Clinical trial • Phase I • Oncology

Lutetium Lu-177; ABY-271 for HER2-positive metastatic breast cancer

Phase I trial of Lutetium Lu-177; ABY-271 for HER2-positive metastatic breast cancer. Randomised, open-label, none/not specified-controlled.

Overview

Trial Therapeutic Area
Oncology
Trial Disease
HER2-positive metastatic breast cancer
Trial Stage
Phase I
Drug Modality
Radiopharmaceutical|Peptide/protein/enzyme

Key dates

Initial CTIS Submission Date
18-12-2024
First CTIS Authorization Date
23-04-2025

Trial design

Randomised, open-label, none/not specified-controlled Phase I trial across 6 sites in Sweden, Germany.

Randomised
Yes
Open Label
Yes
Comparator
None/Not specified
Single Multiple Or Escalation Dose Combined
Yes
Target Sample Size
21

Eligibility

Recruits 21 Exclusion criterion: "Part A and Part B: Subject is considered to belong to a vulnerable population (e.g., placed under guardianship, imprisoned)". Informed consent requirement: "Part A and Part B: Female subject has given her signed declaration of informed consent and data protection declaration". The trial enrols only adults ("At least 18 years of age at screening visit") and vulnerable populations are explicitly excluded..

Pregnancy Exclusion
Part A and Part B: Subject is currently pregnant, intending to become pregnant during the course of the trial, or currently breastfeeding
Vulnerable Population
Exclusion criterion: "Part A and Part B: Subject is considered to belong to a vulnerable population (e.g., placed under guardianship, imprisoned)". Informed consent requirement: "Part A and Part B: Female subject has given her signed declaration of informed consent and data protection declaration". The trial enrols only adults ("At least 18 years of age at screening visit") and vulnerable populations are explicitly excluded.

Inclusion criteria

  • {"criterion_text":"- Part A and Part B: Female subject has given her signed declaration of informed consent and data protection declaration\n- Part A and Part B: Life expectancy of at least 3 months as estimated by the investigator\n- Part A only: Subject is in treatment, or planned to start a new line of standard systemic anti-tumor therapy\n- Part B only: Subject has progressive disease, documented radiologically in the last three months\n- Part B only: Subject has received at least 3 lines of standard systemic anti-tumor therapy in the palliative setting\n- Part B only: Subject has received last dose of previous line of systemic anti-tumor therapy, and has no ongoing treatment related toxicities > grade 1 prior to planned first dose of [177Lu]Lu-ABY-271\n- Part A and Part B: At least 18 years of age at screening visit\n- Part A and Part B: Subject has unresectable locally advanced or metastatic breast cancer\n- Part A and Part B: Subject with histologically or cytologically confirmed carcinoma with documented HER2 overexpression (biopsy not older than 2 years): immunohistochemistry (IHC) score 3+; OR 2+ and fluorescence in situ hybridization (ISH) positive\n- Part A and Part B: At least one known tumor lesion ≥ 15 mm\n- Part A and Part B: Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2\n- Part A and Part B: For females of childbearing potential only: negative serum human chorionic gonadotropin (hCG) test at screening visit\n- Part A and Part B: Willingness and capability of using adequate contraceptive methods from screening visit until 12 weeks after the [177Lu]Lu-ABY-271 dose: a) Female of childbearing potential should use a highly efficient method of contraception (see 8b) but this is not necessary for females of non-childbearing potential who are permanently sterilized or post-menopausal (i.e., at least 12 consecutive months with amenorrhea without other known or suspected medical cause) b) Adequate contraceptive method defined as: i. A method with less than 1% failure rate (e.g., permanent sterilization, hormone implants, hormone injections, some intrauterine devices, or vasectomized partner) OR ii. The use of two methods of contraception (e.g., one barrier method [condom, diaphragm, or cervical / vault caps] with spermicide and one hormonal contraceptive [e.g., combined oral contraceptives, patch, vaginal ring, injectables or implants])\n- Part A and Part B: Willingness and capability of complying with all trial procedure requirements, as per the investigator’s judgement"}

Exclusion criteria

  • {"criterion_text":"- Part A and Part B: Any organ transplant\n- Part A and Part B: History of hypersensitivity or allergy to [177Lu]Lu-ABY-271 or its excipients\n- Part A and Part B: Administration of another IMP within 5 half-lives (for experimental biologics: 6 months or 5 half-lives, whichever is longer) of the planned first dose of [177Lu]Lu-ABY-271\n- Part A and Part B: Evidence or indication of drug and/or alcohol abuse or dependence, according to the judgment of the investigator\n- Part A only: Previous enrollment in part A of this trial\n- Part B only: Previous enrollment in part B of this trial\n- Part B only: Exposure to any anti-tumor therapy since the last documented progression, including any radiotherapy within 7 days prior to the planned first dose of [177Lu]Lu-ABY-271\n- Part A and Part B: Subject is currently pregnant, intending to become pregnant during the course of the trial, or currently breastfeeding\n- Part A and Part B: Subject is an investigator, trial site or Sponsor personnel directly affiliated with this clinical trial and/or their immediate families (partner, spouse, parent, child, or sibling, whether biological or legally adopted)\n- Part A and Part B: Any medical or psychiatric condition which, in the investigator’s opinion, would preclude the subject from adhering to the protocol or completing the clinical trial per protocol\n- Part A and Part B: Subject is considered to belong to a vulnerable population (e.g., placed under guardianship, imprisoned)\n- Part A and Part B: Any known brain metastases\n- Part A and Part B: Known history of other malignancy within the last 5 years. Except: malignancies that were treated curatively and have not recurred within 2 years prior to trial treatment; completely resected basal cell and squamous cell skin cancers; any malignancy considered to be indolent and that has never required therapy; and completely resected carcinoma in situ of any type\n- Part A and Part B: Any uncontrolled medical, psychiatric, or surgical condition or laboratory finding that would pose a risk to subject’s safety or interfere with trial participation or interpretation of subject’s results, as assessed by the investigator\n- Part A and Part B: Any clinically significant electrocardiogram (ECG) or echocardiogram (ECHO) abnormalities\n- Part A and Part B: Any condition that precludes the proper performance of contrast enhanced computed tomography (ceCT)/ ceMRI scan or SPECT/CT\n- Part A and Part B: Peripheral white blood cells (WBC) <3000/μL with absolute neutrophil count <1500/μL, platelet <100,000/μL or hemoglobin <10 g/dL at screening visit\n- Part A and Part B: Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) level ≥3 times the upper limit of normal (ULN) or total bilirubin levels at ≥1.5 times the ULN at screening visit. Subjects with known Gilbert’s Syndrome who have serum bilirubin <3 x ULN may be enrolled\n- Part A and Part B: Estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 according to the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation at screening visit"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Part A and Part B: Treatment emergent adverse events (TEAEs), serious adverse events (SAEs), dose limiting toxicities (DLTs)\n- Part A and Part B: Changes in safety laboratory parameters, vital signs, ECHO, and 12-lead ECG","definition_or_measurement_approach":"Treatment emergent adverse events (TEAEs), serious adverse events (SAEs), and DLTs will be recorded as safety endpoints; changes in safety laboratory parameters, vital signs, ECHO and 12-lead ECG are measured by laboratory tests, vital sign assessments, echocardiography and 12-lead electrocardiogram respectively."}

Secondary endpoints

  • {"endpoint_text":"- Part A and Part B: Absorbed dose in gray (Gy) per organ and selected tumors\n- Part A and Part B: Absorbed dose coefficient (Gy/GBq) per organ and selected tumors\n- Part A and Part B: Normalized whole-body effective dose (millisieverts [mSv]/MBq)\n- Part A and Part B: Time Activity Curves (%ID) for organs and selected tumors\n- Part A and Part B: Plasma concentration of ABY-271 protein after [177Lu]Lu-ABY-271 IV infusion\n- Part A and Part B: Radioactivity concentration in blood of [177Lu]Lu-ABY-271 (kBq/mL)\n- Part A and Part B: Blood PK parameters including tmax, Cmax, Cl, AUC, Vd, MRT, t1/2, λ\n- Part A and Part B: Occurrence of ADAs and change in ADA titers compared to baseline\n- Part A only: Tumor to background absorbed dose ratio for selected organs (e.g., kidney, liver, red marrow)\n- Part A: Tumor to background ratio of activity uptake for selected organs (e.g., kidney, liver, blood)\n- Part B only: Tumor to background absorbed dose ratio for selected organs (e.g., kidney, liver, red marrow)\n- Part B: Tumor to background ratio of activity uptake for selected organs (e.g., kidney, liver, blood)\n- Part B:Objective tumor response as per RECIST v.1.1","definition_or_measurement_approach":"Dosimetry endpoints measured as absorbed dose (Gy) per organ and tumors, absorbed dose coefficient (Gy/GBq), whole-body effective dose (mSv/MBq), and Time Activity Curves (%ID). PK and concentration endpoints measured in plasma/blood (kBq/mL) with standard PK parameters (tmax, Cmax, Cl, AUC, Vd, MRT, t1/2, λ). Immunogenicity measured by occurrence of ADAs and titers. Tumor response assessed by RECIST v1.1 where stated."}

Recruitment

Planned Sample Size
21
Recruitment Window Months
39
Consent Approach
Inclusion requires that the adult female participant "has given her signed declaration of informed consent and data protection declaration". Subject information and informed consent form documents are provided for Sweden and Germany (ICF documents listed for Sweden and Germany). No assent process is indicated (only adults >=18 eligible).

Geography

Total Number Of Sites
6
Total Number Of Participants
21

Sweden

Earliest CTIS Part Ii Submission Date
28-03-2025
Latest Decision Or Authorization Date
07-04-2026
Processing Time Days
375
Number Of Sites
3
Number Of Participants
11

Sites

Site Name
Uppsala University Hospital
Department Name
Hematology, Oncology and Endocrine tumors
Contact Person Name
Henrik Lindman
Contact Person Email
henrik.lindman@akademiska.se
Site Name
Karolinska University Hospital
Department Name
Breast Center
Contact Person Name
Oscar Wiklander
Site Name
Sahlgrenska University Hospital-Vaestra Goetalandsregionen
Department Name
Oncology
Contact Person Name
Leif Klint
Contact Person Email
leif.klint@vgregion.se

Germany

Earliest CTIS Part Ii Submission Date
27-03-2025
Latest Decision Or Authorization Date
07-04-2026
Processing Time Days
376
Number Of Sites
3
Number Of Participants
10

Sites

Site Name
KEM I Evang. Kliniken Essen-Mitte gGmbH
Department Name
Gynecology
Contact Person Name
Sherko Kümmel
Contact Person Email
brustzentrum@kem-med.com
Site Name
Universitaetsklinikum Essen AöR
Department Name
Nuclear Medicine
Contact Person Name
Ken Herrmann
Site Name
Universitaetsklinikum Magdeburg AöR
Department Name
Radiology and nuclear medicine
Contact Person Name
Michael Kreißl
Contact Person Email
michael.kreissl@med.ovgu.de

Sponsor

Primary sponsor

Full Name
Affibody AB
Organisation Type
Pharmaceutical company
Country Of Registered Address
Sweden

Third parties

  • {"country":"Sweden","full_name":"Karolinska University Hospital","duties_or_roles":"[\"14\",\"4\"]","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Sweden","full_name":"SVAR Life Science AB","duties_or_roles":"[\"4\"]","organisation_type":"Pharmaceutical company"}
  • {"country":"Sweden","full_name":"Lablytica Life Science AB","duties_or_roles":"[\"4\"]","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
[177Lu]Lu-ABY-271
Active Substance
Lutetium Lu-177; ABY-271
Modality
Radiopharmaceutical|Peptide/protein/enzyme
Routes Of Administration
INTRAVENOUS INFUSION
Route
Intravenous infusion
Authorisation Status
MIA number: SE-HI-MIA-24-081255
First In Human
Yes
Frequency
Single IV infusion
Maximum Dose
2000 MBq

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