Metastatic Breast Cancer Clinical Trial
Official title:
Enhancing Efficacy of Chemotherapy in Triple Negative/Basal-Like Breast Cancer by Targeting Macrophages: A Multicenter Phase Ib/II Study of PLX 3397 and Eribulin in Patients With Metastatic Breast Cancer
The purpose of the Phase 1b portion of the study is to determine the best dose of PLX3397 when given in combination with standard dose eribulin (Halaven™). The purpose of the Phase 2 portion of the study is to find out what effects, good and/or bad, these drugs have on patients and their metastatic breast cancer.
This is a nonrandomized, open label phase Ib/II study evaluating the safety and efficacy of
eribulin in combination with PLX3397, a novel CSF1 inhibitor, in patients with metastatic
breast cancer. The phase II portion of this trial will be limited to patients with triple
negative disease.
The phase I portion of this trial is a dose escalation of PLX3397 to determine the maximum
tolerated dose (MTD) of PLX3397 when given in combination with standard dose eribulin.
Patients will be enrolled in cohorts of three, using the dose levels and plan outlined in the
statistical section, with 6 patients enrolled at the MTD. All patients with accessible tumor
will be required to have a tumor biopsy at study start before starting therapy.
Pharmacokinetics of PLX3397 and eribulin, and blood levels of CSF1 will be obtained as
outlined in section 14. To allow rapid accrual to phase Ib, and an earlier start to the phase
II trial, patients will be enrolled in phase I with both hormone receptor positive and
negative disease, and at any line of therapy assuming eligibility criteria are otherwise met.
Dose limiting toxicity (DLT) will be defined as any treatment-related toxicity meeting the
criteria below and occurring within the first 21 days of combination therapy. Patients must
receive at least 14 days of PLX3397 and 2 doses of eribulin during the first cycle in order
to be considered evaluable for DLT (unless the missed doses are due to a DLT).
Patients in each cohort will be followed for at least 3 weeks (one full cycle) before opening
accrual to the next dose level. If one patient in any cohort develops a DLT, an additional 3
patients will be enrolled at that level. If no additional toxicities occur in the six
patients, then this particular dose would be used for the phase II trial, and the next higher
dose would be considered the MTD. A minimum of 12 and maximum of 24 patients will be enrolled
in the phase I study. The phase II trial will not open until the last patient in the phase I
study has been followed for at least 3 weeks.
The phase II portion of this trial will evaluate progression free survival (PFS) in patients
with Triple negative breast cancer (TNBC) treated with PLX3397 and eribulin, using the dose
of PLX3397 determined in the phase Ib study in a two-step design. Please see the statistical
section for details regarding enrollment and statistical design. Treatment is preceded by a 5
to 7 day lead-in phase, in which patients will take PLX3397 alone daily. Patients with
accessible tumor will undergo a core biopsy of tumor before the start of PLX3397 treatment,
and then a fine needle aspiration or core biopsy will be performed on the day of or the day
before the start of eribulin (day -1 to day 0).
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