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Study Evaluating Impact of IL-7 on CD4 Lymphopenia, Risks of Severe Haematological Toxicity and Tumor Progression in Metastatic Breast Cancer Patients

Primary Purpose

Metastatic Breast Cancer

Status
Completed
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
placebo
interleukin 7
interleukin 7
interleukin 7
Sponsored by
Centre Leon Berard
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Breast Cancer focused on measuring IL-7, metastatic breast cancer patients, lymphopenia

Eligibility Criteria

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

Inclusion Criteria:

  • Female aged more than 18 years
  • Histologic diagnosis of metastatic breast cancer to be treated with capecitabine at study entry. NB: Patients previously treated with capecitabine are eligible only if more than 6 months have elapsed since the last capecitabine intake.
  • Lymphopenic (i.e. with at least one value of lymphocyte count 1500/µL within 15 days before Day 0).
  • Performance status ECOG of 0, 1,2 or 3
  • Life expectancy ≥ 6months
  • Adequate bone marrow, hepatic and renal function as follows:

    • Neutrophils ≥ 1,000/µL
    • Platelets ≥ 100 109/µL
    • ASAT, ALAT, or Alkaline Phosphatase ≤ 2.5 x ULN
    • Total Bilirubin ≤ 1.5 x ULN
    • INR ≤ 1.5
    • Calculated creatinin clearance ≥ 60mL/min (Cockcroft formula or MDRD formula for patients older than 65 years old)- Ability to understand and sign informed consent
  • Covered by a medical insurance.

Exclusion Criteria:

  • Prior history of other malignancies other than breast cancer (except for basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix) unless the subjects has been free of the disease for at least 3 years.
  • No resolution of specific toxicities related to any prior anti-cancer therapy to Grade ≤2 according to the NCI CTCAE v.4.0 (except lymphopenia, alopecia and neuropathy)
  • Wash out period of less than 5 times the half-life of previous anti-cancer treatment before study entry, except if previous chemotherapy treatment before study entry. NB: For patient previously treated by hormonotherapy, a wash out period of 1 week will be sufficient
  • Uncontrolled hypertension (i.e., resting systolic blood pressure greater than140 mmHg or resting diastolic blood pressure greater than 90 mmHg), despite pharmacologic antihypertensive treatment, confirmed with a second blood pressure measurement done later in the same day
  • History of lymphoid malignancy (e.g. Hodgkin disease, non Hodgkin lymphoma, Leukemia).
  • History of splenectomy or hematologic disease associated with hypersplenism, such as gamma or beta-thalassemia, hereditary spherocytosis, Gaucher's disease, or autoimmune hemolytic anemia.
  • Any cardiac, pulmonary, thyroid, renal, hepatic, neurological severe/uncontrolled concurrent medical disease that in the opinion of the investigator could cause unacceptable safety risks or compromise compliance with the protocol
  • Any history of severe auto-immune disease
  • Hepatitis B antigen (HBs Ag) positive, Hepatitis C (HCV Ab) antibody positive or HCV RNA detectable
  • Documented HIV-1 positivity
  • History of cardiovascular disorders grade >2 (NYHA) within 6 months preceding the inclusion
  • Active uncontrolled viral, fungal or bacterial infection
  • Active drug or alcohol use or dependence that, in the opinion of the investigator, would interfere with adherence to study requirements (participants must agree to refrain from substance abuse use during the entire course of the study)
  • Pregnant or breast-feeding women
  • No use of effective birth control methods for women of childbearing potential
  • Any contraindications to capecitabine treatment (refer to Xeloda SPC Appendix 11) and to any other anti-cancer treatment authorized as per protocol (refer to respective SPC for specific contraindications)

Sites / Locations

  • Centre Leon Berard
  • Institut Curie
  • Institut Gustave Roussy

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Placebo Comparator

Experimental

Experimental

Experimental

Arm Label

Placebo Arm

CYT107 treatment before CT

CYT107 treatment during CT

CYT107 treatment before and during CT

Arm Description

the patients will receive Placebo before the 1st and during the 3rd CT cycle (N=6)

patients will receive an induction cycle of CYT107 (10µg/kg/week subcutaneously for 3 weeks) before the 1st CT cycle and the placebo during the 3rd CT cycle (N=6)

patients will receive the placebo before the 1st CT cycle and a delayed treatment with CYT107 (10µg/kg/week subcutaneously for 3 weeks) during the 3rd CT cycle (N=6)

patients will receive an induction cycle of CYT107 (10µg/kg/week subcutaneously for 3 weeks) before the 1st CT cycle and a maintenance cycle of IL-7 (10µg/kg/week subcutaneously for 3 weeks) during the 3rd CT cycle (N=6).

Outcomes

Primary Outcome Measures

to determine the optimal schedule to deliver CYT107 during chemotherapy based on restoration of CD4 count
Evolution of CD4 count from Day 0 to Week 11 with repeated measures from D0 to W12 (D0, D21, D57, D78).

Secondary Outcome Measures

to determine if CYT107 treatment enables to reduce the incidence of severe haematological toxicity (any type of haematological toxicity Grade ≥ 3) post-chemotherapy
To assess the impact of CYT107 on progression-free survival
Time from randomisation to first evidence of progression or death of any cause.
To assess the impact of CYT107 on compliance to chemotherapy regimen (dose intensity, number of chemotherapy cycles).
Number of CT cycles, CT dose delays and/or reduction, CT discontinuation
To assess the impact of CYT107 on CD4 lymphopenia over the study period
Evolution of CD4 count from Day 0 to end of study visit
to evaluate if CYT107 treatment will selectively stimulate the proliferation and activation of peripheral immune subsets (analysis of phenotype and activation status of peripheral immune e sub-populations)
Measure of frequency and activation status of circulating immune subpopulations on fresh whole blood. Multi-parametric marker sets (6-8 markers) will be used to analyse phenotype of immune subpopulations (TCD4+, TCD8+, Treg, T, NK, DC) and their activation status (PD1, ICOS, CD39, CD73, CD62L, CCR7, CD45RO, CD45RA, CD86).
to evaluate if CYT107 treatment will selectively improve the functional response of T cells, DC subsets and NK cells
Analysis of the functional response of T cells, DC subsets and NK cells
to evaluate if CYT107 treatment will is able to revert tolerogenic immune burden to increase specific anti-tumor response (measure of antigen specific CD8 response, measure of cytokine plasmatic levels)
Analysis of tumor associated antigen (TAA) specific CD8 responses Quantification of circulating cytokines including mainly, but not limited to, IL-6, IL-2, IFN, VEGF, TNF, IL-15,F FGF using Luminex technology and VEGF, TGF, IL-7R by Elisa.
to evaluate if CYT107 treatment will enable to increase TCR diversity (analysis of combinatorial diversity).
Evaluation of T cell receptor diversity using ImmuneTraCkeR test and Constel'ID software (ImmunID Technologies, Grenoble, France).
To assess the impact of CYT107 treatment on overall incidence of side effects
Number of patients with AEs (any type any grade) using NCI-CTCAE scale (version 4.0) from D0 to W12

Full Information

First Posted
June 6, 2011
Last Updated
February 6, 2015
Sponsor
Centre Leon Berard
Collaborators
Ministry of Health, France, Cytheris, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01368107
Brief Title
Study Evaluating Impact of IL-7 on CD4 Lymphopenia, Risks of Severe Haematological Toxicity and Tumor Progression in Metastatic Breast Cancer Patients
Official Title
A Randomised, Multicentric, Phase 2a Study Evaluating the Impact of an Immunotherapy by IL-7 on CD4 Lymphopenia, Risks of Severe Haematological Toxicity and Tumor Progression in Metastatic Breast Cancer Patients
Study Type
Interventional

2. Study Status

Record Verification Date
December 2013
Overall Recruitment Status
Completed
Study Start Date
June 2011 (undefined)
Primary Completion Date
September 2013 (Actual)
Study Completion Date
June 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Centre Leon Berard
Collaborators
Ministry of Health, France, Cytheris, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of the study is to evaluate the impact of an immunotherapy by IL-7 on CD4 lymphopenia, risks of severe haematological toxicity and tumor progression in metastatic breast cancer patients. The primary objective is to determine the optimal schedule to deliver CYT107 during chemotherapy based on restoration of CD4 count. This study is a phase II, randomised, double-blind, placebo-controlled, single-centre. 24 patients will be included in the study.
Detailed Description
A key secondary objective is to determine if CYT107 treatment enables to reduce the incidence of severe haematological toxicity (any type of haematological toxicity Grade ≥ 3) post-chemotherapy. Other secondary objectives are to assess the impact of CYT107 treatment on the following parameters: Overall incidence of side effects (any type any grade) Progression-free survival (PFS) Compliance to chemotherapy regimen (dose intensity, number of chemotherapy cycles). CD4 lymphopenia over the study period Exploratory biological markers A series of biomarkers analyses will be performed to evaluate if CYT107 treatment will: selectively stimulate the proliferation and activation of peripheral immune subsets (analysis of phenotype and activation status of peripheral immune e sub-populations) selectively improve the functional response of T cells, DC subsets and NK cells. is able to revert tolerogenic immune burden to increase specific anti-tumor response (measure of antigen specific CD8 response, measure of cytokine plasmatic levels) enable to increase TCR diversity (analysis of combinatorial diversity).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Breast Cancer
Keywords
IL-7, metastatic breast cancer patients, lymphopenia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo Arm
Arm Type
Placebo Comparator
Arm Description
the patients will receive Placebo before the 1st and during the 3rd CT cycle (N=6)
Arm Title
CYT107 treatment before CT
Arm Type
Experimental
Arm Description
patients will receive an induction cycle of CYT107 (10µg/kg/week subcutaneously for 3 weeks) before the 1st CT cycle and the placebo during the 3rd CT cycle (N=6)
Arm Title
CYT107 treatment during CT
Arm Type
Experimental
Arm Description
patients will receive the placebo before the 1st CT cycle and a delayed treatment with CYT107 (10µg/kg/week subcutaneously for 3 weeks) during the 3rd CT cycle (N=6)
Arm Title
CYT107 treatment before and during CT
Arm Type
Experimental
Arm Description
patients will receive an induction cycle of CYT107 (10µg/kg/week subcutaneously for 3 weeks) before the 1st CT cycle and a maintenance cycle of IL-7 (10µg/kg/week subcutaneously for 3 weeks) during the 3rd CT cycle (N=6).
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Description
Placebo before the 1st (D0, D7, D14)and during the 3rd CT cycle (D57, D64, D71)
Intervention Type
Drug
Intervention Name(s)
interleukin 7
Intervention Description
patients will receive an induction cycle of CYT107 (10µg/kg/week subcutaneously for 3 weeks) before the 1st CT cycle (D0, D7, D14) and the placebo during the 3rd CT cycle (D57, D64, D71)
Intervention Type
Drug
Intervention Name(s)
interleukin 7
Intervention Description
patients will receive the placebo before the 1st CT cycle (D0, D7, D14) and a delayed treatment with CYT107 (10µg/kg/week subcutaneously for 3 weeks) during the 3rd CT cycle (D57, D64, D71)
Intervention Type
Drug
Intervention Name(s)
interleukin 7
Intervention Description
patients will receive an induction cycle of CYT107 (10µg/kg/week subcutaneously for 3 weeks) before the 1st CT cycle (D0, D7, D14) and a maintenance cycle of IL-7 (10µg/kg/week subcutaneously for 3 weeks) during the 3rd CT cycle (D57, D64, D71)
Primary Outcome Measure Information:
Title
to determine the optimal schedule to deliver CYT107 during chemotherapy based on restoration of CD4 count
Description
Evolution of CD4 count from Day 0 to Week 11 with repeated measures from D0 to W12 (D0, D21, D57, D78).
Time Frame
after 11 weeks of treatment
Secondary Outcome Measure Information:
Title
to determine if CYT107 treatment enables to reduce the incidence of severe haematological toxicity (any type of haematological toxicity Grade ≥ 3) post-chemotherapy
Time Frame
at the end of study M12
Title
To assess the impact of CYT107 on progression-free survival
Description
Time from randomisation to first evidence of progression or death of any cause.
Time Frame
at the end of study (M12)
Title
To assess the impact of CYT107 on compliance to chemotherapy regimen (dose intensity, number of chemotherapy cycles).
Description
Number of CT cycles, CT dose delays and/or reduction, CT discontinuation
Time Frame
at the end of study (M12)
Title
To assess the impact of CYT107 on CD4 lymphopenia over the study period
Description
Evolution of CD4 count from Day 0 to end of study visit
Time Frame
at the end of study (M12)
Title
to evaluate if CYT107 treatment will selectively stimulate the proliferation and activation of peripheral immune subsets (analysis of phenotype and activation status of peripheral immune e sub-populations)
Description
Measure of frequency and activation status of circulating immune subpopulations on fresh whole blood. Multi-parametric marker sets (6-8 markers) will be used to analyse phenotype of immune subpopulations (TCD4+, TCD8+, Treg, T, NK, DC) and their activation status (PD1, ICOS, CD39, CD73, CD62L, CCR7, CD45RO, CD45RA, CD86).
Time Frame
D0, D21, D57, D78 and at end of study M12
Title
to evaluate if CYT107 treatment will selectively improve the functional response of T cells, DC subsets and NK cells
Description
Analysis of the functional response of T cells, DC subsets and NK cells
Time Frame
D0, D21, D57, D78 and at the end of study M12
Title
to evaluate if CYT107 treatment will is able to revert tolerogenic immune burden to increase specific anti-tumor response (measure of antigen specific CD8 response, measure of cytokine plasmatic levels)
Description
Analysis of tumor associated antigen (TAA) specific CD8 responses Quantification of circulating cytokines including mainly, but not limited to, IL-6, IL-2, IFN, VEGF, TNF, IL-15,F FGF using Luminex technology and VEGF, TGF, IL-7R by Elisa.
Time Frame
D0, D21, D57, D78 and at the end of study M12
Title
to evaluate if CYT107 treatment will enable to increase TCR diversity (analysis of combinatorial diversity).
Description
Evaluation of T cell receptor diversity using ImmuneTraCkeR test and Constel'ID software (ImmunID Technologies, Grenoble, France).
Time Frame
D0, D21, D57, D78 and at the end of study M12
Title
To assess the impact of CYT107 treatment on overall incidence of side effects
Description
Number of patients with AEs (any type any grade) using NCI-CTCAE scale (version 4.0) from D0 to W12
Time Frame
after 12 weeks of treatment

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Female aged more than 18 years Histologic diagnosis of metastatic breast cancer to be treated with capecitabine at study entry. NB: Patients previously treated with capecitabine are eligible only if more than 6 months have elapsed since the last capecitabine intake. Lymphopenic (i.e. with at least one value of lymphocyte count 1500/µL within 15 days before Day 0). Performance status ECOG of 0, 1,2 or 3 Life expectancy ≥ 6months Adequate bone marrow, hepatic and renal function as follows: Neutrophils ≥ 1,000/µL Platelets ≥ 100 109/µL ASAT, ALAT, or Alkaline Phosphatase ≤ 2.5 x ULN Total Bilirubin ≤ 1.5 x ULN INR ≤ 1.5 Calculated creatinin clearance ≥ 60mL/min (Cockcroft formula or MDRD formula for patients older than 65 years old)- Ability to understand and sign informed consent Covered by a medical insurance. Exclusion Criteria: Prior history of other malignancies other than breast cancer (except for basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix) unless the subjects has been free of the disease for at least 3 years. No resolution of specific toxicities related to any prior anti-cancer therapy to Grade ≤2 according to the NCI CTCAE v.4.0 (except lymphopenia, alopecia and neuropathy) Wash out period of less than 5 times the half-life of previous anti-cancer treatment before study entry, except if previous chemotherapy treatment before study entry. NB: For patient previously treated by hormonotherapy, a wash out period of 1 week will be sufficient Uncontrolled hypertension (i.e., resting systolic blood pressure greater than140 mmHg or resting diastolic blood pressure greater than 90 mmHg), despite pharmacologic antihypertensive treatment, confirmed with a second blood pressure measurement done later in the same day History of lymphoid malignancy (e.g. Hodgkin disease, non Hodgkin lymphoma, Leukemia). History of splenectomy or hematologic disease associated with hypersplenism, such as gamma or beta-thalassemia, hereditary spherocytosis, Gaucher's disease, or autoimmune hemolytic anemia. Any cardiac, pulmonary, thyroid, renal, hepatic, neurological severe/uncontrolled concurrent medical disease that in the opinion of the investigator could cause unacceptable safety risks or compromise compliance with the protocol Any history of severe auto-immune disease Hepatitis B antigen (HBs Ag) positive, Hepatitis C (HCV Ab) antibody positive or HCV RNA detectable Documented HIV-1 positivity History of cardiovascular disorders grade >2 (NYHA) within 6 months preceding the inclusion Active uncontrolled viral, fungal or bacterial infection Active drug or alcohol use or dependence that, in the opinion of the investigator, would interfere with adherence to study requirements (participants must agree to refrain from substance abuse use during the entire course of the study) Pregnant or breast-feeding women No use of effective birth control methods for women of childbearing potential Any contraindications to capecitabine treatment (refer to Xeloda SPC Appendix 11) and to any other anti-cancer treatment authorized as per protocol (refer to respective SPC for specific contraindications)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Isabelle Ray Coquart
Organizational Affiliation
Centre Léon Bérard, Lyon
Official's Role
Principal Investigator
Facility Information:
Facility Name
Centre Leon Berard
City
Lyon
Country
France
Facility Name
Institut Curie
City
Paris
ZIP/Postal Code
75005
Country
France
Facility Name
Institut Gustave Roussy
City
Villejuif
Country
France

12. IPD Sharing Statement

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Study Evaluating Impact of IL-7 on CD4 Lymphopenia, Risks of Severe Haematological Toxicity and Tumor Progression in Metastatic Breast Cancer Patients

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