This phase I/II trial studies the side effects and best dose of interferon gamma-1b in combination with paclitaxel, trastuzumab, and pertuzumab in treating patients with HER-2 positive breast cancer. Interferon gamma-1b is a substance that can improve the body’s natural response and may interfere with the growth of tumor cells. Drugs used in chemotherapy, such as paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Trastuzumab is a form of "targeted therapy" because it works by attaching itself to specific molecules (receptors) on the surface of cancer cells, known as HER2 receptors. When trastuzumab attaches to HER2 receptors, the signals that tell the cells to grow are blocked and the cancer cell may be marked for destruction by the body's immune system. Immunotherapy with monoclonal antibodies, such as pertuzumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Giving interferon gamma, paclitaxel, trastuzumab, and pertuzumab may work better than other therapies in treating HER-2 positive breast cancer.
Additional locations may be listed on ClinicalTrials.gov for NCT03112590.
See trial information on ClinicalTrials.gov for a list of participating sites.
PRIMARY OBJECTIVES:
I. To evaluate the safety and tolerability of the combination of interferon gamma-1b (interferon [IFN]-gamma) with paclitaxel, trastuzumab and pertuzumab for 12 weeks and determine the recommended phase II dose (RP2D) in patients with metastatic breast cancer. (Phase I)
II. To evaluate the pathologic complete response rate (pCR) after combination of IFN-gamma with paclitaxel, trastuzumab and pertuzumab for 12 weeks of neoadjuvant therapy in patients with clinical stage 1-3 (primary tumor size >= 10 mm) HER2 positive breast cancer. (Phase II)
SECONDARY OBJECTIVES:
I. To evaluate overall response rate (OR, complete response [CR] + partial response [PR]) using standard response evaluation criteria in solid tumors (RECIST) version 1.1. (Phase I)
II. To evaluate median progression free survival (PFS). (Phase I)
III. To evaluate safety and tolerability of the combination therapy. (Phase II)
IV. To evaluate the PFS. (Phase II)
EXPLORATORY OBJECTIVES:
I. Determine whether IFN-gamma combination therapies restore anti-HER-2 CD4 Th1 response.
II. Determine whether IFN-gamma combination therapies change the tumor associated immune response.
III. Determine whether IFN-gamma combination therapies change the known tumor biomarkers that predict response in the HER-2 positive breast cancer.
OUTLINE: This is a phase I, dose-escalation study of interferon gamma-1b followed by a phase II study.
Patients receive interferon gamma-1b subcutaneously (SC) three times weekly for 12 weeks. Patients also receive paclitaxel intravenously (IV) over 60 minutes on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 79, and trastuzumab IV over 90 minutes and pertuzumab IV over 60 minutes on day 1. Cycles repeat every 21 days for 12 weeks in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 6 months for up to 2 years.
Lead OrganizationMoffitt Cancer Center
Principal InvestigatorHyo Sook Han