Clinical trial • Phase I/II • Oncology

NADUNOLIMAB for Triple-negative breast cancer|Advanced triple-negative breast cancer

Phase I/II trial of NADUNOLIMAB for Triple-negative breast cancer|Advanced triple-negative breast cancer.

Overview

Trial Therapeutic Area
Oncology
Trial Disease
Triple-negative breast cancer|Advanced triple-negative breast cancer
Trial Stage
Phase I/II
Drug Modality
Monoclonal antibody|Small molecule

Key dates

Initial CTIS Submission Date
03-04-2024
First CTIS Authorization Date
10-04-2024

Trial design

Randomised, open-label, control arm: gemcitabine plus carboplatin (standard of care) — dose and schedule not specified in available documents., adaptive Phase I/II trial across 24 sites in Spain.

Randomised
Yes
Open Label
Yes
Comparator
Control arm: gemcitabine plus carboplatin (standard of care) — dose and schedule not specified in available documents.
Adaptive
True, Phase Ib includes dose-escalation to establish the MTD with Dose Limiting Toxicity (DLT) assessment within the first cycle.
Single Multiple Or Escalation Dose Combined
Yes
Target Sample Size
117

Eligibility

Recruits 117 No vulnerable populations selected. Informed consent required: 'Signed informed consent form before conducting any specific procedure for the study.' Participants are adults (≥ 18 years) so assent is not applicable..

Pregnancy Exclusion
Pregnant or lactating or intending to become pregnant during or within 6 months after the last dose of study treatment.
Vulnerable Population
No vulnerable populations selected. Informed consent required: 'Signed informed consent form before conducting any specific procedure for the study.' Participants are adults (≥ 18 years) so assent is not applicable.

Inclusion criteria

  • {"criterion_text":"- Signed informed consent form before conducting any specific procedure for the study."}
  • {"criterion_text":"- Patients testing positive for human immunodeficiency virus (HIV) are NOT excluded from this study, but HIV-positive patients must meet ALL the following criteria: a. Have CD4+ T-cell (CD4+) counts ≥ 350 cells/µL; b. Have not had an opportunistic infection within the past 12 months. Patients on prophylactic antimicrobials can be included in the study; c. Should be on stable antiretroviral therapy for at least 4 weeks; d. Have an HIV viral load less than 400 copies/mL prior to enrolment."}
  • {"criterion_text":"- Willingness and ability to comply with scheduled visits, treatment plan, laboratory tests and other study procedures."}
  • {"criterion_text":"- Negative serum pregnancy test within 7 days prior to enrolment for premenopausal women, and for women who have experienced menopause onset < 12 month prior to first dose of therapy. • For premenopausal women: agreement to remain abstinent or use single or combined non-hormonal contraceptive methods that result in a failure rate of < 1% per year during the treatment period and for at least 7 months after the last dose of study treatment. • For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures, and to refrain from donating sperm during the same period, as defined below with female partners of childbearing potential or pregnant female partners, men must remain abstinent or use a condom during the treatment period and for at least 6 months after the last dose of carboplatin/gemcitabine to avoid exposing the embryo."}
  • {"criterion_text":"- Female or male BC patients of ≥ 18 years of age."}
  • {"criterion_text":"- Histologically confirmed TNBC that is either locally recurrent, inoperable and cannot be treated with curative intent or is metastatic: a. Documented Hormone Receptor (HR) negative BC based on local laboratory determination on the most recent tumor biopsy; b. Documented Human Epidermal Growth Factor Receptor 2 (HER2) negative BC based on local laboratory determination on the most recent tumor biopsy; c. Patients are eligible for the study irrespectively of BRCA1/2 mutational status."}
  • {"criterion_text":"- Patients should be eligible to receive gemcitabine and carboplatin as the following line of therapy. No more than 1 previous line of systemic therapy for the advanced disease is allowed."}
  • {"criterion_text":"- Documented progressive disease (i.e. biopsy sample, pathology or imaging report) from the last treatment."}
  • {"criterion_text":"- Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 1."}
  • {"criterion_text":"- Patients must have at least one measurable lesion that can be accurately assessed at baseline and is suitable for repeated assessment by CT scan, MRI, plan X-ray or physical examination."}
  • {"criterion_text":"- Adequate organ and bone marrow function defined as follows: a. ANC ≥ 1.500/mm3 (1.5x109/L), without previous G-CSF within 2 weeks prior to the study treatment; b. Platelets ≥ 100.000/mm3 (100x109/L), without previous transfusion within 2 weeks prior to the study treatment; c. Hemoglobin ≥ 9 g/dL (90 g/L), without previous transfusion within 28 days before starting with the study treatment; d. Serum creatinine ≤ 1.5 x ULN or estimated creatinine clearance ≥ 60 mL/min as calculated using the Cockcroft-Gault formula; e. Total serum bilirubin ≤ 1.5 x ULN (≤ 3.0 x ULN if Gilbert´s disease); f. AST and/or ALT ≤ 3.0 x ULN (≤ 5.0 x ULN if liver metastases present); g. Alkaline phosphatase ≤ 2.5 x ULN (≤ 5.0 x ULN if bone or liver metastases present)."}
  • {"criterion_text":"- Resolution of all acute toxic effects of prior anti-cancer therapy or surgical procedures to NCI CTCAE v5.0 Grade ≤ 1"}

Exclusion criteria

  • {"criterion_text":"- Patient has received extended field radiotherapy ≤ 4 weeks before the start of treatment (≤ 2 weeks for limited field radiation for palliation), and who has not recovered to ≤ Grade 1, according to NCI CTCAE v5.0, from related AEs of such therapy (except for alopecia)."}
  • {"criterion_text":"- Pregnant or lactating or intending to become pregnant during or within 6 months after the last dose of study treatment."}
  • {"criterion_text":"- Known hypersensitivity or allergy to any component of the nadunolimab, carboplatin or gemcitabine drug formulations, and known hypersensitivity to platinum-containing compounds."}
  • {"criterion_text":"- Any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding that contraindicates the use of an investigational drug, may affect the interpretation of the results, or may render the patient at high risk from treatment complications."}
  • {"criterion_text":"- Treatment with systemic anticancer treatments, investigational products, or major surgery within 4 weeks before the first dose of study drug or 5 half-lives, whichever is shorter."}
  • {"criterion_text":"- Significant cardiovascular disease, such as New York Heart Association (NYHA) cardiac disease (Class II or greater), myocardial infarction, or cerebrovascular accident within 3 months prior to randomization, unstable arrhythmias, or unstable angina, known left ventricular ejection fraction (LVEF) < 50%."}
  • {"criterion_text":"- Presence of an abnormal ECG that is clinically significant in the investigator’s opinion."}
  • {"criterion_text":"- Patients with uncontrolled brain metastases."}
  • {"criterion_text":"- Spinal cord compression not definitively treated with surgery and/or radiation, or previously diagnosed and treated spinal cord compression without evidence that disease has been clinically stable for > 2 weeks prior to enrolment."}
  • {"criterion_text":"- Severe (Grade 3) infection requiring oral or IV antibiotics within 4 weeks prior to enrolment."}
  • {"criterion_text":"- Positive hepatitis B surface antigen (HBsAg) test at screening. Total hepatitis B core antibody (HBcAb) test at screening must be negative."}
  • {"criterion_text":"- Positive hepatitis C virus (HCV) antibody test at screening: if positive, HCV antibody test followed by a negative HCV RNA test at screening. The HCV RNA test will be performed only for patients who have a positive HCV antibody test."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Phase Ib: To determine the incidence rate of Dose Limiting Toxicity (DLT) within the first Cycle of nadunolimab in combination with GC.","definition_or_measurement_approach":"Incidence rate of Dose Limiting Toxicity (DLT) within the first treatment cycle assessed per NCI CTCAE; DLTs counted among patients in Phase Ib during cycle 1."}
  • {"endpoint_text":"- Phase II: to evaluate the ORR, defined as the rate of Complete Response (CR) plus Partial Response (PR) according to RECIST version 1.1, out of the patients who receive at least one dose of treatment and have measurable disease. These results will be calibrated against the ORR in the control arm.","definition_or_measurement_approach":"Objective response rate (ORR) = CR + PR according to RECIST v1.1 assessed by investigators among patients who received ≥1 dose and have measurable disease; results compared/calibrated against control arm ORR."}

Recruitment

Registry Or Advocacy Recruitment
True, Fundacion Grupo Espanol De Investigacion En Cancer De Mama
Planned Sample Size
117
Recruitment Window Months
55
Consent Approach
Signed informed consent required prior to any study-specific procedure: 'Signed informed consent form before conducting any specific procedure for the study.' Participants are adults (≥ 18 years). Subject information and informed consent forms exist (documents titled e.g. 'L1_SIS and ICF Main_ES_public'), indicating materials available in Spanish.

Geography

Total Number Of Sites
24
Total Number Of Participants
117

Spain

Earliest CTIS Part Ii Submission Date
20-02-2024
Latest Decision Or Authorization Date
02-03-2026
Processing Time Days
741
Number Of Sites
24
Number Of Participants
117

Sites

Site Name
Hospital Universitario Virgen De La Victoria
Department Name
Oncology
Contact Person Name
Javier García Corbacho
Contact Person Email
estudios.clinicos@ibima.eu
Site Name
Hospital Universitario Central De Asturias
Department Name
Oncology
Contact Person Name
Yolanda Fernández Pérez
Contact Person Email
oncologiamedica.gae4@sespa.es
Site Name
Hospital Universitario Virgen De La Macarena
Department Name
Oncology
Contact Person Name
Luis De la Cruz Merino
Contact Person Email
oncomacarena@gmail.com
Site Name
Hospital Clinico Universitario Lozano Blesa
Department Name
Oncology
Contact Person Name
Raquel Andrés Conejero
Contact Person Email
umac.hcu@salud.aragon.es
Site Name
Clinica Universidad De Navarra
Department Name
Oncology
Contact Person Name
Marta Santisteban Eslava
Contact Person Email
msantisteb@unav.es
Site Name
Fundacion Instituto Valenciano De Oncologia
Department Name
Oncology
Contact Person Name
Ángel Luis Guerrero Zotano
Contact Person Email
oncologia@fivo.org
Site Name
Hospital Universitari Arnau De Vilanova De La Gerencia Territorial De Lleida
Department Name
Oncology
Contact Person Name
Searsfín Morales Murillo
Contact Person Email
serafinmorales01@gmail.com
Site Name
Hospital Universitario Lucus Augusti
Department Name
Oncology
Contact Person Name
Silvia Varela Ferreiro
Contact Person Email
hula.oncologia.frd@sergas.es
Site Name
University Hospital Virgen Del Rocio S.L.
Department Name
Oncology
Contact Person Name
Manuel Ruíz Borrego
Contact Person Email
ruizsabater@gmail.com
Site Name
Hospital Universitario De Jaen
Department Name
Oncology
Contact Person Name
Pedro Sánchez Rovira
Contact Person Email
oncojaen@fibao.es
Site Name
Hospital Universitario 12 De Octubre
Department Name
Oncology
Contact Person Name
Pablo Tolosa Ortega
Contact Person Email
pablo.tolosa@salud.madrid.org
Site Name
Hospital General Universitario Gregorio Maranon
Department Name
Oncology
Contact Person Name
Sara López-Tarruella Cobo
Site Name
Fundacion Onkologikoa Fundazioa
Department Name
Oncology
Contact Person Name
Ander Urruticoechea Ribate
Contact Person Email
ensayos@onkologikoa.org
Site Name
Hospital Clinico San Carlos
Department Name
Oncology
Contact Person Name
Fernando Moreno Antón
Contact Person Email
fmorenoa@salud.madrid.org
Site Name
Hospital Del Mar
Department Name
Oncology
Contact Person Name
María Martínez García
Site Name
Hospital Clinic De Barcelona
Department Name
Oncology
Contact Person Name
Montserrat Muñoz Mateu
Contact Person Email
mmunoz@clinic.cat
Site Name
Institut Catala D'oncologia
Department Name
Oncology
Contact Person Name
Agostina Stradella
Site Name
Complexo Hospitalario Universitario A Coruna
Department Name
Oncology
Contact Person Name
Silvia Antolín Novoa
Contact Person Email
silvia.antolin.novoa@sergas.es
Site Name
Complejo Hospitalario Universitario Insular Materno Infantil
Department Name
Oncology
Contact Person Name
Elena Vicente Rubio
Site Name
Hospital Universitario Clinico San Cecilio
Department Name
Oncology
Contact Person Name
Isabel Blancas López-Barajas
Site Name
Hospital General Universitario De Albacete
Department Name
Oncology
Contact Person Name
Encarna Adrover Cebrian
Contact Person Email
eadrover@sescam.jccm.es
Site Name
Hospital Universitario San Juan De Alicante
Department Name
Oncology
Contact Person Name
Nieves Díaz Fernández
Contact Person Email
nievesonco@gmail.com
Site Name
Hospital Universitario Virgen De Las Nieves
Department Name
Oncology
Contact Person Name
Encarnación González Flores
Site Name
Hospital Universitario De Toledo
Department Name
Oncology
Contact Person Name
Ana María García Tapiador
Contact Person Email
latapiador@hotmail.com

Sponsor

Primary sponsor

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

Contract research organisations

Name
PPD (UK) Limited
Responsibilities
[{"code":8}]
Name
PPD Development LP
Responsibilities
[{"code":4}]
Name
PPD Global Central Labs
Responsibilities
[{"id":901035,"code":15,"value":"Sample kits and logistic"}]

Third parties

  • {"country":"United Kingdom","full_name":"PPD (UK) Limited","duties_or_roles":"[{\"code\":8}]","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"PPD Development LP","duties_or_roles":"[{\"code\":4}]","organisation_type":"Pharmaceutical company"}
  • {"country":"France","full_name":"Histalim","duties_or_roles":"[{\"code\":4}]","organisation_type":"Pharmaceutical company"}
  • {"country":"Belgium","full_name":"PPD Global Central Labs","duties_or_roles":"[{\"id\":901035,\"code\":15,\"value\":\"Sample kits and logistic\"}]","organisation_type":"Pharmaceutical company"}
  • {"country":"Spain","full_name":"Fundacion Grupo Espanol De Investigacion En Cancer De Mama","duties_or_roles":"[{\"id\":901028,\"code\":1},{\"id\":901029,\"code\":10},{\"id\":901030,\"code\":11},{\"id\":901031,\"code\":12},{\"id\":901032,\"code\":2},{\"id\":901033,\"code\":5},{\"id\":901034,\"code\":6}]","organisation_type":"Patient organisation/association"}

Investigational products

Investigational Product Name
CAN04
Active Substance
NADUNOLIMAB
Modality
Monoclonal antibody
Routes Of Administration
INTRAVENOUS ADMINISTRATION
Route
Intravenous
Investigational Product Name
GEMCITABINE
Active Substance
Gemcitabine hydrochloride
Modality
Small molecule
Routes Of Administration
INTRAVENIOUS INFUSION
Route
Intravenous infusion
Authorisation Status
Authorized product used as Standard of Care according to SmPC.
Investigational Product Name
CARBOPLATIN
Active Substance
Carboplatin
Modality
Small molecule
Routes Of Administration
INTRAVENOUS INFUSION
Route
Intravenous infusion
Authorisation Status
Authorized product used as Standard of Care according to SmPC.
Combination Treatment
Yes

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