Study With Atezolizumab in Combination With Trastuzumab and Vinorelbine in HER2-positive Advanced/Metastatic Breast Cancer

Last updated: April 16, 2024
Sponsor: SOLTI Breast Cancer Research Group
Overall Status: Active - Recruiting

Phase

2

Condition

Breast Cancer

Cancer

Treatment

Atezolizumab + Trastuzumab + Vinorelbine

Clinical Study ID

NCT04759248
SOLTI-1907
2020-000245-13
  • Ages > 18
  • All Genders

Study Summary

Immune checkpoint inhibitors given in monotherapy in advanced breast cancer have shown modest benefit in first-line, but very limited efficacy in later lines. Thus, combination therapies are needed.

Response following anti-PD1/PD-L1 monotherapy is associated with large survival benefit in the advanced setting.

Previous studies of the intrinsic subtypes have shown that Basal-like and HER2-E are associated with higher expression of immune-related genes or higher infiltration of stromal tumor infiltrating lymphocytes compared to the luminal subtypes. Immune infiltration in BC is associated with chemo/antiHER2 responsiveness and potentially benefit from anti-PD-1/PD-L1 inhibitors.

In addition, one emerging biomarker of response to anti-PD-1 therapy is the tumor mutational burden (I.e. the total number of mutations per coding area of a tumor genome). The HER2-E and Basal-like profiles have been associated with high mutational burden.

A range of studies have been initiated including several phase II/III studies evaluating atezolizumab in combination with different chemotherapeutic compounds routinely used in breast cancer, but none with predefined biomarker beyond the expression of PD-L1 by IHC

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Male or female (Premenopausal or postmenopausal women)
  • ECOG 0 to 2
  • Histologically confirmed adenocarcinoma of the breast, metastatic or unresectablelocally advanced.
  • All patients must have received at least trastuzumab and other anti-HER2 ADCs (including but not limited to T-DM1).
  • Measurable disease according to RECIST 1.1 criteria.
  • Adequate organ function
  • Baseline LVEF ≥50%
  • Participants with asymptomatic brain metastases are eligible.

Exclusion

Exclusion Criteria:

  • Treatment with any investigational anticancer drug within 14 days of the start ofstudy treatment.
  • Patient has received Vinorelbine or any other vinca alkaloids previously immediatelyprior to initiate study treatment.
  • History of other malignant tumors in the past 3 years
  • Known or suspected leptomeningeal disease (LMD)/ poorly controlled (> 1/week)generalized or complex partial seizures, or manifest neurologic progression due tobrain metastases.
  • Symptomatic hypercalcemia requiring treatment with bisphosphonates in the 14 daysprior to inclusion
  • Cardiopulmonary dysfunction
  • Any other severe, uncontrolled
  • Major surgery in the 28 days prior to enrolment
  • Infection with HIV or active Hepatitis B and/or Hepatitis C.
  • History of trastuzumab intolerance, including grade 3-4 infusion reaction orhypersensitivity.
  • Known hypersensitivity or allergy to biopharmaceuticals produced in Chinese hamsterovary cells or any component of the atezolizumab formulation
  • History of autoimmune disease,
  • Prior allogeneic stem cell or solid organ transplantation
  • History of idiopathic pulmonary fibrosis, drug-induced pneumonitis, organizingpneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia), orevidence of active pneumonitis on screening chest CT scan. (Note: History of radiationpneumonitis in the radiation field [fibrosis] is permitted.)
  • Active tuberculosis
  • Receipt of a live, attenuated vaccine within 4 weeks prior to enrollment
  • Prior treatment with CD137 agonists, anti-PD-1, or anti-PD-L1 therapeutic antibody orimmune checkpoint targeting agents
  • Treatment with systemic immunostimulatory agents (including but not limited tointerferons or interleukin [IL]-2) within 4 weeks or five half-lives of the drug priorto enrolment
  • Treatment with systemic immunosuppressive medications within 2 weeks prior toenrolment, or anticipated requirement for systemic immunosuppressive medicationsduring the trial.

Study Design

Total Participants: 55
Treatment Group(s): 1
Primary Treatment: Atezolizumab + Trastuzumab + Vinorelbine
Phase: 2
Study Start date:
March 15, 2021
Estimated Completion Date:
January 01, 2025

Connect with a study center

  • H. Clínico San Cecilio de Granada

    Granada, Andalucía
    Spain

    Active - Recruiting

  • Institut Català d'Oncologia Hospitalet

    Hospitalet de Llobregat, Barcelona
    Spain

    Active - Recruiting

  • Hospital Universitario de Canarias

    Tenerife, Islas Canarias 38320
    Spain

    Active - Recruiting

  • Complejo Hospitalario Universitario A Coruña (CHUAC)

    A Coruña, La Coruña 15006
    Spain

    Active - Recruiting

  • Comp. Hosp.Univ. Santiago (Chus)

    Santiago De Compostela, La Coruña
    Spain

    Site Not Available

  • Hospital General Universitario de Alicante

    Alicante,
    Spain

    Active - Recruiting

  • Hospital Clinic de Barcelona

    Barcelona,
    Spain

    Active - Recruiting

  • Hospital Universitari Vall d' Hebron

    Barcelona,
    Spain

    Active - Recruiting

  • Hospital del Mar

    Barcelona, 08003
    Spain

    Active - Recruiting

  • Hospital San Pedro de Alcántara

    Cáceres,
    Spain

    Active - Recruiting

  • Hospital de León

    León, 24071
    Spain

    Active - Recruiting

  • Hospital Universitario 12 de octubre

    Madrid,
    Spain

    Active - Recruiting

  • Hospital Son Espases

    Palma De Mallorca,
    Spain

    Active - Recruiting

  • Hospital Universitari Sant Joan de Reus

    Reus, 43201
    Spain

    Active - Recruiting

  • Hospital Universitario Virgen del Rocio

    Sevilla,
    Spain

    Active - Recruiting

  • Hospital Clinico Universitario de Valencia

    Valencia,
    Spain

    Active - Recruiting

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