A Pilot Preoperative Trial of Ganetespib With Paclitaxel for Triple-Negative Breast Cancer
Study Details
Study Description
Brief Summary
Based on preclinical data implicating GR, AR, and JAK/STAT activation as potent mechanisms of breast cancer cell survival despite chemotherapy administration (i.e. chemotherapy resistance), the study will test a novel approach for improving chemotherapy effectiveness by adding Hsp90 inhibition to antagonize the anti-apoptotic signaling pathways that are initiated via GR, AR, and JAK/STAT activation.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
N/A |
Detailed Description
STUDY OBJECTIVES
Primary:
• To determine tumor GR, AR, JAK and other Hsp90 client protein expression before and after two weeks of ganetespib monotherapy
Secondary:
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To determine the pathological Complete Response (pCR) rate associated with weekly treatment of ganetespib plus paclitaxel followed by the combination treatment of doxorubicin plus cyclophosphamide
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To characterize the toxicity of study treatment
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Therapy Patients will receive ganetespib monotherapy for two weeks followed by twelve weeks of ganetespib/paclitaxel therapy followed by 4 bi-weekly doses of doxorubicin/cyclophosphamide therapy followed by surgery. |
Drug: Ganetespib
Drug: Paclitaxel
Drug: Doxorubicin
Drug: Cyclophosphamide
|
Outcome Measures
Primary Outcome Measures
- Change in GR protein [2 weeks]
Secondary Outcome Measures
- Pathological Complete Response (pCR) rate [6 month]
Defined as absence of invasive carcinoma in both the breast and axilla at the time of surgery
- Ganetespib toxicity [14 weeks]
Side effects related to Ganetespib as graded per Common Terminology Criteria for Adverse Events (CTCAE) version 4
Eligibility Criteria
Criteria
Inclusion Criteria:
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Invasive carcinoma of the breast
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ER negative and PR negative tumors defined as < 1% of tumor nuclei that are immunoreactive for ER and PR
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HER2 non-overexpressing status documented as:
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FISH ratio of less than 2.0, OR
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IHC staining of 0 or 1+
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No evidence of distant metastatic disease. Patients with regional lymph node involvement are eligible.
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18 years old
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Female
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No prior treatment for the disease under study
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No prior treatment within 5 years for any other cancer including chemotherapy, surgery (except for diagnostic biopsy), radiotherapy, hormonal therapy, or investigational agents, unless curative treatment of non-melanoma skin-cancer or in-situ cancer
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Able to understand and sign an informed consent (or have a legal representative who is able to do so)
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Clinically or radiologically measureable disease in the breast after diagnostic biopsy, defined as longest diameter greater than or equal to 2cm
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Willing to undergo three mandatory core biopsies after diagnosis to obtain tissue for biologic expression profiling.
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An Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0 or 1
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Adequate bone marrow reserves as evidenced by:
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Leukocytes > 3,000/μL
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Absolute neutrophil count (ANC) > 1,500/μL without the use of hematopoietic growth factors,
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Platelet count > 100,000/μL, and
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Hemoglobin > 9 g/dL
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Adequate hepatic function as evidenced by:
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Serum total bilirubin within institutional normal limits
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Aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase less than or equal to 2.5 × ULN
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Adequate renal function as evidenced by a serum creatinine within ULN or creatinine clearance > 60 mL/min/1.73 m2 for patients with creatinine levels above institutional normal
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Eligible for treatment with paclitaxel, doxorubicin and cyclophosphamide
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If of childbearing potential, are willing to abstain from sexual intercourse or to use an effective form of contraception (e.g., a double-barrier method) during the study and for 90 days following the last dose of ganetespib
Exclusion Criteria:
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• Patients may not be receiving any other investigational agents.
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Patients may not have a known hypersensitivity to any of the components of ganetespib
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Patients may not have a history of severe allergic reactions to paclitaxel or other drugs formulated in Cremaphor® EL.
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Patients with a QTc > 470 ms, a family history of long QT Syndrome, and those on medications known to cause Torsades de Pointes will be excluded from the study.
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Patients may not have an uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
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Patients may not have New York Heart Association (NYHA) Class III or IV congestive heart failure or left ventricular ejection fraction (LVEF) < 50%.
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As patients with immune deficiency are at increased risk of lethal infections when treated with marrow-suppressive therapy, HIV-positive patients receiving combination anti-retroviral therapy are excluded from the study.
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Patients may not have a need for chronic systemic steroid therapy
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Patients may not be pregnant or breastfeeding
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- University of Chicago
Investigators
- Principal Investigator: Rita Nanda, MD, University of Chicago
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- IRB15-0848