Adaptive phase II randomized non-comparative trial of nivolumab after induction treatment in triple-negative breast cancer (TNBC) patients: TONIC-trial

2025-520487-18-00 Protocol N15TON Therapeutic exploratory (Phase II) Ongoing, recruitment ended

Start 8 Sep 2015 · Status Ongoing, recruitment ended · 1 EU/EEA countries · 1 sites · Protocol N15TON

Overview

Sponsor-declared trial summary

Phase Therapeutic exploratory (Phase II)
Status Ongoing, recruitment ended
Participants planned 84
Countries 1
Sites 1

Triple negative breast cancer (TNBC) patients with metastatic disease

To determine the activity of nivolumab after four different immune response induction treatments in TNBC patients with metastatic disease. We hypothesize that short-term induction treatment with radiation, doxorubicin, cyclophosphamide or cisplatin induces an anticancer immune response resulting in increased activity o…

Key facts

Sponsor
Het Nederlands Kanker Instituut-Antoni van Leeuwenhoek Ziekenhuis Stichting
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Neoplasms [C04]
Trial duration
8 Sep 2015 → ongoing
Decision date (initial)
2025-01-24
Transition trial
Yes
Low-intervention
No
Rare-disease indication
No
Vulnerable population
No
Funding sources
Bristol-Myers Squibb International Corporation

External identifiers

EU CT number
2025-520487-18-00
EudraCT number
2015-001969-49
ClinicalTrials.gov
NCT02499367

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Safety, Pharmacogenetic, Efficacy, Therapy, Pharmacogenomic

To determine the activity of nivolumab after four different immune response induction treatments in TNBC patients with metastatic disease. We hypothesize that short-term induction treatment with radiation, doxorubicin, cyclophosphamide or cisplatin induces an anticancer immune response resulting in increased activity of nivolumab as compared to unprimed, single agent nivolumab.

Secondary objectives 1

  1. To evaluate the safety of nivolumab treatment after short-term induction therapy with radiation, doxorubicin, cyclophosphamide or cisplatin

Conditions and MedDRA coding

Triple negative breast cancer (TNBC) patients with metastatic disease

VersionLevelCodeTermSystem organ class
27.0 LLT 10027475 Metastatic breast cancer 10029104

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 8

  1. Metastatic ER and HER2 negative breast cancer
  2. 18 years or older
  3. Metastatic lesions accessible for histological biopsy
  4. Maximum of three lines of chemotherapy for metastatic disease
  5. Evaluable disease according to RECIST 1.1
  6. WHO performance status 0 or 1
  7. Subjects with brain metastases are eligible if these have been treated and there is no magnetic resonance imaging (MRI) evidence of progression for at least 4 weeks after treatment is completed and prior to first dose of study drug administration. There must also be no requirement for immunosuppressive doses of systemic corticosteroids (> 10 mg/day prednisone equivalents) for at least 2 weeks prior to study drug administration
  8. Signed written informed consent

Exclusion criteria 4

  1. Known leptomenigeal disease localization
  2. History of having recceived other anticancer therapies within 2 weeks of start of the study drug
  3. History of immunodeficiency, autoimmune disease, conditions requiring immunosuppression (>10 mg daily prednisone equivalents) or chronic infections
  4. Current pregnancy or breastfeeding

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. Progression-free survival (=PFS1, time from randomization to tumor progression or death from any cause). Progression as defined by RECIST 1.1 will be used.

Secondary endpoints 6

  1. Progression-free survival (=PFS1, time from randomization to tumor progression or death from any cause). Progression as defined by modified RECIST 1.1 for immune-based therapeutics (iRECIST) will be used.
  2. Progression-free survival (=PFS2, time from nivolumab treatment initiation to tumor progression). Progression as defined by RECIST 1.1 and iRECIST will be used.
  3. Overall response rate ORR (complete response CR or partial response PR) according to RECIST 1.1 and iRECIST. ORR1 (relative to randomization) and ORR2 (relative to nivolumab initiation) will be used.
  4. Clinical benefit rate (CR+PR+stable disease ≥ 6 months and CR+PR+stable disease ≥ 3 months) according to RECIST 1.1 and iRECIST. CBR1 (relative to randomization) and CBR2 (relative to nivolumab initiation) will be used.
  5. Overall survival (OS, time from nivolumab initiation to death from any cause).
  6. Percentage of patients with toxicity (classified according to CTCAE v4.0) and immune-related toxicity.

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

OPDIVO 10 mg/mL concentrate for solution for infusion.

PRD2941375 · Product

Active substance
Nivolumab
Substance synonyms
BMS936558, ABP 206
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
INTRAVENOUS USE
Max daily dose
3 mg/kg milligram(s)/kilogram
Max total dose
3 mg/kg milligram(s)/kilogram
Max treatment duration
12 Month(s)
Authorisation status
Authorised
ATC code
L01FF01 — -
Marketing authorisation
EU/1/15/1014/002
MA holder
BRISTOL-MYERS SQUIBB PHARMA EEIG
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Het Nederlands Kanker Instituut-Antoni van Leeuwenhoek Ziekenhuis Stichting

Sponsor organisation
Het Nederlands Kanker Instituut-Antoni van Leeuwenhoek Ziekenhuis Stichting
Address
Plesmanlaan 121
City
Amsterdam
Postcode
1066 CX
Country
Netherlands

Scientific contact point

Organisation
Het Nederlands Kanker Instituut-Antoni van Leeuwenhoek Ziekenhuis Stichting
Contact name
Marleen kok

Public contact point

Organisation
Het Nederlands Kanker Instituut-Antoni van Leeuwenhoek Ziekenhuis Stichting
Contact name
Marleen kok

Locations

1 EU/EEA country · 1 investigational sites

By country

CountryMS statusPlanned subjectsSites
Netherlands Ongoing, recruitment ended 84 1
Rest of world 0

Investigational sites

Netherlands

1 site · Ongoing, recruitment ended
Het Nederlands Kanker Instituut-Antoni van Leeuwenhoek Ziekenhuis Stichting
Medical oncology, Plesmanlaan 121, 1066 CX, Amsterdam

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Netherlands 2015-09-08 2015-09-14 2019-07-05

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 3 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_Protocol_2025-520487-18-00_ N15TON_REDACTED 6.0
Recruitment arrangements (for publication) K1_Recruitment procedure_2025-520487-18-00 1
Subject information and informed consent form (for publication) L1_SIS and ICF_2025-520487-18-00_N15TON_REDACTED 5.0

Application history

1 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2025-01-14 Netherlands Acceptable
2025-01-24
2025-01-24