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Neoadjuvant Dalpiciclib Plus Letrozole for HR+/HER2- Breast Cancer

Primary Purpose

Breast Cancer

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
dalpiciclib plus letrozole
Sponsored by
The Affiliated Hospital of Qingdao University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring breast cancer, CDK4/6 inhibitor, endocrine therapy, hormone receptor-positive, dalpiciclib, letrozole

Eligibility Criteria

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

Inclusion Criteria: Postmenopausal, premenopausal or perimenopausal women aged ≥18. Postmenopausal was defined as: 1) received bilateral oophorectomy, or aged ≥60; 2) aged <60, reached natural menopause (defined as no menses for 12 or more consecutive months with no other reason for the amenorrhea), and with postmenopausal E2 and FSH level; 3) premenopausal or perimenopausal women may also be enrolled as long as they are willing to receive LHRH agonist therapy during the study; Operable patients with ER+ (>10%), HER2- invasive breast carcinomas, regardless of PR level. HER2- was defined as IHC score of 0+, or IHC score of 2+ with negative ISH (amplification ratio <2.0) according to 2018 ASCO-CAP guideline; Untreated patients with stage IIB-III according to AJCC criteria (8th edition); Without known hypersensitivity to the study drug or its excipients; A ECOG PS score of 0-1; With the ability to swallow the study drug; With sufficient organ function, including 1) bone marrow function: ANC ≥ 1.5 x 109/L (without growth factors within 14 days); PLT ≥ 100 x 109/L (without corrective therapy within 7 days); Hb ≥ 100 g/L (without corrective therapy within 7 days); 2)liver and kidney function: TBIL ≤ ULN; ALT and AST ≤ 3 × ULN (ALT and AST ≤ 5 × ULN for those with liver metastases); BUN and Cr ≤ 1.5×ULN, and creatinine clearance ≥ 50 mL/min (Cockcroft-Gault formula); 3) QT interval ≤ 480 ms from the 12-lead electrocardiogram; Able to undergo all puncture biopsies required by the protocol; Volunteered to participate in this study; signed informed consent; with good compliance and willingness to follow-up;

Exclusion Criteria: Previously treated patients, including chemotherapy, radiotherapy, targeted therapy or endocrine therapy, etc.; Concurrently receiving any anti-tumor treatments other than that prescribed by the protocol; Patients with bilateral breast cancer, inflammatory breast cancer or occult breast cancer; Patients with stage IV breast cancer; Patients with severe liver, kidney, or heart dysfunction; Inability to swallow, with chronic diarrhea, with intestinal obstruction, or with other factors affecting drug administration and absorption; Participated in other clinical trials within 4 weeks before enrollment; Known hypersensitivity to the study drug or its excipients; history of ;immunodeficiency, including HIV positive, HCV positive, active viral hepatitis B, other acquired or congenital immunodeficiency diseases, or a history of organ transplantation; History of any cardiac disease, including: 1) arrhythmias requiring drug treatment or of clinical significance; 2) myocardial infarction; 3) heart failure; 4) any other cardiac disease to be inappropriate for this trial judged by the investigator; Women who are pregnant or breastfeeding, women of childbearing potential who test positive for pregnancy test at baseline, or women of childbearing potential who are unwilling to use effective contraception during the study; With serious concomitant disease that endanger safety, or interferes with the ability to complete the study judged by the investigator (including, but not limited to, uncontrolled hypertension, severe diabetes, active infection, etc.); History of neurological or psychiatric disorders, including epilepsy or dementia; or any other condition inappropriate for this study deemed by the investigator.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    cohort 1

    Arm Description

    patients with stage IIB-III HR+/HER2- breast cancer

    Outcomes

    Primary Outcome Measures

    Complete cell-cycle arrest at C1D15, defined as ki67≤2.7%
    From the date into this study(signed ICF) to C1D15,defined as ki67≤2.7%

    Secondary Outcome Measures

    residual cancer burden
    The percentage of residual tumors after neoadjuvant therapy is assessed according to breast tumor bed tumors and regional lymph nodes
    objective response rate
    The rate of CR and PR,determined using RECIST v1.1 criteria
    change in Ki67 from baseline to 2 weeks of treatment
    change in Ki67 from baseline(From the date into this study(signed ICF) ) to 2 weeks of treatment
    preoperative endocrine prognostic index
    Prognostic indicators of preoperative endocrine therapy, including mass size after neoadjuvant endocrine therapy, lymph node status, ki67 levels, and estrogen receptor (ER) status
    pathologic complete response
    After neoadjuvant therapy, there are no residual invasive tumors in the primary focus and regional lymph nodes of breast cancer, but ductal carcinoma in situ may be present(ypT0/is ypN0)
    breast-conserving surgery rate
    The number of cases that actually underwent breast-conserving surgery after surgery accounted for the percentage of all breast cancer patients who underwent surgery
    safety profile
    Adverse events (AE) and severe adverse events (SAEs) are recorded. Refer to NCI-CTC AE 5.0 standard

    Full Information

    First Posted
    August 18, 2022
    Last Updated
    August 21, 2022
    Sponsor
    The Affiliated Hospital of Qingdao University
    Collaborators
    Jiangsu HengRui Medicine Co., Ltd.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05512416
    Brief Title
    Neoadjuvant Dalpiciclib Plus Letrozole for HR+/HER2- Breast Cancer
    Official Title
    Neoadjuvant Dalpiciclib Plus Letrozole for HR+/HER2- Breast Cancer: A Single Arm, Open Label, Phase II Trial
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2022
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    August 2022 (Anticipated)
    Primary Completion Date
    August 2023 (Anticipated)
    Study Completion Date
    May 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    The Affiliated Hospital of Qingdao University
    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

    5. Study Description

    Brief Summary
    In this single arm, open label, phase 2 trial, operable patients with stage IIB-III HR+/HER2- breast cancer will be enrolled and receive six cycles of adjuvant dalpiciclib plus letrozole. This study aims to assessed the biological effects and safety of dalpiciclib in combination with letrozole for HR+/HER2- breast cancer in the neoadjuvant setting.
    Detailed Description
    This is a single arm, open label, phase 2 trial aimed to investigate the biological effects and safety of neoadjuvant dalpiciclib in combination with letrozole for HR+/HER2- breast cancer. A total of 35 patients with stage IIB-III HR+/HER2- breast cancer will be enrolled. Six 4-week cycles of adjuvant therapy will be administrated. In each cycle, patients use dalpiciclib orally, 150mg, day 1-21, and letrozole orally, 2.5 mg, day 1-28. Premenopausal or perimenopausal patients should combine ovarian function suppression, including bilateral oophorectomy or treatment with gonadotropin-releasing hormone agonists. The primary endpoint is complete cell-cycle arrest at C1D15, defined as ki67≤2.7%. The secondary endpoints include residual cancer burden, overall response rate, change in Ki67 from baseline to 2 weeks of treatment, preoperative endocrine prognostic index, pathologic complete response, breast-conserving surgery rate and safety profile.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Breast Cancer
    Keywords
    breast cancer, CDK4/6 inhibitor, endocrine therapy, hormone receptor-positive, dalpiciclib, letrozole

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    35 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    cohort 1
    Arm Type
    Experimental
    Arm Description
    patients with stage IIB-III HR+/HER2- breast cancer
    Intervention Type
    Drug
    Intervention Name(s)
    dalpiciclib plus letrozole
    Other Intervention Name(s)
    D+L
    Intervention Description
    Six 4-week cycles of dalpiciclib orally, 150mg, day 1-21, and letrozole orally, 2.5 mg, day 1-28
    Primary Outcome Measure Information:
    Title
    Complete cell-cycle arrest at C1D15, defined as ki67≤2.7%
    Description
    From the date into this study(signed ICF) to C1D15,defined as ki67≤2.7%
    Time Frame
    up 2 years
    Secondary Outcome Measure Information:
    Title
    residual cancer burden
    Description
    The percentage of residual tumors after neoadjuvant therapy is assessed according to breast tumor bed tumors and regional lymph nodes
    Time Frame
    up 2 years
    Title
    objective response rate
    Description
    The rate of CR and PR,determined using RECIST v1.1 criteria
    Time Frame
    up 2 years
    Title
    change in Ki67 from baseline to 2 weeks of treatment
    Description
    change in Ki67 from baseline(From the date into this study(signed ICF) ) to 2 weeks of treatment
    Time Frame
    up 2 years
    Title
    preoperative endocrine prognostic index
    Description
    Prognostic indicators of preoperative endocrine therapy, including mass size after neoadjuvant endocrine therapy, lymph node status, ki67 levels, and estrogen receptor (ER) status
    Time Frame
    up 2 years
    Title
    pathologic complete response
    Description
    After neoadjuvant therapy, there are no residual invasive tumors in the primary focus and regional lymph nodes of breast cancer, but ductal carcinoma in situ may be present(ypT0/is ypN0)
    Time Frame
    up 2 years
    Title
    breast-conserving surgery rate
    Description
    The number of cases that actually underwent breast-conserving surgery after surgery accounted for the percentage of all breast cancer patients who underwent surgery
    Time Frame
    up 2 years
    Title
    safety profile
    Description
    Adverse events (AE) and severe adverse events (SAEs) are recorded. Refer to NCI-CTC AE 5.0 standard
    Time Frame
    up 2 years

    10. Eligibility

    Sex
    Female
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Postmenopausal, premenopausal or perimenopausal women aged ≥18. Postmenopausal was defined as: 1) received bilateral oophorectomy, or aged ≥60; 2) aged <60, reached natural menopause (defined as no menses for 12 or more consecutive months with no other reason for the amenorrhea), and with postmenopausal E2 and FSH level; 3) premenopausal or perimenopausal women may also be enrolled as long as they are willing to receive LHRH agonist therapy during the study; Operable patients with ER+ (>10%), HER2- invasive breast carcinomas, regardless of PR level. HER2- was defined as IHC score of 0+, or IHC score of 2+ with negative ISH (amplification ratio <2.0) according to 2018 ASCO-CAP guideline; Untreated patients with stage IIB-III according to AJCC criteria (8th edition); Without known hypersensitivity to the study drug or its excipients; A ECOG PS score of 0-1; With the ability to swallow the study drug; With sufficient organ function, including 1) bone marrow function: ANC ≥ 1.5 x 109/L (without growth factors within 14 days); PLT ≥ 100 x 109/L (without corrective therapy within 7 days); Hb ≥ 100 g/L (without corrective therapy within 7 days); 2)liver and kidney function: TBIL ≤ ULN; ALT and AST ≤ 3 × ULN (ALT and AST ≤ 5 × ULN for those with liver metastases); BUN and Cr ≤ 1.5×ULN, and creatinine clearance ≥ 50 mL/min (Cockcroft-Gault formula); 3) QT interval ≤ 480 ms from the 12-lead electrocardiogram; Able to undergo all puncture biopsies required by the protocol; Volunteered to participate in this study; signed informed consent; with good compliance and willingness to follow-up; Exclusion Criteria: Previously treated patients, including chemotherapy, radiotherapy, targeted therapy or endocrine therapy, etc.; Concurrently receiving any anti-tumor treatments other than that prescribed by the protocol; Patients with bilateral breast cancer, inflammatory breast cancer or occult breast cancer; Patients with stage IV breast cancer; Patients with severe liver, kidney, or heart dysfunction; Inability to swallow, with chronic diarrhea, with intestinal obstruction, or with other factors affecting drug administration and absorption; Participated in other clinical trials within 4 weeks before enrollment; Known hypersensitivity to the study drug or its excipients; history of ;immunodeficiency, including HIV positive, HCV positive, active viral hepatitis B, other acquired or congenital immunodeficiency diseases, or a history of organ transplantation; History of any cardiac disease, including: 1) arrhythmias requiring drug treatment or of clinical significance; 2) myocardial infarction; 3) heart failure; 4) any other cardiac disease to be inappropriate for this trial judged by the investigator; Women who are pregnant or breastfeeding, women of childbearing potential who test positive for pregnancy test at baseline, or women of childbearing potential who are unwilling to use effective contraception during the study; With serious concomitant disease that endanger safety, or interferes with the ability to complete the study judged by the investigator (including, but not limited to, uncontrolled hypertension, severe diabetes, active infection, etc.); History of neurological or psychiatric disorders, including epilepsy or dementia; or any other condition inappropriate for this study deemed by the investigator.

    12. IPD Sharing Statement

    Learn more about this trial

    Neoadjuvant Dalpiciclib Plus Letrozole for HR+/HER2- Breast Cancer

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