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Metastatic Breast CancerPhase 2NCT04389073

Safety and Efficacy of Toripalimab in HER2- Metastatic Breast Cancer Patients Treated With Metronomic Vinorelbine

A Phase 2 study testing Vinorelbine 40mg, Toripalimab 240mg and Bevacizumab 5 mg/kg in people with Metastatic Breast Cancer, run by Cancer Institute and Hospital, Chinese Academy of Medical Sciences at 2 sites in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The investigators hypothesize that the administration of Toripalimab (anti-PD-1 antibody, JS001) combined to metronomic Vinorelbine may be an interesting therapeutic option for female patients with HER2- metastatic breast cancer. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Metastatic Breast Cancer
What is being tested?
Vinorelbine 40mg, Toripalimab 240mg and Bevacizumab 5 mg/kg
Could I receive a placebo?
No, everyone receives an active treatment
How many people
138 participants
Where
2 sitesChina
Study dates
1 Apr 2020to 31 Dec 2023
Phase
Phase 2
Are there results?
None posted in the registry

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

  • Female patients with life expectancy ≥ 3 months, age ≥ 18 years at the time
  • informed consent is signed.
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1 as assessed within 21 days prior to first dosage.
  • Subjects with HER2 negative metastasis breast cancer, source documented, defined as per American Society of Clinical Oncology - College of American Pathologists (ASCO/CAP) guidelines.
  • Subjects previously treated with no more than one prior line of standard chemotherapy
  • Subjects with measurable metastatic disease defined by Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) guidelines.
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  • Subjects may previously exposed to anthracyclines (e.g. doxorubicin, epirubicin) and/or taxanes (e.g., paclitaxel, docetaxel) including:
  • has been pretreated in the adjuvant or neoadjuvant setting with anthracyclines and/or taxanes before breast cancer relapsing;
  • has experienced treatment failure while receiving or after completing anthracycline- and/or taxane- based chemotherapy;
  • not suitable for the choice of anthracycline- and/or taxane- based chemotherapy as first-line treatment in the judgment of investigator.
  • Prior radiotherapy must have completed before randomization, with full recovery from acute radiation side effects. An interval of less than 4 weeks after radiotherapy was not allowed.Concurrent limited field radiation therapy (RT) is allowed. At least one measurable lesion must be completely outside the radiation portal in accordance with RECIST 1.1 guidelines;
  • At least 30 days from major surgery before randomization, with full recovery;
  • Adequate bone marrow function as evidenced by the following:
  • Absolute Neutrophil Count (ANC) ≥ 1500/mm2;
  • Platelets ≥ 100,000/mm2;
  • Hemoglobin (Hb) ≥ 10 g/dL.
  • Adequate liver function as evidenced by the following:
  • Total serum bilirubin ≤ 1.5 times upper limit of normal range (ULN);
  • Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ≤ 2.5 times ULN (if hepatic metastases present ≤ 5.0 times ULN);
  • Alkaline phosphatase < 5 x ULN.
  • Adequate renal function as evidenced by the following:
  • Creatinine clearance > 40 mL/min (by Cockcroft-Gault).
  • Women of child-bearing potential must have a negative pregnancy test (urine or serum) within 7 days of randomization and agree to take an adequate contraceptive measure.
  • Understand and voluntarily sign an informed consent document prior to any study related assessments/procedures are conducted.
  • Able to adhere to the study visit schedule and other protocol requirements.

Who cannot join

  • History of, or current active cancer other than breast cancer, with the exception of curatively resected non-melanomatous skin cancer, curatively treated cervical carcinoma in situ, or other primary solid tumors curatively treated with no known active disease present and no curative treatment administered for the last 3 years.
  • Patients with medical conditions that the only manifestation is hydrothorax, ascites, bone lesions or other un-measurable diseases.
  • Subjects with visceral crisis in the judgment of investigator. Visceral crisis is defined as severe organ dysfunction as assessed by signs and symptoms, laboratory studies, and rapid progression of disease. Visceral crisis is not the mere presence of disease of visceral metastases, but implies important visceral compromise leading to a clinical indication for a more rapidly efficacious therapy, particularly since chemotherapy option at progression will probably not be possible.
  • Malabsorption syndrome or disease significantly affecting gastro-intestinal function or major resection of the stomach or proximal small bowel that could affect absorption of Oral NVB.
  • Subjects with dysphagia, or inability to swallow the tablets.
  • Subjects with symptoms suggesting central nervous system (CNS) involvement or leptomeningeal metastases, any suspicious sins or symptoms of CNS involvement or leptomeningeal metastases should be excluded by CT or MRI scans.
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  • Other serious illness or medical conditions by the investigator during screening:
  • Clinically significant cardiac disease;
  • Unstable diabetes;
  • Uncontrolled hypercalcemia;
  • Clinically significant active infections (current or in the last two weeks).
  • Previous organ allograft.
  • Current peripheral neuropathy ≥grade 2 according to NCI version 4.0 criteria.
  • Concomitant hormonal therapy for MBC.
  • Ongoing anti-coagulation therapy.
  • Subjects of reproductive potential who are pregnant, breast feeding or not willing to use effective contraceptive precautions during the study and for at least one month after the last dose of investigational product in the judgment of the investigator.
  • Patients with psychiatric disorder or other disease leading to incompliance to the therapy.
  • An interval of less than 3 weeks between the last dose of previous chemotherapy and randomization.
  • Previous treated by oral NVB.
  • Treatment with any investigational drug within 30 days before the beginning of treatment with study drug. Less than 30 days since receipt of any other investigational product or device.
  • Known hypersensitivity to any ingredient of the study drug.

Trial locations and contacts

2 sites in 1 country.

Hongnan Mo contact

86-10-87788120

China2 sites, 2 recruiting
  • Cancer Hospital, Chinese Academy of Medical Sciences

    Beijing, Beijing Municipality, 100021

    Fei Ma, MD, 86-10-87788060, drmafei@126.com

    Recruiting
  • Beijing Huanxing Cancer Hospital

    Beijing, Beijing Municipality

    Hongnan Mo, MD, 86-10-87788120

    Recruiting

Other trials in China

About this study

Official title: Safety and Efficacy of Metronomic Vinorelbine in Combination With Toripalimab for Patients With HER2- Metastatic Breast Cancer

The investigators hypothesize that the administration of Toripalimab (anti-PD-1 antibody, JS001) combined to metronomic Vinorelbine may be an interesting therapeutic option for female patients with HER2- metastatic breast cancer. The approach suggested here is to deplete and active the immune response of these patients. The combination of Toripalimab and Vinorelbine would provide a higher gain in anti-tumor response in these patients than in those with chemotherapy alone.

The investigators proposal is to conduct a multicentric, single arm, Phase II trial in HER2- patients with metastatic breast cancer, aiming to evaluate the clinical activity of the combination therapy Toripalimab + metronomic Vinorelbine. Patients will receive Vinorelbine (40 mg/day, tiw, per os) and Toripalimab (240 mg every 3 weeks, intravenously [IV]). The adverse events of the two drugs are well known.

Read the detailed description

Both study drugs will continue to be administered as long as patient experience clinical benefit in the opinion of the investigator or symptomatic deterioration attributed to disease progression as determined by the investigator after an integrated assessment of radiographic data and clinical status or withdrawal of consent.

Being tested
Vinorelbine 40mg, Toripalimab 240mg, Bevacizumab 5 mg/kg, Cyclophosphamide 50 mg, Capecitabine 500Mg Oral Tablet
Medical subject headings
Breast Neoplasms

What participants receive

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

  • Vinorelbine 40mgDrug

    Two tablets per day, three times a week. Vinorelbine will continue to be administered as long as patient experiences clinical benefit in the opinion of the investigator or symptomatic deterioration attributed to disease progression as determined by the investigator after an integrated assessment of radiographic data and clinical status or withdrawal of consent.

  • Toripalimab 240mgBiological

    Also called JS001

    Toripalimab 240 MG IV infusion every 3 weeks. Toripalimab will continue to be administered as long as patient experiences clinical benefit in the opinion of the investigator or symptomatic deterioration attributed to disease progression as determined by the investigator after an integrated assessment of radiographic data and clinical status or withdrawal of consent.

  • Bevacizumab 5 mg/kgBiological

    Bevacizumab 5 mg/kg IV infusion every 3 weeks. Bevacizumab will continue to be administered as long as patient experiences clinical benefit in the opinion of the investigator or symptomatic deterioration attributed to disease progression as determined by the investigator after an integrated assessment of radiographic data and clinical status or withdrawal of consent.

  • Cyclophosphamide 50 mgDrug

    50 mg per day. Cyclophosphamide will continue to be administered as long as patient experiences clinical benefit in the opinion of the investigator or symptomatic deterioration attributed to disease progression as determined by the investigator after an integrated assessment of radiographic data and clinical status or withdrawal of consent.

  • Capecitabine 500Mg Oral TabletDrug

    500mg three times a day. Capecitabine will continue to be administered as long as patient experiences clinical benefit in the opinion of the investigator or symptomatic deterioration attributed to disease progression as determined by the investigator after an integrated assessment of radiographic data and clinical status or withdrawal of consent.

  • CisplatinDrug

    Cisplatin 50mg/m2 IV infusion every 3 weeks. Cisplatin will continue to be administered as long as patient experiences clinical benefit in the opinion of the investigator or symptomatic deterioration attributed to disease progression as determined by the investigator after an integrated assessment of radiographic data and clinical status or withdrawal of consent.

Study groups in NCT04389073
Study groupRoleWhat they receive
Arm 1 (PD-1+NVB)ExperimentalThe treatments received are: * Vinorelbine (40 mg/day, tiw, per os) * Toripalimab (240 mg every 3 weeks, intravenously [IV]).
Receives: Drug: Vinorelbine 40mg; Biological: Toripalimab 240mg
Arm 2 (PD-1+NVB+Bev)ExperimentalThe treatments received are: * Vinorelbine (40 mg/day, tiw, per os) * Toripalimab (240 mg every 3 weeks, intravenously [IV]) * Bevacizumab (5 mg/kg every 3 weeks, intravenously [IV]).
Receives: Drug: Vinorelbine 40mg; Biological: Toripalimab 240mg; Biological: Bevacizumab 5 mg/kg
Arm 3 (PD-1+NVB+DDP)Experimental* Vinorelbine (40 mg/day, tiw, per os) * Toripalimab (240 mg every 3 weeks, intravenously [IV]) * Cisplatin (50mg/m2 every 3 weeks, intravenously [IV]).
Receives: Drug: Vinorelbine 40mg; Biological: Toripalimab 240mg; Drug: Cisplatin
Arm 4 (PD-1+VEX)Experimental* Vinorelbine (40 mg/day, tiw, per os) * Toripalimab (240 mg every 3 weeks, intravenously [IV]) * Cyclophosphamide (50 mg/day, qd, per os) * Capecitabine (500 mg, tid, per os)
Receives: Drug: Vinorelbine 40mg; Biological: Toripalimab 240mg; Drug: Cyclophosphamide 50 mg; Drug: Capecitabine 500Mg Oral Tablet
Arm 5 (NVB)Active comparator• Vinorelbine (40 mg/day, tiw, per os)
Receives: Drug: Vinorelbine 40mg

What is being measured

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

  1. Clinical Benefit Rate (CBR)

    CBR, defined as the percentage of Complete Response (CR), (Partial Response) PR or Stable Disease (SD) . Response will be evaluated by Response Evaluation Criteria In Solid Tumors (RECIST) V1.1.

    Measured: 6 weeks of treatment

Secondary outcomes (4)
  1. Overall response Rate (ORR)

    The objective response rate (ORR) will be defined as the proportion of patients (described on the efficacy-evaluable population) who achieve complete response (CR) or partial response (PR) as best overall response at 6 weeks of treatment. ORR is based on tumor assessments.

    Measured: 6 weeks of treatment

  2. Progression-Free Survival (PFS)

    Measured from the date of study drugs start to the date of the first objective disease progression or death.

    Measured: 15 months

  3. Overall Survival (OS)

    Defined as the duration of time from start of treatment to time of death.

    Measured: 15 months

  4. Adverse events reporting

    Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

    Measured: 15 months

Timeline

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

  1. First posted15 May 2020
  2. Study start1 Apr 2020
  3. Primary completion31 Dec 2022 (estimated)
  4. Study completion31 Dec 2023 (estimated)

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
138 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04389073
Sponsor's protocol ID
NCC2167
Status last verified
Feb 2022
First submitted
8 May 2020
Last updated
25 Feb 2022
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Mo H, Yu Y, Sun X, Ge H, Yu L, Guan X, Zhai J, Zhu A, Wei Y, Wang J, Yan X, Qian H, Xu B, Ma F. Metronomic chemotherapy plus anti-PD-1 in metastatic breast cancer: a Bayesian adaptive randomized phase 2 trial. Nat Med. 2024 Sep;30(9):2528-2539. doi: 10.1038/s41591-024-03088-2. Epub 2024 Jul 5.

    PubMed 38969879

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Vinorelbine 40mg, Toripalimab 240mg and Bevacizumab 5 mg/kg in people with Metastatic Breast Cancer, run by Cancer Institute and Hospital, Chinese Academy of Medical Sciences at 2 sites in China.

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 25 inclusion and 21 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: status not confirmed, as of the sponsor's last update on 25 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in China. 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

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?

Results are not available in the source record.

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

Contact Fei Ma (86-10-87788060, drmafei@126.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Clinical Benefit Rate (CBR) (time frame: 6 weeks of treatment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04389073, which also lists 1 linked publication.

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 25 Feb 2022.

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