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A Study of ARX788 Combined With Pyrotinib Maleate Versus TCBHP (Trastuzumab Plus Pertuzumab With Docetaxel and Carboplatin) as Neoadjuvant Treatment in HER2-positive Breast Cancer Patients

Primary Purpose

HER2-positive Breast Cancer

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
ARX788
Pyrotinib maleate
Trastuzumab
Pertuzumab
Docetaxel
Carboplatin
Sponsored by
Caigang Liu
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HER2-positive Breast Cancer focused on measuring ARX788, Pyrotinib, HER2-positive Breast Cancer, Neoadjuvant

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Female patients aged ≥ 18 but ≤ 75 years;
  • Diagnosis of breast cancer meets the following criteria: Histologically confirmed invasive breast cancer; Tumor staging: Stage II-III patients who meet the 8th edition of AJCC Cancer Staging Manual;
  • HER2-positive breast cancer pathologically confirmed is defined as Immunohistochemical method (IHC 3+) or IHC 2+ with FISH+;
  • Eastern Cooperative Oncology Group (ECOG) level 0-1;
  • The functional level of major organs must conform to the following requirements: Neutrophils (ANC) ≥ 1.5×10^9/L (with no use of growth factors within 14 days); Platelet count (PLT) ≥ 100×10^9/L (with no correct treatment within 7 days ); Hemoglobin (Hb) ≥ 90 g/L (with no correct treatment within 7 days ); Total bilirubin (TBIL) ≤ 1.5×upper limit of normal (ULN); Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3×ULN; Urea nitrogen and creatinine ≤ 1.5×ULN and creatinine clearance ≥ 50 mL/min (Cockcroft-Gault formula); Cardiac color Doppler ultrasound: left ventricular ejection fraction (LVEF) ≥ 50%; 12-lead electrocardiogram: QT interval ≤ 480 ms;
  • Patients who participate in the trial voluntarily, sign an informed consent, have good compliance and are willing to comply with the follow-up visit.

Exclusion Criteria:

  • Previously received any anti-tumor therapy (chemotherapy, radiotherapy, molecular targeted therapy, endocrine therapy, etc.);
  • Patients who are concurrently receiving other anti-tumor therapy;
  • Bilateral breast cancer, inflammatory breast cancer, or occult breast cancer;
  • Stage IV breast cancer;
  • With a history of any malignancies other than breast cancer in the past 5 years, excluding cured cervical carcinoma in situ and melanoma skin cancer;
  • Inability to swallow, chronic diarrhea and intestinal obstruction, and having many factors that affect drug administration and absorption;
  • Patients with known allergies to any active ingredients or excipients of Investigational medicinal product;
  • With a history of interstitial pulmonary disease, drug-induced pulmonary interstitial disease, and radiation pneumonitis that require hormone therapy, or any clinically active pulmonary interstitial disease as suggested by any evidence;
  • Patients who are currently suffering from keratitis, corneal disease, retinal disease, or active eye infection that require any interventions for the eyes;
  • Once suffered from any heart disease, including: (1) arrhythmia with clinical significance, (2) myocardial infarction; (3) heart failure; (4) investigator's judgment as not suitable for participating in this trial;
  • Female patients during pregnancy and lactation, or those who are fertile and positive for baseline pregnancy test or those of childbearing age who are unwilling to take effective contraceptive measures throughout the trial period;
  • Serious concomitant diseases or other comorbid diseases that will endanger the safety of patients or interfere with the completion of the trial, including but not limited to severe hypertension, severe diabetes mellitus, and active infections that are out of control;

Sites / Locations

  • Shengjing Hospital affiliated to China Medical UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

ARX788 + pyrotinib maleate

trastuzumab + pertuzumab + docetaxel + carboplatin

Arm Description

ARX788 1.5 mg/kg intravenously (IV) every three weeks plus pyrotinib maleate 320 mg orally once daily for 6 cycles

Trastuzumab (8 mg/kg first dose, followed 6 mg/kg) puls pertuzumab (840 mg first dose, followed 420 mg) plus docetaxel (75 mg/m3) plus carboplatin (AUC6) IV every 3 weeks for 6 cycles

Outcomes

Primary Outcome Measures

Total pathological complete response rate (tpCR) in percentage
The standard for removal of breast and lymph node tumors which means there are no infiltrating cancer cells at the primary breast and axillary lymph nodes, and only intraductal cancer is allowed on the breast.

Secondary Outcome Measures

Total breast pathological complete remission rate (bpCR) in percentage
The standard for breast and lymph node tumor removal which means that there are only infiltrating cancer cells at the primary breast tumor site.
Residual tumor burden (RCB) classification in grades
Postoperative pathological results will be used to assess the residual tumor area of primary breast tumor (area in mm×mm), the cell density of the residual tumor(cell density in percentages), the proportion of carcinoma in situ (proportion of carcinoma in percentages), the number of positive lymph nodes and the diameter of largest metastasis with residual nodes (diameter in mm). The RCB class can be estimated from the above five pathological parameters through a network calculation: RCB-0 in grades: pCR; RCB-I in grades: minimal residual tumor; RCB-II: moderate residual tumor; RCB-III in grades: extensive residual tumor.
Best overall response rate (BORR) in percentage
The proportion of patients who achieve remission at any point during the study.
Five-year overall survival (OS)
The time from the random date to death due to any cause.
Disease-free survival (DFS)
The time from the day of enrollment to the first occurrence of recurrent disease, including second primary malignancies in the non-breast area and breast ductal carcinoma in situ.
Adverse events (AE)
Adverse events (AE) will be assessed as per the NCI-CTC AE 5.0 standard.

Full Information

First Posted
June 12, 2022
Last Updated
March 30, 2023
Sponsor
Caigang Liu
Collaborators
Jiangsu HengRui Medicine Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05426486
Brief Title
A Study of ARX788 Combined With Pyrotinib Maleate Versus TCBHP (Trastuzumab Plus Pertuzumab With Docetaxel and Carboplatin) as Neoadjuvant Treatment in HER2-positive Breast Cancer Patients
Official Title
A Randomized, Open Label, Multi-center Phase II-III Neoadjuvant Study Comparing the Efficacy and Safety of ARX788 Combined With Pyrotinib Maleate Versus TCBHP (Trastuzumab Plus Pertuzumab With Docetaxel and Carboplatin) in Patients With HER2-positive Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 23, 2022 (Actual)
Primary Completion Date
December 30, 2025 (Anticipated)
Study Completion Date
December 30, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Caigang Liu
Collaborators
Jiangsu HengRui Medicine Co., Ltd.

4. Oversight

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

5. Study Description

Brief Summary
This is a randomized, open label Phase II-III neoadjuvant study comparing the efficacy and safety of ARX788 combined with pyrotinib maleate versus TCBHP (trastuzumab plus pertuzumab with docetaxel and carboplatin) in patients with HER2-positive breast cancer.
Detailed Description
This is a randomized, open label Phase II-III neoadjuvant study comparing the efficacy and safety of ARX788 combined with pyrotinib maleate versus TCBHP (trastuzumab plus pertuzumab with docetaxel and carboplatin) in patients with HER2-positive breast cancer. Patients will be randomized (1:1) to one of the two treatment arms: arm 1, ARX788 plus pyrotinib maleate for 6 cycles; arm 2, trastuzumab plus pertuzumab with docetaxel and carboplatin for six cycles. Patients will undergo surgery after neoadjuvant therapy. Efficacy will be assessed every 2 cycles.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HER2-positive Breast Cancer
Keywords
ARX788, Pyrotinib, HER2-positive Breast Cancer, Neoadjuvant

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
150 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
ARX788 + pyrotinib maleate
Arm Type
Experimental
Arm Description
ARX788 1.5 mg/kg intravenously (IV) every three weeks plus pyrotinib maleate 320 mg orally once daily for 6 cycles
Arm Title
trastuzumab + pertuzumab + docetaxel + carboplatin
Arm Type
Active Comparator
Arm Description
Trastuzumab (8 mg/kg first dose, followed 6 mg/kg) puls pertuzumab (840 mg first dose, followed 420 mg) plus docetaxel (75 mg/m3) plus carboplatin (AUC6) IV every 3 weeks for 6 cycles
Intervention Type
Drug
Intervention Name(s)
ARX788
Intervention Description
HER2 antibody-drug conjugate
Intervention Type
Drug
Intervention Name(s)
Pyrotinib maleate
Intervention Description
EGFR/HER2 dual inhibitor
Intervention Type
Drug
Intervention Name(s)
Trastuzumab
Intervention Description
anti-Her2 monoclonal antibody
Intervention Type
Drug
Intervention Name(s)
Pertuzumab
Intervention Description
anti-HER2 monoclonal antibody
Intervention Type
Drug
Intervention Name(s)
Docetaxel
Intervention Description
Cytotoxic chemotherapy
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Intervention Description
Cytotoxic chemotherapy
Primary Outcome Measure Information:
Title
Total pathological complete response rate (tpCR) in percentage
Description
The standard for removal of breast and lymph node tumors which means there are no infiltrating cancer cells at the primary breast and axillary lymph nodes, and only intraductal cancer is allowed on the breast.
Time Frame
3 years
Secondary Outcome Measure Information:
Title
Total breast pathological complete remission rate (bpCR) in percentage
Description
The standard for breast and lymph node tumor removal which means that there are only infiltrating cancer cells at the primary breast tumor site.
Time Frame
3 years
Title
Residual tumor burden (RCB) classification in grades
Description
Postoperative pathological results will be used to assess the residual tumor area of primary breast tumor (area in mm×mm), the cell density of the residual tumor(cell density in percentages), the proportion of carcinoma in situ (proportion of carcinoma in percentages), the number of positive lymph nodes and the diameter of largest metastasis with residual nodes (diameter in mm). The RCB class can be estimated from the above five pathological parameters through a network calculation: RCB-0 in grades: pCR; RCB-I in grades: minimal residual tumor; RCB-II: moderate residual tumor; RCB-III in grades: extensive residual tumor.
Time Frame
3 years
Title
Best overall response rate (BORR) in percentage
Description
The proportion of patients who achieve remission at any point during the study.
Time Frame
3 years
Title
Five-year overall survival (OS)
Description
The time from the random date to death due to any cause.
Time Frame
5 years
Title
Disease-free survival (DFS)
Description
The time from the day of enrollment to the first occurrence of recurrent disease, including second primary malignancies in the non-breast area and breast ductal carcinoma in situ.
Time Frame
3 years
Title
Adverse events (AE)
Description
Adverse events (AE) will be assessed as per the NCI-CTC AE 5.0 standard.
Time Frame
3 years
Other Pre-specified Outcome Measures:
Title
Health-related quality of life (HRQOL)
Description
The European Organization for Research and Treatment-QOL questionnaire and breast cancer specific module (EORTC QLQ-C30 and QLQ-BR23) will use to measure the HRQOL. Compare each domain scores and global health/quality-of-life score of EORTC QLQ-C30 with baseline, and compare each domain scores of EORTC QLQ-BR23 with baseline.
Time Frame
3 years

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Female patients aged ≥ 18 but ≤ 75 years; Diagnosis of breast cancer meets the following criteria: Histologically confirmed invasive breast cancer; Tumor staging: Stage II-III patients who meet the 8th edition of AJCC Cancer Staging Manual; HER2-positive breast cancer pathologically confirmed is defined as Immunohistochemical method (IHC 3+) or IHC 2+ with FISH+; Eastern Cooperative Oncology Group (ECOG) level 0-1; The functional level of major organs must conform to the following requirements: Neutrophils (ANC) ≥ 1.5×10^9/L (with no use of growth factors within 14 days); Platelet count (PLT) ≥ 100×10^9/L (with no correct treatment within 7 days ); Hemoglobin (Hb) ≥ 90 g/L (with no correct treatment within 7 days ); Total bilirubin (TBIL) ≤ 1.5×upper limit of normal (ULN); Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3×ULN; Urea nitrogen and creatinine ≤ 1.5×ULN and creatinine clearance ≥ 50 mL/min (Cockcroft-Gault formula); Cardiac color Doppler ultrasound: left ventricular ejection fraction (LVEF) ≥ 50%; 12-lead electrocardiogram: QT interval ≤ 480 ms; Patients who participate in the trial voluntarily, sign an informed consent, have good compliance and are willing to comply with the follow-up visit. Exclusion Criteria: Previously received any anti-tumor therapy (chemotherapy, radiotherapy, molecular targeted therapy, endocrine therapy, etc.); Patients who are concurrently receiving other anti-tumor therapy; Bilateral breast cancer, inflammatory breast cancer, or occult breast cancer; Stage IV breast cancer; With a history of any malignancies other than breast cancer in the past 5 years, excluding cured cervical carcinoma in situ and melanoma skin cancer; Inability to swallow, chronic diarrhea and intestinal obstruction, and having many factors that affect drug administration and absorption; Patients with known allergies to any active ingredients or excipients of Investigational medicinal product; With a history of interstitial pulmonary disease, drug-induced pulmonary interstitial disease, and radiation pneumonitis that require hormone therapy, or any clinically active pulmonary interstitial disease as suggested by any evidence; Patients who are currently suffering from keratitis, corneal disease, retinal disease, or active eye infection that require any interventions for the eyes; Once suffered from any heart disease, including: (1) arrhythmia with clinical significance, (2) myocardial infarction; (3) heart failure; (4) investigator's judgment as not suitable for participating in this trial; Female patients during pregnancy and lactation, or those who are fertile and positive for baseline pregnancy test or those of childbearing age who are unwilling to take effective contraceptive measures throughout the trial period; Serious concomitant diseases or other comorbid diseases that will endanger the safety of patients or interfere with the completion of the trial, including but not limited to severe hypertension, severe diabetes mellitus, and active infections that are out of control;
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Nan Niu, MD
Phone
86-18940256668
Email
niunannancy@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Caigang Liu, MD
Organizational Affiliation
Shengjing Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Shengjing Hospital affiliated to China Medical University
City
Shenyang
State/Province
Liaoning
ZIP/Postal Code
110004
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nan Liu, MD
Phone
86-18940256668
Email
niunannancy@163.com
First Name & Middle Initial & Last Name & Degree
Caigang Liu, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study of ARX788 Combined With Pyrotinib Maleate Versus TCBHP (Trastuzumab Plus Pertuzumab With Docetaxel and Carboplatin) as Neoadjuvant Treatment in HER2-positive Breast Cancer Patients

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