Pre-operative IRX-2 in Early Stage Breast Cancer (ESBC)
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ClinicalTrials.gov Identifier: NCT02950259 |
Recruitment Status :
Active, not recruiting
First Posted : November 1, 2016
Last Update Posted : February 2, 2022
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Condition or disease | Intervention/treatment | Phase |
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Breast Neoplasm Breast Neoplasm, Male Triple Negative Breast Cancer | Drug: Cyclophosphamide Drug: Indomethacin Drug: Omeprazole Dietary Supplement: Multivitamin | Phase 1 |
This will be a Phase Ib study conducted to determine the safety and tolerability of an IRX-2 regimen in ESBC, to be administered pre-operatively before standard-of-care surgical resection and following standard-of-care diagnostic biopsy. This study will also include triple-negative breast cancer patients who will receive the IRX-2 regimen prior to chemotherapy.
Eligible subjects will have early stage breast cancer of any receptor sub-type, for which standard-of-care surgical resection is planned. To be eligible, a minimum of 1 core of tumor-bearing biopsy material must be available for research analysis.
Cohort B will enroll subjects triple negative breast cancer (defined by ER<10%, PR<10%, and HER2-negative by NCCN guidelines), T1c+ tumors for which neoadjuvant anthracycline-based and non-platinum containing chemotherapy is planned. The IRX-2 regimen will be administered and completed preceding chemotherapy. Cohort B subjects must undergo post-IRX-2 Regimen biopsy (2-3 cores), followed by commencement of chemotherapy preferably within one week after biopsy.
The IRX-2 regimen will be administered in all enrolled subjects. IRX 2 will be administered by subcutaneous injection into the periareolar skin of the affected breast.
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 16 participants |
Allocation: | Non-Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | A Phase Ib Study to Assess the Safety, Tolerability and Immunologic Activity of Preoperative IRX 2 In Early Stage Breast Cancer |
Actual Study Start Date : | February 9, 2017 |
Estimated Primary Completion Date : | October 2022 |
Estimated Study Completion Date : | January 2023 |

Arm | Intervention/treatment |
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Experimental: IRX-2 Regimen -Early Stage Breast Cancer
Enrolled subjects with early stage breast cancer will receive a single dose of cyclophosphamide (300 mg/m2) by IV infusion on Day 1. Also starting on Day 1 and continuing until Day 21, subjects will take daily oral indomethacin (25 mg three times each day), daily oral omeprazole (one tablet) and daily oral multivitamin containing 15-30 mg of zinc. On any 10 consecutive day period between Days 4-17, patients will receive two 1 mL subcutaneous periareolar injections of IRX-2.
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Drug: Cyclophosphamide
One dose of cyclophosphamide 300 mg/m2 IV infusion
Other Name: Cytoxan Drug: Indomethacin Indomethacin 25 mg three times a day for 21 days
Other Name: Indocin Drug: Omeprazole One tablet of omeprazole daily for 21 days
Other Name: Prilosec Dietary Supplement: Multivitamin Daily multivitamin containing 15-30 mg of zinc for 21 days.
Other Name: Vitamin |
Experimental: IRX-2 Regimen -Triple Negative Breast Cancer
Enrolled subjects with triple negative breast cancer will receive a single dose of cyclophosphamide (300 mg/m2) by IV infusion on Day 1. Also starting on Day 1 and continuing until Day 21, subjects will take daily oral indomethacin (25 mg three times each day), daily oral omeprazole (one tablet) and daily oral multivitamin containing 15-30 mg of zinc. On any 10 consecutive day period between Days 4-17, patients will receive two 1 mL subcutaneous periareolar injections of IRX-2.
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Drug: Cyclophosphamide
One dose of cyclophosphamide 300 mg/m2 IV infusion
Other Name: Cytoxan Drug: Indomethacin Indomethacin 25 mg three times a day for 21 days
Other Name: Indocin Drug: Omeprazole One tablet of omeprazole daily for 21 days
Other Name: Prilosec Dietary Supplement: Multivitamin Daily multivitamin containing 15-30 mg of zinc for 21 days.
Other Name: Vitamin |
- Surgical Delays [ Time Frame: Day 1 to Day 26 ]Number of surgeries delayed due to adverse events from the IRX-2 regimen
- Tumor Infiltrating Lymphocytes [ Time Frame: Day 26 ]Change in tumor infiltrating lymphocyte (TIL) score as measured by H&E TIL count according to Salgado criteria from pre-surgical biopsy to resected tumor specimen
- Characterization of peripheral lymphocytes [ Time Frame: Day 1 to Day 26 ]Number of peripheral lymphocytes including activated T-cells, T-regulatory cells, natural killer (NK) cells, and myeloid cells
- TIL phenotype [ Time Frame: Day 1 to 26 ]Changes in abundance of T-regulatory cells, activated T-cells, myeloid lineages and dendritic cells
- Intratumoral T-cell response [ Time Frame: Day 1-26 ]change in T-cell clonal responses by T-cell receptor DNA deep sequencing
- Intratumoral Immune Response [ Time Frame: Day 1-26 ]Characterization of intratumoral immune responses by RNA expression using the Nanostring PanCancer Immune panel and/or Prosigna tumor recurrence score

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Ages Eligible for Study: | Child, Adult, Older Adult |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Invasive breast cancer of any receptor subtype diagnosed by core-needle biopsy
- To undergo surgical resection with curative intent by partial mastectomy (lumpectomy) or mastectomy or
- Triple negative breast cancer (defined by ER<10%, PR<10%, and HER2-negative by NCCN guidelines), T1c+ tumors for which neoadjuvant anthracycline-based and non-platinum containing chemotherapy is planned
- Tumor >5 mm in maximum diameter by ultrasound or mammography. (Subjects with smaller tumors may be included at the discretion of the Principal Investigator.)
- Willing and able to provide written informed consent, including consent for use of available tissue and required blood draws for research purposes
- Availability of at least one tumor-bearing core specimen from the breast cancer diagnostic biopsy
- Karnofsky Performance status (KPS) 70% or greater.
- Female or male ≥18 years of age on day of signing informed consent.
- Adequate organ function as defined by protocol specified lab results
Exclusion Criteria:
- Prior neoadjuvant systemic therapy is planned
- Prior surgery, radiotherapy or chemotherapy for this cancer (other than core-needle biopsy)
- Received an investigational agent within 4 weeks of the first dose of treatment.
- Diagnosis of immunodeficiency or has received more than replacement doses of corticosteroids any other immunosuppressive therapy within 4 weeks of the first dose of treatment
- Hypersensitivity to IRX 2, cyclophosphamide, indomethacin, aspirin or ciprofloxacin.
- Chronic anticoagulation, not including aspirin, but including heparins, warfarin, oral anticoagulants or other platelet function inhibitors, that cannot, in the documented opinion of the investigator, safely be interrupted from at least 2 days prior to the initiation of the study regimen until after surgical resection of the tumor.
- Another malignancy that required active treatment within 6 months of the first dose of treatment
- History or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, such that trial participation is not in the best interest of the subject, including but not limited to uncontrolled hypertension or clinically significant cardiovascular disease, myocardial infarction within the previous 3 months, active infection or pneumonitis or other pulmonary disease requiring systemic therapy, clinically significant gastritis or peptic ulcer disease (that would preclude the use of indomethacin), stroke of other symptoms of cerebral vascular insufficient within the last 3 months, autoimmune disease that has required systemic treatment within the past 2 years (other than hormone replacement doses), or uncontrolled psychiatric or substance abuse disorders.
- Pregnancy or lactation.
- Known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies), active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA [qualitative] is detected).

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): NCT02950259
United States, Oregon | |
Providence Portland Medical Center | |
Portland, Oregon, United States, 97213 |
Principal Investigator: | David Page, MD | Providence Health & Services |
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Providence Health & Services |
ClinicalTrials.gov Identifier: | NCT02950259 |
Other Study ID Numbers: |
16-126B IRX-2 2016-B ( Other Identifier: IRX Therapeutics ) |
First Posted: | November 1, 2016 Key Record Dates |
Last Update Posted: | February 2, 2022 |
Last Verified: | January 2022 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Yes |
Plan Description: | Providence Health & Services has agreed to allow IRX Therapeutics to have access PHI for auditing purposes. Any non-Providence Health & Services employee who will access PHI will be required to sign a confidentiality agreement and will not be permitted to remove PHI from Providence Health & Services. |
Supporting Materials: |
Study Protocol Statistical Analysis Plan (SAP) Informed Consent Form (ICF) Clinical Study Report (CSR) Analytic Code |
Time Frame: | 5 years |
Access Criteria: | IPD will be accessed for data verification purposes only. |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Breast Cancer Early Stage Breast Cancer Male breast cancer |
IRX-2 Immunotherapy Triple Negative Breast Cancer |
Breast Neoplasms Neoplasms Triple Negative Breast Neoplasms Breast Neoplasms, Male Neoplasms by Site Breast Diseases Skin Diseases Indomethacin Cyclophosphamide Omeprazole Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Antirheumatic Agents Antineoplastic Agents, Alkylating |
Alkylating Agents Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Myeloablative Agonists Anti-Ulcer Agents Gastrointestinal Agents Proton Pump Inhibitors Enzyme Inhibitors Anti-Inflammatory Agents, Non-Steroidal Analgesics, Non-Narcotic Analgesics Sensory System Agents Peripheral Nervous System Agents Anti-Inflammatory Agents Gout Suppressants |