This proposal uses HER2Bi armed activated T-cells (HER2 BATs) to target breast cancer in combination with pembrolizumab (PBZ) in women with metastatic breast cancer (MBC). Phase I will determine a safe dose of the combination of PBZ and HER2 BATs in 3 to 18 patients. In the phase II portion, an additional 12 patients will be treated at the selected dose to further evaluate the safety and preliminary efficacy. Study treatment includes a combination of 8 infusions of BATs using a previously established schedule and one to three infusions of PBZ (200 mg per dose). PBZ will be added to 8 infusions of BATs in 3 schedules: #1) after the 8th BATs infusion; #2) after the 4th and 8th BATs infusions; and then, #3) before the 1st and after the 4th and 8th BATs infusions.
Once subjects are determined eligible, white blood cells (lymphocytes) are collected via leukapheresis procedure. Depending on arm/schedule, about 4-5 weeks later, study treatment will begin. For HER2 BATs, the white blood cells, specifically T cells, are then mixed with two proteins - OKT3 and IL-2 -- which activates the cells to multiply. After approximately 14 days in culture, the activated T cells are coated with OKT3 and trastuzumab/Herceptin (HER2Bi), and washed to remove excess Herceptin in order to produce bispecific antibody armed T cells (BATs). Cells are then frozen and stored until scheduled to be infused. Follow-up appointment schedule will include clinic visits 2 weeks, 1 month, 3 months, and 6 months after the last dose of Pembrolizumab.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
22
8 infusions of HER2 BATs with 1-3 infusions of Pembrolizumab
Ashley Donihee
Charlottesville, Virginia, United States
Dose Limiting Toxicities (Escalation and Expansion Cohorts)
Maximum tolerated dose will be based on number of dose limiting toxicities in each schedule/arm
Time frame: From start of study treatment until 3 weeks after last dose of study treatment, assessed over about 10 weeks.
Dose Limiting Toxicities on the Selected Arm in the Expansion Cohort
Dose Limiting toxicities on the arm selected based on the dose/schedule selection part of the study.
Time frame: From start of study treatment until 3 weeks after last dose of study treatment, assessed over about 10 weeks.
Objective Response Rate
The percentage of subjects with a response of complete response (CR) or partial response (PR) per immune related response criteria (irRC)
Time frame: Imaging will be done prior to study treatment, 1 month, 3 months and 6 months after completion of study treatment (about 8.5 months after starting study treatment). Imaging will then be performed according to standard of care.
Overall Survival
Time from enrollment until death from any cause
Time frame: Every 3 months following last study visit until death
Progression-Free Survival
Time from enrollment to time of first progression after enrollment (days)
Time frame: Checked from enrollment through first progression, about every 3 months, through death or end of study
Immune Response to Treatment in Blood
Sequential monitoring of phenotype, IFN-γ EliSpots, anti-breast cancer cytotoxicity of peripheral blood mononuclear cells (PBMC) directed at breast cancer cell lines, Th1/Th2 serum cytokine patterns, and anti-breast cancer antibodies in the serum during the "vaccinate and consolidate" process
Time frame: Blood will be collected about 5 weeks before any treatment, just before first HER2 BATs infusion, before HER2 BATs #5, before HER2 BATs #8, and 2 weeks, 1 month, 3 months, and 6 months after last Pembrolizumab
Disease Control Rate
The percentage of subjects who achieve complete response, partial response and stable disease following treatment.
Time frame: Imaging will be done prior to study treatment, 1 month, 3 months and 6 months after completion of study treatment. Imaging will then be performed according to standard of care.
Duration of Response
The time from documentation of tumor response to disease progression.
Time frame: Imaging will be done prior to study treatment, 1 month, 3 months and 6 months after completion of study treatment. Imaging will then be performed according to standard of care.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.