Allogenic Haematopoietic Cell Transplantation Using a Non-myeloablative Preparative Regimen of Total Lymphoid Irradiation and Anti-Thymocyte Globulin for Patients With Refractory "Triple Negative" Breast Cancer
Breast cancer (BC) is the most common cancer among women and approximately 45% of breast
cancer patients develop metastatic disease that generally remains incurable with a median
survival of approximately 18 to 24 months. A subpopulation emerging as having particularly
poor prognosis is patients who have disease that is receptor negative for oestrogen,
progestin and HER2/neu (triple receptor negative). Since no effective therapy is available
in this setting of patients, the investigators propose allogeneic haematopoietic cell
transplantation.
Recent advances in allogeneic haematopoietic cell transplantation (HCT) have led to reduced
intensity preparative regimens that are non-myeloablative and permit the development of
sustained donor chimerism. As a result, regimen related organ toxicities (RROT), and
consequently non-relapse mortality has been reduced. However, the incidence of acute and
chronic graft-versus-host disease (aGVHD and cGVHD, respectively) has remained a major
complication. Pre-clinical data, developed by the Stanford group, established that
nonmyeloablative conditioning with total lymphoid irradiation (TLI) combined with depletive
anti-T cell antibodies protects against GVHD by skewing peripheral T cell subsets to favour
suppressive regulatory T cells. The current proposal is a Phase II study evaluating safety
and activity of the allogeneic peripheral blood progenitor cell (PBPC) transplantation using
TLI/ATG conditioning regimen, the kinetics of donor haematopoietic cell engraftment and
chimerism, the incidence and severity of acute GVHD following allogeneic transplantation
using the novel preparative regimen of TLI combined with antithymocyte globulin (ATG).
Patients with triple negative breast cancer will be considered for transplantation using
donor grafts from HLA-matched related donors. The preparative regimen of TLI combined with
ATG is expected to result in high levels of sustained donor haematopoietic cell engraftment
with a significantly reduced incidence of acute GVHD.
Interventional
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Response to treatment according to RECIST criteria
Response to treatment according to RECIST criteria evaluated after 90 days from baseline
90 after the baseline
No
Rocco Pastano, MD
Principal Investigator
European Institute of Oncology
Italy: Ethics Committee
IEO S438/508
NCT01375023
June 2009
December 2013
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