MagSense® Human Epidermal Growth Factor Receptor 2 (HER2) Imaging Agent (MSH2IA)

NCT07885683 — Phase 1 / Phase 2, Not yet recruiting, 70 participants, Imagion Biosystems, Inc.

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A Phase 1b/2 Study Investigating MagSense® Human Epidermal Growth Factor Receptor 2 (HER2) Imaging Agent (MSH2IA) Using Magnetic Resonance Imaging in Participants With HER2+ Breast Cancer for the Assessment of Tumor Involvement in the Lymph Nodes (MSH2IA Phase 1b/2 Study)

RegistryNCT07885683
StatusNot yet recruiting
PhasePhase 1 / Phase 2
Study typeInterventional; non randomized, sequential, masking: none, diagnostic
Enrollment70 (Estimated)
SponsorImagion Biosystems, Inc. (Industry); collaborators: City of Hope National Medical Center
ConditionsHER2-positive Breast Cancer
InterventionsThe MagSense® HER2 Imaging Agent (MSH2IA) (Combination product)
Datesstart 2026-11-30 (estimated), primary completion 2029-01-31 (estimated), completion 2029-07-23 (estimated), first posted 2026-10-21, last updated 2026-10-21

Related Papers Related Patents Related Grants Related Experts
All trials for HER2-positive Breast Cancer All trials of The MagSense® HER2 Imaging Agent (MSH2IA)

-Summary

This Phase 1b/2 study is designed as an open-label, multicenter, 3 group, interventional study in which Phase 1b will evaluate the pharmacokinetics (PK) of MSH2IA and Phase 2 will confirm lowest effective dose as well as evaluate image timing, and diagnostic performance of a selected dose of MSH2IA when administered by subareolar or peritumoral injection.

No hypothesis testing is planned. Comparative statistics will be used to generate hypotheses to be tested in subsequent studies.

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+Arms and interventions

ArmTypeInterventionsDescription
Phase 1b - MSH2IA PharmacokineticsExperimentalCombination Product: The MagSense® HER2 Imaging Agent (MSH2IA)Participants enrolled in Phase 1b will receive MSH2IA to evaluate its pharmacokinetic (PK) profile.
Phase 2 - MSH2IA Dose and Diagnostic PerformanceExperimentalCombination Product: The MagSense® HER2 Imaging Agent (MSH2IA)Participants enrolled in Phase 2 will receive MSH2IA via subareolar or peritumoral injection to confirm the lowest effective dose, evaluate image timing, and assess the diagnostic performance of a selected dose of MSH2IA.
  • The MagSense® HER2 Imaging Agent (MSH2IA) (Combination product): Imaging Agent intended as an adjunct to MRI for the assessment of axillary nodal disease in participants diagnosed with HER2+ primary breast cancer.

+Outcome measures

Primary outcomes

  • Phase 1b: Level of Fe in blood [24 hours post injection]: PK MSH2IA Fe concentration > LLOQ in human whole blood
  • Phase 2 (Imaging Schedule): Dose and Imaging schedule for MSH2IA [24 hours post injection]: MSH2IA dose to image suspicious versus normal nodes and Post dose MRI imaging timing
  • Phase 2 (Diagnostic Performance): Diagnostic performance comparison between MSH2IA and SOC [24 hours post injection]: Patient level concordance of MSH2IA imaging to clinical pathology and Patient level concordance of MSH2IA to AxUS as measured by PPV, NPV, and Overall Predictive Concordance (PPV+NPV).

Secondary outcomes

  • Safety and Tolerability of MSH2IA Across All Phases [From baseline through 1 year]: All Phases: Assess safety and tolerability of MSH2IA Incidence and severity of AEs, serious adverse events and Injection site reactions (ISRs)

+Eligibility

Sex: Female, ages: 18 Years to any

Inclusion Criteria:

1. Female participants ≥18 years of age and are willing to provide written informed consent.
2. In the opinion of the Investigator, willing and able to comply with required study procedures.
3. Histologically confirmed primary HER2+ breast cancer; participants with a second primary tumor in the contralateral breast are eligible, but only 1 side will be evaluated.
4. Primary tumor must be HER2+, defined according to ASCO/CAP 2018 guidelines as either IHC 3+ or IHC 2+ with confirmatory ISH-positive.
5. Phase 1b and Phase 2 (Imaging Schedule) participants must be node suspicious by SOC assessment.
6. No previous treatment of the primary tumor or ipsilateral axilla that includes surgery (other than biopsy), radiotherapy, or a biologic such as trastuzumab. In Phase 2 (Diagnostic Performance) only, participants who have received NCT are eligible if treatment has not included trastuzumab.
7. Female participants of nonchildbearing potential: defined as either surgically sterilized (eg, hysterectomy, bilateral salpingectomy, bilateral oophorectomy ≥6 weeks before screening) or postmenopausal (ie, no menses for 12 months without an alternative medical cause.
8. Female participants of childbearing potential are eligible to participate if not pregnant, not breastfeeding, and using birth control.

Exclusion Criteria:

Participants will be excluded from the study if ANY of the following criteria are applicable:

1. Contraindications to the use of the Magtrace™ and Sentimag® Magnetic Localization System (Magtrace 2018), including use before NCT when MRI will be the primary imaging method for evaluation of breast cancer
2. Previous or current diseases of Fe metabolism or history of adverse reactions to intravenous Fe products
3. Known hypersensitivity to trastuzumab, iron oxide, or polyethylene glycol compounds
4. Treatment by Herceptin® or biosimilar within prior six months
5. Planned or prior use of Magtrace™ and Sentimag as a diagnostic agent, as it might interfere with MagSense® evaluations
6. Known clinical or radiological evidence of distant metastases (Stage IV disease)
7. Inflammatory breast cancer
8. Prior surgical axillary procedure, including SLNB or ALND, or previous radiation on the ipsilateral side of the breast cancer primary
9. Prior history of breast cancer in the ipsilateral breast
10. Metal devices or fragments other than post-breast biopsy clips in the ipsilateral axilla or in the ipsilateral chest
11. Any contraindications to MRI imaging

+Publications

  • Voduc KD, Cheang MC, Tyldesley S, Gelmon K, Nielsen TO, Kennecke H. Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol. 2010 Apr 1;28(10):1684-91. doi: 10.1200/JCO.2009.24.9284. Epub 2010 Mar 1. PMID 20194857
  • Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, Intra M, Veronesi P, Robertson C, Maisonneuve P, Renne G, De Cicco C, De Lucia F, Gennari R. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med. 2003 Aug 7;349(6):546-53. doi: 10.1056/NEJMoa012782. PMID 12904519
  • Slamon DJ, Godolphin W, Jones LA, Holt JA, Wong SG, Keith DE, Levin WJ, Stuart SG, Udove J, Ullrich A, et al. Studies of the HER-2/neu proto-oncogene in human breast and ovarian cancer. Science. 1989 May 12;244(4905):707-12. doi: 10.1126/science.2470152. PMID 2470152
  • Slamon DJ, Clark GM, Wong SG, Levin WJ, Ullrich A, McGuire WL. Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science. 1987 Jan 9;235(4785):177-82. doi: 10.1126/science.3798106. PMID 3798106
  • Shen J, Gilcrease MZ, Babiera GV, Ross MI, Meric-Bernstam F, Feig BW, Kuerer HM, Francis A, Ames FC, Hunt KK. Feasibility and accuracy of sentinel lymph node biopsy after preoperative chemotherapy in breast cancer patients with documented axillary metastases. Cancer. 2007 Apr 1;109(7):1255-63. doi: 10.1002/cncr.22540. PMID 17330229
  • Sharifi N, Ahmad S. Breast cancer-related lymphedema: A critical review on recent progress. Surg Oncol. 2024 Oct;56:102124. doi: 10.1016/j.suronc.2024.102124. Epub 2024 Aug 23. PMID 39208532
  • Perou CM, Sorlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, Pollack JR, Ross DT, Johnsen H, Akslen LA, Fluge O, Pergamenschikov A, Williams C, Zhu SX, Lonning PE, Borresen-Dale AL, Brown PO, Botstein D. Molecular portraits of human breast tumours. Nature. 2000 Aug 17;406(6797):747-52. doi: 10.1038/35021093. PMID 10963602
  • Kennecke H, Yerushalmi R, Woods R, Cheang MC, Voduc D, Speers CH, Nielsen TO, Gelmon K. Metastatic behavior of breast cancer subtypes. J Clin Oncol. 2010 Jul 10;28(20):3271-7. doi: 10.1200/JCO.2009.25.9820. Epub 2010 May 24. PMID 20498394
  • Iqbal N, Iqbal N. Human Epidermal Growth Factor Receptor 2 (HER2) in Cancers: Overexpression and Therapeutic Implications. Mol Biol Int. 2014;2014:852748. doi: 10.1155/2014/852748. Epub 2014 Sep 7. PMID 25276427
  • Harbeck N, Thomssen C. A new look at node-negative breast cancer. Oncologist. 2011;16 Suppl 1:51-60. doi: 10.1634/theoncologist.2011-S1-51. PMID 21278441
  • Giuliano AE, Dale PS, Turner RR, Morton DL, Evans SW, Krasne DL. Improved axillary staging of breast cancer with sentinel lymphadenectomy. Ann Surg. 1995 Sep;222(3):394-9; discussion 399-401. doi: 10.1097/00000658-199509000-00016. PMID 7677468
  • Cancer Genome Atlas Network. Comprehensive molecular portraits of human breast tumours. Nature. 2012 Oct 4;490(7418):61-70. doi: 10.1038/nature11412. Epub 2012 Sep 23. PMID 23000897