Etude : PELICAN /

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Acronyme / Nom
Situation thérapeutique
Cadre réglementaire
Présentation de l'étude
Acronyme / Nom : PELICAN

Situation thérapeutique : Néoadjuvant

Traitement : Chimiothérapie / Immunothérapie

Cadre réglementaire : RIPH1

Dernière MÀJ : 02/08/2022
CIM10 - Localisation(s)
Informations principales
Titre : Etude de phase II prospective multicentrique randomisée et en ouvert, du Pembrolizumab en combinaison avec le traitement néoadjuvant (F)EC-Paclitaxel dans le cancer du sein inflammatoire HER2 négatif

Spécialité : Seins, organes génitaux de la femme
Localisation : C50 - Tumeur maligne du sein
Informations complémentaires
Schéma : Inflammatory breast cancer (IBC) is a rare and highly aggressive subtype of locally advanced breast cancer representing approximately 5% of all breast cancers that requires immediate aggressive treatment. Significant progress has been made in recent years using a combination of treatments, including neoadjuvant chemotherapy, surgery and radiation therapy.

Accumulating data indicate a prognostic and/or predictive impact for immune-response variables in BC. Recent data, suggest that PD-L1 is overexpressed in a significant number of BC, notably in IBC and may have significant prognostic or predictive value. Furthermore it may be targeted to restore or boost functional antitumor immunity. Pembrolizumab, a PD-1-directed monoclonal antibody is already registered and has an out-standing activity in advanced melanoma and NSCLC patients, with promising results in several other tumor types, including triple-negative BC, and a favorable profile of tolerance.

Thus, potential benefits of pembrolizumab in combination with a conventional cytotoxic backbone may be considered as high in HER2-negative IBC.

The aim of the study is to assess the pathological complete response rate following neoadjuvant (F)EC-paclitaxel chemotherapy plus pembrolizumab and to assess if neoadjuvant chemotherapy with anthracycline-based induction in combination with pembrolizumab exposes IBC patients to significant toxicity rates.

This phase II multicentre randomized open-label study will assess the safety and efficacy of Pembrolizumab in combination with standard chemotherapy in inflammatory breast cancer. Pembrolizumab will be administered every 3 weeks during the neoadjuvant chemotherapy. Tissue and blood samples will be collected pre- and post-treatment for translational research.

Phase : II

Stade : Localement avancé

Critères d'inclusion
Critères de non-inclusion
Critères d'inclusion et de non-inclusion
Critères d'inclusion : - 18 years or older,
- Performance status 0 to 2,
- Able to comply with the protocol,
- Patient affiliated to the national "Social Security" regimen or beneficiary of this regimen,
- Patient must have signed a written informed consent form prior to any study specific screening procedures,
- Previously untreated, histologically confirmed breast cancer and confirmed inflammatory breast cancer defined as follows:
--> T4d any N following American Joint Committee on Cancer (AJCC)-7th version classification: diffuse Erythema and edema ("peau d'orange") of the breast, occupying at least 1/3 of the breast, with or without underlying palpable mass
- HER2 negative tumors by immunohistochemistry (IHC 0 or 1+) or fluorescent/chromogenic in situ hybridization (FISH- or CISH-)
- Hormone receptors status known,
- No metastases,
- Adequate hematologic function: absolute neutrophil count ≥ 1.2 x 109/L AND platelets ≥ 100 x 109 AND Hb ≥ 9 g/dL,
- Adequate liver function: total bilirubin ≤ 1.5 ULN unless elevation is due to Gilbert's disease or similar syndrome involving slow conjugation of bilirubin AND - ASAT < 2.5 ULN AND ALAT < 2.5 ULN,
- Adequate kidney function: serum creatinine ≤ 1.25 ULN or creatinine clearance ≥ 50 mL/min according to the Cockcroft and Gault formula AND no proteinuria (> 1 g/24 hours),
- Adequate cardiac function: left ventricular ejection fraction (LVEF) ≥ 50% (isotopic or ultrasound methods),
- International Normalized Ratio (INR) or Prothrombin Time (PT) ≤ 1.5 ULN AND normal TCA unless subject is receiving anticoagulant therapy, as long as PT or TCA is within therapeutic range of intended use of the anticoagulants,
- Female subjects of childbearing potential should be willing to use 2 methods of birth control or be surgically sterile, or abstain from heterosexual activity for the course of the study through 120 days after the last dose of study medication. Subjects of child bearing potential are those who have not been surgically sterilized or have not been free from menses for >1 year. Note: Abstinence is acceptable if this is the established and preferred contraception for the subject,
- Female subject of childbearing potential should have a negative urine or serum preg-nancy within 72 hours prior to receiving the first dose of study medication. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required,
- Male subjects should agree to use an adequate method of contraception starting with the first dose of study therapy through 120 days after the last dose of study therapy.

Critères de non-inclusion : - Has metastatic breast cancer,
- Has HER2-positive breast cancer,
- 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 systemic steroid therapy 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),
- Hypersensitivity to pembrolizumab or any of its excipients,
- If subject received major surgery, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting therapy,
- Has a known additional malignancy that progressed or required treatment in the last 5 years, Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer,
- Has active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (eg. thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment,
- Has history of/active pneumonitis requiring treatment with steroids or has history of/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 pre-screening or screening visit through 120 days after the last dose of trial treatment,
- Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent,
- Has a known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies),
- Has known active Hepatitis B (e.g., HBs Ag reactive) or Hepatitis C (e.g., HCV RNA [qualitative] is detected),
- Has received a live vaccine within 30 days of planned start of study therapy.
Informations relatives au promoteur
Promoteur :
Type de sponsor : Institutionnel
13009 MARSEILLE 09

Coordonnateur :
Centre investigateur
Informations relatives aux investigateurs
Centre investigateur :
Centre Henri Becquerel - Rue d'Amiens CS 11516 - Cedex 1 - 76000 ROUEN

Investigateur :


Statut de l'essai : OUVERT

MAJ : 01/08/2019