Triple Negative Breast Cancer Clinical Trial
Official title:
Randomized Phase Ⅲ Trial Comparing Dose-dense Epirubicin and Cyclophosphamide Followed by Paclitaxel With Paclitaxel Plus Carboplatin as Adjuvant Therapy for Triple-negative Breast Cancer With Homologous Recombination Repair Deficiency
The purpose of this trial is to compare the 3-year disease-free survival of dose-dense
epirubicin and cyclophosphamide followed by paclitaxel with paclitaxel plus carboplatin as
adjuvant therapy for triple-negative breast cancer with homologous recombination repair
deficiency.
The other purpose of this trial is to observe the patient's tolerance.
Triple-negative breast cancer (TNBC) lack the expression of oestrogen receptor (ER),
progesterone receptor(PR) and human epidermal growth factor receptor 2 (HER2) , and
characterizes an aggressive behavior with higher risk of recurrence and death compared to
other breast cancer subtypes. Little therapeutic progress has been made in adjuvant therapy
in TNBC during the past decades and the standard of care is still missing.
Pre-clinical and clinical data suggest that platinum-based regimens represent an emerging
therapeutic option for selected patients with homologous recombination repair deficiency
(HRD). The HR system is critical in regulating and maintaining genome stability, and is one
of the most commonly altered systems in TNBCs, up to 15-20% TNBC patients carry germline
BRCA1/2 mutations. Other HR genes included PALB2, RAD51 etc. Tumors that harbor HRD possess
an increased burden of genomic aberrations and lesions, and have been shown to have increased
sensitivity to DNA crosslinking agents such as platinum salts. Platinum-based regimens have
been encouraging in TNBC patients with HRD, given increases in both pathologic complete
response (pCR) rates in neoadjuvant trials and objective response rates(ORR) in metastatic
diseases. Further information are needed on how platinum-containing therapies affect
long-term outcomes in the adjuvant setting.
In this trial, the investigators intend to compare the 3-year disease-free survival (DFS) of
dose-dense epirubicin and cyclophosphamide followed by paclitaxel with paclitaxel plus
carboplatin as adjuvant therapy in high-risk node-negative or node-positive TNBC patients
with HRD. The other purpose of this trial is to observe the participants' tolerance.
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