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Leronlimab (PRO 140) Combined With Carboplatin in Patients With Cytokine Chemokine Receptor 5 Positive (CCR5+) mTNBC

Phase 1
Terminated
Conditions
Triple Negative Breast Neoplasms
Interventions
Registration Number
NCT03838367
Lead Sponsor
CytoDyn, Inc.
Brief Summary

This is a phase Ib/II Study of Leronlimab (PRO 140) combined with Carboplatin in Patients with CCR5+ Metastatic Triple Negative Breast Cancer (mTNBC).

Study population will consist of patients with CCR5-positive, locally advanced or metastatic triple-negative breast cancer (mTNBC) who are naïve to chemotherapy in metastatic setting but have been exposed to anthracyclines and taxane in neoadjuvant and adjuvant settings (first-line).

Detailed Description

Phase Ib

Phase Ib is a dose escalation phase with 3 dose levels (cohorts) of leronlimab (PRO 140) administered in combination with a fixed dose of carboplatin at AUC 5 (area under the curve). This dose finding portion of study will follow a "3+3" designed to determine the maximum tolerated dose (MTD) of leronlimab (PRO 140) administered as subcutaneous (SC) injection in subjects with histologically confirmed mTNBC that express CCR5.

Phase II

Phase II is a single arm study with 30 patients in order to test the hypothesis that the combination of carboplatin AUC 5 intravenously and MTD of leronlimab (PRO 140) SC will increase Progression Free Survival (PFS) in patients with CCR5 + mTNBC.

Recruitment & Eligibility

Status
TERMINATED
Sex
Female
Target Recruitment
10
Inclusion Criteria
  1. Must have a histologically confirmed diagnosis of TNBC. Must demonstrate HER-2 negative (IHC 0, 1+, or fluorescence in situ hybridization (FISH) negative and ER<1%, and PR < 1%, per ASCO/CAP criteria);

  2. Demonstrate CCR5 + by IHC (>10% membranous staining completed at the reference laboratory of Dr. Hallgeir Rui at Medical College of Wisconsin).

    Note: This test will be done as part of the pre-screening period. It will be performed in archival metastatic tissue. If archival tissue is not available then, fresh biopsy will be done;

  3. Be willing to provide tissue from a newly obtained core or excisional biopsy of a tumor lesion (in case archival tissue is not available);

  4. Patients with stage IV de-novo disease or patients that develop recurrence after completion of neoadjuvant or adjuvant therapy are eligible; Note: Patients who have been exposed to carboplatin in neoadjuvant or adjuvant setting will be allowed to enroll, if they have progressed ≥ 6 months from completion of treatment.

  5. Phase 1 study section:

    Subjects must have disease recurrence and progression after ≤ 2 line of therapy in metastatic setting but untreated with carboplatin;

    Phase 2 study section:

    Subjects must be naive to chemotherapy or untreated with carboplatin in metastatic setting (first-line) OR excluding carboplatin chemotherapy, subjects must have failed first-line combination of chemotherapy and a checkpoint inhibitor in metastatic setting;

  6. Patients must have measurable disease based on RECIST v1.1;

  7. Female patients, ≥ 18 years of age;

  8. Patients must exhibit a/an ECOG performance status of 0-1;

  9. Life expectancy of at least 6 months;

  10. Patients must have adequate organ and bone marrow function within 28 days prior to registration, as defined below:

    • leukocytes ≥ 3,000/mcL;
    • absolute neutrophil count ≥ 1,500/mcL;
    • platelets ≥ 100,000/mcL;
    • total bilirubin: within normal institutional limits;
    • AST(SGOT) &ALT(SPGT) ≤ 2.5 X institutional upper limit of normal (ULN) (applicable to all patients, irrespective of liver disease or metastasis); and
    • creatinine: within normal institutional limits.
  11. Clinically normal resting 12-lead ECG at Screening Visit or, if abnormal, considered not clinically significant by the Principal Investigator.

  12. Females of child-bearing potential (FOCBP) and males must agree to use two medically accepted methods of contraception with hormonal or barrier method of birth control, or abstinence, prior to study entry, for the duration of study participation and for 60 days after the last dose of study drug (Refer to Appendix 1). Should a female patient become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. Note: A FOCBP is any woman (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria:

    • Has not undergone a hysterectomy or bilateral oophorectomy; and
    • Has had menses at any time in the preceding 12 consecutive months (and therefore has not been naturally postmenopausal for > 12 months).
  13. FOCBP must have a negative serum pregnancy test at Screening Visit and negative urine pregnancy test prior to receiving the first dose of study drug; and

  14. Patients must have the ability to understand and the willingness to sign a written informed consent prior to registration on study.

Exclusion Criteria
  1. HER-2 overexpressed/amplified metastatic breast cancer (MBC) (Appendix 2 for guidelines from ASCO);
  2. ER and or PR expressing tumors;
  3. Is currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 28 days prior to enrollment;
  4. Patients who have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to leronlimab (PRO 140) are not eligible;
  5. Patients who have had prior exposure to CCR5 antagonists are not eligible;
  6. Patients who have a known additional malignancy that is progressing or requires active treatment are not eligible. Patients who have had a prior diagnosis of cancer and if it has been <3 years since their last treatment are not eligible. Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer;
  7. Has an active infection requiring systemic therapy. Note: Patients must complete any treatment with antibiotics prior to registration;
  8. Patients who have a known HIV positive status or known/ active Hepatitis B and/or C infection are not eligible;
  9. Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Note: Subjects with previously treated brain metastases may participate provided they are stable (without evidence of progression by imaging for at least four weeks prior to the first dose of trial treatment and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are not using steroids for at least 7 days prior to trial treatment. This exception does not include carcinomatous meningitis which is excluded regardless of clinical stability;
  10. Has a 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, or is not in the best interest of the subject to participate, in the opinion of the treating investigator;
  11. Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial; and
  12. Is pregnant or breastfeeding, or expecting to conceive or have children within the projected duration of the trial, starting with the pre-screening or screening visit through the duration of study participation.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Phase I-Cohort A: 350 mg PRO 140 SC weekly + AUC 5 Carboplatin350 mg leronlimabCohort A: 350 mg PRO 140 SC weekly + AUC 5 Carboplatin every 3 weeks
Phase I-Cohort A: 350 mg PRO 140 SC weekly + AUC 5 CarboplatinAUC 5 CarboplatinCohort A: 350 mg PRO 140 SC weekly + AUC 5 Carboplatin every 3 weeks
Phase I-Cohort B: 525 mg PRO 140 SC weekly + AUC 5 Carboplatin525 mg leronlimabCohort B: 525 mg PRO 140 SC weekly + AUC 5 Carboplatin every 3 weeks
Phase I-Cohort B: 525 mg PRO 140 SC weekly + AUC 5 CarboplatinAUC 5 CarboplatinCohort B: 525 mg PRO 140 SC weekly + AUC 5 Carboplatin every 3 weeks
Phase I-Cohort C: 700 mg PRO 140 SC weekly + AUC 5 Carboplatin700 mg leronlimabCohort C: 700 mg PRO 140 SC weekly + AUC 5 Carboplatin every 3 weeks
Phase I-Cohort C: 700 mg PRO 140 SC weekly + AUC 5 CarboplatinAUC 5 CarboplatinCohort C: 700 mg PRO 140 SC weekly + AUC 5 Carboplatin every 3 weeks
Phase II- MTD to be established for the combination treatmentAUC 5 CarboplatinMTD PRO 140 SC + AUC 5 Carboplatin
Phase II- MTD to be established for the combination treatmentMaximum Tolerated Dose (MTD) of leronlimabMTD PRO 140 SC + AUC 5 Carboplatin
Primary Outcome Measures
NameTimeMethod
Phase I: Maximum Tolerated Dose (MTD) of Leronlimab (PRO 140) When Combined With Carboplatin AUC5From treatment cycle 1 day 1 (C1D1) until MTD reached (each cycle being 3 weeks), up to 26 weeks

The MTD is defined as 1 dose level (cohort) below the dose in which dose limiting toxicities (DLTs) were observed in \>= 33% of the participants.

Phase II: Progression Free Survival (PFS) Defined as Time in Months From the Date of First Study Treatment to the Date of Disease Progression or Death From Any Cause, Whichever Comes First.Planned every 6 to 9 weeks after Phase II study start, until progression or death, assessing up to 2 years after completion of treatment

All patients who received at least one dose of leronlimab (PRO 140) and carboplatin combination was intended to be included in the primary analyses of PFS. The Response Evaluation Criteria in Solid Tumors (RECIST v1.1) criteria was planned to be used for objective tumor response assessment.

Secondary Outcome Measures
NameTimeMethod
Phase I: Number of Participants With Any Adverse Events (AE) or Serious Adverse Events (SAE) Collected From the Time of First Treatment Until Study Termination to Evaluate Safety of Leronlimab (PRO 140) and Carboplatin in Subjects With CCR5+ mTNBC.From Cycle 1, Day 1 (each treatment cycle is 3 weeks) until last dose of study drug, up to 26 weeks

For Phase I: Adverse events followed National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. This will be the Number of Participants with Any Adverse Events (AE) or Serious Adverse Events (SAE) collected from the time of first treatment until study termination to evaluate safety of leronlimab (PRO 140) and carboplatin in subjects with CCR5+ metastatic triple negative breast cancer.

Phase II: Progression Free Survival (PFS) According to RECIST v1.1 in Participants With Detectable Programmed Death-Ligand 1 (PD-L1)Planned every 6 to 9 weeks after Phase II study start, until progression or death, assessing up to 2 years after completion of treatment

Phase II: Progression Free Survival (PFS) according to RECIST v1.1 in participants with Detectable Programmed Death-Ligand 1 (PD-L1)

Trial was terminated prematurely and no efficacy data was collected from the Phase II portion.

Phase II: Overall Response Rate (ORR, Defined as Complete Response (CR) + Partial Response (PR)), and Clinical Benefit Rate (CBR, Defined as CR + PR + Stable Disease (SD)) in Subjects With CCR5+ mTNBC Treated With Leronlimab (PRO 140) and Carboplatin.Planned every 6 to 9 weeks after Phase II study start, until progression or death, assessing up to 2 years after completion of treatment

Phase II: Overall response rate (ORR, defined as Complete Response (CR) + Partial Response (PR)), and clinical benefit rate (CBR, defined as CR + PR + Stable Disease (SD)) in subjects with CCR5+ mTNBC treated with

The trial was terminated early, efficacy data is not available

Phase II: Time to New Metastases (TTNM)Planned every 6 to 9 weeks after Phase II study start, until progression or death, assessing up to 2 years after completion of treatment

Trial was terminated prematurely and no efficacy data was collected.

Phase II: The Change From Baseline in Circulating Tumor Cells (CTC) Level in the Peripheral Blood.Planned every 21 days (i.e., Day 1 of each treatment cycle) through treatment completion, an average of 6 months.

Phase II: The change from baseline in circulating tumor cells (CTC) level in the peripheral blood.

No efficacy data was available due to early termination of the trial.

Phase II: Overall Survival Defined as Time in Months From the Date of First Study Treatment to the Date of Death;Planned from Day 1 to death from any cause, assessing up to 2 years after completion of treatment.

Phase II: Overall survival defined as time in months from the date of first study treatment to the date of death; No efficacy data is available due to early termination of the trial.

Phase II: Number, Frequency, and Severity of AEs Collected From the Time of First Treatment Until 12 Weeks After Study Treatment Completion to Evaluate Safety of Leronlimab (PRO 140) and Carboplatin in Subjects With CCR5+ mTNBC.Planned from Cycle 1, Day 1 (each treatment cycle is 21 days) to 12 weeks after the last dose of study drug)

Phase II: Number, frequency, and severity of AEs collected from the time of first treatment until 12 weeks after study treatment completion to evaluate safety of leronlimab (PRO 140) and carboplatin in subjects with CCR5+ mTNBC.

No safety data was available from the Phase II portion of the trial due to early termination of the study.

Trial Locations

Locations (2)

Quest Clinical Research

🇺🇸

San Francisco, California, United States

CD07 Investigational Site

🇺🇸

Chicago, Illinois, United States

Quest Clinical Research
🇺🇸San Francisco, California, United States

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