DecipHER Trial - DC1 Tx for Early-Stage TNBC and ER Low Positive Breast Cancer (DecipHER)
Primary Purpose
Triple Negative Breast Cancer, HER2-negative Breast Cancer
Status
Suspended
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
HER2 - primed Dendritic cells
HER3 - primed Dendritic cells
Sponsored by
About this trial
This is an interventional treatment trial for Triple Negative Breast Cancer focused on measuring Breast Cancer
Eligibility Criteria
Inclusion Criteria:
- A diagnosis of HER2-negative breast cancer.
- Diagnosis of HR negative or HR low positive tumor.
- Clinical stage T1c, nodal stage N1-N2 or stage T2-4, nodal stage N0-N2 breast cancer.
- Participant must be medically and surgically appropriate to undergo neoadjuvant chemotherapy regimen followed by standard of care local therapy as determined by their treating physician.
- Age ≥18 years.
- ECOG performance status 0 or 1.
- Patients must have normal organ and marrow function, as defined below, within 14 days of registration:
- *Absolute neutrophil count (ANC) ≥ 1500/μL
- *Platelets ≥ 75 000/μL
- *Total bilirubin ≤ 1.5 x institutional ULN, except patients with Gilbert's syndrome in whom total bilirubin must be < 3.0 mg/dL
- *AST/ALT ≤ 3 x institutional ULN
- *Creatinine ≤ 1.5 x institutional ULN
- Left ventricular ejection fraction above institutional lower limit of normal (by echocardiogram or MUGA scan).
- Female patients of childbearing potential must agree to use dual methods of contraception and have a negative serum pregnancy test at screening. Acceptable methods of contraception are condoms with contraceptive foam, oral, implantable or injectable contraceptives, contraceptive patch, intrauterine device, diaphragm with spermicidal gel, or a sexual partner who is surgically sterilized or post-menopausal. Effective methods of contraception must be used throughout the study and for 5 months following the last dose. To show that women do not have childbearing potential, postmenopausal women must be amenorrheic for at least 12 months naturally (and not because of/following chemotherapy) or patients must be surgically sterile.
- Ability to understand and the willingness to sign a written informed consent agreement prior to study registration.
Exclusion Criteria:
- Patients who received prior anthracycline-based chemotherapy for the treatment of any cancer.
- Patients with inflammatory breast cancer.
- Patients must not be receiving any other investigational agents or active antineoplastic therapies.
- 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.
- Patients with active autoimmune disease or history of autoimmune disease that might recur, which may affect vital organ function or require immune-suppressive treatment, including chronic prolonged systemic corticosteroid use (defined as corticosteroid use lasting one month or more).
- Female patients who are pregnant or nursing.
- No other prior malignancy is allowed, except for the following: a. adequately treated basal-cell or squamous-cell skin cancer, b. in situ cervical cancer, c. or any other cancer from which the patient has been disease free for at least 3 years.
- History of testing positive for human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS).
- History of positive test for Hepatitis B or Hepatitis C virus indicating acute or chronic infection.
- Patients who have received a live attenuated vaccine ≤ 30 days prior to registration.
- Unable to comply with the treatment schedule and study procedures for any reason.
- Previously treated with breast cancer-directed vaccine therapies in prior 3 months.
- Previously treated with any form HER2- or HER3-primed DC1 therapy.
Sites / Locations
- Moffitt Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Dendritic Cell Vaccine dose Escalation
Arm Description
Dose escalation to determine the maximum tolerated dose (MTD) of HER2- and HER3- primed DC1 study vaccines. Participants will be treated in cohorts of size three to six and the dosage will be escalated if the clinical toxicity is acceptable. A total of 3 dose levels will be used.
Outcomes
Primary Outcome Measures
Maximum Tolerated Dose (MTD)
Maximum Tolerated Dose (MTD) of HER2- and HER3- primed DC1 study vaccines. The MTD will be defined as the highest dose level at which < 2 of 6 patients experience dose-limiting toxicities (DLTs).
Secondary Outcome Measures
Number of Dose Limiting Toxicities
Number of DLTs experienced by participants
Participants with pathological complete response after receiving HER2/HER3 DC1 intratumoral injections
Pathological complete response defined as the absence of invasive breast cancer in the breast and lymph nodes after completion of treatment with DC1 injections and neoadjuvant chemotherapy.
Participants with clinical and radiological responses after receiving HER2/HER3 DC1
Clinical or radiological complete responses (CR): Palpable or visible lesion(s) identified at baseline are no longer palpable and there are no new lesion(s) or other signs of disease progression.
Participants with clinical and radiological partial responses after receiving HER2/HER3 DC1
Clinical or radiological partial responses (PR): A reduction in the product of the two largest perpendicular diameters of the primary tumor by 50% or more.
Participants with clinical and radiological progression of disease after receiving HER2/HER3 DC1
Clinical or radiological progression of disease (PD): An increase in the product of the two largest perpendicular diameters of the primary tumor by 25% or more or the presence of a new lesion.
Participants with clinical and radiological stable disease after receiving HER2/HER3 DC1
Clinical or radiological stable disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD.
Participants with Recurrence Free Survival (RFS)
Recurrence free survival (RFS) defined as time I months to breast cancer recurrence or death (whichever comes first) since date of surgical treatment of breast cancer.
Full Information
NCT ID
NCT05504707
First Posted
August 15, 2022
Last Updated
September 22, 2023
Sponsor
H. Lee Moffitt Cancer Center and Research Institute
Collaborators
The Shulas' Foundation
1. Study Identification
Unique Protocol Identification Number
NCT05504707
Brief Title
DecipHER Trial - DC1 Tx for Early-Stage TNBC and ER Low Positive Breast Cancer
Acronym
DecipHER
Official Title
Phase 1 Dose-Escalation, Dose-Expansion Trial of Intratumoral HER2- and HER3-Primed Dendritic Cells Injections for the Treatment of Early-Stage TNBC and ER Low Positive Breast Cancer (DecipHER)
Study Type
Interventional
2. Study Status
Record Verification Date
June 2023
Overall Recruitment Status
Suspended
Why Stopped
Reagent supply shortage
Study Start Date
August 26, 2022 (Actual)
Primary Completion Date
April 2024 (Anticipated)
Study Completion Date
April 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
H. Lee Moffitt Cancer Center and Research Institute
Collaborators
The Shulas' Foundation
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 vaccine called Dendritic Cell (DC) vaccine given together with standard of care chemotherapy drugs can help people with Triple Negative and HR low positive breast cancer.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Triple Negative Breast Cancer, HER2-negative Breast Cancer
Keywords
Breast Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Dendritic Cell Vaccine dose Escalation
Arm Type
Experimental
Arm Description
Dose escalation to determine the maximum tolerated dose (MTD) of HER2- and HER3- primed DC1 study vaccines. Participants will be treated in cohorts of size three to six and the dosage will be escalated if the clinical toxicity is acceptable. A total of 3 dose levels will be used.
Intervention Type
Biological
Intervention Name(s)
HER2 - primed Dendritic cells
Intervention Description
Dendritic cell will be administered at ultra-sound guided injections. Participants will receive 8 intratumoral injections. These injections will be administered twice per week per week (given 3 days apart). Participants will receive alternating injections (3 days apart) of HER2-primed followed by HER3-primed DCs.
Participants will be treated at the following dose levels:
Dose level 1: HER2 - primed Dendritic cells dose 10-20 million Dose level 2: HER2 - primed Dendritic cells dose 30-50 million Dose level 3: HER2 - primed Dendritic cells dose 80-100 million
Intervention Type
Biological
Intervention Name(s)
HER3 - primed Dendritic cells
Intervention Description
Dendritic cell will be administered at ultra-sound guided injections. Participants will receive 8 intratumoral injections. These injections will be administered twice per week per week (given 3 days apart). Participants will receive alternating injections (3 days apart) of HER2-primed followed by HER3-primed DCs.
Participants will be treated at the following dose levels:
Dose level 1: HER3 - primed Dendritic cells dose 10-20 million Dose level 2: HER3 - primed Dendritic cells dose 30-50 million Dose level 3: HER3 - primed Dendritic cells dose 80-100 million
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD)
Description
Maximum Tolerated Dose (MTD) of HER2- and HER3- primed DC1 study vaccines. The MTD will be defined as the highest dose level at which < 2 of 6 patients experience dose-limiting toxicities (DLTs).
Time Frame
4 weeks after start of treatment
Secondary Outcome Measure Information:
Title
Number of Dose Limiting Toxicities
Description
Number of DLTs experienced by participants
Time Frame
5 weeks after start of treatment
Title
Participants with pathological complete response after receiving HER2/HER3 DC1 intratumoral injections
Description
Pathological complete response defined as the absence of invasive breast cancer in the breast and lymph nodes after completion of treatment with DC1 injections and neoadjuvant chemotherapy.
Time Frame
Up to 24 weeks
Title
Participants with clinical and radiological responses after receiving HER2/HER3 DC1
Description
Clinical or radiological complete responses (CR): Palpable or visible lesion(s) identified at baseline are no longer palpable and there are no new lesion(s) or other signs of disease progression.
Time Frame
Up to 36 Months
Title
Participants with clinical and radiological partial responses after receiving HER2/HER3 DC1
Description
Clinical or radiological partial responses (PR): A reduction in the product of the two largest perpendicular diameters of the primary tumor by 50% or more.
Time Frame
Up to 36 Months
Title
Participants with clinical and radiological progression of disease after receiving HER2/HER3 DC1
Description
Clinical or radiological progression of disease (PD): An increase in the product of the two largest perpendicular diameters of the primary tumor by 25% or more or the presence of a new lesion.
Time Frame
Up to 36 Months
Title
Participants with clinical and radiological stable disease after receiving HER2/HER3 DC1
Description
Clinical or radiological stable disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD.
Time Frame
Up to 36 Months
Title
Participants with Recurrence Free Survival (RFS)
Description
Recurrence free survival (RFS) defined as time I months to breast cancer recurrence or death (whichever comes first) since date of surgical treatment of breast cancer.
Time Frame
Up to 36 Months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
A diagnosis of HER2-negative breast cancer.
Diagnosis of HR negative or HR low positive tumor.
Clinical stage T1c, nodal stage N1-N2 or stage T2-4, nodal stage N0-N2 breast cancer.
Participant must be medically and surgically appropriate to undergo neoadjuvant chemotherapy regimen followed by standard of care local therapy as determined by their treating physician.
Age ≥18 years.
ECOG performance status 0 or 1.
Patients must have normal organ and marrow function, as defined below, within 14 days of registration:
*Absolute neutrophil count (ANC) ≥ 1500/μL
*Platelets ≥ 75 000/μL
*Total bilirubin ≤ 1.5 x institutional ULN, except patients with Gilbert's syndrome in whom total bilirubin must be < 3.0 mg/dL
*AST/ALT ≤ 3 x institutional ULN
*Creatinine ≤ 1.5 x institutional ULN
Left ventricular ejection fraction above institutional lower limit of normal (by echocardiogram or MUGA scan).
Female patients of childbearing potential must agree to use dual methods of contraception and have a negative serum pregnancy test at screening. Acceptable methods of contraception are condoms with contraceptive foam, oral, implantable or injectable contraceptives, contraceptive patch, intrauterine device, diaphragm with spermicidal gel, or a sexual partner who is surgically sterilized or post-menopausal. Effective methods of contraception must be used throughout the study and for 5 months following the last dose. To show that women do not have childbearing potential, postmenopausal women must be amenorrheic for at least 12 months naturally (and not because of/following chemotherapy) or patients must be surgically sterile.
Ability to understand and the willingness to sign a written informed consent agreement prior to study registration.
Exclusion Criteria:
Patients who received prior anthracycline-based chemotherapy for the treatment of any cancer.
Patients with inflammatory breast cancer.
Patients must not be receiving any other investigational agents or active antineoplastic therapies.
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.
Patients with active autoimmune disease or history of autoimmune disease that might recur, which may affect vital organ function or require immune-suppressive treatment, including chronic prolonged systemic corticosteroid use (defined as corticosteroid use lasting one month or more).
Female patients who are pregnant or nursing.
No other prior malignancy is allowed, except for the following: a. adequately treated basal-cell or squamous-cell skin cancer, b. in situ cervical cancer, c. or any other cancer from which the patient has been disease free for at least 3 years.
History of testing positive for human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS).
History of positive test for Hepatitis B or Hepatitis C virus indicating acute or chronic infection.
Patients who have received a live attenuated vaccine ≤ 30 days prior to registration.
Unable to comply with the treatment schedule and study procedures for any reason.
Previously treated with breast cancer-directed vaccine therapies in prior 3 months.
Previously treated with any form HER2- or HER3-primed DC1 therapy.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ricardo Costa, MD
Organizational Affiliation
Moffitt Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Moffitt Cancer Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Links:
URL
https://moffitt.org/clinical-trials-research/clinical-trials/?gclid=EAIaIQobChMImIymzIa-9gIVAZ2GCh3uzAWJEAAYASAAEgI0ovD_BwE
Description
Moffitt Clinical Trial Search
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DecipHER Trial - DC1 Tx for Early-Stage TNBC and ER Low Positive Breast Cancer
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