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Study Comparing EC-T Verses PCb in the Adjuvant Chemotherapy of Non-triple Negative Breast Cancer (PANSY)

Primary Purpose

Breast Cancer

Status
Recruiting
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
Paclitaxel
Carboplatin
Epirubicin
Cyclophosphamide
Trastuzumab
Pertuzumab
Docetaxel
Sponsored by
Fudan University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring adjuvant chemotherapy, epirubicin, cyclophosphamide, docetaxel, paclitaxel, carboplatin, trastuzumab, non-triple negative breast cancer, pertuzumab

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Female patients aged 18-70 years old;
  2. Histologically confirmed unilateral invasive breast cancer (regardless of pathological type)
  3. Operable breast cancer at first diagnosis, without any absolute surgical contraindication.
  4. No gross nor microscopic residual tumor after surgery.
  5. HER2-positive with ≥ 1 positive axillary lymph node; or estrogen receptor (ER) and/or progesterone receptor (PR)-positive and HER2-negative with ≥ 4 positive axillary lymph node. HER2-positive is defined as an immunohistochemistry (IHC) status of 3+, or a positive in situ hybridization (Fluorescence in situ hybridization (FISH), Chromogenic in situ hybridization (CISH)) test. ER-positive is defined as immunohistochemistry showing that ≥ 1% of tumor cells were ER positive. PR-positive is defined as immunohistochemistry showing that ≥ 1% of tumor cells were PR positive.
  6. Preoperative examination found no evidence of metastasis in clinical examination nor imaging examination.
  7. No peripheral neuropathy.
  8. Karnofsky score > 70.
  9. Good postoperative recovery, at least 1 week has passed since most recent surgery.
  10. Has adequate bone marrow function: leukocyte count > 4x10ˆ9 / L, absolute neutrophil count > 2x10ˆ9 /L; platelet count > 100x10ˆ9 /L, hemoglobin > 9g/dL.
  11. Has adequate liver function: alanine aminotransferase (ALT) < 1.5×upper limit of normal (ULN), aspartate aminotransferase (AST) < 1.5×ULN, alkaline phosphatase (AKP) < 2.5×ULN, total bilirubin (TBIL) < 1.5×ULN.
  12. Has adequate kidney function: serum creatinine < 1.5×ULN.
  13. Contraception during treatment for women of childbearing age.
  14. Has adequate cardiac function: echocardiography showed left ventricular ejection fraction (LVEF) > 50%.
  15. Participants voluntarily joined the study, has signed informed consent before any trial related activities are conducted, has good compliance and has agreed to follow-up.

Exclusion Criteria:

  1. Has received previous chemotherapy for late stage disease.
  2. Has bilateral breast cancer or bilateral carcinoma in situ.
  3. Has metastatic (Stage 4) breast cancer.
  4. Has clinical T4 lesion (UICC1987) (with skin involvement, mass adhesion and fixation, and inflammatory breast cancer).
  5. Has received neoadjuvant therapy (include chemotherapy, targeted therapy, radiotherapy or endocrine therapy).
  6. Has previous history of additional malignancy(with the exception of adequately treated basal cell carcinoma and cervical carcinoma in situ), including contralateral breast cancer.
  7. Is already participating in another clinical trial.
  8. Has severe systemic disease and/or uncontrolled infection.
  9. Has insufficient cardiac function: echocardiography showed LVEF< 50%.
  10. Has suffered from severe cardiovascular and cerebrovascular diseases disease within the 6 months previous of randomization (such as unstable angina, chronic heart failure, uncontrolled hypertension with blood pressure>150/90 mmHg, myocardial infarction, or cerebrovascular accident.
  11. Has known allergy to chemotherapy drugs used in this study.
  12. Is pregnant, is breast feeding, or is a woman of childbearing age who cannot practice effective contraceptives during treatment and until 8 weeks after the end of treatment.
  13. Has entered the study, but pre-treatment examination showed a positive pregnancy test.
  14. Has a history of mental disorders, cognitive impairment, inability to understand the study protocol and side effects, inability to complete the study protocol and follow-up workers (systematic evaluation is required before the patient is enrolled into the study), or is without independent civil capacity.
  15. The researchers judged patients to be unsuitable for the study.

Sites / Locations

  • Cancer Hospital Affiliated to Fudan UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Experimental

Active Comparator

Experimental

Arm Label

PANSY-1: EC-T

PANSY-1: PCb

PANSY-2: EC-TH(P)

PANSY-2: PCbH(P)

Arm Description

4 cycles of EC (epirubicin 90 mg/m^2 ivgtt d1+ cyclophosphamide 600 mg/m^2 iv d1, 21 days per cycle), followed by 4 cycles of T (docetaxel 100 mg/m^2 ivgtt d1, 21 days per cycle)

6 cycles of weekly PCb (paclitaxel 80 mg/m^2 ivgtt d1, d8, d15+ carboplatin Area Under Curve (AUC)=2 ivgtt d1, d8, d15, 28 days per cycle)

4 cycles of EC (epirubicin 90 mg/m^2 ivgtt d1+cyclophosphamide 600 mg/m^2 iv d1, 21 days per cycle), followed by 4 cycles of TH(P) (docetaxel 100 mg/m^2 ivgtt d1 + trastuzumab 6 mg/kg (loading dose 8mg/kg) ivgtt d1, 21 days per cycle, with pertuzumab 420mg (loading dose 840mg) ivgtt d1, 21 days per cycle for participants receiving dual-targeted therapy). After 8 cycles of chemotherapy, patient will continue to complete 1 year of adjuvant trastuzumab (6 mg/kg ivgtt every 3 weeks), with pertuzumab (420mg ivgtt every 3 weeks) for participants receiving dual-targeted therapy.

6 cycles of weekly PCbH(P) (paclitaxel 80 mg/m^2 ivgtt d1, d8, d15 + carboplatin AUC=2 ivgtt d1, d8, d15 + trastuzumab 2 mg/kg (loading dose 4mg/kg, w1) ivgtt d1, d8, d15, d22, 28 days per cycle, with pertuzumab 420mg (loading dose 840mg) ivgtt d1, 21 days per cycle for participants receiving dual-targeted therapy). Participants may also choose to receive trastuzumab 6 mg/kg (loading dose 8mg/kg) ivgtt d1, 21 days per cycle with chemotherapy. After 6 cycles of chemotherapy, patient will continue to complete 1 year of adjuvant trastuzumab (6 mg/kg ivgtt every 3 weeks), with pertuzumab (420mg ivgtt every 3 weeks) for participants receiving dual-targeted therapy.

Outcomes

Primary Outcome Measures

disease free survival

Secondary Outcome Measures

Invasive Disease Free Survival
Distant Disease Free Survival
Overall Survival
Number of Participants with Treatment Related Adverse Events as Assessed by CTCAE v4.0
Graded according to Common Terminology Criteria for Adverse Events (CTC-AE) 4.0 according to CTC-AE 4.0

Full Information

First Posted
December 8, 2019
Last Updated
March 5, 2020
Sponsor
Fudan University
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1. Study Identification

Unique Protocol Identification Number
NCT04193059
Brief Title
Study Comparing EC-T Verses PCb in the Adjuvant Chemotherapy of Non-triple Negative Breast Cancer
Acronym
PANSY
Official Title
Study Comparing the Efficacy and Safety of Epirubicin Combined With Cyclophosphamide Followed by Docetaxel (EC-T) Verses Paclitaxel Combined With Carboplatin (PCb) in the Adjuvant Chemotherapy of Non-triple Negative Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
March 2020
Overall Recruitment Status
Recruiting
Study Start Date
August 1, 2018 (Actual)
Primary Completion Date
July 2021 (Anticipated)
Study Completion Date
July 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Fudan University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This study is a randomized, single center, phase III clinical trial comparing the efficacy and safety of four cycles of epirubicin combined with cyclophosphamide followed by four cycles of docetaxel (EC*4-T*4) verses 6 cycles of weekly paclitaxel combined with carboplatin (PCb*6) in the adjuvant chemotherapy of non-triple negative breast cancer patients. The study is divided in to 2 branches: PANSY-1 and PANSY-2. PANSY-1 is a study of hormone receptor (HR)-positive/human epidermal growth factor receptor-2 (HER2)-negative patients with ≥4 positive lymph node, while PANSY-2 is a study of HER2-positive patients with ≥1 positive lymph node.
Detailed Description
PANSY-1 will be comparing the efficacy and safety of four cycles of epirubicin combined with cyclophosphamide followed by four cycles of docetaxel (EC-T) verses six cycles of paclitaxel combined with carboplatin (PCb). PANSY-2 will be comparing the efficacy and safety of four cycles of epirubicin combined with cyclophosphamide followed by four cycles of docetaxel with trastuzumab (EC-TH) verses six cycles of paclitaxel combined with carboplatin and trastuzumab (PCbH); both followed by 1 year adjuvant trastuzumab. After pertuzumab became legally available in China, participants of PANSY-2 may choose to receive trastuzumab and pertuzumab dual targeted therapy, thus comparing the efficacy and safety of four cycles of epirubicin combined with cyclophosphamide followed by four cycles of docetaxel with trastuzumab and pertuzumab (EC-THP) verses six cycles of paclitaxel combined with carboplatin, trastuzumab and pertuzumab (PCbHP); both followed by 1 year adjuvant trastuzumab and pertuzumab. With the inclusion of pertuzumab in China's medical insurance in January 2020, study protocols were revised to include dual targeted therapy for HER2-positive participants.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
adjuvant chemotherapy, epirubicin, cyclophosphamide, docetaxel, paclitaxel, carboplatin, trastuzumab, non-triple negative breast cancer, pertuzumab

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
PANSY-1: Arm 1: EC-T: 4 cycles of EC (epirubicin + cyclophosphamide), followed by 4 cycles of T (docetaxel) . Arm 2: PCb: 6 cycles of weekly PCb (paclitaxel + carboplatin). PANSY-2: Arm 1: EC-TH(P): 4 cycles of EC (epirubicin + cyclophosphamide), followed by 4 cycles of TH TH(P) (docetaxel + trastuzumab, with pertuzumab for participants receiving dual-targeted therapy). After completing chemotherapy, patient will continue to complete 1 year of adjuvant trastuzumab, with pertuzumab for participants receiving dual-targeted therapy. Arm 2: PCbH(P): 6 cycles of weekly PCbH(P) (paclitaxel + carboplatin + trastuzumab, with pertuzumab for participants receiving dual-targeted therapy. After completing chemotherapy, patient will continue to complete 1 year of adjuvant trastuzumab, with pertuzumab for participants receiving dual-targeted therapy.
Masking
None (Open Label)
Masking Description
Open label
Allocation
Randomized
Enrollment
1560 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
PANSY-1: EC-T
Arm Type
Active Comparator
Arm Description
4 cycles of EC (epirubicin 90 mg/m^2 ivgtt d1+ cyclophosphamide 600 mg/m^2 iv d1, 21 days per cycle), followed by 4 cycles of T (docetaxel 100 mg/m^2 ivgtt d1, 21 days per cycle)
Arm Title
PANSY-1: PCb
Arm Type
Experimental
Arm Description
6 cycles of weekly PCb (paclitaxel 80 mg/m^2 ivgtt d1, d8, d15+ carboplatin Area Under Curve (AUC)=2 ivgtt d1, d8, d15, 28 days per cycle)
Arm Title
PANSY-2: EC-TH(P)
Arm Type
Active Comparator
Arm Description
4 cycles of EC (epirubicin 90 mg/m^2 ivgtt d1+cyclophosphamide 600 mg/m^2 iv d1, 21 days per cycle), followed by 4 cycles of TH(P) (docetaxel 100 mg/m^2 ivgtt d1 + trastuzumab 6 mg/kg (loading dose 8mg/kg) ivgtt d1, 21 days per cycle, with pertuzumab 420mg (loading dose 840mg) ivgtt d1, 21 days per cycle for participants receiving dual-targeted therapy). After 8 cycles of chemotherapy, patient will continue to complete 1 year of adjuvant trastuzumab (6 mg/kg ivgtt every 3 weeks), with pertuzumab (420mg ivgtt every 3 weeks) for participants receiving dual-targeted therapy.
Arm Title
PANSY-2: PCbH(P)
Arm Type
Experimental
Arm Description
6 cycles of weekly PCbH(P) (paclitaxel 80 mg/m^2 ivgtt d1, d8, d15 + carboplatin AUC=2 ivgtt d1, d8, d15 + trastuzumab 2 mg/kg (loading dose 4mg/kg, w1) ivgtt d1, d8, d15, d22, 28 days per cycle, with pertuzumab 420mg (loading dose 840mg) ivgtt d1, 21 days per cycle for participants receiving dual-targeted therapy). Participants may also choose to receive trastuzumab 6 mg/kg (loading dose 8mg/kg) ivgtt d1, 21 days per cycle with chemotherapy. After 6 cycles of chemotherapy, patient will continue to complete 1 year of adjuvant trastuzumab (6 mg/kg ivgtt every 3 weeks), with pertuzumab (420mg ivgtt every 3 weeks) for participants receiving dual-targeted therapy.
Intervention Type
Drug
Intervention Name(s)
Paclitaxel
Intervention Description
paclitaxel 80 mg/m^2 ivgtt d1, d8, d15, 28 days per cycle, 6 cycles.
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Intervention Description
carboplatin AUC=2 ivgtt d1, d8, d15, 28 days per cycle, 6 cycles.
Intervention Type
Drug
Intervention Name(s)
Epirubicin
Intervention Description
epirubicin 90 mg/m^2 ivgtt d1, 21 days per cycle, 4 cycles.
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Intervention Description
cyclophosphamide 600 mg/m^2 iv d1, 21 days per cycle, 4 cycles.
Intervention Type
Drug
Intervention Name(s)
Trastuzumab
Intervention Description
trastuzumab 6 mg/kg (loading dose 8mg/kg) ivgtt d1, 21 days per cycle with chemotherapy; or trastuzumab 2 mg/kg (loading dose 4mg/kg, w1) ivgtt d1, d8, d15, d22, 28 days per cycle with chemotherapy. After chemotherapy, patient will continue to complete 1 year of adjuvant trastuzumab (6 mg/kg ivgtt every 3 weeks).
Intervention Type
Drug
Intervention Name(s)
Pertuzumab
Intervention Description
pertuzumab 420mg (loading dose 840mg) ivgtt d1, 21 days per cycle with chemotherapy. After chemotherapy, patient will continue to complete 1 year of adjuvant pertuzumab (420mg ivgtt every 3 weeks).
Intervention Type
Drug
Intervention Name(s)
Docetaxel
Intervention Description
docetaxel 100 mg/m^2 ivgtt d1, 21 days per cycle, 4 cycles.
Primary Outcome Measure Information:
Title
disease free survival
Time Frame
5 years
Secondary Outcome Measure Information:
Title
Invasive Disease Free Survival
Time Frame
5 years
Title
Distant Disease Free Survival
Time Frame
5 years
Title
Overall Survival
Time Frame
5 years
Title
Number of Participants with Treatment Related Adverse Events as Assessed by CTCAE v4.0
Description
Graded according to Common Terminology Criteria for Adverse Events (CTC-AE) 4.0 according to CTC-AE 4.0
Time Frame
5 years

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Female patients aged 18-70 years old; Histologically confirmed unilateral invasive breast cancer (regardless of pathological type) Operable breast cancer at first diagnosis, without any absolute surgical contraindication. No gross nor microscopic residual tumor after surgery. HER2-positive with ≥ 1 positive axillary lymph node; or estrogen receptor (ER) and/or progesterone receptor (PR)-positive and HER2-negative with ≥ 4 positive axillary lymph node. HER2-positive is defined as an immunohistochemistry (IHC) status of 3+, or a positive in situ hybridization (Fluorescence in situ hybridization (FISH), Chromogenic in situ hybridization (CISH)) test. ER-positive is defined as immunohistochemistry showing that ≥ 1% of tumor cells were ER positive. PR-positive is defined as immunohistochemistry showing that ≥ 1% of tumor cells were PR positive. Preoperative examination found no evidence of metastasis in clinical examination nor imaging examination. No peripheral neuropathy. Karnofsky score > 70. Good postoperative recovery, at least 1 week has passed since most recent surgery. Has adequate bone marrow function: leukocyte count > 4x10ˆ9 / L, absolute neutrophil count > 2x10ˆ9 /L; platelet count > 100x10ˆ9 /L, hemoglobin > 9g/dL. Has adequate liver function: alanine aminotransferase (ALT) < 1.5×upper limit of normal (ULN), aspartate aminotransferase (AST) < 1.5×ULN, alkaline phosphatase (AKP) < 2.5×ULN, total bilirubin (TBIL) < 1.5×ULN. Has adequate kidney function: serum creatinine < 1.5×ULN. Contraception during treatment for women of childbearing age. Has adequate cardiac function: echocardiography showed left ventricular ejection fraction (LVEF) > 50%. Participants voluntarily joined the study, has signed informed consent before any trial related activities are conducted, has good compliance and has agreed to follow-up. Exclusion Criteria: Has received previous chemotherapy for late stage disease. Has bilateral breast cancer or bilateral carcinoma in situ. Has metastatic (Stage 4) breast cancer. Has clinical T4 lesion (UICC1987) (with skin involvement, mass adhesion and fixation, and inflammatory breast cancer). Has received neoadjuvant therapy (include chemotherapy, targeted therapy, radiotherapy or endocrine therapy). Has previous history of additional malignancy(with the exception of adequately treated basal cell carcinoma and cervical carcinoma in situ), including contralateral breast cancer. Is already participating in another clinical trial. Has severe systemic disease and/or uncontrolled infection. Has insufficient cardiac function: echocardiography showed LVEF< 50%. Has suffered from severe cardiovascular and cerebrovascular diseases disease within the 6 months previous of randomization (such as unstable angina, chronic heart failure, uncontrolled hypertension with blood pressure>150/90 mmHg, myocardial infarction, or cerebrovascular accident. Has known allergy to chemotherapy drugs used in this study. Is pregnant, is breast feeding, or is a woman of childbearing age who cannot practice effective contraceptives during treatment and until 8 weeks after the end of treatment. Has entered the study, but pre-treatment examination showed a positive pregnancy test. Has a history of mental disorders, cognitive impairment, inability to understand the study protocol and side effects, inability to complete the study protocol and follow-up workers (systematic evaluation is required before the patient is enrolled into the study), or is without independent civil capacity. The researchers judged patients to be unsuitable for the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
ZhiMin Shao, MD, PhD
Phone
+86-21-64175590
Ext
8808
Email
zhimingshao@yahoo.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
ZhiMin Shao, MD, PhD
Organizational Affiliation
Fudan University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cancer Hospital Affiliated to Fudan University
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200032
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhimin Shao, MD, PhD
Phone
+86-021-64175590
Ext
8888
Email
zhimingshao@yahoo.com

12. IPD Sharing Statement

Learn more about this trial

Study Comparing EC-T Verses PCb in the Adjuvant Chemotherapy of Non-triple Negative Breast Cancer

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