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Comparing the Efficacy of Nab-PHP and TCbHP in Neoadjuvant Therapy for HER2 Positive Operable Breast Cancer

Primary Purpose

Breast Cancer,Her2 Positive

Status
Recruiting
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
Albumin binding paclitaxel+ trastuzumab+ patuzumab
Docetaxel+ carboplatin+ trastuzumab + patuzumab
Sponsored by
Henan Cancer Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer,Her2 Positive

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. 18 years ≤ age ≤ 65 years, Performance Status- Eastern Cooperative Oncology Group (ECOG) 0-1
  2. Clinical T2-T4d, or T1c with axillary LN+
  3. HER2 + invasive breast cancer confirmed by histopathology Note: HER2 expression positive refers to the tumor cells with immunohistochemical staining intensity of 3 + or confirmed positive by fluorescence in situ hybridization [fish] at least once during the pathological detection/review of primary tumor in the Department of pathology of participating research center hospital
  4. Clinically measurable lesions: measurable lesions revealed by ultrasound, molybdenum target or MR (optional) within 1 month before randomization
  5. Organ and bone marrow function test within one month before chemotherapy showed no chemotherapy contraindication

    • Absolute value of neutrophil count ≥ 2.0×10^9 / L
    • Hemoglobin ≥ 100g / L
    • Platelet count ≥ 100×10^9 / L
    • Total bilirubin < 1.5 ULN (upper limit of normal value)
    • Creatinine < 1.5 × ULN
    • AST/ALT < 1.5×ULN
  6. Echocardiography: left ventricular ejection fraction (LVEF ≥ 55%)
  7. For women of childbearing age, serum pregnancy test was negative 14 days before randomization
  8. KPS score ≥ 80 points
  9. Signed the informed consent form prior to patient entry

Exclusion Criteria:

  1. Metastatic breast cancer (Stage IV)
  2. Chemotherapy, endocrine therapy, targeted therapy and reflexotherapy have been used for this disease
  3. The patient had a second primary malignant tumor, except for the well treated skin cancer
  4. Patients who had undergone major surgery unrelated to breast cancer within 4 weeks before enrollment, or had not recovered completely from such operations
  5. Serious heart disease or discomfort, including but not limited to the following diseases:

    • History of heart failure or systolic dysfunction (LVEF < 50%)
    • high risk uncontrolled arrhythmias such as atrial tachycardia, resting heart rate > 100 BPM, significant ventricular arrhythmias (e.g., ventricular tachycardia) or higher-level atrioventricular block (i.e., mobitz II second degree atrioventricular block or third degree atrioventricular block)
    • angina pectoris requiring anti angina drugs
    • Heart valve disease with clinical significance
    • ECG showed transmural myocardial infarction
    • Poor control of hypertension (systolic blood pressure > 180 mmHg and / or diastolic blood pressure > 100 mmHg)
  6. Due to serious and uncontrollable other medical diseases, the researchers believe that there are chemotherapy contraindications
  7. Those who have been known to have allergic history to the drug components of this regimen; have a history of immune deficiency, including HIV positive test, or have other acquired or congenital immunodeficiency diseases, or have a history of organ transplantation;

Sites / Locations

  • Henan cancer hospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

nab-PHP

TCbHP

Arm Description

Albumin binding paclitaxel + trastuzumab+ patuzumab

Docetaxel + carboplatin + trastuzumab + patuzumab

Outcomes

Primary Outcome Measures

Pathological Complete Response (pCR)
Percentage of Participants With Pathological Complete Response (pCR) (ypT0/is/N0M0) after 6 cycles of neoadjuvant chemotherapy

Secondary Outcome Measures

number of adverse events
Evaluate the nature, incidence and severity of chemotherapy adverse events according to CTCAE 4.0
Number of patients with adverse events
Dose adjustment rate and withdrawal rate of chemotherapy drugs in two chemotherapy regimens
ORR
Objective response rate, ORR assessed according to the evaluation criteria for the efficacy of solid tumors (RECIST 1.1)
DFS
Disease-free Survival,From the date of surgery to the first local, regional, contralateral or distant recurrence, and death from any cause

Full Information

First Posted
August 29, 2020
Last Updated
March 15, 2023
Sponsor
Henan Cancer Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT04547907
Brief Title
Comparing the Efficacy of Nab-PHP and TCbHP in Neoadjuvant Therapy for HER2 Positive Operable Breast Cancer
Official Title
Comparing the Efficacy and Security of Nab-PHP and TCbHP in Neoadjuvant Chemotherapy for HER2 Positive Operable Breast Cancer , A Multicenter, Randomized, Phase III Clinical Trial
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 18, 2020 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Henan Cancer Hospital

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
At present, trastuzumab combined with patuzumab has become the standard neoadjuvant therapy for high-risk HER2 positive breast cancer. TCbHP has been the standard choice of neoadjuvant therapy for HER2 positive breast cancer patients with early high-risk or locally advanced HER2 positive breast cancer. Whether nab-PHP can achieve the same effect as TCbHP is still uncertain.
Detailed Description
In order to compare the effects of nab-PHP and TCBHP chemotherapy regimens in the neoadjuvant treatment of HER2-positive breast cancer, this study randomly divided patients who met the inclusion criteria into 2 groups through a randomized control regimen. nab-PHP regimen:Albumin binding paclitaxel 125 mg / m2 (1, 8, 15 days) + trastuzumab (8 mg / kg for the first loading dose and 6 mg / kg for the sequential maintenance dose) + patuzumab (840mg for the first loading dose and 420mg for the sequential maintenance dose) ,every 21 days for 6 cycles. TCbHP regimen:Docetaxel 75 mg/m2 + carboplatin (AUC = 6) + trastuzumab(8 mg / kg for the first loading dose and 6 mg / kg for the sequential maintenance dose) + patuzumab (840mg for the first loading dose and 420mg for the sequential maintenance dose) ,every 21 days for 6 cycles. Finally, the safety and efficacy of the two chemotherapy regimens were evaluated by postoperative PCR, ORR, DFS, OS and number of adverse events.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer,Her2 Positive

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
558 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
nab-PHP
Arm Type
Experimental
Arm Description
Albumin binding paclitaxel + trastuzumab+ patuzumab
Arm Title
TCbHP
Arm Type
Active Comparator
Arm Description
Docetaxel + carboplatin + trastuzumab + patuzumab
Intervention Type
Drug
Intervention Name(s)
Albumin binding paclitaxel+ trastuzumab+ patuzumab
Other Intervention Name(s)
nab-PHP regimen group
Intervention Description
Albumin binding paclitaxel 125 mg / m2 (1, 8, 15 days) + trastuzumab (8 mg / kg for the first loading dose and 6 mg / kg for the sequential maintenance dose) + patuzumab (840mg for the first loading dose and 420mg for the sequential maintenance dose) ,every 21 days for 6 cycles.
Intervention Type
Drug
Intervention Name(s)
Docetaxel+ carboplatin+ trastuzumab + patuzumab
Other Intervention Name(s)
TCbHP regimen group
Intervention Description
Docetaxel 75 mg/m2 + carboplatin (AUC = 6) + trastuzumab(8 mg / kg for the first loading dose and 6 mg / kg for the sequential maintenance dose) + patuzumab (840mg for the first loading dose and 420mg for the sequential maintenance dose) ,every 21 days for 6 cycles.
Primary Outcome Measure Information:
Title
Pathological Complete Response (pCR)
Description
Percentage of Participants With Pathological Complete Response (pCR) (ypT0/is/N0M0) after 6 cycles of neoadjuvant chemotherapy
Time Frame
through study completion, an average of 1 year
Secondary Outcome Measure Information:
Title
number of adverse events
Description
Evaluate the nature, incidence and severity of chemotherapy adverse events according to CTCAE 4.0
Time Frame
After each cycle of chemotherapy (21 days as 1 cycle)
Title
Number of patients with adverse events
Description
Dose adjustment rate and withdrawal rate of chemotherapy drugs in two chemotherapy regimens
Time Frame
After each cycle of chemotherapy (21 days as 1 cycle)
Title
ORR
Description
Objective response rate, ORR assessed according to the evaluation criteria for the efficacy of solid tumors (RECIST 1.1)
Time Frame
After each cycle of chemotherapy (21 days as 1 cycle)
Title
DFS
Description
Disease-free Survival,From the date of surgery to the first local, regional, contralateral or distant recurrence, and death from any cause
Time Frame
5-10 years after surgery.

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 18 years ≤ age ≤ 65 years, Performance Status- Eastern Cooperative Oncology Group (ECOG) 0-1 Clinical T2-T4d, or T1c with axillary LN+ HER2 + invasive breast cancer confirmed by histopathology Note: HER2 expression positive refers to the tumor cells with immunohistochemical staining intensity of 3 + or confirmed positive by fluorescence in situ hybridization [fish] at least once during the pathological detection/review of primary tumor in the Department of pathology of participating research center hospital Clinically measurable lesions: measurable lesions revealed by ultrasound, molybdenum target or MR (optional) within 1 month before randomization Organ and bone marrow function test within one month before chemotherapy showed no chemotherapy contraindication Absolute value of neutrophil count ≥ 2.0×10^9 / L Hemoglobin ≥ 100g / L Platelet count ≥ 100×10^9 / L Total bilirubin < 1.5 ULN (upper limit of normal value) Creatinine < 1.5 × ULN AST/ALT < 1.5×ULN Echocardiography: left ventricular ejection fraction (LVEF ≥ 55%) For women of childbearing age, serum pregnancy test was negative 14 days before randomization KPS score ≥ 80 points Signed the informed consent form prior to patient entry Exclusion Criteria: Metastatic breast cancer (Stage IV) Chemotherapy, endocrine therapy, targeted therapy and reflexotherapy have been used for this disease The patient had a second primary malignant tumor, except for the well treated skin cancer Patients who had undergone major surgery unrelated to breast cancer within 4 weeks before enrollment, or had not recovered completely from such operations Serious heart disease or discomfort, including but not limited to the following diseases: History of heart failure or systolic dysfunction (LVEF < 50%) high risk uncontrolled arrhythmias such as atrial tachycardia, resting heart rate > 100 BPM, significant ventricular arrhythmias (e.g., ventricular tachycardia) or higher-level atrioventricular block (i.e., mobitz II second degree atrioventricular block or third degree atrioventricular block) angina pectoris requiring anti angina drugs Heart valve disease with clinical significance ECG showed transmural myocardial infarction Poor control of hypertension (systolic blood pressure > 180 mmHg and / or diastolic blood pressure > 100 mmHg) Due to serious and uncontrollable other medical diseases, the researchers believe that there are chemotherapy contraindications Those who have been known to have allergic history to the drug components of this regimen; have a history of immune deficiency, including HIV positive test, or have other acquired or congenital immunodeficiency diseases, or have a history of organ transplantation;
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Zhenzhen Liu
Phone
13603862755
Email
liuzhenzhen73@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Jiujun Zhu
Phone
13676962766
Email
bigapple0601@126.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Zhenzhen Liu
Organizational Affiliation
Study Principal Investigator Henan Cancer Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Henan cancer hospital
City
Zhengzhou
State/Province
Henan
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhenzhen Liu
Phone
17729798130
Email
liuzhenzhen73@126.com

12. IPD Sharing Statement

Learn more about this trial

Comparing the Efficacy of Nab-PHP and TCbHP in Neoadjuvant Therapy for HER2 Positive Operable Breast Cancer

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