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Trial record 16 of 103 for:    "Kennedy disease"

Pembrolizumab and Enobosarm in Treating Patients With Androgen Receptor Positive Metastatic Triple Negative Breast Cancer

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ClinicalTrials.gov Identifier: NCT02971761
Recruitment Status : Recruiting
First Posted : November 23, 2016
Last Update Posted : November 7, 2018
Sponsor:
Collaborator:
National Cancer Institute (NCI)
Information provided by (Responsible Party):
City of Hope Medical Center

Brief Summary:
This phase II trial studies the side effects and how well pembrolizumab and enobosarm work in treating patients with androgen receptor positive triple negative breast cancer that has spread to other places in the body. Monoclonal antibodies, such as pembrolizumab, may interfere with the ability of tumor cells to grow and spread. Androgen can cause the growth of breast cancer cells. Hormone therapy using enobosarm may fight breast cancer by blocking the use of androgen by the tumor cells. Giving pembrolizumab and enobosarm may work better in treating patients with androgen receptor positive triple negative breast cancer.

Condition or disease Intervention/treatment Phase
Androgen Receptor Positive Estrogen Receptor Negative HER2/Neu Negative Progesterone Receptor Negative Recurrent Breast Carcinoma Stage III Breast Cancer Stage IIIA Breast Cancer Stage IIIB Breast Cancer Stage IIIC Breast Cancer Stage IV Breast Cancer Metastatic Triple-Negative Breast Carcinoma Drug: Enobosarm Other: Laboratory Biomarker Analysis Biological: Pembrolizumab Phase 2

Detailed Description:

PRIMARY OBJECTIVES:

I. To evaluate the safety/tolerability of the combination regimen.

II. To determine the response rate (complete response [CR] or partial response [PR] via Response Evaluation Criteria in Solid Tumors [RECIST] 1.1) of the combination of pembrolizumab with enobosarm (GTx-024) in patients with advanced androgen receptor (AR) positive (+) triple negative breast cancer (TNBC).

SECONDARY OBJECTIVES:

I. To evaluate clinical outcomes by RECIST 1.1 including clinical benefit rate (CBR) at 24 weeks, progression free-survival (PFS), duration of response (DOR), event free survival (EFS), time-to-treatment failure (TTF); and overall survival (OS).

II. To evaluate the role of immune-related response criteria (irRECIST).

III. To evaluate the association of AR by immunohistochemistry (IHC) and clinical response.

TERTIARY OBJECTIVES:

I. To evaluate the association of an AR gene expression signature and clinical response.

II. To evaluate genomic and phenotypic status of breast tumor.

III. To evaluate the effect of the combination therapy on peripheral blood circulating tumor cells (CTCs) and circulating tumor deoxyribonucleic acid (DNA) (ctDNA).

IV. To evaluate the effect of combination therapy on tumor-derived exosomes (TEX) and TEX associated immune biomarkers.

V. To evaluate pre-treatment programmed death ligand 1 (PD-L1) and tumor infiltrating lymphocytes (TILs) as a predictor of response to combination therapy.

VI. To evaluate specific TIL subsets (e.g. CD4, CD8, regulatory T cell [Treg] distribution) and other immunological correlative (e.g. T cell receptor [TCR] repertoire analysis) as possible predictors of response.

VII. To evaluate change in TILs as a result of the combination therapy.

VIII. To evaluate peripheral blood, immune biomarkers.

OUTLINE: Patients receive pembrolizumab intravenously (IV) over 30 minutes on day 1 and enobosarm orally (PO) once daily (QD) on days 1-21. Treatment repeats every 21 days for up to 35 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up at 30 and 90 days, every 3 months, and bi-annually.


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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 29 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 2 Clinical Trial of the Combination of Pembrolizumab and Selective Androgen Receptor Modulator (SARM) GTX-024 in Patients With Metastatic Androgen Receptor (AR) Positive Triple Negative Breast Cancer (TNBC)
Actual Study Start Date : June 1, 2017
Estimated Primary Completion Date : October 2019
Estimated Study Completion Date : October 2019

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Breast Cancer

Arm Intervention/treatment
Experimental: Treatment (pembrolizumab, enobosarm)
Patients receive pembrolizumab IV over 30 minutes on day 1 and enobosarm PO QD on days 1-21. Courses repeat every 21 days for up to 35 courses in the absence of disease progression or unacceptable toxicity.
Drug: Enobosarm
Given PO
Other Names:
  • Gtx-024
  • Ostarine

Other: Laboratory Biomarker Analysis
Correlative studies

Biological: Pembrolizumab
Given IV
Other Names:
  • Keytruda
  • Lambrolizumab
  • MK-3475
  • SCH 900475




Primary Outcome Measures :
  1. Dose limiting toxicities assessed by NCI CTCAE v4.0 [ Time Frame: Up to 21 days ]
  2. Incidence of adverse events (AEs) assessed by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v4.0 [ Time Frame: Up to 36 months ]
    AEs will be analyzed including but not limited to all AEs, serious adverse events, fatal AEs and laboratory changes. Immune-related adverse events will also be collected.

  3. Response rate (CR or PR) assessed using RECIST v1.1 [ Time Frame: Up to 36 months ]

Secondary Outcome Measures :
  1. CBR assessed by irRECIST [ Time Frame: 24 weeks ]
  2. DOR defined as time from documentation of tumor response to disease progression or death in CR or PR patients assessed by irRECIST [ Time Frame: Up to 36 months ]
  3. EFS defined as failure of treatment or death as a result of any cause assessed by RECIST v1.1 [ Time Frame: Up to 1 year ]
    Kaplan-Meier estimates will be generated.

  4. OS assessed by RECIST v1.1 [ Time Frame: Time to death as a result of any cause, assessed up to 36 months ]
    Kaplan-Meier estimates will be generated.

  5. PFS assessed using RECIST v1.1 [ Time Frame: Time to disease progression/relapse or death as a result of any cause, assessed up to 36 months ]
    Kaplan-Meier estimates will be generated.

  6. TTF defined as time to treatment termination for any reason assessed by RECIST v1.1 [ Time Frame: Up to 36 months ]

Other Outcome Measures:
  1. AR expression profile assessed in tumor by IHC [ Time Frame: Up to 36 months ]
  2. miRNA/mRNA profiling assessed in tumor and blood [ Time Frame: Up to 36 months ]
  3. Number of CTCS and quantitation of ctDNA assessed in blood [ Time Frame: Up to 36 months ]
  4. PD-L1 and TIL profile, immune signatures, and genomic analysis assessed in tumor [ Time Frame: Up to 36 months ]
  5. Temporal profile of tumor-derived exosomes assessed in peripheral blood [ Time Frame: Up to 36 months ]
  6. Temporal profile of TIL subsets and other immunological correlatives assessed in tumor and blood [ Time Frame: Up to 36 months ]


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Documented informed consent
  • Willing to provide a sample from a recently obtained (within 42 days prior to initiation of day 1) biopsy of a tumor lesion;

    • If recently-obtained samples are unavailable an archived metastatic specimen not previously irradiated may be submitted upon agreement from the study principal investigator (PI)
  • Eastern Cooperative Oncology Group (ECOG) performance status of =< 1
  • Life expectancy of > 3 months
  • Metastatic triple negative breast cancer (TNBC)
  • Measurable disease per RECIST version (v)1.1 criteria: at least 1 lesion of > 10 mm in long axis diameter for non-lymph nodes or > 15 mm in short axis diameter for lymph nodes that is serially measurable according to RECIST 1.1 using computerized tomography, magnetic resonance imaging, or panoramic and close-up color photography
  • Histologically proven diagnosis of TNBC per current American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guideline;

    • Estrogen receptor (ER) negative (ER expression =< 10% positive tumor nuclei), progesterone receptor (PR) negative (PR expression =< 10% positive tumor nuclei) and HER2 negative breast cancer by IHC and /or fluorescence in situ hybridization (FISH)
  • Androgen receptor positive (AR+)

    • Defined as >= 50% nuclear AR staining by immunohistochemistry (IHC) in either the primary or metastatic lesion
    • NOTE: Research testing of AR status is available at City of Hope Pathology
  • Resolution of grade 2 and above toxicities of most recent therapy except for stable sensory neuropathy (=< grade 2) and alopecia
  • Female (childbearing potential): use an adequate method of birth control (except hormonal contraception) or be surgically sterile, or abstain from heterosexual activity for the course of the study through 120 days after the last dose of study medication

    • Childbearing potential defined as not being surgically sterilized or have not been free from menses for > 1 year
  • Male: use and adequate method of contraception with the first dose of study therapy through 120 days after the last dose of study therapy

    • Note: abstinence is acceptable if this is the usual lifestyle and preferred contraception for the subject
  • Absolute neutrophil count (ANC) >= 1500/mm^3
  • Platelets >= 100,000/mm^3
  • Hemoglobin >= 9 g/dL or >= 5.6 mmol/L without transfusion or erythropoietin (EPO) dependency (within 7 days of assessment)
  • Serum total bilirubin =< 1.5 x upper limit of normal (ULN) OR direct bilirubin =< ULN if total bilirubin levels > 1.5 x ULN
  • Albumin >= 2.5 mg/dL
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 2.5 x ULN OR =< 5.0 x ULN if liver metastases present
  • Serum creatinine =< 1.5 x ULN OR creatinine clearance (if measured or calculated per institutional standard; glomerular filtration rate [GFR] can also be used in place of creatinine or creatinine clearance [CrCl]) >= 60 mL/min if creatinine levels > 1.5 x ULN
  • Female of childbearing potential only: negative urine or serum pregnancy test; if the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required

Exclusion Criteria:

  • Anti-programmed cell death protein-1 (anti-PD-1), PD ligand-1 (PD-L1), PD ligand-2 (PD-L2) agent, an antibody targeting other immuno-regulatory receptors or mechanisms.
  • Radiotherapy within 14 days prior to day 1 of protocol therapy
  • AR targeted agents (including GTx-024, enzalutamide or other AR targeted therapies)
  • Investigational agent within 21 days prior to day 1 of protocol therapy
  • Hormone replacement therapies (estrogens, megestrol acetate) within 14 days prior to day 1 of protocol therapy
  • Live-virus vaccination within 30 days prior to day 1 of protocol therapy
  • Systemic cytotoxic chemotherapy, antineoplastic biologic therapy, or major surgery within 21 days of the first dose of trial medication
  • Testosterone or testosterone-like agents (methyltestosterone, oxandrolone, oxymetholone, danazol, fluoxymesterone, dehydroepiandrosterone, androstenedione) other androgenic compounds or anti-androgens within 30 days prior to day 1 of protocol therapy
  • Chronic systemic steroid therapy or on any other for, of immunosuppressive medication
  • Unstable or untreated brain/leptomeningeal metastasis
  • Clinically active diverticulitis, intra-abdominal abscess, gastrointestinal (GI) obstruction, or abdominal carcinomatosis (known risks factors for bowel perforation)
  • Active central nervous system metastases and/or carcinomatous meningitis
  • Severe hypersensitivity reaction to treatment with another monoclonal antibody
  • Active autoimmune disease that has required systemic treatment in the past 2 years (replacement therapies for hormone deficiencies are allowed)
  • Known history of human immunodeficiency virus (HIV), hepatitis B or hepatitis C
  • History of pneumonitis (non-infectious) that required steroids or current pneumonitis
  • Diagnosed with or treated for cancer within the previous two years, other than breast cancer or non-melanoma carcinoma of the skin
  • Unable to swallow capsules
  • Currently on bisphosphonate or denosumab with elevated serum calcium levels corrected for albumin/ionized calcium levels outside of institutional normal limits
  • Female: pregnant or lactating
  • Concomitant medical condition that precludes adequate study treatment compliance or assessment, or increases subject risk, in the opinion of the investigator, such as but not limited to:

    • Myocardial infarction or arterial thromboembolic events within 6 months prior to baseline or severe or unstable angina, New York Heart Association (NYHA) class III or IV disease, or a QTCB (corrected according to Bazett's formula) interval > 470 msec; serious uncontrolled cardiac arrhythmia grade II or higher according to NYHA; uncontrolled hypertension (systolic > 150 and/or diastolic > 100 mm Hg)
    • Acute and chronic active infectious disorders and non-malignant medical illnesses that are uncontrolled or whose control may be jeopardized by the complications of this study therapy
    • Impairment of gastrointestinal function or gastrointestinal disease that may significantly alter the absorption of study drugs (e.g., ulcerative disease, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome)
  • Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics)

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02971761


Locations
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United States, California
City of Hope Corona Recruiting
Corona, California, United States, 92879
Contact: Cheryl Corpus    626-256-4673 ext 81529    ccorpus@coh.org   
Principal Investigator: Misagh Karimi, MD         
City of Hope Medical Center Recruiting
Duarte, California, United States, 91010
Contact: Yuan Yuan, MD, PhD    626-256-4673 ext 89200    yuyuan@coh.org   
Principal Investigator: Yuan Yuan, MD, Phd         
City of Hope Antelope Valley Recruiting
Lancaster, California, United States, 93534
Contact: Regan Johnson    626-256-4673 ext 25648    regjohnson@coh.org   
Principal Investigator: Mohammad Fekrazad, MD         
City of Hope Mission Hills Recruiting
Mission Hills, California, United States, 91345
Contact: Amy Shousha    626-256-4673 ext 81865    ashousha@coh.org   
Principal Investigator: Suzy Melkonian, MD         
City of Hope Rancho Cucamonga Recruiting
Rancho Cucamonga, California, United States, 91730
Contact: Valerie Estala    626-256-4673 ext 81699    vestala@coh.org   
Principal Investigator: Benham Ebrahimi, MD         
University of California Davis Comprehensive Cancer Center Not yet recruiting
Sacramento, California, United States, 95817
Contact: Mili Arora, MD    916-734-8614    marora@ucdavis.edu   
Principal Investigator: Mili Arora, MD         
City of Hope South Pasadena Recruiting
South Pasadena, California, United States, 91030
Contact: Odessa T. Rodriguez    626-256-4673 ext 81409    orodriguez@coh.org   
Principal Investigator: Christina H. Yeon         
City of Hope West Covina Recruiting
West Covina, California, United States, 91790
Contact: Mei Zheng    626-256-4673 ext 81336    mzheng@coh.org   
Principal Investigator: Gargi Upadhyaya, MD         
United States, Kansas
University of Kansas Cancer Center Not yet recruiting
Kansas City, Kansas, United States, 66160
Contact: Anne O'Dea, MD    913-588-7750    aodea@kumc.edu   
Principal Investigator: Anne O'Dea, MD         
United States, Ohio
Ohio State University Comprehensive Cancer Center Not yet recruiting
Columbus, Ohio, United States, 43210
Contact: Daniel Stover, MD    614-685-6700    Daniel.Stover@osumc.edu   
Principal Investigator: Daniel Stover, MD         
United States, Utah
Huntsman Cancer Institute/University of Utah Not yet recruiting
Salt Lake City, Utah, United States, 84112
Contact: Adam Cohen, MD    801-587-4725    adam.cohen@hci.utah.edu   
Principal Investigator: Adam Cohen, MD         
Sponsors and Collaborators
City of Hope Medical Center
National Cancer Institute (NCI)
Investigators
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Principal Investigator: Yuan Yuan, MD, PhD City of Hope Medical Center

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Responsible Party: City of Hope Medical Center
ClinicalTrials.gov Identifier: NCT02971761     History of Changes
Other Study ID Numbers: 16131
NCI-2016-01759 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) )
16131 ( Other Identifier: City of Hope Medical Center )
First Posted: November 23, 2016    Key Record Dates
Last Update Posted: November 7, 2018
Last Verified: November 2018

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:
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Carcinoma
Breast Neoplasms
Triple Negative Breast Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Neoplasms by Site
Breast Diseases
Skin Diseases
Pembrolizumab
Androgens
Antineoplastic Agents, Immunological
Antineoplastic Agents
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs