Breast Cancer Clinical Trial
Official title:
Comparison of Neoadjuvant Aromatase Inhibitors With Ovarian Suppression Versus Chemotherapy in Premenopausal Patients With Hormone Receptor-positive Breast Cancer (COMPETE): a Randomized Phase 3 Trial
To compare the efficacy and safety of neoadjuvant aromatase inhibitor plus ovarian suppression with chemotherapy in premenopausal patients with hormone receptor-positive breast cancer.
Neoadjuvant therapy is nowadays the standard treatment for both early stage and locally
advanced breast cancer, and exhibited similar benefit compared with adjuvant therapy in terms
of disease free and overall survival. Patients achieved pathological complete response(pCR)
after neoadjuvant chemotherapy have superior outcome compared with those with residual tumors
in breast and/or axilla. pCR is now the most wildly accepted surrogate marker for long-term
survival of patients, especially in those with triple negative or human epidermal growth
factor receptor-2(HER2)-positive breast cancer. However, in luminal HER2-negative breast
cancer, neoadjuvant chemotherapy is not as effective as in other subtypes of breast cancer,
pCR is less noted and seems barely correlated to long-term survival benefit.
In postmenopausal patients with hormone receptor-positive breast cancer, neoadjuvant
endocrine therapy of aromatase inhibitor achieved similar clinical response rate compared
with neoadjuvant chemotherapy, and in premenopausal hormone receptor-positive, HER2-negative
breast cancer patients, neoadjuvant aromatase inhibitor plus ovarian function
suppression(OFS) has showed more pronounced efficacy than tamoxifen plus OFS.
In adjuvant setting, aromatase inhibitor combined with OFS in premenopausal patients with
hormone receptor-positive breast cancer has demonstrated superior benefit in terms of disease
free survival, and has been established as one of the routine options of adjuvant endocrine
therapy. Notwithstanding the remarkable performance of combination of aromatase inhibitor and
OFS in adjuvant therapy, the role of this treatment strategy in neoadjuvant setting has yet
not been proved when compared with neoadjuvant chemotherapy.
The aim of this study is to prospectively compare the efficacy and safety of neoadjuvant
aromatase inhibitor plus OFS with chemotherapy in premenopausal patients with hormone
receptor-positive HER2-negative breast cancer.
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