Study of Naxitamab and Sacituzumab Govitecan in Patients With Metastatic Triple-negative Breast Cancer (TNBC)

Purpose

This phase I/II trial tests the safety, best dose, and effectiveness of naxitamab in combination with sacituzumab govitecan in treating patients with triple-negative breast cancer (TNBC) that has spread from where it first started (primary site) to other places in the body (metastatic).

Condition

  • Metastatic Triple-Negative Breast Cancer

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Male and female participants aged 18 years or older and able to understand and give written informed consent - Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1 (for the phase I portion of the study) and ECOG performance status of 0-2 (for the phase II portion of the study) - Life expectancy of at least 3 months - Histologically confirmed metastatic TNBC. (Estrogen receptor [ER] ≤10%; Progesterone receptor [PgR] ≤10%, HER2-negative as per ASCO/CAP guidelines) - Willingness to provide archival tumor tissue for correlative studies associated with this trial. - Received at least 1 prior line of systemic chemotherapy for metastatic TNBC and/or meet criteria to receive sacituzumab govitecan as standard of care - Measurable disease by CT or MRI as per RECIST Version 1.1 criteria - Adequate organ and marrow function as defined below: 2.

Exclusion Criteria

Participants who meet any of the following exclusion criteria are not eligible to be enrolled in this study. - Positive serum pregnancy test or women who are lactating. - Known or severe (≥ Grade 3) hypersensitivity or allergy to naxitamab and/or sacituzumab govitecan, their metabolites, or formulation excipient. - Grade 3 or greater peripheral neuropathy - Have previously received treatment with an anti-GD2 antibody - Prior treatment with TROP2-targeting antibody drug conjugates in the metastatic setting. Participant s who have received TROP2-targeting antibody drug conjugates in the neoadjuvant setting or adjuvant setting are eligible if at least 6 months have elapsed since the last dose of TROP2-targeting antibody drug conjugate. - Have an active second malignancy. Participant s with a history of active cancer for 3 years prior to enrollment, or participant s with surgically cured tumors with low risk of recurrence (eg, nonmelanoma skin cancer, histologically confirmed complete excision of carcinoma in situ, or similar) are allowed to enroll. - Have known active central nervous system (CNS) metastases and/or carcinomatous meningitis. - Have undergone an allogenic tissue or solid organ transplant. - Uncontrolled hypertension, defined as a consistently elevated systolic blood pressure of >160 mmHg despite optimal medical management - Clinically significant cardiac disease - Inadequate pulmonary function - Active chronic inflammatory bowel disease (ulcerative colitis, Crohn's disease) or GI perforation within 6 months of enrollment. - Uncontrolled seizure disorders despite anticonvulsant therapy (defined as a seizure event within 3 months prior to enrollment) - Active serious infection requiring systemic antimicrobial therapy. - Participants positive for HIV-1 or 2 with a history of Kaposi sarcoma and/or Multicentric Castleman Disease. - Have active hepatitis B or C infection - Has a diagnosis of immunodeficiency or receiving systemic corticosteroid therapy (higher than physiologic doses) ≥ 10 mg of prednisone per day or equivalent] or any other form of immunosuppressive therapy within 14 days of initiation of study treatment. - Has received prior radiotherapy within 1 weeks of start of study intervention.

Study Design

Phase
Phase 1/Phase 2
Study Type
Interventional
Allocation
N/A
Intervention Model
Single Group Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Treatment with Naxitamab and Sacituzumab Govitecan IV Q3W
Patients receive naxitamab IV on days 2, 4, and 6 of cycles 1-8 and sacituzumab govitecan IV days 1 and 8 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity.
  • Drug: Sacituzumab govitecan
    Given by IV
  • Drug: Naxitamab
    Given by IV

Recruiting Locations

The University of Texas M. D. Anderson Cancer Center
Houston, Texas 77030
Contact:
Clinton Yam, MD
713-792-2817
TNBC-NOW@mdanderson.org

More Details

Status
Recruiting
Sponsor
M.D. Anderson Cancer Center

Study Contact

Akshara S Raghavendra
713-792-2817
TNBC-NOW@mdanderson.org

Detailed Description

1. Primary Objectives - To determine the safety and tolerability and establish the maximum tolerated dose/recommended phase 2 dose (MTD/RP2D) of the combination of naxitamab and sacituzumab govitecan in participant s with metastatic TNBC. - To determine the objective response rate (ORR) of naxitamab in combination with sacituzumab govitecan per RECIST v1.1 criteria in participant s with metastatic TNBC at the MTD/RP2D. 2. Secondary Objectives - To determine the duration of response, progression-free survival, and overall survival for participant s with metastatic TNBC treated with the combination of naxitamab plus SG: - To identify GD2-related biomarkers of response and resistance to the combination of naxitamab and sacituzumab govitecan. 3. Exploratory/Correlative Objectives • Investigate potential resistance mechanisms to naxitamab and develop a pre-clinical rationale for future therapeutic strategies.