Anatomic Stage IV Breast Cancer AJCC v8Phase 2NCT06860815
Cemiplimab and Transarterial Radioembolization With Y-90 SIR-S Spheres for the Treatment of Liver Directed Metastatic Breast Cancer
A Phase 2 study testing Biopsy, Biospecimen Collection and Cemiplimab in people with Anatomic Stage IV Breast Cancer AJCC v8 and Metastatic Breast Carcinoma, run by City of Hope Medical Center at 1 site in United States.
Trial summary
This phase II trial tests how well cemiplimab and transarterial radioembolization (TARE) with yttrium-90 (Y90) SIR-Spheres, registered trademark, works in treating breast cancer that has spread from where it first started (primary site) to the liver (metastatic). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Anatomic Stage IV Breast Cancer AJCC v8, Metastatic Breast Carcinoma, Metastatic Carcinoma in the Liver
- What is being tested?
- Biopsy, Biospecimen Collection and Cemiplimab
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 11 participants
- Where
- 1 siteUnited States
- Study dates
- 30 Jan 2026to 30 Jan 2027
- Phase
- Phase 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
Who may be able to join
- Documented informed consent of the participant and/or legally authorized representative.
- Assent, when appropriate, will be obtained per institutional guidelines
- Agreement to allow the use of archival tissue from diagnostic tumor biopsies
- If unavailable, exceptions may be granted with study principal investigator (PI) approval
- Age: ≥ 18 years
- Eastern Cooperative Oncology Group (ECOG) 0-1
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- Must have a life expectancy of at least 12 weeks
- Evidence of post-menopausal status or negative urinary or serum pregnancy test for female pre-menopausal patients. Women will be considered post-menopausal if they have been amenorrheic for 12 months without an alternative medical cause. The following age-specific requirements apply:
- Women < 50 years of age would be considered post-menopausal if they have been amenorrheic for 12 months or more following cessation of exogenous hormonal treatments and if they have luteinizing hormone and follicle-stimulating hormone levels in the post-menopausal range for the institution or underwent surgical sterilization (bilateral oophorectomy or hysterectomy)
- Women ≥ 50 years of age would be considered post-menopausal if they have been amenorrheic for 12 months or more following cessation of all exogenous hormonal treatments, had radiation-induced menopause with last menses > 1 year ago, had chemotherapy-induced menopause with last menses > 1 year ago, or underwent surgical sterilization (bilateral oophorectomy, bilateral salpingectomy, or hysterectomy)
- Male patients must be surgically sterile, or if sexually active and having a pre-menopausal female partner then must be using an acceptable form of contraception
- Patients with metastatic breast cancer, previously treated with ≥ 1 line of chemotherapy in metastatic setting
- Candidate for TARE based on evaluation by board certified interventional radiologist; must have measurable metastatic liver disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as outlined in RECIST version 1.1; not all liver tumors will be treated with TARE in a single session
- Liver tumor burden < 50%
- No radiographic or clinical evidence of cirrhosis
- Other treated stable metastases are allowed, including treated stable brain metastases
- Fully recovered from the acute toxic effects (except alopecia) to ≤ grade 1 to prior anti-cancer therapy
- Body weight > 30 kg
- No untreated, active hepatitis
- Hemoglobin ≥ 9.0 g/dL (within 14 days prior to day 1 of protocol therapy unless otherwise stated)
- Absolute neutrophil count (ANC) ≥ 1500/uL (within 14 days prior to day 1 of protocol therapy unless otherwise stated)
- Platelet count ≥ 75000/uL (within 14 days prior to day 1 of protocol therapy unless otherwise stated)
- Total bilirubin < 2.0mg/dL (within 14 days prior to day 1 of protocol therapy unless otherwise stated)
- Aspartate aminotransferase (AST/serum glutamic oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT/serum glutamic pyruvic transaminase [SGPT]) ≤ 5 x upper limit of normal (ULN) (within 14 days prior to day 1 of protocol therapy unless otherwise stated)
- Albumin ≥ 2.8 g/dL (within 14 days prior to day 1 of protocol therapy unless otherwise stated)
- International normalized ration (INR) ≤ 1.6 (within 14 days prior to day 1 of protocol therapy unless otherwise stated)
- Measured creatinine clearance (CL) > 40 mL/min or calculated creatinine CL > 40 mL/min by the Cockcroft-Gault formula (Cockcroft and Gault 1976) or by 24-hour urine collection for determination of creatinine clearance (within 14 days prior to day 1 of protocol therapy unless otherwise stated)
Who cannot join
- Prior immunotherapy in the past 12 months
- Progressing or untreated extra-hepatic metastatic disease
- Autoimmune disease requiring therapy; immunodeficiency, or any disease process requiring immunosuppressive therapy
- Any other condition that would, in the investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns with clinical study procedures
- Portal vein invasion
- Evidence of diffuse metastatic disease (tumor burden occupying > 50% of liver)
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- Major surgical procedure (as defined by the investigator) within 28 days prior to radioembolization. Note: Local surgery of isolated lesions for palliative intent is acceptable
- Participation in another clinical study with an investigational product during the last 4 weeks
- Concurrent enrollment in another clinical study, unless it is an observational (non-interventional) clinical study or during the follow-up period of an interventional study
- Receipt of the last dose of anticancer therapy (chemotherapy, immunotherapy, endocrine therapy, targeted therapy, biologic therapy, tumor embolization, monoclonal antibodies) ≤ 28 days prior to the first dose of study drug. If sufficient wash-out time has not occurred due to the schedule or pharmacokinetics (PK) properties of an agent, a longer wash-out period will be required, as agreed by Regeneron and the investigator
- Prior exposure to anti-PD-1/PD-L1 inhibitor or anti-CTLA4 inhibitor, including cemiplimab in the past 12 months
- Any unresolved toxicity National Cancer Institute (NCI) CTCAE grade ≥ 2 from previous anticancer therapy with the exception of alopecia, vitiligo, and the laboratory values defined in the inclusion criteria
- Patients with grade ≥ 2 neuropathy will be evaluated on a case-by-case basis after consultation with the study physician
- Patients with irreversible toxicity not reasonably expected to be exacerbated by treatment with cemiplimab may be included only after consultation with the study physician
- Active or prior documented autoimmune or inflammatory disorders (including inflammatory bowel disease [e.g., colitis or Crohn's disease], diverticulitis [with the exception of diverticulosis], systemic lupus erythematosus, sarcoidosis syndrome, or Wegener syndrome [granulomatosis with polyangiitis, Graves disease, rheumatoid arthritis, hypophysitis, uveitis, etc.]). The following are exceptions to this criterion: Patients with vitiligo or alopecia; patients with hypothyroidism (e.g., following Hashimoto syndrome) stable on hormone replacement; any chronic skin condition that does not require systemic therapy; patients without active disease in the last 5 years may be included but only after consultation with the study physician; patients with celiac disease that is controlled by diet alone
- History of allogeneic organ transplantation
- Expected radiation lung dose of > 30Gy
- Uncontrolled intercurrent illness, including but not limited to, ongoing or active infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris, cardiac arrhythmia, interstitial lung disease, serious chronic gastrointestinal conditions associated with diarrhea, or psychiatric illness/social situations that would limit compliance with study requirement, substantially increase risk of incurring adverse events (AEs) or compromise the ability of the patient to give written informed consent
- History of another primary malignancy except for:
- Malignancy treated with curative intent and with no known active disease ≥ 5 years before the first dose of study treatment and of low potential risk for recurrence
- Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease
- Adequately treated carcinoma in situ without evidence of disease
- History of active primary immunodeficiency or acquired human immunodeficiency virus (HIV/AIDS)
- Receipt of live attenuated vaccine within 30 days prior to the first dose of study treatment. Note: Patients, if enrolled, should not receive live vaccine whilst receiving study treatment and up to 30 days after the last dose of study treatment
- Active systemic infection including tuberculosis (clinical evaluation that includes clinical history, physical examination and radiographic findings, and tuberculosis (TB) testing in line with local practice. Use of antibiotics to treat superficial infection or contamination of tumor shall not, by itself, be considered evidence of infection
- History of leptomeningeal carcinomatosis
- Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients
- Any concurrent chemotherapy, intraperitoneal (IP), biologic, or hormonal therapy for cancer treatment. Concurrent use of hormonal therapy for non-cancer-related conditions (e.g., hormone replacement therapy) is acceptable
- Current or prior use of immunosuppressive medication within 14 days before the first dose of cemiplimab. The following are exceptions to this criterion: Intranasal, inhaled, topical steroid or local steroid injections (e.g., intra articular injection); systemic corticosteroids at physiologic doses not to exceed 10 mg/day of prednisone or its equivalent; steroids as premedication for hypersensitivity reactions (e.g., CT scan premedication)
- Female patients who are pregnant or breastfeeding or male or female patients of reproductive potential who are not willing to employ effective birth control from screening to 120 days (4 months) after the last dose of cemiplimab therapy or 120 days (4 months) days after the last TARE, whichever is longer
- Female subjects, unless postmenopausal or surgically sterile, unwillingness to practice effective contraception, as per investigator discretion during the study. The rhythm method is not to be used as the sole method of contraception
- Male subjects, unwillingness to practice effective contraception (per Investigator discretion) while taking part in this study, because the effects of the SIR-Spheres treatment on sperm or upon the development of an unborn child are unknown
- Inability or unwillingness to understand or sign a written informed consent document
- Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics)
- Presence of cardiovascular disease, as defined by:
- New York Heart Association heart failure classifications of class II, III, or IV; or myocardial infarction, or acute coronary syndrome within 12 months of first dose of study medication; or
- Transient ischemic attack or stroke within 1 year
- Any condition that requires ongoing/continuous corticosteroid therapy (> 10 mg prednisone/day or anti-inflammatory equivalent) within 1 week prior to the first dose of study medication. Participants who require a brief course of steroids (up to 2 days in the week before enrollment) or physiologic replacement are not excluded
- Ongoing or recent evidence of significant autoimmune disease that required treatment with systemic immunosuppressive treatments
- Note: The following are not exclusionary: vitiligo, childhood asthma that has resolved, endocrinopathies (such as hypothyroidism or type 1 diabetes) that require only hormone replacement, or psoriasis that does not require systemic treatment
- Any infection requiring hospitalization or treatment with IV anti-infectives within 2 weeks of first dose of study medication
- Uncontrolled infection with HIV, hepatitis B or hepatitis C infection, diagnosis of immunodeficiency, and/or tuberculosis (active or latent)
- Participants with known controlled HIV infection (undetectable viral load on HIV ribonucleic acid [RNA] polymerase chain reaction [PCR]) and CD4 count above 350 either spontaneously or on a stable antiviral regimen are eligible. For these participants monitoring will be performed per local standards
- Participants with hepatitis B surface antigen (HBsAg) positive who have controlled infection (serum hepatitis B virus [HBV] deoxyribonucleic acid [DNA] PCR that is below the limit of detection and receiving anti-viral therapy for hepatitis B) are eligible. Participants with controlled infections must undergo periodic monitoring of HBV DNA. Participants must remain on anti-viral therapy for at least 6 months beyond the last dose of investigational study medication
- Participants with HBsAg negative but total hepatitis B core antibody (HBcAb) positive are permitted with the following requirements: If serum HBV DNA PCR is above the limit of detection at screening, initiate HBV antiviral therapy before study entry. If serum HBV DNA PCR is below the limit of detection, periodic monitoring of HBsAg must be performed
- Participants who are hepatitis C virus (HCV) antibody positive (Ab+) who have controlled infection (undetectable HCV RNA by PCR either spontaneously or in response to a successful prior course of anti-HCV therapy) are eligible
- Receipt of a live vaccine within 4 weeks of start of study medication
- Receipt of COVID-19 vaccination within 1 week of planned start of study medication or for which the planned COVID-19 vaccinations would not be completed 1 week prior to start of study medication
- Known hypersensitivity to the active substances or to any of the excipients
- Women of childbearing potential (WOCBP) and men who are unwilling to practice highly effective contraception prior to the initial dose/start of the first treatment, during the study, and for at least 6 months after the last dose. Highly effective contraceptive measures include:
- Stable use of combined (estrogen and progestogen containing) hormonal contraception (oral, intravaginal, transdermal) or progestogen-only hormonal contraception (oral, injectable, implantable) associated with inhibition of ovulation initiated 2 or more menstrual cycles prior to screening;
- Intrauterine device; intrauterine hormone-releasing system;
- Bilateral tubal occlusion/ligation;
- Vasectomized partner (provided that the male vasectomized partner is the sole sexual partner of the WOCBP study participant and that the vasectomized partner has obtained medical assessment of surgical success for the procedure); and/or
- Sexual abstinence
- Pregnancy testing and contraception are required for WOCBP. Pregnancy testing and contraception are not required for women who are postmenopausal or permanently sterile
- WOCBP are defined as women who are fertile following menarche until becoming postmenopausal, unless permanently sterile. Permanent sterilization methods include hysterectomy, bilateral salpingectomy, and bilateral oophorectomy
- A postmenopausal state is defined as no menses for 12 months without an alternative medical cause. A high follicle-stimulating hormone (FSH) level in the postmenopausal range may be used to confirm a postmenopausal state in women not using hormonal contraception or hormonal replacement therapy. However, in the absence of 12 months of amenorrhea, a single FSH measurement is insufficient to determine the occurrence of a postmenopausal state. The above definitions are according to the Clinical Trials Facilitation and Coordination Group (CTFG) guidance. Pregnancy testing and contraception are not required for women with documents hysterectomy or tubal ligation
- Male participants: A male participant will be excluded from the study if that participant does not agree to use condoms or practice sexual abstinence, unless vasectomized, prior to the initial dose/start of study medication, during the study, and for at least 6 months after the last dose. Sperm donation is also prohibited during the same period. Vasectomy success must be confirmed by semen analysis
- Sexual abstinence is considered a highly effective method only if defined as refraining from heterosexual intercourse during the entire period of risk associated with the study drugs. The reliability of sexual abstinence needs to be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the participant
- Periodic abstinence (calendar, symptothermal, post-ovulation methods), withdrawal (coitus interruptus), spermicides only, and lactational amenorrhea method are not acceptable methods of contraception. Female condom and male condom should not be used together
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site, 1 recruiting
- Recruiting
City of Hope Medical Center
Duarte, California, 91010
Jonathan Kessler, 626-218-8398, jkessler@coh.org
Jonathan Kessler
About this study
Official title: Pilot Study of Cemiplimab and Hepatic Radioembolization in Patients With Liver Dominant Metastatic Breast Cancer
This phase II trial tests how well cemiplimab and transarterial radioembolization (TARE) with yttrium-90 (Y90) SIR-Spheres, registered trademark, works in treating breast cancer that has spread from where it first started (primary site) to the liver (metastatic). Immunotherapy with monoclonal antibodies, such as cemiplimab, may help the body's immune system attack the tumor, and may interfere with the ability of tumor cells to grow and spread. TARE is a treatment that uses radioactive microspheres, such as Y90 SIR-S Spheres, to both cause hepatic artery embolization and to deliver regional radiotherapy. Y90 SIR-S Spheres is an injectable form of the radioisotope yttrium Y 90 encapsulated in resin microspheres. When injected into the artery supplying the tumor, yttrium Y 90 resin microspheres block the tumor blood vessels and deliver the yttrium Y 90 directly to the tumor site, which may kill or slow tumor growth. Giving cemiplimab and Y90 SIR-Spheres by TARE to the tumor in the liver may kill more tumor cells in patients with metastatic breast cancer.
Read the detailed description
PRIMARY OBJECTIVE:
- To describe the effect of cemiplimab and yttrium Y90 resin microspheres (90Y TARE) on immune activation in the treated tumor based on CD8+ T cells.
SECONDARY OBJECTIVES:
- To evaluate other measures of changes (both in treated and untreated lesions after the first TARE treatment) in the tumor microenvironment (TME) of 10 metastatic breast cancer (MBC) patients with liver-dominant disease.
II. To identify systemic immune activation in the peripheral blood. III. To determine the safety and tolerability of cemiplimab and hepatic radioembolization in patients with liver dominant metastatic breast cancer using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 criteria.
IV. To evaluate objective tumor response of the target lesion treated with Y90 by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and modified RECIST (mRECIST).
OUTLINE:
Patients receive cemiplimab intravenously (IV) over 30 minutes on day 1 of each cycle. Cycles repeat every 21 days for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients receive Y90 SIR-Spheres intratumorally via TARE over 60-90 minutes once during days 7-14 and on day 67. Patients also undergo tumor biopsy at baseline and at day 42 after immunotherapy begins. Additionally patients also undergo blood sample collection and computed tomography (CT) or magnetic resonance imaging (MRI) throughout the study.
After completion of study treatment, patients are followed up at 30 days, every 3 months within 1 year of start of treatment, and then every 6 months for up to 2 years.
- Conditions
- Anatomic Stage IV Breast Cancer AJCC v8, Metastatic Breast Carcinoma, Metastatic Carcinoma in the Liver
- Being tested
- Biopsy, Biospecimen Collection, Cemiplimab, Computed Tomography, Magnetic Resonance Imaging
- Medical subject headings
- Breast Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
BiopsyProcedure or surgery
Also called BIOPSY_TYPE, Bx
Undergo tumor biopsy
Biospecimen CollectionProcedure or surgery
Also called Biological Sample Collection, Biospecimen Collected, Specimen Collection
Undergo blood sample collection
CemiplimabBiological
Also called Cemiplimab RWLC, Cemiplimab-rwlc, Libtayo, REGN 2810
Given IV
Computed TomographyProcedure or surgery
Also called CAT, CAT Scan, Computed Axial Tomography, Computerized Axial Tomography
Undergo CT
Magnetic Resonance ImagingProcedure or surgery
Also called Magnetic Resonance, Magnetic Resonance Imaging (MRI), Magnetic resonance imaging (procedure), Magnetic Resonance Imaging Scan
Undergo MRI
Transarterial RadioembolizationRadiation
Also called Hepatic Radioembolization, TARE, Transarterial Hepatic Radioembolization
Undergo TARE
Yttrium Y 90 Resin MicrospheresRadiation
Also called SIR-Spheres, Y-90 Sirsphere
Given intratumorally
| Study group | Role | What they receive |
|---|---|---|
| Treatment (cemiplimab, Y90 SIR-Spheres, TARE) | Experimental | Patients receive cemiplimab IV over 30 minutes on day 1 of each cycle. Cycles repeat every 21 days for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients receive Y90 SIR-Spheres intratumorally via TARE over 60-90 minutes once during days 7-14 and on day 67. Patients also undergo tumor biopsy at baseline and at day 42 after immunotherapy begins. Additionally patients also undergo blood sample collection and CT or MRI throughout the study. Receives: Procedure: Biopsy; Procedure: Biospecimen Collection; Biological: Cemiplimab; Procedure: Computed Tomography; Procedure: Magnetic Resonance Imaging; Radiation: Transarterial Radioembolization; Radiation: Yttrium Y 90 Resin Microspheres |
What is being measured
The primary outcome is the main question the study is designed to answer.
CD8+ T cell infiltration in tumor microenvironment (TME): baseline
Will be analyzed using multiplex immunofluorescence (IF) of formalin-fixed paraffin-embedded (FFPE) tissue. Will estimated the mean and standard deviation of the percent change.
Measured: At baseline
CD8+ T cell infiltration in tumor microenvironment (TME): post TARE -1 (day 21)
Will be analyzed using multiplex immunofluorescence (IF) of formalin-fixed paraffin-embedded (FFPE) tissue. Will estimated the mean and standard deviation of the percent change.
Measured: At Post-transarterial radioembolization TARE -1 (day 21)
CD8+ T cell infiltration in tumor microenvironment (TME): prior to TARE-2 (day 42)
Will be analyzed using multiplex immunofluorescence (IF) of formalin-fixed paraffin-embedded (FFPE) tissue. Will estimated the mean and standard deviation of the percent change.
Measured: At prior to TARE-2 (day 42)
Secondary outcomes (12)
Incidence of adverse events
Will be assessed and graded using National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0.
Measured: Up to 30 days after last dose of study treatment
T cell activation in TME: baseline
Will be analyzed using multiplex IF of FFPE.
Measured: At baseline
T cell activation in TME: post-TARE-1 (day 21)
Will be analyzed using multiplex IF of FFPE.
Measured: At Post-transarterial radioembolization TARE -1 (day 21)
T cell activation in TME: prior to TARE-2 (Day 42)
Will be analyzed using multiplex IF of FFPE.
Measured: At prior to TARE-2 (Day 42)
Dendritic cell activation in TME: baseline
Will be analyzed using multiplex IF of FFPE.
Measured: At baseline
Dendritic cell activation in TME: post-TARE-1 (day 21)
Will be analyzed using multiplex IF of FFPE.
Measured: At Post-transarterial radioembolization TARE -1 (day 21)
Dendritic cell activation in TME: prior to TARE-2 (Day 42)
Will be analyzed using multiplex IF of FFPE.
Measured: At prior to TARE-2 (Day 42)
PD-L1 expression in TME: baseline
Will be analyzed using multiplex IF of FFPE.
Measured: At baseline
PD-L1 expression in TME: post-TARE-1 (day 21)
Will be analyzed using multiplex IF of FFPE.
Measured: At Post-transarterial radioembolization TARE -1 (day 21)
PD-L1 expression in TME: prior to TARE-2 (Day 42)
Will be analyzed using multiplex IF of FFPE.
Measured: At prior to TARE-2 (Day 42)
Immune activation
High parameter flow cytometry of peripheral blood samples used to assess proliferating (Ki-67+) CD8+ T cells, activated Tregs (CTLA-4+, TIGIT+), exhausted CD8+ T cells (PD-1high, CD39+, CD38+), CD8:Treg ratio, and myeloid derived suppressor cells (HLA-DR low monocytes).
Measured: At baseline and post-TARE-1 (day 7-14)
Objective tumor response
Evaluated using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and modified RECIST (mRECIST).
Measured: Up to 2 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Mar 2025
- Study start30 Jan 2026
- Primary completion30 Jan 2027 (estimated)
- Study completion30 Jan 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Anatomic Stage IV Breast Cancer AJCC v8Studies of the same condition, open and under way.
- More trials run by City of Hope Medical CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 11 participants (estimated)
Sponsor and investigators
- Lead sponsor
- City of Hope Medical Center
- Sponsor type
- University, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Jonathan Kessler, Principal investigator, City of Hope Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06860815
- Sponsor's protocol ID
- 23768
- Other IDs
- NCI-2025-00340, 23768, P30CA033572
- Status last verified
- May 2026
- First submitted
- 4 Feb 2025
- Last updated
- 20 May 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 20 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Pilot Study of Cemiplimab and Hepatic Radioembolization in Patients With Liver Dominant Metastatic Breast Cancer
- ClinicalTrials.gov ID
- NCT06860815
- Acronym / sponsor ID
- 23768
- Conditions
- Anatomic Stage IV Breast Cancer AJCC v8, Metastatic Breast Carcinoma, Metastatic Carcinoma in the Liver
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 11 participants (estimated)
- Lead sponsor
- City of Hope Medical CenterUniversity, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Study start
- 30 Jan 2026 (actual)
- Primary completion
- 30 Jan 2027 (estimated)
- Study completion
- 30 Jan 2027 (estimated)
- First posted
- 6 Mar 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This phase II trial tests how well cemiplimab and transarterial radioembolization (TARE) with yttrium-90 (Y90) SIR-Spheres, registered trademark, works in treating breast cancer that has spread from where it first started (primary site) to the liver (metastatic). Immunotherapy with monoclonal antibodies, such as cemiplimab, may help the body's immune system attack the tumor, and may interfere with the ability of tumor cells to grow and spread. TARE is a treatment that uses radioactive microspheres, such as Y90 SIR-S Spheres, to both cause hepatic artery embolization and to deliver regional radiotherapy. Y90 SIR-S Spheres is an injectable form of the radioisotope yttrium Y 90 encapsulated in resin microspheres. When injected into the artery supplying the tumor, yttrium Y 90 resin microspheres block the tumor blood vessels and deliver the yttrium Y 90 directly to the tumor site, which may kill or slow tumor growth. Giving cemiplimab and Y90 SIR-Spheres by TARE to the tumor in the liver may kill more tumor cells in patients with metastatic breast cancer.
Detailed description
PRIMARY OBJECTIVE:
- To describe the effect of cemiplimab and yttrium Y90 resin microspheres (90Y TARE) on immune activation in the treated tumor based on CD8+ T cells.
SECONDARY OBJECTIVES:
- To evaluate other measures of changes (both in treated and untreated lesions after the first TARE treatment) in the tumor microenvironment (TME) of 10 metastatic breast cancer (MBC) patients with liver-dominant disease.
II. To identify systemic immune activation in the peripheral blood. III. To determine the safety and tolerability of cemiplimab and hepatic radioembolization in patients with liver dominant metastatic breast cancer using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 criteria.
IV. To evaluate objective tumor response of the target lesion treated with Y90 by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and modified RECIST (mRECIST).
OUTLINE:
Patients receive cemiplimab intravenously (IV) over 30 minutes on day 1 of each cycle. Cycles repeat every 21 days for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients receive Y90 SIR-Spheres intratumorally via TARE over 60-90 minutes once during days 7-14 and on day 67. Patients also undergo tumor biopsy at baseline and at day 42 after immunotherapy begins. Additionally patients also undergo blood sample collection and computed tomography (CT) or magnetic resonance imaging (MRI) throughout the study.
After completion of study treatment, patients are followed up at 30 days, every 3 months within 1 year of start of treatment, and then every 6 months for up to 2 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Treatment (cemiplimab, Y90 SIR-Spheres, TARE) | Experimental | Procedure: Biopsy, Procedure: Biospecimen Collection, Biological: Cemiplimab, Procedure: Computed Tomography, Procedure: Magnetic Resonance Imaging, Radiation: Transarterial Radioembolization, Radiation: Yttrium Y 90 Resin MicrospheresPatients receive cemiplimab IV over 30 minutes on day 1 of each cycle. Cycles repeat every 21 days for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients receive Y90 SIR-Spheres intratumorally via TARE over 60-90 minutes once during days 7-14 and on day 67. Patients also undergo tumor biopsy at baseline and at day 42 after immunotherapy begins. Additionally patients also undergo blood sample collection and CT or MRI throughout the study. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (27 listed)
- Documented informed consent of the participant and/or legally authorized representative.
- Agreement to allow the use of archival tissue from diagnostic tumor biopsies
- Age: ≥ 18 years
- Eastern Cooperative Oncology Group (ECOG) 0-1
- Must have a life expectancy of at least 12 weeks
Key exclusion criteria (61 listed)
- Prior immunotherapy in the past 12 months
- Progressing or untreated extra-hepatic metastatic disease
- Autoimmune disease requiring therapy; immunodeficiency, or any disease process requiring immunosuppressive therapy
- Any other condition that would, in the investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns with clinical study procedures
- Portal vein invasion
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| BiopsyAlso: BIOPSY_TYPE, BxUndergo tumor biopsy | Procedure or surgery | Treatment (cemiplimab, Y90 SIR-Spheres, TARE) |
| Biospecimen CollectionAlso: Biological Sample Collection, Biospecimen Collected, Specimen CollectionUndergo blood sample collection | Procedure or surgery | Treatment (cemiplimab, Y90 SIR-Spheres, TARE) |
| CemiplimabAlso: Cemiplimab RWLC, Cemiplimab-rwlc, Libtayo, REGN 2810Given IV | Biological | Treatment (cemiplimab, Y90 SIR-Spheres, TARE) |
| Computed TomographyAlso: CAT, CAT Scan, Computed Axial Tomography, Computerized Axial TomographyUndergo CT | Procedure or surgery | Treatment (cemiplimab, Y90 SIR-Spheres, TARE) |
| Magnetic Resonance ImagingAlso: Magnetic Resonance, Magnetic Resonance Imaging (MRI), Magnetic resonance imaging (procedure), Magnetic Resonance Imaging ScanUndergo MRI | Procedure or surgery | Treatment (cemiplimab, Y90 SIR-Spheres, TARE) |
| Transarterial RadioembolizationAlso: Hepatic Radioembolization, TARE, Transarterial Hepatic RadioembolizationUndergo TARE | Radiation | Treatment (cemiplimab, Y90 SIR-Spheres, TARE) |
| Yttrium Y 90 Resin MicrospheresAlso: SIR-Spheres, Y-90 SirsphereGiven intratumorally | Radiation | Treatment (cemiplimab, Y90 SIR-Spheres, TARE) |
Primary outcome
CD8+ T cell infiltration in tumor microenvironment (TME): baseline
Time frame: At baseline
Will be analyzed using multiplex immunofluorescence (IF) of formalin-fixed paraffin-embedded (FFPE) tissue. Will estimated the mean and standard deviation of the percent change.
CD8+ T cell infiltration in tumor microenvironment (TME): post TARE -1 (day 21)
Time frame: At Post-transarterial radioembolization TARE -1 (day 21)
Will be analyzed using multiplex immunofluorescence (IF) of formalin-fixed paraffin-embedded (FFPE) tissue. Will estimated the mean and standard deviation of the percent change.
CD8+ T cell infiltration in tumor microenvironment (TME): prior to TARE-2 (day 42)
Time frame: At prior to TARE-2 (day 42)
Will be analyzed using multiplex immunofluorescence (IF) of formalin-fixed paraffin-embedded (FFPE) tissue. Will estimated the mean and standard deviation of the percent change.
12 secondary outcomes
Incidence of adverse events
Time frame: Up to 30 days after last dose of study treatment
T cell activation in TME: baseline
Time frame: At baseline
T cell activation in TME: post-TARE-1 (day 21)
Time frame: At Post-transarterial radioembolization TARE -1 (day 21)
T cell activation in TME: prior to TARE-2 (Day 42)
Time frame: At prior to TARE-2 (Day 42)
Dendritic cell activation in TME: baseline
Time frame: At baseline
Dendritic cell activation in TME: post-TARE-1 (day 21)
Time frame: At Post-transarterial radioembolization TARE -1 (day 21)
Dendritic cell activation in TME: prior to TARE-2 (Day 42)
Time frame: At prior to TARE-2 (Day 42)
PD-L1 expression in TME: baseline
Time frame: At baseline
PD-L1 expression in TME: post-TARE-1 (day 21)
Time frame: At Post-transarterial radioembolization TARE -1 (day 21)
PD-L1 expression in TME: prior to TARE-2 (Day 42)
Time frame: At prior to TARE-2 (Day 42)
Immune activation
Time frame: At baseline and post-TARE-1 (day 7-14)
Objective tumor response
Time frame: Up to 2 years
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 May 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Jonathan Kessler principal investigator
City of Hope Medical Center
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Biopsy, Biospecimen Collection and Cemiplimab in people with Anatomic Stage IV Breast Cancer AJCC v8 and Metastatic Breast Carcinoma, run by City of Hope Medical Center at 1 site 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?
The sponsor lists 27 inclusion and 61 exclusion criteria. 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 20 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site 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 phase mean?
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?
Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
CD8+ T cell infiltration in tumor microenvironment (TME): baseline (time frame: At baseline). The study lists 3 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 20 May 2026.