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Efficacy and Safety of Fluzoparib Combined With Adjuvant Endocrine Therapy for HR+/HER2- SNF3-subtype Early Breast Cancer

Primary Purpose

Breast Cancer

Status
Not yet recruiting
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Fluzoparib
Anastrozole
Letrozole
Exemestane
Tamoxifen
Toremifene
Abemaciclib
LHRH agonist
Sponsored by
Fudan University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring fluzoparib, adjuvant treatment, SNF3-subtype

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria: Women aged 18-70 years old; ECOG score 0 or 1; ER+/HER2- confirmed by histopathology after early breast cancer surgery(ER positive is defined as immunohistochemistry(IHC) detection of ER ≥ 1% HER2-negative is defined as a negative in situ hybridization test or an IHC status of 0, 1+ or 2+. If IHC is 2+, a negative in situ hybridization (Fluorescence in situ hybridization (FISH), Chromogenic in situ hybridization (CISH) , or Silver in situ hybridization (SISH)) test is required by local laboratory testing.); definition of SNF3 subtype: SNF3 subtype confirmed by digital pathology of H&E sections; Postoperative pathological stage T2-4N0-3M0; Patients who have previously received neoadjuvant chemotherapy and/or adjuvant chemotherapy; Time of randomization from surgery does not exceed 16 months; Time of endocrine therapy from last non-endocrine anti-tumor treatment does not exceed 12 weeks; Has adequate organ function meeting the following criteria: (1) adequate bone marrow function: hemoglobin ≥ 90 g/L (no blood transfusion within 14 days); absolute neutrophil count ≥ 1.5 x 10^9 /L; platelet count ≥ 100 * 10^9 /L; (2)adequate liver and kidney function: Alanine Aminotransferase (ALT) ≤ 3×upper limit of normal (ULN), Aspartate Aminotransferase (AST) ≤ 3×ULN, Total Bilirubin (TBIL)≤ 1.5×ULN, serum creatinine ≤ 1×ULN,and with endogenous creatinine clearance rate of >50 ml/min (Cockcroft-Gault formula); Patients receiving radiotherapy must recover from the acute phase reaction of radiotherapy, with a washout period of at least 14 days from the end of radiotherapy to randomization; Patients who received chemotherapy in the early stage must recover from acute adverse reactions to chemotherapy ([CTCAE] grade ≤ 1) before randomization, except for hair loss or grade 2 peripheral neuropathy. There is a washout period of at least 21 days from the last chemotherapy administration to randomization (assuming the patient has not received radiotherapy); Patients can take medication orally on their own; Female subjects with fertility are required to use a medically approved contraceptive method during the study treatment Participants voluntarily joined the study, has signed informed consent before any trial related activities are conducted, has good compliance and has agreed to follow-up. Exclusion Criteria: Has bilateral breast cancer; Has previous history of additional malignancy, with the exception of adequately treated basal cell carcinoma and cervical carcinoma in situ. Has metastatic (Stage 4) breast cancer; Is pregnant, is breast feeding women, or women of childbearing age who cannot practice effective contraceptives; Patients participating in other clinical trials at the same time; Has severe organ dysfunction (cardiopulmonary liver and kidney) insufficiency, left ventricular ejection fraction (LVEF) < 50% (cardiac ultrasound); severe cardio cerebral vascular disease within the 6 months previous of randomization (such as unstable angina, chronic heart failure, uncontrolled hypertension with blood pressure>150/90mmgh, myocardial infarction, or cerebral blood vessel); diabetic patients with poor blood glucose control; patients with severe hypertension; Has known allergy to fluzoparib and excipients. Has severe or uncontrolled infection; Has a history of psychotropic substance abuse and were unable to abandon drug habits, or those with history of mental disorders; The researchers judged patients to be unsuitable for the study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Fluzoparib+Endocrine Therapy

    Endocrine Therapy

    Arm Description

    Fluzoparib 50mg bid orally for 1 year, combined with physician's choice of endocrine therapy as clinically indicated (eg, aromatase inhibitor, tamoxifen, toremifene endocrine therapy for 5 to 10 years; CDK4/6 inhibitor therapy for 2 years; ovarian function suppression with LHRH agonist).

    Physician's choice of endocrine therapy as clinically indicated (eg, aromatase inhibitor, tamoxifen, toremifene endocrine therapy for 5 to 10 years; CDK4/6 inhibitor therapy for 2 years; ovarian function suppression with LHRH agonist).

    Outcomes

    Primary Outcome Measures

    invasive disease free survival (iDFS)
    defined as occurrence of any of the following: ipsilateral invasive breast cancer recurrence, regional invasive breast cancer recurrence, distant recurrence, death attributable to any cause, contralateral invasive breast cancer, or second non-breast invasive cancer.In-situ events are not included.

    Secondary Outcome Measures

    distant relapse free survival (DRFS)
    the time from operation to the first distant recurrence, and the cases of death without distant recurrence was censored at the time of the death
    overall survival (OS)
    the time from treatment to death, regardless of disease recurrence
    Adverse Effects
    an undesired harmful effect resulting from a medication or other intervention
    Number of participants with Patient Reported Outcome (PRO)
    a health outcome directly reported by the patient who experienced it.

    Full Information

    First Posted
    May 24, 2023
    Last Updated
    June 5, 2023
    Sponsor
    Fudan University
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05891093
    Brief Title
    Efficacy and Safety of Fluzoparib Combined With Adjuvant Endocrine Therapy for HR+/HER2- SNF3-subtype Early Breast Cancer
    Official Title
    A Prospective, Randomized, Open-label Phase III Clinical Study of the Efficacy and Safety of Fluzoparib Combined With Adjuvant Endocrine Therapy Versus Adjuvant Endocrine Therapy for HR+/HER2- SNF3-subtype Early Breast Cancer
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    June 1, 2023 (Anticipated)
    Primary Completion Date
    May 31, 2028 (Anticipated)
    Study Completion Date
    May 31, 2031 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Fudan University

    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 prospective, randomized, open-label phase III clinical study on the efficacy and safety of fluzoparib combined with adjuvant endocrine therapy versus adjuvant endocrine therapy for HR+/HER2- SNF3-subtype early breast cancer.
    Detailed Description
    This is a prospective, randomized, open-label phase III clinical study on the efficacy and safety of fluzoparib combined with adjuvant endocrine therapy versus adjuvant endocrine therapy for HR+/HER2- SNF3-subtype early breast cancer. A total of 766 patients with luminal-type early breast cancer who received surgery at the Fudan University Shanghai Cancer Cancer and were classified as SNF3 (proliferative) by SNF algorithm fusion clustering will be collected for this study. Before enrollment, the primary tumors of the patients were subjected to molecular typing based on H&E slices combined with digital pathology, and subsequent enrollment could be considered if patient pathology was confirmed as SNF3 subtype.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Breast Cancer
    Keywords
    fluzoparib, adjuvant treatment, SNF3-subtype

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    Fluzoparib+Endocrine Therapy
    Arm Type
    Experimental
    Arm Description
    Fluzoparib 50mg bid orally for 1 year, combined with physician's choice of endocrine therapy as clinically indicated (eg, aromatase inhibitor, tamoxifen, toremifene endocrine therapy for 5 to 10 years; CDK4/6 inhibitor therapy for 2 years; ovarian function suppression with LHRH agonist).
    Arm Title
    Endocrine Therapy
    Arm Type
    Active Comparator
    Arm Description
    Physician's choice of endocrine therapy as clinically indicated (eg, aromatase inhibitor, tamoxifen, toremifene endocrine therapy for 5 to 10 years; CDK4/6 inhibitor therapy for 2 years; ovarian function suppression with LHRH agonist).
    Intervention Type
    Drug
    Intervention Name(s)
    Fluzoparib
    Intervention Description
    Fluzoparib 50mg bid orally for 1 year.
    Intervention Type
    Drug
    Intervention Name(s)
    Anastrozole
    Intervention Description
    1mg, qd orally
    Intervention Type
    Drug
    Intervention Name(s)
    Letrozole
    Intervention Description
    2.5mg, qd orally
    Intervention Type
    Drug
    Intervention Name(s)
    Exemestane
    Intervention Description
    25mg, qd orally
    Intervention Type
    Drug
    Intervention Name(s)
    Tamoxifen
    Intervention Description
    10mg, bid orally
    Intervention Type
    Drug
    Intervention Name(s)
    Toremifene
    Intervention Description
    60mg, qd orally
    Intervention Type
    Drug
    Intervention Name(s)
    Abemaciclib
    Intervention Description
    150mg/100mg/50mg, bid orally for 2 years
    Intervention Type
    Drug
    Intervention Name(s)
    LHRH agonist
    Intervention Description
    Leuprorelin acetate, goserelin acetate
    Primary Outcome Measure Information:
    Title
    invasive disease free survival (iDFS)
    Description
    defined as occurrence of any of the following: ipsilateral invasive breast cancer recurrence, regional invasive breast cancer recurrence, distant recurrence, death attributable to any cause, contralateral invasive breast cancer, or second non-breast invasive cancer.In-situ events are not included.
    Time Frame
    5 years
    Secondary Outcome Measure Information:
    Title
    distant relapse free survival (DRFS)
    Description
    the time from operation to the first distant recurrence, and the cases of death without distant recurrence was censored at the time of the death
    Time Frame
    5 years
    Title
    overall survival (OS)
    Description
    the time from treatment to death, regardless of disease recurrence
    Time Frame
    5 years
    Title
    Adverse Effects
    Description
    an undesired harmful effect resulting from a medication or other intervention
    Time Frame
    5 years
    Title
    Number of participants with Patient Reported Outcome (PRO)
    Description
    a health outcome directly reported by the patient who experienced it.
    Time Frame
    5 years

    10. Eligibility

    Sex
    Female
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Women aged 18-70 years old; ECOG score 0 or 1; ER+/HER2- confirmed by histopathology after early breast cancer surgery(ER positive is defined as immunohistochemistry(IHC) detection of ER ≥ 1% HER2-negative is defined as a negative in situ hybridization test or an IHC status of 0, 1+ or 2+. If IHC is 2+, a negative in situ hybridization (Fluorescence in situ hybridization (FISH), Chromogenic in situ hybridization (CISH) , or Silver in situ hybridization (SISH)) test is required by local laboratory testing.); definition of SNF3 subtype: SNF3 subtype confirmed by digital pathology of H&E sections; Postoperative pathological stage T2-4N0-3M0; Patients who have previously received neoadjuvant chemotherapy and/or adjuvant chemotherapy; Time of randomization from surgery does not exceed 16 months; Time of endocrine therapy from last non-endocrine anti-tumor treatment does not exceed 12 weeks; Has adequate organ function meeting the following criteria: (1) adequate bone marrow function: hemoglobin ≥ 90 g/L (no blood transfusion within 14 days); absolute neutrophil count ≥ 1.5 x 10^9 /L; platelet count ≥ 100 * 10^9 /L; (2)adequate liver and kidney function: Alanine Aminotransferase (ALT) ≤ 3×upper limit of normal (ULN), Aspartate Aminotransferase (AST) ≤ 3×ULN, Total Bilirubin (TBIL)≤ 1.5×ULN, serum creatinine ≤ 1×ULN,and with endogenous creatinine clearance rate of >50 ml/min (Cockcroft-Gault formula); Patients receiving radiotherapy must recover from the acute phase reaction of radiotherapy, with a washout period of at least 14 days from the end of radiotherapy to randomization; Patients who received chemotherapy in the early stage must recover from acute adverse reactions to chemotherapy ([CTCAE] grade ≤ 1) before randomization, except for hair loss or grade 2 peripheral neuropathy. There is a washout period of at least 21 days from the last chemotherapy administration to randomization (assuming the patient has not received radiotherapy); Patients can take medication orally on their own; Female subjects with fertility are required to use a medically approved contraceptive method during the study treatment Participants voluntarily joined the study, has signed informed consent before any trial related activities are conducted, has good compliance and has agreed to follow-up. Exclusion Criteria: Has bilateral breast cancer; Has previous history of additional malignancy, with the exception of adequately treated basal cell carcinoma and cervical carcinoma in situ. Has metastatic (Stage 4) breast cancer; Is pregnant, is breast feeding women, or women of childbearing age who cannot practice effective contraceptives; Patients participating in other clinical trials at the same time; Has severe organ dysfunction (cardiopulmonary liver and kidney) insufficiency, left ventricular ejection fraction (LVEF) < 50% (cardiac ultrasound); severe cardio cerebral vascular disease within the 6 months previous of randomization (such as unstable angina, chronic heart failure, uncontrolled hypertension with blood pressure>150/90mmgh, myocardial infarction, or cerebral blood vessel); diabetic patients with poor blood glucose control; patients with severe hypertension; Has known allergy to fluzoparib and excipients. Has severe or uncontrolled infection; Has a history of psychotropic substance abuse and were unable to abandon drug habits, or those with history of mental disorders; The researchers judged patients to be unsuitable for the study.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Zhimin Shao, MD, PhD
    Phone
    +86-021-64175590
    Ext
    8808
    Email
    zhimingshao@yahoo.com

    12. IPD Sharing Statement

    Learn more about this trial

    Efficacy and Safety of Fluzoparib Combined With Adjuvant Endocrine Therapy for HR+/HER2- SNF3-subtype Early Breast Cancer

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