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临床试验/NCT01042379
NCT01042379
招募中
2 期

I-SPY Trial (Investigation of Serial Studies to Predict Your Therapeutic Response With Imaging And moLecular Analysis 2)

QuantumLeap Healthcare Collaborative78 个研究点 分布在 1 个国家目标入组 5,000 人2010年3月1日

概览

阶段
2 期
干预措施
Pembrolizumab - 8 cycle
疾病 / 适应症
Breast Neoplasms
发起方
QuantumLeap Healthcare Collaborative
入组人数
5000
试验地点
78
主要终点
Determine whether adding experimental agents to standard neoadjuvant medications increases the probability of pathologic complete response (pCR) over standard neoadjuvant chemotherapy for each biomarker signature established at trial entry.
状态
招募中
最后更新
上个月

概览

简要总结

The purpose of this study is to further advance the ability to practice personalized medicine by learning which new drug agents are most effective with which types of breast cancer tumors and by learning more about which early indicators of response (tumor analysis prior to surgery via magnetic resonance imaging (MRI) images along with tissue and blood samples) are predictors of treatment success.

详细描述

I-SPY2 will assess the efficacy of novel drugs in sequence with standard chemotherapy. The goal is identify treatment strategies for subsets on the basis of molecular characteristics (biomarker signatures) of their disease with high estimated pCR rate. As described for previous adaptive trials, novel regimens with sufficiently high activities alone and contribute to treatment strategies that show a high Bayesian predictive probability of being more effective than the dynamic control will graduate from the trial with their corresponding biomarker signature(s). Treatment strategies will be dropped if they show a low probability of improved efficacy with any biomarker signature. New drugs will enter as those that have undergone testing complete their evaluation.

注册库
clinicaltrials.gov
开始日期
2010年3月1日
结束日期
2031年12月1日
最后更新
上个月
研究类型
Interventional
研究设计
Parallel
性别
All

研究者

责任方
Sponsor

入排标准

入选标准

  • Histologically confirmed invasive cancer of the breast
  • Clinically or radiologically measureable disease in the breast after diagnostic biopsy, defined as longest diameter greater than or equal to 25 mm (2.5cm)
  • No prior cytotoxic regimens are allowed for this malignancy. Patients may not have had prior chemotherapy or prior radiation therapy to the ipsilateral breast for this malignancy. Prior bis-phosphonate therapy is allowed
  • Age ≥18 years
  • ECOG performance status 0-1
  • Willing to undergo core biopsy of the primary breast lesion to assess baseline biomarkers
  • Non-pregnant and non-lactating
  • No ferromagnetic prostheses. Patients who have metallic surgical implants that are not compatible with an MRI machine are not eligible.
  • Ability to understand and willingness to sign a written informed consent (I-SPY TRIAL Screening Consent)
  • Eligible tumors must meet one of the following criteria: Stage II or III, or T4, any N, M0, including clinical or pathologic inflammatory cancer or Regional Stage IV, where supraclavicular lymph nodes are the only sites metastasis

排除标准

  • Use of any other investigational agents within 30 days of starting study treatment
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to the study agent or accompanying supportive medications.
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements

研究组 & 干预措施

Pembrolizumab 8 cycle

Arm is closed.

干预措施: Pembrolizumab - 8 cycle

Ganetespib

Arm is closed.

干预措施: Ganetespib

ABT-888

Arm is closed.

干预措施: ABT-888

Neratinib

Arm is closed.

干预措施: Neratinib

PLX3397

Arm is closed.

干预措施: PLX3397

Pembrolizumab 4 cycle

Arm is closed.

干预措施: Pembrolizumab - 4 cycle

Talazoparib plus Irinotecan

Arm is closed.

干预措施: Talazoparib plus Irinotecan

Patritumab with or without Trastuzumab

Arm is closed.

干预措施: Patritumab and Trastuzumab

Pertuzumab and Trastuzumab

Arm is closed. Novel Control Investigational Agent.

干预措施: Pertuzumab and Trastuzumab

Standard Therapy

Paclitaxel, Herceptin followed by Doxorubicin and Cyclophosphamide treatment depending on HR/HER-2 status.

干预措施: Standard Therapy

AMG 386 with or without Trastuzumab

Arm is closed.

干预措施: AMG 386 with or without Trastuzumab

AMG 386 with or without Trastuzumab

Arm is closed.

干预措施: AMG 386 and Trastuzumab

AMG 479 plus Metformin

Arm is closed.

干预措施: AMG 479 (Ganitumab) plus Metformin

MK-2206 with or without Trastuzumab

Arm is closed.

干预措施: MK-2206 with or without Trastuzumab

T-DM1 and Pertuzumab

Arm is closed.

干预措施: T-DM1 and Pertuzumab

SGN-LIV1A

Arm is closed.

干预措施: SGN-LIV1A

Durvalumab plus Olaparib

Arm is closed.

干预措施: Durvalumab plus Olaparib

SD-101 + Pembrolizumab

Arm is closed.

干预措施: SD-101 + Pembrolizumab

Tucatinib

Arm is closed.

干预措施: Tucatinib plus trastuzumab and pertuzumab

Cemiplimab

Arm is closed. Novel Investigational Agent.

干预措施: Cemiplimab

Cemiplimab plus REGN3767

Arm is closed. Novel Investigational Agent.

干预措施: Cemiplimab plus REGN3767

Trilaciclib with or without trastuzumab + pertuzumab

Arm is closed. Novel Investigational Agent.

干预措施: Trilaciclib with or without trastuzumab + pertuzumab

SYD985 ([vic-]trastuzumab duocarmazine)

Arm is closed. Novel Investigational Agent.

干预措施: SYD985 ([vic-]trastuzumab duocarmazine)

Oral Paclitaxel + Encequidar + Dostarlimab (TSR-042) + Carboplatin with or without trastuzumab

Arm is closed. Novel Investigational Agent.

干预措施: Oral Paclitaxel + Encequidar + Dostarlimab (TSR-042) + Carboplatin with or without trastuzumab

Oral Paclitaxel + Encequidar + Dostarlimab (TSR-042) with or without trastuzumab

Arm is closed. Novel Investigational Agent.

干预措施: Oral Paclitaxel + Encequidar + Dostarlimab (TSR-042) with or without trastuzumab

Endocrine Optimization Pilot: Amcenestrant Monotherapy

Arm is closed. Novel Investigational Agent.

干预措施: Amcenestrant

Endocrine Optimization Pilot: Amcenestrant + Abemaciclib

Arm is closed. Novel Investigational Agent.

干预措施: Amcenestrant + Abemaciclib

Endocrine Optimization Pilot: Amcenestrant + Letrozole

Arm is closed. Novel Investigational Agent.

干预措施: Amcenestrant + Letrozole

ARX788 in Block A and followed by SOC in Block B

Arm is closed for accrual for accrual. Novel investigational Agent followed by SOC.

干预措施: ARX788

ARX788 + Cemiplimab in Block A and followed by SOC in Block B

Arm is closed for accrual. Novel investigational Agent followed by SOC.

干预措施: ARX788 + Cemiplimab

VSV-IFNβ-NIS (VOYAGER V1™; VV1) + Cemiplimab in Block A and followed by SOC in block B

Arm is closed for accrual. Novel investigational Agent followed by SOC.

干预措施: VV1 + Cemiplimab

Datopotamab Deruxtecan in Block A and followed by SOC in block B

Arm is closed for accrual. Novel investigational Agent followed by SOC.

干预措施: Datopotamab deruxtecan

Datopotamab Deruxtecan + Durvalumab in Block A and followed by SOC in block B

Arm is closed for accrual. Novel investigational Agent followed by SOC.

干预措施: Datopotamab deruxtecan + Durvalumab

Endocrine Optimization Pilot: Lasofoxifene

Arm is closed for accrual. Novel investigational Agent.

干预措施: Lasofoxifene

Endocrine Optimization Pilot: (Z)-Endoxifen

Arm is closed for accrual. Novel investigational Agent.

干预措施: Z-endoxifen

Endocrine Optimization Pilot: ARV-471

Arm is closed for accrual. Novel investigational Agent.

干预措施: ARV-471

Endocrine Optimization Pilot: ARV-471 + Letrozole

Arm is closed for accrual. Novel investigational Agent.

干预措施: ARV-471 + Letrozole

Endocrine Optimization Pilot: ARV-471 + Abemaciclib

Arm is closed for accrual. Novel investigational Agent.

干预措施: ARV-471 + Abemaciclib

Endocrine Optimization Pilot: (Z)-Endoxifen + Abemaciclib

Arm is open for accrual. Novel investigational Agent.

干预措施: Endoxifen + Abemaciclib

Rilvegostomig + TDXd in Block A and followed by SOC in Block B

Arm is closed for accrual. Novel investigational Agent.

干预措施: Rilvegostomig + TDXd

DAN222 + Niraparib in Block A and followed by SOC in Block B

Arm is closed for accrual. Novel investigational Agent.

干预措施: Dan222 + Niraparib

Sarilumab + Cemiplimab + Paclitaxel in Block B followed by SOC Block C

Arm is closed for accrual. Novel investigational Agent.

干预措施: Sarilumab + Cemiplimab + Paclitaxel

GSK 5733584 in Block A and followed by SOC in Block B

Arm is open for accrual. Novel Investigational Agent.

干预措施: GSK 5733584

GSK 5733584 + Dostarlimab in Block A and followed by SOC in Block B

Arm is open for accrual. Novel Investigational Agent.

干预措施: GSK 5733584 + Dostarlimab

Zanidatamab for Block ABC

Arm open for accrual. Novel investigational Agent.

干预措施: Zanidatamab

结局指标

主要结局

Determine whether adding experimental agents to standard neoadjuvant medications increases the probability of pathologic complete response (pCR) over standard neoadjuvant chemotherapy for each biomarker signature established at trial entry.

时间窗: Post surgery based on upto 36-week treatment

次要结局

  • Establishing predictive and prognostic indices based on qualification and exploratory markers to predict pCR and residual cancer burden (RCB).(Blood and Tissue Collection: Baseline, Post-Randomization, Pre-AC, Pre- and Post-Surgery)
  • To determine three- and five-year relapse-free survival (RFS) and OS among the treatment arms.(Three- and Five-Year Post-surgery Follow-up)
  • MRI Volume(Four time points during the on-study phase: Baseline, Post-randomization, Pre-AC treatment and Pre-Surgery)
  • To determine incidence of adverse events (AEs), serious adverse events (SAEs), and laboratory abnormalities of each investigational agent tested.(Post-Randomization, Pre-AC, Pre-Surgery, Post-Surgery upto One Year during follow-up)

研究点 (78)

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Major Advances in Breast Cancer Treatment Highlighted in 2024• Inavolisib, combined with palbociclib and fulvestrant, received FDA approval for HR+/HER2-, PIK3CA-mutated advanced breast cancer, offering a new targeted therapy option. • Ribociclib was approved for adjuvant treatment of HR+/HER2- early breast cancer with high recurrence risk, based on improved invasive disease-free survival in the NATALEE trial. • Olaparib demonstrated a significant overall survival benefit in BRCA-mutated, HER2-negative early breast cancer, marking the first PARP inhibitor to achieve this milestone. • Fam-trastuzumab deruxtecan-nxki (T-DXd) showed statistically significant progression-free survival improvement in HR+/HER2-low metastatic breast cancer after endocrine therapy.Dato-DXd Plus Durvalumab Shows Variable pCR Rates in High-Risk Breast Cancer Subtypes- The I-SPY 2.2 trial evaluated datopotamab deruxtecan (Dato-DXd) plus durvalumab in stage II/III high-risk HER2-negative breast cancer, revealing an overall pathologic complete response (pCR) rate of 50%. - Treatment response varied significantly across response predictive subtypes (RPS), with the HR-negative/HER2-negative/immune-negative/DRD-negative subtype showing a pCR rate of 44% compared to 16% in the control. - The combination's toxicity profile was consistent with prior studies, and a substantial proportion of pCRs were achieved early in treatment, potentially avoiding standard chemotherapy. - These findings support further investigation in randomized controlled trials, particularly focusing on immune-positive and HR-negative/DRD-negative subtypes to optimize neoadjuvant breast cancer treatment.