Efficacy of Personalized Tumorogram-based Therapy in Cancer Established From Patient-derived Organoid (AVATAR)

NCT ID: NCT06459791

Last Updated: 2026-01-29

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 110 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-12-06
• Study Completion Date: 2028-09-30

Brief Summary

A biopsy of a tumor lesion (breast or other localisation) will be performed for processing to establish avatars (patient-derived organoids -PDO). A personalized tumorogram for each patient will be provided, based on the results of the drug screening (= tumor predicted as sensitive, intermediate, resistant or non-evaluable for each drug tested). Patients with an informative tumorogram will receive one of the recommended treatments (line N+1) in the event of tumor progression, administered according to standard procedures and validated at medical meetings specific to each center, and their fate will be monitored.

Detailed Description

A biopsy of a tumor lesion (breast or other localisation) will be performed and transferred to the LIP laboratory at the Institut Curie (Laboratoire d'Investigation Préclinique, Département de Recherche Translationnelle) for processing to establish avatars (patient-derived organoids -PDO).

Step 1: Establishment of avatar (PDO): follow-up of line N (standard care) when the tumorogram is established, then follow-up of standard line N+1.

• The patient will then be treated (line N) as part of standard care while awaiting the result of the tumorogram.
• A drug screening will be carried out on the PDO (~5-10 drugs/patient), which will be progressive and adapted to the clinical context (including treatment history), including drugs used in standard care (cf. list in Table 1).
• A personalized tumorogram for each patient will be provided, based on the results of the drug screening (= tumor predicted as sensitive, intermediate, resistant or non-evaluable for each drug tested).
• A multidisciplinary committee will be set up for this study, which will meet regularly (~1 time per week) to discuss patients included in the study, obtaining PDOs, drugs to be prioritized in the screening, results of the drug screening and personalized tumorograms. The committee will include at least one oncologist and one biologist from the laboratory.
• The multidisciplinary committee will make a therapeutic recommendation based on the personalized tumorogram, which may include several drugs considered sensitive to the tumour
• A tumorogram will be considered as informative if it proposes at least one chemotherapy molecule considered as sensitive in the PDO model.
• Patients whose PDO could not be obtained, or whose tumorogram was not informative, will receive standard treatment.

Step 2: informative tumorogram: follow-up of experimental line N+1 Patients with an informative tumorogram will receive one of the recommended treatments (line N+1) in the event of tumor progression, administered according to standard procedures and validated at medical meetings specific to each center, and their fate will be monitored.

Conditions

Metastatic Breast Cancer

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Line N in step 1

Step 1: follow-up of line N (standard care) when the tumorogram is established. Intervention is the biopsy performed before start of treatment in line N. Standard of Care treatment

Group Type: OTHER

Biopsy

Intervention Type: PROCEDURE

The recommandation done based on informative tumorogram is up to study investigator

Line N+1 in step 2

Step 2: in case of informative tumorogram: follow-up of experimental line N+1. If tumorogram is informative on organoid issued from biospy, a specific standard of Care treatment will be recommanded.

Group Type: EXPERIMENTAL

Biopsy

Intervention Type: PROCEDURE

The recommandation done based on informative tumorogram is up to study investigator

Interventions

Biopsy

The recommandation done based on informative tumorogram is up to study investigator

Intervention Type: PROCEDURE

Other Intervention Names

Line N+1 treatment recommandation

Eligibility Criteria

Inclusion Criteria

1. Patient over 18 years of age

2. Advanced breast cancer

3. Triple-negative phenotype (HR-/HER2-) or HR+/HER2- after hormone resistance (progression after treatment with hormone therapy + CDK4/6 inhibitor)

4. Tumor measurable according to RECISTv1.1 criteria, accessible to biopsy

5. Performans Status 0-1

Exclusion Criteria

1. More than 3 lines of chemotherapy in the advanced setting (excluding hormone therapy/CDK4/6 inhibitor)

2. Progressive brain metastases

3. Leptomeningeal metastasis

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Institut Curie

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Luc CABEL, MD

Role: PRINCIPAL_INVESTIGATOR

Institut Curie

Locations

Institut Curie

Paris, , France

Site Status: RECRUITING

Hôpital Saint-Louis - AP-HP Senopole

Paris, , France

Site Status: NOT_YET_RECRUITING

Institut Curie

Saint-Cloud, , France

Site Status: RECRUITING

Countries

France

Central Contacts

Luc CABEL, MD

Role: CONTACT

drci.promotion@curie.fr

+33 1 56 24 55 00

Anne-Sophie Plissonnier

Role: CONTACT

anne-sophie.plissonnier@curie.fr

+33 1 47 11 23 78

Facility Contacts

Luc CABEL, MD

Role: primary

Delphine COCHEREAU, MD

Role: primary

Alexandre DE MOURA, MD

Role: primary

Other Identifiers

IC 2023-08

Identifier Type: -

Identifier Source: org_study_id