Clinical Trials /

Phase 2 Study of the Monoclonal Antibody MGAH22 (Margetuximab) in Patients With Relapsed or Refractory Advanced Breast Cancer

NCT01828021

Description:

The purpose of this study is to determine if margetuximab is effective in the treatment of certain patients with relapsed or refractory advanced breast cancer.

Related Conditions:
  • Breast Carcinoma
Recruiting Status:

Completed

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Phase 2 Study of the Monoclonal Antibody MGAH22 (Margetuximab) in Patients With Relapsed or Refractory Advanced Breast Cancer
  • Official Title: A Single Arm, Open-Label, Phase 2 Study of MGAH22 (Fc-optimized Chimeric Anti-HER2 Monoclonal Antibody) in Patients With Relapsed or Refractory Advanced Breast Cancer Whose Tumors Express HER2 at the 2+ Level by Immunohistochemistry and Lack Evidence of HER2 Gene Amplification by FISH

Clinical Trial IDs

  • ORG STUDY ID: CP-MGAH22-02
  • NCT ID: NCT01828021

Conditions

  • Breast Cancer

Interventions

DrugSynonymsArms
MargetuximabMGAH22margetuximab

Purpose

The purpose of this study is to determine if margetuximab is effective in the treatment of certain patients with relapsed or refractory advanced breast cancer.

Detailed Description

      In the pivotal study that established that Herceptin® was highly effective when added to
      standard chemotherapy in the front-line treatment of women with HER2 positive metastatic
      breast cancer, benefit appeared to accrue to those patients whose tumors expressed the HER2
      oncoprotein at the 3+ level by immunohistochemistry (IHC) or those patients whose tumors
      demonstrated evidence of HER2 gene amplification by fluorescence in situ hybridization (FISH)
      testing. Similarly, when Herceptin® was used as a single therapy in women with metastatic
      breast cancer that had progressed following cytotoxic chemotherapy, 3+ overexpression of
      HER2, but not 2+ expression, was associated with response to treatment. These and other
      studies have led to the recommendation that Herceptin® should be administered to patients
      with breast cancer whose tumors exhibit 3+ overexpression or gene amplification. This study
      will evaluate whether treatment of patients with tumors that would not be expected to respond
      to Herceptin® therapy, namely those that lack HER2 gene amplification and express the
      oncoprotein at the 2+ level by IHC, may benefit from the use of the anti-HER2 monoclonal
      antibody, MGAH22. If 5 or more responses are seen in 41 evaluable patients, then further
      clinical development of margetuximab will be justified.
    

Trial Arms

NameTypeDescriptionInterventions
margetuximabExperimentalMonotherapy of Anti-HER2 monoclonal antibody
  • Margetuximab

Eligibility Criteria

        Inclusion Criteria:

          -  Histologically or cytologically confirmed invasive carcinoma of the breast

          -  Treatment with at least two prior systemic therapies for advanced (unresectable
             locoregional or metastatic) disease

          -  Evidence of HER2 oncoprotein expression at the 2+ level by central laboratory.
             Patients whose tumors exhibit 2+ staining by IHC are eligible for the study.

          -  Patients whose tumors score 1+ by conventional IHC, are non-amplified by FISH testing,
             and whose tumors score > or = 10.5 by HERmark® testing, are eligible for the study.

          -  Evidence of lack of HER2 oncogene amplification as determined by FISH testing by
             central laboratory

          -  Performance Status of 0 or 1

          -  Life expectancy at least 6 months

          -  Measurable disease (by RECIST 1.1)

          -  Acceptable laboratory parameters and organ reserve

          -  Baseline left ventricular ejection fraction > or = 50%

          -  Anti-cancer therapy (including conventional cytotoxic chemotherapy and/or biological
             therapy) and radiotherapy must be completed and any associated toxicities resolved to
             </= Grade 1 levels or baseline levels and at least 2 weeks must have elapsed before
             enrollment. Treatment with monoclonal antibodies must be completed at least 14 days
             before entry. Must have completed immunosuppressive medications or vaccinations before
             enrollment.

          -  Patients who are estrogen receptor+ and/or progesterone receptor+ and who are
             receiving anti-hormone therapy for at least three months may continue to receive such
             therapy during the course of the trial

          -  Eighteen (18) years of age or older

        Exclusion Criteria:

          -  Major surgery or trauma within 4 weeks

          -  Known hypersensitivity to murine or recombinant proteins, polysorbate 80, or any
             excipient contained in the margetuximab drug formulation

          -  Second primary malignancy that has not been in remission for more than 3 years

          -  History of active viral, bacterial, or systemic fungal infection requiring parenteral
             treatment within 14 days

          -  History within 3 months of deep vein thrombosis, pulmonary embolism, or stroke

          -  Symptomatic or untreated central nervous system (CNS) metastatic disease. Patients
             with previously treated CNS metastatic disease which has been stable for at least 56
             days are eligible

          -  Requirement, at time of study entry, for concurrent steroids > 10 mg/day of oral
             prednisone or the equivalent, except steroid inhaler, nasal spray, or ophthalmic
             solution

          -  Serious medical condition that would impair the ability to receive or tolerate
             margetuximab; dementia or altered mental status that would preclude provision of
             informed consent

          -  Uncontrolled hypertension, heart disease including history of congestive heart
             failure, history of myocardial infarction, angina pectoris requiring medication,
             clinically significant valvular heart disease, high risk arrhythmias, or disease
             corresponding to New York Heart Association class III or IV.

          -  Significant pulmonary compromise

          -  Have previously been exposed to MGAH22 in this or any other trial
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Best Overall Response
Time Frame:Cycle 2, Day 21
Safety Issue:
Description:Response based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria based on Cycle 2, Day 21 computed tomography (CT) scans. Response is categorized as complete response (CR): disappearance of all target lesions, confirmed at ≥ 4 weeks; partial response (PR): ≥ 30% decrease in target lesions from baseline, confirmed at ≥ 4 weeks; progressive disease (PD): ≥ 20% increase over smallest sum observed with an absolute increase of at least 5 mm, or appearance of new lesions; and stable disease (SD): neither PR or PD criteria met. A Simon two-stage design was planned in which an initial cohort of 21 patients was treated. If 2 or more responses (PR or CR) are seen at the first tumor re-evaluation on day 21 of Cycle 2, the study would be expanded to include up to 41 patients (20 additional patients in Cohort 2, the second stage of the study) in order to determine whether further development of the drug is warranted (5 or more responses in 41 evaluable patients).

Secondary Outcome Measures

Measure:Response Rate
Time Frame:Day 49
Safety Issue:
Description:Response rate is the proportion of patients achieving a best response of complete response or partial response when such responses are confirmed at least 28 days after initial observation of response. Response based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria based on Cycle 2, Day 21 computed tomography (CT) scans. Response is categorized as complete response (CR): disappearance of all target lesions, confirmed at ≥ 4 weeks; partial response (PR): ≥ 30% decrease in target lesions from baseline, confirmed at ≥ 4 weeks; progressive disease (PD): ≥ 20% increase over smallest sum observed with an absolute increase of at least 5 mm, or appearance of new lesions; and stable disease (SD): neither PR or PD criteria met.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Completed
Lead Sponsor:MacroGenics

Trial Keywords

  • HER2 2+
  • FISH non-amplified
  • Relapsed
  • Refractory
  • Advanced
  • Margetuximab
  • MGAH22

Last Updated

September 17, 2020