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Charleston Oncology | Charleston, NC

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Study of Magrolimab Combination Therapy in Patients With Non-Surgically Removable Locally Advanced or Metastatic Triple-Negative Breast Cancer (ELEVATE TNBC)

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Gilead Sciences

Status and phase

Terminated
Phase 2

Conditions

Triple-Negative Breast Cancer

Treatments

Drug: Sacituzumab Govitecan-hziy
Drug: Magrolimab
Drug: Nab-Paclitaxel
Drug: Paclitaxel

Study type

Interventional

Funder types

Industry

Identifiers

NCT04958785
GS-US-586-6144
2021-001074-27 (EudraCT Number)

Details and patient eligibility

About

The goals of this clinical study are to learn about the safety, tolerability, dosing and effectiveness of magrolimab in combination with nab-paclitaxel or paclitaxel (cohort 1) or with sacituzumab govitecan-hziy (cohort 2) in participants with non-surgically removable locally advanced or metastatic triple-negative breast cancer.

The primary objective of this study for the safety run-in cohorts of the study is to evaluate the safety, tolerability, and recommended Phase 2 dose (RP2D) of magrolimab in combination with nab-paclitaxel or paclitaxel (Safety Run-In Cohort 1), and sacituzumab govitecan (Safety Run-In Cohort 2) in metastatic triple-negative breast cancer (mTNBC).

This study in the Phase 2 Cohort 1 also compares the efficacy of magrolimab in combination with nab-paclitaxel or paclitaxel versus nab-paclitaxel or paclitaxel alone, as determined by progression-free survival (PFS) by investigator assessment.

This study in the Phase 2 Cohort 2 also evaluates the efficacy of magrolimab in combination with sacituzumab govitecan as determined by confirmed objective response rate (ORR) by investigator assessment.

Enrollment

92 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Key Inclusion criteria:

  • Adequate performance status, hematologic, renal and liver function.
  • Measurable disease per response evaluation criteria in solid tumors (RECIST) v1.1
  • Cohort 1: Individuals with previously untreated with systemic therapy for unresectable locally advanced or metastatic triple-negative breast cancer (mTNBC) that are considered programmed cell death ligand 1 (PD-L1) negative (as determined by an approved test according to local regulations).
  • Cohort 2: Individuals with unresectable, locally advanced or metastatic breast cancer with a diagnosis of TNBC who have received at least 1 and no more than 2 prior lines of systemic therapy in the unresectable, locally advanced or metastatic setting. Individuals must have been previously treated with a taxane in any setting. Individuals with tumors that are considered positive for PD-L1 expression (as determined by an approved test according to local regulations) must have received an immune checkpoint inhibitor for a prior-line of treatment for unresectable locally advanced/metastatic TNBC.

Key Exclusion Criteria:

  • Positive serum pregnancy test or breastfeeding female.

  • Active central nervous system (CNS) disease. Individuals with asymptomatic and stable, treated CNS lesions (who have been off steroids, radiation and/or surgery and/or other CNS-directed therapy for at least 4 weeks) are allowed.

  • Red blood cell (RBC) transfusion dependence, defined as requiring more than 2 units of packed RBC transfusions during the 4-week period prior to screening. Red blood cell transfusions are permitted during the screening period and prior to enrollment to meet the hemoglobin inclusion criteria.

  • History of hemolytic anemia, autoimmune thrombocytopenia, or Evans syndrome in the last 3 months.

  • Prior treatment with cluster of differentiation 47 (CD47) or signal regulatory protein alpha-targeting agents.

  • Known inherited or acquired bleeding disorders.

  • Cohort 1 only: Disease progression within 6 months following neoadjuvant/adjuvant therapy.

  • Cohort 2 only:

    • Individuals with active chronic inflammatory bowel disease (ulcerative colitis, Crohn disease) and Individuals with a history of bowel obstruction or gastrointestinal perforation within 6 months of enrollment.

    • Individuals who previously received topoisomerase I inhibitors or antibody-drug conjugates containing a topoisomerase inhibitor.

    • High-dose systemic corticosteroids (≥ 20 mg of prednisone or its equivalent) are not allowed within 2 weeks of Cycle 1 Day 1.

    • Have not recovered (ie, ≥ Grade 2 is considered not recovered) from adverse events (AEs) due to a previously administered agent.

      • Note: Individuals with any grade of neuropathy, alopecia, hypo- or hyperthyroidism, or other endocrinopathies that are well controlled with hormone replacement are an exception to this criterion and will qualify for the study.
      • Note: if individuals received major surgery, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting therapy.

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Sequential Assignment

Masking

None (Open label)

92 participants in 5 patient groups

Safety Run-in Cohort 1: Magrolimab + Nab-Paclitaxel or Paclitaxel
Experimental group
Description:
Participants will receive magrolimab intravenous (IV) infusion + nab-paclitaxel IV or paclitaxel IV as mentioned below: * Magrolimab 1 mg/kg on Cycle 1 Day 1; 30 mg/kg, on Cycle 1 Days 8, 15, 22, Cycle 2 Days 1, 8, 15, 22 and Cycle 3 Days 1 and 15 onwards for every 28-days cycle; * Nab-paclitaxel 100 mg/m\^2 or paclitaxel 90 mg/m\^2 on Days 1, 8 and 15 of every 28-days cycle.
Treatment:
Drug: Paclitaxel
Drug: Nab-Paclitaxel
Drug: Magrolimab
Phase 2 Cohort 1 Arm A: Magrolimab + Nab-Paclitaxel or Paclitaxel
Experimental group
Description:
Participants will receive magrolimab IV infusion + nab-paclitaxel IV or paclitaxel IV as mentioned below: * Magrolimab 1 mg/kg on Cycle 1 Day 1; 30 mg/kg, on Cycle 1 Days 8, 15, 22, Cycle 2 Days 1, 8, 15, 22 and Cycle 3 Days 1 and 15 onwards for every 28-days cycle; * Nab-paclitaxel 100 mg/m\^2 or paclitaxel 90 mg/m\^2 on Days 1, 8 and 15 of every 28-days cycle.
Treatment:
Drug: Paclitaxel
Drug: Nab-Paclitaxel
Drug: Magrolimab
Phase 2 Cohort 1 Arm B: Nab-Paclitaxel or Paclitaxel
Active Comparator group
Description:
Participants will receive nab-paclitaxel IV or paclitaxel IV as mentioned below: * Nab-paclitaxel 100 mg/m\^2 or paclitaxel 90 mg/m\^2 on Days 1, 8 and 15 of every 28-day cycle.
Treatment:
Drug: Paclitaxel
Drug: Nab-Paclitaxel
Drug: Magrolimab
Safety Run-in Cohort 2: Magrolimab + Sacituzumab govitecan
Experimental group
Description:
Participants will receive magrolimab IV infusion + sacituzumab govitecan IV infusion as mentioned below: * Magrolimab 1 mg/kg on Cycle 1 Day 1; 30 mg/kg, on Cycle 1 Days 8, 15, Cycle 2 Days 1, 8, and 15; 60 mg/kg, on Cycle 3 Day 1 onwards for every 21-day cycle; * Sacituzumab govitecan 10 mg/kg on Days 1 and 8 onwards for every 21-day cycle.
Treatment:
Drug: Sacituzumab Govitecan-hziy
Drug: Magrolimab
Phase 2 Cohort 2: Magrolimab + Sacituzumab govitecan
Experimental group
Description:
Participants will receive magrolimab IV infusion + sacituzumab govitecan IV infusion as mentioned below: * Magrolimab 1 mg/kg on Cycle 1 Day 1; 30 mg/kg, on Cycle 1 Days 8, 15, Cycle 2 Days 1, 8, and 15; 60 mg/kg, on Cycle 3 Day 1 onwards for every 21-day cycle; * Sacituzumab govitecan 10 mg/kg on Days 1 and 8 onwards for every 21-day cycle.
Treatment:
Drug: Sacituzumab Govitecan-hziy
Drug: Magrolimab

Trial documents
2

Trial contacts and locations

45

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Central trial contact

Gilead Clinical Study Information Center

Data sourced from clinicaltrials.gov

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