A Study of Immunotherapy Combined With Neoadjuvant Therapy Versus Neoadjuvant Therapy for Breast Cancer
Primary Purpose
Stage II-III Breast Cancer
Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
cytotoxic chemotherapy (docetaxel or epirubicin or cyclophosphamide or carboplatin)
anti-Her2 monoclonal antibody (Trastuzumab, Pertuzumab)
traditional herbal medicine
Sponsored by
About this trial
This is an interventional treatment trial for Stage II-III Breast Cancer
Eligibility Criteria
Inclusion Criteria:
- Female patients aged ≥ 18 but ≤ 75 years;
- Diagnosis of breast cancer meets the following criteria: Stage II-III patients who meet the 8th edition of AJCC Cancer Staging Manual and meet the indications of neoadjuvant therapy;
- Diagnosis of breast cancer meets the following criteria: Histologically confirmed invasive breast cancer
- KPS score≥70
- 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;
- Intolerant to herbs or poor compliance;
- 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;
- Severe heart, liver, kidney and other important organ dysfunction;
- Inability to swallow, chronic diarrhea and intestinal obstruction, and having many factors that affect drug administration and absorption;
- Participated in clinical trials of other drugs within 4 weeks before enrollment;
- Known history of allergy to the drug components of this regimen; History of immunodeficiency, including HIV positive, HCV, live active hepatitis B or other acquired or congenital immune deficiency diseases, or a history of organ transplantation;
- Have used drugs that affect immune function within 1 year;
- 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;
- Pregnant, lactating women, fertile women with positive baseline pregnancy test or in the entire women of reproductive age who were unwilling to use effective contraception during the trial;
- According to the investigator's judgment, there are comorbidities (including but) that seriously endanger the patient's safety or affect the patient's ability to complete the study not limited to severe hypertension, severe diabetes, active infection, etc., which cannot be controlled by drugs);
- A clear past history of neurological or psychiatric disorders, including epilepsy or dementia. The investigator considered the patient unsuitable for the study in any other case.
Sites / Locations
- ShengJing ospital of China Medical UniversityRecruiting
- Shengjing Hospital Affiliated to China Medical UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Other
Arm Label
Immunotherapy and neoadjuvant therapy
neoadjuvant therapy
Arm Description
Traditional herbal medicine twice daily combined with neoadjuvant therapy recommended by the guidelines every 3 weeks, for 6 or 8 cycles.
Only received neoadjuvant therapy recommended by the guidelines every 3 weeks, for 6 or 8 cycles.
Outcomes
Primary Outcome Measures
Total pathological complete response rate (tpCR)
The disappearance of all invasive tumours in the breast and axillary lymph nodes
Secondary Outcome Measures
Global health status and functioning subscales
Health-related quality of life (HRQoL) was measured using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core-30 (QLQ-C30; version 3).
Cancer-related fatigue scores
Piper Fatigue Scale will be used to measure cancer-related fatigue. The scale scores were measured:at baseline, at the end of cycles 2 and 4, and before surgery. Each score represents the degree of fatigue: a score of 0 means none, 1-3 means mild, 4-6 means moderate, 7-10 means severe.
Adverse events (AE) and serious adverse events (SAE)
For adverse events (AE) and serious adverse events (SAE), refer to NCI-CTC AE 5.0 standard.
Disease free survival (DFS)
Disease-free survival (DFS) is 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.
Five-year overall survival (OS)
Five-year overall survival (OS) is the time from the random date to death due to any cause.
Expression of immune cells
Expression of immune cells (T cell, B cell, NK cell )
Expression of cytokines (IL, INF-r, TNF-a)
Expression of cytokines (IL, INF-r, TNF-a)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05483439
Brief Title
A Study of Immunotherapy Combined With Neoadjuvant Therapy Versus Neoadjuvant Therapy for Breast Cancer
Official Title
Clinical Study Comparing the Efficacy and Safety of Traditional Herbal Medicine for Cancer Immunotherapy Combined With Neoadjuvant Therapy Versus Neoadjuvant Therapy in Patients With Stage II-III Breast Cancer.
Study Type
Interventional
2. Study Status
Record Verification Date
August 2022
Overall Recruitment Status
Recruiting
Study Start Date
October 20, 2021 (Actual)
Primary Completion Date
July 1, 2023 (Anticipated)
Study Completion Date
July 1, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Shengjing 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
This is a randomized, open label Phase II neoadjuvant study comparing the efficacy and safety of the combination of traditional herbal medicine for cancer immunotherapy and neoadjuvant therapy versus neoadjuvant therapy in patients with breast cancer.
Detailed Description
This is a randomized, open label Phase II neoadjuvant study comparing the efficacy and safety of the combination of traditional herbal medicine for cancer immunotherapy and neoadjuvant therapy versus neoadjuvant therapy in patients with breast cancer. Patients will be randomized (1:1) to one of the two treatment arms: arm 1, combination of traditional herbal medicine for cancer immunotherapy and neoadjuvant therapy for 6 or 8 cycles; arm 2, neoadjuvant therapy 6 or 8 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
Stage II-III Breast Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
100 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Immunotherapy and neoadjuvant therapy
Arm Type
Experimental
Arm Description
Traditional herbal medicine twice daily combined with neoadjuvant therapy recommended by the guidelines every 3 weeks, for 6 or 8 cycles.
Arm Title
neoadjuvant therapy
Arm Type
Other
Arm Description
Only received neoadjuvant therapy recommended by the guidelines every 3 weeks, for 6 or 8 cycles.
Intervention Type
Drug
Intervention Name(s)
cytotoxic chemotherapy (docetaxel or epirubicin or cyclophosphamide or carboplatin)
Intervention Description
Drug: cytotoxic chemotherapy (docetaxel or epirubicin or cyclophosphamide or carboplatin)
Intervention Type
Drug
Intervention Name(s)
anti-Her2 monoclonal antibody (Trastuzumab, Pertuzumab)
Intervention Description
anti-Her2 monoclonal antibody (Trastuzumab, Pertuzumab)
Intervention Type
Drug
Intervention Name(s)
traditional herbal medicine
Intervention Description
traditional herbal medicine
Primary Outcome Measure Information:
Title
Total pathological complete response rate (tpCR)
Description
The disappearance of all invasive tumours in the breast and axillary lymph nodes
Time Frame
One month after surgery
Secondary Outcome Measure Information:
Title
Global health status and functioning subscales
Description
Health-related quality of life (HRQoL) was measured using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core-30 (QLQ-C30; version 3).
Time Frame
One month after surgery
Title
Cancer-related fatigue scores
Description
Piper Fatigue Scale will be used to measure cancer-related fatigue. The scale scores were measured:at baseline, at the end of cycles 2 and 4, and before surgery. Each score represents the degree of fatigue: a score of 0 means none, 1-3 means mild, 4-6 means moderate, 7-10 means severe.
Time Frame
One month after surgery
Title
Adverse events (AE) and serious adverse events (SAE)
Description
For adverse events (AE) and serious adverse events (SAE), refer to NCI-CTC AE 5.0 standard.
Time Frame
Period of neoadjuvant therapy (treatment 1-6 months)
Title
Disease free survival (DFS)
Description
Disease-free survival (DFS) is 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
5 years
Title
Five-year overall survival (OS)
Description
Five-year overall survival (OS) is the time from the random date to death due to any cause.
Time Frame
5 years
Title
Expression of immune cells
Description
Expression of immune cells (T cell, B cell, NK cell )
Time Frame
One month after surgery
Title
Expression of cytokines (IL, INF-r, TNF-a)
Description
Expression of cytokines (IL, INF-r, TNF-a)
Time Frame
One month after surgery
10. Eligibility
Sex
All
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: Stage II-III patients who meet the 8th edition of AJCC Cancer Staging Manual and meet the indications of neoadjuvant therapy;
Diagnosis of breast cancer meets the following criteria: Histologically confirmed invasive breast cancer
KPS score≥70
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;
Intolerant to herbs or poor compliance;
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;
Severe heart, liver, kidney and other important organ dysfunction;
Inability to swallow, chronic diarrhea and intestinal obstruction, and having many factors that affect drug administration and absorption;
Participated in clinical trials of other drugs within 4 weeks before enrollment;
Known history of allergy to the drug components of this regimen; History of immunodeficiency, including HIV positive, HCV, live active hepatitis B or other acquired or congenital immune deficiency diseases, or a history of organ transplantation;
Have used drugs that affect immune function within 1 year;
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;
Pregnant, lactating women, fertile women with positive baseline pregnancy test or in the entire women of reproductive age who were unwilling to use effective contraception during the trial;
According to the investigator's judgment, there are comorbidities (including but) that seriously endanger the patient's safety or affect the patient's ability to complete the study not limited to severe hypertension, severe diabetes, active infection, etc., which cannot be controlled by drugs);
A clear past history of neurological or psychiatric disorders, including epilepsy or dementia. The investigator considered the patient unsuitable for the study in any other case.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Caigang Liu, doctor
Phone
18940254967
Email
liucg@sj-hospital.org
First Name & Middle Initial & Last Name or Official Title & Degree
Shuo Cao, doctor
Phone
18940254228
Email
caos4228@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Caigang Liu, doctor
Organizational Affiliation
Shengjing hospital affiliated to China Medical University
Official's Role
Principal Investigator
Facility Information:
Facility Name
ShengJing ospital of China Medical University
City
Shenyang
State/Province
Liaoning
ZIP/Postal Code
110022
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Liu Caigang
Phone
+8618940254967
Email
liucg@sj-hospital.org
First Name & Middle Initial & Last Name & Degree
Niu Nan
Phone
+8618940256668
Email
niunannancy@163.com
First Name & Middle Initial & Last Name & Degree
Liu Caigang
Facility Name
Shengjing Hospital Affiliated to China Medical University
City
Shenyang
State/Province
Liaoning
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
CaoShuo Cao, doctor
Phone
18940254228
12. IPD Sharing Statement
Learn more about this trial
A Study of Immunotherapy Combined With Neoadjuvant Therapy Versus Neoadjuvant Therapy for Breast Cancer
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