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Immune Therapy in HR-positive/HER2-negative Metastatic Breast Cancer(ENIGMA)-BCTOP-L-M02

Phase 2
Recruiting
Conditions
Breast Cancer
Metastatic Cancer
Interventions
Drug: Nab paclitaxel
Drug: SHR-1316
Drug: SHR6390
Drug: SERD
Drug: AI
Registration Number
NCT05205200
Lead Sponsor
Fudan University
Brief Summary

This study is a prospective, open-label, phase II clinical study for patients with HR+/HER2- advanced breast cancer.

Detailed Description

Patients with SNF2 subtype of HR+/HER2- advanced breast cancer confirmed by the Department of Pathology and Key Laboratory of Breast Cancer of Fudan University Affiliated Cancer Hospital are planned to be enrolled. Five treatment arms were set up based on the whether they have exposed to CDK4/6 inhibitors before. The main purpose is to evaluate immune therapy in SNF2 subtype of HR+/HER2- advanced breast cancer and prepare for subsequent randomized controlled phase III clinical studies with larger sample size.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
338
Inclusion Criteria
  • Females ≥18 years and ≤ 75 years old;
  • Histologically confirmed HR + / HER2- invasive breast cancer (specific definition: immunohistochemical detection of ER> 10% tumor cell positive is defined as ER positive, PR> 10% tumor cell positive is defined as PR positive, ER and / or PR Positive is defined as HR positive; HER2 0-1 + or HER2 is ++ but negative followed by FISH detection, no amplification, defined as HER2 negative);
  • Subtype of similarity network fusion-2 (SNF-2) confirmed by the Department of Pathology and Key Laboratory of Breast Cancer of Fudan University Affiliated Cancer Hospital
  • Locally advanced breast cancer (incapable of radical local treatment) or recurrent metastatic breast cancer;
  • Measurable disease according to Response Evaluation Criteria in Solid Tumors v1.1 (RECIST v1.1); or unmeasurable lytic or mixed (osteolytic + osteoblastic) bone lesions in the absence of measurable lesions;
  • Has adequate bone marrow function: absolute neutrophil count > 1.5x10ˆ9 /L; platelet count > 75x10ˆ9 /L, hemoglobin > 9g/dL;
  • Patients had received no previous chemotherapy or targeted therapy for metastatic disease
  • Has adequate liver function and kidney function: serum creatinine
  • ECOG score ≤ 2 and life expectancy ≥ 3 months;
  • Participants voluntarily joined the study, has signed informed consent before any trial related activities are conducted, has good compliance and has agreed to follow-up.
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Exclusion Criteria
  • Treatment with chemotherapy, radiotherapy, immunotherapy or surgery (outpatient clinic surgery excluded) for metastatic disease

    • Symptomatic, untreated, or actively progressing CNS metastases(glucocorticoids or mannitol needed to control symptoms);
    • Significant cardiovascular disease(including congestive heart failure, angina pectoris, myocardial infarction or ventricular arrhythmia in the last 6 months);
    • is pregnant or breast feeding;
    • Malignant tumors in the past five years (except cured skin basal cell carcinoma and cervical carcinoma in situ).
    • History of autoimmune disease
    • Positive test for human immunodeficiency virus
    • Active hepatitis B or hepatitis C
    • Uncontrolled pleural effusion and ascites
    • Thyroid dysfunction.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Cohort 2BNab paclitaxelIn this cohort, a patient would single nab-paclitaxel.
Cohort 1ASHR6390In this cohort, a patient would receive SHR6390(CDK4/6 inhibitor) combined with SHR1316 (anti-PD-L1) and endocrine therapy.
Cohort 1BSHR6390In this cohort, a patient would receive SHR6390(CDK4/6 inhibitor) combined with endocrine therapy.
Cohort 2ASHR-1316In this cohort, a patient would receive SHR1316 (anti-PD-L1) combined with nab-paclitaxel.
Cohort 2CSERDIn this cohort, a patient would receive SHR6390(CDK4/6 inhibitor) combined with fulvestrant.
Cohort 1ASHR-1316In this cohort, a patient would receive SHR6390(CDK4/6 inhibitor) combined with SHR1316 (anti-PD-L1) and endocrine therapy.
Cohort 1BSERDIn this cohort, a patient would receive SHR6390(CDK4/6 inhibitor) combined with endocrine therapy.
Cohort 2CSHR-1316In this cohort, a patient would receive SHR6390(CDK4/6 inhibitor) combined with fulvestrant.
Cohort 1ASERDIn this cohort, a patient would receive SHR6390(CDK4/6 inhibitor) combined with SHR1316 (anti-PD-L1) and endocrine therapy.
Cohort 1AAIIn this cohort, a patient would receive SHR6390(CDK4/6 inhibitor) combined with SHR1316 (anti-PD-L1) and endocrine therapy.
Cohort 1BAIIn this cohort, a patient would receive SHR6390(CDK4/6 inhibitor) combined with endocrine therapy.
Cohort 2ANab paclitaxelIn this cohort, a patient would receive SHR1316 (anti-PD-L1) combined with nab-paclitaxel.
Primary Outcome Measures
NameTimeMethod
PFSRandomization until the first occurrence of disease progression or death from any cause, which ever occurs first, through the end of study (approximately 5 years)

time to progressive disease (according to RECIST1.1)

Secondary Outcome Measures
NameTimeMethod
OSRandomization to death from any cause, through the end of study (approximately 5 years)

time to death due to any cause

ORRRandomization until the first occurrence of disease progression or death from any cause, which ever occurs first, through the end of study (approximately 5 years)

The proportion of participants whose best outcome is complete remission or partial remission (according to RECIST1.1)

CBRRandomization until the first occurrence of disease progression or death from any cause, which ever occurs first, through the end of study (approximately 5 years)

the percentage of subjects with CR+PR+SD and last more than 24 weeks in all of the

Trial Locations

Locations (1)

Fudan University Shanghai cancer center

🇨🇳

Shanghai, China

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