Trial Outcomes & Findings for Topical Imiquimod and Abraxane in Treating Patients With Advanced Breast Cancer (NCT NCT00821964)

NCT ID: NCT00821964

Last Updated: 2018-01-02

Results Overview

Tumor responses will be determined using the sum of the products of the largest perpendicular dimensions. Target lesions will be evaluated by the following response criteria: complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). Evaluation of target lesions per modified WHO response criteria: * Complete response (CR): complete clearance (100%) of target lesion(s) * Partial response (PR): ≥ 50% decrease in target lesion size * Stable disease (SD): \< 50% decrease in target lesion size * Progressive (PD): ≥ 25% increase in target lesion size Overall Response Rate (ORR) determined at end of study treatment which was 1 week after cycle #3, unless patient was withdrawn from study. If patient was withdrawn from study, then ORR was determined after their last cycle of treatment received.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

15 participants

Primary outcome timeframe

Baseline and then every 4 weeks until week 24

Results posted on

2018-01-02

Participant Flow

Participant milestones

Participant milestones
Measure
Treatment (Biological Therapy, Chemo)
Patients receive Abraxane IV over 30 minutes on days 1, 8, and 15 and apply topical imiquimod to cutaneous lesions QD on days 1-4, 8-11, 15-18, and 22-25. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. imiquimod: Given topically Abraxane: Given IV laboratory biomarker analysis: Correlative studies RNA analysis: Correlative studies immunoenzyme technique: Correlative studies
Overall Study
STARTED
15
Overall Study
Evaluable for Clinical Response
14
Overall Study
Evaluable for Pathologic Response
7
Overall Study
COMPLETED
9
Overall Study
NOT COMPLETED
6

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Topical Imiquimod and Abraxane in Treating Patients With Advanced Breast Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Treatment (Biological Therapy, Chemo)
n=15 Participants
Patients receive Abraxane IV over 30 minutes on days 1, 8, and 15 and apply topical imiquimod to cutaneous lesions QD on days 1-4, 8-11, 15-18, and 22-25. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. imiquimod: Given topically Abraxane: Given IV laboratory biomarker analysis: Correlative studies RNA analysis: Correlative studies immunoenzyme technique: Correlative studies
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
13 Participants
n=5 Participants
Age, Categorical
>=65 years
2 Participants
n=5 Participants
Sex: Female, Male
Female
15 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
15 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
Race (NIH/OMB)
White
13 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
Region of Enrollment
United States
15 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline and then every 4 weeks until week 24

Tumor responses will be determined using the sum of the products of the largest perpendicular dimensions. Target lesions will be evaluated by the following response criteria: complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). Evaluation of target lesions per modified WHO response criteria: * Complete response (CR): complete clearance (100%) of target lesion(s) * Partial response (PR): ≥ 50% decrease in target lesion size * Stable disease (SD): \< 50% decrease in target lesion size * Progressive (PD): ≥ 25% increase in target lesion size Overall Response Rate (ORR) determined at end of study treatment which was 1 week after cycle #3, unless patient was withdrawn from study. If patient was withdrawn from study, then ORR was determined after their last cycle of treatment received.

Outcome measures

Outcome measures
Measure
Treatment (Biological Therapy, Chemo)
n=14 Participants
Patients receive Abraxane IV over 30 minutes on days 1, 8, and 15 and apply topical imiquimod to cutaneous lesions QD on days 1-4, 8-11, 15-18, and 22-25. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. imiquimod: Given topically Abraxane: Given IV laboratory biomarker analysis: Correlative studies RNA analysis: Correlative studies immunoenzyme technique: Correlative studies
HER2, IGFBP-2, MAGE3, Topo IIa Antigen - Baseline to Week 24
Precursor frequency of HER2, IGFBP-2, MAGE3, Topo IIa Antigen - Baseline to Week 24
Anti-tumor Effects of Imiquimod as Assessed by Modified World Health Organization (WHO) Criteria
Total Evaluated in this Outcome Measure
14 Participants
Anti-tumor Effects of Imiquimod as Assessed by Modified World Health Organization (WHO) Criteria
Complete Response (CR)
5 Participants
Anti-tumor Effects of Imiquimod as Assessed by Modified World Health Organization (WHO) Criteria
Partial Response (PR)
5 Participants
Anti-tumor Effects of Imiquimod as Assessed by Modified World Health Organization (WHO) Criteria
Stable Disease (SD)
3 Participants
Anti-tumor Effects of Imiquimod as Assessed by Modified World Health Organization (WHO) Criteria
Progressive Disease (PD)
1 Participants

PRIMARY outcome

Timeframe: Baseline and weeks 5, 9 13, 16, 20, and 24

Evaluated according to the Cancer Therapy Evaluation Program (CTEP) Common Terminology Criteria for Adverse Events (CTCAE) v3.0 and monitoring of adverse events will be done per Food and Drug Administration (FDA) and National Cancer Institute (NCI) guidelines for the time frame below. Number of Participants with at Least 1 Adverse Event as Assessed by a Review of Medical History, Physical Exam, Systems, Performance Status, and Clinical Labs (CBC and CMP) under the following CTCAE categories: Constitutional (Fatigue) Neurological (Neuropathy (sensory or motor)) Cardiac (Arrhythemia) Pulmonary (Cough, Pharyngitis) GI (Constipation, Diarrhea, Mucositis, Vomiting) Dermatology (Ulceration, Hairloss/alopecia) Pain (Headache, other pain) Syndrome (Flu-like) Visual Changes Hearing/Auditory Edema Other (General) In addition they were asked the severity of the event so that a clinician could grade the event.

Outcome measures

Outcome measures
Measure
Treatment (Biological Therapy, Chemo)
n=15 Participants
Patients receive Abraxane IV over 30 minutes on days 1, 8, and 15 and apply topical imiquimod to cutaneous lesions QD on days 1-4, 8-11, 15-18, and 22-25. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. imiquimod: Given topically Abraxane: Given IV laboratory biomarker analysis: Correlative studies RNA analysis: Correlative studies immunoenzyme technique: Correlative studies
HER2, IGFBP-2, MAGE3, Topo IIa Antigen - Baseline to Week 24
Precursor frequency of HER2, IGFBP-2, MAGE3, Topo IIa Antigen - Baseline to Week 24
Safety and Systemic Toxicity as Assessed by a Review of Medical History, Physical Exam, Systems, Performance Status, and Clinical Labs (CBC and CMP)
15 Participants

PRIMARY outcome

Timeframe: Pre-and post-treatment

This is done by IHC staining reviewed by a pathologist. This is done by comparing the baseline to the post-treatment biopsy tissue. Yes equals absence of residual disease.

Outcome measures

Outcome measures
Measure
Treatment (Biological Therapy, Chemo)
n=7 Participants
Patients receive Abraxane IV over 30 minutes on days 1, 8, and 15 and apply topical imiquimod to cutaneous lesions QD on days 1-4, 8-11, 15-18, and 22-25. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. imiquimod: Given topically Abraxane: Given IV laboratory biomarker analysis: Correlative studies RNA analysis: Correlative studies immunoenzyme technique: Correlative studies
HER2, IGFBP-2, MAGE3, Topo IIa Antigen - Baseline to Week 24
Precursor frequency of HER2, IGFBP-2, MAGE3, Topo IIa Antigen - Baseline to Week 24
Pathologic Response by Immunohistochemical (IHC)as Assessed by Skin Punch Biopsy of the Target Lesion
Total Number of Evaluable for Pathologic Response
7 Participants
Pathologic Response by Immunohistochemical (IHC)as Assessed by Skin Punch Biopsy of the Target Lesion
Evaluable Pts. with Pathologic Response Post Tx
5 Participants
Pathologic Response by Immunohistochemical (IHC)as Assessed by Skin Punch Biopsy of the Target Lesion
Evaluable Pts. without Pathologic Response Post Tx
2 Participants

SECONDARY outcome

Timeframe: Baseline and at weeks 13 and 24

Peripheral blood will be obtained at baseline, after cycle 3 (end of study treatment) and at week 24 (end of study) to assess the immune response. A positive antigen-specific T cell immune response will be defined as a T cell precursor frequency more robust than 1:20,000 PBMC if the patients did not have a detectable response prior to treatment. In patients with a pre-existent immune response, the development of an immune response twice baseline will constitute augmentation.

Outcome measures

Outcome measures
Measure
Treatment (Biological Therapy, Chemo)
n=8 Participants
Patients receive Abraxane IV over 30 minutes on days 1, 8, and 15 and apply topical imiquimod to cutaneous lesions QD on days 1-4, 8-11, 15-18, and 22-25. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. imiquimod: Given topically Abraxane: Given IV laboratory biomarker analysis: Correlative studies RNA analysis: Correlative studies immunoenzyme technique: Correlative studies
HER2, IGFBP-2, MAGE3, Topo IIa Antigen - Baseline to Week 24
n=3 Participants
Precursor frequency of HER2, IGFBP-2, MAGE3, Topo IIa Antigen - Baseline to Week 24
Endogenous Immunity to Common Breast Tumor Antigens (HER2, IGFBP-2, Topoisomerase II-alpha, and p53) in Peripheral Blood as Assessed by IFN-gamma and ELISPOT Assay
HER2 Antigen · Positive antigen-specific T cell immune response
0 Participants
0 Participants
Endogenous Immunity to Common Breast Tumor Antigens (HER2, IGFBP-2, Topoisomerase II-alpha, and p53) in Peripheral Blood as Assessed by IFN-gamma and ELISPOT Assay
HER2 Antigen · Negative antigen specific T cell immune response
8 Participants
3 Participants
Endogenous Immunity to Common Breast Tumor Antigens (HER2, IGFBP-2, Topoisomerase II-alpha, and p53) in Peripheral Blood as Assessed by IFN-gamma and ELISPOT Assay
IGFBP-2 Antigen · Positive antigen-specific T cell immune response
2 Participants
1 Participants
Endogenous Immunity to Common Breast Tumor Antigens (HER2, IGFBP-2, Topoisomerase II-alpha, and p53) in Peripheral Blood as Assessed by IFN-gamma and ELISPOT Assay
IGFBP-2 Antigen · Negative antigen specific T cell immune response
6 Participants
2 Participants
Endogenous Immunity to Common Breast Tumor Antigens (HER2, IGFBP-2, Topoisomerase II-alpha, and p53) in Peripheral Blood as Assessed by IFN-gamma and ELISPOT Assay
MAGE3 Antigen · Positive antigen-specific T cell immune response
5 Participants
1 Participants
Endogenous Immunity to Common Breast Tumor Antigens (HER2, IGFBP-2, Topoisomerase II-alpha, and p53) in Peripheral Blood as Assessed by IFN-gamma and ELISPOT Assay
MAGE3 Antigen · Negative antigen specific T cell immune response
3 Participants
2 Participants
Endogenous Immunity to Common Breast Tumor Antigens (HER2, IGFBP-2, Topoisomerase II-alpha, and p53) in Peripheral Blood as Assessed by IFN-gamma and ELISPOT Assay
TopoII-alpha Antigen · Positive antigen-specific T cell immune response
2 Participants
0 Participants
Endogenous Immunity to Common Breast Tumor Antigens (HER2, IGFBP-2, Topoisomerase II-alpha, and p53) in Peripheral Blood as Assessed by IFN-gamma and ELISPOT Assay
TopoII-alpha Antigen · Negative antigen specific T cell immune response
6 Participants
3 Participants

SECONDARY outcome

Timeframe: Baseline and at weeks 13

Incidence of reduction of serum TGF-beta levels as assessed by ELISA and correlation with Th1 adaptive immunity and clinical response is defined as a reduction of at least 25% from baseline value to the value measured at week 13.

Outcome measures

Outcome measures
Measure
Treatment (Biological Therapy, Chemo)
n=8 Participants
Patients receive Abraxane IV over 30 minutes on days 1, 8, and 15 and apply topical imiquimod to cutaneous lesions QD on days 1-4, 8-11, 15-18, and 22-25. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. imiquimod: Given topically Abraxane: Given IV laboratory biomarker analysis: Correlative studies RNA analysis: Correlative studies immunoenzyme technique: Correlative studies
HER2, IGFBP-2, MAGE3, Topo IIa Antigen - Baseline to Week 24
Precursor frequency of HER2, IGFBP-2, MAGE3, Topo IIa Antigen - Baseline to Week 24
Incidence of Reduction of Serum TGF-beta Levels as Assessed by ELISA and Correlation With Th1 Adaptive Immunity and Clinical Response
No incidence of 25% reduction of TGF-beta at week1
8 Participants
Incidence of Reduction of Serum TGF-beta Levels as Assessed by ELISA and Correlation With Th1 Adaptive Immunity and Clinical Response
Incidence of 25% reduction of TGF-beta at week 13
0 Participants

Adverse Events

Treatment (Biological Therapy, Chemo)

Serious events: 1 serious events
Other events: 15 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Treatment (Biological Therapy, Chemo)
n=15 participants at risk
Patients receive Abraxane IV over 30 minutes on days 1, 8, and 15 and apply topical imiquimod to cutaneous lesions QD on days 1-4, 8-11, 15-18, and 22-25. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. imiquimod: Given topically Abraxane: Given IV laboratory biomarker analysis: Correlative studies RNA analysis: Correlative studies immunoenzyme technique: Correlative studies
General disorders
Pain
6.7%
1/15 • Number of events 1

Other adverse events

Other adverse events
Measure
Treatment (Biological Therapy, Chemo)
n=15 participants at risk
Patients receive Abraxane IV over 30 minutes on days 1, 8, and 15 and apply topical imiquimod to cutaneous lesions QD on days 1-4, 8-11, 15-18, and 22-25. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. imiquimod: Given topically Abraxane: Given IV laboratory biomarker analysis: Correlative studies RNA analysis: Correlative studies immunoenzyme technique: Correlative studies
Investigations
ANC/AGC High
13.3%
2/15 • Number of events 2
Blood and lymphatic system disorders
Other - Low HCT
73.3%
11/15 • Number of events 23
Blood and lymphatic system disorders
Other - High immature granulocytes
46.7%
7/15 • Number of events 13
Blood and lymphatic system disorders
Other - Low immuature granulocytes
6.7%
1/15 • Number of events 1
Blood and lymphatic system disorders
Other - High MCH
6.7%
1/15 • Number of events 1
Blood and lymphatic system disorders
Other - Low MCHC
26.7%
4/15 • Number of events 8
Blood and lymphatic system disorders
Other High MCV
20.0%
3/15 • Number of events 8
Blood and lymphatic system disorders
Other - High monocytes
6.7%
1/15 • Number of events 2
Blood and lymphatic system disorders
Other - Low RBC
53.3%
8/15 • Number of events 14
Blood and lymphatic system disorders
Others - High RDWCV
26.7%
4/15 • Number of events 5
Blood and lymphatic system disorders
Anemia
86.7%
13/15 • Number of events 28
Blood and lymphatic system disorders
Lymphopenia
73.3%
11/15 • Number of events 23
Blood and lymphatic system disorders
Leukocytes High
6.7%
1/15 • Number of events 1
Blood and lymphatic system disorders
Leukopenia
86.7%
13/15 • Number of events 37
Blood and lymphatic system disorders
Neutropenia
53.3%
8/15 • Number of events 17
Blood and lymphatic system disorders
Thrombocytopenia
13.3%
2/15 • Number of events 2
General disorders
Fatigue
46.7%
7/15 • Number of events 12
General disorders
Sweating (diaphoresis)
6.7%
1/15 • Number of events 1
Gastrointestinal disorders
Weight Loss
6.7%
1/15 • Number of events 1
Skin and subcutaneous tissue disorders
Hair Loss/Alopecia (scalp or body)
73.3%
11/15 • Number of events 12
General disorders
Nail Changes
6.7%
1/15 • Number of events 1
Skin and subcutaneous tissue disorders
Pruritus/Itching
6.7%
1/15 • Number of events 2
Skin and subcutaneous tissue disorders
Rash/Desquamation
20.0%
3/15 • Number of events 7
Skin and subcutaneous tissue disorders
Rash: Acne/Acneiform
6.7%
1/15 • Number of events 1
Skin and subcutaneous tissue disorders
Rash: Hand-Foot Skin Reaction
6.7%
1/15 • Number of events 1
Metabolism and nutrition disorders
Anorexia
53.3%
8/15 • Number of events 11
Gastrointestinal disorders
Constipation
26.7%
4/15 • Number of events 7
Metabolism and nutrition disorders
Dehydration
6.7%
1/15 • Number of events 1
Gastrointestinal disorders
Diarrhea
26.7%
4/15 • Number of events 6
Gastrointestinal disorders
Mucositis/Stomatitis
20.0%
3/15 • Number of events 3
Gastrointestinal disorders
Mucositis/Stromatitis
13.3%
2/15 • Number of events 2
Gastrointestinal disorders
Nausea
46.7%
7/15 • Number of events 13
Gastrointestinal disorders
Vomiting
26.7%
4/15 • Number of events 11
Respiratory, thoracic and mediastinal disorders
Nose Bleeds
6.7%
1/15 • Number of events 2
Vascular disorders
Edema: Limb
13.3%
2/15 • Number of events 3
Investigations
Alkaline Phosphatase
20.0%
3/15 • Number of events 3
Investigations
ALT/ SGPT High
13.3%
2/15 • Number of events 2
Investigations
AST/SGOT High
6.7%
1/15 • Number of events 2
Investigations
AST/SGOT Low
6.7%
1/15 • Number of events 1
Investigations
Creatinine High
6.7%
1/15 • Number of events 1
Investigations
Creatinine Low
6.7%
1/15 • Number of events 1
Investigations
GFR Low
6.7%
1/15 • Number of events 1
Metabolism and nutrition disorders
Hyperkalemia
6.7%
1/15 • Number of events 2
Metabolism and nutrition disorders
Hypoalbuminemia
33.3%
5/15 • Number of events 6
Metabolism and nutrition disorders
Hypocalcemia
6.7%
1/15 • Number of events 3
Metabolism and nutrition disorders
Hypokalemia
33.3%
5/15 • Number of events 6
Metabolism and nutrition disorders
Hyponatremia
6.7%
1/15 • Number of events 1
Investigations
BUN High
20.0%
3/15 • Number of events 3
Investigations
BUN Low
13.3%
2/15 • Number of events 2
Investigations
Chloride High
13.3%
2/15 • Number of events 2
Investigations
Ion gap high
6.7%
1/15 • Number of events 1
Investigations
Protein Low
13.3%
2/15 • Number of events 2
Nervous system disorders
Dizziness
20.0%
3/15 • Number of events 3
Nervous system disorders
Neuropathy: Motor
13.3%
2/15 • Number of events 2
Nervous system disorders
Neuropathy: Sensory
60.0%
9/15 • Number of events 13
Eye disorders
Ocular/Visual Other
6.7%
1/15 • Number of events 1
Eye disorders
Blurred Vision
6.7%
1/15 • Number of events 1
Musculoskeletal and connective tissue disorders
Arthralgia
6.7%
1/15 • Number of events 2
Musculoskeletal and connective tissue disorders
Pain - Back
6.7%
1/15 • Number of events 1
Nervous system disorders
Headache
40.0%
6/15 • Number of events 9
Musculoskeletal and connective tissue disorders
Myalgia
13.3%
2/15 • Number of events 2
Musculoskeletal and connective tissue disorders
Pain (unspecified)
20.0%
3/15 • Number of events 10
Musculoskeletal and connective tissue disorders
Shoulder (right) - muscular/bony
6.7%
1/15 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Dyspnea
40.0%
6/15 • Number of events 10
Cardiac disorders
Hypertension
6.7%
1/15 • Number of events 1
Skin and subcutaneous tissue disorders
Psoriasis-like rash
6.7%
1/15 • Number of events 1
Gastrointestinal disorders
Distension/Bloating, abdominal
6.7%
1/15 • Number of events 1
Injury, poisoning and procedural complications
Seroma Axillary on Right Side
6.7%
1/15 • Number of events 1
Infections and infestations
Beta-Hemolytic Streptococcus Bacteria
6.7%
1/15 • Number of events 1
Infections and infestations
Renal Pyelonephritis
6.7%
1/15 • Number of events 1
Infections and infestations
Upper Respiratory Infection
6.7%
1/15 • Number of events 1
Investigations
Axilla (left)
6.7%
1/15 • Number of events 1
General disorders
Axilla (right), shoulder, lateral back
6.7%
1/15 • Number of events 1
Reproductive system and breast disorders
Pain - Breast
6.7%
1/15 • Number of events 1
General disorders
Pain - Chest, Noncardiac
6.7%
1/15 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Cough
13.3%
2/15 • Number of events 2

Additional Information

Principal Investigator

University of Washington

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place