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HER2 树突状细胞治疗乳腺癌:I 期临床试验(H. Lee Moffitt Cancer)

英文原题:DecipHER Trial - DC1 Tx for Early-Stage TNBC and ER Low Positive Breast Cancer

ClinicalTrials.gov 2022/08/17(首次登记) I 期注册临床试验 · 招募中

简要介绍

这是一项 I 期注册临床试验,评估 HER2 树突状细胞治疗乳腺癌的安全性、可行性及初步疗效。当前状态:招募中。计划入组 30 例。试验地点:美国 · 坦帕(共 1 个中心)。登记号:NCT05504707。

入组条件决定能不能参加

不限性别 · ≥ 18 Years

纳入标准:

* 确诊HER2阴性乳腺癌;
* 肿瘤为激素受体(HR)阴性或HR低表达阳性;
* 临床分期T1c且淋巴结分期N1–N2,或T2–4且N0–N2;
* 治疗医生判断,患者在医学和手术方面适合接受新辅助化疗后再行标准局部治疗;
* 年龄≥18岁;
* ECOG体能状态评分0或1分;
* 入组前14天内器官及骨髓功能正常:ANC≥1500/μL;血小板≥75,000/μL;总胆红素≤机构ULN的1.5倍,Gilbert综合征患者须<3.0 mg/dL;AST/ALT≤机构ULN的3倍;肌酐≤机构ULN的1.5倍;
* 超声心动图或MUGA扫描显示左心室射血分数高于机构正常值下限;
* 有生育能力的女性患者同意采用双重避孕方法,筛查时血清妊娠检测阴性。可接受的方法包括避孕套加避孕泡沫剂、口服/植入/注射避孕药、避孕贴片、宫内节育器、隔膜加杀精凝胶,或伴侣已手术绝育/绝经。研究期间及末次给药后5个月内须持续有效避孕。绝经后女性须自然闭经至少12个月(并非化疗所致/化疗之后),或已手术绝育;
* 能够理解并愿意在研究登记前签署书面知情同意书。

排除标准:

* 既往因任何癌症接受过蒽环类化疗;
* 炎性乳腺癌;
* 同时接受其他研究药物或活动性抗肿瘤治疗;
* 未控制的并发疾病,包括但不限于持续或活动性感染、有症状的充血性心力衰竭、不稳定型心绞痛、心律失常,或会妨碍依从研究要求的精神疾病/社会状况;
* 活动性自身免疫性疾病,或可能复发并影响重要器官功能/需要免疫抑制治疗的自身免疫病史,包括长期全身性皮质类固醇治疗(定义为持续1个月或以上);
* 妊娠或哺乳期女性;
* 除以下情况外不允许有其他恶性肿瘤史:充分治疗的皮肤基底细胞癌或鳞状细胞癌;宫颈原位癌;其他癌症已无病至少3年;
* HIV或AIDS检测曾阳性;
* 乙型或丙型肝炎病毒检测阳性且提示急性或慢性感染;
* 登记前≤30天接种减毒活疫苗;
* 因任何原因无法遵守治疗时间表和研究程序;
* 过去3个月内接受过乳腺癌靶向疫苗治疗;
* 既往接受过任何HER2或HER3启动的DC1治疗。
核对登记原文(英文)
Inclusion Criteria:

* A diagnosis of HER2-negative breast cancer.
* Diagnosis of HR negative or HR low positive tumor.
* Clinical stage T1c, nodal stage N1-N2 or stage T2-4, nodal stage N0-N2 breast cancer.
* Participant must be medically and surgically appropriate to undergo neoadjuvant chemotherapy regimen followed by standard of care local therapy as determined by their treating physician.
* Age ≥18 years.
* ECOG performance status 0 or 1.
* Patients must have normal organ and marrow function, as defined below, within 14 days of registration:
* \*Absolute neutrophil count (ANC) ≥ 1500/μL
* \*Platelets ≥ 75 000/μL
* \*Total bilirubin ≤ 1.5 x institutional ULN, except patients with Gilbert's syndrome in whom total bilirubin must be \< 3.0 mg/dL
* \*AST/ALT ≤ 3 x institutional ULN
* \*Creatinine ≤ 1.5 x institutional ULN
* Left ventricular ejection fraction above institutional lower limit of normal (by echocardiogram or MUGA scan).
* Female patients of childbearing potential must agree to use dual methods of contraception and have a negative serum pregnancy test at screening. Acceptable methods of contraception are condoms with contraceptive foam, oral, implantable or injectable contraceptives, contraceptive patch, intrauterine device, diaphragm with spermicidal gel, or a sexual partner who is surgically sterilized or post-menopausal. Effective methods of contraception must be used throughout the study and for 5 months following the last dose. To show that women do not have childbearing potential, postmenopausal women must be amenorrheic for at least 12 months naturally (and not because of/following chemotherapy) or patients must be surgically sterile.
* Ability to understand and the willingness to sign a written informed consent agreement prior to study registration.

Exclusion Criteria:

* Patients who received prior anthracycline-based chemotherapy for the treatment of any cancer.
* Patients with inflammatory breast cancer.
* Patients must not be receiving any other investigational agents or active antineoplastic therapies.
* 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.
* Patients with active autoimmune disease or history of autoimmune disease that might recur, which may affect vital organ function or require immune-suppressive treatment, including chronic prolonged systemic corticosteroid use (defined as corticosteroid use lasting one month or more).
* Female patients who are pregnant or nursing.
* No other prior malignancy is allowed, except for the following: a. adequately treated basal-cell or squamous-cell skin cancer, b. in situ cervical cancer, c. or any other cancer from which the patient has been disease free for at least 3 years.
* History of testing positive for human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS).
* History of positive test for Hepatitis B or Hepatitis C virus indicating acute or chronic infection.
* Patients who have received a live attenuated vaccine ≤ 30 days prior to registration.
* Unable to comply with the treatment schedule and study procedures for any reason.
* Previously treated with breast cancer-directed vaccine therapies in prior 3 months.
* Previously treated with any form HER2- or HER3-primed DC1 therapy.

以上为辅助阅读译文。是否适合入组须由主治医生判断,最终以登记平台与研究者确认为准。

研究终点衡量什么算有效

  • 主要终点最大耐受剂量(MTD)治疗开始后4周
  • 次要终点剂量限制性毒性(DLT)人数
  • 次要终点接受HER2/HER3 DC1瘤内注射后达到病理完全缓解的受试者人数
  • 次要终点接受HER2/HER3 DC1后出现临床及影像学缓解的受试者人数
  • 次要终点接受HER2/HER3 DC1后出现临床及影像学部分缓解的受试者人数
  • 次要终点接受HER2/HER3 DC1后临床及影像学疾病进展的受试者人数
  • 次要终点接受HER2/HER3 DC1后临床及影像学疾病稳定的受试者人数
  • 次要终点无复发生存期(RFS)
核对登记原文(英文)

主要终点:Maximum Tolerated Dose (MTD) · Maximum Tolerated Dose (MTD) of HER2- and HER3- primed DC1 study vaccines. The MTD will be defined as the highest dose level at which \< 2 of 6 patients experience dose-limiting toxicities (DLTs). · 4 weeks after start of treatment
次要终点:Number of Dose Limiting Toxicities;Participants with pathological complete response after receiving HER2/HER3 DC1 intratumoral injections;Participants with clinical and radiological responses after receiving HER2/HER3 DC1;Participants with clinical and radiological partial responses after receiving HER2/HER3 DC1;Participants with clinical and radiological progression of disease after receiving HER2/HER3 DC1;Participants with clinical and radiological stable disease after receiving HER2/HER3 DC1;Participants with Recurrence Free Survival (RFS)

研究设计怎么做的

研究类型
干预性研究
入组人数
30 人(预计)
分组方式
不适用(单臂)
  • 树突状细胞疫苗剂量递增组试验组

    剂量递增以确定HER2和HER3预刺激DC1研究疫苗的MTD。受试者以每队列3–6人的规模入组;临床毒性可接受时递增剂量,共设置3个剂量水平。

核对分组登记原文(英文)
  • Dendritic Cell Vaccine dose Escalation · EXPERIMENTAL · Dose escalation to determine the maximum tolerated dose (MTD) of HER2- and HER3- primed DC1 study vaccines. Participants will be treated in cohorts of size three to six and the dosage will be escalated if the clinical toxicity is acceptable. A total of 3 dose levels will be used.

关键日期

开始日期
2022-08-26
主要完成日期
2026-10
全部完成日期
2026-10
登记状态核实于
2026-02

联系与责任方

申办方
H. Lee Moffitt Cancer Center and Research Institute
合作方
The Shulas' Foundation
联系邮箱
Ricardo.Costa@moffitt.org
联系电话
813-745-5051

登记简述

本研究旨在了解一种研究性树突状细胞(DC)疫苗与标准化疗联合使用,是否有助于治疗三阴性及激素受体低表达的乳腺癌患者。

核对登记原文(英文)

The purpose of the study is to find out if an investigational vaccine called Dendritic Cell (DC) vaccine given together with standard of care chemotherapy drugs can help people with Triple Negative and HR low positive breast cancer.

登记原文与核验信息

试验登记号
NCT05504707
试验期别
I 期
试验状态
招募中
试验中心
Moffitt Cancer Center · 坦帕 · 美国
适应症(原文)
Triple Negative Breast Cancer; HER2-negative Breast Cancer
干预方式(原文)
HER2 - primed Dendritic cells; HER3 - primed Dendritic cells