with trastuzumab and vinorelbine in patients with locally advanced or metastatic PAM50 non-luminal/HER2+ BC refractory to trastuzumab based therapy and anti-HER2 ADC treatment.
Masking
None (Open Label)
Allocation
N/A
Enrollment
55 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Atezolizumab in combination with Trastuzumab and Vinorelbine
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Atezolizumab + Trastuzumab + Vinorelbine
Intervention Description
Atezolizumab IV 1200 mg in combination with
Trastuzumab sc 600mg or IV 6mg/kg every 3 weeks and
Vinorelbine 25 mg/m² IV or 60 mg/m2 PO on days 1 and 8, every 3 weeks during the first cycle and if there are no toxicity signs dose will be increased to 80 mg/m2 PO o 30 mg/m2 IV.
Primary Outcome Measure Information:
Title
Overall Response rate
Description
the proportion of patients with best overall response of complete response (CR) or partial response (PR), as per local investigator´s assessment and according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria
Time Frame
until disease progression or up to 2 years after treatment ends
Secondary Outcome Measure Information:
Title
Overall Response rate in PD-L1+ patients
Description
the proportion of patients with best overall response of complete response (CR) or partial response (PR), as per local investigator´s assessment and according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria
Time Frame
until disease progression or up to 2 years after treatment ends
Title
Clinical Benefit
Description
Clinical Benefit Rate at 24 weeks
Time Frame
24 weeks
Title
Overal survival
Description
Time from the date of allocation to the date of death due to any cause.
Time Frame
Until analysis data cutoff, 2 years
Title
Progression free survival
Description
Survival witouth observed progression
Time Frame
24 weeks
Title
Duration of response
Description
time from first documented response until progression
Time Frame
24 weeks
Title
Time to response
Description
time until first documented response
Time Frame
24 weeks
Title
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
Description
AEs according to CTCAE v 5.0.
Time Frame
until end of treatment / through study completion, an average of 1 year
Title
Overall Response rate in patients with brain metastases at baseline
Description
Patients with a history of brain metastases, current brain metastases, or equivocal brain lesions at baseline
Time Frame
Until disease progression or up to 2 years after treatment ends
Title
Clinical Benefit in patients with brain metastases at baseline
Description
Clinical Benefit Rate at 24 weeks in patients with a history of brain metastases, current brain metastases, or equivocal brain lesions at baseline
Time Frame
24 weeks
Title
Progression free survival in patients with brain metastases at baseline
Description
Survival without observed progression in patients with a history of brain metastases, current brain metastases, or equivocal brain lesions at baseline
Time Frame
24 weeks
Title
Overal survival in patients with brain metastases at baseline
Description
Time from the date of allocation to the date of death due to any cause.
Time Frame
Until analysis data cutoff, 2 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female (Premenopausal or postmenopausal women)
ECOG 0 to 2
Histologically confirmed adenocarcinoma of the breast, metastatic or unresectable locally advanced.
All patients must have received at least trastuzumab and other anti-HER2 ADCs (including but not limited to T-DM1).
Measurable disease according to RECIST 1.1 criteria.
Adequate organ function
Baseline LVEF ≥50%
Participants with asymptomatic brain metastases are eligible.
Exclusion Criteria:
Treatment with any investigational anticancer drug within 14 days of the start of study treatment.
Patient has received Vinorelbine or any other vinca alkaloids previously immediately prior to initiate study treatment.
History of other malignant tumors in the past 3 years
Known or suspected leptomeningeal disease (LMD)/ poorly controlled (> 1/week) generalized or complex partial seizures, or manifest neurologic progression due to brain metastases.
Symptomatic hypercalcemia requiring treatment with bisphosphonates in the 14 days prior to inclusion
Cardiopulmonary dysfunction
Any other severe, uncontrolled
Major surgery in the 28 days prior to enrolment
Infection with HIV or active Hepatitis B and/or Hepatitis C.
History of trastuzumab intolerance, including grade 3-4 infusion reaction or hypersensitivity.
Known hypersensitivity or allergy to biopharmaceuticals produced in Chinese hamster ovary cells or any component of the atezolizumab formulation
History of autoimmune disease,
Prior allogeneic stem cell or solid organ transplantation
History of idiopathic pulmonary fibrosis, drug-induced pneumonitis, organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia), or evidence of active pneumonitis on screening chest CT scan. (Note: History of radiation pneumonitis in the radiation field [fibrosis] is permitted.)
Active tuberculosis
Receipt of a live, attenuated vaccine within 4 weeks prior to enrollment
Prior treatment with CD137 agonists, anti-PD-1, or anti-PD-L1 therapeutic antibody or immune checkpoint targeting agents
Treatment with systemic immunostimulatory agents (including but not limited to interferons or interleukin [IL]-2) within 4 weeks or five half-lives of the drug prior to enrolment
Treatment with systemic immunosuppressive medications within 2 weeks prior to enrolment, or anticipated requirement for systemic immunosuppressive medications during the trial.
Facility Information:
Facility Name
H. Clínico San Cecilio de Granada
City
Granada
State/Province
Andalucía
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Isabel Blancas
Phone
+34 958 02 30 00
First Name & Middle Initial & Last Name & Degree
Isabel Blancas, MD
Facility Name
Institut Català d'Oncologia Hospitalet
City
Hospitalet de Llobregat
State/Province
Barcelona
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sonia Pernas
Phone
+34 932 60 77 33
First Name & Middle Initial & Last Name & Degree
Sonia Pernas, MD
Facility Name
Hospital Universitario de Canarias
City
Tenerife
State/Province
Islas Canarias
ZIP/Postal Code
38320
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Josefina Cruz Jurado
Phone
+34 922 67 80 00
First Name & Middle Initial & Last Name & Degree
Josefina Cruz Jurado, MD
Facility Name
Complejo Hospitalario Universitario A Coruña (CHUAC)
City
A Coruña
State/Province
La Coruña
ZIP/Postal Code
15006
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
María E Perez López
Phone
+34 981 178 000
First Name & Middle Initial & Last Name & Degree
Maria E Perez López, MD
Facility Name
Hospital General Universitario de Alicante
City
Alicante
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Juan José Ponce Lorenzo
Phone
+34 965 93 30 00
First Name & Middle Initial & Last Name & Degree
José Juan Ponce Lorenzo
Facility Name
Hospital del Mar
City
Barcelona
ZIP/Postal Code
08003
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sonia Servitja Tormo
Phone
+34 932 48 30 00
First Name & Middle Initial & Last Name & Degree
Sonia Servitja Tormo, MD
Facility Name
Hospital Clinic de Barcelona
City
Barcelona
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Olga Martinez
Phone
+34 932 27 54 00
First Name & Middle Initial & Last Name & Degree
Olga Martínez, MD
Facility Name
Hospital Universitari Vall d' Hebron
City
Barcelona
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Santiago Escrivá
Phone
+34 934 89 30 00
First Name & Middle Initial & Last Name & Degree
Santiago Escrivá, MD
Facility Name
Hospital San Pedro de Alcántara
City
Cáceres
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Santiago Gonzalez
Phone
+34 927 25 62 00
First Name & Middle Initial & Last Name & Degree
Santiago González, MD
Facility Name
Hospital de León
City
León
ZIP/Postal Code
24071
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ana Lopez
Phone
+34 987 23 74 00
First Name & Middle Initial & Last Name & Degree
Ana López, MD
Facility Name
Hospital Universitario 12 de octubre
City
Madrid
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Eva Ciruelos
Phone
+34 91 390 86 26
First Name & Middle Initial & Last Name & Degree
Eva Ciruelos, MD
Facility Name
Hospital Son Espases
City
Palma De Mallorca
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Antonia Perelló
Phone
+34 871 20 50 00
First Name & Middle Initial & Last Name & Degree
Antonia Perelló, MD
Facility Name
Hospital Universitari Sant Joan de Reus
City
Reus
ZIP/Postal Code
43201
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Cinta Albacar
Phone
+34 977 31 03 00
First Name & Middle Initial & Last Name & Degree
Cinta Albacar, MD
Facility Name
Hospital Universitario Virgen del Rocio
City
Sevilla
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Javier Salvador Bonfill
Phone
+34 955 01 20 00
First Name & Middle Initial & Last Name & Degree
Javier Salvador Bonfill, MD
Facility Name
Hospital Clinico Universitario de Valencia
City
Valencia
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Juan Miguel Cejalvo
Phone
+34 961 97 35 00
First Name & Middle Initial & Last Name & Degree
Juan Miguel Cejalvo, MD
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Study With Atezolizumab in Combination With Trastuzumab and Vinorelbine in HER2-positive Advanced/Metastatic Breast Cancer
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