Not yet recruitingPhase 2

ASTRAEA: ReinvigorAting ReSponse To ImmunotheRApy in MEtAstatic TNBC With Combination Myeloid Inhibition and Radiation

IIT2024-02-SHIAO-ASTRAEA: ReinvigorAting ReSponse To ImmunotheRApy in MEtAstatic TNBC With Combination Myeloid Inhibition and Radiation

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 and older
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: 2 years

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
  • "Pembrolizumab (MK-3475), 200 mg IV Q3W starting at C1D1/Week 1 for up to 2 years, until disease progression, or treatment intolerance."
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 pembrolizumab and axatilimab with radiation to treat triple-negative breast cancer (TNBC). It is for adults whose cancer has spread or returned near where it started and who have already received immunotherapy, a treatment that helps the immune system fight cancer.

Open label, single-arm, prospective therapeutic trial. Pembrolizumab (MK-3475), 200 mg IV Q3W starting at C1D1/Week 1 for up to 2 years, until disease progression, or treatment intolerance. RT, 8 Gy x 3 fractions over 3 consecutive days at C1D8/Week 2; Axatilimab (SNDX-6352; INCA034176), 1 mg/kg, IV, Q2W starting 1 week post- RT C1D15/Week 3 until disease progression or treatment intolerance.

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

Eligibility

Who can join

  • Be age 18 or older.
  • Have TNBC confirmed by a tissue or cell test. This cancer has low levels of estrogen and progesterone receptors and is HER2-negative.
  • Have cancer that has spread or returned locally, and have received immunotherapy before.
  • Have at least 2 tumors that can be measured outside the liver and bones. At least one must be suitable for radiation, and another must not receive radiation.
  • Be fully active or able to do light work, and have organs that work well enough.
  • If able to become pregnant, have a negative pregnancy test or a doctor's confirmation that you are not pregnant before treatment.
  • Use highly effective birth control, as required, during treatment and for 120 days afterward. Men must also avoid donating sperm during this time.
  • Sign a consent form and be able to follow study requirements.

Who can't join

  • Have received certain recent treatments: radiation within 2 weeks, cancer antibody treatment within 4 weeks, chemotherapy or targeted drugs within 2 weeks, or research treatment or devices within 4 weeks. Some radiation exceptions apply. Ongoing treatment side effects may also exclude you.
  • Have a weak immune system, take medicines that suppress it, or have an autoimmune disease needing whole-body treatment in the past 2 years. Also excluded are severe pembrolizumab allergy, certain immune-related treatment side effects, or a transplant from a donor.
  • Have a history of active tuberculosis, HIV, hepatitis B, active hepatitis C, or an infection needing whole-body treatment. A live vaccine within 30 days before pembrolizumab also excludes you.
  • Have another cancer that is growing or needed treatment within 5 years, with some exceptions. Active cancer in the brain, spinal cord, or their lining also excludes you; treated, stable brain tumors may be allowed. People eligible for PARP inhibitor drugs cannot join.
  • Have certain lung inflammation or a history of pancreas inflammation. Pancreas inflammation with a known cause may be allowed if it has cleared.
  • Have had a blood clot, stroke, or heart attack within 6 months, or have serious active heart disease, uncontrolled blood pressure or heartbeat problems, or recent unstable chest pain.
  • Be pregnant or breastfeeding, or plan to become pregnant or father a child during the study or within 120 days after the last dose.
  • Have another health condition, test result, mental health condition, or substance use problem that could make the study unsafe or prevent you from following its requirements.

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

Official eligibility criteria

Inclusion Criteria * Age ≥ 18 years at the time of consent. * Patients with metastatic or locally recurrent TNBC who received prior immunotherapy in any setting (curative or advanced/metastatic). * Have ≥2 measurable, non-osseous, non-hepatic recurrent or metastatic lesions. Of these lesions, at least one is indicated for radiation therapy and at least one will not be irradiated to be used to determine response. Notes on lesions: patients are still eligible if they have liver or bone lesions, so long as at least 2 measurable lesions are non-osseous, non-hepatic recurrent or metastatic per above criterion. * Histologically or cytologically-confirmed TNBC, defined as ER \<10%, PR \<10%, HER2-negative by ASCO CAP guidelines. Note: HER2 0-2+ IHC is allowed (i.e., if FISH-negative, this is still considered HER2-negative). * ECOG Performance Status ≤ 1. * Demonstrate adequate organ function * Female subject of childbearing potential should have a negative serum or urine pregnancy test or documentation of absence of pregnancy by a gynecologist within 14 days of initiating first dose of pembrolizumab for eligibility verification. * Female subjects of childbearing potential should be willing to use highly effective contraceptive methods (Appendix 12.6) during the treatment period through 120 days after the last dose of study medication. Subjects of childbearing potential are those who have not been surgically sterilized or have not been free from menses for \> 1 year. * Male participants should be willing to use highly effective contraceptive methods (Appendix 12.6) during the treatment period through 120 days after the last dose of study treatment and refrain from donating sperm during this period. * Written informed consent obtained from subject and ability for subject to comply with the requirements of the study. Exclusion Criteria * Has received prior radiotherapy within 2 weeks of start of study intervention or radiation-related toxicities requiring corticosteroids. Note: Two weeks or fewer of palliative radiotherapy for non-CNS disease is permitted. The last radiotherapy treatment must have been performed at least 7 days before the first dose of study intervention. * Is currently participating and receiving study therapy, or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of treatment. * Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment. * Has a known history of active TB (Bacillus Tuberculosis). * Has severe hypersensitivity (≥Grade 3) to pembrolizumab and/or any of its excipients. * Has had prior anti-cancer monoclonal antibody (mAb) within 4 weeks prior to study treatment Day 1 or who has not recovered (i.e., \> Grade 1 or baseline) from adverse events due to agents administered more than 4 weeks earlier. * Has had prior chemotherapy or targeted small molecule therapy within 2 weeks prior to study Day 1 or who has not recovered (i.e., \> Grade 1 or baseline) from adverse events due to a previously administered agent. Note: Subjects with ≤ Grade 2 neuropathy are an exception to this criterion and may qualify for the study. * Has a known additional malignancy that is progressing or has required treatment within the last 5 years. Note: Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin or carcinoma in situ, excluding carcinoma in situ of the bladder, that have undergone potentially curative therapy are not excluded. Participants with low-risk early-stage prostate cancer (T1-T2a, Gleason score ≤6, and PSA \<10 ng/mL) either treated with definitive intent or untreated in active surveillance with stable disease are not excluded. * Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Subjects with previously treated brain metastases may participate provided they are radiologically stable, i.e., without evidence of progression for at least four weeks by repeat imaging (note that the repeat imaging should be performed during study screening), clinically stable and without requirement of steroid treatment for at least 14 days prior to first dose of study intervention. * Has active autoimmune disease that has required systemic treatment in the past 2 years except replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.). * Has known history of/active, non-infectious pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/active interstitial lung disease. * Has an active infection requiring systemic therapy. * Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator. * Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial. * Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the screening visit through 120 days after the last dose of trial treatment. Note: Negative urine or serum pregnancy test is also conducted within 72 hours prior to C1D1 for study procedures but if screening pregnancy test is done within 72 hours of C1D1, it is not required to be repeated. * Has a known history of Human Immunodeficiency Virus (HIV). HIV testing is not required unless mandated by local health authority. * History of Hepatitis B (defined as HBsAg reactive) or known active Hepatitis C virus (defined as detectable HCV RNA \[qualitative\]) infection. Note: Testing for Hepatitis B or C is not required unless mandated by local health authority. * Has received a live vaccine or live-attenuated vaccine within 30 days of planned start of pembrolizumab. Administration of killed vaccines is allowed. * Has had an allogeneic tissue/solid organ transplant, including patients with prior allogeneic hematopoietic stem-cell transplant. * Patients eligible for PARP inhibitor therapy. * Any patient with prior immune-related treatment toxicity for which permanent discontinuation is indicated. * History of acute or chronic pancreatitis. Note: Participants who had a defined pancreatitis etiology (e.g., pancreatitis due to gallstones, trauma/injury, or medications such as asparaginase) may be enrolled if pancreatitis resolved prior to study enrollment. * History of thromboembolic events (such as deep vein thrombosis, pulmonary embolism, stroke, myocardial infarction) in the 6 months prior to study enrollment. * Currently active significant cardiac disease, such as uncontrolled arrhythmias, uncontrolled hypertension, or Class 3 or 4 congestive heart failure as defined by New York Heart Association, or a history of myocardial infarction or unstable angina within 6 months prior to study enrollment.

Study sites (1)

CA