Clinical Study of Chidamide Combined With Chemotherapy in Neoadjuvant Treatment of HR+/ HER2-BC
Primary Purpose
Breast Cancer
Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Chidamide
Sponsored by
About this trial
This is an interventional treatment trial for Breast Cancer
Eligibility Criteria
Inclusion Criteria:
- Women aged 18 years or older and 75 years or younger;
- All patients were histopathologically confirmed to be estrogen receptor (ER) positive (& GT; 10%),HER2 receptor negative follows the 2018 ASCO-CAP HER2 negative interpretation guideline criteria;
- Newly treated patients with stage II-III tumor staging meeting AJCC Version 8 criteria;
- KPS score ≥70;
The functional level of the organ must meet the following requirements:
- Bone marrow function
- ANC ≥ 1.5×10 9 /L (growth factor not used within 14 days);
- PLT ≥ 100×10 9 /L (no corrective treatment within 7 days);
- Hb ≥ 100 g/L (no corrective treatment within 7 days);
- Liver and kidney function
- TBIL ≤1.5 x ULN;
- ALT and AST≤3×ULN;
- BUN and Cr≤1.5×ULN and creatinine clearance ≥50 mL/min (Cockcroft-Gault formula);
- Able to undergo needle biopsy;
- Volunteered to participate in the study, signed informed consent, had good compliance and was willing to cooperate with follow-up.
Exclusion Criteria:
-
Participants are not allowed to participate in the clinical study under any of the following conditions:
- Have received any other form of anti-tumor therapy (chemotherapy, radiotherapy, molecular targeted therapy, endocrine therapy, etc.);
- Receiving any other antitumor therapy;
- Bilateral breast cancer, inflammatory breast cancer or ocessive breast cancer;
- Stage IV breast cancer;
- Breast cancer without histopathological diagnosis;
- Other malignant tumors within the past 5 years, except cured carcinoma in situ of the cervix;
- Severe heart, liver, kidney and other important organ dysfunction;
- Inability to swallow, chronic diarrhea and intestinal obstruction, there are many factors affecting drug taking 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;
- History of any heart disease, including :(1) medically required or clinically significant arrhythmia; (2) myocardium infarction; (3) heart failure; (4) Any other heart disease deemed unsuitable for the study by the investigator;
- 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
- Cancer Hospital affiliated to Harbin Medical UniversityRecruiting
- Bethune First Hospital of Jilin UniversityRecruiting
- Health Science and Technology Information Center of Liaoning Health Industry Group Co., LTDRecruiting
- Affiliated Zhongshan Hospital Dalian UniversityRecruiting
- Shengjing Hospital of China Medical UniversityRecruiting
- Liaoning Cancer HospitalRecruiting
- The First Affiliated Hospital of China Medical UniversityRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
treatment group
Arm Description
Chidamide combined with EC -- T regimen was treated with 1 cycle every 21 days, followed by 4 cycles of EC followed by 4 cycles of T, a total of 8 cycles
Outcomes
Primary Outcome Measures
RCB 0-1 points ratio
Residual tumor burden
Secondary Outcome Measures
pCR(ypT0/is、ypN0)
There was no residual tumor
bpCR(ypT0/is)
Breast pCRwith ypT0/is carcinoma in situ
ORR
Proportion of patients who had a 30% reduction in tumor volume and maintained it for more than four weeks
Breast retention rate
Percentage of patients with successful breast preservation
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05400993
Brief Title
Clinical Study of Chidamide Combined With Chemotherapy in Neoadjuvant Treatment of HR+/ HER2-BC
Official Title
A Multicenter, Single-arm Prospective Phase II Study of Chidamide in Combination With Chemotherapy for Neoadjuvant Treatment of HR-positive/HER2-negative Breast Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
June 2022
Overall Recruitment Status
Recruiting
Study Start Date
May 23, 2022 (Actual)
Primary Completion Date
May 23, 2023 (Anticipated)
Study Completion Date
May 23, 2024 (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
Neoadjuvant therapy for HR+/HER2- breast cancer is dominated by anthracycline combined with paclitaxel chemotherapy. Aggressive neoadjuvant chemotherapy can only achieve pCR in about 10% of PATIENTS with HR-positive breast cancer. The emergence of new targeted drugs brings new life and hope to HR-positive breast cancer patients.Basic studies have shown that the abnormal state of epigenetics is associated with the metastasis of drug resistance and recurrence of tumor histone deacetylase (HDAC) is an important regulator of epigenetic regulation, and drugs targeting HDAC provide a new strategy for tumor therapy. The ACE study suggests that selective HDAC inhibitor chidamide in combination with endocrine therapy significantly improves survival benefit in patients with hr-positive HER2-negative advanced breast cancer who relapsed or progressed after endocrine therapy, providing a new treatment option for these patients.In conclusion, we hypothesize that neoadjuvant therapy with chidamide combination therapy provides a better strategy for patients with HR + /HER2 - breast adenocarcinoma.
Detailed Description
A total of 59 patients with stage Ii-III HR + / HER2 - breast cancer were enrolled in a multi-center, single-arm prospective design. The main purpose of the study was to observe the efficacy and safety of chidamide combined with chemotherapy in neoadjuvant treatment of stage II-III HR + / HER2 - breast cancer Breast MRI and other imaging examinations were reviewed every 2 cycles to evaluate the efficacy. If the efficacy was accurate, surgical treatment was performed within 4 weeks after the 8th cycle of neoadjuvant therapy. If the efficacy was SD+/PD, the study would be withdrawn Within 4 weeks after surgical treatment, the resected tumor tissue and lymph nodes were histopathologically examined (including the pathology of the tumor resection margin). The pathological sections were uniformly lent to the master research unit for unified review
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
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
59 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
treatment group
Arm Type
Experimental
Arm Description
Chidamide combined with EC -- T regimen was treated with 1 cycle every 21 days, followed by 4 cycles of EC followed by 4 cycles of T, a total of 8 cycles
Intervention Type
Combination Product
Intervention Name(s)
Chidamide
Other Intervention Name(s)
pharmorubicin, Cyclophosphamide, Docetaxel
Intervention Description
Chidamide: take orally twice a week,4 tablets/time (20mg/ time), the interval between two doses should not be less than 3 days (such as Monday and Thursday, Tuesday and Friday, Wednesday and Saturday, etc.), the day before chemotherapy, 30 minutes after breakfast; Chidamide: 20mg, orally, twice a week, oral for two weeks and one week, a total of 8 cycles; Epirubicin 90mg/m2 , ivgtt, d1 Cyclophosphamide 600mg/m 2, ivgtt, d1 Q3w, 4 cycle; sequential Docetaxel 100 mg/m 2, IVGtt, D1 Q3w, 4 cycle。
Primary Outcome Measure Information:
Title
RCB 0-1 points ratio
Description
Residual tumor burden
Time Frame
One month after surgery
Secondary Outcome Measure Information:
Title
pCR(ypT0/is、ypN0)
Description
There was no residual tumor
Time Frame
One month after surgery
Title
bpCR(ypT0/is)
Description
Breast pCRwith ypT0/is carcinoma in situ
Time Frame
One month after surgery
Title
ORR
Description
Proportion of patients who had a 30% reduction in tumor volume and maintained it for more than four weeks
Time Frame
Period of neoadjuvant therapy (treatment 1-6 months)
Title
Breast retention rate
Description
Percentage of patients with successful breast preservation
Time Frame
One month after surgery
Other Pre-specified Outcome Measures:
Title
Adverse Events (AE) and Serious Adverse Events (SAE)
Description
Any adverse events
Time Frame
Period of neoadjuvant therapy (treatment 1-6 months)And chidamide 3 weeks after withdrawal
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:
Women aged 18 years or older and 75 years or younger;
All patients were histopathologically confirmed to be estrogen receptor (ER) positive (& GT; 10%),HER2 receptor negative follows the 2018 ASCO-CAP HER2 negative interpretation guideline criteria;
Newly treated patients with stage II-III tumor staging meeting AJCC Version 8 criteria;
KPS score ≥70;
The functional level of the organ must meet the following requirements:
Bone marrow function
ANC ≥ 1.5×10 9 /L (growth factor not used within 14 days);
PLT ≥ 100×10 9 /L (no corrective treatment within 7 days);
Hb ≥ 100 g/L (no corrective treatment within 7 days);
Liver and kidney function
TBIL ≤1.5 x ULN;
ALT and AST≤3×ULN;
BUN and Cr≤1.5×ULN and creatinine clearance ≥50 mL/min (Cockcroft-Gault formula);
Able to undergo needle biopsy;
Volunteered to participate in the study, signed informed consent, had good compliance and was willing to cooperate with follow-up.
Exclusion Criteria:
-
Participants are not allowed to participate in the clinical study under any of the following conditions:
Have received any other form of anti-tumor therapy (chemotherapy, radiotherapy, molecular targeted therapy, endocrine therapy, etc.);
Receiving any other antitumor therapy;
Bilateral breast cancer, inflammatory breast cancer or ocessive breast cancer;
Stage IV breast cancer;
Breast cancer without histopathological diagnosis;
Other malignant tumors within the past 5 years, except cured carcinoma in situ of the cervix;
Severe heart, liver, kidney and other important organ dysfunction;
Inability to swallow, chronic diarrhea and intestinal obstruction, there are many factors affecting drug taking 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;
History of any heart disease, including :(1) medically required or clinically significant arrhythmia; (2) myocardium infarction; (3) heart failure; (4) Any other heart disease deemed unsuitable for the study by the investigator;
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, doctoral
Phone
18940264967
Email
liucg@sj-hospital.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Caigang Liu, doctoral
Organizational Affiliation
Shengjing Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cancer Hospital affiliated to Harbin Medical University
City
Haerbin
State/Province
Heilongjiang
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhigao Li, professor
Facility Name
Bethune First Hospital of Jilin University
City
Changchun
State/Province
Jilin
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dong Song, professor
Facility Name
Health Science and Technology Information Center of Liaoning Health Industry Group Co., LTD
City
Benxi
State/Province
Liaoning
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Honglu Li, professor
Facility Name
Affiliated Zhongshan Hospital Dalian University
City
Dalian
State/Province
Liaoning
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dianlong Zhang, professor
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
Facility Name
Liaoning Cancer Hospital
City
Shenyang
State/Province
Liaoning
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hong Xu, Professor
Facility Name
The First Affiliated Hospital of China Medical University
City
Shenyang
State/Province
Liaoning
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xinyu Zheng, professor
12. IPD Sharing Statement
Learn more about this trial
Clinical Study of Chidamide Combined With Chemotherapy in Neoadjuvant Treatment of HR+/ HER2-BC
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