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Breast CancerPhase 1/2NCT02708680

Randomized Phase 2 Study of Atezolizumab and Entinostat in Patients With aTN Breast Cancer With Phase 1b Lead In

A Phase 1/2 study testing Entinostat and Atezolizumab in people with Breast Cancer, run by Syndax Pharmaceuticals at 29 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this study is to determine the safety and tolerability of entinostat used in combination with atezolizumab in participants with Advanced Triple Negative Breast Cancer (aTNBC). Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Breast Cancer
What is being tested?
Entinostat and Atezolizumab
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
89 participants
Where
29 sitesin 2 countries
Study dates
May 2016to 31 Mar 2021
Phase
Phase 1/2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Has histologically or cytologically confirmed triple negative breast carcinoma that is either metastatic (stage IV of the TNM classification) or locally recurrent and not amenable to local curative treatment.
  • Evidence of measurable, locally recurrent or metastatic disease based on imaging studies within 28 days before the first dose of study drug.
  • Has received at least 1, but no more than 2, prior lines of systemic therapy for locally recurrent and/or metastatic disease.
  • If participant has a history of treated asymptomatic CNS metastases they are eligible, provided they meet all of the following criteria: participant has measurable disease outside CNS; participant does not have metastases to midbrain, pons, medulla or spinal cord; participant is not on corticosteroids as therapy for CNS disease (anticonvulsants at a stable dose are allowed); participant has not had whole-brain radiation within 6 weeks prior to study enrollment; participant has stable CNS disease as demonstrated by at least 4 weeks of stability between the last intervention scan and the study screening scan.
  • ECOG performance status of 0 or 1.
  • Has acceptable, applicable laboratory parameters.
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  • Female participants must not be pregnant; willing to use 2 methods of birth control/abstinence if applicable through 120 days after the last dose of study drug.
  • Experienced resolution of toxic effect(s) of the most recent prior anti-cancer therapy to Grade <1 (except alopecia or neuropathy).
  • Able to understand and give written informed consent and comply with study procedures.

Who cannot join

  • Diagnosis of immunodeficiency or receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of study drug.
  • Active autoimmune disease including active diverticulitis, symptomatic peptic ulcer disease, colitis, or inflammatory bowel disease that has required systemic treatment in past 2 years.
  • Previously treated with a PD-1/PD-L1-blocking antibody or a histone deacetylase inhibitor.
  • History or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the participant's participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating Investigator, including, but not limited to: history of immune deficiencies or autoimmune disease; myocardial infarction or arterial thromboembolic events within 6 months prior to screening or severe or unstable angina, New York Heart Association (NYHA) Class III or IV disease, or a QTc interval > 470 msec; uncontrolled hypertension or diabetes mellitus; another known malignancy that is progressing or requires active treatment; active infection requiring systemic therapy; known active central nervous system (CNS) metastases and/or carcinomatous meningitis.
  • Any contraindication to oral agents or significant nausea and vomiting, malabsorption, or significant small bowel resection that, in the opinion of the investigator, would preclude adequate absorption.
  • Received a live vaccine within 30 days of the first dose of treatment.
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  • Prior anti-cancer monoclonal antibody (mAb) within 4 weeks prior to enrollment or who has not recovered from AEs due to mAb agents administered more than 4 weeks earlier.
  • Prior chemotherapy within 3 weeks, targeted small molecule therapy or radiation therapy within 2 weeks prior to enrollment, or who has not recovered (i.e., ≤Grade 1 at enrollment) from AEs due to a previously administered agent.
  • Received transfusion of blood products or administration of colony stimulating factors within 4 weeks prior to the first dose of treatment.
  • 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 drug.
  • Currently receiving treatment with any other agent listed on the prohibited medication list.
  • If female, is pregnant, breastfeeding, or expecting to conceive starting with the screening visit through 120 days after the last dose of study drug.
  • Known history of human immunodeficiency virus (HIV) (HIV 1/2 antibodies).
  • Known active hepatitis B or hepatitis C.
  • Allergy to benzamide or inactive components of entinostat.
  • History of allergies to any active or inactive ingredients of atezolizumab.
  • Known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the study.

Trial locations and contacts

29 sites in 2 countries.

29 sites in 2 countries

United States19 sites
  • Hope Women's Cancer Centers

    Asheville, North Carolina, 28806

  • CBCC Global Research at Comprehensive Blood and Cancer Center

    Bakersfield, California, 93309

  • UAB Comprehensive Cancer Center

    Birmingham, Alabama, 35201

  • Texas Oncology-Baylor Charles A. Sammons Cancer Center

    Dallas, Texas, 75201

  • Ft. Wayne Hematology and Oncology

    Fort Wayne, Indiana, 46804

  • Ft. Wayne Medical Oncology & Hematology, Inc

    Fort Wayne, Indiana, 46845

  • St. Jude Medical Center

    Fullerton, California, 92835

  • Los Angeles Hematology Oncology Medical Group

    Glendale, California, 91204

  • Saint Mary's Regional Cancer Center

    Grand Junction, Colorado, 81501

  • Office of Human Research

    Hollywood, Florida, 33020

  • Saint Barnabas Medical Cancer Center

    Livingston, New Jersey, 07039

  • Orlando Health, Inc.

    Orlando, Florida, 32806

  • Torrance Memorial Cancer Care Associates

    Redondo Beach, California, 90277

  • Frauenshuh Cancer Center at Park Nicollet Health Service

    Saint Louis Park, Minnesota, 55426

  • SLO Oncology and Hematology Health Center

    San Luis Obispo, California, 93401

  • Central Coast Medical Oncology Group

    Santa Maria, California, 93454

  • UCLA Hematology/Oncology - Santa Monica

    Santa Monica, California, 90404

  • Cancer Center of Kansas

    Wichita, Kansas, 67214

  • Wake Forest Baptist Medical Center

    Winston-Salem, North Carolina, 27157

Other trials in United States

Georgia10 sites
  • Cancer Center of Adjara Autonomous Republic

    Batumi, Adjara, 6010

  • Saint Nikolozi Surgery and Oncological Centre

    Kutaisi, Imereti, 4600

  • Unimed Adjara - Oncology Center

    Kutaisi, Imereti, 4600

  • Health House

    Tbilisi, 0144

  • Institute of Clinical Oncology

    Tbilisi, 0159

  • New Vision University Hospital

    Tbilisi, 0159

  • Cancer Research Center

    Tbilisi, 0177

  • S. Khechinashvili, University Hospital

    Tbilisi, 0179

  • Multiprofile Clinic Consilium Medulla

    Tbilisi, 0186

  • Research Institute of Clinical Medicine

    Tbilisi, 4600

Other trials in Georgia

About this study

Official title: A Randomized, Placebo-controlled, Double-blind, Multicenter Phase 2 Study of Atezolizumab With or Without Entinostat in Patients With Advanced Triple Negative Breast Cancer, With a Phase 1b Lead in Phase

The purpose of this study is to determine the safety and tolerability of entinostat used in combination with atezolizumab in participants with Advanced Triple Negative Breast Cancer (aTNBC). Additionally, the purpose of the study is to assess how effective entinostat and atezolizumab are in combination in participants with aTNBC.

Read the detailed description

SNDX-275-0602 is a Phase 1b/2 study evaluating the combination of entinostat plus atezolizumab in participants with aTNBC. The study has 2 phases: an open-label Dose Determination Phase (Phase 1b) followed by an Expansion Phase (Phase 2). The Expansion Phase will evaluate the efficacy and safety of entinostat when administered at the RP2D with atezolizumab in participants with aTNBC in a randomized, double-blind, placebo-controlled setting.

Safety will be assessed during the study by documentation of AEs, clinical laboratory tests, physical examinations, vital sign measurements, electrocardiograms (ECGs), and Eastern Cooperative Oncology Group (ECOG) performance status. Adverse events of special interest (AESI) will be collected and reviewed in a manner consistent with serious adverse event reporting procedures.

Conditions
Breast Cancer
Being tested
Entinostat, Atezolizumab, Placebo
Medical subject headings
Breast Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • EntinostatDrug

    Also called SNDX-275, MS-275

    An orally available histone deacetylases inhibitor (HDAC).

  • AtezolizumabDrug

    Also called MPDL3280A

    A humanized, engineered monoclonal antibody of IgG1 isotype against the protein programmed cell death ligand 1 (PD-L1).

  • PlaceboDrug

    A pill containing no active drug ingredient

Study groups in NCT02708680
Study groupRoleWhat they receive
Entinostat plus AtezolizumabActive comparatorParticipants in this arm will receive entinostat in combination with atezolizumab. Phase 1b Dose Determination: The initial 3 to 6 participants will receive entinostat at a starting dose of 5 milligrams (mg) (Dose Group 1) on Days 1, 8, and 15 along with atezolizumab 1200 mg via intravenous (IV) infusion on Day 1 of each 21-day cycle. If the 5 mg dose exceeds the maximum tolerated dose (MTD), then a 3 mg dose of entinostat (Dose Group -1) will be evaluated in the same manner. If the -1 dose level exceeds the MTD, then a 2 mg dose of entinostat (Dose Group -2) will be evaluated. Phase 2 Dose Expansion: Participants will receive the RP2D identified in the Dose Determination Phase.
Receives: Drug: Entinostat; Drug: Atezolizumab
Placebo plus AtezolizumabPlacebo comparatorParticipants in this arm will receive placebo in combination with atezolizumab 1200 mg.
Receives: Drug: Atezolizumab; Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Phase 1b: Participants Experiencing DLT

    Phase 1b employed a classical 3+3 design, with the determination of DLT based on entinostat in combination with atezolizumab within the first cycle of treatment (that is, between Day 1 to Day 21 of Cycle 1). Six participants were required to be treated in a dose level for it to be considered MTD or the Recommended Phase 2 Dose (RP2D). A DLT was defined as the occurrence of specific events, defined in the protocol, that were considered by the investigator to be at least possibly related to study drug using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events version 4.03.The DLT assessment window (Cycle 1) was the time period between Cycle 1 Day 1 until Cycle 2 Day 1 (expected to be 21 days after Cycle 1 Day 1).

    Measured: Up to 21 days after Cycle 1 Day 1

  2. Phase 1b: Determination of the RP2D

    Phase 1b employed a classical 3+3 design, with the determination of the RP2D based on entinostat in combination with atezolizumab within the first cycle of treatment (that is, between Day 1 to Day 21 of Cycle 1). The RP2D was defined as equal to or less than the preliminary maximum tolerated dose (MTD) and was determined in discussion with the sponsor, the study medical monitor, and dose determination phase investigators. The MTD was defined as the highest dose level at which <33% of 6 participants experience DLT.

    Measured: Up to 21 days after Cycle 1 Day 1

  3. Phase 2 Expansion: Duration of Progression-free Survival (PFS) Using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1)

    The duration of PFS, assessed using RECIST 1.1, was used to evaluate the efficacy of entinostat at the RP2D in combination with atezolizumab in participants with advanced triple negative breast cancer (aTNBC). It was defined as the number of months from randomization to the earlier of progressive disease or death due to any cause. One month was considered 30.4375 days. PFS (months) = (Date of Progression or Censoring - Date of Randomization + 1)/30.4375.

    Measured: Up to 1 year

Secondary outcomes (6)
  1. Phase 2 Expansion: Duration of PFS Using Immune Response RECIST (irRECIST)

    The duration of PFS, assessed using irRECIST, was used to evaluate the efficacy of entinostat at the RP2D in combination with atezolizumab in participants with aTNBC. It was defined as the number of months from randomization to the earlier of progressive disease or death due to any cause. One month was considered 30.4375 days. PFS (months) = (Date of Progression or Censoring - Date of Randomization + 1)/30.4375.

    Measured: Up to 1 year

  2. Phase 2 Expansion: Overall Response Rate (ORR) Using RECIST 1.1 and irRECIST

    ORR was defined as the crude percentage of participants achieving a best overall response of complete response (CR) or partial response (PR) assessed using RECIST 1.1 and irRECIST. ORR calculated as: (number of participants with best overall response as CR or PR)/total number of participants. The overall response was determined locally by the investigator at each scheduled assessment.

    Measured: Up to 1 year

  3. Phase 2 Expansion: Clinical Benefit Rate (CBR) Using RECIST 1.1 and irRECIST

    CBR was estimated based on the crude percentage of participants in each treatment arm whose best overall response during the course of study treatment was CR, PR, or stable disease (SD) lasting for at least 24 weeks (measured from the date of randomization to the last date where SD was reported).

    Measured: Up to 1 year

  4. Phase 2 Expansion: Overall Survival (OS)

    OS was defined as the number of months from randomization to date of death from any cause. Participants who were alive or lost to follow-up as of a data analysis cutoff date were right-censored. One month was considered 30.4375 days. OS (months) = (Date of Death/Censoring - Date of Randomization + 1)/30.4375

    Measured: Up to 5 years

  5. Phase 2 Expansion: Duration of Response (DOR)

    DOR was defined as the number of months from the date where a CR/PR (based on RECIST 1.1) or immune response CR (irCR)/immune response PR (irPR) was firstly observed, to the first date that recurrent or progressive disease was documented.

    Measured: Up to 2 years

  6. Phase 2 Expansion: Time To Response (TTR)

    TTR was defined for the subset of participants that achieved best overall response of confirmed CR/PR or confirmed irCR/irPR as the number of months from date of randomization to date of the initial documented response of CR/PR (based on RECIST 1.1) or irCR/irPR (based on irRECIST).

    Measured: Up to 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Mar 2016 (estimated)
  2. Study startMay 2016
  3. Primary completion31 Mar 2021
  4. Study completion31 Mar 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
89 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02708680
Sponsor's protocol ID
SNDX-275-0602
Status last verified
Nov 2024
First submitted
9 Mar 2016
Last updated
4 Dec 2024
Data monitoring committee
Yes
Individual data sharing
No: An independent data safety monitoring board (DSMB) will be established for the Phase 2 portion of this study to act in an advisory capacity to the Sponsor with respect to safeguarding the interests of trial patients and assessing the safety of the interventions administered during the trial.

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Entinostat and Atezolizumab in people with Breast Cancer, run by Syndax Pharmaceuticals at 29 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 4 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 29 sites in United States, Georgia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 14 Sep 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Phase 1b: Participants Experiencing DLT (time frame: Up to 21 days after Cycle 1 Day 1). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Dec 2024; AzTrials last refreshed its copy on 7 Nov 2026.

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