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Pyrotinib Combined With Trastuzumab, Dalpiciclib, Letrozole Versus TCbHP (Trastuzumab Plus Pertuzumab With Docetaxel and Carboplatin) as Neoadjuvant Treatment in HR +/HER2 + Breast Cancer

Primary Purpose

Breast Cancer

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Pyrotinib
Trastuzumab
Dalpiciclib
Letrozole
Pertuzumab
Docetaxel
Carboplatin
Gonadotropin-releasing hormone agonist
Sponsored by
Shengjing Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer

Eligibility Criteria

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

Inclusion Criteria: Female patients aged 18 -75 ; Willing to receive LHRH agonist therapy (premenopausal patients only); All patients were histopathologically confirmed to be estrogen receptor (ER) -positive and HER2-positive. Treatment-naïve stage II-III patients with tumor stage meeting AJCC version 8 criteria; ECOG score 0-1; Organ function level must meet the following requirements: (1) bone marrow function • ANC ≥ 1.5 x 109/L ; • PLT ≥ 100 × 109/L • Hb ≥ 90 g/L ; (2) hepatic and renal function • TBIL ≤ 1.5 × ULN; • AL and AST ≤ 3 × ULN (ALT and AST ≤ 5 × ULN in patients with liver metastases); • BUN and Cr ≤ 1.5 × ULN and creatinine clearance ≥ 50 mL/min; (Cockcroft-Gault formula) (3) Echocardiography: LVEF ≥ 50%; (4) 12-lead ECG: QT interval ≤ 480 ms; 7. Able to undergo needle biopsy; 8. Voluntarily join this study to sign informed consent, have good compliance and willing to cooperate with follow-up. Exclusion Criteria: Received any form of anti-tumor therapy (chemotherapy, radiotherapy, molecular targeted therapy, endocrine therapy, etc.); Received any other anti-tumor therapy at the same time; Bilateral breast cancer, inflammatory breast cancer or occult breast cancer; Stage IV breast cancer; Breast cancer without histopathological diagnosis; Other malignant tumors in the past 5 years, except cured cutaneous basal cell carcinoma and cervical carcinoma in situ; Severe heart, liver and kidney and other vital organ dysfunction; Inability to swallow, chronic diarrhea and intestinal obstruction, there are a variety of factors affecting drug administration and absorption; Participated in other drug clinical trials within 4 weeks before enrollment; Known history of hypersensitivity to the drug components of this protocol; history of immunodeficiency, including positive HIV test, HCV, active viral hepatitis B or other acquired, congenital immunodeficiency diseases, or history of organ transplantation; Had any cardiac disease, including: (1) cardiac arrhythmia requiring medication or clinically significant; (2) myocardial infarction; (3) heart failure; (4) any other cardiac disease judged by the investigator to be inappropriate for participation in this trial; Female patients who are pregnant or lactating, female patients of childbearing potential with a positive baseline pregnancy test, or female patients of childbearing age who are unwilling to take effective contraceptive measures throughout the trial; According to the investigator 's judgment, there are concomitant diseases that seriously jeopardize the patient' s safety or affect the patient 's completion of the study (including but not limited to uncontrolled severe hypertension, severe diabetes, active infection, etc.); Had a documented history of neurological or psychiatric disorders, including epilepsy or dementia.Any other condition that, in the opinion of the investigator, would make the patient inappropriate for participation in this study.

Sites / Locations

  • Shengjing Hospital of China Medical UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Pyrotinib +trastuzumab+dalpiciclib+letrozole

Trastuzumab + pertuzumab + docetaxel + carboplatin

Arm Description

Every 4 weeks for 5 cycles. Cumulative 20 weeks of treatment. Premenopausal patients need to receive ovarian function suppression

Every 3 weeks for 6 cycles. Cumulative 18 weeks of treatment

Outcomes

Primary Outcome Measures

Pathologic Complete Response Rate (tpCR: ypT0-is/ypN0)
Proportion of patients without any residual invasive cancer in pathological assessment of hematoxylin and eosin-stained resected breast cancer samples and all ipsilateral lymph node samples following completion of neoadjuvant therapy and surgery

Secondary Outcome Measures

Best overall response
Proportion of patients with tumor response at any time during the study
Breast Pathologic Complete Response Rate (bpCR: ypT0-is)
Proportion of patients without any residual invasive carcinoma in pathological assessment of hematoxylin and eosin stained resected breast cancer samples following completion of neoadjuvant therapy and surgery.
Residual cancer burden (RCB)
RCB score is obtained according to pathological evaluation after completion of neoadjuvant treatment and surgery

Full Information

First Posted
November 24, 2022
Last Updated
March 16, 2023
Sponsor
Shengjing Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05638594
Brief Title
Pyrotinib Combined With Trastuzumab, Dalpiciclib, Letrozole Versus TCbHP (Trastuzumab Plus Pertuzumab With Docetaxel and Carboplatin) as Neoadjuvant Treatment in HR +/HER2 + Breast Cancer
Official Title
A Randomized Controlled, Open-label, Multicenter Clinical Study of Pyrotinib Maleate Combined With Trastuzumab,Dalpiciclib, and Letrozole Versus Trastuzumab Combined With Pertuzumab, Docetaxel, and Carboplatin as Neoadjuvant Therapy for Stage II-III HR +/HER2 + Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 20, 2022 (Actual)
Primary Completion Date
December 10, 2025 (Anticipated)
Study Completion Date
December 10, 2027 (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
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is an investigator-initiated randomized controlled, open-label, multicenter, prospective Phase 2 clinical study. Patients with stage II-III HR +/HER2 + breast cancer were randomly divided into two groups at a ratio of 1:1. The experimental group received pyrotinib combined with trastuzumab, dalpiciclib and letrozole; the control group received trastuzumab combined with pertuzumab, docetaxel and carboplatin. The main study objective was to evaluate the efficacy and safety of neoadjuvant therapy for HR +/HER2 + breast cancer in the two groups.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Pyrotinib +trastuzumab+dalpiciclib+letrozole
Arm Type
Experimental
Arm Description
Every 4 weeks for 5 cycles. Cumulative 20 weeks of treatment. Premenopausal patients need to receive ovarian function suppression
Arm Title
Trastuzumab + pertuzumab + docetaxel + carboplatin
Arm Type
Active Comparator
Arm Description
Every 3 weeks for 6 cycles. Cumulative 18 weeks of treatment
Intervention Type
Drug
Intervention Name(s)
Pyrotinib
Intervention Description
320mg, qd
Intervention Type
Drug
Intervention Name(s)
Trastuzumab
Other Intervention Name(s)
Herceptin
Intervention Description
8 mg/kg first dose, then 6 mg/kg,q3w
Intervention Type
Drug
Intervention Name(s)
Dalpiciclib
Intervention Description
125mg , qd,d1-21, q4w
Intervention Type
Drug
Intervention Name(s)
Letrozole
Intervention Description
2.5mg,qd
Intervention Type
Drug
Intervention Name(s)
Pertuzumab
Other Intervention Name(s)
Perjeta
Intervention Description
840 mg first dose, then 420 mg, q3w
Intervention Type
Drug
Intervention Name(s)
Docetaxel
Intervention Description
75 mg/m2, q3w
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Intervention Description
AUC 6, q3w
Intervention Type
Drug
Intervention Name(s)
Gonadotropin-releasing hormone agonist
Intervention Description
Every 4 weeks for 5 cycles, premenopausal patients only
Primary Outcome Measure Information:
Title
Pathologic Complete Response Rate (tpCR: ypT0-is/ypN0)
Description
Proportion of patients without any residual invasive cancer in pathological assessment of hematoxylin and eosin-stained resected breast cancer samples and all ipsilateral lymph node samples following completion of neoadjuvant therapy and surgery
Time Frame
3 years
Secondary Outcome Measure Information:
Title
Best overall response
Description
Proportion of patients with tumor response at any time during the study
Time Frame
3 years
Title
Breast Pathologic Complete Response Rate (bpCR: ypT0-is)
Description
Proportion of patients without any residual invasive carcinoma in pathological assessment of hematoxylin and eosin stained resected breast cancer samples following completion of neoadjuvant therapy and surgery.
Time Frame
3 years
Title
Residual cancer burden (RCB)
Description
RCB score is obtained according to pathological evaluation after completion of neoadjuvant treatment and surgery
Time Frame
3 years
Other Pre-specified Outcome Measures:
Title
Disease-free survival (DFS)
Description
It refers to the length of time from the start of medication after enrollment to the death of the patient because of the recurrence, distant metastasis of the disease, invasive contralateral breast cancer, or any other cause
Time Frame
6 years
Title
Overall survival (OS)
Description
It refers to the length of time from the start of treatment to the death of the patient.
Time Frame
10 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 -75 ; Willing to receive LHRH agonist therapy (premenopausal patients only); All patients were histopathologically confirmed to be estrogen receptor (ER) -positive and HER2-positive. Treatment-naïve stage II-III patients with tumor stage meeting AJCC version 8 criteria; ECOG score 0-1; Organ function level must meet the following requirements: (1) bone marrow function • ANC ≥ 1.5 x 109/L ; • PLT ≥ 100 × 109/L • Hb ≥ 90 g/L ; (2) hepatic and renal function • TBIL ≤ 1.5 × ULN; • AL and AST ≤ 3 × ULN (ALT and AST ≤ 5 × ULN in patients with liver metastases); • BUN and Cr ≤ 1.5 × ULN and creatinine clearance ≥ 50 mL/min; (Cockcroft-Gault formula) (3) Echocardiography: LVEF ≥ 50%; (4) 12-lead ECG: QT interval ≤ 480 ms; 7. Able to undergo needle biopsy; 8. Voluntarily join this study to sign informed consent, have good compliance and willing to cooperate with follow-up. Exclusion Criteria: Received any form of anti-tumor therapy (chemotherapy, radiotherapy, molecular targeted therapy, endocrine therapy, etc.); Received any other anti-tumor therapy at the same time; Bilateral breast cancer, inflammatory breast cancer or occult breast cancer; Stage IV breast cancer; Breast cancer without histopathological diagnosis; Other malignant tumors in the past 5 years, except cured cutaneous basal cell carcinoma and cervical carcinoma in situ; Severe heart, liver and kidney and other vital organ dysfunction; Inability to swallow, chronic diarrhea and intestinal obstruction, there are a variety of factors affecting drug administration and absorption; Participated in other drug clinical trials within 4 weeks before enrollment; Known history of hypersensitivity to the drug components of this protocol; history of immunodeficiency, including positive HIV test, HCV, active viral hepatitis B or other acquired, congenital immunodeficiency diseases, or history of organ transplantation; Had any cardiac disease, including: (1) cardiac arrhythmia requiring medication or clinically significant; (2) myocardial infarction; (3) heart failure; (4) any other cardiac disease judged by the investigator to be inappropriate for participation in this trial; Female patients who are pregnant or lactating, female patients of childbearing potential with a positive baseline pregnancy test, or female patients of childbearing age who are unwilling to take effective contraceptive measures throughout the trial; According to the investigator 's judgment, there are concomitant diseases that seriously jeopardize the patient' s safety or affect the patient 's completion of the study (including but not limited to uncontrolled severe hypertension, severe diabetes, active infection, etc.); Had a documented history of neurological or psychiatric disorders, including epilepsy or dementia.Any other condition that, in the opinion of the investigator, would make the patient inappropriate for participation in this study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Nan Niu
Phone
+8618940256668
Email
niunannancy@163.com
Facility Information:
Facility Name
Shengjing Hospital of 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
Cai-Gang Liu, PHD
Phone
+86 18940254967
Email
liucg@sj-hospital.org
First Name & Middle Initial & Last Name & Degree
Cai-Gang Liu, PHD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Pyrotinib Combined With Trastuzumab, Dalpiciclib, Letrozole Versus TCbHP (Trastuzumab Plus Pertuzumab With Docetaxel and Carboplatin) as Neoadjuvant Treatment in HR +/HER2 + Breast Cancer

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