Phase II Trial of Carboplatin +/- Tocilizumab for Metastatic Triple Negative and ER-low Breast Cancers

Trial Title: Phase II Trial of Carboplatin +/- Tocilizumab for Metastatic Triple Negative and ER-low Breast Cancers

NCT ID: NCT05846789

Condition: Metastatic Breast Cancer
Triple Negative Breast Cancer
Estrogen-receptor-low Breast Cancer

Conditions: Official terms:
Breast Neoplasms
Triple Negative Breast Neoplasms
Carboplatin

Conditions: Keywords:
Breast Cancer
Phase II

Study type: Interventional

Study phase: Phase 2

Overall status: Recruiting

Study design:

Allocation: Randomized

Intervention model: Parallel Assignment

Intervention model description: Patients are stratified by either Black or non-Black (race-based cohort) and are then randomized 1:1 to either the monotherapy or combination arm. This requires 42 patients (21 per treatment arm) in stage I for each race-based cohort. If the no. of response in experimental - no. of response in control is no greater than -1, the trial is early stopped at stage I for futility. Otherwise, additional 42 patients for each race-based cohort will be enrolled and randomized to the study in stage II for a total of 168 subjects across all 4 arms.

Primary purpose: Treatment

Masking: None (Open Label)

Intervention:

Intervention type: Drug
Intervention name: Carboplatin
Description: Carboplatin will be given AUC 6 IV q3 weeks for a maximum of 9 infusions.
Arm group label: Black Combination treatment
Arm group label: Black Monotherapy
Arm group label: Non-Black Combination treatment
Arm group label: Non-Black Monotherapy

Intervention type: Drug
Intervention name: Tocilizumab
Description: Tocilizimab 8 mg/ actual body weight in kg IV q4 weeks
Arm group label: Black Combination treatment
Arm group label: Non-Black Combination treatment

Summary: This is a randomized Phase II study of carboplatin monotherapy vs. carboplatin combined with tocilizumab in in Black and non-Black patients with metastatic triple negative or ER low breast cancer.

Detailed description: Randomized phase II using a two-stage Bayesian optimal phase II two-arm design (BOP2). Patients are randomized 1:1 to either the monotherapy or combination arms. This requires 42 patients (21 per treatment arm) in stage I for each race-based cohort. If the no. of response in experimental - no. of response in control is no greater than -1, the trial is early stopped at stage I for futility. Otherwise, additional 42 patients for each race-based cohort will be enrolled and randomized to the study in stage II.

Criteria for eligibility:
Criteria:
Inclusion Criteria: 1. ≥ 18 years old at the time of informed consent 2. Ability to provide written informed consent and HIPAA authorization 3. Locally recurrent (not amenable to local therapy with curative intent) or metastatic breast cancer that is triple negative or ER-low (ER and PR ≤ 9% weak staining) 4. No prior chemotherapy for metastatic disease a. Prior (neo)adjuvant therapy must have been completed at least 12 months from diagnosis of unresectable locally recurrent or metastatic disease. 5. Measurable disease based on RECIST 1.1 criteria. 6. Disease amenable to and consent for study-specific biopsy a. NOTE: If no disease amenable to biopsy is present at the time of second biopsy, subjects may continue participation in the study and further study specific biopsies will not be required. 7. ECOG PS 0 or 1 8. Patients with treated, asymptomatic CNS disease may participate if the patient is > 4 weeks from completion of CNS therapy (radiation and/or surgery), is clinically stable at the time of study entry, and is receiving a stable or decreasing dose of corticosteroid therapy. Brain MRI or head CT is required at screening for patients with known brain metastases. 9. Adequate organ function as indicated by: 1. Total bilirubin < ULN (except in patients with documented Gilbert's disease, who must have a total bilirubin < 3.0 mg/dL) 2. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 5.0 x ULN 3. Creatinine clearance of > 50 mL/min using the Cockcroft-Gault formula 4. Absolute neutrophil count (ANC) > 1.5 K/mm3 5. Platelets > 100 K/ mm3 6. Hgb > 9.0 g/dL 10. Women of childbearing potential must have a negative pregnancy test within 14 days of protocol registration. Women are considered to have childbearing potential (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) unless they meet one of the following criteria: 1. Has undergone a hysterectomy or bilateral oophorectomy; or 2. Has been naturally amenorrheic for at least 24 consecutive months. 11. Women of childbearing potential and men must agree to use effective contraception throughout the study and for 6 months after the last study treatment. Note: Acceptable methods of birth control include abstinence, partner with previous vasectomy, placement of an intrauterine device (IUD), condom with spermicidal foam/gel/film/cream/suppository, diaphragm or cervical vault cap, or hormonal birth control (pills or injections). Exclusion Criteria: 1. Prior treatment with or known contraindication to treatment with tocilizumab or other IL-6/IL-6R targeted agent 2. Patients who are PD-L1 positive (CPS ≥ 10), unless they have a clear contraindication to pembrolizumab therapy. 3. Active infection requiring parenteral antibiotics 4. Concurrent use of methotrexate or systemic corticosteroids 5. Active or symptomatic CNS disease 6. Patients with HER2+ disease HER2 will be considered positive if scored 3+ by immunohistochemistry (IHC) or 2+ by IHC associated with a fluorescence in situ hybridization (FISH) ratio of > 2.0 or > 6 total HER2 gene copies per cell. 7. Patients with active malignancy other than breast cancer. Patients with prior malignancies without recurrence after standard treatment will not be excluded 8. Radiation therapy within 2 weeks of registration 9. Hormone therapy within 2 weeks of registration

Gender: All

Minimum age: 18 Years

Maximum age: N/A

Healthy volunteers: No

Locations:

Facility:
Name: IU Health Joe and Shelly Schwarz Cancer Center

Address:
City: Carmel
Zip: 46032
Country: United States

Status: Recruiting

Facility:
Name: Indiana University Melvin and Bren Simon Comprehensive Cancer Center

Address:
City: Indianapolis
Zip: 46202
Country: United States

Status: Recruiting

Contact:
Last name: Xin Bryan, RN

Phone: 317-274-5495
Email: zhongx@iupui.edu

Contact backup:
Last name: Kathy Miller, MD

Facility:
Name: Sidney and Lois Eskenazi Hospital

Address:
City: Indianapolis
Zip: 46202
Country: United States

Status: Recruiting

Facility:
Name: Roswell Park Comprehensive Cancer Center

Address:
City: Buffalo
Zip: 14203
Country: United States

Status: Recruiting

Contact:
Last name: Lindsay Moshides, MS

Phone: 716-854-1300

Phone ext: 6328
Email: Lindsay.Moshides@RoswellPark.org

Contact backup:
Last name: Shipra Gandhi, MD

Start date: July 2, 2024

Completion date: December 2026

Lead sponsor:
Agency: Kathy Miller
Agency class: Other

Collaborator:
Agency: Genentech, Inc.
Agency class: Industry

Source: Indiana University

Record processing date: ClinicalTrials.gov processed this data on November 12, 2024

Source: ClinicalTrials.gov page: https://clinicaltrials.gov/ct2/show/NCT05846789