Cryoablation Combined With Tirelizumab and Bevacizumab in Liver Metastatic TNBC Patients Failed by Multiline Therapy (Castle06(BC))
Primary Purpose
Metastatic Breast Cancer in the Liver
Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Cryoablation Combined with Tirelizumab and Bevacizumab
Sponsored by
About this trial
This is an interventional treatment trial for Metastatic Breast Cancer in the Liver focused on measuring Triple Negative Breast Cancer, Cryoablation, Tirelizumab, Bevacizumab
Eligibility Criteria
Inclusion Criteria:
- Histologically or Imageologically confirmed liver metastatic tnbc patients;
- Histologically confirmed diagnosis of TNBC characterized by estrogen receptor negative (ER-), progesterone receptor negative (PR-) and human epidermal growth factor-2 receptor negative (HER2-);
- ≥ 2 prior lines systemic therapy;
- Measurable disease according to Response Evaluation Criteria in Solid Tumors v1.1 (RECIST v1.1);
- The patients show no signs of bile duct obstruction, and the bilirubin is below the upper limit of 1.5x normal value (ULN);
- Age ≥ 18 years on the day of signing the ICF (or the legal age of consent in the jurisdiction in which the study is taking place);
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1;
- The functions of the patient's organs and blood system meet the requirements;
- Blood system function: absolute neutrophil count (ANC) ≥ 1.5 x 109 / L, platelet count ≥ 100 x 109 / L
- Renal function: estimated glomerular filtration rate or creatinine clearance > 50 ml / min / 1.73 M2
- Liver function: total bilirubin ≤ 1.5 x ULN, AST and alt ≤ 5 x ULN
- Estimated survival time ≥12 weeks.
Exclusion Criteria:
- The patient is currently receiving or has received irradiation or local treatment for the target lesion in the past 3 weeks.
- The patient had previously received cryoablation.
- The patient received major surgery within 14 days before enrolling in the study.
- Palliative radiotherapy must be completed at least 2 weeks before enrolling in the study, and there is no plan for additional radiotherapy for the same lesion; ·Patients whose AE caused by radiotherapy did not recover to ≤ CTCAE 1 degree
- The patient had metastatic brain lesions, including asymptomatic and well controlled lesions.
- Complicated with infection and requiring intravenous antibiotic treatment.
- The patient has any clinically significant disease or history that the investigator believes may endanger the safety of the patient or the reliability of the study results.
- The patient has a history of any other malignancy unless the remission period exceeds 1 year. (do not exclude skin cancer, cervical cancer in situ, superficial bladder cancer, and breast cancer in radical treatment).
- Female patients are pregnant or breastfeeding.
- The patient received any trial drug within 14 days before receiving the first study drug.
- The patient had undiminished or unstable severe toxicity (≥ CTCAE 4.0 grade 2) after previous use of another trial drug and / or previous cancer treatment, except anemia, weakness and hair loss.
- Patients are allergic to the test drug or any of its excipients.
- Patients are known to be HIV positive, have HCB, or have HBV infection and HBV DNA exceeds 2000 IU / ml.
- The patient has a known history of drug addiction in the past 1 year, because this situation may lead to a high risk of non-compliance of the trial drug.
- The patient has known active or suspected autoimmune disease. Subjects who are in a stable state and do not need systemic immunosuppressive therapy are allowed to be enrolled.
- Subjects requiring systemic treatment with corticosteroids (> 10mg / day prednisone efficacy dose) or other immunosuppressants within 14 days before the administration of the study drug were allowed to inhale or locally use steroids and adrenal hormone replacement with a dose > 10mg / day prednisone efficacy dose in the absence of active autoimmune diseases.
- The patient had a baseline corrected QT interval QTc > 450 ms, or the patient had known QT prolongation syndrome, torsade de pointe ventricular tachycardia, symptomatic ventricular tachycardia, unstable heart syndrome within 3 months before the screening visit, > grade 2 New York Heart Association heart failure, > grade 2 Canadian Cardiovascular Association angina pectoris.
Sites / Locations
- Fudan University Shangshai Cancer CenterRecruiting
- Fudan University Shanghai Cancer CenterRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
cryoablation combined with tirelizumab + Bevacizumab
Arm Description
Outcomes
Primary Outcome Measures
ORR
The number of people with tumor responses according to RECIST (V1.1): the proportion of participants who achieves a best overall response of complete response (CR) or partial response (PR).
Secondary Outcome Measures
Duration of Response (DOR)
The time from the date that response criteria are first met to the date that progressive disease (PD) is objectively documented or death, whichever occurs first.
Disease Control Rate (DCR)
The proportion of participants who achieves a best overall response of CR, PR or stable disease(SD).
Progression-free Survival (PFS)
Time from the date of randomization to the date of progressive disease (PD) or death, whichever occurs first.
One-year overall survival (OS) rate
OS defined as the time from the date of randomization to the date of death due to any reason. One-year survival rate (percentage of subjects alive at 1 year) was estimated from OS data.
Frequencies of Biomarkers
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05303038
Brief Title
Cryoablation Combined With Tirelizumab and Bevacizumab in Liver Metastatic TNBC Patients Failed by Multiline Therapy
Acronym
Castle06(BC)
Official Title
A Phase II Clinical Study of Cryoablation Combined With Tirelizumab and Bevacizumab in Liver Metastatic Triple Negative Breast Cancer Patients Failed by Multiline Therapy
Study Type
Interventional
2. Study Status
Record Verification Date
April 2022
Overall Recruitment Status
Recruiting
Study Start Date
May 1, 2022 (Actual)
Primary Completion Date
April 1, 2024 (Anticipated)
Study Completion Date
April 1, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Fudan University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
5. Study Description
Brief Summary
This is a Phase II, open-label study evaluating the efficacy and safety of Cryoablation combined with Tirelizumab and Bevacizumab in liver metastatic triple-negative breast cancer patients failed by multiline therapy.
Detailed Description
This is a prospective, single-arm, single-center phase II clinical trial in liver metastatic triple-negative breast cancer patients failed by multiline therapy.
All subjects will receive cryoablation combined with tirelizumab + bevacizumab:
Cryoablation of liver metastases: Cryoablation of 1-2 typical metastatic lesions will be performed on D1 under general anesthesia and ultrasound guidance for two cycles. If the patient has no measurable lesions outside the liver, the measurable lesions should be retained after partial ablation of the liver lesions.
PD-1 antibody + anti vascular therapy: patients will receive 200mg Tirelizumab ( IV Q3W) + Bevacizumab 7.5mg/kg ( IV Q3W) at D14 after cryoablation until there is disease progression, intolerable toxic reaction, subject withdraws informed consent or the study ends (whichever comes first).
Puncture biopsy of liver metastases will completed 1-3 days before cryoablation, 1-3 days before the first treatment with tirelizumab + bevacizumab, 2 cycles after treatment with tirelizumab + bevacizumab and after disease progression, and blood samples (about 10ml) were collected for mutation load detection and immune function evaluation.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Breast Cancer in the Liver
Keywords
Triple Negative Breast Cancer, Cryoablation, Tirelizumab, Bevacizumab
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
15 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
cryoablation combined with tirelizumab + Bevacizumab
Arm Type
Experimental
Intervention Type
Combination Product
Intervention Name(s)
Cryoablation Combined with Tirelizumab and Bevacizumab
Intervention Description
Cryoablation of 1-2 typical metastatic lesions will be performed on D1 under general anesthesia and ultrasound guidance for two cycles.
200mg Tirelizumab ( IV Q3W) + Bevacizumab 7.5mg/kg ( IV Q3W) will be administered at D14 after cryoablation.
Primary Outcome Measure Information:
Title
ORR
Description
The number of people with tumor responses according to RECIST (V1.1): the proportion of participants who achieves a best overall response of complete response (CR) or partial response (PR).
Time Frame
Up to 12 months
Secondary Outcome Measure Information:
Title
Duration of Response (DOR)
Description
The time from the date that response criteria are first met to the date that progressive disease (PD) is objectively documented or death, whichever occurs first.
Time Frame
Up to 12 months
Title
Disease Control Rate (DCR)
Description
The proportion of participants who achieves a best overall response of CR, PR or stable disease(SD).
Time Frame
Up to 12 months
Title
Progression-free Survival (PFS)
Description
Time from the date of randomization to the date of progressive disease (PD) or death, whichever occurs first.
Time Frame
Up to 12 months
Title
One-year overall survival (OS) rate
Description
OS defined as the time from the date of randomization to the date of death due to any reason. One-year survival rate (percentage of subjects alive at 1 year) was estimated from OS data.
Time Frame
Up to 12 months
Title
Frequencies of Biomarkers
Time Frame
Up to 12 months
10. Eligibility
Sex
Female
Gender Based
Yes
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically or Imageologically confirmed liver metastatic tnbc patients;
Histologically confirmed diagnosis of TNBC characterized by estrogen receptor negative (ER-), progesterone receptor negative (PR-) and human epidermal growth factor-2 receptor negative (HER2-);
≥ 2 prior lines systemic therapy;
Measurable disease according to Response Evaluation Criteria in Solid Tumors v1.1 (RECIST v1.1);
The patients show no signs of bile duct obstruction, and the bilirubin is below the upper limit of 1.5x normal value (ULN);
Age ≥ 18 years on the day of signing the ICF (or the legal age of consent in the jurisdiction in which the study is taking place);
Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1;
The functions of the patient's organs and blood system meet the requirements;
Blood system function: absolute neutrophil count (ANC) ≥ 1.5 x 109 / L, platelet count ≥ 100 x 109 / L
Renal function: estimated glomerular filtration rate or creatinine clearance > 50 ml / min / 1.73 M2
Liver function: total bilirubin ≤ 1.5 x ULN, AST and alt ≤ 5 x ULN
Estimated survival time ≥12 weeks.
Exclusion Criteria:
The patient is currently receiving or has received irradiation or local treatment for the target lesion in the past 3 weeks.
The patient had previously received cryoablation.
The patient received major surgery within 14 days before enrolling in the study.
Palliative radiotherapy must be completed at least 2 weeks before enrolling in the study, and there is no plan for additional radiotherapy for the same lesion; ·Patients whose AE caused by radiotherapy did not recover to ≤ CTCAE 1 degree
The patient had metastatic brain lesions, including asymptomatic and well controlled lesions.
Complicated with infection and requiring intravenous antibiotic treatment.
The patient has any clinically significant disease or history that the investigator believes may endanger the safety of the patient or the reliability of the study results.
The patient has a history of any other malignancy unless the remission period exceeds 1 year. (do not exclude skin cancer, cervical cancer in situ, superficial bladder cancer, and breast cancer in radical treatment).
Female patients are pregnant or breastfeeding.
The patient received any trial drug within 14 days before receiving the first study drug.
The patient had undiminished or unstable severe toxicity (≥ CTCAE 4.0 grade 2) after previous use of another trial drug and / or previous cancer treatment, except anemia, weakness and hair loss.
Patients are allergic to the test drug or any of its excipients.
Patients are known to be HIV positive, have HCB, or have HBV infection and HBV DNA exceeds 2000 IU / ml.
The patient has a known history of drug addiction in the past 1 year, because this situation may lead to a high risk of non-compliance of the trial drug.
The patient has known active or suspected autoimmune disease. Subjects who are in a stable state and do not need systemic immunosuppressive therapy are allowed to be enrolled.
Subjects requiring systemic treatment with corticosteroids (> 10mg / day prednisone efficacy dose) or other immunosuppressants within 14 days before the administration of the study drug were allowed to inhale or locally use steroids and adrenal hormone replacement with a dose > 10mg / day prednisone efficacy dose in the absence of active autoimmune diseases.
The patient had a baseline corrected QT interval QTc > 450 ms, or the patient had known QT prolongation syndrome, torsade de pointe ventricular tachycardia, symptomatic ventricular tachycardia, unstable heart syndrome within 3 months before the screening visit, > grade 2 New York Heart Association heart failure, > grade 2 Canadian Cardiovascular Association angina pectoris.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Zhimin Shao, Professor
Phone
+86 021-6417559
Ext
88807
Email
zhimingshao@yahoo.com
First Name & Middle Initial & Last Name or Official Title & Degree
Lei Fan, Dr
Phone
+86 021-6417559
Ext
88603
Email
teddyfl@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Zhimin Shao, Professor
Organizational Affiliation
Fudan University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fudan University Shangshai Cancer Center
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200032
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhimin Shao, Professor
Phone
86-021-64175590
Ext
88807
Email
zhimingshao@yahoo.com
Facility Name
Fudan University Shanghai Cancer Center
City
Shanghai
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhimin Shao
Phone
86-021-64175590
Ext
88807
Email
zhimingshao@yahoo.com
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Learn more about this trial
Cryoablation Combined With Tirelizumab and Bevacizumab in Liver Metastatic TNBC Patients Failed by Multiline Therapy
We'll reach out to this number within 24 hrs