search
Back to results

Pre-operative IRX-2 in Early Stage Breast Cancer (ESBC)

Primary Purpose

Breast Neoplasm, Breast Neoplasm, Male, Triple Negative Breast Cancer

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Cyclophosphamide
Indomethacin
Omeprazole
Multivitamin
Sponsored by
Providence Health & Services
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Neoplasm focused on measuring Breast Cancer, Early Stage Breast Cancer, Male breast cancer, IRX-2, Immunotherapy, Triple Negative Breast Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Invasive breast cancer of any receptor subtype diagnosed by core-needle biopsy
  • To undergo surgical resection with curative intent by partial mastectomy (lumpectomy) or mastectomy or
  • Triple negative breast cancer (defined by ER<10%, PR<10%, and HER2-negative by NCCN guidelines), T1c+ tumors for which neoadjuvant anthracycline-based and non-platinum containing chemotherapy is planned
  • Tumor >5 mm in maximum diameter by ultrasound or mammography. (Subjects with smaller tumors may be included at the discretion of the Principal Investigator.)
  • Willing and able to provide written informed consent, including consent for use of available tissue and required blood draws for research purposes
  • Availability of at least one tumor-bearing core specimen from the breast cancer diagnostic biopsy
  • Karnofsky Performance status (KPS) 70% or greater.
  • Female or male ≥18 years of age on day of signing informed consent.
  • Adequate organ function as defined by protocol specified lab results

Exclusion Criteria:

  • Prior neoadjuvant systemic therapy is planned
  • Prior surgery, radiotherapy or chemotherapy for this cancer (other than core-needle biopsy)
  • Received an investigational agent within 4 weeks of the first dose of treatment.
  • Diagnosis of immunodeficiency or has received more than replacement doses of corticosteroids any other immunosuppressive therapy within 4 weeks of the first dose of treatment
  • Hypersensitivity to IRX 2, cyclophosphamide, indomethacin, aspirin or ciprofloxacin.
  • Chronic anticoagulation, not including aspirin, but including heparins, warfarin, oral anticoagulants or other platelet function inhibitors, that cannot, in the documented opinion of the investigator, safely be interrupted from at least 2 days prior to the initiation of the study regimen until after surgical resection of the tumor.
  • Another malignancy that required active treatment within 6 months of the first dose of treatment
  • History or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, such that trial participation is not in the best interest of the subject, including but not limited to uncontrolled hypertension or clinically significant cardiovascular disease, myocardial infarction within the previous 3 months, active infection or pneumonitis or other pulmonary disease requiring systemic therapy, clinically significant gastritis or peptic ulcer disease (that would preclude the use of indomethacin), stroke of other symptoms of cerebral vascular insufficient within the last 3 months, autoimmune disease that has required systemic treatment within the past 2 years (other than hormone replacement doses), or uncontrolled psychiatric or substance abuse disorders.
  • Pregnancy or lactation.
  • Known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies), active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA [qualitative] is detected).

Sites / Locations

  • Providence Portland Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

IRX-2 Regimen -Early Stage Breast Cancer

IRX-2 Regimen -Triple Negative Breast Cancer

Arm Description

Enrolled subjects with early stage breast cancer will receive a single dose of cyclophosphamide (300 mg/m2) by IV infusion on Day 1. Also starting on Day 1 and continuing until Day 21, subjects will take daily oral indomethacin (25 mg three times each day), daily oral omeprazole (one tablet) and daily oral multivitamin containing 15-30 mg of zinc. On any 10 consecutive day period between Days 4-17, patients will receive two 1 mL subcutaneous periareolar injections of IRX-2.

Enrolled subjects with triple negative breast cancer will receive a single dose of cyclophosphamide (300 mg/m2) by IV infusion on Day 1. Also starting on Day 1 and continuing until Day 21, subjects will take daily oral indomethacin (25 mg three times each day), daily oral omeprazole (one tablet) and daily oral multivitamin containing 15-30 mg of zinc. On any 10 consecutive day period between Days 4-17, patients will receive two 1 mL subcutaneous periareolar injections of IRX-2.

Outcomes

Primary Outcome Measures

Surgical Delays
Number of surgeries delayed due to adverse events from the IRX-2 regimen

Secondary Outcome Measures

Tumor Infiltrating Lymphocytes
Change in tumor infiltrating lymphocyte (TIL) score as measured by H&E TIL count according to Salgado criteria from pre-surgical biopsy to resected tumor specimen

Full Information

First Posted
October 28, 2016
Last Updated
January 31, 2022
Sponsor
Providence Health & Services
Collaborators
Brooklyn ImmunoTherapeutics, LLC
search

1. Study Identification

Unique Protocol Identification Number
NCT02950259
Brief Title
Pre-operative IRX-2 in Early Stage Breast Cancer (ESBC)
Official Title
A Phase Ib Study to Assess the Safety, Tolerability and Immunologic Activity of Preoperative IRX 2 In Early Stage Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
February 9, 2017 (Actual)
Primary Completion Date
October 2022 (Anticipated)
Study Completion Date
January 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Providence Health & Services
Collaborators
Brooklyn ImmunoTherapeutics, LLC

4. Oversight

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

5. Study Description

Brief Summary
The goal of this study is assess the safety and tolerability of the IRX-2 regimen in patients with early stage breast cancer (ESBC) and to estimate the pathologic complete response rate to neoadjuvant anthracycline-based and non-platinum containing chemotherapy in patients with triple-negative breast cancer who have received the IRX-2 Regimen before chemotherapy.
Detailed Description
This will be a Phase Ib study conducted to determine the safety and tolerability of an IRX-2 regimen in ESBC, to be administered pre-operatively before standard-of-care surgical resection and following standard-of-care diagnostic biopsy. This study will also include triple-negative breast cancer patients who will receive the IRX-2 regimen prior to chemotherapy. Eligible subjects will have early stage breast cancer of any receptor sub-type, for which standard-of-care surgical resection is planned. To be eligible, a minimum of 1 core of tumor-bearing biopsy material must be available for research analysis. Cohort B will enroll subjects triple negative breast cancer (defined by ER<10%, PR<10%, and HER2-negative by NCCN guidelines), T1c+ tumors for which neoadjuvant anthracycline-based and non-platinum containing chemotherapy is planned. The IRX-2 regimen will be administered and completed preceding chemotherapy. Cohort B subjects must undergo post-IRX-2 Regimen biopsy (2-3 cores), followed by commencement of chemotherapy preferably within one week after biopsy. The IRX-2 regimen will be administered in all enrolled subjects. IRX 2 will be administered by subcutaneous injection into the periareolar skin of the affected breast.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Neoplasm, Breast Neoplasm, Male, Triple Negative Breast Cancer
Keywords
Breast Cancer, Early Stage Breast Cancer, Male breast cancer, IRX-2, Immunotherapy, Triple Negative Breast Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
16 (Actual)

8. Arms, Groups, and Interventions

Arm Title
IRX-2 Regimen -Early Stage Breast Cancer
Arm Type
Experimental
Arm Description
Enrolled subjects with early stage breast cancer will receive a single dose of cyclophosphamide (300 mg/m2) by IV infusion on Day 1. Also starting on Day 1 and continuing until Day 21, subjects will take daily oral indomethacin (25 mg three times each day), daily oral omeprazole (one tablet) and daily oral multivitamin containing 15-30 mg of zinc. On any 10 consecutive day period between Days 4-17, patients will receive two 1 mL subcutaneous periareolar injections of IRX-2.
Arm Title
IRX-2 Regimen -Triple Negative Breast Cancer
Arm Type
Experimental
Arm Description
Enrolled subjects with triple negative breast cancer will receive a single dose of cyclophosphamide (300 mg/m2) by IV infusion on Day 1. Also starting on Day 1 and continuing until Day 21, subjects will take daily oral indomethacin (25 mg three times each day), daily oral omeprazole (one tablet) and daily oral multivitamin containing 15-30 mg of zinc. On any 10 consecutive day period between Days 4-17, patients will receive two 1 mL subcutaneous periareolar injections of IRX-2.
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Other Intervention Name(s)
Cytoxan
Intervention Description
One dose of cyclophosphamide 300 mg/m2 IV infusion
Intervention Type
Drug
Intervention Name(s)
Indomethacin
Other Intervention Name(s)
Indocin
Intervention Description
Indomethacin 25 mg three times a day for 21 days
Intervention Type
Drug
Intervention Name(s)
Omeprazole
Other Intervention Name(s)
Prilosec
Intervention Description
One tablet of omeprazole daily for 21 days
Intervention Type
Dietary Supplement
Intervention Name(s)
Multivitamin
Other Intervention Name(s)
Vitamin
Intervention Description
Daily multivitamin containing 15-30 mg of zinc for 21 days.
Primary Outcome Measure Information:
Title
Surgical Delays
Description
Number of surgeries delayed due to adverse events from the IRX-2 regimen
Time Frame
Day 1 to Day 26
Secondary Outcome Measure Information:
Title
Tumor Infiltrating Lymphocytes
Description
Change in tumor infiltrating lymphocyte (TIL) score as measured by H&E TIL count according to Salgado criteria from pre-surgical biopsy to resected tumor specimen
Time Frame
Day 26
Other Pre-specified Outcome Measures:
Title
Characterization of peripheral lymphocytes
Description
Number of peripheral lymphocytes including activated T-cells, T-regulatory cells, natural killer (NK) cells, and myeloid cells
Time Frame
Day 1 to Day 26
Title
TIL phenotype
Description
Changes in abundance of T-regulatory cells, activated T-cells, myeloid lineages and dendritic cells
Time Frame
Day 1 to 26
Title
Intratumoral T-cell response
Description
change in T-cell clonal responses by T-cell receptor DNA deep sequencing
Time Frame
Day 1-26
Title
Intratumoral Immune Response
Description
Characterization of intratumoral immune responses by RNA expression using the Nanostring PanCancer Immune panel and/or Prosigna tumor recurrence score
Time Frame
Day 1-26

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Invasive breast cancer of any receptor subtype diagnosed by core-needle biopsy To undergo surgical resection with curative intent by partial mastectomy (lumpectomy) or mastectomy or Triple negative breast cancer (defined by ER<10%, PR<10%, and HER2-negative by NCCN guidelines), T1c+ tumors for which neoadjuvant anthracycline-based and non-platinum containing chemotherapy is planned Tumor >5 mm in maximum diameter by ultrasound or mammography. (Subjects with smaller tumors may be included at the discretion of the Principal Investigator.) Willing and able to provide written informed consent, including consent for use of available tissue and required blood draws for research purposes Availability of at least one tumor-bearing core specimen from the breast cancer diagnostic biopsy Karnofsky Performance status (KPS) 70% or greater. Female or male ≥18 years of age on day of signing informed consent. Adequate organ function as defined by protocol specified lab results Exclusion Criteria: Prior neoadjuvant systemic therapy is planned Prior surgery, radiotherapy or chemotherapy for this cancer (other than core-needle biopsy) Received an investigational agent within 4 weeks of the first dose of treatment. Diagnosis of immunodeficiency or has received more than replacement doses of corticosteroids any other immunosuppressive therapy within 4 weeks of the first dose of treatment Hypersensitivity to IRX 2, cyclophosphamide, indomethacin, aspirin or ciprofloxacin. Chronic anticoagulation, not including aspirin, but including heparins, warfarin, oral anticoagulants or other platelet function inhibitors, that cannot, in the documented opinion of the investigator, safely be interrupted from at least 2 days prior to the initiation of the study regimen until after surgical resection of the tumor. Another malignancy that required active treatment within 6 months of the first dose of treatment History or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, such that trial participation is not in the best interest of the subject, including but not limited to uncontrolled hypertension or clinically significant cardiovascular disease, myocardial infarction within the previous 3 months, active infection or pneumonitis or other pulmonary disease requiring systemic therapy, clinically significant gastritis or peptic ulcer disease (that would preclude the use of indomethacin), stroke of other symptoms of cerebral vascular insufficient within the last 3 months, autoimmune disease that has required systemic treatment within the past 2 years (other than hormone replacement doses), or uncontrolled psychiatric or substance abuse disorders. Pregnancy or lactation. Known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies), active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA [qualitative] is detected).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Page, MD
Organizational Affiliation
Providence Health & Services
Official's Role
Principal Investigator
Facility Information:
Facility Name
Providence Portland Medical Center
City
Portland
State/Province
Oregon
ZIP/Postal Code
97213
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Providence Health & Services has agreed to allow IRX Therapeutics to have access PHI for auditing purposes. Any non-Providence Health & Services employee who will access PHI will be required to sign a confidentiality agreement and will not be permitted to remove PHI from Providence Health & Services.
IPD Sharing Time Frame
5 years
IPD Sharing Access Criteria
IPD will be accessed for data verification purposes only.
Citations:
PubMed Identifier
33413574
Citation
Sanchez K, Kim I, Chun B, Pucilowska J, Redmond WL, Urba WJ, Martel M, Wu Y, Campbell M, Sun Z, Grunkemeier G, Chang SC, Bernard B, Page DB. Multiplex immunofluorescence to measure dynamic changes in tumor-infiltrating lymphocytes and PD-L1 in early-stage breast cancer. Breast Cancer Res. 2021 Jan 7;23(1):2. doi: 10.1186/s13058-020-01378-4.
Results Reference
derived
Links:
URL
https://oregon.providence.org/our-services/p/providence-cancer-center/
Description
Providence Cancer Center

Learn more about this trial

Pre-operative IRX-2 in Early Stage Breast Cancer (ESBC)

We'll reach out to this number within 24 hrs