Skip to main content

ASPEN-09-03: A Study of Evorpacept in Combination With Trastuzumab and Chemotherapy in Metastatic HER2-Positive Breast Cancer

  • PhasePhase 2
  • StatusRecruiting
  • Planned enrollment120 people
  • Recruiting US sites28
  • SponsorALX Oncology Inc.
  • RegistryNCT07007559

Recruitment re-checked on ClinicalTrials.gov Oct 30, 2026. Public record; not medical advice.

ASPEN-09-03: A Study of Evorpacept in Combination With Trastuzumab and Chemotherapy in Metastatic HER2-Positive Breast Cancer: a one-minute explainerNCT070075591 min

Eligibility

Who can join

The film gives the main points. The full list below is copied from the registry; the study team makes the final decision.

  • Age18 Years to no maximum
  • SexAll
  • Healthy volunteersNo

You may be able to join if

  • Histologically confirmed invasive HER2+ breast cancer based on an evaluable tumor tissue biopsy obtained after cessation of T-DXd (ENHERTU) treatment and no more than 6 months prior to C1D1.
  • Received no more than 4 prior lines of HER2-directed therapy including at least one prior line of T-DXd (ENHERTU) for locally advanced/metastatic HER2+ breast cancer. Prior neoadjuvant therapy which resulted in relapse within 6 months of completion of T-DXd will be considered a line of treatment for metastatic disease. Participants who discontinue T-DXd due to intolerance are considered eligible.
  • Progressed on or following the most recent line of therapy.
  • Eligible to receive one of the following chemotherapy options (capecitabine, eribulin, gemcitabine, paclitaxel or vinorelbine).
  • Measurable disease as defined by RECIST v1.1.
  • LVEF ≥50%.
  • Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) must be 0 to 1.
  • Life expectancy of at least 3 months.
  • Adequate renal function (estimated creatinine clearance ≥30 mL/min as calculated using the Cockcroft-Gault equation or Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.
  • Adequate liver function:
  • Total bilirubin ≤1.5 x upper limit of normal (ULN) (≤3.0 x ULN if the participant has documented Gilbert syndrome);
  • Aspartate and alanine transaminase (AST and ALT) ≤3 x ULN (≤5.0 x ULN if liver involved by metastatic disease).
  • Participants must have recovered from all AEs due to previous therapies, procedures, and surgeries to baseline severity or ≤Grade 1 per NCI CTCAE v5.0 except for AEs not deemed reversible and which do not constitute a safety risk by Investigator judgment.

You cannot join if

  • Untreated CNS metastases.
  • Prior exposure to any anti-CD47 or anti-SIRPα agent.
  • Any condition that would be contraindicated to receiving trastuzumab
  • Has a diagnosis of complete dihydropyrimidine dehydrogenase (DPD) deficiency or significant toxicity with prior flurouracil (5FU) based regimen
  • Following anti-cancer therapy with insufficient washout before start of treatment:
  • chemotherapy, hormonal therapy, radiation therapy or small molecule anti-cancer therapy within 14 days or 5 half-lives (whichever is shorter) of start of treatment.
  • Immune therapy or other biologic therapy (e.g., monoclonal antibodies, antibody-drug conjugates) for the treatment of cancer for: 28 days or 5 half-lives (whichever is shorter) of start of treatment).
  • History of autoimmune hemolytic anemia, autoimmune thrombocytopenia, or hemolytic transfusion reaction.
  • Had an allogeneic tissue/solid organ transplant.
  • Any active, unstable cardiovascular disease.
  • Intolerance to or who have had a severe allergic or anaphylactic reaction to antibodies or infused therapeutic proteins or participants who have had a severe allergic or anaphylactic reaction to any of the substances included in the study drug (including excipients).
  • Has an active autoimmune disease that has required systemic treatment in past 2 years.
  • Other primary malignancy within 2 years.

The treatment

How it is intended to work

This is how the treatment is meant to work. Whether it helps, and how safe it is, is what this trial is testing.

Evorpacept. A variant of signal regulatory protein alpha (SIRPa) that antagonizes the human cell surface antigen CD47, with potential phagocytosis-inducing, immunostimulating and antineoplastic activities. Upon administration, evorpacept binds to CD47 expressed on tumor cells and prevents the interaction of CD47 with its ligand SIRPa, a protein expressed on phagocytic cells. This prevents CD47/SIRPa-mediated signaling and abrogates the CD47/SIRPa-mediated inhibition of phagocytosis. This induces pro-phagocytic signaling mediated by the binding of the pro-phagocytic signal calreticulin (CRT), which is specifically expressed on the surface of tumor cells, to low-density lipoprotein (LDL) receptor-related protein (LRP), expressed on macrophages. This results in macrophage activation and the specific phagocytosis of tumor cells. In addition, blocking CD47 signaling activates both an anti-tumor cytotoxic T-lymphocyte (CTL) immune response and T cell-mediated killing of CD47-expressing tumor cells. CD47, also called integrin-associated protein (IAP), is a tumor-associated antigen (TAA) expressed on normal, healthy hematopoietic stem cells (HSC) and overexpressed on the surface of a variety of cancer cells. Expression of CD47, and its interaction with SIRPa, leads to the inhibition of macrophage activation and protects cancer cells from phagocytosis, which allows cancer cells to proliferate. NCI Drug Dictionary

ado-trastuzumab emtansine. An antibody-drug conjugate (ADC) consisting of the recombinant anti-epidermal growth factor receptor 2 (HER2) monoclonal antibody trastuzumab conjugated to the maytansinoid DM1 via a nonreducible thioether linkage (MCC) with potential antineoplastic activity. The trastuzumab moiety of this ADC binds to HER2 on tumor cell surfaces; upon internalization, the DM1 moiety is released and binds to tubulin, thereby disrupting microtubule assembly/disassembly dynamics and inhibiting cell division and the proliferation of cancer cells that overexpress HER2. Linkage of antibody and drug through a nonreducible linker has been reported to contribute to the improved efficacy and reduced toxicity of this ADC compared to similar ADCs constructed with reducible linkers. NCI Drug Dictionary

Treatments listed in the registry

  • Evorpacept (ALX148) (Drug): IV infusion
  • Trastuzumab (Drug): IV infusion
  • Paclitaxel (Drug): IV infusion
  • Capecitabine (Drug): Oral administration
  • Eribulin (Drug): IV infusion
  • Gemcitabine (Drug): IV infusion
  • Vinorelbine (Drug): IV infusion

The study

Treatment groups

Na · Single Group · masking: None

Evorpacept+Trastuzumab+Chemo in participants with metastatic HER2+ breast cancer (Experimental)

* Evorpacept (IV) - once every 3 weeks (Q3W) * Trastuzumab (IV) - once every 3 weeks (Q3W) * Chemotherapy (physician selects one of the following): * Capecitabine (Oral) twice a day for 14 days every 3 weeks * Eribulin (IV) twice every 3 weeks * Gemcitabine (IV) twice every 3 weeks * Paclitaxel (IV) once every 3 weeks (Q3W) or once weekly (QW) * Vinolrebine (IV) twice every 3 weeks

Goals

What the study measures

Main goals

  • Overall Response Rate (ORR) using RECIST v1.1 based on BICR assessment (Approximately 6 months after the last participant is enrolled)

Other goals

  • Overall Response Rate (ORR) based on Investigator assessment
  • Clinical Benefit Rate (CBR) using RECIST v1.1 based on BICR and Investigator assessment
  • Duration of Response (DoR) using RECIST v1.1 based on BICR and Investigator assessment
  • Progression-Free Survival (PFS) using RECIST v1.1 based on BICR and Investigator assessment
  • Overall Survival (OS)
  • Number of participants with adverse events (AEs) and with laboratory abnormalities
  • Maximum Concentration (Cmax)
  • Time at Maximum Concentration (Tmax)
  • Area under the Concentration-Time Curve (AUC)
  • Clearance (CL)
  • Terminal elimination half-life (t1/2)
  • Evaluate the immunogenicity of evorpacept

Planned enrollment: 120 (estimated).

Where

Recruiting US sites

  • Mayo Clinic Building-Phoenix, Phoenix, Arizona
  • The University of Arizona Cancer Center - North Campus, Tucson, Arizona
  • City of Hope, Duarte, California
  • UC San Diego Moores Cancer Center, La Jolla, California
  • UC Irvine Health - Chao Family Comprehensive Cancer Center, Orange, California
  • Saint Joseph Hospital - Cancer Centers of Colorado, Denver, Colorado
  • Lutheran Hospital - Cancer Centers of Colorado, Golden, Colorado
  • Saint Mary's Regional Hospital - Cancer Centers of Colorado, Grand Junction, Colorado
  • The George Washington Medical facility Associates, Washington D.C., District of Columbia
  • Mayo Clinic, Jacksonville, Florida
  • Sylvester Comprehensive Cancer Center, Miami, Florida
  • Moffitt Cancer Center, Tampa, Florida
  • City of Hope Chicago, Zion, Illinois
  • University of Michigan Rogel Cancer Center, Ann Arbor, Michigan
  • Mayo Clinic Cancer Center, Rochester, Minnesota
  • HealthPartners Frauenshuh Cancer Center, Saint Louis Park, Minnesota
  • Washington University School of Medicine- Siteman Cancer Center, St Louis, Missouri
  • St. Vincent Regional Hospital - Cancer Centers of Montana, Billings, Montana
  • Oncology Hematology West, Pc Dba Nebraska Cancer Specialists, Omaha, Nebraska
  • Memorial Sloan Kettering Cancer Center, New York, New York
  • Duke Cancer Institute, Durham, North Carolina
  • Gabrail Cancer Center, Canton, Ohio
  • Oregon Health and Science University, Portland, Oregon
  • University of Texas Southwestern Medical Center, Dallas, Texas
  • Houston Methodist Cancer Center, Houston, Texas
  • The University of Texas M.D. Anderson Cancer Center, Houston, Texas
  • Virginia Cancer Specialists, Fairfax, Virginia
  • Fred Hutchinson Cancer Center, Seattle, Washington

32 recruiting sites outside the US. Site status as of Oct 30, 2026. Check the live record before contacting a site.

Sources

Where this comes from

Registry record reviewed as fetched Oct 30, 2026, last updated by the sponsor Sep 24, 2026. Public record; not medical advice.

For you, or someone you love

Whether or not this trial is the one, bring AI into your corner.

A complex diagnosis brings new questions every week, in a trial and out of one. Triangle keeps your whole medical file together, reads it with you in plain language, and helps you and your family decide what to ask next.

Start your 7-day free trial

Then $9 a month. Cancel anytime.

  • Every record in one place

    Requested from your hospitals and clinics through the national networks. Add scans, pathology and anything on paper.

  • Read in plain words

    Reports explained as they come in, with lab values you can follow before treatment, during a trial and after.

  • Ready for every appointment

    Ask about your own file, and walk in with questions for your oncologist or the trial team.

  • Your people, in the loop

    Share one profile with the family helping you, and with your doctors.

Members also get a deeper analysis of their records and any sequencing data, including clinical trials that may fit, reviewed by a licensed physician before they receive it.

Already in a trial?

It turns into a project to manage: visits, scans, labs, side effects and paperwork. Triangle keeps it organized in one place for you or for whoever's helping.

Organize my trial

7-day free trial, then $9 a month. Cancel anytime.