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HER2-positive Breast CancerPhase 1/2PRE-ISPYNCT05868226

PRE-ISPY Phase I/II Oncology Platform Program

A Phase 1/2 study testing ALX148, Fam-Trastuzumab Deruxtecan-Nxki and Zanidatamab in people with HER2-positive Breast Cancer and Metastatic Cancer, run by QuantumLeap Healthcare Collaborative at 10 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

PRE-ISPY Phase I/II (I-SPY-P1) is an open-label, multisite platform study with multiple ongoing drug regimen arms added by protocol amendment which is designed to evaluate single agents or combinations in locally advanced, incurable, or metastatic solid tumors and/or oligometastatic malignancy and/or a high risk of… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
ALX148, Fam-Trastuzumab Deruxtecan-Nxki and Zanidatamab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
280 participants
Where
10 sitesUnited States
Study dates
15 Feb 2023to 30 Dec 2031
Phase
Phase 1/2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

General Inclusion Criteria (GIC):

  • GIC1: The participant must have ability to understand and willingness to provide signed written informed consent prior to any study related assessments and procedures and for collection of archival FFPE blocks for research. If FFPE blocks cannot be submitted, 20 to 40 freshly cut FFPE tissue slices (4 to 7 microns thick each) from a representative FFPE block, mounted on charged glass slides and left unstained will be acceptable. This criteria can be modified in specific drug regimens.
  • GIC2: Age ≥ 18 years at the time of signing the informed consent
  • GIC3: Gender: Male or female (premenopausal and postmenopausal)
  • GIC4: ECOG performance status Grade 0-2. This criteria can be modified in specific drug regimens.
  • GIC5: Estimated life expectancy > 12 weeks at the start of investigational medicinal product (IMP) treatment.
  • GIC6: Adequate organ function, evidenced by the following laboratory results within 30 days of the start of IMP:
  • Absolute neutrophil count ≥ 1,500/mm3
  • Platelet count ≥ 100,000/mm3
  • Hemoglobin ≥ 9.0 g/dL with no blood transfusion in the past 28 days
  • Total bilirubin ≤ 1.5 x the upper limit of normal (ULN)
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3.0 x ULN
  • Estimated Creatinine clearance (using Cockcroft-Gault formula) ≥ 60 mL/min for small molecules and >30 mL/min for monoclonal antibodies unless otherwise specified in the Arm Specific Eligibility.

These cut-off values may be modified with supporting data for specific drug regimens.

  • GIC7: Non-Pregnant: Serum or urine pregnancy test must be negative within 14 days of IMP treatment start in women of childbearing potential. Pregnancy testing does not need to be pursued in patients who are judged as postmenopausal before enrollment, or who have undergone bilateral oophorectomy, total hysterectomy, or bilateral tubal ligation. If male, they must agree to refrain from donating sperm during treatment.
  • GIC8: Contraception: Women of childbearing potential and men must be willing to use adequate contraception for the duration of protocol treatment. Additional information regarding contraception for the specific treatment arm will be added to the drug arm description. Adequate contraception is defined as one highly effective form (i.e., abstinence, (fe)male sterilization) OR two effective forms (e.g., non-hormonal IUD and condom / occlusive cap with spermicidal foam / gel / film / cream / suppository).
  • GIC9: Prior therapy effects: Resolution of all acute toxic effects of prior therapy, including radiotherapy, to grade ≤1 and neuropathy to grade ≤2 (except toxicities not considered a safety risk for the patient) and recovery from surgical procedures.
  • GIC10: Participant compliance: Patients who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.
  • Additional arm specific inclusion criteria as needed by drug arm regimen

General Exclusion Criteria (GEC):

  • GEC1: Wash out periods: Other anticancer therapy within the following period:
  • chemotherapy or investigational agents, 3 weeks
  • mitomycin C and nitrosoureas, 6 weeks
  • if radiotherapy is less than 5 days, 1 week wash out; if >5 days, then 2 weeks washout
  • for radionuclides, contact Study PI or Study Chaperone to determine washout
  • targeted therapy, 2 weeks
  • MAbs, ADCs, and immunotherapy, 3 weeks
  • endocrine therapy, no washout needed
  • GEC2: Concurrent therapy with other Investigational Products.
  • GEC3: Prior history of drug/regimen hypersensitivity: History of infusion-related reactions and/or hypersensitivity to IMP or excipients of the study drug/drugs which led to permanent discontinuation of the treatment.
  • GEC4: Uncontrolled intercurrent illness including active infection, diabetes, adrenal insufficiency, pulmonary embolism, stroke in the past 6 months, or psychiatric illness/social situations that would limit compliance with study requirements.
  • GEC5: Cardiovascular disease: History (within 6 months prior to start IMP) of clinically significant cardiovascular disease such as unstable angina, congestive heart failure (CHF), myocardial infarction, uncontrolled hypertension, cardiac arrhythmia requiring medication, or baseline corrected QT by Fridericia's formula (QTcF) length > 470 msec for men and women. The QTcF cut-off value may be modified with supporting data for specific drug regimens.
  • GEC6: CNS tumoral spread: Active uncontrolled/symptomatic central nervous system cancer/spinal cord compression. Previously treated and clinically stable lesions, as per Investigator's judgment, are permitted. Exception: Newly discovered asymptomatic lesions that are not life threatening and do not require urgent local treatment to ensure patient safety, including new parenchymal lesions or leptomeningeal disease, if the treating physician determines that immediate CNS specific treatment is not required and is unlikely to be required during the first cycle of therapy, after consultation with study regimen chaperones, may be permitted. This criteria can be modified in specific drug regimens.
  • GEC7: Liver disease: Patients with clinically significant history of liver disease, including viral or other known hepatitis, current alcohol abuse, or cirrhosis.
  • GEC8: Recent major surgery within 4 weeks prior to start IMP treatment
  • GEC9: Pregnancy or breastfeeding
  • GEC10: Individuals accommodated in an institution because of regulatory or legal order; prisoners or participants who are legally institutionalized.
  • GEC11: Other conditions, which in the opinion of the investigator, would compromise the safety of the patient or the patient's ability to complete the study.
  • GEC12: Concomitant malignancies: A diagnosis of a malignancy in the 2 years prior to starting study treatment other than the disease under study. Exceptions include indolent or definitively treated malignancy not expected to require treatment during the study, affect the safety of participants, or affect the endpoints of the trial.
  • Additional arm specific exclusion criteria as needed by drug arm regimen

Trial locations and contacts

10 sites in 1 country. Contact the study team or a site near you to ask about taking part.

10 sites in 1 country

United States10 sites, 7 recruiting
  • University of Colorado Cancer Center

    Aurora, Colorado, 80045

    Active, not recruiting
  • The University of Alabama at Birmingham O'Neal Comprehensive Cancer Center

    Birmingham, Alabama, 35233

    Anethea Tolliver, 205-644-9896, anetheatolliver@uabmc.edu

    Lindsey M Waldheim, lwaldheim@uabmc.edu

    Recruiting
  • The University of Chicago Medicine Comprehensive Cancer Center

    Chicago, Illinois, 60637

    Clara Duarte, 773-834-5727, vqq5698@bsd.uchicago.edu

    Nan Chen, MD

    Recruiting
  • The University of Texas MD Anderson Cancer Center

    Houston, Texas, 77030

    Active, not recruiting
  • University of Minnesota Masonic Cancer Center

    Minneapolis, Minnesota, 55455

    Katie Vaughn, RN, 612-624-6968, schro811@umn.edu

    Erin Rogers, roge0507@umn.edu

    Recruiting
  • UChicago Medicine Comprehensive Cancer Center at Silver Cross Hospital

    New Lenox, Illinois, 60451

    Clara Duarte, 773-834-5727, vqq5698@bsd.uchicago.edu

    Nan Chen, MD

    Recruiting
  • UChicago Medicine Orland Park

    Orland Park, Illinois, 60462

    Clara Duarte, 773-834-5727, vqq5698@bsd.uchicago.edu

    Nan Chen, MD

    Recruiting
  • Mayo Clinic Comprehensive Cancer Center

    Phoenix, Arizona, 85054

    Clinical Trials Referral Office, 855-776-0015, mayocliniccancerstudies@mayo.edu

    Lida Mina, MD

    Not yet recruiting
  • Mayo Clinic Comprehensive Cancer Center

    Rochester, Minnesota, 55905

    Clinical Trials Referral Office, 855-776-0015, mayocliniccancerstudies@mayo.edu

    Roberto A Leon-Ferre, MD

    Not yet recruiting
  • Moffitt Cancer Center

    Tampa, Florida, 33612

    Active, not recruiting

Other trials in United States

About this study

Official title: PRE-Investigation of Serial Studies to Predict Your Therapeutic Response With Imaging And moLecular Analysis: A Phase I/II Platform Trial

PRE-ISPY Phase I/II (I-SPY-P1) is an open-label, multisite platform study with multiple ongoing drug regimen arms added by protocol amendment which is designed to evaluate single agents or combinations in locally advanced, incurable, or metastatic solid tumors and/or oligometastatic malignancy and/or a high risk of recurrence following prior treatment with curative intent. The overall goal is moving promising drug regimens into a larger phase II (or III) trial and in general could feed the neoadjuvant breast I-SPY 2 Trial (NCT01042379) and/or other oncology solid tumor trial in a timely manner.

Read the detailed description

The PRE-ISPY/I-SPY-P1 study is a platform trial with multiple ongoing drug regimen arms. Each drug regimen arm may have a Phase I dose-finding group (Part 1), a dose-expansion group (Part 2), and/or a Phase II component. Participant eligibility may vary according to the investigational arm or the part within the study arm, including with respect to diagnosis. Arms may restrict enrollment to a certain molecular pathway abnormality or histologic diagnosis (e.g. metastatic TNBC or MRD CRC). The trial allows for various study arm designs, with the goal to complete analysis of a study arm in 12 to 18 months.

Being tested
ALX148, Fam-Trastuzumab Deruxtecan-Nxki, Zanidatamab, Tucatinib, TTX-MC138
Keywords
I-SPY Trials, Quantum Leap Healthcare Collaborative, QLHC, I-SPY, I-SPY2, I-SPY1, PRE-ISPY, PRE-I-SPY, I-SPY Phase 1, I-SPY Phase 1b, I-SPY-P1, ISPY, ISPYP1, I-SPY Phase 1 Platform, ISPY2, ISPY1, Phase 1 Platform, Phase 1 Oncology Platform, T-DXd naive, PRE1
Medical subject headings
Neoplasm Metastasis, Breast Neoplasms, Triple Negative Breast Neoplasms, Neoplasm, Residual, Colonic Neoplasms, Rectal Neoplasms, Colorectal Neoplasms, Adenocarcinoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ALX148Drug

    Also called Evorpacept

    Starting dose Dose Level 1 30mg/kg IV Q3W; Dose Level Minus 1 20 mg/kg IV Q3W (if needed); Dose Level 2 45 mg/kg IV Q3W;

  • Fam-Trastuzumab Deruxtecan-NxkiDrug

    Also called Enhertu, T-DXd

    5.4 mg/kg IV Q3W; allowed to dose reduce after DLT observation period

  • ZanidatamabDrug

    Also called ZW25, zani, Ziihera

    20 mg/kg IV Q2W on Day 1 and Day 15 of each 28 day cycle

  • TucatinibDrug

    Also called TUKYSA

    Dose Level 1: 300 mg PO BID daily; Dose Leve Minus 1: 250 mg PO BID daily

  • TTX-MC138Drug

    4.8 mg/kg Q4W IV on Day 1 for up to 12 cycles as interception therapy

Study groups in NCT05868226
Study groupRoleWhat they receive
PRE1 ALX148 (Evorpacept) + Fam-Trastuzumab Deruxtecan-Nxki (T-DXd, Enhertu®)ExperimentalThe combination of T-DXd and ALX148 aims to explore the anti-tumoral effects of trastuzumab, of the topoisomerase inhibitor DXd and of the CD47-blocking agent ALX148. The rationale for this combination is that ALX148 is hypothesized, based on preclinical data, to facilitate antibody-dependent cellular phagocytosis (ADCP) of HER2 expressing (>HER2 1+) breast cancer binding T-DXd while cancer cell intrinsic or bystander cytotoxicity of T-DXd will result in the release of neoantigens promoting immune mediated antitumor activity in the tumor microenvironment.
Receives: Drug: ALX148; Drug: Fam-Trastuzumab Deruxtecan-Nxki
PRE2 Zanidatamab (Ziihera®, ZW25, zani) + Tucatinib (TUKYSA®)ExperimentalZanidatamab is a bispecific IgG1-like antibody directed against two distinct HER2 epitopes. It induces formation of receptor clusters and internalization resulting in downregulation. It also inhibits growth factor-dependent and -independent tumor cell proliferation and potently activates ADCC, ADCP, and CDC. FDA approved for metastatic HER2+ bile duct cancer. Tucatinib is a highly selective, small molecule tyrosine kinase inhibitor (TKI) of HER2 compared to other TKI's (i.e., EGFR). It is well tolerated, crosses the blood brain barrier and can treat CNS disease. FDA approved for HER2+ breast cancer. Given the promising clinical data for each of these drugs which have different mechanisms, the effect of zanidatamab after T-DXd (Enhertu®) in breast cancer patients, and the favorable toxicity profile of both drugs, we hypothesize that the combination of tucatinib and zanidatamab will be well tolerated and more efficacious than either drug alone for the treatment of HER2+ breast cancer.
Receives: Drug: Zanidatamab; Drug: Tucatinib
PRE4 TTX-MC138ExperimentalTTX-MC138 is an antisense oligonucleotide targeting miR-10b. MicroRNA-10b (miR-10b) was identified in metastatic cell lines and tumors from participants with metastatic breast cancer and has been shown to regulate the ability of metastatic tumor cells to survive outside of the primary tumor and to migrate and invade surrounding tissue. miRNA-10b is critical to tumor growth and is a master regulator of metastatic cell viability in a range of cancers, including breast, pancreatic, ovarian, colon cancer, glioblast. This is a PRE-ISPY PHASE II study of TTX-MC138 as interception treatment in patients with Stage I-III adenocarcinoma of the colon or rectum (Cohort A) who have documented minimal residual disease by tumor informed ctDNA, that was collected following completion of standard therapy with curative intent.
Receives: Drug: TTX-MC138

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incidence of Adverse Events related to the treatment

    Evaluate the number of adverse events related to the treatment according to the current version of CTCAE during the trial.

    Measured: Start of treatment to 30 days post treatment (estimated 12 -18 months)

  2. For Phase Ib Part 1 study design: Incidence of Dose Limiting Toxicities (DLTs) at each dose level

    To determine the safety and tolerability of new agents/regimens in participants with certain advanced solid tumors and breast cancer. DLT rate (number of participants who experience a protocol defined DLT/total number of DLT cohort participants at that dose).

    Measured: DLT observation period: Start of treatment to end of Cycle 1

  3. For select drug arms, Maximum Tolerated Dose (MTD)

    The maximum dose level (mg/kg) which is not eliminated.

    Measured: Start of treatment to the date of last participant at end of DLT observation period at highest dose level (estimated 6 months)

  4. For Phase Ib Part 1 drug arms, Recommended Phase 2 Dose (RP2D)

    Using all available data, computation of RP2D (mg/kg), which may not be the MTD.

    Measured: Start of treatment to the date of last participant at highest dose level (estimated 6 months)

  5. Overall Response Rate (ORR)

    To obtain preliminary efficacy data of the new agents/regimens in participants with certain advanced solid tumors and breast cancer.

    Measured: Start of treatment to 12 months

  6. Duration of Response (DOR)

    To obtain preliminary efficacy data of the new agents/regimens in participants with certain advanced solid tumors and breast cancer.

    Measured: Start of treatment to 12 months

Secondary outcomes (2)
  1. Progression Free Survival (PFS) - descriptive

    To provide descriptive assessment of Progression Free Survival (PFS) of the new agents/regimens with certain advanced solid tumors and breast cancer

    Measured: Start of treatment to 12 months

  2. Clinical Benefit Rate (CBR) at 6 months

    To obtain preliminary Clinical Benefit Rate (CBR) at 6 months of participants treated with the new agents/regimens.

    Measured: Start of treatment to 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 May 2023
  2. Study start15 Feb 2023
  3. Primary completion30 Dec 2030 (estimated)
  4. Study completion30 Dec 2031 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
This is an open-label, multi-site, multi-arm platform study, where each drug regimen arm may have different study designs and eligibility. In particular, dose finding parts may employ different designs (e.g., 3+3, Bayesian Optimal Interval Design \[BOIN\], continual reassessment method \[CRM\], etc.) for each arm in the PRE-I-SPY program. See each arm for specific study model details.
Masking
None (open label)
Enrolment
280 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05868226
Sponsor's protocol ID
I-SPY-P1
Acronym
PRE-ISPY
Status last verified
Sep 2026
First submitted
22 Apr 2022
Last updated
30 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing ALX148, Fam-Trastuzumab Deruxtecan-Nxki and Zanidatamab in people with HER2-positive Breast Cancer and Metastatic Cancer, run by QuantumLeap Healthcare Collaborative at 10 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 30 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 10 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Smita M Asare ((855) 866-0505 ext. 104, smita.asare@qlhc.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of Adverse Events related to the treatment (time frame: Start of treatment to 30 days post treatment (estimated 12 -18 months)). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Sep 2026.

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