Study of Adagloxad Simolenin (OBI-822)/​OBI-821 in the Adjuvant Treatment of Patients With Globo H Positive TNBC

• Biological: adagloxad simolenin combined with OBI-821
• Device: Globo H IHC Assay
• Other: Standard of care treatment

Inclusion Criteria

• Documented radiographic and histopathologic confirmed primary localized invasive breast cancera disease where abnormal cells split without control and spread to other nearby body tissue and/or organs.
• Histologically documented TNBC (estrogen receptor negative [ER-]/progesterone receptor negative [PR-]/human epidermal growth factor 2 negative [HER2-]) defined as ER-negative and PR-negative (≤5% positive cellsthe basic structural and functional unit of all living things stain by IHC for both ER and PR), and negative HER2/neu- status, confirmed on tumor sample.
• HER2/neu negative will be defined as one of the following criteria:
  • IHC 0 or 1+
  • Single-probe average HER2 gene copy number of <6 signals/nucleus
  • Dual-probe fluorescent in-situ hybridization (FISH) HER2/neu chromosome 17 (CEP17) non-amplified ratio of <2
• Globo H IHC H-score ≥15 from the residual primary site/or lymph nodea small lump or mass of tissue in your body (if primary site is not available) tumor obtained at time of definitive surgerytreatment involving removal of cancerous tissue and/or tumours and a margin of healthy tissue around it to reduce recurrence or initial diagnosisthe process of identifying a disease based on signs and symptoms, patient history and medical test results (only if surgical tumor sample is not available). Globo H expression will be determined during pre-screening by Central lab. Instructions for submission of slides/tumor tissuea group of cells that work together to perform a function blocks are provided in the protocol and study Lab Manual.
• No evidence of metastatic disease in chest, abdomenstomach, stomach area, belly and pelvis by CT or other adequate imagining during the Screeningtesting for cancer or conditions that can lead to cancer before symptoms appear, also known as cancer screening Phase. Imagingtests that create detailed images of areas inside the body within 3 months prior to randomization is acceptable as baseline scan. Bone scans and imaging of the brain at screening is optional, and should be symptom directed.
• High risk patients with no evidence of disease after completing standard treatment and meeting ONE of the following criteria:
  • Neoadjuvant chemotherapya cancer treatment that uses drugs to kill or slow the growth of cancer cells, while minimising damage to healthy cells followed by definitive surgery: Residual invasive disease following neoadjuvant chemotherapy defined as: A contiguous focus of residual invasive cancer in the surgical breast specimena sample for investigating (e.g. blood, stools, urine, sputum etc.) measuring ≥1 cm in diameter and/or with residual invasive cancer in at least one axillary node (micrometastases or macrometastases), as determined by local pathologythe study of disease review.
  • Definitive surgery followed by adjuvant chemotherapychemotherapy given after primary treatment, such as surgery, to reduce the risk of your cancer coming back: Pathological Prognostic Stage IIB, Stage IIIA , Stage IIIB, or Stage IIIC disease according to the 8th edition of the American Joint Committee on Cancer (AJCC) Cancer Stagingthe process of determining how big the cancer is, where it started and if it has spread to other areas Manual.
• Must have completed at least 4 cycles of a standard taxane and anthracycline-based multi-agent chemotherapy regimen (or a taxane-only regimen if the patient is ineligible for anthracycline treatment) either in the neoadjuvant or adjuvant setting (e.g., National Comprehensive Cancer Network recommended regimens):.
  • Randomization must occur (a) within 16 weeks after definitive surgery and radiation therapya treatment that uses controlled doses of radiation to damage or kill cancer cells (if radiation therapy administered) in patients who received neoadjuvant multiagent chemotherapy or, (b) for patients receiving adjuvant multiagent chemotherapy (not including capecitabine, immune checkpoint inhibitor), within 16 weeks after the completion of the adjuvant multiagent chemotherapy and radiation therapy (if radiation therapy administered). Note: patients may be randomized and initiate study treatment concurrent with adjuvant SOC therapy (observation, capecitabine, immune checkpoint inhibitor ± capecitabine).
• Randomization must occur (a) within 16 weeks after definitive surgery and radiation therapy (if radiation therapy administered) in patients who received neoadjuvant multiagent chemotherapy or, (b) for patients receiving adjuvant multiagent chemotherapy (not including capecitabine, immune checkpoint inhibitor), within 16 weeks after the completion of the adjuvant multiagent chemotherapy and radiation therapy (if radiation therapy administered). Note: patients may be randomized and initiate study treatment concurrent with adjuvant SOC therapy (observation, capecitabine, immune checkpoint inhibitor ± capecitabine).
• All treatment-related toxicities resolved to Gradea description of how abnormal cancer cells and tissue look under a microscope when compared to healthy cells <1 on National cancer institute Common Terminology Criteria for Adverse Events (NCI-CTCAE version 5.0) criteria (except hair loss and ≤Grade 2 neuropathy, which are acceptable).
• Eastern Cooperative Oncologythe study, diagnosis and treatment of cancer Group (ECOG) performance status ≤ 1.
• Females must be either of non-childbearing potential, i.e., surgically sterilized (have documented sterilization, bilateralaffecting both sides oophorectomy/salpingectomy at least 3 months before the start of the trial and/or hysterectomycomplete or partial removal of the uterus), or one year postmenopausal; or if of childbearing potential must have a negative pregnancy test (urine or serum) at screening.
• Males and females of childbearing potential and their partners must be willing to use effective contraception during the entire Treatment Phase and for at least 4 weeks (28 days) after the last dosethe amount of medication taken of study treatment.
• Adequate hematological, hepatic and renal function as defined below:
  • Absolute neutrophil count (ANC) ≥1,500/µL
  • Plateletssmall disc-shaped blood cells that clump together to form clots to stop bleeding ≥75,000/µL
  • Hemoglobin ≥8.5g/dL
  • Serum creatinine ≤1.5 × upper limit of normal (ULN) or calculated creatinine clearance ≥55 mL/min for subjects with creatinine levels >1.5 × institutional ULN (glomerular filtration rate can also be used in place of creatinine or creatinine clearance may be calculated per institutional standard)
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤3 × ULN
  • Alkaline Phosphatase (ALP) ≤2.5 × ULN
  • Serum total bilirubin ≤1.5 × ULN (unless Gilbert’s disease is documented)
• Consent to participate with a signed and dated Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved patient informed consenta process in which a patient receives detailed information about a procedure or treatment, including its potential risks, benefits, and alternatives. The patient then has the opportunity to understand the information and voluntarily agree to the procedure or treatment. for the study prior to beginning any specific study procedures.
• Ability to understand and willingness to complete all protocol required procedures.