Evaluation of Pharmacodynamic Effects of IT-pIL12-EP in Patients With TNBC (TNBC)
Primary Purpose
ER-Negative PR-Negative HER2-Negative Breast Cancer
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
IT-pIL12-EP
Sponsored by
About this trial
This is an interventional treatment trial for ER-Negative PR-Negative HER2-Negative Breast Cancer focused on measuring TNBC, Triple Negative Breast Cancer
Eligibility Criteria
Inclusion Criteria:
- Patients with histologically confirmed diagnosis of locally-advanced, inoperable, metastatic and/or treatment-refractory triple negative breast cancer (TNBC). *Treatment refractory disease is defined as the persistence of tumor lesions following at least one intervention that may include chemotherapy, radiation and/or surgery, or any combination thereof. *Patients must have both ER and PR staining < 5% and be HER2-negative. Patients with ER or PR staining of 5-10%, but who have historically been treated as TNBC may also be enrolled. *Patients must not have disease that, in the opinion of the investigator, is considered amenable to potentially curative treatment.
- Age ≥ 18 years.
- ECOG Performance Status of 0-1.
- Life expectancy ≥ 6 months.
- Patients may have had radiation therapy, but must have progressive disease after radiation therapy if the lesions to be treated are within the radiation field. Radiation treatment must be completed ≥ 4 weeks prior to Cycle 1 Day 1.
- Adequate hepatic function with total bilirubin and ALT < 1.5X the upper limit of normal (ULN), except in patients with Gilbert's Syndrome must have a total bilirubin < 3X ULN and ALT < 3X ULN. In cases of known liver metastases, ALT ≤ 5X ULN is acceptable (total bilirubin must be < 1.5X ULN).
- Adequate renal function, estimated or calculated creatinine clearance of > 50 mL/min (calculated using the formula of Cockcroft and Gault) -or- serum creatinine ≤ 2.0 mg/dL.
- Adequate hematological function, defined as ANC ≥ 1,500/mm3, Hb ≥ 9.0 g/dL, and platelet count ≥ 100,000/mm3.
- Lesions that are accessible for injection and electroporation, defined as cutaneous or subcutaneous disease.
- At least 2 anatomically distinct lesions accessible for biopsy.
- Must consent to study-specific biopsies at two separate timepoints: pre-treatment (Screening) and post-treatment (Day 28 or EOS).
- Tumor lesions in the CNS are permitted but lesions must have been stable for at least 3 months prior to Cycle 1 Day 1 (C1D1). Stable CNS lesions are defined as not requiring steroid prophylaxis or other medications to prevent seizures or other complications associated with CNS lesions and no evidence of worsening of CNS disease.
- Female patients of childbearing potential must have a negative serum or urine pregnancy test within 3 days prior to C1D1 and agree to use dual methods of contraception during the study and for a minimum of 30 days following the last treatment. Post menopausal females (>45 years old and without menses for > 1 year) and surgically sterilized females are exempt from these requirements.
Male patients must use an effective barrier method of contraception during the study and for a minimum of 30 days following the last treatment if sexually active with a female of childbearing potential.
- Resolution of all treatment-related toxicities, except alopecia, anemia and neuropathy, from any previous cancer therapy to ≤ Grade 1 prior to the first dose of study treatment.
- Ability to provide written informed consent.
Exclusion Criteria:
- Any other current or previous malignancy within the past three years that, in the opinion of the Principal Investigator, will interfere with study-specific objectives.
- Patients with electronic pacemakers or defibrillators.
- Chemotherapy or hormonal therapy for anti-cancer treatment within 28 days prior to Cycle 1 Day 1.
- Immunotherapy or biological therapy (e.g., monoclonal antibodies) within 28 days prior to Cycle 1 Day 1, unless pre-approval is obtained from the Sponsor Medical Monitor.
- Treatment with unapproved investigational therapeutic agent within 28 days prior to Cycle 1 Day 1, unless pre-approval is obtained from the Sponsor Medical Monitor.
- Patients receiving systemic steroid therapy for a chronic inflammatory condition (e.g., rheumatoid arthritis, Crohn's Disease, etc.). Topical steroids are also excluded. Nasal and inhaled steroids are permitted.
Unstable/inadequate cardiac function:
- symptomatic ischemia
- uncontrolled or clinically significant conduction abnormalities; first degree AV block or asymptomatic LAFB/RBBB are eligible
- myocardial infarction in the previous six months
- congestive heart failure (New York Heart Association class III to IV)
- Major surgery within 28 days prior to C1D1.
- Infection requiring parenteral antibiotics, antivirals, or antifungals within 2 weeks prior to C1D1.
- Patients who are known to have HIV infection/seropositivity.
- Active Hepatitis A, B, or C infection or known to be positive for HCV RNA or HBV surface antigen. Patients who have been vaccinated against Hepatitis B and who are positive for ONLY the Hepatitis B surface antibody are permitted to participate in the study.
- Serious psychiatric or medical conditions that could interfere with treatment or protocol-related procedures.
- Patients who are pregnant or lactating.
Sites / Locations
- Stanford University
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
IT-pIL12-EP
Arm Description
intratumoral injection of plasmid-IL12 following immediately by electroporation
Outcomes
Primary Outcome Measures
Changes in the proportion of intratumoral lymphocyte subsets
Paired tumor biopsy samples will be quantitatively analyzed for the number and distribution of tumor infiltrating lymphocytes (TILs).
NanoString-based gene expression
Comparison of NanoString-based gene expression profiles will be completed from paired tumor samples obtained pre- and post-treatment
Secondary Outcome Measures
Number of Participants with Treatment-Related Adverse Events as assessed by the CTCAE v4.0
Patients will be evaluated throughout study participation with physical exams and standard clinical laboratory tests (e.g., hematology, serum chemistry) for the occurrence of adverse events. The incidence and severity of treatment-related adverse events will reported using descriptive statistics.
Anti-tumor activity
Describe evidence of anti-tumor activity
Detection of plasmid IL-12 in untreated lesions
Assessment of plasmid IL-12 expression for biodistribution evaluation
Full Information
NCT ID
NCT02531425
First Posted
August 18, 2015
Last Updated
May 11, 2023
Sponsor
OncoSec Medical Incorporated
1. Study Identification
Unique Protocol Identification Number
NCT02531425
Brief Title
Evaluation of Pharmacodynamic Effects of IT-pIL12-EP in Patients With TNBC
Acronym
TNBC
Official Title
Evaluation of Pharmacodynamic Effects of Intratumoral Delivery of Plasmid IL-12 Electroporation in Patients With Triple Negative Breast Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
May 2023
Overall Recruitment Status
Completed
Study Start Date
September 2015 (undefined)
Primary Completion Date
July 2018 (Actual)
Study Completion Date
July 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
OncoSec Medical Incorporated
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Intratumoral plasmid IL-12 electroporation (IT-pIL12-EP) will be administered to approximately 10 patients with triple negative breast cancer (TNBC) with cutaneous or subcutaneous disease. Patients will receive one complete cycle of therapy, consisting of local injection of plasmid IL-12 (pIL-12) followed immediately by electroporation (EP), into accessible tumor lesions. IT-pIL12-EP will be administered in Days 1, 5, and 8 of the single 28-day cycle.
Detailed Description
This pilot study will evaluate the pharmacodynamic effects of intratumoral injection of pIL-12 followed immediately by electroporation (IT-pIL12-EP). A minimum of ten patients with biopsy-accessible triple negative breast cancer (TNBC) will be treated in this study. Additional patients, up to a maximum of 25 patients, may be enrolled based upon pharmacodynamic observations and at the discretion of the Principal Investigator, in consultation with the Sponsor. All patients will receive a single 28-day treatment cycle. One lesion will remain untreated (the control lesion). Treatment will be administered on Days 1,5, and 8 of the single 28-day cycle. Treatments will consist of direct injection of pIL-12 into tumor lesions, followed immediately by electroporation of the lesions. At the end of the treatment cycle, patients will return to clinic for a final safety evaluation and tumor biopsy. This end of study (EOS) visit will occur prior to initiating any new anti-cancer therapy/regimen.
All patients will undergo tumor biopsies at two separate timepoints for molecular and histological analyses associated with the primary endpoint. At least one lesion will be biopsied at Screening (pre-treatment sample). Biopsies of the untreated control lesion and at least one treated lesion will be obtained at the EOS visit (post-treatment samples). Additional tumor biopsy samples may be requested if there is either tumor regression or progression prior to EOS.
Duration of participation will be approximately 4 weeks for each patient. A patient is considered to have completed the study if all three IT-pIL12-EP treatments (Days 1, 5, & 8) and all required pre- and post-treatment tumor biopsies have been obtained and EOS safety follow-up evaluations have been performed.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
ER-Negative PR-Negative HER2-Negative Breast Cancer
Keywords
TNBC, Triple Negative Breast Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)
8. Arms, Groups, and Interventions
Arm Title
IT-pIL12-EP
Arm Type
Experimental
Arm Description
intratumoral injection of plasmid-IL12 following immediately by electroporation
Intervention Type
Biological
Intervention Name(s)
IT-pIL12-EP
Other Intervention Name(s)
intratumoral plasmid-IL-12 + Electroporation
Intervention Description
Intratumoral pIL-12 injections followed immediately by electroporation into accessible tumor lesions
Primary Outcome Measure Information:
Title
Changes in the proportion of intratumoral lymphocyte subsets
Description
Paired tumor biopsy samples will be quantitatively analyzed for the number and distribution of tumor infiltrating lymphocytes (TILs).
Time Frame
28 days
Title
NanoString-based gene expression
Description
Comparison of NanoString-based gene expression profiles will be completed from paired tumor samples obtained pre- and post-treatment
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Number of Participants with Treatment-Related Adverse Events as assessed by the CTCAE v4.0
Description
Patients will be evaluated throughout study participation with physical exams and standard clinical laboratory tests (e.g., hematology, serum chemistry) for the occurrence of adverse events. The incidence and severity of treatment-related adverse events will reported using descriptive statistics.
Time Frame
28 days
Title
Anti-tumor activity
Description
Describe evidence of anti-tumor activity
Time Frame
28 days
Title
Detection of plasmid IL-12 in untreated lesions
Description
Assessment of plasmid IL-12 expression for biodistribution evaluation
Time Frame
28 days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients with histologically confirmed diagnosis of locally-advanced, inoperable, metastatic and/or treatment-refractory triple negative breast cancer (TNBC). *Treatment refractory disease is defined as the persistence of tumor lesions following at least one intervention that may include chemotherapy, radiation and/or surgery, or any combination thereof. *Patients must have both ER and PR staining < 5% and be HER2-negative. Patients with ER or PR staining of 5-10%, but who have historically been treated as TNBC may also be enrolled. *Patients must not have disease that, in the opinion of the investigator, is considered amenable to potentially curative treatment.
Age ≥ 18 years.
ECOG Performance Status of 0-1.
Life expectancy ≥ 6 months.
Patients may have had radiation therapy, but must have progressive disease after radiation therapy if the lesions to be treated are within the radiation field. Radiation treatment must be completed ≥ 4 weeks prior to Cycle 1 Day 1.
Adequate hepatic function with total bilirubin and ALT < 1.5X the upper limit of normal (ULN), except in patients with Gilbert's Syndrome must have a total bilirubin < 3X ULN and ALT < 3X ULN. In cases of known liver metastases, ALT ≤ 5X ULN is acceptable (total bilirubin must be < 1.5X ULN).
Adequate renal function, estimated or calculated creatinine clearance of > 50 mL/min (calculated using the formula of Cockcroft and Gault) -or- serum creatinine ≤ 2.0 mg/dL.
Adequate hematological function, defined as ANC ≥ 1,500/mm3, Hb ≥ 9.0 g/dL, and platelet count ≥ 100,000/mm3.
Lesions that are accessible for injection and electroporation, defined as cutaneous or subcutaneous disease.
At least 2 anatomically distinct lesions accessible for biopsy.
Must consent to study-specific biopsies at two separate timepoints: pre-treatment (Screening) and post-treatment (Day 28 or EOS).
Tumor lesions in the CNS are permitted but lesions must have been stable for at least 3 months prior to Cycle 1 Day 1 (C1D1). Stable CNS lesions are defined as not requiring steroid prophylaxis or other medications to prevent seizures or other complications associated with CNS lesions and no evidence of worsening of CNS disease.
Female patients of childbearing potential must have a negative serum or urine pregnancy test within 3 days prior to C1D1 and agree to use dual methods of contraception during the study and for a minimum of 30 days following the last treatment. Post menopausal females (>45 years old and without menses for > 1 year) and surgically sterilized females are exempt from these requirements.
Male patients must use an effective barrier method of contraception during the study and for a minimum of 30 days following the last treatment if sexually active with a female of childbearing potential.
Resolution of all treatment-related toxicities, except alopecia, anemia and neuropathy, from any previous cancer therapy to ≤ Grade 1 prior to the first dose of study treatment.
Ability to provide written informed consent.
Exclusion Criteria:
Any other current or previous malignancy within the past three years that, in the opinion of the Principal Investigator, will interfere with study-specific objectives.
Patients with electronic pacemakers or defibrillators.
Chemotherapy or hormonal therapy for anti-cancer treatment within 28 days prior to Cycle 1 Day 1.
Immunotherapy or biological therapy (e.g., monoclonal antibodies) within 28 days prior to Cycle 1 Day 1, unless pre-approval is obtained from the Sponsor Medical Monitor.
Treatment with unapproved investigational therapeutic agent within 28 days prior to Cycle 1 Day 1, unless pre-approval is obtained from the Sponsor Medical Monitor.
Patients receiving systemic steroid therapy for a chronic inflammatory condition (e.g., rheumatoid arthritis, Crohn's Disease, etc.). Topical steroids are also excluded. Nasal and inhaled steroids are permitted.
Unstable/inadequate cardiac function:
symptomatic ischemia
uncontrolled or clinically significant conduction abnormalities; first degree AV block or asymptomatic LAFB/RBBB are eligible
myocardial infarction in the previous six months
congestive heart failure (New York Heart Association class III to IV)
Major surgery within 28 days prior to C1D1.
Infection requiring parenteral antibiotics, antivirals, or antifungals within 2 weeks prior to C1D1.
Patients who are known to have HIV infection/seropositivity.
Active Hepatitis A, B, or C infection or known to be positive for HCV RNA or HBV surface antigen. Patients who have been vaccinated against Hepatitis B and who are positive for ONLY the Hepatitis B surface antibody are permitted to participate in the study.
Serious psychiatric or medical conditions that could interfere with treatment or protocol-related procedures.
Patients who are pregnant or lactating.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sharron Gargosky, PhD
Organizational Affiliation
OncoSec Medical Incorporated
Official's Role
Study Director
Facility Information:
Facility Name
Stanford University
City
Stanford
State/Province
California
ZIP/Postal Code
94305-5826
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Evaluation of Pharmacodynamic Effects of IT-pIL12-EP in Patients With TNBC
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