Breast Cancer Clinical Trial
Official title:
A Phase III, Open-label, Randomised Study of Neoadjuvant Datopotamab Deruxtecan (Dato-DXd) Plus Durvalumab Followed by Adjuvant Durvalumab With or Without Chemotherapy Versus Neoadjuvant Pembrolizumab Plus Chemotherapy Followed by Adjuvant Pembrolizumab With or Without Chemotherapy for the Treatment of Adult Patients With Previously Untreated Triple-Negative or Hormone Receptor-low/HER2-negative Breast Cancer (D926QC00001; TROPION-Breast04)
This is a Phase III, 2-arm, randomised, open-label, multicentre, global study assessing the efficacy and safety of neoadjuvant Dato-DXd plus durvalumab followed by adjuvant durvalumab with or without chemotherapy compared with neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab with or without chemotherapy in participants with previously untreated TNBC or hormone receptor-low/HER2-negative breast cancer.
Status | Recruiting |
Enrollment | 1728 |
Est. completion date | August 28, 2030 |
Est. primary completion date | March 29, 2028 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Participant must be = 18 years, at the time of signing the ICF. - Histologically confirmed Stage II or III unilateral or bilateral primary invasive TNBC or hormone receptor-low/HER2-negative breast cancer - ECOG PS of 0 or 1 - Provision of acceptable tumor sample - Adequate bone marrow reserve and organ function - Contraceptive use by males or females should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. Exclusion criteria: - History of another primary malignancy except for malignancy treated with curative intent with no known active disease within 3 years before randomization and of low potential risk for recurrence. - Evidence of distant disease. - Clinically significant corneal disease. - Has active or uncontrolled hepatitis B or C virus infection. - Known HIV infection that is not well controlled. - Uncontrolled infection requiring i.v. antibiotics, antivirals or antifungals; suspected infections; or inability to rule out infections. - Known to have active tuberculosis infection - Resting ECG with clinically significant abnormal findings. - Uncontrolled or significant cardiac disease. - History of non-infectious ILD/pneumonitis - Any prior or concurrent surgery, radiotherapy or systemic anticancer therapy for TNBC or hormone receptor-low/HER2-negative breast cancer - For females only: is pregnant (confirmed with positive serum pregnancy test) or breastfeeding, or planning to become pregnant. - Female participants should refrain from breastfeeding from enrolment throughout the study and for at least 7 months after last dose of study intervention, or as dictated by local PI for SoC if longer. |
Country | Name | City | State |
---|---|---|---|
Australia | Research Site | Darlinghurst | |
Australia | Research Site | East Melbourne | |
Australia | Research Site | Heidelberg | |
Australia | Research Site | Herston | |
Australia | Research Site | Nedlands | |
Australia | Research Site | Waratah | |
Austria | Research Site | Feldkirch | |
Austria | Research Site | Graz | |
Austria | Research Site | Innsbruck | |
Austria | Research Site | Linz | |
Austria | Research Site | Salzburg | |
Belgium | Research Site | Brasschaat | |
Belgium | Research Site | Charleroi | |
Belgium | Research Site | Gent | |
Belgium | Research Site | Leuven | |
Belgium | Research Site | Libramont-Chevigny | |
Belgium | Research Site | Wilrijk | |
Brazil | Research Site | Brasilia | |
Brazil | Research Site | Curitiba | |
Brazil | Research Site | Fortaleza | |
Brazil | Research Site | Londrina | |
Brazil | Research Site | Natal | |
Brazil | Research Site | Porto Alegre | |
Brazil | Research Site | Porto Alegre | |
Brazil | Research Site | Ribeirão Preto | |
Brazil | Research Site | Santo Andre | |
Brazil | Research Site | São Paulo | |
Brazil | Research Site | Taubaté | |
Brazil | Research Site | Vitória | |
Bulgaria | Research Site | Plovdiv | |
Bulgaria | Research Site | Shumen | |
Bulgaria | Research Site | Sofia | |
Bulgaria | Research Site | Sofia | |
Bulgaria | Research Site | Sofia | |
Bulgaria | Research Site | Sofia | |
Bulgaria | Research Site | Vratza | |
Canada | Research Site | Abbotsford | British Columbia |
Canada | Research Site | Barrie | Ontario |
Canada | Research Site | Calgary | Alberta |
Canada | Research Site | Levis | Quebec |
Canada | Research Site | London | Ontario |
Canada | Research Site | Montreal | Quebec |
Canada | Research Site | Montreal | Quebec |
Canada | Research Site | Montreal | Quebec |
Canada | Research Site | Montreal | |
Canada | Research Site | Oshawa | Ontario |
Canada | Research Site | Ottawa | |
Canada | Research Site | Saskatoon | Saskatchewan |
Canada | Research Site | Sherbrooke | Quebec |
Canada | Research Site | St-Jerome | Quebec |
Canada | Research Site | St. John's | Newfoundland and Labrador |
Canada | Research Site | Toronto | Ontario |
Canada | Research Site | Vancouver | British Columbia |
China | Research Site | Beijing | |
China | Research Site | Beijing | |
China | Research Site | Bengbu | |
China | Research Site | Changchun | |
China | Research Site | Changsha | |
China | Research Site | Changsha | |
China | Research Site | Chengdu | |
China | Research Site | Chongqing | |
China | Research Site | Guangzhou | |
China | Research Site | Guangzhou | |
China | Research Site | Hangzhou | |
China | Research Site | Hangzhou | |
China | Research Site | Harbin | |
China | Research Site | Hefei | |
China | Research Site | Jinan | |
China | Research Site | Kunming | |
China | Research Site | Linhai | |
China | Research Site | Nanchang | |
China | Research Site | Nanchang | |
China | Research Site | Nanjing | |
China | Research Site | Nanjing | |
China | Research Site | Nanning | |
China | Research Site | Shanghai | |
China | Research Site | Shenyang | |
China | Research Site | Shenyang | |
China | Research Site | Shijiazhuang | |
China | Research Site | Suining | |
China | Research Site | Suzhou | |
China | Research Site | Tianjin | |
China | Research Site | Urumqi | |
China | Research Site | Wuhan | |
China | Research Site | Xi'an | |
China | Research Site | Xintai | |
China | Research Site | Zhengzhou | |
France | Research Site | Avignon | |
France | Research Site | Bayonne | |
France | Research Site | Caen Cedex 5 | |
France | Research Site | Clermont Ferrand | |
France | Research Site | Limoges | |
France | Research Site | Lyon | |
France | Research Site | Marseille | |
France | Research Site | Montpellier | |
France | Research Site | Nice | |
France | Research Site | Paris | |
France | Research Site | Reims Cedex | |
France | Research Site | Saint Herblain | |
France | Research Site | Toulouse | |
France | Research Site | Vandoeuvre les Nancy | |
France | Research Site | Villejuif Cedex | |
Germany | Research Site | Augsburg | |
Germany | Research Site | Berlin | |
Germany | Research Site | Berlin | |
Germany | Research Site | Dessau-Roßlau | |
Germany | Research Site | Dresden | |
Germany | Research Site | Erlangen | |
Germany | Research Site | Essen | |
Germany | Research Site | Esslingen am Neckar | |
Germany | Research Site | Frankfurt am Main | |
Germany | Research Site | Freiburg | |
Germany | Research Site | Freiburg | |
Germany | Research Site | Hannover | |
Germany | Research Site | Hannover | |
Germany | Research Site | Heidelberg | |
Germany | Research Site | Kiel | |
Germany | Research Site | Mainz | |
Germany | Research Site | Mannheim | |
Germany | Research Site | München | |
Germany | Research Site | Münster | |
Germany | Research Site | Trier | |
Germany | Research Site | Ulm | |
Hong Kong | Research Site | Hong Kong | |
Hong Kong | Research Site | Hong Kong | |
Hong Kong | Research Site | Hong Kong | |
Hong Kong | Research Site | Kwai Chung | |
Hungary | Research Site | Budapest | |
Hungary | Research Site | Kecskemét | |
Hungary | Research Site | Miskolc | |
Hungary | Research Site | Nyíregyháza | |
Hungary | Research Site | Salgótarján | |
Hungary | Research Site | Szekszárd | |
India | Research Site | Bengaluru | |
India | Research Site | Dehradun | |
India | Research Site | Delhi | |
India | Research Site | Delhi | |
India | Research Site | Kolkata | |
India | Research Site | Kolkata | |
India | Research Site | Marg Jaipur | |
India | Research Site | Nagpur | |
India | Research Site | Nashik | |
India | Research Site | Puducherry | |
India | Research Site | Thiruvananthapuram | |
India | Research Site | Vadodara | |
Italy | Research Site | Empoli | |
Italy | Research Site | Lucca | |
Italy | Research Site | Macerata | |
Italy | Research Site | Milano | |
Italy | Research Site | Modena | |
Italy | Research Site | Napoli | |
Italy | Research Site | Padova | |
Italy | Research Site | Roma | |
Italy | Research Site | Rozzano | |
Italy | Research Site | Torino | |
Italy | Research Site | Tricase | |
Italy | Research Site | Udine | |
Japan | Research Site | Akashi-shi | |
Japan | Research Site | Akita-shi | |
Japan | Research Site | Bunkyo-ku | |
Japan | Research Site | Chiba-shi | |
Japan | Research Site | Chuo-ku | |
Japan | Research Site | Fukuoka-shi | |
Japan | Research Site | Fukushima-shi | |
Japan | Research Site | Gifu-shi | |
Japan | Research Site | Hidaka-shi | |
Japan | Research Site | Hirakata-shi | |
Japan | Research Site | Hiroshima-shi | |
Japan | Research Site | Hiroshima-shi | |
Japan | Research Site | Isehara-shi | |
Japan | Research Site | Kashiwa | |
Japan | Research Site | Koto-ku | |
Japan | Research Site | Kumamoto-shi | |
Japan | Research Site | Kurume-shi | |
Japan | Research Site | Matsuyama-shi | |
Japan | Research Site | Nagoya-shi | |
Japan | Research Site | Nagoya-shi | |
Japan | Research Site | Nagoya-shi | |
Japan | Research Site | Niigata-shi | |
Japan | Research Site | Okayama | |
Japan | Research Site | Osaka-shi | |
Japan | Research Site | Sapporo-shi | |
Japan | Research Site | Sapporo-shi | |
Japan | Research Site | Sendai-shi | |
Japan | Research Site | Shinagawa-ku | |
Japan | Research Site | Shinjuku-ku | |
Japan | Research Site | Shinjuku-ku | |
Japan | Research Site | Sunto-gun | |
Japan | Research Site | Tokyo | |
Japan | Research Site | Tsu-shi | |
Japan | Research Site | Yokohama-shi | |
Korea, Republic of | Research Site | Daegu | |
Korea, Republic of | Research Site | Goyang-si | |
Korea, Republic of | Research Site | Seongnam | |
Korea, Republic of | Research Site | Seoul | |
Korea, Republic of | Research Site | Seoul | |
Korea, Republic of | Research Site | Seoul | |
Korea, Republic of | Research Site | Seoul | |
Korea, Republic of | Research Site | Seoul | |
Korea, Republic of | Research Site | Seoul | |
Korea, Republic of | Research Site | Seoul | |
Malaysia | Research Site | George Town | |
Malaysia | Research Site | Kuala Lumpur | |
Malaysia | Research Site | Kuala Lumpur | |
Malaysia | Research Site | Kuching | |
Malaysia | Research Site | Selangor | |
Poland | Research Site | Bialystok | |
Poland | Research Site | Bydgoszcz | |
Poland | Research Site | Gdansk | |
Poland | Research Site | Gdynia | |
Poland | Research Site | Lódz | |
Poland | Research Site | Tomaszów Mazowiecki | |
Poland | Research Site | Warszawa | |
Poland | Research Site | Wroclaw | |
Singapore | Research Site | Singapore | |
Spain | Research Site | Barcelona | |
Spain | Research Site | Barcelona | |
Spain | Research Site | Granada | |
Spain | Research Site | Hospitalet deLlobregat | |
Spain | Research Site | Madrid | |
Spain | Research Site | Madrid | |
Spain | Research Site | Santiago de Compostela | |
Spain | Research Site | Sevilla | |
Spain | Research Site | Zaragoza | |
Switzerland | Research Site | Baden | |
Switzerland | Research Site | Basel | |
Switzerland | Research Site | Bern | |
Switzerland | Research Site | Frauenfeld | |
Switzerland | Research Site | Rennaz | |
Taiwan | Research Site | Changhua | |
Taiwan | Research Site | Kaohsiung | |
Taiwan | Research Site | Taichung | |
Taiwan | Research Site | Tainan | |
Taiwan | Research Site | Taipei | |
Taiwan | Research Site | Taipei | |
Taiwan | Research Site | Taipei | |
Taiwan | Research Site | Taoyuan | |
Thailand | Research Site | Bangkok | |
Thailand | Research Site | Bangkok | |
Thailand | Research Site | Dusit | |
Thailand | Research Site | Muang | |
Thailand | Research Site | Songkhla | |
Turkey | Research Site | Adapazari | |
Turkey | Research Site | Ankara | |
Turkey | Research Site | Ankara | |
Turkey | Research Site | Ankara | |
Turkey | Research Site | Istanbul | |
Turkey | Research Site | Kayseri | |
Turkey | Research Site | Samsun | |
United Kingdom | Research Site | Birmingham | |
United Kingdom | Research Site | Cardiff | |
United Kingdom | Research Site | Edinburgh | |
United Kingdom | Research Site | Guildford | |
United Kingdom | Research Site | Lancaster | |
United Kingdom | Research Site | London | |
United Kingdom | Research Site | Northampton | |
United Kingdom | Research Site | Oxford | |
United States | Research Site | Annapolis | Maryland |
United States | Research Site | Atlanta | Georgia |
United States | Research Site | Atlanta | Georgia |
United States | Research Site | Aurora | Colorado |
United States | Research Site | Austin | Texas |
United States | Research Site | Bakersfield | California |
United States | Research Site | Baton Rouge | Louisiana |
United States | Research Site | Blue Ash | Ohio |
United States | Research Site | Boston | Massachusetts |
United States | Research Site | Bridgeport | Connecticut |
United States | Research Site | Burnsville | Minnesota |
United States | Research Site | Camden | New Jersey |
United States | Research Site | Canton | Ohio |
United States | Research Site | Charlotte | North Carolina |
United States | Research Site | Chicago Ridge | Illinois |
United States | Research Site | Columbia | Missouri |
United States | Research Site | Commack | New York |
United States | Research Site | Dallas | Texas |
United States | Research Site | Dallas | Texas |
United States | Research Site | Dallas | Texas |
United States | Research Site | Dallas | Texas |
United States | Research Site | Daphne | Alabama |
United States | Research Site | Des Moines | Iowa |
United States | Research Site | Detroit | Michigan |
United States | Research Site | Durham | North Carolina |
United States | Research Site | Dyer | Indiana |
United States | Research Site | East Brunswick | New Jersey |
United States | Research Site | Edgewood | Kentucky |
United States | Research Site | El Paso | Texas |
United States | Research Site | Eugene | Oregon |
United States | Research Site | Falls Church | Virginia |
United States | Research Site | Flower Mound | Texas |
United States | Research Site | Fort Collins | Colorado |
United States | Research Site | Fort Myers | Florida |
United States | Research Site | Fort Worth | Texas |
United States | Research Site | Fullerton | California |
United States | Research Site | Goodyear | Arizona |
United States | Research Site | Grand Rapids | Michigan |
United States | Research Site | Henderson | Nevada |
United States | Research Site | Horsham | Pennsylvania |
United States | Research Site | Houston | Texas |
United States | Research Site | Houston | Texas |
United States | Research Site | Jacksonville | Florida |
United States | Research Site | Jacksonville | Florida |
United States | Research Site | Jonesboro | Arkansas |
United States | Research Site | Longmont | Colorado |
United States | Research Site | Los Angeles | California |
United States | Research Site | Los Angeles | California |
United States | Research Site | Louisville | Kentucky |
United States | Research Site | Madison | Wisconsin |
United States | Research Site | Minneapolis | Minnesota |
United States | Research Site | Nashville | Tennessee |
United States | Research Site | New Brunswick | New Jersey |
United States | Research Site | New Haven | Connecticut |
United States | Research Site | New York | New York |
United States | Research Site | Newark | Delaware |
United States | Research Site | Newport Beach | California |
United States | Research Site | Norfolk | Virginia |
United States | Research Site | Omaha | Nebraska |
United States | Research Site | Orange | California |
United States | Research Site | Philadelphia | Pennsylvania |
United States | Research Site | Phoenix | Arizona |
United States | Research Site | Pittsburgh | Pennsylvania |
United States | Research Site | Port Jefferson Station | New York |
United States | Research Site | Port Saint Lucie | Florida |
United States | Research Site | Portland | Oregon |
United States | Research Site | Providence | Rhode Island |
United States | Research Site | Richmond | Virginia |
United States | Research Site | Roanoke | Virginia |
United States | Research Site | Rogers | Arkansas |
United States | Research Site | Saint Louis | Missouri |
United States | Research Site | Saint Petersburg | Florida |
United States | Research Site | San Antonio | Texas |
United States | Research Site | Santa Barbara | California |
United States | Research Site | Santa Rosa | California |
United States | Research Site | Sylmar | California |
United States | Research Site | Tacoma | Washington |
United States | Research Site | Tallahassee | Florida |
United States | Research Site | Torrance | California |
United States | Research Site | Traverse City | Michigan |
United States | Research Site | Tucson | Arizona |
United States | Research Site | Van Nuys | California |
United States | Research Site | Webster | Texas |
United States | Research Site | West Palm Beach | Florida |
United States | Research Site | Winchester | Virginia |
Vietnam | Research Site | Hanoi | |
Vietnam | Research Site | Ho Chi Minh city | |
Vietnam | Research Site | Ho Chi Minh city | |
Vietnam | Research Site | Vinh |
Lead Sponsor | Collaborator |
---|---|
AstraZeneca | Daiichi Sankyo |
United States, Vietnam, Australia, Austria, Belgium, Brazil, Bulgaria, Canada, China, France, Germany, Hong Kong, Hungary, India, Italy, Japan, Korea, Republic of, Malaysia, Poland, Singapore, Spain, Switzerland, Taiwan, Thailand, Turkey, United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Pathologic Complete Response (pCR) in the experimental vs control arms | pCR rate is defined as the proportion of participants who have no evidence by haematoxylin and eosin staining of residual invasive disease at the time of definitive surgery in the complete resected breast specimen and all sampled regional lymph nodes (ypT0/Tis ypN0) by blinded central evaluation.
The analysis will include all randomised participants, as randomised, regardless of whether the participant withdraws from randomised therapy or receives another anticancer therapy. The measure of interest will be the difference between the pCR rates. |
At the time of definitive surgery | |
Primary | Event-free survival (EFS) in the experimental vs control arms | EFS is defined as the time from the date of randomisation until the date of the first occurrence of any of the following events: disease progression precluding surgery, disease recurrence (local, regional, distant, or contralateral), second primary non-breast invasive cancer (other than squamous or basal cell skin cancer), or death by any cause (in the absence of recurrence).
The analysis will include all randomised participants, as randomised, regardless of whether the participant withdraws from randomised therapy or receives another anticancer therapy. The measure of interest will be the Hazard Ratio of EFS. |
Date of randomization to date of the EFS event, up to 68 months after the first subject randomized | |
Secondary | Overall Survival (OS) in the experimental vs control arms | OS is defined as the time from the date of randomisation until the date of death due to any cause.
The analysis will include all randomised participants, as randomised, regardless of whether the participant withdraws from randomised therapy or receives another anticancer therapy. The measure of interest will be the Hazard Ratio of OS. |
Date of randomization to date of death due to any cause, up to 82 months after the first subject randomized | |
Secondary | Distant disease-free survival (DDFS) in the experimental vs control arms | DDFS is defined as the time from the date of randomisation until the date of the first occurrence of any of the following events: distant metastasis, occurrence of second primary non-breast invasive cancer (other than squamous or basal cell skin cancer), or death by any cause (in the absence of recurrence).
The analysis will include all randomised participants, as randomised, regardless of whether the participant withdraws from randomised therapy or receives another anticancer therapy. The measure of interest will be the Hazard Ratio of DDFS. |
Date of randomization to date of the DDFS event, up to 68 months after the first subject randomized | |
Secondary | Participant-reported breast and arm symptoms in the experimental vs. control arms | Breast and arm symptoms measured by the EORTC IL116. The analysis will include all randomised participants, as randomised, regardless of whether the participant withdraws from randomised therapy or receives another anticancer therapy.
The measure of interest is the mean between-arm difference in breast and arm symptom scores. |
From Cycle 1 Day 1 of neoadjuvant treatment until pre-surgery safety FU visit (for approximately 24 weeks) or EOT - whichever occurs first. | |
Secondary | Participant-reported physical function in the experimental vs. control arms | Physical function measured by the PROMIS Physical Function Short Form 8c. The analysis will include all dosed participants. The measure of interest is the mean between-arm difference in physical function scores. | From Cycle 1 Day 1 of neoadjuvant treatment until pre-surgery safety FU visit (for approximately 24 weeks) or EOT - whichever occurs first, and then from Cycle 1 Day 1 of adjuvant treatment until EOT (for approximately 27 weeks). | |
Secondary | Participant-reported fatigue in the experimental vs. control arms | Fatigue measured by the PROMIS Fatigue Short Form 7a. The analysis will include all dosed participants. The measure of interest will be the difference on the proportions of participants reporting different levels of fatigue and mean between-arm difference in the fatigue scores. | From Cycle 1 Day 1 of neoadjuvant treatment until pre-surgery safety FU visit (for approximately 24 weeks) or EOT - whichever occurs first, and then from Cycle 1 Day 1 of adjuvant treatment until EOT (for approximately 27 weeks). | |
Secondary | Participant-reported Global health status/Quality of life (GHS/QoL)in the experimental vs. control arms | Global health status/Quality of life measured by EORTC IL172. The analysis will include all randomised participants, as randomised, regardless of whether the participant withdraws from randomised therapy or receives another anticancer therapy.
The measure of interest is the mean between-arm difference in GHS/QoL scores. |
From Cycle 1 Day 1 of neoadjuvant treatment until pre-surgery safety FU visit (for approximately 24 weeks) or EOT - whichever occurs first, and then from Cycle 1 Day 1 of adjuvant treatment until EOT (for approximately 27 weeks). | |
Secondary | Pharmacokinetics of Dato-DXd (in combination with durvalumab) | Plasma concentrations of Dato-DXd (ug/ml ) | Day 1 of cycles 1,2,4,8 (Each cycle is 21 days) and at pre-surgery safety follow up visit | |
Secondary | Pharmacokinetics of Dato-DXd (in combination with durvalumab) | Plasma concentrations of total anti-TROP2 antibody (ug/ml ) | Day 1 of cycles 1,2,4,8 (Each cycle is 21 days) and at pre-surgery safety follow up visit | |
Secondary | Pharmacokinetics of Dato-DXd (in combination with durvalumab) | Plasma concentrations of DXd (MAAA-1181a) (ng/ml) | Day 1 of cycles 1,2,4,8 (Each cycle is 21 days) and at pre-surgery safety follow up visit | |
Secondary | Immunogenicity of Dato-DXd (in combination with durvalumab) | Presence of antidrug antibodies (ADAs) for Dato-DXd (confirmatory results: positive or negative, titres). | Day 1 of cycles 1,2,4,8 (Each cycle is 21 days) and at pre-surgery safety follow up visit | |
Secondary | Safety of Dato-DXd (in combination with durvalumab) | Safety and tolerability will be evaluated in terms of AEs graded by CTCAE version 5.0 | Randomization to final safety follow-up visit, either 90 days after last dose of study intervention for those who complete planned study intervention or 90 days after date of discontinuation for those who discontinue study intervention prematurely |
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