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Study of HER2 Directed Dendritic Cell (DC1) Vaccine + Weekly Paclitaxel, Trastuzumab & Pertuzumab

Primary Purpose

HER2-positive Breast Cancer

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
HER-2 pulsed DC1
Trastuzumab
Pertuzumab
Paclitaxel
Resection surgery
Sponsored by
H. Lee Moffitt Cancer Center and Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HER2-positive Breast Cancer focused on measuring Breast Cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Participants must have histologically confirmed clinical stage I- III, HER2+ (per ASCO/CAP criteria) invasive carcinoma of the breast. Primary tumor should measure at least 1 cm by clinical exam or radiologic tests
  • Candidate for neoadjuvant chemotherapy with Paclitaxel, Trastuzumab, Pertuzumab regimen followed by standard of care local therapy as determined by the treating physician
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
  • Participants must have normal organ and marrow function as defined per protocol.
  • Cardiac ejection fraction within institutional normal limits by either Multigated Acquisition Scan (MUGA) or Echocardiogram at baseline.
  • Women of child-bearing potential and their male partners must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. Sexually active male participants should use a barrier method or exercise abstinence during chemotherapy administration until surgery.
  • Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

  • Participants with inflammatory breast cancer, widespread locally advanced unresectable disease involving the chest wall/nodal basins in which a curative surgical resection cannot be performed, or those in whom de novo metastatic disease is suspected or confirmed.
  • Patients may not be receiving any other investigational agents for the treatment of their breast cancer.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to the study vaccine components and any of the chemotherapy drugs (paclitaxel, trastuzumab, pertuzumab).
  • Participants who are unwilling or unable to undergo an apheresis for production of their vaccine.
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Pregnant women and women who are breastfeeding.
  • Participants with known congenital or acquired immune deficiency (including those patients who require systemic immunosuppressant drugs for autoimmune disease or organ transplant).

Sites / Locations

  • Moffitt Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Lead In - Dose level 1

Lead In: Dose Level 2

Expansion -Estrogen Receptor (ER) positive

Expansion -Estrogen Receptor (ER) negative

Arm Description

Six participants will be treated at dose level 1: DC vaccine given at the dose of 50 million once per week for 6 weeks

Six participants will be treated at dose level 2: DC vaccine given at the dose of 100 million once per week for 6 weeks

An additional 24 participants will be enrolled at dose level 2 if determined to be safe in lead in phase to have a total of 28 evaluable participants for pathologic response assessment (including 6 pts from the lead in phase).

An additional 23 participants will be enrolled at dose level 2 if determined to be safe in lead in phase to have a total of 28 evaluable participants for pathologic response assessment (including 6 pts from the lead in phase).

Outcomes

Primary Outcome Measures

Lead in Phase: Immunogenicity of each dose level
Immunogenicity: will be characterized by quantifying CD4TH1 response via ELISPot. ELISPot is an enzyme-linked immunospot assay. It is a highly sensitive immunoassay that measures the frequency of cytokine-secreting cells at the single-cell level.
Expansion Phase: Pathologic Complete Response Rate
Pathologic complete response rate of participants treated in the Expansion Phase. Clinical efficacy will be defined by the pathologic complete response (pCR) rate, the percentage of patients who achieve pCR based on surgical pathology assessment. Pathologic Complete Response defined as no residual invasive disease in the breast and nodes (ypT0/is N0) at definitive surgery after completion of protocol therapy. The pathologic response to treatment will be assessed by the pathologist. The "Residual Cancer Burden" (RCB) for each patient as described in the online calculator also will be evaluated per the pathologist. (http://www3.mdanderson.org/app/medcalc/index.cfm?pagename=jsconvert3)

Secondary Outcome Measures

Expansion Phase: Radiologic tumor response rate after 6 weeks
Radiologic tumor response rate measured by MRI
Expansion Phase: Radiologic tumor response rate at completion of therapy
Radiologic tumor response rate measured by MRI
Expansion Phase: Immunogenicity
Immunogenicity: will be characterized by quantifying CD4TH1 response via ELISPot. ELISPot is an enzyme-linked immunospot assay. It is a highly sensitive immunoassay that measures the frequency of cytokine-secreting cells at the single-cell level.
Recurrence Free Survival
Recurrence free survival defined as the length of time after treatment that patient survives without any signs or symptoms of cancer.

Full Information

First Posted
March 30, 2022
Last Updated
October 17, 2023
Sponsor
H. Lee Moffitt Cancer Center and Research Institute
Collaborators
ImmunoRestoration
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1. Study Identification

Unique Protocol Identification Number
NCT05325632
Brief Title
Study of HER2 Directed Dendritic Cell (DC1) Vaccine + Weekly Paclitaxel, Trastuzumab & Pertuzumab
Official Title
A Phase II Study of Human Epidermal Growth Factor Receptor 2 (HER-2) Directed Dendritic Cell (DC1) Vaccine Plus Weekly Paclitaxel, Trastuzumab and Pertuzumab in Patients With HER-2 Positive Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 28, 2021 (Actual)
Primary Completion Date
October 27, 2024 (Anticipated)
Study Completion Date
October 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
H. Lee Moffitt Cancer Center and Research Institute
Collaborators
ImmunoRestoration

4. Oversight

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

5. Study Description

Brief Summary
The purpose of the study is to find out if an investigational drug called Dendritic Cell (DC1) vaccine added to standard neoadjuvant (given before main treatment) therapy can help people with HER2 (human epidermal growth factor receptor 2) positive breast cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HER2-positive Breast Cancer
Keywords
Breast Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
53 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Lead In - Dose level 1
Arm Type
Experimental
Arm Description
Six participants will be treated at dose level 1: DC vaccine given at the dose of 50 million once per week for 6 weeks
Arm Title
Lead In: Dose Level 2
Arm Type
Experimental
Arm Description
Six participants will be treated at dose level 2: DC vaccine given at the dose of 100 million once per week for 6 weeks
Arm Title
Expansion -Estrogen Receptor (ER) positive
Arm Type
Experimental
Arm Description
An additional 24 participants will be enrolled at dose level 2 if determined to be safe in lead in phase to have a total of 28 evaluable participants for pathologic response assessment (including 6 pts from the lead in phase).
Arm Title
Expansion -Estrogen Receptor (ER) negative
Arm Type
Experimental
Arm Description
An additional 23 participants will be enrolled at dose level 2 if determined to be safe in lead in phase to have a total of 28 evaluable participants for pathologic response assessment (including 6 pts from the lead in phase).
Intervention Type
Biological
Intervention Name(s)
HER-2 pulsed DC1
Intervention Description
Vaccine will be administered weekly for 6 weeks. Boosters will be given at months 6, 9 and 12.
Intervention Type
Drug
Intervention Name(s)
Trastuzumab
Other Intervention Name(s)
Herceptin
Intervention Description
8mg/kg IV Trastuzumab will be given week 1, followed by 6 mg/kg on subsequent cycles every 3 weeks
Intervention Type
Drug
Intervention Name(s)
Pertuzumab
Other Intervention Name(s)
Perjeta
Intervention Description
840 mg IV Pertuzumab will be given week 1, followed by 420 mg on subsequent cycles every 3 weeks.
Intervention Type
Drug
Intervention Name(s)
Paclitaxel
Other Intervention Name(s)
Abraxane
Intervention Description
80 mg/m^2 IV paclitaxel will be given weekly weeks 7-18
Intervention Type
Procedure
Intervention Name(s)
Resection surgery
Intervention Description
After week 18, participants will undergo standard of care resection surgery.
Primary Outcome Measure Information:
Title
Lead in Phase: Immunogenicity of each dose level
Description
Immunogenicity: will be characterized by quantifying CD4TH1 response via ELISPot. ELISPot is an enzyme-linked immunospot assay. It is a highly sensitive immunoassay that measures the frequency of cytokine-secreting cells at the single-cell level.
Time Frame
at 4 weeks
Title
Expansion Phase: Pathologic Complete Response Rate
Description
Pathologic complete response rate of participants treated in the Expansion Phase. Clinical efficacy will be defined by the pathologic complete response (pCR) rate, the percentage of patients who achieve pCR based on surgical pathology assessment. Pathologic Complete Response defined as no residual invasive disease in the breast and nodes (ypT0/is N0) at definitive surgery after completion of protocol therapy. The pathologic response to treatment will be assessed by the pathologist. The "Residual Cancer Burden" (RCB) for each patient as described in the online calculator also will be evaluated per the pathologist. (http://www3.mdanderson.org/app/medcalc/index.cfm?pagename=jsconvert3)
Time Frame
at 12 months
Secondary Outcome Measure Information:
Title
Expansion Phase: Radiologic tumor response rate after 6 weeks
Description
Radiologic tumor response rate measured by MRI
Time Frame
at 6 weeks
Title
Expansion Phase: Radiologic tumor response rate at completion of therapy
Description
Radiologic tumor response rate measured by MRI
Time Frame
at 12 months
Title
Expansion Phase: Immunogenicity
Description
Immunogenicity: will be characterized by quantifying CD4TH1 response via ELISPot. ELISPot is an enzyme-linked immunospot assay. It is a highly sensitive immunoassay that measures the frequency of cytokine-secreting cells at the single-cell level.
Time Frame
at 12 months
Title
Recurrence Free Survival
Description
Recurrence free survival defined as the length of time after treatment that patient survives without any signs or symptoms of cancer.
Time Frame
up to 3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants must have histologically confirmed clinical stage I- III, HER2+ (per ASCO/CAP criteria) invasive carcinoma of the breast. Primary tumor should measure at least 1 cm by clinical exam or radiologic tests Candidate for neoadjuvant chemotherapy with Paclitaxel, Trastuzumab, Pertuzumab regimen followed by standard of care local therapy as determined by the treating physician Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 Participants must have normal organ and marrow function as defined per protocol. Cardiac ejection fraction within institutional normal limits by either Multigated Acquisition Scan (MUGA) or Echocardiogram at baseline. Women of child-bearing potential and their male partners must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. Sexually active male participants should use a barrier method or exercise abstinence during chemotherapy administration until surgery. Ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: Participants with inflammatory breast cancer, widespread locally advanced unresectable disease involving the chest wall/nodal basins in which a curative surgical resection cannot be performed, or those in whom de novo metastatic disease is suspected or confirmed. Patients may not be receiving any other investigational agents for the treatment of their breast cancer. History of allergic reactions attributed to compounds of similar chemical or biologic composition to the study vaccine components and any of the chemotherapy drugs (paclitaxel, trastuzumab, pertuzumab). Participants who are unwilling or unable to undergo an apheresis for production of their vaccine. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. Pregnant women and women who are breastfeeding. Participants with known congenital or acquired immune deficiency (including those patients who require systemic immunosuppressant drugs for autoimmune disease or organ transplant).
Facility Information:
Facility Name
Moffitt Cancer Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jennifer Childress
Phone
813-745-8000
Email
Jennifer.Childress@moffitt.org
First Name & Middle Initial & Last Name & Degree
Hyo Han, MD
First Name & Middle Initial & Last Name & Degree
Avan Armaghani, MD
First Name & Middle Initial & Last Name & Degree
Ricardo Costa, MD, MSc
First Name & Middle Initial & Last Name & Degree
Brian Czerniecki, MD, PhD
First Name & Middle Initial & Last Name & Degree
Martine Extermann, MD, PhD
First Name & Middle Initial & Last Name & Degree
Hung Khong, MD
First Name & Middle Initial & Last Name & Degree
Kimberley Lee, MD, MHS
First Name & Middle Initial & Last Name & Degree
Loretta Loftus, MD, MBA
First Name & Middle Initial & Last Name & Degree
Christine Sam, MD
First Name & Middle Initial & Last Name & Degree
Hatem Soliman, MD
First Name & Middle Initial & Last Name & Degree
Aixa Soyano Muller, MD

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Links:
URL
https://www.moffitt.org/clinical-trials-research/clinical-trials/
Description
Moffitt Cancer Center Clinical Trials website

Learn more about this trial

Study of HER2 Directed Dendritic Cell (DC1) Vaccine + Weekly Paclitaxel, Trastuzumab & Pertuzumab

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