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PRE-I-SPY Phase I/Ib Oncology Platform Program (PRE-I-SPY-PI)

Primary Purpose

HER2-positive Breast Cancer, Metastatic Cancer, Metastatic Breast Cancer

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
ALX148
Fam-Trastuzumab Deruxtecan-Nxki
Sponsored by
QuantumLeap Healthcare Collaborative
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HER2-positive Breast Cancer focused on measuring I-SPY Trials, Quantum Leap Healthcare Collaborative, QLHC, I-SPY, I-SPY2, I-SPY1, PRE-ISPY, PRE-I-SPY, I-SPY Phase 1, I-SPY Phase 1b, I-SPY-P1, ISPY, ISPYP1, I-SPY Phase 1 Platform, ISPY2, ISPY1, Phase 1 Platform, Phase 1 Oncology Platform

Eligibility Criteria

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

General Inclusion Criteria (GIC): GIC1: The participant must have ability to understand and willingness to provide signed written informed consent prior to any study related assessments and procedures and for collection of archival FFPE blocks (freshly cut 14 unstained tumor slides would be acceptable). GIC2: Age ≥ 18 years at the time of signing the informed consent GIC3: Gender: Male or female (premenopausal and postmenopausal) GIC4: ECOG performance status Grade 0-2 GIC5: Estimated life expectancy > 12 weeks at the start of investigational medicinal product (IMP) treatment. GIC6: Adequate organ function, evidenced by the following laboratory results within 30 days of the start of IMP: Absolute neutrophil count ≥ 1,500/mm3 Platelet count ≥ 100,000/mm3 Hemoglobin ≥ 9.0 g/dL with no blood transfusion in the past 28 days Total bilirubin ≤ 1.5 x the upper limit of normal (ULN) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3.0 x ULN Serum creatinine within normal institutional limits or estimated creatinine clearance ≥ 50 mL/min/1.73 m2 for patients with serum creatinine levels above institutional ULN. GIC7: Non-Pregnant: Serum or urine pregnancy test must be negative within 14 days of IMP treatment start in women of childbearing potential. Pregnancy testing does not need to be pursued in patients who are judged as postmenopausal before enrollment, or who have undergone bilateral oophorectomy, total hysterectomy, or bilateral tubal ligation. If male, they must agree to refrain from donating sperm during treatment. GIC8: Contraception: Women of childbearing potential and men must be willing to use adequate contraception for the duration of protocol treatment. Additional information regarding contraception for the specific treatment arm will be added to the drug arm description. Adequate contraception is defined as one highly effective form (i.e., abstinence, (fe)male sterilization) OR two effective forms (e.g., non-hormonal IUD and condom / occlusive cap with spermicidal foam / gel / film / cream / suppository). GIC9: Prior therapy effects: Resolution of all acute toxic effects of prior therapy, including radiotherapy and surgery, to grade ≤1 and neuropathy to grade ≤2 (except toxicities not considered a safety risk for the patient). GIC10: Participant compliance: Patients who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures. GIC11: Full COVID-19 vaccination (verified by COVID vaccine card or medical record): will be required per published CDC guidelines on the day of consent. Additional arm specific inclusion criteria as needed by drug arm regimen General Exclusion Criteria (GEC): GEC1: Wash out periods: No other anticancer therapy within the following periods: chemotherapy 3 weeks investigational agents, 3 weeks or 5x drug elimination half-lives, whichever is greater mitomycin C and nitrosoureas, 6 weeks radiotherapy, 3 weeks targeted therapy and endocrine therapy, 2 weeks MAbs, ADCs, and immunotherapy, 3 weeks endocrine therapy, no washout needed GEC2: Concurrent therapy with other Investigational Products. GEC3: Prior history of drug/regimen hypersensitivity: History of infusion-related reactions and/or hypersensitivity to IMP or excipients of the study drug/drugs which led to permanent discontinuation of the treatment. Prior mild infusion-related reactions that did not lead to drug discontinuation are allowed. GEC4: Currently uncontrolled intercurrent illness including (active infection, diabetes, hypertension, pulmonary embolism, or psychiatric illness/social situations that would limit compliance with study requirements). GEC5: Cardiovascular disease: History (within 6 months prior to start IMP) of clinically significant cardiovascular disease such as unstable angina, congestive heart failure (CHF), myocardial infarction, cardiac arrhythmia requiring IV medication, or baseline corrected QT by Fridericia's formula (QTcF) length ≥ 450 ms for men and ≥ 470 ms for women. GEC6: CNS tumoral spread: Active uncontrolled/symptomatic central nervous system cancer/spinal cord compression. Previously treated and clinically stable lesions, as per Investigator's judgment, are permitted. GEC7: Liver disease: Patients with clinically significant history of liver disease, including viral or other known hepatitis, current alcohol abuse, or cirrhosis. GEC8: Recent major surgery within 4 weeks prior to start IMP treatment GEC9: Pregnancy or breastfeeding GEC10: Individuals accommodated in an institution because of regulatory or legal order; prisoners or participants who are legally institutionalized. GEC11: Other conditions, which in the opinion of the investigator, would compromise the safety of the patient or the patient's ability to complete the study. Additional arm specific exclusion criteria as needed by drug arm regimen

Sites / Locations

  • The University of Chicago Medicine Comprehensive Cancer CenterRecruiting
  • University of Minnesota Masonic Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

PRE1 ALX148 (Evorpacept) + Fam-Trastuzumab Deruxtecan-Nxki (T-DXd, Enhertu®)

Arm Description

The combination of T-DXd and ALX148 aims to explore the anti-tumoral effects of trastuzumab, of the topoisomerase inhibitor DXd and of the CD47-blocking agent ALX148. The rationale for this combination is that ALX148 is hypothesized, based on preclinical data, to facilitate antibody-dependent cellular phagocytosis of HER2 expressing (>HER2 1+) breast cancer binding T-DXd while cancer cell intrinsic or bystander cytotoxicity of T-DXd will result in the release of neoantigens promoting immune mediated antitumor activity in the tumor microenvironment.

Outcomes

Primary Outcome Measures

Incidence of Adverse Events related to the treatment
Evaluate the number of adverse events related to the treatment according to the current version of CTCAE during the trial.
Incidence of Dose Limiting Toxicities (DLTs) at each dose level
To determine the safety and tolerability of new agents/regimens in participants with certain advanced solid tumors and breast cancer. DLT rate (number of participants who experience a protocol defined DLT/total number of DLT cohort participants at that dose).
Maximum Tolerated Dose (MTD)
The maximum dose level (mg/kg) which is not eliminated.
Recommended Phase 2 Dose (RP2D)
Using all available data, computation of RP2D (mg/kg), which may not be the MTD.
Overall Response Rate (ORR)
To obtain preliminary efficacy data of the new agents/regimens in participants with certain advanced solid tumors and breast cancer.
Duration of Response (DOR)
To obtain preliminary efficacy data of the new agents/regimens in participants with certain advanced solid tumors and breast cancer.

Secondary Outcome Measures

Progression Free Survival (PFS) - descriptive
To provide descriptive assessment of Progression Free Survival (PFS) of the new agents/regimens with certain advanced solid tumors and breast cancer
Clinical Benefit Rate (CBR) at 6 months
To obtain preliminary Clinical Benefit Rate (CBR) at 6 months of participants treated with the new agents/regimens.

Full Information

First Posted
April 22, 2022
Last Updated
June 8, 2023
Sponsor
QuantumLeap Healthcare Collaborative
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1. Study Identification

Unique Protocol Identification Number
NCT05868226
Brief Title
PRE-I-SPY Phase I/Ib Oncology Platform Program
Acronym
PRE-I-SPY-PI
Official Title
PRE-Investigation of Serial Studies to Predict Your Therapeutic Response With Imaging And moLecular Analysis: A Phase I/Ib Platform Trial
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 22, 2022 (Actual)
Primary Completion Date
December 30, 2026 (Anticipated)
Study Completion Date
December 30, 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
QuantumLeap Healthcare Collaborative

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
I-SPY Phase I/Ib (I-SPY-P1) is an open-label, multisite platform study designed to evaluate single agents or combinations in a metastatic treatment setting that may be relevant for breast cancer patients with the overall goal of moving promising drug regimens into the I-SPY 2 SMART Design Trial (NCT01042379) and/or other oncology-based trials in a timely manner.
Detailed Description
The PRE-I-SPY/I-SPY-P1 study is a platform trial with multiple ongoing drug regimen arms. In most cases, the treatment arm will have a dose-finding group (Part 1) and a dose-expansion group (Part 2). Eligibility criteria will vary according to the experimental regimen. Participant eligibility may vary according to the arm or the part within the study arm, including with respect to diagnosis. Arms could include participants diagnosed with certain solid tumors or specifically with breast cancer. Arms may restrict enrollment to a certain molecular pathway abnormality or histologic diagnosis. The trial allows for various study arm designs, with the goal to complete analysis of a study arm in 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HER2-positive Breast Cancer, Metastatic Cancer, Metastatic Breast Cancer, Metastatic, HER2-positive Metastatic Breast Cancer, HER2 Mutation-Related Tumors, HER-2 Protein Overexpression, HER2-negative Breast Cancer, Triple Negative Breast Cancer, HR Positive, Hormone Receptor-positive Breast Cancer, Estrogen Receptor Positive Tumor, Progesterone Receptor-positive Breast Cancer, Hormone Receptor Negative Breast Carcinoma, Solid Tumor, Solid Tumor, Adult, Solid Carcinoma, HER2 Low Breast Cancer
Keywords
I-SPY Trials, Quantum Leap Healthcare Collaborative, QLHC, I-SPY, I-SPY2, I-SPY1, PRE-ISPY, PRE-I-SPY, I-SPY Phase 1, I-SPY Phase 1b, I-SPY-P1, ISPY, ISPYP1, I-SPY Phase 1 Platform, ISPY2, ISPY1, Phase 1 Platform, Phase 1 Oncology Platform

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
This is an open-label, multi-site, multi-arm platform study, where each drug regimen arm may have different study designs and eligibility. In particular, dose finding parts may employ different designs (e.g., 3+3, Bayesian Optimal Interval Design [BOIN], continual reassessment method [CRM], etc.) for each arm in the PRE-I-SPY program. See each arm for specific study model details.
Masking
None (Open Label)
Allocation
N/A
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
PRE1 ALX148 (Evorpacept) + Fam-Trastuzumab Deruxtecan-Nxki (T-DXd, Enhertu®)
Arm Type
Experimental
Arm Description
The combination of T-DXd and ALX148 aims to explore the anti-tumoral effects of trastuzumab, of the topoisomerase inhibitor DXd and of the CD47-blocking agent ALX148. The rationale for this combination is that ALX148 is hypothesized, based on preclinical data, to facilitate antibody-dependent cellular phagocytosis of HER2 expressing (>HER2 1+) breast cancer binding T-DXd while cancer cell intrinsic or bystander cytotoxicity of T-DXd will result in the release of neoantigens promoting immune mediated antitumor activity in the tumor microenvironment.
Intervention Type
Drug
Intervention Name(s)
ALX148
Other Intervention Name(s)
Evorpacept
Intervention Description
CD47 Inhibitor: A fusion protein containing a high affinity engineered D1 domain of human signal regulatory protein alpha (SIRPα) variant 1 (v1) genetically linked to a modified and inactive Fc domain of human immunoglobulin (Ig) G1.
Intervention Type
Drug
Intervention Name(s)
Fam-Trastuzumab Deruxtecan-Nxki
Other Intervention Name(s)
Enhertu, T-DXd
Intervention Description
Antibody-drug conjugate (ADC): Recombinant humanized anti-human HER2 IgG1 monoclonal antibody, conjugated with linker to a Topoisomerase I inhibitor
Primary Outcome Measure Information:
Title
Incidence of Adverse Events related to the treatment
Description
Evaluate the number of adverse events related to the treatment according to the current version of CTCAE during the trial.
Time Frame
Start of treatment to 30 days post treatment (estimated 12 -18 months)
Title
Incidence of Dose Limiting Toxicities (DLTs) at each dose level
Description
To determine the safety and tolerability of new agents/regimens in participants with certain advanced solid tumors and breast cancer. DLT rate (number of participants who experience a protocol defined DLT/total number of DLT cohort participants at that dose).
Time Frame
DLT observation period: Start of treatment to 21 days (Cycle 1)
Title
Maximum Tolerated Dose (MTD)
Description
The maximum dose level (mg/kg) which is not eliminated.
Time Frame
Start of treatment to the date of last participant at end of DLT observation period at highest dose level (estimated 6 months)
Title
Recommended Phase 2 Dose (RP2D)
Description
Using all available data, computation of RP2D (mg/kg), which may not be the MTD.
Time Frame
Start of treatment to the date of last participant at highest dose level (estimated 6 months)
Title
Overall Response Rate (ORR)
Description
To obtain preliminary efficacy data of the new agents/regimens in participants with certain advanced solid tumors and breast cancer.
Time Frame
Start of treatment to 12 months
Title
Duration of Response (DOR)
Description
To obtain preliminary efficacy data of the new agents/regimens in participants with certain advanced solid tumors and breast cancer.
Time Frame
Start of treatment to 12 months
Secondary Outcome Measure Information:
Title
Progression Free Survival (PFS) - descriptive
Description
To provide descriptive assessment of Progression Free Survival (PFS) of the new agents/regimens with certain advanced solid tumors and breast cancer
Time Frame
Start of treatment to 12 months
Title
Clinical Benefit Rate (CBR) at 6 months
Description
To obtain preliminary Clinical Benefit Rate (CBR) at 6 months of participants treated with the new agents/regimens.
Time Frame
Start of treatment to 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
General Inclusion Criteria (GIC): GIC1: The participant must have ability to understand and willingness to provide signed written informed consent prior to any study related assessments and procedures and for collection of archival FFPE blocks (freshly cut 14 unstained tumor slides would be acceptable). GIC2: Age ≥ 18 years at the time of signing the informed consent GIC3: Gender: Male or female (premenopausal and postmenopausal) GIC4: ECOG performance status Grade 0-2 GIC5: Estimated life expectancy > 12 weeks at the start of investigational medicinal product (IMP) treatment. GIC6: Adequate organ function, evidenced by the following laboratory results within 30 days of the start of IMP: Absolute neutrophil count ≥ 1,500/mm3 Platelet count ≥ 100,000/mm3 Hemoglobin ≥ 9.0 g/dL with no blood transfusion in the past 28 days Total bilirubin ≤ 1.5 x the upper limit of normal (ULN) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3.0 x ULN Serum creatinine within normal institutional limits or estimated creatinine clearance ≥ 50 mL/min/1.73 m2 for patients with serum creatinine levels above institutional ULN. GIC7: Non-Pregnant: Serum or urine pregnancy test must be negative within 14 days of IMP treatment start in women of childbearing potential. Pregnancy testing does not need to be pursued in patients who are judged as postmenopausal before enrollment, or who have undergone bilateral oophorectomy, total hysterectomy, or bilateral tubal ligation. If male, they must agree to refrain from donating sperm during treatment. GIC8: Contraception: Women of childbearing potential and men must be willing to use adequate contraception for the duration of protocol treatment. Additional information regarding contraception for the specific treatment arm will be added to the drug arm description. Adequate contraception is defined as one highly effective form (i.e., abstinence, (fe)male sterilization) OR two effective forms (e.g., non-hormonal IUD and condom / occlusive cap with spermicidal foam / gel / film / cream / suppository). GIC9: Prior therapy effects: Resolution of all acute toxic effects of prior therapy, including radiotherapy and surgery, to grade ≤1 and neuropathy to grade ≤2 (except toxicities not considered a safety risk for the patient). GIC10: Participant compliance: Patients who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures. GIC11: Full COVID-19 vaccination (verified by COVID vaccine card or medical record): will be required per published CDC guidelines on the day of consent. Additional arm specific inclusion criteria as needed by drug arm regimen General Exclusion Criteria (GEC): GEC1: Wash out periods: No other anticancer therapy within the following periods: chemotherapy 3 weeks investigational agents, 3 weeks or 5x drug elimination half-lives, whichever is greater mitomycin C and nitrosoureas, 6 weeks radiotherapy, 3 weeks targeted therapy and endocrine therapy, 2 weeks MAbs, ADCs, and immunotherapy, 3 weeks endocrine therapy, no washout needed GEC2: Concurrent therapy with other Investigational Products. GEC3: Prior history of drug/regimen hypersensitivity: History of infusion-related reactions and/or hypersensitivity to IMP or excipients of the study drug/drugs which led to permanent discontinuation of the treatment. Prior mild infusion-related reactions that did not lead to drug discontinuation are allowed. GEC4: Currently uncontrolled intercurrent illness including (active infection, diabetes, hypertension, pulmonary embolism, or psychiatric illness/social situations that would limit compliance with study requirements). GEC5: Cardiovascular disease: History (within 6 months prior to start IMP) of clinically significant cardiovascular disease such as unstable angina, congestive heart failure (CHF), myocardial infarction, cardiac arrhythmia requiring IV medication, or baseline corrected QT by Fridericia's formula (QTcF) length ≥ 450 ms for men and ≥ 470 ms for women. GEC6: CNS tumoral spread: Active uncontrolled/symptomatic central nervous system cancer/spinal cord compression. Previously treated and clinically stable lesions, as per Investigator's judgment, are permitted. GEC7: Liver disease: Patients with clinically significant history of liver disease, including viral or other known hepatitis, current alcohol abuse, or cirrhosis. GEC8: Recent major surgery within 4 weeks prior to start IMP treatment GEC9: Pregnancy or breastfeeding GEC10: Individuals accommodated in an institution because of regulatory or legal order; prisoners or participants who are legally institutionalized. GEC11: Other conditions, which in the opinion of the investigator, would compromise the safety of the patient or the patient's ability to complete the study. Additional arm specific exclusion criteria as needed by drug arm regimen
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Smita M Asare
Phone
(855) 866-0505
Ext
104
Email
smita.asare@quantumleaphealth.org
First Name & Middle Initial & Last Name or Official Title & Degree
Maria Pitsiouni, PhD
Phone
(415) 651-8047
Ext
172
Email
m.pitsiouni@quantumleaphealth.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paula R Pohlmann, MD, MSc, PhD
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
The University of Chicago Medicine Comprehensive Cancer Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Clara Duarte
Email
vqq5698@bsd.uchicago.edu
First Name & Middle Initial & Last Name & Degree
Taylor Embry
Email
tembry1@medicine.bsd.uchicago.edu
First Name & Middle Initial & Last Name & Degree
Nan Chen, MD
First Name & Middle Initial & Last Name & Degree
Rita Nanda, MD
Facility Name
University of Minnesota Masonic Cancer Center
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Katie Vaughn, RN
Email
schro811@umn.edu
First Name & Middle Initial & Last Name & Degree
Jessica Hellmer
Email
jessi013@umn.edu
First Name & Middle Initial & Last Name & Degree
David Potter, MD, PhD
First Name & Middle Initial & Last Name & Degree
Doug Yee, MD

12. IPD Sharing Statement

Learn more about this trial

PRE-I-SPY Phase I/Ib Oncology Platform Program

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