A Phase II Double-Blinded, Randomized, Placebo-Controlled Study of Docetaxel in Combination With 1-methyl-D-tryptophan (Indoximod) in Metastatic Breast Cancer
It is estimated that 230,480 US women will be diagnosed with and 39,520 women will die of
breast cancer in 2011. Metastatic breast cancer is a terminal condition and treatments are
palliative in nature. The median survival for patients with metastatic breast cancer is
approximately 2.5 years. The standard therapies currently in use include anti-estrogen
therapies (anastrazole, letrozole, fulvestrant, tamoxifen), chemotherapy agents (taxanes,
capecitabine, navelbine, gemcitabine, eribulin, ixabepilone), targeted therapies
(trastuzumab, lapatinib), and supportive care agents (zolendronic acid, denosumab). While
breast cancer typically responds well to treatment, the response is transient and their
disease becomes more refractory with continued therapy. Also, quality of life is a
significant issue for these patients as many of these therapies are associated with
significant side effects. Well tolerated, novel agents which improve the efficacy of
existing chemotherapy agents would prove quite useful in managing metastatic breast cancer.
Preclinical data derived from MMTV-Neu mice with autochthonous tumors studied the
interaction between indoximod and various chemotherapeutic agents. Mice with 5-10mm tumors
were enrolled into control and treatment groups. Mice were treated with indoximod alone,
chemotherapy alone (paclitaxel, doxorubicin, cyclophosphamide, and others), and the
combination of indoximod and chemotherapy. treatment with indoximod or paclitaxel alone
caused retardation of tumor growth in this model but no regressions were seen. the
combination of indoximod plus paclitaxel caused 30% tumor regression and histologically
there was significantly enhanced tumor cell death with the combination versus either agent
alone. This synergism was abrogated when the mice underwent CD4+ T cell depletion prior to
treatment with the combination, suggesting the immune response played a role in the observed
effect. Based on this data and other reports suggesting systemic immunomodulating drugs like
indoximod can synergize with chemotherapy agents such as taxanes, the decision was made to
devise this combination of therapy of docetaxel with indoximod in metastatic breast cancer.
Interventional
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
Progression Free Survival
The primary objective of this phase 2 study is the progression free survival of docetaxel in combination with indoximod compared to docetaxel plus placebo in metastatic breast cancer.
12 months
No
Nicholas Vahanian, MD
Study Director
NewLink Genetics Corporation
United States: Food and Drug Administration
NLG2101
NCT01792050
February 2013
January 2015
Name | Location |
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H. Lee Moffitt Cancer Center and Research Institute | Tampa, Florida 33612 |