This is a multicenter Phase Ib/II, open-label, dose-escalation study to optimize POL6326 (balixafortide) in combination with nab-paclitaxel or eribulin in patients with HER2-negative advanced breast cancer.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
POL6326 (balixafortide): starting dose at 5.5 mg/Kg. Intravenous administration on day 1 and 8 of each 21-day cycle (+/- 1 day) (Phase Ib ARM A and Phase II ARM A ) or on day 1, 8 and 15 of each 28-day cycle (Phase Ib ARM B and Phase 2 ARM B) (+/- 1 day).
Eribulin: 1.23 mg/m2 (equivalent to 1.4 mg/m2 eribulin mesylate). Intravenous administration on day 1 and 8 of each 21-day cycle (+/- 1 day) (Phase Ib ARM A and Phase II ARM A ) or on day 1, 8 and 15 of each 28-day cycle (Phase Ib ARM B and Phase 2 ARM B) (+/- 1 day).
Nab-paclitaxel: 100 mg/m2. Intravenous administration on day 1 and 8 of each 21-day cycle (+/- 1 day) (Phase Ib ARM A and Phase II ARM A) or on day 1, 8 and 15 of each 28-day cycle (Phase Ib ARM B and Phase 2 ARM B) (+/- 1 day).
PHASE Ib: Maximum tolerated dose (MTD) / Recommended phase II dose (RP2D) of POL6326 (balixafortide)
MTD/RP2D, based on the incidence of Dose limiting toxicities (DLT) defined as the highest dose level explored at which up to one third of evaluable patients develop a DLT during the first treatment cycle.
Time frame: 12 - 24 months
PHASE 2: Progression free survival (PFS)
To assess the efficacy of POL6326 (balixafortide) in combination with either eribulin or nab-paclitaxel in terms of PFS as per RECIST v. 1.1 in patients with HER2-negative ABC.
Time frame: from treatment initiation until objective tumor progression or death (at least 4.5 months)
PHASE Ib: PFS
To assess the efficacy of POL6326 (balixafortide) in combination with either eribulin or nab-paclitaxel in terms of PFS as per RECIST v. 1.1 in patients with HER2-negative ABC.
Time frame: from treatment initiation until objective tumor progression or death (at least 4.5 months)
PHASE Ib: Overall response rate (ORR)
To assess the preliminary efficacy of POL6326 (balixafortide) in combination with either eribulin or nab-paclitaxel in terms of ORR defined as the proportion of patients with complete response (CR) or partial response (PR) as per RECIST v.1.1
Time frame: from baseline until end of study (will occur when all patients have discontinued treatment or 12 month after the last patient was enrolled on the study plus the safety follow up window of 28 days after last dose of study treatment in the last patient)
PHASE Ib: clinical benefit rate (CBR)
To assess the preliminary efficacy of POL6326 (balixafortide) in combination with either eribulin or nab-paclitaxel in terms of CBR, defined as the proportion of patients who obtain an objective response (CR or PR), or SD for at least 6 months for both combinations of the POL6326 (balixafortide) as per RECIST v.1.1.
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Time frame: at least 6 months
PHASE IB: duration of response (DoR)
To assess the preliminary efficacy of POL6326 (balixafortide) in combination with either eribulin or nab-paclitaxel in terms of DoR, defined as the time from the first occurrence of a documented objective response to disease progression or death from any cause, whichever occurs first, as per Investigator assessment using RECIST v.1.1.
Time frame: from the first occurrence of a documented objective response to disease progression or death, up to 12 months
PHASE Ib: maximum tumor shrinkage (MTS)
To assess the preliminary efficacy of POL6326 (balixafortide) in combination with either eribulin or nab-paclitaxel in terms of MTS, from baseline in the size of target tumor lesions, defined as the biggest decrease, or smallest increase if no decrease observed, as per RECIST v.1.1.
Time frame: from baseline until end of study (will occur when all patients have discontinued treatment or 12 month after the last patient was enrolled on the study plus the safety follow up window of 28 days after last dose of study treatment in the last patient
PHASE 2: ORR
To assess the efficacy, of POL6326 (balixafortide) in combination with either eribulin or nab-paclitaxel in terms of ORR, defined as the proportion of patients with CR or PR, as per RECIST v.1.1.
Time frame: from baseline until end of study (will occur when all patients have discontinued treatment or 12 month after the last patient was enrolled on the study plus the safety follow up window of 28 days after last dose of study treatment in the last patient)
PHASE 2: CBR
To assess the efficacy, of POL6326 (balixafortide) in combination with either eribulin or nab-paclitaxel in terms of CBR, defined as the proportion of patients who obtain an objective response (CR or PR), or stable disease for at least 6 months for both combinations of the POL6326 (balixafortide) as per RECIST v.1.1.
Time frame: at least 6 months
PHASE 2: time to response (TTR)
To assess the efficacy, of POL6326 (balixafortide) in combination with either eribulin or nab-paclitaxel in terms of TTR, defined as the time from treatment initiation to time of the first objective tumor response (tumor shrinkage of ≥ 30%) in patients who achieved a CR or PR, as per using RECIST v.1.1.
Time frame: from treatment initiation to time of the first objective tumor response up to 12 months
PHASE 2: DoR
To assess the efficacy, of POL6326 (balixafortide) in combination with either eribulin or nab-paclitaxel in terms of DoR, defined as the time from the first occurrence of a documented objective response to disease progression or death from any cause, whichever occurs first, as per Investigator assessment using RECIST v.1.1.
Time frame: from the first occurrence of a documented objective response to disease progression or death, up to 12 months
PHASE 2: overall survival (OS)
To assess the efficacy, of POL6326 (balixafortide) in combination with either eribulin or nab-paclitaxel in terms of OS, defined as the time from treatment initiation to death from any cause.
Time frame: from baseline until end of study (will occur when all patients have discontinued treatment or 12 month after the last patient was enrolled on the study plus the safety follow up window of 28 days after last dose of study treatment in the last patient
PHASE 2: MTS
To assess the efficacy, of POL6326 (balixafortide) in combination with either eribulin or nab-paclitaxel in terms of MTS from baseline in the size of target tumor lesions, defined as the biggest decrease, or smallest increase if no decrease observed, as per RECIST v.1.1.
Time frame: from baseline until end of study (will occur when all patients have discontinued treatment or 12 month after the last patient was enrolled on the study plus the safety follow up window of 28 days after last dose of study treatment in the last patient
PHASE Ib/ PHASE 2: Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability] of POL6326 (balixafortide) in combination with either eribulin or nab-paclitaxel
Incidence and severity of AEs and SAEs according to the NCI-CTCAE v.5.0, including dose reductions, delays, and treatment discontinuations.
Time frame: from baseline until end of study.All patients must be followed for AEs and SAEs for 28 days following the last dose of study drug
PHASE Ib - PHARMACOKINETICS (PK) in terms of area under the curve (AUC)
Plasma PK parameter AUC of POL6326 (balixafortide)
Time frame: At the end of Cycle 1 (each cycle is 28 days in POL6326 (balixafortide) - eribulin combination and 21 days in POL6326 (balixafortide) - nab paclitaxel combination)
PHASE Ib - PK in terms of clearance (CL),
Plasma PK parameter CL of POL6326 (balixafortide)
Time frame: At the end of Cycle 1 (each cycle is 28 days in POL6326 (balixafortide) - eribulin combination and 21 days in POL6326 (balixafortide) - nab paclitaxel combination)
PHASE Ib - PK in terms of distribution volume (Vd)
Plasma PK parameter Vd of POL6326 (balixafortide)
Time frame: At the end of Cycle 1 (each cycle is 28 days in POL6326 (balixafortide) - eribulin combination and 21 days in POL6326 (balixafortide) - nab paclitaxel combination)
PHASE Ib - PK in terms of apparent half-life (t1/2)
Plasma PK parameter t1/2 of POL6326 (balixafortide)
Time frame: At the end of Cycle 1 (each cycle is 28 days in POL6326 (balixafortide) - eribulin combination and 21 days in POL6326 (balixafortide) - nab paclitaxel combination)
PHASE Ib - PK in terms of maximal serum concentration (Cmax)
Plasma PK parameter Cmax of POL6326 (balixafortide)
Time frame: At the end of Cycle 1 (each cycle is 28 days in POL6326 (balixafortide) - eribulin combination and 21 days in POL6326 (balixafortide) - nab paclitaxel combination)
PHASE Ib - PK in terms of trough concentrations (Ctrough)
Plasma PK parameter Ctrough of POL6326 (balixafortide)
Time frame: At the end of Cycle 1 (each cycle is 28 days in POL6326 (balixafortide) - eribulin combination and 21 days in POL6326 (balixafortide) - nab paclitaxel combination)
PHASE Ib - PK in terms of time of maximum concentration observed (tmax)
Plasma PK parameter tmax of POL6326 (balixafortide)
Time frame: At the end of Cycle 1 (each cycle is 28 days in POL6326 (balixafortide) - eribulin combination and 21 days in POL6326 (balixafortide) - nab paclitaxel combination)
PHASE Ib - PK in terms of time to last measurable plasma (tlast)
Plasma PK parameter tlast of POL6326 (balixafortide)
Time frame: At the end of Cycle 1 (each cycle is 28 days in POL6326 (balixafortide) - eribulin combination and 21 days in POL6326 (balixafortide) - nab paclitaxel combination)
PHASE 2 - PK in terms of Cmax
Plasma PK parameter Cmax of POL6326 (balixafortide)
Time frame: At the end of Cycle 1 (each cycle is 28 days in POL6326 (balixafortide) - eribulin combination and 21 days in POL6326 (balixafortide) - nab paclitaxel combination)
PHASE 2 - PK in terms of Cthrough
Plasma PK parameter Cthrough of POL6326 (balixafortide)
Time frame: At the end of Cycle 1 (each cycle is 28 days in POL6326 (balixafortide) - eribulin combination and 21 days in POL6326 (balixafortide) - nab paclitaxel combination)
PHASE 2 - PK in terms of tmax
Plasma PK parameter tmax of POL6326 (balixafortide)
Time frame: At the end of Cycle 1 (each cycle is 28 days in POL6326 (balixafortide) - eribulin combination and 21 days in POL6326 (balixafortide) - nab paclitaxel combination)