eoadjuvant therapy in TRIPle negative breast cancer with antiPDL1

Phase 1

• Conditions: Women with a diagnosis of invasive unilateral, early high-risk and locally advanced or inflammatory, triple negative (HER2-negative and ER-negative and PgRnegative) breast cancer of high proliferation or grade suitable for neoadjuvant Therapy.; MedDRA version: 20.0Level: PTClassification code 10006200Term: Breast cancer stage IISystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps); MedDRA version: 20.0Level: LLTClassification code 10006196Term: Breast cancer NOS stage IIISystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps); MedDRA version: 20.0Level: LLTClassification code 10006195Term: Breast cancer NOS stage IISystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps); MedDRA version: 20.0Level: PTClassification code 10006201Term: Breast cancer stage IIISystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps); MedDRA version: 20.0Level: PTClassification code 10075566Term: Triple negative breast cancerSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps); MedDRA version: 21.0Level: LLTClassification code 10021975Term: Inflammatory breast cancer stage IIISystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps); Therapeutic area: Diseases [C] - Cancer [C04]

• Registration Number: EUCTR2014-005017-23-DE
• Lead Sponsor: Fondazione Michelangelo - Avanzamento dello studio e cura dei tumori

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2015-10-05
• Last Update Posted: 23 May 2022

Recruitment & Eligibility

• Status: Authorised-recruitment may be ongoing or finished
• Sex: Female
• Target Recruitment: 272

Inclusion Criteria

1. Female patients aged 18 years or older with early high-risk (T1cN1 ; T2N1; T3N0) or locally advanced and inflammatory breast cancers (stage III A-C according to AJCC) suitable
for neoadjuvant treatment
2. Histologically confirmed unilateral breast cancer with invasive ductal histology not otherwise specified (NOS) of high proliferation or grade
3. HER2 negative disease defined as 0-1+ by immunohistochemistry or 2+ by immunohistochemistry without HER2 amplification by either In Situ Hybridization (ISH) or other amplification tests done locally.
4. Negative estrogen receptor (ER) and progesterone receptor (PgR), both < 1% locally assessed
5. Representative paraffin-embedded (FFPE) tumor block taken at diagnostic biopsy for confirmation of HER2, ER and PgR eligibility, for assessment of PD-L1 expression and for further exploratory biomarker evaluation is mandatory. Note: FFPE tumor blocks are also mandatory after the first cycle of therapy; surgery tissue (residual tumor or tumor bed in case of pCR) is also mandatory
6. ECOG performance status 0 or 1
7. Written informed consent to participate in the trial (approved by the Institutional Review Board [IRB]/ Independent Ethics Committee [IEC])
obtained prior to any study specific screening procedures
8. Willing and able to comply with the protocol
9. Consent to the collection of blood samples mandatorily before starting neoadjuvant treatment, after the first cycle of therapy, at the end of
neoadjuvant treatment (before surgery), at the end of adjuvant chemotherapy and once a year for 2 years during follow-up
10. For women who are not postmenopausal (=12months of non-therapyinducedamenorrhea) or surgically sterile (absence of ovaries and/or
uterus): agreement to remain abstinent or use single or combinedcontraceptive methods that result in a failure rate of<1% per year during the treatment period and for at least 6 months after the last dose of study drug. Abstinence is only acceptable if it is in line with the preferred and usual lifestyle of the patient. Periodic abstinence (e.g., calendar, ovulation, symptothermal, or postovulation methods) and withdrawal are not acceptable methods of contraception. Examples of contraceptive methods with a failure rate of< 1% per year include tubal ligation, hormonal implants, established, proper use of combined oral or injected hormonal contraceptives, and certain intrauterine devices. Note: patients with no Uterus do not need to be on contraception.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 272
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 272

Exclusion Criteria

1.Evidence of bilateral breast cancer or metastatic disease (M1)
2.Cases with an histology different from invasive ductal NOS of high proliferation or grade
3.Patients with HER2-positive disease according to ASCO/CAP guidelines 2013 are considered not eligible for the study
4.Pregnant or lactating women.
5.Previous treatment with chemotherapy, hormonal therapy or an investigational drug for any type of malignancy. Presence of bleeding
tumors
6.Previous investigational treatment for any condition within 4 weeks or five half-lives of randomization date, whichever is longer
7.Administration of a live,attenuated vaccine within 4 weeks before C1D1 or anticipation that such a live attenuated vaccine will be required during study or within 5 months after last atezolizumab dose.
8.Previous or concomitant invasive malignancy of any other type or previous invasive breast cancer or curatively treated basal cell carcinoma of the skin or in situ cervix cancer are generally eligible
9.Pre-existing motor or sensory neuropathy of grade > 1 for any reason
10.History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion Proteins, to human albumin solution, hypersensitivity to platinum containing compounds.
11.Known hypersensitivity or allergy to biopharmaceuticals produced in Chinese hamster ovary cells or any component of the Atezolizumab formulation
12.Patients with prior allogeneic stem cell or solid organ transplantation
13.History of autoimmune disease including, but not limited to, systemic lupus erythematosus, heumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with antiphospholipid syndrome, Wegener’s granulomatosis, Sjögren’s syndrome, Bell’s palsy, Guillain-Barré syndrome, multiple sclerosis, vasculitis, or glomerulonephritis
14.History of idiopathic pulmonary fibrosis (including bronchiolitis obliterans with organizing pneumonia) or evidence of active pneumonitis on screening chest computed tomography scan
15.Known clinically significant liver disease, including active viral, alcoholic, or other hepatitis, cirrhosis, fatty liver, and inherited liver disease
16.History of HIV infection, active hepatitis B (chronic or acute), or hepatitis C infection. All patients have to undergo hepatitis and HIV testing during screening.
17.Active tuberculosis
18.Severe infections within 4 weeks prior to C1D1, including, but not limited to, ospitalization for complications of infection, bacteremia, or severe pneumonia. Signs or symptoms of significant infection within 2 weeks prior to cycle 1 Day 1
19.Received oral or IV antibiotics within 2 weeks prior to Cycle 1 Day 1
20.History of documented congestive cardiac failure; New York Heart Association (NYHA) Class II or greater CHF; angina pectoris requiring anti-anginal medication or unstable angina within 6 months prior to cycle 1 Day 1; evidence of transmural infarction on ECG; myocardial infarction stroke or transient ischemic attack (TIA) within 6 months prior to cycle 1 Day 1; poorly controlled hypertension (e.g. systolic >180 mm Hg or diastolic >100 mm Hg; however, patients with hypertension which is well controlled on medication are eligible); clinically significant valvular heart disease; high-risk uncontrolled arrhythmias
21.Patients with a history of uncontrolled seizures, central nervous system disorders or psychiatric disability judged by the investigator to be clinically significant and precluding informe

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified