RecruitingPhase 1 / Phase 2

A Study of Tetrathiomolybdate (TM) Plus Capecitabine

Novel Targeting of the Microenvironment to Decrease Metastatic Recurrence of High-Risk TNBC: A Randomized Phase II Study of Tetrathiomolybdate (TM) Plus Capecitabine in Patients With Breast Cancer at High Risk of Recurrence

Who can join

As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.

Age
18 Years to 80 Years
Sex
All sexes
Healthy volunteers
Not accepted
Compensation
Not stated

Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.

What to expect

No one can promise a trial will help you personally — that is what the research is trying to find out.

What participation involves

  • Time periods mentioned: 6 months, 1 year
  • Procedures mentioned: Pills

Only what the study's summary and detailed description on ClinicalTrials.gov say. Time periods may describe the whole study or a part of it — ask the study team what applies to you.

Show the study's own words
  • "The capecitabine will be for 6 months with concurrent TM and TM will continue for an additional 2.5 years (for a total of 3 years of treatment)."
  • "TM dosed according to Cp level and ANC in 20mg TM capsule increments."
  • "Capecitabine Dose: 1000 mg per square meter of body-surface area, twice per day, on days 1 to 14 every 3 weeks for a total of 6 months Pembrolizumab: Standard doses will be used (200 mg IV Q3 weeks or 400 mg IV Q6 weeks for one year total as per package insert or per physician's choice)."
  • "Study Duration: TM and capecitabine and pembrolizumab will be administered concurrently for 6 months, and the TM will continue for an additional 2.5 years (total duration of TM treatment is 3 years)."
  • "If pembrolizumab was administered in the neoadjuvant setting and the oncology team chooses to continue in the adjuvant setting, standard doses will be used (200 mg IV Q3weeks or 400 mg IV Q6 weeks for one year total as per package insert or per physician's choice) * Induction Phase TM dose: Will be determined in phase 1b part of this study."
  • "Standard doses will be used (200 mg IV Q3weeks or 400 mg IV Q6 weeks for one year total per package insert or per physician's choice * Maintenance Phase TM dose: Will be determined in phase 1b part of this study."
Compensation
Not stated
  • Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
  • Participants are monitored closely by the research team throughout the study.
  • Some participants may receive access to an investigational treatment, which is still being studied.
  • Your participation helps researchers learn whether this approach could help future patients.

About this study

In plain language

This study tests adding 3 years of tetrathiomolybdate (TM) to 6 months of capecitabine after surgery. It is for adults with triple-negative breast cancer, a type of breast cancer with a high risk of coming back despite treatment. The first part checks safety with pembrolizumab, an immune treatment; the second part compares TM plus capecitabine with capecitabine alone.

There are two parts to this study. It is a phase 1b followed by a randomized phase 2 study to assess whether adding 3 years of adjuvant tetrathiomolybdate (TM) to standard 6 months treatment of adjuvant capecitabine and pembrolizumab in high risk for relapse triple negative breast cancer. In the phase 1b part of the study, TM is added to adjuvant capecitabine and pembrolizumab in high risk for relapse triple negative breast cancer (RCB 2, 3, risk for relapse \>60% at 5 years) after completion of neoadjuvant chemo-immunotherapy and surgery to establish the safety of the combination. This will be followed by a randomized phase 2 clinical trial of adjuvant TM and capecitabine vs capecitabine alone. If pembrolizumab was administered in the neoadjuvant setting, it may be continued in the adjuvant setting per investigator discretion.

Compensation is read from the study's own description and may be missing — always confirm with the study team.

Eligibility

Who can join

  • You must be 18 or older and have triple-negative breast cancer confirmed by a tissue test.
  • You must have finished at least 6 rounds of standard chemotherapy before surgery. Cancer must still have been found in lymph nodes, or a moderate to large amount must have remained after treatment (RCB 2 or 3).
  • You must have had breast surgery with no cancer at the edges of the removed tissue, plus lymph node testing or removal. Radiation is required after surgery that removes only part of the breast.
  • For the first part, you must have received pembrolizumab before surgery and plan to continue it for at least the first study treatment cycle. It is allowed in the second part.
  • Exams and scans must show no cancer after treatment. You must be able to do normal daily tasks with few or no symptoms and be expected to live more than 3 months.
  • Blood counts and liver tests must meet study limits, and vitamin B12 must be normal.
  • If you take medicine for nerve damage caused by chemotherapy, your treatment must have been stable for at least 2 weeks.
  • You must understand and sign a consent form. If you or your partner could become pregnant, you must agree to use birth control before and during the study.

Who can't join

  • You had chemotherapy or radiation less than 2 weeks ago, surgery less than 4 weeks ago, or your final breast surgery more than 12 weeks before the study starts.
  • You have taken capecitabine before or are taking warfarin, a blood thinner.
  • For the first part, you did not receive immune treatment before surgery or do not plan to continue it for at least the first study treatment cycle.
  • Tests show breast cancer is still present or has spread, including active cancer in the brain or its lining.
  • Your kidney filtering rate is below 60 mL per minute.
  • You have had an allergic reaction to drugs similar to TM or capecitabine.
  • You are pregnant. Breastfeeding must stop if you receive TM.
  • You have HIV and are taking a combination of medicines to treat it.

Simplified for readability. The official criteria below are what the study team uses.

Official eligibility criteria

Inclusion Criteria: 1. Patients must have histologically confirmed breast malignancy that is Triple negative tumors as defined as ER and PR \<1% and HER2 negative as per ASCO/CAP guidelines 2. The patient must have completed standard neoadjuvant chemotherapy which constitutes at least 6 cycles of chemotherapy. 3. Phase Ib: Patients must have residual invasive carcinoma, at minimum in one of the following capacities: (1) node positive disease after treatment without residual invasive carcinoma in the breast; (2) RCB 2 or RCB 3 MDAH Calculator; Standard therapy consists of the following: (1) Local therapy: (a) Lumpectomy or mastectomy to negative margins. (b) Sentinel lymph node biopsy or axillary node dissection; (c) Radiation therapy to breast if patient received a lumpectomy and per investigator choice if considering chest wall/extended field RT. (2) Systemic therapy: Prior chemotherapy is required for patients entered on the trial. Neoadjuvant treatment should consist of the following standard therapy: Anthracycline and taxane-based therapy (i.e. AC-\>T, AC-\>Tcarbo, Keynote 522 regimen) or a non-anthracycline based chemo and immunotherapy regimen (NeoPACT). Patients must have received neoadjuvant Pembrolizumab for the phase Ib only and plan to continue it in the adjuvant setting for at least the first cycle of treatment. Randomized Phase 2: Patients must have residual invasive carcinoma, at minimum in one of the following capacities: (1) node positive disease after treatment without residual invasive carcinoma in the breast; (2) RCB 2 or RCB 3 MDAH Calculator; Standard therapy consists of the following: (1) Local therapy: (a) Lumpectomy or mastectomy to negative margins. (b) Sentinel lymph node biopsy or axillary node dissection; (c) Radiation therapy to breast if patient received a lumpectomy and per investigator choice if considering chest wall/extended field RT. (2) Systemic therapy: Prior chemotherapy is required for patients entered on the trial. Neoadjuvant treatment should consist of the following standard therapy: Anthracycline and taxane-based therapy (i.e. AC-\>T, AC-\>Tcarbo, Keynote 522 regimen) or a non-anthracycline based chemo and immunotherapy regimen (NeoPACT). Pembrolizumab is allowed. Patients will be stratified by: (1) Treatment (chemotherapy vs chemotherapy + immunotherapy); (2) Age (Age ≤ 40 yrs vs \> 40 yrs); and (3) RCB 2 vs RCB 3. These important stratification factors represent variables that are known to affect outcome for patients with TNBC. 4. At least two weeks must have elapsed from last chemotherapy or radiation therapy. At least 4 weeks must have elapsed from most recent surgery. 5. No clinical or radiologic evidence of disease after surgery and/or systemic treatment (by CT scan of chest, abdomen and pelvis and bone scan or PET scan prior to enrollment). 6. Previous treatment with capecitabine is not allowed. 7. Because no dosing or adverse event data are currently available on the use of TM in patients \<18 years of age, children are excluded from this study. 8. KPS 90 or 100. 9. Life expectancy of greater than 3 months. 10. Patients must have normal organ and marrow function as defined below: * hemoglobin \>10mg/dL * absolute neutrophil count \>1,500/ µL * platelets \>100,000/µL * total bilirubin \<1.5 x normal institutional limits * AST (SGOT)/ALT (SGPT) \<1.5 X institutional upper limit of normal 11. Antiresorptive therapy and denosumab may be administered. 12. Patients must be on stable medical therapy for at least 2 weeks if they are being treated medically for their chemotherapy induced peripheral neuropathy. 13. The effects of TM on the developing human fetus are unknown. For this reason, women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. 14. Ability to understand and the willingness to sign a written informed consent document. 15. Normal B12 levels. Exclusion Criteria: 1. Patients who have had chemotherapy or radiotherapy within 2 weeks prior to entering the study. Patients who have had surgery within 4 weeks. 2. Patients who have received capecitabine or who are on warfarin 3. Patients who had their final breast surgery more than 12 weeks prior to study start. 4. Phase Ib: patients who have not received neoadjuvant immunotherapy and/or do not plan to continue treatment with immunotherapy for at least the first cycle of study treatment. 5. Objective evidence of breast cancer. 6. Metastatic disease 7. Carcinomatous meningitis or active parenchymal brain metastases. 8. Estimated creatinine clearance \< 60 ml/min 9. History of allergic reactions attributed to compounds of similar chemical or biologic composition to TM or capecitabine. 10. Pregnant women are excluded from this study because TM has the potential to have teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with TM, breastfeeding should be discontinued if the mother is treated with TM. 11. Because 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 because of possible pharmacokinetic interactions with TM.

Study sites (3)

IN

  • Indiana University Simon Cancer Center · Indianapolis, IN 46202Bryan Schneider, MD · Principal investigatorMore trials in Indianapolis

NH

NY