This is a single arm, proof of concept phase II clinical trial to evaluate the combination of Pembrolizumab and Carboplatin plus Paclitaxel in patients with localized TNBC (tumor size ≥ 10 mm and ≤ 20 mm by mammogram and/or ultrasound, and/or ≥ 10 mm and ≤ 25 mm by breast MRI if performed within 2 weeks after biopsy, considering possible tissue inflammation post-procedure, as per local assessment), node-negative status (by clinical exam and local radiological evaluation) and who have not previously received chemotherapy, targeted therapy, and/or radiotherapy for invasive breast cancer.
After signing informed consent form (ICF) and confirmed eligibility, eligible patients with localized TNBC, node-negative status, and who have not previously received chemotherapy, targeted therapy, and/or radiotherapy for invasive breast cancer (N=30) will receive treatment with Pembrolizumab and Carboplatin plus Paclitaxel up to surgery as indicated below: * Pembrolizumab: 200 mg, every three weeks (Q3W), intravenously (IV) on day 1 (D1) of each cycle. * Carboplatin: area under the curve (AUC) 1.5 (maximum dose of 225 mg), IV on D1, D8 and D15 of each 21-days cycle. * Paclitaxel: 80 mg/m2, IV on D1, D8 and D15 of each 21-days cycle. The treatment is composed by 4 cycles of 21 days each (patients will be treated for a total of 84 days) and treatment will last until surgery. After treatment discontinuation (EoT), all patients will have a safety visit scheduled 28 days (± 7 days) after the last dose of study treatment, in order to follow up toxicities and changes in concomitant medication. Patients discontinuing the study treatment period will enter a post-treatment follow-up period during which survival and new anti-cancer therapy information will be collected every 12 weeks (± 7 days) after the safety visit until death, lost to follow-up, elective withdrawal from the study, or end of study (EoS), whichever occurs first.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
31
Pembrolizumab 200 mg administered every three weeks intravenously on day 1 of each cycle.
Carboplatin: area under the curve (AUC) of 1.5 mg/mL x min (maximum dose of 225 mg), intravenously on day 1, day 8 and day 15 of each 21-days cycle.
Paclitaxel: 80 mg/m2, intravenously on day 1, day 8 and day 15 of each 21-days cycle.
Complejo Hospitalario Universitario A Coruña (CHUAC)
A Coruña, Spain
Hospital Universitari Dexeus
Barcelona, Spain
Hospital Universitari Vall D'Hebron
Barcelona, Spain
Institut Català d' Oncologia Girona (ICO)
Girona, Spain
Hospital Universitario Clínico San Cecilio de Granada
Granada, Spain
Hospital Beata María Ana
Madrid, Spain
Hospital Cínico San Carlos
Madrid, Spain
Hospital Universitario de Navarra
Pamplona, Spain
Complejo Hospitalario Universitario de Santiago (CHUS)
Santiago de Compostela, Spain
Hospital Universitario Virgen del Rocío
Seville, Spain
...and 1 more locations
To assess pathological complete response (pCR) rate in all patients.
To evaluate the pCR rate defined as the percentage of patients with ypT0/is, ypN0 at surgery based on local assessment. The efficacy will be evaluated by pCR rates concerning breast and lymph nodes (pCR breast + lymph node) in the overall population.
Time frame: From baseline up to 84 days (the date of breast surgery).
To assess pathological complete response (pCR) rate according to PD-L1 status.
pCR rates will be calculated concerning breast and lymph nodes (pCR breast + lymph node) in patients with PD-L1 (+) tumors.
Time frame: From baseline up to 84 days (the date of breast surgery).
To evaluate residual cancer burden (RCB) at surgery.
RCB score is a numeric index with numerical cutoffs to define the four classes (RCB-0: No carcinoma in breast or axillary lymph nodes; RCB-1; RCB-2; and RCB-3). RCB score will be calculated in the overall population at surgery.
Time frame: At breast surgery.
To evaluate the incidence of adverse events [Safety and Tolerability].
Incidence, severity, and relationship of treatment-emergent adverse events (TEAEs) based on local Investigator assessment as per NCI-CTCAE v5.0.
Time frame: From baseline up to 84 days (the date of breast surgery).
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