MEDI4736 and Tremelimumab in Treating Patients With Metastatic HER2 Negative Breast Cancer

Inclusion Criteria:

Patients must have a histologically documented (either primary or metastatic site) diagnosis of breast cancer that is HER2 non-overexpressing by immunohistochemistry, namely 0 or 1; if they have an equivocal immunohistochemistry, 2, the tumor must be non-gene amplified by fluorescence in situ hybridization (FISH) performed upon the primary tumor or metastatic lesion (ratio < 2 and HER2 copy number < 4); estrogen receptor (ER) positivity is defined as 1% or greater
Patients must have measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) criteria
Patients who are ER negative must have progressed through at least one prior chemotherapy regimen in the metastatic setting or within 12 months of their last adjuvant systemic treatment; patients who are ER positive must have progressed through standard hormone therapy options and have received at least one line of chemotherapy in the metastatic setting
Completion of prior chemotherapy systemic anticancer therapy at least 2 weeks prior to study entry
Radiation therapy must be completed at least 2 weeks prior to study entry; radiated lesions may not serve as measurable disease unless they have been radiated over 12 months prior to enrollment
Patients may have parenchymal brain metastases if stable (no evidence of progression) for at least 1 month after local therapy (radiation or surgery); leptomeningeal disease is excluded; must have completed any prescribed steroid taper
Patients may have had a prior diagnosis of cancer if it has been > 5 years since their last treatment
Patients must exhibit an Eastern Cooperative Oncology Group (ECOG) performance status of =< 2
Absolute neutrophil count >= 1,000/mcL
Platelets >= 50,000/mcl
Total bilirubin =< 1.5 times the institutional upper limit of normal (ULN) (or =< 3 times ULN in case of liver metastasis)
Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SPGT]) =< 2.5 X institutional ULN (or =< 5 times ULN in case of liver metastasis)
Creatinine =< 2 ng/ml

Females of child-bearing potential (FOCBP) and males must agree to use 2 methods of adequate contraception prior to study entry, for the duration of study participation, and for number (#) days following completion of therapy; should a female patient become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately

NOTE: A FOCBP is any woman (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria:
Has not undergone a hysterectomy or bilateral oophorectomy
Has had menses at any time in the preceding 12 consecutive months (and therefore has not been naturally postmenopausal for > 12 months)
FOCBP must have a negative pregnancy test within 7 days prior to registration on study
Willingness to provide a fresh biopsy prior to study enrollment and after 2 cycles of treatment
Patients must have the ability to understand and the willingness to sign a written informed consent prior to registration on study

Exclusion Criteria:

Patients who have had chemotherapy or radiotherapy within 2 weeks prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier are not eligible.
Current or prior use of immunosuppressive therapy within 2 weeks of starting investigational therapy
Patients who are taking any herbal (alternative) medicines are NOT eligible for participation; patients must be off any such medications by the time of registration for at least 2 weeks; NOTE: Vitamin supplements are acceptable
Patients may not have received any other investigational agents within 4 weeks prior to registration
Prior treatment with immune therapy (including but not limited to cluster of differentiation [CD]137, OX40, programmed death [PD]-1, PD-L1 or cytotoxic T-lymphocyte antigen 4 [CTLA4] inhibitors)
Prior severe infusion reaction to a monoclonal antibody

Patients with a history of or active autoimmune disease within the past 3 years with the following exceptions:

Vitiligo or alopecia
Hypothyroidism on stable doses of thyroid replacement therapy
Psoriasis not requiring systemic therapy within the past 3 years
History of primary immunodeficiency disease or tuberculosis
Major medical conditions that might affect study participation (uncontrolled pulmonary, renal, or hepatic dysfunction, uncontrolled infection) are not eligible; other significant comorbid condition which the investigator feels might compromise effective and safe participation in the study

Patients who have an uncontrolled intercurrent illness including, but not limited to any of the following, are not eligible:

Uncontrolled pulmonary, renal, or hepatic dysfunction
Ongoing or active infection requiring systemic treatment
Known active or chronic viral hepatitis or human immunodeficiency virus (HIV)
Psychiatric illness/social situations that would limit compliance with study requirements
Any other illness or condition that the treating investigator feels would interfere with study compliance or would compromise the patient's safety or study endpoints
Female patients who are pregnant or nursing are not eligible