Breast Cancer With Low to Intermediate HER2 Expression Clinical Trial
Official title:
PRESENT: Prevention of Recurrence in Early-Stage, Node-Positive Breast Cancer With Low to Intermediate HER2 Expressions With NeuVax™Treatment
Purpose of this trial:
1. To assess the efficacy and safety of NeuVax™ administered with adjuvant Leukine®
(sargramostim, GM-CSF).
2. To evaluate and compare the disease free survival (DFS) in the vaccinated and control
subjects.
This is a multicenter, multinational, prospective, randomized, double-blind, controlled
Phase 3 study.
The subjects eligible for this trial have an early stage node-positive breast cancer. Their
tumors express low or intermediate levels of the HER2 protein. NeuVax™ will be administered
after completion of front-line, standard of care therapy (surgery, radiation therapy, and
chemotherapy) and can be given concomitantly with physician prescribed endocrine treatment.
NeuVax™ is the immmunodominant nonapeptide derived from the extracellular domain of the HER2
protein, a well-established target for therapeutic intervention in breast carcinoma. The
nelipepimut sequence stimulates specific CD8+ cytotoxic T lymphocytes (CTL) following
binding to HLA-A2/A3 molecules on antigen presenting cells (APC). These activated specific
CTLs recognize, neutralize and destroy through cell lysis HER2 expressing cancer cells,
including occult cancer cells and micrometastatic foci. The nelipepimut immune response can
also generate CTLs to other immunogenic peptides through inter- and intra-antigenic epitope
spreading. Based on a successful Phase 2 trial, which achieved its primary endpoint of DFS,
the Food and Drug Administration (FDA) granted NeuVax a Special Protocol Assessment (SPA)
for its Phase 3 PRESENT (Prevention of Recurrence in Early-Stage, Node-Positive Breast
Cancer with Low to Intermediate HER2 Expression with NeuVax Treatment) study.
The active portion of the study will last three years (36 months). The follow-up will last
from 5 to 10 years.
Endpoints:
1. Primary efficacy endpoint:
- 3-year DFS
2. Secondary efficacy endpoints:
- 5- and 10-year DFS
- 3-year OS
- 5- and 10-year OS
- Safety profile, and adverse events (AEs)
- Patterns of recurrence to include Time to recurrence (TTR), time to local
recurrence (TTLR), time to distant recurrence (TTDR), time to bone metastases
(TTBM)
Safety Assessments:
Subjects will be assessed at every study visit for the safety endpoints, AEs,vital signs,
physical examinations and laboratory data; yearly follow-up of survival will include imaging
studies, ECGs, MUGA or ECHO scans and concomitant medications.
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