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Bemcentinib (BGB324) in Combination With Pembrolizumab in Patients With TNBC

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ClinicalTrials.gov Identifier: NCT03184558
Recruitment Status : Recruiting
First Posted : June 12, 2017
Last Update Posted : May 8, 2018
Sponsor:
Collaborator:
Merck Sharp & Dohme Corp.
Information provided by (Responsible Party):
BerGenBio ASA

Brief Summary:
This is an open label, single arm, multi-centre phase II study to assess the anti-tumour activity and safety of bemcentinib (BGB324) in combination with pembrolizumab in up to 56 patients with previously treated, locally advanced and unresectable, or metastatic TNBC or TN-IBC. The study will utilise an extension of Simon's 2-stage design. The primary objective is objective response rate.

Condition or disease Intervention/treatment Phase
Triple Negative Breast Cancer Inflammatory Breast Cancer Stage IV Drug: Bemcentinib; pembrolizumab Phase 2

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 56 participants
Intervention Model: Single Group Assignment
Intervention Model Description: Extension to Simon's 2-stage design allowing termination at the end of Stage 1 for either futility or efficacy.
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase II, Multi Centre Study of BGB324 in Combination With Pembrolizumab in Patients With Previously Treated, Locally Advanced and Unresectable or Metastatic Triple Negative Breast Cancer (TNBC) or Triple Negative Inflammatory Breast Cancer (TN-IBC)
Actual Study Start Date : July 26, 2017
Estimated Primary Completion Date : December 2018
Estimated Study Completion Date : December 2019

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Breast Cancer

Arm Intervention/treatment
Experimental: Bemcentinib (BGB324) + pembrolizumab
Bemcentinib (BGB324) in combination with pembrolizumab. Bemcentinib capsules are administered at 400mg on days 1-3, and 200mg there after. Pembrolizumab is an IV infusion, administered at a dose of 200mg every 3 weeks.
Drug: Bemcentinib; pembrolizumab
Bemcentinib is a selective Axl kinase inhibitor; pembrolizumab is a PD-1 inhibitor.
Other Name: BGB324; Keytruda




Primary Outcome Measures :
  1. Objective Response Rate [ Time Frame: The disease response is the best improvement or change in a patient's cancer burden, as measured from baseline (screening) and then measured again at regular intervals over the whole period of the study, an average of 24 months. ]
    Objective Response Rate includes all patients whose cancer has a partial or complete response.


Secondary Outcome Measures :
  1. Disease Control Rate [ Time Frame: Disease response is assessed every 9 weeks for the first 45 weeks and then every 12 weeks until disease progression (worsens) or study completion, an average of 24 months. ]
    Disease Control Rate includes all patients who have a partial or complete response, or who maintain stable disease.

  2. Duration of Response [ Time Frame: Disease response is assessed every 9 weeks for the first 45 weeks and then every 12 weeks until disease progression or study completion, an average of 24 months. ]
    Duration of Response includes patients with a partial or complete response and is measured from the date of response until the cancer progresses (worsens).

  3. Time to Progression [ Time Frame: Disease assessments are conducted at screening and then every 9 weeks for the first 45 weeks and then every 12 weeks until disease progression or death, whichever comes first, up to study completion (an average of 24 months). ]
    Time to Progression is measured from the date of first dose to the date the cancer progresses (worsens) and includes all patients.

  4. Overall Survival [ Time Frame: Survival visits are conducted every 12 weeks after disease progression until death or until study completion (an average of 24 months). ]
    Overall Survival is measured from the date of first dose to the date of death or the date the patient is last known to be alive. It includes all patients.

  5. Number of patients with Adverse Events (as assessed by CTCAE v4.03) [ Time Frame: Adverse Events are recorded from the date of consent until up to 120 days after cessation of both treatments ]
    The number of patients with each Adverse Event will be summarised.


Other Outcome Measures:
  1. Correlation of Response Rate with baseline biomarkers [ Time Frame: The biomarkers are collected at screening; the response rate is the best improvement or change in a patient's cancer burden, as measured from baseline (screening) and then again at regular intervals, over the whole study (an average of 24 months). ]
    Biomarkers (Axl kinase and PD-L1 expression) will be measured at screening using a diagnostic test. The Response Rate will be summarised according to Biomarker status (positive or negative) and includes all patients.



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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:

  1. Provision of signed informed consent.
  2. Male and non-pregnant females who are aged 18 years or older at the time of provision of informed consent.
  3. Histopathologically or cytologically documented TNBC or TN-IBC. Tumors must have been confirmed negative for ER and PR by IHC (<1% positive tumor nuclei, as per ASCO-CAP guideline recommendations) and negative for HER2 by IHC or fluorescent or chromogenic in situ hybridization (FISH or CISH). Patients with equivocal HER2 results by IHC should have their negativity status confirmed by FISH.
  4. Locally advanced and unresectable or metastatic TNBC or triple negative inflammatory breast cancer.
  5. Received one or more prior therapies for TNBC or inflammatory breast cancer in the metastatic setting, and prior treatment (metastatic or (neo) adjuvant) must have included a prior taxane and/or anthracycline-based therapy.
  6. Has measurable disease as defined by RECIST 1.12 on computed tomography (CT) or magnetic resonance imaging (MRI) and as determined by the site study team. Tumor lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions.
  7. Provision of suitable tumor tissue for the analysis of Axl kinase expression and PD-L1 expression.
  8. Eastern Cooperative Oncology Group (ECOG) performance score 0 or 1.
  9. Life expectancy of at least 3 months.
  10. Adequate organ function confirmed at Screening and within 10 days of initiating treatment, as evidenced by:

    • Platelet count ≥100,000 /mm3;
    • Hemoglobin ≥9.0 g/dL (≥5.6 mmol/L);.
    • Absolute neutrophil count (ANC) >1,500 /mm3;
    • Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) ≤2.5 times the upper limit of normal (ULN), or ≤5 times the ULN for patients with liver metastases;
    • Total bilirubin ≤1.5 times the ULN, or direct bilirubin <ULN for patients with total bilirubin levels >1.5xULN;
    • Creatinine ≤1.5 times the ULN and calculated creatinine clearance >60 mL/min (by Cockcroft Gault formula; see Appendix B);
    • International Normalized Ratio (INR) or Prothrombin Time (PT) ≤1.5 times the ULN and Activated Partial Thromboplastin Time (aPTT) ≤1.5 times the ULN. Note: If patient is receiving anticoagulant therapy, then PT or PTT must be within therapeutic range of intended use of anticoagulants;
    • LDH ≤2.5 times the ULN.
  11. Female patients of childbearing potential must have a negative pregnancy test (either urine or serum pregnancy test) within 72 hours prior to the first dose of study treatment. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
  12. Have resolution of toxic effect(s) of the most recent prior chemotherapy to Grade 1 or less (except alopecia). If the patient received major surgery or radiation therapy of >30 Gy, they must have recovered from the toxicity and/or complications from the intervention.
  13. Patients of reproductive potential must be willing to practice highly effective methods of contraception throughout the study and for 120 days after the last dose of study medication. Abstinence is acceptable if this is the usual lifestyle of the patient.

Exclusion Criteria:

  1. Has disease that is suitable for local therapy administered with curative intent.
  2. More than 3 previous lines of therapy in the metastatic setting.
  3. Has received prior therapy with an immunomodulatory agent.
  4. Has a known additional malignancy that is progressing or requires active treatment. Note: Exceptions include basal cell carcinoma of the skin, squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer.
  5. Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis.
  6. History of the following cardiac conditions:

    • Congestive cardiac failure of >Grade II severity according to the NYHA;
    • Ischemic cardiac event including myocardial infarction within 3 months prior to first dose;
    • Uncontrolled cardiac disease, including unstable angina, uncontrolled hypertension (i.e. sustained systolic BP >160 mmHg or diastolic BP >90 mmHg), or need to change medication due to lack of disease control within 6 weeks prior to the provision of consent;
    • History or presence of sustained bradycardia (≤55 BPM), left bundle branch block, cardiac pacemaker or ventricular arrhythmia. Note: Patients with a supraventricular arrhythmia requiring medical treatment, but with a normal ventricular rate are eligible;
    • Family history of long QTc syndrome; personal history of long QTc syndrome or previous drug-induced QTc prolongation of at least Grade 3 (QTc >500 ms).
  7. Abnormal left ventricular ejection fraction on echocardiography or MUGA (less than the lower limit of normal for a patient of that age at the treating institution or <45%, whichever is lower).
  8. Current treatment with any agent known to cause Torsades de Pointes which cannot be discontinued at least five half-lives or two weeks prior to the first dose of study treatment.
  9. Screening 12-lead ECG with a measurable QTc interval according to Fridericia's correction >450 ms.
  10. Is currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of study treatment.
  11. Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study Day 1 or who has not recovered (i.e., ≤Grade 1 or at baseline) from AEs due to a previously administered agent.
  12. Received an anti-cancer monoclonal antibody (mAb) within 4 weeks prior to the first dose of study treatment or who has not recovered (i.e. ≤Grade 1 or baseline) from AEs due to agents administered more than 4 weeks earlier.
  13. Major surgery within 28 days prior to start of study treatment and failure to have recovered adequately from the toxicity and/or complications from the intervention prior to the first dose of study treatment.
  14. Received transfusion of blood products (including platelets or red blood cells) or administration of colony stimulating factors (including G-CSF, GM-CSF or recombinant erythropoetin) within 4 weeks prior to the first dose of study treatment.
  15. Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of study treatment.
  16. Active autoimmune disease that has required systemic treatment in past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs).
  17. Known history of human immunodeficiency virus (HIV 1/2 antibodies)
  18. Has known active infection with Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA (qualitative) is detected).
  19. Has received a live-virus vaccination within 30 days of planned treatment start. Note: Seasonal flu vaccines that do not contain live virus are permitted.
  20. Has a history of (non-infectious) pneumonitis that required steroids or current pneumonitis.
  21. Has a history of interstitial lung disease.
  22. Inability to swallow or tolerate oral medication.
  23. Existing gastrointestinal disease affecting drug absorption such as celiac disease or Crohn's disease, or previous bowel resection which is considered to be clinically significant or could interfere with absorption.
  24. Known lactose intolerance.
  25. Requires vitamin K antagonists. Note: Patients receiving low doses prescribed to maintain the patency of venous access devices may be included. Factor Xa antagonists are permitted.
  26. Treatment with any of the following: histamine receptor 2 inhibitors, proton pump inhibitors or antacids within 7 days of start of study treatment.
  27. Treatment with any medication which is predominantly metabolized by CYP3A4 and has a narrow therapeutic index.
  28. Known hypersensitivity to bemcentinib, pembrolizumab, or any of their excipients.
  29. Has an active infection requiring systemic therapy (apart from cutaneous infections).
  30. Has a history or current evidence of any condition, therapy, or laboratory abnormality that, in the opinion of the Investigator, might confound the results of the trial, interfere with the patient's participation and compliance in the trial, or means it is not in the best interests of the patient to participate.
  31. Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting from Screening through to 120 days after the last dose of study treatment.
  32. Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.

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): NCT03184558


Contacts
Contact: Murray Yule, MD +4753501564 murray.yule@bergenbio.com
Contact: Viki Wills +4755961159 viki.wills@bergenbio.com

Locations
United States, California
City of Hope Cancer Center Recruiting
Duarte, California, United States, 91010-3012
Contact: Yuan Yuan, MD    626-256-4673    yuyuan@coh.org   
Sharp memorial Hospital, 7901 Frost Street, Recruiting
San Diego, California, United States, 92123-2701
Contact: Reema Batra, MD       reema.batra@sharp.com   
United States, Missouri
Saint Luke's Cancer Institute Recruiting
Kansas City, Missouri, United States, 64111
Contact: Timothy Pluard, MD       tpluard@saint-lukes.org   
United States, New Hampshire
Dartmouth-Hitchcock Medical Center Not yet recruiting
Lebanon, New Hampshire, United States, 03756
Contact: Peter Kaufman, MD         
United States, Pennsylvania
Magee-Womens Hospital, UPMC Cancer Pavilion Recruiting
Pittsburgh, Pennsylvania, United States, 15232-1309
Contact: Adam M Brufsky, MD       brufskyam@upmc.edu   
Norway
Haukeland University Hospital Recruiting
Bergen, Norway, 5021
Contact: Oddbjorn Straume, MD       oddbjorn.straume@helse-bergen.no   
Spain
University General Hospital of Alicante Recruiting
Alicante, Spain, 03010
Contact: Jose Juan Ponce Lorenzo, MD    +34 65 208 8227    joseponcelorenzo@hotmail.com   
Hospital Clinic i Provincial de Barcelona Recruiting
Barcelona, Spain, 08036
Contact: Barbara Adamo, MD    +34 93 227 54 00 ext 3456    adamo@clinic.cat   
Hospital Universitario Germans Trias i Pujol - Institut Catala d'Oncologia Recruiting
Barcelona, Spain, 08916
Contact: Beatriz Cirauqui, MD    +34 93 497 89 25    bcirauqui@iconcologia.net   
Hospital Universitario Amau de Vilanova de Lieda, Servicio de Oncologia Recruiting
Lleida, Spain, 25198
Contact: Serafin Morales, MD    +34 696 72 94 51    serafin.morales@geicam.org   
Hospital General Universitario Gregorio Maranon Recruiting
Madrid, Spain, 28007
Contact: Yolanda Jerez Gilarranz, MD    +34 91 586 81 16    itacayoli@hotmail.com   
Hospital Universitario Ramon y Cajal Recruiting
Madrid, Spain, 28034
Contact: Esther Holgado, MD    +34 91 336 82 63    eholgado@oncologiahrc.com   
Hospital Universitario Miguel Servet Recruiting
Zaragoza, Spain, 50009
Contact: Antonio Anton, MD    +34 976 76 56 44    aantont@gmail.com   
United Kingdom
Beatson West of Scotland Cancer Centre Recruiting
Glasgow, Scotland, United Kingdom, G12 0YN
Contact: Iain Macpherson, MD    +44(0)141 301 7128    iain.macpherson@glasgow.ac.uk   
Imperial College Healthcare NHS Trust, Charing Cross Hospital Recruiting
London, United Kingdom, W6 8RF
Contact: Laura Kenny, MD    +44(0)203 313 6198    l.kenny@imperial.ac.uk   
The Christie NHS Foundation Trust Recruiting
Manchester, United Kingdom, M20 4BX
Contact: Anne Armstrong, MD       anne.armstrong@christie.nhs.uk   
Nottingham University Hospitals, City Campus, Hucknall Road Recruiting
Nottingham, United Kingdom, NG5 1 PB
Contact: Stephen Chan, MD    44(0) 115 969 1169 ext 57298    steve.chan@nuh.nhs.uk   
Sponsors and Collaborators
BerGenBio ASA
Merck Sharp & Dohme Corp.

Responsible Party: BerGenBio ASA
ClinicalTrials.gov Identifier: NCT03184558     History of Changes
Other Study ID Numbers: BGBC007
MK-3475 PN530 ( Other Identifier: MSD )
2016-003608-30 ( EudraCT Number )
First Posted: June 12, 2017    Key Record Dates
Last Update Posted: May 8, 2018
Last Verified: May 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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

Keywords provided by BerGenBio ASA:
bemcentinib
TNBC
pembrolizumab
Keytruda
BGB324

Additional relevant MeSH terms:
Breast Neoplasms
Triple Negative Breast Neoplasms
Inflammatory Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Pembrolizumab
Antineoplastic Agents