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| Name | Class |
|---|---|
| Bristol-Myers Squibb | INDUSTRY |
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This is a single center non-blinded randomized non-comparative phase II trial. The first stage of the trial consists of five arms ( with induction treatment followed by nivolumab, 1 with no induction treatment before nivolumab).
For the second stage, the number of arms will be reduced based on the results obtained in the first stage.
Triple negative breast cancer (TNBC) patients have a relatively high relapse rate and upon relapse the median overall survival is less than a year. No targeted therapies are currently available for this subgroup. Compared to other breast cancer subtypes, the percentage of tumor-infiltrating lymphocytes (TILs) is significantly higher in TNBC. Given the durable responses induced by the immune checkpoint inhibitor nivolumab in other advanced solid cancers, immunotherapeutic approaches, such as blockade of PD-1 by nivolumab may be the key to treat TNBC. Moreover, since classical anticancer agents can stimulate immune effector cells, the investigators hypothesize that short-term induction treatment with radiation, doxorubicin, cyclophosphamide or cisplatin induces an anticancer immune response resulting in synergistic activity with nivolumab.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Radiation therapy | Active Comparator | Radiotherapy on metastatic lesion |
|
| Low dose doxorubicin | Active Comparator | 15mg flat dose, once weekly for 2 weeks |
|
| Cyclophosphamide | Active Comparator | metronomic schedule, 50mg daily orally for 2 weeks |
|
| Cisplatin | Active Comparator | 40mg/m2, weekly for 2 weeks |
|
| No induction treatment | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nivolumab | Drug | nivolumab 3 mg/kg, every 2 weeks after induction treatment |
|
| Measure | Description | Time Frame |
|---|---|---|
| Progression free survival | Time from randomization todate of first tumor progression | assessed monthly until progression; median 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Overall response rate | complete response or partial response at 12 weeks and 6 months | At 12 weeks and 6 months |
| Clinical benefit rate | Beneficial response (complete response, partial response or stable disease) at 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Marleen Kok, MD | Antoni van Leeuwenhoek | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Antoni van Leeuwenhoek | Amsterdam | 1066 CX | Netherlands |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41406937 | Derived | Lin AY, Isaeva OI, Deger T, Geurts VCM, Vessies DCL, Voorwerk L, Slagter M, Moore KS, van der Leest P, Martens JWM, van den Broek D, Wessels LFA, Kok M. CfDNA-based copy-number dynamics during anti-PD1 treatment in metastatic triple negative breast cancer. Cell Rep Med. 2025 Dec 16;6(12):102512. doi: 10.1016/j.xcrm.2025.102512. |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D009362 | Neoplasm Metastasis |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
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| ID | Term |
|---|---|
| D000077594 | Nivolumab |
| D011878 | Radiotherapy |
| D004317 | Doxorubicin |
| D003520 | Cyclophosphamide |
| D002945 | Cisplatin |
| ID | Term |
|---|---|
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
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| Radiation therapy | Radiation | 20 Gy to metastatic lesion |
|
| Low dose doxorubicin | Drug | 15 mg flat dose, once weekly for 2 weeks |
|
| Cyclophosphamide | Drug | metronomic schedule, 50 mg daily orally for 2 weeks |
|
| Cisplatin | Drug | 40 mg/m2, weekly for 2 weeks |
|
| At 6 months |
| Toxicity of all study regimens | adverse events will be graded according to NCI Common Toxicity Criteria v 4.0 | assessed until 100 days after of treatment end |
| D017437 |
| Skin and Connective Tissue Diseases |
| D009385 | Neoplastic Processes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007162 |
| Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D013812 | Therapeutics |
| D003630 | Daunorubicin |
| D018943 | Anthracyclines |
| D009279 | Naphthacenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D011083 | Polycyclic Compounds |
| D000617 | Aminoglycosides |
| D006027 | Glycosides |
| D002241 | Carbohydrates |
| D010752 | Phosphoramide Mustards |
| D009588 | Nitrogen Mustard Compounds |
| D009150 | Mustard Compounds |
| D006846 | Hydrocarbons, Halogenated |
| D063088 | Phosphoramides |
| D009943 | Organophosphorus Compounds |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017672 | Nitrogen Compounds |
| D017671 | Platinum Compounds |