Clinical trial • Phase II • Oncology
CARBOPLATIN for Triple-negative breast cancer | High-risk triple-negative breast cancer | Early-stage triple-negative breast cancer
Phase II trial of CARBOPLATIN for Triple-negative breast cancer | High-risk triple-negative breast cancer | Early-stage triple-negative breast cancer.
Overview
- Trial Therapeutic Area
- Oncology
- Trial Disease
- Triple-negative breast cancer | High-risk triple-negative breast cancer | Early-stage triple-negative breast cancer
- Trial Stage
- Phase II
- Drug Modality
- Monoclonal antibody|Small molecule|Peptide/protein/enzyme
Key dates
- Initial CTIS Submission Date
- 08-11-2023
- First CTIS Authorization Date
- 13-03-2024
Trial design
Pembrolizumab plus anthracycline-containing chemotherapy (EC/AC) versus pembrolizumab plus carboplatin/paclitaxel-containing chemotherapy; specific doses and schedules not specified in the available data.-controlled, adaptive Phase II trial in Portugal.
- Comparator
- Pembrolizumab plus anthracycline-containing chemotherapy (EC/AC) versus pembrolizumab plus carboplatin/paclitaxel-containing chemotherapy; specific doses and schedules not specified in the available data.
- Adaptive
- True, the protocol specifies response-guided treatment sequencing: response assessment after the first block of chemo + pembrolizumab with the possibility of earlier surgery if imaging shows complete response, otherwise continuing with the second block and standard surgery timing (as described in the protocol product change description).
- Biomarker Stratified
- True, TILs (stromal tumor-infiltrating lymphocytes) ≥10%
- Target Sample Size
- 20
- Trial Duration For Participant
- 365
Eligibility
Recruits 20 Participants must be at least 18 years old and provide written informed consent. 'Subjects without legal capacity who are unable to understand the nature, scope, significance and consequences of this clinical trial and to consent' are explicitly excluded. The consent permits optional consent for future biomedical research; participants may participate in the main study without consenting to future biomedical research..
- Pregnancy Exclusion
- Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through at least 12 months after the last dose of cyclophosphamide or 6 months after last chemotherapy (whichever occurs last).
- Vulnerable Population
- Participants must be at least 18 years old and provide written informed consent. 'Subjects without legal capacity who are unable to understand the nature, scope, significance and consequences of this clinical trial and to consent' are explicitly excluded. The consent permits optional consent for future biomedical research; participants may participate in the main study without consenting to future biomedical research.
Inclusion criteria
- {"criterion_text":"- Be willing and able to provide written informed consent for the trial.\n- Male participants: A male participant must agree to use a contraception as detailed in Appendix 3 of this protocol during the treatment period and for at least 12 months after the last dose of cyclophosphamide or 6 months after last chemotherapy (whichever occurs last) and refrain from donating sperm during this period. Female participants: A female participant is eligible to participate if she is not pregnant (see Appendix 3), not breastfeeding, and at least one of the following conditions applies: a. Not a woman of childbearing potential (WOCBP) as defined in Appendix 3 OR b. A WOCBP who agrees to follow the contraceptive guidance in Appendix 3 during the treatment period and for at least 12 months after the last dose of cyclophosphamide or 6 months after last chemotherapy (whichever occurs last).\n- Be a female or male participant who is at least 18 years of age on the day of signing informed consent.\n- Have locally histologically confirmed diagnosis of invasive carcinoma of the breast that is classified as TNBC, as defined by the most recent ASCO/CAP guidelines.\n- Has locally confirmed tumor infiltrating lymphocytes (stromal) (sTILs) equal to or above 10%, as defined by the most recent International Guidelines on TIL Assessment in Breast Cancer.\n- Have previously untreated non-metastatic (M0) TNBC defined as the following combined primary tumor (T) and regional lymph node (N) staging per current AJCC staging criteria for breast cancer staging criteria as assessed by the investigator based on radiological and/or clinical assessment: a. T1c, N1-N2; b. T2, N0-N2; c. T3, N0-N2; d. T4a-d, N0-N2.\n- Provide a core needle biopsy consisting of at least 3 separate tumor cores from the primary tumor at screening to the designated central biobank (or responsible laboratories) and is willing to provide a second biopsy at the end of the first cycle of treatment.\n- Have Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 performed within 10 days of treatment initiation.\n- Have left ventricular ejection fraction (LVEF) of ≥50% or ≥ institution lower limit of normal (LLN) as assessed by echocardiogram (ECHO) or multigated acquisition (MUGA) scan performed at screening.\n- Have adequate organ function as defined in Table 2 of this protocol. Specimens must be collected within 28 days prior to the start of study intervention."}
Exclusion criteria
- {"criterion_text":"- Has a history of invasive malignancy ≤5 years prior to signing informed consent except for adequately treated basal cell or squamous cell skin cancer or in situ cervical cancer.\n- Has had an allogenic tissue/solid organ transplant.\n- Has received prior chemotherapy, targeted therapy, and radiation therapy within the past 12 months.\n- Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (eg, CTLA-4, OX-40, CD137).\n- Is currently participating in or has participated in an interventional clinical trial with an investigational compound or device within 4 weeks of the first dose of treatment in this current trial.\n- Has received a live vaccine or live-attenuated vaccine within 30 days prior to the first dose of study drug. Administration of killed vaccines is allowed.\n- 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.\n- Has active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (eg., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment and is allowed.\n- Has a history of (non-infectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease.\n- Has significant cardiovascular disease, such as: a. History of myocardial infarction, acute coronary syndrome or coronary angioplasty/stenting/bypass grafting within the last 6 months; b. Congestive heart failure (CHF) New York Heart Association (NYHA) Class II-IV or history of CHF NYHA class III or IV.\n- Subjects without legal capacity who are unable to understand the nature, scope, significance and consequences of this clinical trial and to consent\n- Has a known history of Human Immunodeficiency Virus (HIV) infection.\n- Has a known history of Hepatitis B (defined as Hepatitis B surface antigen [HBsAg] reactive) or known active Hepatitis C virus (defined as HCV RNA [qualitative] is detected) infection.\n- Has a known history of active TB (Bacillus Tuberculosis).\n- Has an active infection requiring systemic therapy.\n- If surgery was performed prior to screening, has persistent adverse events or incomplete wound healing considered clinically relevant by the treating investigator.\n- Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the participant‘s participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating investigator.\n- Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.\n- Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through at least 12 months after the last dose of cyclophosphamide or 6 months after last chemotherapy (whichever occurs last)."}
Endpoints
Primary endpoints
- {"endpoint_text":"- Primary efficacy endpoint: Pathological complete response;","definition_or_measurement_approach":"Pathological complete response (pCR) as stated (no additional definition provided in the available data)."}
- {"endpoint_text":"- Primary translational endpoint: Fate bifurcation is defined as the proportion of TILs with the phenotype T-bet(hi) PD1(mid) CD8+. Quantification of number of T cells per mm2 with different phenotypes will be performed, and averages will be calculated per disease sampling (i.e., pre-treatment and C2D1), per arm and by pCR status.","definition_or_measurement_approach":"Fate bifurcation defined as proportion of TILs with phenotype T-bet(hi) PD1(mid) CD8+. Measurement: quantification of number of T cells per mm2 with different phenotypes; averages calculated per disease sampling (pre-treatment and C2D1), per arm and by pCR status."}
Recruitment
- Planned Sample Size
- 20
- Recruitment Window Months
- 36
- Consent Approach
- Written informed consent is required from participants (must be ≥18). Subject information and informed consent form documents are available (e.g., L1_SIS and ICF versions listed). The ICF permits optional consent for future biomedical research; participants may join the main study without consenting to future biomedical research.
Geography
- Total Number Of Sites
- 3
- Total Number Of Participants
- 20
Portugal
- Earliest CTIS Part Ii Submission Date
- 06-03-2024
- Latest Decision Or Authorization Date
- 27-06-2025
- Processing Time Days
- 479
- Number Of Sites
- 3
- Number Of Participants
- 20
Sites
- Site Name
- Instituto Portugues De Oncologia Do Porto Francisco Gentil E.P.E.
- Department Name
- Oncologia Médica
- Contact Person Name
- Miguel Abreu
- Contact Person Email
- antonio.m.abreu@ipoporto.min-saude.pt
- Site Name
- Centro Hospitalar Universitario De Lisboa Norte E.P.E.
- Department Name
- Oncologia
- Contact Person Name
- Rita Teixeira de Sousa
- Contact Person Email
- arita.sousa@gmail.com
- Site Name
- Champalimaud Clinical Centre
- Department Name
- Unidade de Mama
- Contact Person Name
- Márcio Debiasi
- Contact Person Email
- marcio.debiasi@fundacaochampalimaud.pt
Sponsor
Primary sponsor
- Full Name
- Champalimaud Clinical Centre
- Organisation Type
- Hospital/Clinic/Other health care facility
- Country Of Registered Address
- Portugal
Third parties
- {"country":"Portugal","full_name":"W4research Lda.","duties_or_roles":"Sponsor duties codes: 1,12,5,6,7; contact email: magda.mota@w4research.com","organisation_type":"Pharmaceutical company"}
Investigational products
- Investigational Product Name
- CARBOPLATIN
- Active Substance
- CARBOPLATIN
- Modality
- Small molecule
- Routes Of Administration
- INTRAVENIOUS INFUSION
- Route
- INTRAVENIOUS INFUSION
- Dose Levels
- maxDailyDoseAmount: 225 mg; maxTotalDoseAmount: 1800 mg
- Maximum Dose
- 225 mg
- Investigational Product Name
- EPIRUBICIN HYDROCHLORIDE
- Active Substance
- EPIRUBICIN HYDROCHLORIDE
- Modality
- Small molecule
- Routes Of Administration
- INTRAVENIOUS INFUSION
- Route
- INTRAVENIOUS INFUSION
- Dose Levels
- maxDailyDoseAmount: 100 mg/m2; maxTotalDoseAmount: 800 mg/m2
- Maximum Dose
- 100 mg/m2
- Investigational Product Name
- KEYTRUDA 25 mg/mL concentrate for solution for infusion
- Active Substance
- PEMBROLIZUMAB
- Modality
- Monoclonal antibody
- Routes Of Administration
- INTRAVENIOUS INFUSION
- Route
- INTRAVENIOUS INFUSION
- Authorisation Status
- Authorised (EU/1/15/1024/002)
- Dose Levels
- maxDailyDoseAmount: 400 mg; maxTotalDoseAmount: 3600 mg
- Maximum Dose
- 400 mg
- Investigational Product Name
- GLATIRAMER ACETATE
- Active Substance
- GLATIRAMER ACETATE
- Modality
- Other
- Routes Of Administration
- SUBCUTANEOUS INJECTION
- Route
- SUBCUTANEOUS INJECTION
- Dose Levels
- maxDailyDoseAmount: 6 mg; maxTotalDoseAmount: 6 mg
- Maximum Dose
- 6 mg
- Investigational Product Name
- PACLITAXEL
- Active Substance
- PACLITAXEL
- Modality
- Small molecule
- Routes Of Administration
- INTRAVENIOUS INFUSION
- Route
- INTRAVENIOUS INFUSION
- Dose Levels
- maxDailyDoseAmount: 80 mg/m2; maxTotalDoseAmount: 640 mg/m2
- Maximum Dose
- 80 mg/m2
- Investigational Product Name
- DOXORUBICIN HYDROCHLORIDE
- Active Substance
- DOXORUBICIN HYDROCHLORIDE
- Modality
- Small molecule
- Routes Of Administration
- INTRAVENIOUS INFUSION
- Route
- INTRAVENIOUS INFUSION
- Dose Levels
- maxDailyDoseAmount: 60 mg/m2; maxTotalDoseAmount: 480 mg/m2
- Maximum Dose
- 60 mg/m2
- Investigational Product Name
- CYCLOPHOSPHAMIDE
- Active Substance
- CYCLOPHOSPHAMIDE
- Modality
- Small molecule
- Routes Of Administration
- INTRAVENIOUS INFUSION
- Route
- INTRAVENIOUS INFUSION
- Dose Levels
- maxDailyDoseAmount: 600 mg/m2; maxTotalDoseAmount: 4800 mg/m2
- Maximum Dose
- 600 mg/m2
- Investigational Product Name
- FILGRASTIM
- Active Substance
- FILGRASTIM
- Modality
- Peptide/protein/enzyme
- Routes Of Administration
- SUBCUTANEOUS INJECTION
- Route
- SUBCUTANEOUS INJECTION
- Dose Levels
- maxDailyDoseAmount: 300 µg; maxTotalDoseAmount: 3600 µg
- Maximum Dose
- 300 µg
- Combination Treatment
- Yes
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