Description:
The purpose of this study is to learn more about how to treat patients with HER-2/neu
positive invasive breast cancer (IBC). HER-2/neu is a type of protein that is known to be
over-expressed in aggressive breast cancer.
The study drug for this trial is DC1 study vaccine which is a HER2-sensitized dendritic cell
(DC) study vaccine. This study vaccine is made from the participant's blood cells collected
from a procedure called leukapheresis. Dendritic cells are immune cells that can tell the
immune system to fight infection. In laboratory testing and from previous studies in
participants, these cells may also help the immune system attack tumors such as breast
cancer.
Title
- Brief Title: HER2 Directed Dendritic Cell Vaccine During Neoadjuvant Therapy of HER2+Breast Cancer
- Official Title: A Pilot Study Utilizing a HER2 Directed Dendritic Cell Vaccine During Neoadjuvant Therapy of HER2+ Breast Cancer
Clinical Trial IDs
- ORG STUDY ID:
MCC-19337
- NCT ID:
NCT03387553
Conditions
- Breast Cancer
- Breast Cancer Female
- Breast Cancer, Male
- Invasive Breast Cancer
- HER2-positive Breast Cancer
- HER2 Positive Breast Carcinoma
- Stage II Breast Cancer
- Stage III Breast Cancer
Interventions
Drug | Synonyms | Arms |
---|
Dendritic Cell Vaccine (DC1) | Immunotherapy | Expansion Phase |
Neoadjuvant Chemotherapy | TCHP | Expansion Phase |
Purpose
The purpose of this study is to learn more about how to treat patients with HER-2/neu
positive invasive breast cancer (IBC). HER-2/neu is a type of protein that is known to be
over-expressed in aggressive breast cancer.
The study drug for this trial is DC1 study vaccine which is a HER2-sensitized dendritic cell
(DC) study vaccine. This study vaccine is made from the participant's blood cells collected
from a procedure called leukapheresis. Dendritic cells are immune cells that can tell the
immune system to fight infection. In laboratory testing and from previous studies in
participants, these cells may also help the immune system attack tumors such as breast
cancer.
Detailed Description
The trial will consist of two phases. The first lead in phase will enroll 12 participants
evenly divided into two arms (alternating enrollment) with different initial priming study
vaccination schedules.
Arm A: One DC1 study vaccination per week x 3 weeks. Arm B: Two DC1 study vaccinations per
week (given 3 days apart for example Mon and Thurs or Tues and Friday) x 3 weeks.
Following accrual of this initial group of 12 participants, HER2 ELISPOT post study
vaccination responses will be assessed to determine which of the two sequences provides the
greater increase in anti HER2 response at week 4 over baseline. This will determine which
sequence will be used in the second expansion phase of accrual. If both arms are determined
equal then Arm A will be selected as the default sequence.
Second phase of accrual will consist of 14 additional participants to undergo study
vaccination using the optimal schedule declared in the first phase of the trial. The trial
will consist of two phases. The first lead in phase will enroll 12 participants evenly
divided into two arms (alternating enrollment) with different initial priming study
vaccination schedules.
Arm A: One DC1 study vaccination per week x 3 weeks Arm B: Two DC1 study vaccinations per
week (given 3 days apart for example Mon and Thurs or Tues and Friday) x 3 weeks.
Following accrual of this initial group of 12 participants, HER2 ELISPOT post study
vaccination responses will be assessed to determine which of the two sequences provides the
greater increase in anti HER2 response at week 4 over baseline. This will determine which
sequence will be used in the second expansion phase of accrual. If both arms are determined
equal then Arm A will be selected as the default sequence.
Second phase of accrual will consist of 14 additional participants to undergo study
vaccination using the optimal schedule declared in the first phase of the trial.
Trial Arms
Name | Type | Description | Interventions |
---|
Lead In Phase - Arm A | Active Comparator | Arm A: One Dendritic Cell Vaccine (DC1) per week x 3 weeks. | - Dendritic Cell Vaccine (DC1)
- Neoadjuvant Chemotherapy
|
Lead In Phase - Arm B | Active Comparator | Arm B: Two DC1 vaccinations per week (given 3 days apart i.e., Mon and Thurs or Tues and Friday) x 3 weeks. | - Dendritic Cell Vaccine (DC1)
- Neoadjuvant Chemotherapy
|
Expansion Phase | Experimental | DC1 vaccinations according to optimal vaccination schedule. Participants will receive a booster intranodal study vaccine at week 25 prior to receiving surgery. Participants will then undergo definitive curative surgery following completion of the neoadjuvant therapy, additional adjuvant locoregional/systemic therapy (as deemed appropriate by their treating physicians). | - Dendritic Cell Vaccine (DC1)
- Neoadjuvant Chemotherapy
|
Eligibility Criteria
Inclusion Criteria:
- Participants must have histologically confirmed clinical stage II or III ERPR- HER2+
(per CAP criteria) invasive carcinoma of the breast
- Medically and surgically appropriate to undergo neoadjuvant chemotherapy with TCH-P
Taxotere (docetaxel), Carboplatin, Herceptin (trastuzumab), Perjeta (pertuzumab)
regimen followed by standard of care local therapy as determined by their treating
physician
- Age ≥18 years.
- Eastern Cooperative Oncology Group (ECOG) performance status less than 2
- Patients must have normal organ and marrow function as defined below:
- leukocytes ≥3,000/μL
- absolute neutrophil count ≥1,500/μL
- platelets ≥100,000/μL
- total bilirubin within normal institutional limits
- AST(SGOT)/ALT(SGPT) less than or equal to 2.5 X institutional upper limit of
normal
- creatinine within normal institutional limits - OR -
- creatinine clearance ≥60 mL/min/1.73 m^2 for patients with creatinine levels
above institutional normal
- Cardiac ejection fraction within institutional normal limits by either MUGA or ECHO at
baseline.
- Women of child-bearing potential and their male partners must agree to use adequate
contraception (hormonal or barrier method of birth control; abstinence) prior to study
entry and for the duration of study participation. Should a woman become pregnant or
suspect she is pregnant while participating in this study, she should inform her
treating physician immediately. Sexually active male participants should use a barrier
method or exercise abstinence during chemotherapy administration until surgery.
- Ability to understand and the willingness to sign a written informed consent document.
Exclusion Criteria:
- Patients with inflammatory breast cancer, widespread locally advanced unresectable
disease involving the chest wall/nodal basins in which a curative surgical resection
cannot be performed, or those in whom de novo metastatic disease is suspected or
confirmed
- May not be receiving any other investigational agents for the treatment of their
breast cancer.
- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to the study vaccine components and any of the chemotherapy drugs
(docetaxel, carboplatin, trastuzumab, pertuzumab)
- Unwilling or unable to undergo an apheresis for production of their vaccine
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
study requirements.
- Women who are pregnant or breastfeeding
- Known congenital or acquired immune deficiency (including those patients who require
systemic immunosuppressant drugs for autoimmune disease or organ transplant).
- Pre-existing peripheral neuropathy that would limit treatment with taxanes and
platinum agents
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Expansion Phase Schedule Selection by Week 4 |
Time Frame: | By Week 4 |
Safety Issue: | |
Description: | Immunogenicity of HER2 DC Vaccine per treatment Arm, based on week 4 ELISPOTs. Three metrics of CD4+ Th1 response will be computed for each patient, (a) overall anti-HER2 responsivity (i.e., if patient demonstrates a positive ELISPOT response to >1 peptide, (b) response repertoire (i.e., number of reactive peptides) and (c) cumulative response (total SFC/10^6 cells across 6 peptides). The primary immunogenicity outcome will be the cumulative response at week 4 (week after completion of all vaccinations). |
Secondary Outcome Measures
Measure: | Recurrence Free Survival (RFS) |
Time Frame: | Up to 3 years post-surgery |
Safety Issue: | |
Description: | Recurrence-free survival (RFS) will be defined as the time from first vaccination to documented recurrence (any breast event), death due to any cause or last patient contact that documents recurrence-free status (i.e., a clinic or scan date). |
Details
Phase: | Early Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | H. Lee Moffitt Cancer Center and Research Institute |
Trial Keywords
- Immunotherapy
- Dendritic Cell Vaccine
- DC1
Last Updated
July 14, 2021