A Study of Sacituzumab With Chemoimmunotherapy to Treat Advanced Triple-Negative Breast Cancer After Prior Therapies
Primary Purpose
Advanced Triple Negative Breast Cancer
Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
N-803
PD-L1 t-haNK
Sacituzumab Govitecan-Hziy
Cyclophosphamide
Sponsored by
About this trial
This is an interventional treatment trial for Advanced Triple Negative Breast Cancer focused on measuring Chemoimmunotherapy, Stage IV TNBC, Sacituzumab, N-803, PD-L1 t-haNK, Cyclophosphamide
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 18 years.
- Able to understand and provide a signed informed consent that fulfills the relevant IRB or Independent Ethics Committee (IEC) guidelines.
- Histologically confirmed stage IV TNBC. Subjects must have had at least 2 prior treatments for TNBC. TNBC is defined as breast cancer that lacks estrogen receptor (ER) and progesterone receptor (PgR) expression (both ≤ 1% of tumor cell nuclei), and human epidermal growth factor receptor 2 (HER2) overexpression and/or amplification (IHC 0 or 1+, or IHC 2+ and fluorescence in situ hybridization [FISH]-), according to American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guideline criteria, as evaluated by local institutions.
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 to 2.
- Have at least 1 measurable lesion of ≥ 1.0 cm and/or non-measurable disease evaluable in accordance with RECIST V1.1.
- Ability to attend required study visits and return for adequate follow-up, as required by this protocol.
- Agreement to practice effective contraception for female subjects of child-bearing potential and non-sterile males. Female subjects of child-bearing potential must agree to use effective contraception while on study and for at least 5 months after the last dose of study treatment. Non-sterile male subjects must agree to use a condom while on study and for up to 5 months after the last dose of study treatment. Effective contraception includes surgical sterilization (eg, vasectomy, tubal ligation), two forms of barrier methods (eg, condom, diaphragm) used with spermicide, intrauterine devices (IUDs), oral contraceptives, and abstinence.
Exclusion Criteria:
- Have previously received or are currently receiving treatment with sacituzumab govitecan-hziy.
- Serious uncontrolled concomitant disease that would contraindicate the use of the investigational drug used in this study or that would put the subject at high risk for treatment-related complications.
- Systemic autoimmune disease (eg, lupus erythematosus, rheumatoid arthritis, Addison's disease, autoimmune disease associated with lymphoma).
- History of organ transplant requiring immunosuppression.
- History of or active inflammatory bowel disease (eg, Crohn's disease, ulcerative colitis).
Inadequate organ function, evidenced by the following laboratory results:
- Absolute neutrophil count (ANC) < 1500 cells/mm3.
- Platelet count < 75,000 cells/mm3.
- Hemoglobin < 9 g/dL.
- Total bilirubin greater than the upper limit of normal (ULN; unless the subject has documented Gilbert's syndrome).
- Aspartate aminotransferase (AST [SGOT]) or alanine aminotransferase (ALT [SGPT]) > 2.5 × ULN (> 5 × ULN in subjects with liver metastases).
- Alkaline phosphatase (ALP) levels > 2.5 × ULN (> 5 × ULN in subjects with liver metastases, or >10 × ULN in subjects with bone metastases).
- Serum creatinine > 2.0 mg/dL or 177 μmol/L.
- Uncontrolled hypertension (systolic > 160 mm Hg and/or diastolic > 110 mm Hg) or clinically significant (ie, active) cardiovascular disease, cerebrovascular accident/stroke, or myocardial infarction within 6 months prior to first study medication; unstable angina; congestive heart failure of New York Heart Association grade 2 or higher; or serious cardiac arrhythmia requiring medication.
- Current chronic daily treatment (continuous for > 3 months) with systemic corticosteroids (dose equivalent to or greater than 10 mg/day methylprednisolone), excluding inhaled steroids. Short-term steroid use to prevent IV contrast allergic reaction or anaphylaxis in subjects who have known contrast allergies is allowed.
- Known hypersensitivity to any component of the study medication(s).
- Subjects taking any medication(s) (herbal or prescribed) known to have an adverse drug reaction with any of the study medications.
- Known uridine diphosphate-glucuronosyl transferase 1A1 (UGT1A1) gene polymorphism resulting in reduced function.
- Assessed by the Investigator to be unable or unwilling to comply with the requirements of the protocol.
- Concurrent participation in any interventional clinical trial.
- Pregnant and nursing women. A negative serum pregnancy test during screening and a negative pregnancy test within 72 hours prior to the first dose must be documented before study drug is administered to a female subject of child-bearing potential.
Sites / Locations
- Hoag Memorial Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
All subjects
Arm Description
Sacituzumab plus chemoimmunotherapy (cyclophosphamide, N-803, and PD-L1 t-haNK)
Outcomes
Primary Outcome Measures
Phase 1b: Maximum Tolerated Dose (MTD) or Highest Tolerated Dose (HTD)
Determine the MTD or HTD and designate a recommended phase 2 dose (RP2D)
Phase 1b: Safety Profile of sacituzumab plus chemoimmunotherapy
Incidence of dose limiting toxicities, treatment-emergent adverse events, and serious adverse events
Phase 2: Objective Response Rate (ORR) per Response Evaluation Criteria in Solid Tumors (RECIST) V1.1
Phase 2 primary endpoint
Secondary Outcome Measures
Phase 1b:ORR per RECIST V1.1
Phase 1b secondary endpoint
Phase 1b: Progression Free Survival (PFS) per RECIST V1.1
Phase 1b secondary endpoint
Phase 1b: Overall Survival (OS)
Phase 1b secondary endpoint
Phase 1b: Duration of Response (DOR) per RECIST V1.1
Phase 1b secondary endpoint
Phase 1b: Disease Control Rate (DCR) per RECIST V1.1
Phase 1b secondary endpoint
Phase 2: PFS per RECIST V1.1
Phase 2 secondary efficacy endpoint
Phase 2: OS
Phase 2 secondary endpoint
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04927884
Brief Title
A Study of Sacituzumab With Chemoimmunotherapy to Treat Advanced Triple-Negative Breast Cancer After Prior Therapies
Official Title
Open-Label Phase 1b/2 Study of Sacituzumab Govitecan-Hziy Plus Chemoimmunotherapy for the Treatment of Subjects With Advanced Triple-Negative Breast Cancer After Prior Therapy
Study Type
Interventional
2. Study Status
Record Verification Date
June 2023
Overall Recruitment Status
Terminated
Why Stopped
Study not meeting recruitment goals
Study Start Date
September 27, 2021 (Actual)
Primary Completion Date
January 4, 2023 (Actual)
Study Completion Date
January 4, 2023 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ImmunityBio, Inc.
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 1b/2 open-label study to evaluate the safety and efficacy of sacituzumab govitecan-hziy in combination with chemoimmunotherapy (cyclophosphamide, N-803, and PD-L1 t-haNK) in subjects with Triple Negative Breast Cancer (TNBC) after at least 2 prior treatments for metastatic disease.
Detailed Description
In part 1 of phase 1b, 3 to 6 subjects will be sequentially enrolled starting at dose level 1 and will be assessed for dose limiting toxicities (DLTs). Dose level cohorts for sacituzumab govitecan-hziy are as follows:
Dose level 1: Sacituzumab govitecan-hziy (7.5 mg/kg IV)
Dose level 2: Sacituzumab govitecan-hziy (10 mg/kg IV)
Dose level 1 (if needed): Sacituzumab govitecan-hziy (5.0 mg/kg IV)
In part 2 of phase 1b, dose expansion will occur when the RP2D has been determined. An additional 4 subjects may be enrolled, for a total of up to 10 subjects at the RP2D. Following part 2 of the phase 1b portion of the study, the Safety Review Committee (SRC) will meet to determine if enrollment into phase 2 should proceed.
In the phase 2 portion of the study, 22 subjects will be enrolled at the RP2D in the first stage of Simon's two stage optimal design. If ≥ 9 of 22 subjects exhibit a confirmed response, the study will proceed to the second stage.
If the study proceeds to the second stage, an additional 41 subjects will be enrolled for a total of 63 subjects in the phase 2. If ≥ 27 of the 63 subjects exhibit a confirmed response, the combination therapy will be considered for further development.
All subjects may receive up to 17 cycles (ie, 51 weeks) of treatment administered in 3-week cycles.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Advanced Triple Negative Breast Cancer
Keywords
Chemoimmunotherapy, Stage IV TNBC, Sacituzumab, N-803, PD-L1 t-haNK, Cyclophosphamide
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
3 (Actual)
8. Arms, Groups, and Interventions
Arm Title
All subjects
Arm Type
Experimental
Arm Description
Sacituzumab plus chemoimmunotherapy (cyclophosphamide, N-803, and PD-L1 t-haNK)
Intervention Type
Biological
Intervention Name(s)
N-803
Intervention Description
Dose: 15 μg/kg subcutaneously (SC)
Frequency: administered on Day 8 of each cycle (every 3 weeks)
Intervention Type
Biological
Intervention Name(s)
PD-L1 t-haNK
Intervention Description
Dose: ~2 × 10^9 cells intravenously (IV)
Frequency: administered on Days 1 and 8 of each cycle (every 3 weeks)
Intervention Type
Drug
Intervention Name(s)
Sacituzumab Govitecan-Hziy
Intervention Description
Phase 1b:
Dose level 1: Sacituzumab govitecan-hziy (7.5 mg/kg IV) Dose level 2: Sacituzumab govitecan-hziy (10 mg/kg IV) Dose level -1 (if needed): Sacituzumab govitecan-hziy (5.0 mg/kg IV)
Phase 2: Dose based on Phase 1b Recommended Phase 2 Dose (IV)
Frequency: administered on Days 1 and 8 of each cycle (every 3 weeks)
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Intervention Description
Dose: 25 mg capsules taken twice per day by mouth (PO)
Frequency: to be taken Days 1-15 and 15-19 of each cycle (every 3 weeks)
Primary Outcome Measure Information:
Title
Phase 1b: Maximum Tolerated Dose (MTD) or Highest Tolerated Dose (HTD)
Description
Determine the MTD or HTD and designate a recommended phase 2 dose (RP2D)
Time Frame
12 months
Title
Phase 1b: Safety Profile of sacituzumab plus chemoimmunotherapy
Description
Incidence of dose limiting toxicities, treatment-emergent adverse events, and serious adverse events
Time Frame
12 months
Title
Phase 2: Objective Response Rate (ORR) per Response Evaluation Criteria in Solid Tumors (RECIST) V1.1
Description
Phase 2 primary endpoint
Time Frame
48 months
Secondary Outcome Measure Information:
Title
Phase 1b:ORR per RECIST V1.1
Description
Phase 1b secondary endpoint
Time Frame
48 months
Title
Phase 1b: Progression Free Survival (PFS) per RECIST V1.1
Description
Phase 1b secondary endpoint
Time Frame
48 months
Title
Phase 1b: Overall Survival (OS)
Description
Phase 1b secondary endpoint
Time Frame
48 months
Title
Phase 1b: Duration of Response (DOR) per RECIST V1.1
Description
Phase 1b secondary endpoint
Time Frame
48 months
Title
Phase 1b: Disease Control Rate (DCR) per RECIST V1.1
Description
Phase 1b secondary endpoint
Time Frame
48 months
Title
Phase 2: PFS per RECIST V1.1
Description
Phase 2 secondary efficacy endpoint
Time Frame
48 months
Title
Phase 2: OS
Description
Phase 2 secondary endpoint
Time Frame
48 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age ≥ 18 years.
Able to understand and provide a signed informed consent that fulfills the relevant IRB or Independent Ethics Committee (IEC) guidelines.
Histologically confirmed stage IV TNBC. Subjects must have had at least 2 prior treatments for TNBC. TNBC is defined as breast cancer that lacks estrogen receptor (ER) and progesterone receptor (PgR) expression (both ≤ 1% of tumor cell nuclei), and human epidermal growth factor receptor 2 (HER2) overexpression and/or amplification (IHC 0 or 1+, or IHC 2+ and fluorescence in situ hybridization [FISH]-), according to American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guideline criteria, as evaluated by local institutions.
Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 to 2.
Have at least 1 measurable lesion of ≥ 1.0 cm and/or non-measurable disease evaluable in accordance with RECIST V1.1.
Ability to attend required study visits and return for adequate follow-up, as required by this protocol.
Agreement to practice effective contraception for female subjects of child-bearing potential and non-sterile males. Female subjects of child-bearing potential must agree to use effective contraception while on study and for at least 5 months after the last dose of study treatment. Non-sterile male subjects must agree to use a condom while on study and for up to 5 months after the last dose of study treatment. Effective contraception includes surgical sterilization (eg, vasectomy, tubal ligation), two forms of barrier methods (eg, condom, diaphragm) used with spermicide, intrauterine devices (IUDs), oral contraceptives, and abstinence.
Exclusion Criteria:
Have previously received or are currently receiving treatment with sacituzumab govitecan-hziy.
Serious uncontrolled concomitant disease that would contraindicate the use of the investigational drug used in this study or that would put the subject at high risk for treatment-related complications.
Systemic autoimmune disease (eg, lupus erythematosus, rheumatoid arthritis, Addison's disease, autoimmune disease associated with lymphoma).
History of organ transplant requiring immunosuppression.
History of or active inflammatory bowel disease (eg, Crohn's disease, ulcerative colitis).
Inadequate organ function, evidenced by the following laboratory results:
Absolute neutrophil count (ANC) < 1500 cells/mm3.
Platelet count < 75,000 cells/mm3.
Hemoglobin < 9 g/dL.
Total bilirubin greater than the upper limit of normal (ULN; unless the subject has documented Gilbert's syndrome).
Aspartate aminotransferase (AST [SGOT]) or alanine aminotransferase (ALT [SGPT]) > 2.5 × ULN (> 5 × ULN in subjects with liver metastases).
Alkaline phosphatase (ALP) levels > 2.5 × ULN (> 5 × ULN in subjects with liver metastases, or >10 × ULN in subjects with bone metastases).
Serum creatinine > 2.0 mg/dL or 177 μmol/L.
Uncontrolled hypertension (systolic > 160 mm Hg and/or diastolic > 110 mm Hg) or clinically significant (ie, active) cardiovascular disease, cerebrovascular accident/stroke, or myocardial infarction within 6 months prior to first study medication; unstable angina; congestive heart failure of New York Heart Association grade 2 or higher; or serious cardiac arrhythmia requiring medication.
Current chronic daily treatment (continuous for > 3 months) with systemic corticosteroids (dose equivalent to or greater than 10 mg/day methylprednisolone), excluding inhaled steroids. Short-term steroid use to prevent IV contrast allergic reaction or anaphylaxis in subjects who have known contrast allergies is allowed.
Known hypersensitivity to any component of the study medication(s).
Subjects taking any medication(s) (herbal or prescribed) known to have an adverse drug reaction with any of the study medications.
Known uridine diphosphate-glucuronosyl transferase 1A1 (UGT1A1) gene polymorphism resulting in reduced function.
Assessed by the Investigator to be unable or unwilling to comply with the requirements of the protocol.
Concurrent participation in any interventional clinical trial.
Pregnant and nursing women. A negative serum pregnancy test during screening and a negative pregnancy test within 72 hours prior to the first dose must be documented before study drug is administered to a female subject of child-bearing potential.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bobby Reddy, MD
Organizational Affiliation
ImmunityBio, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Hoag Memorial Hospital
City
Newport Beach
State/Province
California
ZIP/Postal Code
92663
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
A Study of Sacituzumab With Chemoimmunotherapy to Treat Advanced Triple-Negative Breast Cancer After Prior Therapies
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