This is a single arm, pilot study assessing safety/feasibility and efficacy of neo-adjuvant glembatumumab vedotin (GV) in patients with high risk triple negative breast cancer (TNBC) with glycoprotein-NMB (gpNMB) expression ≥ 25%. Primary endpoints will be safety/feasibility, and secondary endpoints will be rates of pathologic complete response (pCR), and measurements of growth differentiation factor-11 (GDF11) and glycoprotein NMB (gpNMB) expression.
Patients will receive neo-adjuvant dose-dense (DD) doxorubicin (Adriamycin)/cyclophosphamide (AC) followed by GV. After completion of neo-adjuvant therapy, all patients will undergo lumpectomy (with radiation therapy) or mastectomy, and tissue will be assessed for residual disease to determine rates of pCR. Tumor tissue will be obtained by core needle biopsy and at the time of surgery for use in the correlative studies.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Standard neo-adjuvant dose-dense doxorubicin 60 mg/m2 and Cytoxan 600 mg/m2 IV every 14 days for 4 cycles followed by GV 1.9 mg/kg IV every 21 days for 4 cycles.
Incidence of Adverse Events (AEs)
Adverse events will be assessed using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.03
Time frame: Adverse events will be assessed from the time of consent through 30 days after participants complete GV treatment (unless study treatment is stopped for safety or investigator or participant decision, study treatment will last 25-28 weeks)
Proportion of patients who complete the 4 cycles of GV within 15 weeks of the first dose of GV (without dose limiting adverse events).
To assess feasibility, the proportion of patients who receive the intended dose within 15 weeks of the first dose will be estimated with an 80% confidence interval.
Time frame: Within 4 months of the last patient enrollment
Number of discontinuations due to AEs
Adverse events will be assessed using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.03. Participants that discontinue study treatment because of AEs based on protocol-defined stopping rules will be included.
Time frame: During each participant's study treatment. Unless study treatment is stopped for safety or investigator or participant decision, study treatment will last about 22 weeks.
Efficacy
Rates of pathologic complete response (pCR) following GV therapy
Time frame: 3-6 weeks after last GV infusion for each patient
Growth Differentiation Factor-11 (GDF11) expression in the tumor
GDF11 expression by immunohistochemistry prior to and following doxorubicin/cyclophosphamide and GV therapy
Time frame: Prior to therapy (in the 28 days prior to starting study treatment) and 3-6 weeks after last GV infusion for each patient.
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Glycoprotein-NMB (gpNMB) expression in the tumor
gpNMB expression by immunohistochemistry prior to and following doxorubicin/cyclophosphamide and GV therapy
Time frame: Prior to therapy (in the 28 days prior to starting study treatment) and 3-6 weeks after last GV infusion for each patient