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Sponsor: SOLTI Breast Cancer Research Group
Conditions: Breast Cancer
Interventions: Atezolizumab + Trastuzumab + Vinorelbine
Countries: Spain
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
Sex: ALL
Age: 18 Years to —
Healthy volunteers: No
Study type: INTERVENTIONAL
Inclusion Criteria: * Male or female (Premenopausal or postmenopausal women) * ECOG 0 to 2 * Histologically confirmed adenocarcinoma of the breast, metastatic or unresectable locally 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 Criteria: * Treatment with any investigational anticancer drug within 14 days of the start of study treatment. * Patient has received Vinorelbine or any other vinca alkaloids previously immediately prior 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 to brain metastases. * Symptomatic hypercalcemia requiring treatment with bisphosphonates in the 14 days prior 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 or hypersensitivity. * Known hypersensitivity or allergy to biopharmaceuticals produced in Chinese hamster ovary 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, organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia), or evidence of active pneumonitis on screening chest CT scan. (Note: History of radiation pneumonitis 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 or immune checkpoint targeting agents * Treatment with systemic immunostimulatory agents (including but not limited to interferons or interleukin \[IL\]-2) within 4 weeks or five half-lives of the drug prior to enrolment * Treatment with systemic immunosuppressive medications within 2 weeks prior to enrolment, or anticipated requirement for systemic immunosuppressive medications during the trial.
- Granada, Andalusia, Spain
- Barcelona, Barcelona, Spain
- L'Hospitalet de Llobregat, Barcelona, Spain
- Santa Cruz de Tenerife, Canary Islands, Spain
- A Coruña, La Coruña, Spain
- Alicante, Spain
- Barcelona, Spain
- Barcelona, Spain
- Cáceres, Spain
- León, Spain
- Madrid, Spain
- Palma de Mallorca, Spain
- Reus, Spain
- Seville, Spain
- Valencia, Spain