PRE-I-SPY Phase I/Ib Oncology Platform Program (PRE-I-SPY-PI)
HER2-positive Breast Cancer, Metastatic Cancer, Metastatic Breast Cancer
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
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
Experimental
PRE1 ALX148 (Evorpacept) + Fam-Trastuzumab Deruxtecan-Nxki (T-DXd, Enhertu®)
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.