The goal of this protocol is to evaluate the safety and efficacy of an alternative systemic combination approach that omits or delays the use of chemotherapy in metastatic disease, while improving efficacy and durability of response. The approach combines two potentially effective and previously studied strategies: androgen receptor blockade and immune checkpoint therapy.
This is a phase II trial to assess the clinical efficacy and safety of nivolumab (anti-Programmed Death receptor-1, or anti-PD-1) combined with bicalutamide (Androgen Receptor (AR) inhibitor) and ipilimumab (anti-cytotoxic T-lymphocyte-associated protein 4, or anit-CTLA4) in patients with advanced breast cancer. This study will include adult women with metastatic or locally advanced unresectable Human Epidermal Growth Factor (HER2)-negative breast cancer (by National Comprehensive Cancer Network (NCCN) criteria). Triple-negative breast cancer tumors will require confirmation of AR positivity at screening. Participants will have had no more than one line of previous chemotherapy in non-curative setting; subjects with metastatic progression within 1 year following completion of curative-intent chemotherapy are eligible if they have not received any additional lines of systemic therapy in the non-curative setting. Women who meet all of the study inclusion criteria, none of the study exclusion criteria, and agree to participate will receive a combination of the following: * Intravenous nivolumab 240mg, every 2 weeks until progression or unacceptable toxicity * Intravenous ipilimumab 1mg/kg, every 6 weeks until progression or unacceptable toxicity * Oral bicalutamide 150mg, daily until progression or unacceptable toxicity Participants are to be treated for up to 24 months. Patients who have ongoing response will discontinue ipilimumab and nivolumab after 24 months, but at the discretion of the investigator may continue bicalutamide, and will continue assessments as per standard of care. Any patient who subsequently progresses will have the option to resume treatment upon disease progression.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
Nivolumab 240 mg IV every 2 weeks
Ipilimumab 1 mg/kg IV every 6 weeks.
Oral bicalutamide 150mg (3 x 50mg tablets) daily
Memorial Sloan Kettering Cancer Center
New York, New York, United States
Providence Oncology & Hematology Care Clinic - Eastside
Portland, Oregon, United States
iRECIST Clinical Benefit Rate (the number of patients with objective response or ongoing stable disease at week 24 using iRECIST guidelines)
To assess the 24-week clinical benefit rate of nivolumab combined with bicalutamide and ipilimumab in advanced HER2-negative breast cancers assessed by radiographic criteria (computed tomography (CT) scan or magnetic resonance imaging (MRI) according to iRECIST criteria.
Time frame: 24 weeks
Assess best overall objective response rate (proportion of patients who achieve a complete or partial response)
Best overall objective response rate will be assessed by radiographic criteria from CT or MRI scans and will be based on RECIST 1.1 and iRECIST criteria
Time frame: 24 months
Duration of progression free survival
Average length of time between study entry and disease progression or death
Time frame: From first patient enrolled through last patient's progression or 24 months following last patient enrolled, whichever comes first.
Overall survival rate
Number of patients who are alive
Time frame: 24 months.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.