This is an open label, lead in phase Ib dose confirmation study in patients with advanced solid tumors, followed by a phase II single arm study as neoadjuvant therapy in stage I-III HER2 negative breast cancer. Primary Objectives * To determine the safety profile of combination of ADG106 with dose dense doxorubicin/cyclophosphamide, and with weekly paclitaxel. * To determine the Recommended Phase 2 Dose (RP2D) of ADG106 in combination with dose dense doxorubicin/cyclophosphamide, and with weekly paclitaxel. * To evaluate biological changes on immunohistochemistry in HER2 negative breast cancer after treatment with ADG106 alone and in combination with chemotherapy. Secondary Objectives * To determine the efficacy of combination of ADG106 with standard neoadjuvant combination chemotherapy in HER2 negative breast cancer: objective response rates. * To correlate tumor and plasma biomarkers with efficacy outcomes.
The phase Ib segment will be carried out with a standard 3+3 dose de-escalation design. Patients with advanced/ metastatic solid organ cancers will be enrolled in 2 parallel cohorts. Cohort 1 will receive ADG106 in combination with dose dense doxorubicin/ cyclophosphamide (AC). Cohort 2 will receive ADG106 in combination with weekly paclitaxel. In the phase II portion, patients with stage I-III HER2 negative breast cancer planned for neoadjuvant chemotherapy will be enrolled. Patients will be treated with neoadjuvant chemotherapy (ddAC followed by paclitaxel for 12 weeks) combined with ADG106, before definitive breast cancer surgery
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
66
Administered as an intravenous infusion over 60-90 minutes in the initial cycle and over 30 minutes in subsequent cycle if well tolerated.
Administered as an intravenous infusion.
Administered as an intravenous infusion.
Administered as an intravenous infusion.
National University Hospital
Singapore, Singapore
Number of participant with treatment related toxicities
Toxicities will be graded using the Common Terminology Criteria for Adverse Events (CTCAE) toxicity grading version 5.0.
Time frame: From enrolment till 30 days after last dose of study treatment
Histological response after neoadjuvant ADG106 + chemotherapy
Biological changes on immunohistochemistry will be evaluated using paraffin-embedded tumor specimens.
Time frame: After 20 weeks of neoadjuvant chemotherapy
Objective response rate in Phase Ib
Complete and partial clinical response will be measured by RECIST 1.1.
Time frame: At the end of every 3 cycles up to 24 weeks, at the end of every 6 cycles after 24 weeks up to 60 weeks (each cycle is 2 weeks)
Overall survival in Phase Ib
Defined as the time from the date of study enrolment to the date of death from any cause, regardless of whether the death occurred during the study or following treatment discontinuation.
Time frame: From enrolment till date of death or final follow up visit (maximum 1 year after last treatment dose)
Correlation of plasma biomarkers with efficacy outcome in Phase Ib
Correlation of biomarkers with Objective Response Rate, Progression Free Survival, Overall Survival
Time frame: baseline, at the end of week 1, 2, 4, 6, 8, 10, 12, 14, 18, 30, 42, 54, 66
Progression free survival in Phase Ib
Defined as the time from the date of study enrolment to the first date of documented disease progression.
Time frame: From enrolment till disease progression or date of death or final follow-up visit (maximum 1 year after last treatment dose).
Clinical response rate in Phase II
Clinical response rate will be measured by calipers
Time frame: baseline, at the end of 2 weeks, 4 weeks, 8 weeks, 10 weeks, 12 weeks of treatment.
Pathological complete response rate in Phase II
Defined as any patient who demonstrates no histological evidence of invasive tumor in the primary breast site as well as in resected axillary lymph nodes.
Time frame: after 20 weeks neoadjuvant chemotherapy
Relapse free survival in Phase II
Defined as the time from the date of study enrolment to the first date of documented disease relapse.
Time frame: From enrolment to final follow up visit (maximum 6 years from last treatment dose)
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