A Phase II Trial Evaluating Safety and Efficacy of Pembrolizumab and Cisplatin in Patients With Advanced Triple Negative Breast Cancer
Overview
- Phase
- Phase 2
- Intervention
- Pembrolizumab
- Conditions
- Estrogen Receptor Negative
- Sponsor
- University of Washington
- Locations
- 1
- Primary Endpoint
- To evaluate the efficacy of combination pembrolizumab and cisplatin in participants with advanced TNBC
- Status
- Withdrawn
- Last Updated
- 7 years ago
Overview
Brief Summary
This is a Phase II treatment study that is done to evaluate how effective and safe the combination of pembrolizumab and cisplatin work in treating participants with triple-negative breast cancer that had spread to other parts of the body, has come back, or cannot be removed by surgery. Pembrolizumab (investigational drug) is a monoclonal antibody that works by helping your immune system to fight cancer. Cisplatin is a chemotherapy drug that works by interfering with tumor cell division. Studies also suggest that treatment with chemotherapy, like cisplatin, may improve the effectiveness of pembrolizumab. This study will test the effectiveness of pembrolizumab and cisplatin in participants with advanced triple-negative breast cancer.
Detailed Description
Participants will receive pembrolizumab intravenously (IV) over 30 minutes and cisplatin once every 3 weeks for a total of 6 doses. Both drugs are given by vein (Intravenous(IV)) on day 1. Participants that are responding to the study treatment will continue to receive pembrolizumab alone for up to 24 months until disease gets worse, having bad side effects, no longer wish to be in the study, or have become pregnant (whichever comes first). In addition to study drug administration visits, participants will be asked to have physical exams, blood draws every three weeks and tumor evaluation using MRI or CT scans every 9 weeks. After completion of study treatment, participants are followed up for safety within at 30 days of last dose of study treatment and then every 12 weeks until study completion.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Have histologically confirmed diagnosis of metastatic or locally recurrent and inoperable triple negative breast cancer (estrogen receptor \[ER\] \< 10%, progesterone receptor \[PR\] \< 10% and HER2 negative by IHC or fluorescence in situ hybridization \[FISH\]).
- •Be willing and able to provide written informed consent for the trial.
- •Have measurable disease based on RECIST 1.
- •Be willing to provide tissue from a newly obtained core or excisional biopsy of a tumor lesion. Newly-obtained is defined as a specimen obtained up to 6 weeks (42 days) prior to initiation of treatment on day
- •Participants for whom newly-obtained samples cannot be provided (e.g. inaccessible or participant safety concern) may submit an archived specimen only upon agreement from the principal investigator. \* Participants that are screening for second course phase (retreatment period) do not need to comply with the tumor tissue collection eligibility criteria.
- •Have a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) performance scale. Evaluation of ECOG is to be performed within 10 days prior to the date of treatment initiation.
- •Absolute neutrophil count (ANC) \>= 1500/uL, performed within 10 days of treatment initiation.
- •Platelets \>= 100 000/uL, performed within 10 days of treatment initiation.
- •Hemoglobin \>= 9.0 g/dL or \>= 5.6 mmol/L, performed within 10 days of treatment initiation.
- •Creatinine =\< 1.5 x upper limit of normal (ULN) OR measured or calculated creatinine clearance (glomerular filtration rate \[GFR\] can also be used in place of creatinine or creatinine clearance \[CrCl\]) \>= 30 mL/min for participant with creatinine levels \> 1.5 x institutional ULN, performed within 10 days of treatment initiation.
Exclusion Criteria
- •Has received greater than 3 lines of cytotoxic chemotherapy for metastatic breast cancer.
- •Documented disease progression on prior cisplatin therapy.
- •Is currently participating in or has participated in a study of an investigational agent or using an investigational device within 4 weeks of the first dose of treatment. \* Note: participants who have entered the follow-up phase of an investigational study may participate as long as it has been 4 weeks after the last dose of the previous investigational agent.
- •Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of study drug.
- •Has had a prior monoclonal antibody within 4 weeks prior to study day 1 or who has not recovered (i.e., =\< grade 1 or at baseline) from adverse events due to agents administered more than 4 weeks earlier.
- •Has received prior systemic anti-cancer therapy including investigational agents within 2 weeks prior to first dose of study treatment. \* Note: participants must have recovered from all adverse events (AEs) due to previous therapies to =\< grade 1 or baseline. Participants with =\< grade 2 neuropathy may be eligible. \* Note: if participant received major surgery, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting study treatment.
- •Has a known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (e.g. breast carcinoma, cervical cancer in situ) that has undergone potentially curative therapy.
- •Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are radiologically stable, i.e. without evidence of progression for at least 4 weeks by repeat imaging (note that the repeat imaging should be performed during study screening), clinically stable and without requirement of steroid treatment for at least 14 days prior to first dose of study treatment.
- •Has severe hypersensitivity (\>= grade 3) to pembrolizumab and/or any of its excipients.
- •Has received prior radiotherapy within 2 weeks of start of study treatment. Participants must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis. A 1-week washout is permitted for palliative radiation (=\< 2 weeks of radiotherapy) to non-CNS disease.
Arms & Interventions
Treatment (pembrolizumab, cisplatin)
Participants receive pembrolizumab and cisplatin once every 3 weeks for a total of 6 doses. Both drugs are given by vein (IV). Participants that are responding to the study treatment will continue to receive pembrolizumab alone beyond 6 cycles for up to 24 months until disease gets worse, having bad side effects, no longer wish to be in the study, or have become pregnant (whichever comes first). Participants receive pembrolizumab over 30 minutes and cisplatin on day 1. Treatment repeats every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity. Participants without disease progression after 6 courses may continue on pembrolizumab IV on day 1 every 21 days for up to 24 months (or 35 courses) in the absence of disease progression or unacceptable toxicity.
Intervention: Pembrolizumab
Treatment (pembrolizumab, cisplatin)
Participants receive pembrolizumab and cisplatin once every 3 weeks for a total of 6 doses. Both drugs are given by vein (IV). Participants that are responding to the study treatment will continue to receive pembrolizumab alone beyond 6 cycles for up to 24 months until disease gets worse, having bad side effects, no longer wish to be in the study, or have become pregnant (whichever comes first). Participants receive pembrolizumab over 30 minutes and cisplatin on day 1. Treatment repeats every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity. Participants without disease progression after 6 courses may continue on pembrolizumab IV on day 1 every 21 days for up to 24 months (or 35 courses) in the absence of disease progression or unacceptable toxicity.
Intervention: Cisplatin
Outcomes
Primary Outcomes
To evaluate the efficacy of combination pembrolizumab and cisplatin in participants with advanced TNBC
Time Frame: Up to 10 years
Measured by overall response rate (ORR) assessed by RECIST v1.1 criteria.
Secondary Outcomes
- Disease Control Rate(Up to 10 years)
- Disease control rate (DCR)(Up to 10 years)
- Overall survival (OS) in participants with advanced TNBC treated with pembrolizumab and cisplatin(Up to 10 years)
- Duration of response (DoR)(Up to 10 years)
- Safety of pembrolizumab and cisplatin in participants with advanced TNBC(Up to 10 years)
- Progression-free survival(Up to 10 years)