Study of AVB-620 in Women With Primary, Nonrecurrent Breast Cancer Undergoing Surgery

Phase 2, open-label study of AVB-620 in women with primary, nonrecurrent, nonmetastatic
breast cancer undergoing either a lumpectomy with simultaneous sentinel lymph node biopsy
(SLNB) or axillary lymph node dissection (ALND), or a mastectomy and simultaneous ALND.
AVB-620 is a synthetic protease-activated peptide dye conjugate administered intravenously
for the fluorescence detection and localization of potentially malignant tissue in primary
tumor, tumor margins, or lymph nodes. A fluorescence image will be displayed on a monitor and
will assist the surgeon to assess potentially cancerous tissue within the primary tumor site,
tumor margins, or in lymph nodes which drain the primary tumor site.

Eligible patients will receive a single dose of AVB-620 by IV infusion up to 24 hours prior
to breast surgery.

The study will evaluate the effect of timing of AVB-620 administration relative to surgery on
the fluorescence and the accuracy of the AVB-620 imaging data to distinguish between
malignant and nonmalignant tissues.

Inclusion Criteria:

- DCIS or Stage I-III primary invasive carcinoma of the breast

- Primary surgical treatment is lumpectomy + SLNB or ALND --or-- mastectomy + ALND

- Signed written informed consent

- At least 18 years of age

- ECOG performance status 0 to 2

- Life expectancy of at least 6 months

- Total bilirubin ≤ 2 mg/dL

- AST/SGOT and ALT/SGPT ≤ 2.5 X ULN

- Negative serum pregnancy test and using medically acceptable form of contraception if
of child bearing potential

- LVEF within normal limits if patient received prior anthracycline therapy [Period 1].

Exclusion Criteria:

- Recurrent ipsilateral breast cancer

- Prior neoadjuvant chemotherapy, endocrine therapy, or biologic therapy for current
breast cancer [Period 2]

- Prior neoadjuvant chemo or biologic therapy for current breast cancer within 4 weeks
prior to planned surgery [Period 1]

- Open surgery in ipsilateral breast within 1 year.

- Prior malignancy, other than breast cancer, active within the last 6 months

- Prior radiation therapy to the chest [Period 2]

- Radiation therapy to ipsilateral breast [Period 1]

- Abnormal cardiac rhythm not controlled with medication; Hx of stroke within 1 year; Hx
of coronary events and/or heart failure within 1 year.

- Diagnosis of autoimmune disorder, including RA, SLE, or Sjogren's syndrome

- Hx of drug-related anaphylactic reactions, severe allergic reactions related to drug;
active diagnosis of uncontrolled airway hyperactivity, uncontrolled asthma, or asthma
requiring oral corticosteroids.

- Hx of drug-induced acute tubular necrosis.

- Chronic renal failure or current evidence of moderate to severe renal impairment.

- Current diagnosis of any other active or clinically significant nonbreast cancer

- Received systemic investigational drug within 6 weeks prior to AVB-620 administration
or has received AVB-620 previously.

- Pregnant or breast feeding or plans to become pregnant within 6 months of AVB-620
administration.

- Unresolved acute toxicity from prior anticancer therapy