INVINCIBLE TRIAL: Intratumoral INT230-6 in Breast Cancer
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|ClinicalTrials.gov Identifier: NCT04781725|
Recruitment Status : Recruiting
First Posted : March 4, 2021
Last Update Posted : November 17, 2021
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|Condition or disease||Intervention/treatment||Phase|
|Breast Cancer||Drug: INT230-6 Other: Saline injection||Phase 2|
The study comprises 2 consecutive parts. The first part will be to test safety and feasibility of the dosing procedures. Results from Part I of the study will standardise the optimal dose and frequency of INT230-6 for participants in Part II.
Part I: Open-label 2:1 randomized study of up to 30 patients. Treatment arm patients will be given up to 3 doses of INT230-6 injected weekly prior to breast surgery, at a dose based on longest diameter. The control arm patients receive no treatment.
Part II: Double-blind, 2:1 randomized study of up to an additional 60 patients. The placebo arm includes a saline injection of similar dose and frequency as the treatment arm (up to 2 doses of INT230-6/saline injected weekly prior to breast surgery).
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||90 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)|
|Official Title:||A Phase II Randomized Window of Opportunity Trial Evaluating Clinical and Biological Effects of Intratumoral INT230-6 in Early Stage Breast Cancer: The INVINCIBLE Trial|
|Actual Study Start Date :||March 25, 2021|
|Estimated Primary Completion Date :||March 1, 2022|
|Estimated Study Completion Date :||March 1, 2023|
Experimental: INT230-6 Treated Arm
Part I: Patients will receive up to 3 doses of INT230-6 injected weekly prior to breast surgery
Part II: Patients will receive up to 2 intratumoral doses of INT230-6 (over a 15-day period) prior to breast surgery
INT230-6 is a formulation of two well known chemotherapeutic agents, cisplatin (0.5mg/mL) and vinblastine sulfate (0.1mg/mL), combined with 2-hydroxybenzoylaminooctanoate (also known as SHAO-FA or SHAO as a sodium salt at 10mg/mL).
Other: Saline injection
Standard 0.9 % NaCl Normal Saline
Placebo Comparator: Control Arm
Part I: No intervention while awaiting surgery
Part II: Placebo saline injection
Other: Saline injection
Standard 0.9 % NaCl Normal Saline
- The proportion of patients achieving a CCCA defined as a reduction in the proportion of cells staining positive for Ki67 as assessed by immunohistochemistry to less than a natural logarithm, or ≤2.7%, at the post-treatment specimen. [ Time Frame: presurgical window (period from diagnosis to surgery window of 3-6 weeks) ]Tumor's viable plus necrotic tissue, at the post-treatment specimen.
- The proportion of patients that achieved a complete pathologic response on surgical pathology as measured by the residual cancer burden index [ Time Frame: presurgical window (period from diagnosis to surgery of 3-6 weeks) ]Assessed by the local pathologist at the time of definitive surgery in subjects with breast cancer
- Immunohistochemical and gene expression markers of necrosis, apoptosis and tumor proliferation pathways. [ Time Frame: presurgical window (period from diagnosis to surgery of 3-6 weeks) ]Comparison of pre (diagnostic biopsy) and post treatment (surgical resection) samples
- Markers of immunomodulation including macrophages, NK, DC, CD4 T-cells, CD8 T-cells, regulatory T-cells. [ Time Frame: presurgical window (period from diagnosis to surgery of 3-6 weeks) ]Comparison of pre (diagnostic biopsy) and post treatment (surgical resection) samples
- Adverse effects of INT230-6 injected to breast cancers in healthy patients prior to surgery. [ Time Frame: presurgical window (period from diagnosis to surgery of 3-6 weeks) ]overall safety of INT230-6 injected prior to surgery
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
|Ages Eligible for Study:||Child, Adult, Older Adult|
|Sexes Eligible for Study:||Female|
|Accepts Healthy Volunteers:||Yes|
- Female patients with newly diagnosed histologically confirmed primary invasive breast cancer currently not undergoing any treatment while awaiting surgery.
- Patients with early, operable stage I to II breast cancer amendable for complete surgical resection as assessed by treating surgical oncologist.
- Tumors must be clinically palpable by surgeon. Part I: ≥ 1.0 cm by palpation or on imaging. Part II: ≥ 1.5 cm by palpation or on imaging.
- Histologic Bloom Richardson grade ≥2.
4. Invasive ductal or lobular carcinoma, invasive carcinoma Not Otherwise Specified (NOS).
5. ECOG PS 0-2 (Appendix A). 6. The participant (or legally acceptable representative if applicable) is able to provide written informed consent for the study.
- Locally advanced or metastatic breast cancer.
- Prior therapy with chemotherapy or planned neoadjuvant chemotherapy.
- Pre-dominant histology other than invasive ductal or lobular carcinoma or invasive carcinoma NOS.
- Patients with an active infection.
- Absolute Neutrophil Count < 1.5 x 10^9/L.
- Patients with pre-existing renal impairment, Creatinine clearance calculated by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation of less than 50 mL/min/1.73m2.
- Any serious known immediate or delayed hypersensitivity reaction(s) to vinblastine or cisplatin or idiosyncrasy to drugs chemically related to the investigational drugs.
- Known allergic reaction to local anesthetic (Xylocaine, Marcaine).
- Concurrent medical condition requiring the use of immunosuppressive medications, or systemic corticosteroids at doses of greater than 10 mg Prednisone-equivalent Topical steroids and other localized corticosteroids are permitted. Use of steroids as prophylactic treatment for subjects with contrast allergies to diagnostic imaging contrast dyes will be permitted.
- Concurrent use of a prohibited medication or planned use of any forbidden medications during treatment with INT230-6, or within 4 weeks prior to study drug administration, which include chemotherapy, immunotherapy (tumor vaccine, cytokine, or growth factor given to control the cancer: systemic or intratumoral), other biologic therapy, investigational therapy, or hormonal therapy, cisplatin containing agents, and vinblastine containing agents while on treatment in this study. Other prohibited concomitant medications that will interact with vinblastine and cisplatin include mitomycin, phenytoin, CYP3A4 inhibitors (ketoconazole, voriconazole, clarithromycin, erythromycin), nephrotoxic drugs (aminoglycosides, amphotericin), or pure pyridoxine (pyridoxine contained in multivitamin is permitted). Use of other investigational drugs (drugs not marketed for any indication) within 4 weeks prior to study drug administration not permitted.
- Pregnancy if patient is of childbearing age) or breast feeding.
- Subjects with signs/symptoms suggestive of COVID-19 or known COVID-19 positive contacts in the past 14 days would be tested as per local Public Health and/or Institutional Guidelines. If patients are COVID-19 positive at the time of screening, they would be excluded from the trial.
- Any underlying medical condition that, in the Principal Investigator's opinion, will make the administration of study drug hazardous or obscure the interpretation of toxicity determination or adverse events, or renders the patient ineligible to be on study.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04781725
|Contact: Angel Arnaout, MDfirstname.lastname@example.org|
|The Ottawa Hospital Research Institute and Cancer Center||Recruiting|
|Ottawa, Ontario, Canada, K1Y 4E9|
|Contact: Angel Arnaout, MD 613-798-5555 ext 79622 email@example.com|
|Principal Investigator:||Angel Arnaout, MD||Ottawa Hospital Research Institute|
|Principal Investigator:||Arif Awan, MD||Ottawa Hospital Research Institute|
|Responsible Party:||Ottawa Hospital Research Institute|
|Other Study ID Numbers:||
OTT 20-11 (IT-02)
|First Posted:||March 4, 2021 Key Record Dates|
|Last Update Posted:||November 17, 2021|
|Last Verified:||November 2021|
|Individual Participant Data (IPD) Sharing Statement:|
|Plan to Share IPD:||No|
|Studies a U.S. FDA-regulated Drug Product:||Yes|
|Studies a U.S. FDA-regulated Device Product:||No|
|Product Manufactured in and Exported from the U.S.:||Yes|
window of opportunity
complete pathologic response (PCR)
cell cycle arrest
Neoplasms by Site
Antineoplastic Agents, Phytogenic
Molecular Mechanisms of Pharmacological Action