This is an open-label, multicenter, randomized, Phase 2/3 study in patients with locally recurrent or metastatic triple-negative breast cancer (TNBC) with no more than one prior systemic therapy for locally recurrent or metastatic disease.
The study will consist of 2 parts: * Part 1 is an open-label, multicenter, randomized Phase 2 exploratory study that will investigate the clinical activity of the combination of eryaspase and gemcitabine/carboplatin in patients with locally recurrent or metastatic TNBC. Data analysis of Part 1 will inform choices for the final design and patient population in Part 2 (Phase 3 study). Patients recruited into Part 1 will not be included in the Intent-to-Treat patient (ITT) population of Part 2 of the study. * Part 2 will be a randomized Phase 3 study designed to evaluate the efficacy of the combination of eryaspase and gemcitabine/carboplatin in TNBC patients. The current protocol will focus on Part 1. Part 1 is the focus of the current protocol, with a primary endpoint of DCR. DCR data as determined by an IRR will determine whether or not proceeding to Part 2 is warranted. If so, Part 2 will be implemented via a major amendment to the protocol. Meanwhile, sites will remain open with the expectation that Part 2 will be activated After providing informed consent and completing the screening assessments, patients who meet all inclusion and no exclusion criteria will be randomized in a 1:1 ratio to one of the following treatment arms: * Arm A (experimental arm): eryaspase 100 U/kg on Days 1 and 8 of combination chemotherapy with gemcitabine/carboplatin, or * Arm B (control arm): gemcitabine/carboplatin combination. Treatment will continue until objective disease progression, unacceptable toxicity, or the patient's withdrawal of consent. A survival follow-up period will include the collection of survival, progression of disease if applicable, subsequent anti-cancer therapy every 12 weeks (± 1 week)
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
27
ZNA Middelheim
Antwerp, Belgium
Institut Jules Bordet
Brussels, Belgium
UZ Brussel
Brussels, Belgium
Disease Control Rate (DCR)
To determine whether the addition of eryaspase to gemcitabine and carboplatin improves the disease control rate (DCR) by modified Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as determined by an independent radiological review (IRR) in patients with locally recurrent or metastatic triple-negative breast cancer (TNBC) compared with chemotherapy alone.
Time frame: 1 year after last patient randomized
Disease Control Rate (DCR)
To compare the DCR between the two treatment arms as determined by the Investigator's assessment.
Time frame: 1 year after last patient randomized
Objective response rate (ORR)
To compare the objective response rate (ORR) between the two treatment arms as determined by the independent radiological review (IRR).
Time frame: 1 year after last patient randomized.
Progression-Free Survival (PFS)
To compare progression-free survival (PFS) between the two treatment arms.
Time frame: 1 year after last patient randomized.
Duration of Response (DoR)
To compare the duration of response (DoR) between the two treatment arms.
Time frame: 1 year after last patient randomized.
Overall Survival (OS)
To compare overall survival (OS) between the two treatment arms.
Time frame: 1 year after last patient randomized.
Incidence of treatment emergent adverse events as assessed by CTCAE v5.0
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Grand Hôpital de Charleroi asbl
Charleroi, Belgium
Clinique Sainte-Elisabeth
Namur, Belgium
Debreceni Egyetem - Klinikai Kozpont - Onkologiai Klinika
Debrecen, Hungary
Bacs Kiskun Megyei Korhaz
Kecskemét, Hungary
Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelointezet
Szolnok, Hungary
Complejo Hospitalario Universitario A Coruña
A Coruña, Spain
Hospital Universitario Germans Trias i Pujol
Badalona, Spain
...and 6 more locations
To evaluate the safety and tolerability of eryaspase in combination with chemotherapy versus chemotherapy alone by assessing the number of patients with treatment emergent adverse events per CTCAE v5.0.
Time frame: Collected from time of informed consent until 30 days after last study treatment.
Clinical response assessed by F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) imaging
To evaluate the change in F-18 fluorodeoxyglucose (FDG) tumor uptake as a predictor of clinical response following one cycle of treatment with eryaspase and chemotherapy.
Time frame: Collected at baseline and within 3 days of the end of Cycle 1 in all patients.
Eryaspase induced immunogenecity
To determine the anti-asparaginase antibodies titer.
Time frame: Samples will be collected pre-dose at Cycle 1 Day 1 and pre-dose at Cycle 3 Day 1 (each Cycle is 21 days)
Biomarkers potentials in predicting eryaspase activity.
To determine DNA, RNA and protein levels present in tumor tissues and blood samples.
Time frame: Tissue samples will be collected at baseline. Blood samples for biomarker analysis will be collected during screening, at Cycle 1 Day 1 and Day 8, and at Day 1 of every second cycle ( each is 21 days) until End of Treatment (EOT) visit.
Pharmacokinetics of eryaspase
To determine total and plasma asparaginase activity (U/L)
Time frame: Samples will be collected the first day (D1) and the eight day (D8) of Cycle 1 and Cycle 3 treatment (each Cycle is 21 days) and at End of treatment (EOT)
Pharmacodynamics of eryaspase
To determine plasma concentrations of asparagine and glutamine (µmol/L)
Time frame: Samples will be collected the first day (D1) and the eight day (D8) of Cycle 1 and Cycle 3 treatment (each Cycle is 21 days) and at End of treatment (EOT)