Exploring Whether Disease-free Intervals Can Guide Endocrine Combined Targeted Therapy for ER+/HER2+ Advanced Breast Cancer (T-sunflower)

Metastatic Breast Cancer Clinical Trial

Official title:

Exploring Whether Disease-free Intervals Can Guide Endocrine Combined Targeted Therapy for ER+/HER2+ Advanced Breast Cancer (T-sunflower)

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05577923
• Other study ID #: FUSCC-T-sunflower
• Status: Not yet recruiting
• Phase: Phase 2
• Start date: November 1, 2022
• Est. completion date: March 1, 2026

Study information

• Verified date: October 2022
• Source: Fudan University
• Contact: zhimin U Shao, professor
• Phone: 08602164175590
• Email: zhimingshao[@]yahoo.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study is a prospective, single-arm, phase II clinical study for patients with ER+/HER2+ advanced breast cancer.

Description:

Patients with ER+/HER2+ advanced breast cancer are planned to be enrolled. Patients will receive first-line endocrine therapy combined with anti-HER2 therapy. The main purpose is to evaluate whether disease-free intervals can guide first-line endocrine combined targeted therapy for ER+/HER2+ advanced breast cancer.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 126
• Est. completion date: March 1, 2026
• Est. primary completion date: September 1, 2024
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 18 Years to 75 Years

Eligibility

Inclusion Criteria:

Females =18 years and = 75 years old;

• Histologically confirmed ER + / HER2- invasive breast cancer (specific definition:

immunohistochemical detection of ER> 10% tumor cell positive is defined as ER positive, HER2 3+ or HER2 amplification followed by FISH detection);

• Stage IV breast cancer or recurrent metastatic breast cancer;

• Patients had received no previous chemotherapy or targeted therapy for metastatic disease

• At least one lesion (measurable and/or non-measurable) that has not previously received radiation therapy

• Normal heart function, normal ECG and LVEF = 55%;

• Has adequate bone marrow function: absolute neutrophil count > 1.5x10ˆ9 /L; platelet count > 75x10ˆ9 /L, hemoglobin > 9g/dL;

• Has adequate liver function and kidney function: TBIL =1.5 times of the normal upper limit;ALT and AST =3 times of the normal upper limit;if liver metastases,then ALT and AST= 5 times of the normal upper limit;serum creatinine =1.5 times of the normal upper limit; Child-Pugh A/B(=9 score)

• 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:

• Treatment with chemotherapy, radiotherapy, immunotherapy or surgery (outpatient clinic surgery excluded) for metastatic disease

• CNS metastases

• Significant cardiovascular disease(including congestive heart failure, angina pectoris, myocardial infarction or ventricular arrhythmia in the last 6 months);

• is pregnant or breast feeding;

• Malignant tumors in the past five years (except cured skin basal cell carcinoma and cervical carcinoma in situ).

• Positive test for human immunodeficiency virus

• Active hepatitis B or hepatitis C

• Rapid progression of the disease, researchers judge that endocrine combination targeted therapy is not suitable, including the number of liver metastases exceeding 10 or the maximum diameter of a single liver metastases = 10 cm, symptomatic thoraco-ascites, etc.;

• Subjects with uncontrolled lung disease, severe infection, active gastrointestinal ulcer, coagulopathy, severe uncontrolled diabetes, connective tissue disease or inhibition of bone marrow function who cannot tolerate therapy;

• Current use or anticipated need for food or drugs that are known strong CYP3A4 (cytochrome P450 3A4) inhibitors or inducers.

1. Strong CYP3A inhibitors, including, boceprevir, clarithromycin, conivaptan, delavirdine, indinavir, itraconazole, ketoconazole, lopinavir, mibefradil, miconazole, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, suboxone, telaprevir, telithromycin, voriconazole, and grapefruit, grapefruit juice or any product containing grapefruit.

2. Strong CYP3A inducers, including carbamazepine, phenytoin, primidone, rifampin, rifapentin, and St. John's wort.

• Moderate infection occurs within 4 weeks before the first administration (e.g. intravenous drip of antibiotics, antifungal or antiviral drugs according to clinical criteria), fever of unknown origin occurs during the screening period/before the first administration.

Related Conditions & MeSH terms

• Breast Neoplasms
• Metastatic Breast Cancer

Intervention

Drug:
• Trastuzumab
8 mg/kg loading dose IV, then 6 mg/kg IV, every 3 weeks
• pyrotinib
Pyrotinib 320mg, PO daily, continuously
• Dalpiciclib
Dalpiciclib will be given at the dose of 125 mg po q.d. x 21 every 4 weeks
• fulvestrant
Fulvestrant will be given intramuscle at the dose of 500 mg every 4 weeks (with an additional 500 mg dose given two weeks after the initial dose.

Locations

Country	Name	City	State
China	Fudan University Shanghai Cancer Center Shanghai, China, 200032	Shanghai	Shanghai

Sponsors (1)

Lead Sponsor	Collaborator
Fudan University

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	PFS	time to progressive disease (according to RECIST1.1)	Randomization until the first occurrence of disease progression or death from any cause, which ever occurs first, through the completion of study (approximately 5 years)
Secondary	ORR	The proportion of participants whose best outcome is complete remission or partial remission (according to RECIST1.1)	Randomization until the first occurrence of disease progression or death from any cause, which ever occurs first, through the completion of study (approximately 5 years)
Secondary	CBR	the percentage of subjects with CR+PR+SD and last more than 24 weeks in all of the	Randomization until the first occurrence of disease progression or death from any cause, which ever occurs first, through the completion of study (approximately 5 years)
Secondary	DOR	Duration of whose best outcome is complete remission or partial remission (according to RECIST1.1)	Randomization until the first occurrence of disease progression or death from any cause, which ever occurs first, through the completion of study (approximately 5 years)