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A Study Comparing the Efficacy of TCbHP and ECHP-THP in the Neoadjuvant Treatment of HER2-positive Breast Cancer

Primary Purpose

Breast Cancer, HER2-positive Breast Cancer

Status
Recruiting
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
Docetaxel + Carboplatin + Trastuzumab + Pertuzumab
(Epirubicin + Cyclophosphamide - Docetaxel) + (Trastuzumab + Pertuzumab)
Sponsored by
Henan Cancer Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring Breast cancer, HER2, pathological complete remission

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. 18 years ≤ age ≤ 65 years, Performance Status- Eastern Cooperative Oncology Group (ECOG) 0-1;
  2. Clinical T2-T4d, or T1c with axillary LN+;
  3. HER2 + invasive breast cancer confirmed by histopathology Note: HER2 expression positive refers to the tumor cells with immunohistochemical staining intensity of 3 + or confirmed positive by fluorescence in situ hybridization [fish] at least once during the pathological detection/review of primary tumor in the Department of pathology of participating research center hospital;
  4. Clinically measurable lesions: measurable lesions revealed by ultrasound, molybdenum target or MR (optional) within 1 month before randomization
  5. Organ and bone marrow function test within one month before chemotherapy showed no chemotherapy contraindication: Absolute value of neutrophil count ≥ 2.0×10^9 / L Hemoglobin ≥ 100g / L Platelet count ≥ 100×10^9 / L Total bilirubin < 1.5 ULN (upper limit of normal value) Creatinine < 1.5 × ULN AST/ALT < 1.5×ULN
  6. Echocardiography: left ventricular ejection fraction (LVEF ≥ 55%);
  7. For women of childbearing age, serum pregnancy test was negative 14 days ;
  8. Signed the informed consent form prior to patient entry;

Exclusion Criteria:

  1. Stage IV (metastatic) breast cancer;
  2. supraclavicular lymph node metastasis;
  3. For this disease, chemotherapy, endocrine therapy, targeted therapy, reflex therapy, etc. have been received;
  4. The patient has a second primary malignancy other than adequately treated skin cancer;
  5. The patient has undergone major surgical procedures not related to breast cancer within 4 weeks prior to enrollment, or the patient has not fully recovered from such surgical procedures;
  6. The patient has severe heart disease or discomfort, including but not limited to the following:Diagnosed history of heart failure or systolic dysfunction (LVEF < 50%);High-risk uncontrolled arrhythmias;Angina pectoris requiring antianginal medication;Clinically significant heart valve disease;ECG showing transmural myocardial infarction;Poorly controlled high blood pressure;
  7. Because the patient has other serious and uncontrollable medical diseases, the investigator believes that chemotherapy is contraindicated;
  8. Known history of allergy to the drug components of this regimen; history of immunodeficiency, including HIV positive test, or other acquired or congenital immunodeficiency diseases, or a history of organ transplantation;

Sites / Locations

  • Henan cancer hospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

TCbHP chemotherapy regimen

ECHP-THP chemotherapy regimen

Arm Description

Docetaxel + Carboplatin + Trastuzumab + Pertuzumab

(Epirubicin + Cyclophosphamide - Docetaxel) + (Trastuzumab + Pertuzumab)

Outcomes

Primary Outcome Measures

Pathological Complete Response (pCR)
Percentage of Participants With Pathological Complete Response (pCR) (ypT0/is/N0M0) after 6 cycles of neoadjuvant chemotherapy

Secondary Outcome Measures

Number of treatment-related adverse events assessed by CTCAE v4.0
Evaluate the nature, incidence and severity of chemotherapy adverse events according to CTCAE 5.0
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Dose adjustment rate and withdrawal rate of chemotherapy drugs in two chemotherapy regimens
ORR
Objective response rate.ORR assessed according to the evaluation criteria for the efficacy of solid tumors (RECIST 1.1)
DFS
From the date of surgery to the first local, regional, contralateral or distant recurrence, and death from any cause
OS
From date of surgery to death from any cause,whichever came first

Full Information

First Posted
May 17, 2022
Last Updated
July 24, 2022
Sponsor
Henan Cancer Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05474690
Brief Title
A Study Comparing the Efficacy of TCbHP and ECHP-THP in the Neoadjuvant Treatment of HER2-positive Breast Cancer
Official Title
A Non-inferior, Randomized Controlled Phase III Clinical Study Comparing the Efficacy of TCbHPand ECHP-THP in Neoadjuvant Treatment of Operable HER2-positive Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Recruiting
Study Start Date
May 11, 2022 (Actual)
Primary Completion Date
September 30, 2024 (Anticipated)
Study Completion Date
September 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Henan Cancer Hospital

4. Oversight

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

5. Study Description

Brief Summary
In 2020, the incidence of breast cancer surpassed that of lung cancer for the first time, becoming the number one cancer in the world. HER2 is an important prognostic indicator and therapeutic target for breast cancer. HER2-overexpressing breast cancer accounts for about 20% to 30% of all breast cancer patients. Targeted therapy for HER2 protein is the core treatment for this type of breast cancer. At present, the neoadjuvant treatment mode of trastuzumab and pertuzumab dual-target chemotherapy has become the standard neoadjuvant treatment for high-risk HER2-positive breast cancer. For patients with early-stage high-risk or locally advanced HER2-positive breast cancer, whether standard neoadjuvant regimen without anthracycline can achieve the same therapeutic effect compared with regimen containing anthracycline is still inconclusive.Therefore, this study aimed to compare the efficacy and safety of two neoadjuvant treatment regimens, TCbHP*6 and ECHP*4-THP*4, in the neoadjuvant treatment of HER2-positive breast cancer through a randomized controlled phase 3 clinical trial.
Detailed Description
Subjects were screened according to inclusion and exclusion criteria. Subjects who met the inclusion conditions were randomly divided into TCbHP group and ECHP-THP group according to 1:1. Stratified at randomization by the following factors: T, N, HER2 expression (HER2 protein 3+ vs HER2 protein 2+ but FISH+), and hormone receptor status (HR positive vs HR negative). Drug dose of TCbHP regimen: docetaxel 75 mg/m2 + carboplatin (AUC=6) + trastuzumab (first loading dose 8 mg/kg, sequential maintenance dose 6 mg/kg) + Pascal Tocilizumab (initial loading dose of 840 mg, followed by maintenance dose of 420 mg), every 21 days as a cycle. Dosage of ECHP-THP regimen: epirubicin 90mg/m2 + cyclophosphamide 600mg/m2 followed by docetaxel 90mg/m2, trastuzumab (the first loading dose of 8 mg/kg, followed by maintenance The dose is 6 mg/kg) + Pertuzumab (the initial loading dose of 840 mg, and the sequential maintenance dose of 420 mg), every 21 days as a cycle.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer, HER2-positive Breast Cancer
Keywords
Breast cancer, HER2, pathological complete remission

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
TCbHP chemotherapy regimen
Arm Type
Active Comparator
Arm Description
Docetaxel + Carboplatin + Trastuzumab + Pertuzumab
Arm Title
ECHP-THP chemotherapy regimen
Arm Type
Experimental
Arm Description
(Epirubicin + Cyclophosphamide - Docetaxel) + (Trastuzumab + Pertuzumab)
Intervention Type
Drug
Intervention Name(s)
Docetaxel + Carboplatin + Trastuzumab + Pertuzumab
Other Intervention Name(s)
TCbHP regimen group
Intervention Description
Subjects who met the inclusion conditions were randomly divided into TCbHP group and ECHP-THP group according to 1:1. Stratified at randomization by the following factors: T, N, HER2 expression (HER2 protein 3+ vs HER2 protein 2+ but FISH+), and hormone receptor status (HR positive vs HR negative). TCbHP regimen drug dose: docetaxel 75 mg/m2 + carboplatin (AUC=6) + trastuzumab (first loading dose 8 mg/kg, sequential maintenance dose 6 mg/kg) + pertuzumab Antibiotics (the initial loading dose of 840 mg, and the sequential maintenance dose of 420 mg), every 21 days as a cycle.
Intervention Type
Drug
Intervention Name(s)
(Epirubicin + Cyclophosphamide - Docetaxel) + (Trastuzumab + Pertuzumab)
Other Intervention Name(s)
ECHP-THP regimen group
Intervention Description
Dosage of ECHP-THP regimen: epirubicin 90mg/m2+cyclophosphamide 600mg/m2 followed by docetaxel 90mg/m2, trastuzumab (first loading dose 8 mg/kg, sequential maintenance dose 6 mg /kg) + Pertuzumab (the initial loading dose of 840 mg, and the sequential maintenance dose of 420 mg), every 21 days as a cycle.
Primary Outcome Measure Information:
Title
Pathological Complete Response (pCR)
Description
Percentage of Participants With Pathological Complete Response (pCR) (ypT0/is/N0M0) after 6 cycles of neoadjuvant chemotherapy
Time Frame
up to 24 weeks
Secondary Outcome Measure Information:
Title
Number of treatment-related adverse events assessed by CTCAE v4.0
Description
Evaluate the nature, incidence and severity of chemotherapy adverse events according to CTCAE 5.0
Time Frame
up to 24 weeks
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Description
Dose adjustment rate and withdrawal rate of chemotherapy drugs in two chemotherapy regimens
Time Frame
up to 24 weeks
Title
ORR
Description
Objective response rate.ORR assessed according to the evaluation criteria for the efficacy of solid tumors (RECIST 1.1)
Time Frame
up to 24 weeks
Title
DFS
Description
From the date of surgery to the first local, regional, contralateral or distant recurrence, and death from any cause
Time Frame
up to 60 months
Title
OS
Description
From date of surgery to death from any cause,whichever came first
Time Frame
up to 120 months
Other Pre-specified Outcome Measures:
Title
gene mutation rate
Description
Exploring polygenic predictive models that influence PCR for different neoadjuvant regimens
Time Frame
up to 24 weeks

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 18 years ≤ age ≤ 65 years, Performance Status- Eastern Cooperative Oncology Group (ECOG) 0-1; Clinical T2-T4d, or T1c with axillary LN+; HER2 + invasive breast cancer confirmed by histopathology Note: HER2 expression positive refers to the tumor cells with immunohistochemical staining intensity of 3 + or confirmed positive by fluorescence in situ hybridization [fish] at least once during the pathological detection/review of primary tumor in the Department of pathology of participating research center hospital; Clinically measurable lesions: measurable lesions revealed by ultrasound, molybdenum target or MR (optional) within 1 month before randomization Organ and bone marrow function test within one month before chemotherapy showed no chemotherapy contraindication: Absolute value of neutrophil count ≥ 2.0×10^9 / L Hemoglobin ≥ 100g / L Platelet count ≥ 100×10^9 / L Total bilirubin < 1.5 ULN (upper limit of normal value) Creatinine < 1.5 × ULN AST/ALT < 1.5×ULN Echocardiography: left ventricular ejection fraction (LVEF ≥ 55%); For women of childbearing age, serum pregnancy test was negative 14 days ; Signed the informed consent form prior to patient entry; Exclusion Criteria: Stage IV (metastatic) breast cancer; supraclavicular lymph node metastasis; For this disease, chemotherapy, endocrine therapy, targeted therapy, reflex therapy, etc. have been received; The patient has a second primary malignancy other than adequately treated skin cancer; The patient has undergone major surgical procedures not related to breast cancer within 4 weeks prior to enrollment, or the patient has not fully recovered from such surgical procedures; The patient has severe heart disease or discomfort, including but not limited to the following:Diagnosed history of heart failure or systolic dysfunction (LVEF < 50%);High-risk uncontrolled arrhythmias;Angina pectoris requiring antianginal medication;Clinically significant heart valve disease;ECG showing transmural myocardial infarction;Poorly controlled high blood pressure; Because the patient has other serious and uncontrollable medical diseases, the investigator believes that chemotherapy is contraindicated; Known history of allergy to the drug components of this regimen; history of immunodeficiency, including HIV positive test, or other acquired or congenital immunodeficiency diseases, or a history of organ transplantation;
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Zhenzhen Liu
Phone
13603862755
Email
liuzhenzhen73@126.com
First Name & Middle Initial & Last Name or Official Title & Degree
Dechuang Jiao
Phone
13598004327
Email
jiaodechuang@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Zhenzhen Liu
Organizational Affiliation
Henan Cancer Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Henan cancer hospital
City
Zhengzhou
State/Province
Henan
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhenzhen Liu
Phone
13603862755
Email
liuzhenzhen73@126.com

12. IPD Sharing Statement

Learn more about this trial

A Study Comparing the Efficacy of TCbHP and ECHP-THP in the Neoadjuvant Treatment of HER2-positive Breast Cancer

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