A Study of Atezolizumab (Tecentriq) Plus Nab-Paclitaxel in the Treatment of Unresectable Locally Advanced or Metastatic Triple-Negative Breast Cancer in PD-L1-positive Populatio
- Conditions
- nresectable locally advanced or metastatic triple-negative breast cancer (TNBC)MedDRA version: 20.0Level: PTClassification code 10075566Term: Triple negative breast cancerSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)Therapeutic area: Diseases [C] - Cancer [C04]
- Registration Number
- EUCTR2019-002488-91-HU
- Lead Sponsor
- F. Hoffmann-La Roche Ltd
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Authorised-recruitment may be ongoing or finished
- Sex
- All
- Target Recruitment
- 180
- Female or male >=18 years
- Ability to comply with the study protocol, in the investigator’s judgment
- Patients with unresectable locally advanced or metastatic, histologically documented TNBC (negative for HER2 and ER and PgR)
- Patient with at least one specimen positive for PD-L1 status as determined by VENTANA PD-L1 SP142 IHC assay
o Specimens with PD-L1 expression on tumor-infiltrating immune cells (IC) covering >=1% of tumor area would be PD-L1 positive, whereas PD-L1 expression on IC covering <1% of tumor area would be PD-L1 negative
o If multiple tumor specimens are available, patients may be eligible if at least one specimen is evaluable for PD-L1 testing and shows PD-L1 expression on >=1% IC
o Acceptable samples include core needle biopsies for deep tumor tissue or excisional, incisional, punch, or forceps biopsies for cutaneous, subcutaneous, or mucosal lesions
o Fine needle aspiration, brushing, cell pellet from pleural effusion, bone metastases, and lavage samples are not acceptable
o Tumor tissue from bone metastases is not evaluable for PD-L1 expression and is therefore not acceptable
o In case of previous hormonal-receptor-positive breast cancer (HR+BC), a biopsy from metastatic site showing TNBC is mandatory. PD-L1 positivity must also be confirmed in a TNBC sample
- No prior chemotherapy, experimental or targeted systemic therapy for unresectable locally advanced or metastatic TNBC
- Eastern Cooperative Oncology Group performance status of 0, 1 or 2
- Life expectancy >=12 weeks
- Measurable disease, as defined by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1)
- Adequate haematologic and end-organ function within 14 days prior to the initiation of study treatment
- Negative hepatitis B surface antigen (HbsAg) test at screening
- Positive hepatitis B surface antibody (HBsAb) test at screening, or negative HBsAb at screening accompanied by either of the following:
a) Negative total hepatitis B core antibody (HBcAb) test, or
b) Positive total HBcAb test followed by a negative hepatitis B virus (HBV) deoxyribonucleic acid (DNA) test at screening
- Negative hepatitis C virus (HCV) antibody test or positive HCV antibody test followed by a negative HCV ribonucleic acid (RNA) test at screening
- Patients with treated asymptomatic central nervous system (CNS) metastases are potentially eligible
- Patients with a history of autoimmune disease are allowed if controlled and on stable treatment for the last 12 weeks
- For women of childbearing potential: agreement to remain abstinent or use contraceptive methods that result in a failure rate of < 1% per year, during the treatment period and for at least 5 months after the final dose of atezolizumab or 6 months after the final dose of nab-paclitaxel, whichever is later. In addition, women must refrain from donating eggs during the same time period
- For men: with female partners of childbearing potential or pregnant female partners, men must remain abstinent or use a condom during the treatment period and for at least 6 months after the final dose of any component of the study treatment. Men must refrain from donating sperm during this same period
- Women who are not postmenopausal or surgically sterile must have a negative serum pregnancy test result within 14 days prior to initiation of study drug
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
Cancer-Specific Exclusion Criteria
- Spinal cord compression not definitively treated with surgery and/or radiation, or previously diagnosed and treated spinal cord compression without evidence that disease has been clinically stable for > 2 weeks prior to the first dose of study treatment
- Leptomeningeal carcinomatosis or any symptomatic CNS metastases
- Uncontrolled symptomatic pleural effusion, pericardial effusion, or ascites
- Uncontrolled tumor-related pain and uncontrolled or symptomatic hypercalcemia
- Malignancies other than breast cancer within 5 years prior to the first dose of study treatment, with the exception of those with a negligible risk of metastasis or death and treated with expected curative outcome
General Medical Exclusion Criteria:
- Pregnancy or lactation
- Evidence of significant uncontrolled concomitant disease that could affect compliance with the protocol or interpretation of results, including significant liver disease
- Significant cardiovascular disease such as New York Heart Association cardiac disease, myocardial infarction within 3 months prior to the first dose of study treatment, unstable arrhythmias, or unstable angina
- Severe infection within 4 weeks prior to the first dose of study treatment, including but not limited to hospitalization for complications of infection, bacteremia, severe pneumonia, or any active infection that, in the opinion of the investigator, could impact patient safety
- Treatment with oral or IV antibiotics within 2 weeks prior to initiation of study treatment
- Major surgical procedure within 28 days prior to the first dose of study treatment, or anticipation of the need for a major surgical procedure during the course of the study
- Treatment with investigational therapy within 4 weeks prior to Cycle 1, Day 1
- Known hypersensitivity to nab-paclitaxel or any of the excipients
- Positive human immunodeficiency virus test at screening, unless the patient meets all of the following conditions: (a) Stable on anti-retroviral therapy, (b) CD4 count >= 200/mL, (c) Undetectable viral load.
- Any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding that contraindicates the use of an investigational drug, may affect the interpretation of the results, or may render the patient at high risk from treatment complications
Exclusion Criteria Related to Atezolizumab
- History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins
- Known hypersensitivity or allergy to biopharmaceuticals produced in Chinese hamster ovary cells or any component of the atezolizumab formulation
- Prior allogenic stem cell or solid organ transplantation
- History of idiopathic pulmonary fibrosis, drug-induced pneumonitis, organizing pneumonia, or evidence of active pneumonitis on screening chest computed tomography scan
- Current treatment with anti-viral therapy for HBV
- Active tuberculosis
- Receipt of a live, attenuated vaccine within 4 weeks prior to the first dose of study treatment, or anticipation that such a live, attenuated vaccine will be required during atezolizumab treatment or within 5 months following the final dose of atezolizumab
- Prior treatment with CD137 agonists or immune checkpoint blockade therapies (including anti-CTLA4 antibodies) except for anti-PD-1 or anti-PD-L1 antibodies
- Treatment with syst
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method