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Agatolimod and Trastuzumab in Treating Patients With Locally Advanced or Metastatic Breast Cancer

A Phase II Open-label Study of Subcutaneous CPG ODN (PF03512676) in Combination With Trastuzumab in Patients With Metastatic Breast Cancer

Status
Terminated
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00824733
Enrollment
6
Registered
2009-01-19
Start date
2009-02-28
Completion date
2014-04-30
Last updated
2016-01-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Breast Cancer

Keywords

recurrent breast cancer, stage IV breast cancer, stage IIIA breast cancer, stage IIIB breast cancer, stage IIIC breast cancer, HER2-positive breast cancer, male breast cancer

Brief summary

RATIONALE: Biological therapies, such as agatolimod, may stimulate the immune system in different ways and stop tumor cells from growing. Monoclonal antibodies, such as trastuzumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Giving agatolimod together with trastuzumab may kill more tumor cells. PURPOSE: This phase II trial is studying how well giving agatolimod together with trastuzumab works in treating patients with locally advanced or metastatic breast cancer.

Detailed description

OBJECTIVES: Primary * To evaluate the progression-free survival of patients with HER2-overexpressing locally advanced or metastatic breast cancer treated with trastuzumab (Herceptin®) and agatolimod sodium. Secondary * To determine if agatolimod sodium augments antibody-mediated cytoxicity (ADCC) against trastuzumab-coated target cells by evaluating the ability of patient immune-effector cells to conduct ADCC and produce interferon gamma. OUTLINE: This is a multicenter study. Patients receive trastuzumab (Herceptin®) IV over 30-90 minutes on day 1. Patients also receive agatolimod sodium subcutaneously on days 15 and 22 of course 1 and on days 1, 8, 15, and 22 of all subsequent courses. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Blood samples are collected periodically for correlative laboratory studies. Samples are analyzed for antibody-mediated cytotoxicity (ADCC) by chromium-release assay; IFN-γ production and quantification by flow cytometry and reverse transcriptase-polymerase chain reaction (RT-PCR); and levels of cytokines (IFN-γ and TNF-α) by ELISA. After completion of study therapy, patients are followed periodically.

Interventions

DRUGTrastuzumab

IV at 2 mg/kg over 30 minutes on day 1 of each weekly cycle. Patients who have not received trastuzumab for 4 weeks or more will receive a loading dose of 4 mg/kg over 90 minutes day 1 of the first cycle. The dose of trastuzumab will be based on the patient's actual weight at the start of each 4 week treatment cycle.

DRUGPF03512676

Patients also receive PF03512676 subcutaneously on days 15 and 22 of course 1 and on days 1, 8, 15, and 22 of all subsequent courses.

Blood for performing the correlative studies will be drawn on week 1, 2, 6, 12 and 18.

Sponsors

Pfizer
CollaboratorINDUSTRY
Bhuvaneswari Ramaswamy
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

DISEASE CHARACTERISTICS: * Histologically or cytologically confirmed breast cancer * Locally advanced or metastatic disease * HER2-overexpressing tumor, defined as 3+ overexpression by IHC and/or HER2 amplified by FISH * Non-measurable disease allowed * Achieved partial response, complete response, or stable disease (i.e., no disease progression for ≥ 12 weeks) while on trastuzumab (Herceptin®) and chemotherapy, hormonal therapy alone, or trastuzumab alone * Last dose of trastuzumab must have been administered within the past 16 weeks * No unstable brain metastases * Patients with brain metastases are eligible provided they have been stable for ≥ 1 month after surgery or radiotherapy/radiosurgery AND off corticosteroids and anticonvulsants for ≥ 4 weeks * Hormone receptor status unspecified PATIENT CHARACTERISTICS: * ECOG(Eastern Cooperative Oncology Group)performance status (PS) 0-2 (Karnofsky PS 70-100%) * Absolute neutrophil count ≥ 1,500/mm³ * Hemoglobin \> 8 g/dL (transfusion/epoetin alfa allowed) * Platelet count ≥ 100,000/mm³ * Total bilirubin \< 1.5 times upper limit of normal (ULN) * AST and ALT ≤ 2.5 times ULN (≤ 5.0 times ULN if known liver metastases) * Creatinine \< 2 mg/mL * Ejection fraction ≥ 50% by echocardiogram or MUGA * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception before, during, and for ≥ 3 months after completion of study treatment * No ongoing or active infection requiring oral or IV antibiotics * No known autoimmune disorders or antibody-mediated disorders * No known HIV positivity * No known history of hepatitis B or C (active and/or previously treated) * No other malignancies within the past 5 years except nonmelanoma skin cancer or cervical cancer in situ * No history of allergic reactions attributed to compounds of similar chemical or biologic composition to study drugs PRIOR CONCURRENT THERAPY: * See Disease Characteristics * More than 12 weeks since prior chloroquine * More than 4 weeks since prior growth factors * More than 4 weeks since prior systemic corticosteroids * More than 4 weeks since prior chemotherapy, radiotherapy, or monoclonal antibody therapy (except trastuzumab) * No prior agatolimod sodium * No prior allogeneic stem cell transplantation * No prior continuous treatment with single-agent trastuzumab for \> 6 months * No more than 3 prior chemotherapy regimens for metastatic breast cancer * Any number of prior hormonal therapies allowed * No other concurrent investigational agents or monoclonal antibodies * No other concurrent anticancer agents or therapies * Concurrent bisphosphonates for skeletal metastasis allowed

Design outcomes

Primary

MeasureTime frame
PF-03512676 Augments Antibody Mediated Cytoxicity (ADCC)Against Trastuzumab-coated Target Cells in Metastatic HER2 Overexpressing Breast Cancer.up to 18 weeks

Secondary

MeasureTime frameDescription
Progression-free Survival for Patients With Metastatic Breast Cancer That Are Receiving Trastuzumab Plus PF-03512676up to 18 weeksProgression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions
Combination of PF-03512676 and Trastuzumab Induces MIP-1 (Macrophage Inflammatory Protein 1), MCP-1 (Monocyte Chemoattract Protein 1) and RANTES.up to 18 weeks

Countries

United States

Participant flow

Participants by arm

ArmCount
Arm I: Treatment (PF03512676 in Combination With Trastuzumab)
12 weekly treatments. Week 1-12 patients will receive Trastuzumab 2mg/kg IV(intervenous infusion). Patients who have not been treated wih Trastuzumab within 4 weeks will receive a loading dose of 4 mg/kg on week 1 and PF-03512676-0.16 mg/kg subcutaneous injection.Correlative studies will be drawn on week 1, 2, 6, 12 and 18. Trastuzumab: IV at 2 mg/kg over 30 minutes on day 1 of each weekly cycle. Patients who have not received trastuzumab for 4 weeks or more will receive a loading dose of 4 mg/kg over 90 minutes day 1 of the first cycle. The dose of trastuzumab will be based on the patient's actual weight at the start of each 4 week treatment cycle. PF03512676: Patients also receive PF03512676 subcutaneously on days 15 and 22 of course 1 and on days 1, 8, 15, and 22 of all subsequent courses. Correlative Studies: Blood for performing the correlative studies will be drawn on week 1, 2, 6, 12 and 18.
6
Total6

Baseline characteristics

CharacteristicArm I: Treatment (PF03512676 in Combination With Trastuzumab)
Age, Categorical
<=18 years
0 Participants
Age, Categorical
>=65 years
0 Participants
Age, Categorical
Between 18 and 65 years
6 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
6 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
0 Participants
Race (NIH/OMB)
Black or African American
1 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
White
5 Participants
Region of Enrollment
United States
6 patients
Sex: Female, Male
Female
6 Participants
Sex: Female, Male
Male
0 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
3 / 6
serious
Total, serious adverse events
2 / 6

Outcome results

Primary

PF-03512676 Augments Antibody Mediated Cytoxicity (ADCC)Against Trastuzumab-coated Target Cells in Metastatic HER2 Overexpressing Breast Cancer.

Time frame: up to 18 weeks

Population: Samples were not analyzed for primary endpoint due to the sample numbers being too small. No data were collected from the samples.

Secondary

Combination of PF-03512676 and Trastuzumab Induces MIP-1 (Macrophage Inflammatory Protein 1), MCP-1 (Monocyte Chemoattract Protein 1) and RANTES.

Time frame: up to 18 weeks

Population: The study was terminated early due to poor patient accrual and no data was collected and analyzed.

Secondary

Progression-free Survival for Patients With Metastatic Breast Cancer That Are Receiving Trastuzumab Plus PF-03512676

Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions

Time frame: up to 18 weeks

ArmMeasureValue (MEDIAN)
Arm I: Treatment (PF03512676 in Combination With Trastuzumab)Progression-free Survival for Patients With Metastatic Breast Cancer That Are Receiving Trastuzumab Plus PF-0351267613 weeks

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026