This early phase I trial studies how well a HER2 directed dendritic cell vaccine, trastuzumab, pertuzumab, and chemotherapy work in treating participants with stage II-III HER-2 positive breast cancer. Dendritic cells are immune cells that can tell the immune system to fight infection. Vaccines made from a person's dendritic cells may help the body build an effective immune response to kill tumor cells that express HER2. 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. Monoclonal antibodies, such as pertuzumab, may interfere with the ability of tumor cells to grow and spread. Drugs used in chemotherapy, such as docetaxel and carboplatin, 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. Giving a HER2 directed dendritic cell vaccine, trastuzumab, pertuzumab, and chemotherapy may work better in participants with HER-2 positive breast cancer.
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT03387553.
PRIMARY OBJECTIVES:
I. Immunogenicity of human epidermal growth factor 2 (HER2) dendritic cell (DC) vaccine by week 4 enzyme-linked immunosorbent spot assay (ELISPOT).
II. Pathologic complete response rate of treated patients.
SECONDARY OBJECTIVES:
I. Safety/toxicity using Common Terminology Criteria for Adverse Events (CTCAE) 4.03 criteria.
II. Recurrence free survival rate at 3 years.
III. Persistence of immune response throughout booster sequence.
IV. Evaluation of immune correlates by immunohistochemistry.
OUTLINE: Participants are assigned to 1 of 2 arms.
ARM A: Participants receive a HER2 directed DC vaccine intranodally once a week for 3 weeks. Beginning in week 4, patients then receive pertuzumab intravenously (IV) over 30-60 minutes and trastuzumab IV over 30-90 minutes. Patients also receive docetaxel IV piggyback (PB) over 1 hour and carboplatin IVPB over 1 hour on day 1. Cycles repeat every 3 weeks until week 21. Participants also undergo surgery during weeks 26-28, and receive HER2 directed DC booster vaccines at week 25, 56, 80, and 104.
ARM B: Participants receive a HER2 directed DC vaccine intranodally twice a week, 3 days apart, for 3 weeks. Participants also receive docetaxel, carboplatin, trastuzumab, and pertuzumab, undergo surgery, and receive HER2 directed DC booster vaccines as in Arm A.
ARM C: Patients receive a HER2 directed DC vaccine twice a week (one of them intranodally and the second one intratumorally), 3 days apart, for 3 weeks. Participants also receive docetaxel, carboplatin, trastuzumab, and pertuzumab, and undergo surgery as in Arm A. Participants also receive HER2 directed DC booster vaccines at week 25, then every 6 months for up to 3 doses.
After completion of study treatment, participants are followed up at 30 days and every 6 months for up to 3 years.
Lead OrganizationMoffitt Cancer Center
Principal InvestigatorHatem H. Soliman