TNBC - Triple-Negative Breast Cancer, Ovarian Cancer
Conditions
Keywords
Triple Negative Breast Cancer, TNBC, Ovarian Cancer
Brief summary
This is a Phase 1/1b, open-label, dose-escalation, and dose-expansion study to evaluate the safety, tolerability, pharmacokinetic (PK), pharmacodynamic (PD), and clinical activity of etrumadenant (AB928) in combination with pegylated liposomal doxorubicin (PLD) with or without IPI-549 in participants with advanced metastatic triple-negative breast cancer (TNBC) or ovarian cancer, and etrumadenant in combination with nanoparticle albumin-bound-paclitaxel (NP) in participants with advanced metastatic TNBC.
Detailed description
In the dose escalation phase, the following will be assessed: * Arm A: escalating doses of etrumadenant in combination with PLD at standard doses will be assessed in participants with advanced metastatic triple-negative breast cancer or ovarian cancer. Eligible participants will receive oral administration of etrumadenant as well as intravenous (IV) infusion of PLD. The recommended dose (RDE) for expansion Arms 1 and 2 and escalation Arm C will be determined upon completion of this dose escalation arm. * Arm B: escalating doses of etrumadenant in combination with the NP at standard doses will also be assessed in participants with advanced metastatic TNBC. Eligible participants will receive oral administration of etrumadenant as well as NP infusion. The RDE of etrumadenant will be determined upon completion of this dose escalation arm. * Arm C: escalating doses of IPI-549 in combination with the RDE of etrumadenant (from Arm A) and PLD at standard doses will be assessed in participants with advanced metastatic TNBC or ovarian cancer. Eligible participants will receive oral administration of both etrumadenant and IPI-549 as well as IV infusion of PLD. The RDE of IPI-549 for expansion Arm 4 will be determined upon completion of this dose escalation arm. In the dose expansion phase, the following will be assessed: * Arms 1 and 2: Etrumadenant at the RDE in combination with PLD at standard doses may be assessed in participants with advanced metastatic TNBC or ovarian cancer. * Arm 3: Etrumadenant at the RDE in combination with NP at standard doses may be assessed in participants with advanced metastatic TNBC. * Arm 4: Etrumadenant and IPI-549 at the RDE in combination with PLD at standard doses may be assessed in participants with advanced metastatic TNBC. Overall duration of treatment will depend on how well the treatment is tolerated. Treatment may continue until unacceptable toxicity or progressive disease or other reasons specified in the protocol.
Interventions
DRUGEtrumadenant
Etrumadenant is an A2aR and A2bR antagonist for oral use
DRUGIPI-549
IPI-549 is a phosphoinositide-3-kinase-gamma inhibitor for oral use
DRUGPegylated liposomal doxorubicin (PLD)
Doxil is an anthracycline topoisomerase II inhibitor that is encapsulated in liposomes for intravenous (IV) use
DRUGnanoparticle albumin-bound paclitaxel (NP)
NP is a microtubule inhibitor for intravenous (IV) use
Sponsors
Infinity Pharmaceuticals, Inc.
Arcus Biosciences, Inc.
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
3+3 dose escalation
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Female participants, 18 years or older * Measurable disease per radiographic evaluation * Performance status 0 or 1 * Available archival tissue sample (within 2 years) or a fresh tumor biopsy may be required * Adequate organ, cardiac, and bone marrow function * Dose escalation * Participants with breast cancer: * Locally advanced or metastatic triple negative breast cancer (ER-negative, PgR-negative, and HER2-negative according to ASCO/CAP guidelines) with disease progression * No available alternative or curative therapy * Participants may have received any number of prior therapies for advanced/recurrent and progressive disease * Participants with ovarian cancer: * Locally advanced or metastatic ovarian cancer with disease progression * No available alternative or curative therapy * Participants may have received any number of prior therapies for advanced/recurrent and progressive disease * Dose expansion * Participants with breast cancer: * Locally advanced or metastatic triple negative breast cancer (ER-negative, PgR-negative, and HER2-negative according to ASCO/CAP guidelines) * Disease progression after no more than 3 prior lines of therapy * Participants with ovarian cancer: * Locally advanced or metastatic ovarian cancer that is platinum-resistant * Disease progression after no more than 3 prior lines of therapy
Exclusion criteria
* Received a live, attenuated vaccine within 4 weeks prior to first study treatment * Prior anticancer treatment including approved agents, systemic radiotherapy, or investigational therapy within 4 weeks prior first study treatment * Cancer other than the disease under study within 2 years prior to study entry, except for some cancers with a low risk of spreading like non-melanoma skin cancers * Inability to swallow oral medications * Participant is breastfeeding, pregnant, or expects to become pregnant during the study * Active autoimmune disease or documented history of autoimmune disease within 2 years prior to first study treatment * History of peptic ulcer or stomach bleeding within 6 months prior to first study treatment * Use of drugs contraindicated by the protocol within 4 weeks prior to and during study treatment * Prior treatment with drugs that suppress the immune system within 2 weeks prior to first study treatment * Presence of metastases in the brain or cancer spreading into the cerebrospinal fluid - CSF (leptomeningeal disease) * HIV, Hepatitis B, and C test results negative prior to first study treatment * Major surgery within 4 weeks prior to first study treatment * Participants who have previously received maximum cumulative lifetime anthracycline dosage or baseline ejection fraction \<50% (on heart echography)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of Adverse Events (AEs) | From first dose date to 30 days after the last dose (Approximately 1 year) |
| Incidence of dose-limiting toxicities (DLTs) during the dose escalation phase | From first dose date to 28 days after the first dose |
Secondary
| Measure | Time frame |
|---|---|
| Plasma concentration of IPI-549 | Recorded at baseline (prior to first dose), during the first 4 cycles of treatment (4 months) and at the end of treatment (i.e. in total approximately 5 months) |
| Percentage of participants with a best overall response of Complete Response (CR) or Partial Response (PR), as determined by Investigator according to Response Evaluation in Solid Tumors (RECIST) v 1.1 | From study enrollment until participation discontinuation, first occurrence of progressive disease or death from any cause, whichever occurs first (approximately 3-5 years) |
| Percentage of participants with Disease Control (complete response, partial response, or stable disease) for > 6 months as determined by RECIST v1.1 | From study enrollment until disease progression or loss of clinical benefit (up to approximately 3-5 years) |
| Percentage of etrumadenant target inhibition in peripheral blood | Cycle 1 Day 1 through Cycle 4 Day 1 (4 months) and at the end of treatment (in total approximately 5 months) |
| Progression Free Survival (PFS) as determined by the Investigator according to RECIST v1.1 | From start of the treatment up to first occurrence of progressive disease or death from any cause, whichever occurs first (up to approximately 3-5 years) |
| Overall Survival (OS) as determined by the Investigator according to RECIST v1.1 | From start of treatment up to death from any cause (up to approximately 3-5 years) |
| Immunophenotyping activity in select immune subsets for etrumadenant and IPI-549 in peripheral blood | Cycle 1 Day 1 through Cycle 4 Day 1 (4 months) and at the end of treatment (in total approximately 5 months). |
| Duration of Response as determined by the Investigator according to RECIST v1.1 | From the date of the first occurrence of a documented objective response to first documentation of disease progression or death from any cause, whichever occurs first (up to approximately 3-5 years) |
| Plasma concentration of etrumadenant | Recorded at baseline (prior to first dose), during the first 4 cycles of treatment (4 months) and at the end of treatment (i.e. in total approximately 5 months) |
Countries
Australia, United States
Outcome results
None listed