DecipHER Trial - DC1 Tx for Early-Stage TNBC and ER Low Positive Breast Cancer

Triple Negative Breast Cancer Clinical Trial

— DecipHER  

Official title:

Phase 1 Dose-Escalation, Dose-Expansion Trial of Intratumoral HER2- and HER3-Primed Dendritic Cells Injections for the Treatment of Early-Stage TNBC and ER Low Positive Breast Cancer (DecipHER)

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05504707
• Other study ID #: MCC-20897
• Status: Recruiting
• Phase: Phase 1
• Start date: August 26, 2022
• Est. completion date: April 2025

Study information

• Verified date: May 2024
• Source: H. Lee Moffitt Cancer Center and Research Institute
• Contact: Ricardo Costa
• Phone: 813-745-5051
• Email: Ricardo.Costa[@]moffitt.org
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of the study is to find out if an investigational vaccine called Dendritic Cell (DC) vaccine given together with standard of care chemotherapy drugs can help people with Triple Negative and HR low positive breast cancer.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 30
• Est. completion date: April 2025
• Est. primary completion date: June 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• A diagnosis of HER2-negative breast cancer.

• Diagnosis of HR negative or HR low positive tumor.

• Clinical stage T1c, nodal stage N1-N2 or stage T2-4, nodal stage N0-N2 breast cancer.

• Participant must be medically and surgically appropriate to undergo neoadjuvant chemotherapy regimen followed by standard of care local therapy as determined by their treating physician.

• Age =18 years.

• ECOG performance status 0 or 1.

• Patients must have normal organ and marrow function, as defined below, within 14 days of registration:

• *Absolute neutrophil count (ANC) = 1500/µL

• *Platelets = 75 000/µL

• *Total bilirubin = 1.5 x institutional ULN, except patients with Gilbert's syndrome in whom total bilirubin must be < 3.0 mg/dL

• *AST/ALT = 3 x institutional ULN

• *Creatinine = 1.5 x institutional ULN

• Left ventricular ejection fraction above institutional lower limit of normal (by echocardiogram or MUGA scan).

• Female patients of childbearing potential must agree to use dual methods of contraception and have a negative serum pregnancy test at screening. Acceptable methods of contraception are condoms with contraceptive foam, oral, implantable or injectable contraceptives, contraceptive patch, intrauterine device, diaphragm with spermicidal gel, or a sexual partner who is surgically sterilized or post-menopausal. Effective methods of contraception must be used throughout the study and for 5 months following the last dose. To show that women do not have childbearing potential, postmenopausal women must be amenorrheic for at least 12 months naturally (and not because of/following chemotherapy) or patients must be surgically sterile.

• Ability to understand and the willingness to sign a written informed consent agreement prior to study registration.

Exclusion Criteria:

• Patients who received prior anthracycline-based chemotherapy for the treatment of any cancer.

• Patients with inflammatory breast cancer.

• Patients must not be receiving any other investigational agents or active antineoplastic therapies.

• 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.

• Patients with active autoimmune disease or history of autoimmune disease that might recur, which may affect vital organ function or require immune-suppressive treatment, including chronic prolonged systemic corticosteroid use (defined as corticosteroid use lasting one month or more).

• Female patients who are pregnant or nursing.

• No other prior malignancy is allowed, except for the following: a. adequately treated basal-cell or squamous-cell skin cancer, b. in situ cervical cancer, c. or any other cancer from which the patient has been disease free for at least 3 years.

• History of testing positive for human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS).

• History of positive test for Hepatitis B or Hepatitis C virus indicating acute or chronic infection.

• Patients who have received a live attenuated vaccine = 30 days prior to registration.

• Unable to comply with the treatment schedule and study procedures for any reason.

• Previously treated with breast cancer-directed vaccine therapies in prior 3 months.

• Previously treated with any form HER2- or HER3-primed DC1 therapy.

Related Conditions & MeSH terms

• Breast Neoplasms
• HER2-negative Breast Cancer
• Triple Negative Breast Cancer
• Triple Negative Breast Neoplasms

Intervention

Biological:
• HER2 - primed Dendritic cells
Dendritic cell will be administered at ultra-sound guided injections. Participants will receive 8 intratumoral injections. These injections will be administered twice per week per week (given 3 days apart). Participants will receive alternating injections (3 days apart) of HER2-primed followed by HER3-primed DCs. Participants will be treated at the following dose levels: Dose level 1: HER2 - primed Dendritic cells dose 10-20 million Dose level 2: HER2 - primed Dendritic cells dose 30-50 million Dose level 3: HER2 - primed Dendritic cells dose 80-100 million
• HER3 - primed Dendritic cells
Dendritic cell will be administered at ultra-sound guided injections. Participants will receive 8 intratumoral injections. These injections will be administered twice per week per week (given 3 days apart). Participants will receive alternating injections (3 days apart) of HER2-primed followed by HER3-primed DCs. Participants will be treated at the following dose levels: Dose level 1: HER3 - primed Dendritic cells dose 10-20 million Dose level 2: HER3 - primed Dendritic cells dose 30-50 million Dose level 3: HER3 - primed Dendritic cells dose 80-100 million

Locations

Country	Name	City	State
United States	Moffitt Cancer Center	Tampa	Florida

Sponsors (2)

Lead Sponsor	Collaborator
H. Lee Moffitt Cancer Center and Research Institute	The Shulas' Foundation

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Maximum Tolerated Dose (MTD)	Maximum Tolerated Dose (MTD) of HER2- and HER3- primed DC1 study vaccines. The MTD will be defined as the highest dose level at which < 2 of 6 patients experience dose-limiting toxicities (DLTs).	4 weeks after start of treatment
Secondary	Number of Dose Limiting Toxicities	Number of DLTs experienced by participants	5 weeks after start of treatment
Secondary	Participants with pathological complete response after receiving HER2/HER3 DC1 intratumoral injections	Pathological complete response defined as the absence of invasive breast cancer in the breast and lymph nodes after completion of treatment with DC1 injections and neoadjuvant chemotherapy.	Up to 24 weeks
Secondary	Participants with clinical and radiological responses after receiving HER2/HER3 DC1	Clinical or radiological complete responses (CR): Palpable or visible lesion(s) identified at baseline are no longer palpable and there are no new lesion(s) or other signs of disease progression.	Up to 36 Months
Secondary	Participants with clinical and radiological partial responses after receiving HER2/HER3 DC1	Clinical or radiological partial responses (PR): A reduction in the product of the two largest perpendicular diameters of the primary tumor by 50% or more.	Up to 36 Months
Secondary	Participants with clinical and radiological progression of disease after receiving HER2/HER3 DC1	Clinical or radiological progression of disease (PD): An increase in the product of the two largest perpendicular diameters of the primary tumor by 25% or more or the presence of a new lesion.	Up to 36 Months
Secondary	Participants with clinical and radiological stable disease after receiving HER2/HER3 DC1	Clinical or radiological stable disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD.	Up to 36 Months
Secondary	Participants with Recurrence Free Survival (RFS)	Recurrence free survival (RFS) defined as time I months to breast cancer recurrence or death (whichever comes first) since date of surgical treatment of breast cancer.	Up to 36 Months

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