Pyrotinib or Trastuzumab Plus Nab-paclitaxel as Neoadjuvant Therapy in HER2-positive Breast Cancer

Phase 2TerminatedNCT04066790

Shanghai Jiao Tong University School of Medicine12 enrolled

Overview

This study aims to evaluate the efficacy and safety of pyrotinib in combination with nab-paclitaxel or trastuzumab with nab-paclitaxel as neoadjuvant therapy in early stage or locally advanced HER2-positive breast cancer.

The study evaluate the pathological complete response rate, event-free survival, disease-free survival, overall survival and safety of pyrotinib in combination with nab-paclitaxel or trastuzumab with nab-paclitaxel as neoadjuvant therapy in early stage or locally advanced HER2-positive breast cancer. Patients will receive 4 cycles of pyrotinib in combination with nab-paclitaxel or 4 cycles of trastuzumab with nab-paclitaxel as neoadjuvant therapy, then undergo surgery, then receive 4 cycles of epirubicin in combination with cyclophosphamide, then complete 1 year of trastuzumab.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Breast Cancer

Interventions

PyrotinibDRUG

Pyrotinib 400 mg taken orally everyday, every 3 weeks, for 4 cycles.

nab-PaclitaxelDRUG

Nab-paclitaxel 100mg/m2 by intravenous (IV) infusion on day1, day8 and day15, every 3 weeks, for 4 cycles.

TrastuzumabDRUG

Trastuzumab IV infusion in 3-week cycles. Neoadjuvant treatment: 8 milligrams per kilogram (mg/kg) loading dose for Cycle 1, followed by 6 mg/kg for Cycles 2-4. Adjuvant treatment: 8 mg/kg loading dose for Cycle 9, followed by 6 mg/kg for remaining cycles till completion of 1 year trastuzumab

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * With signed consent * Histologically confirmed invasive breast carcinoma with a primary tumor size of no less than (≥) 2 centimeters (cm) by standard local assessment technique * Breast cancer stage at presentation: stage I-III * HER2-positive breast cancer defined as 3+ score by immunohistochemistry in \> 10 percent (%) of immunoreactive cells or HER2 gene amplification by in situ hybridization * Known hormone receptor status (estrogen receptor and/or progesterone receptor) * Eastern Cooperative Oncology Group Performance Status equal to or less than (\<=) 1 * Baseline left ventricular ejection fracture \>= 50% measured by echocardiography * Willing to use highly effective form of nonhormonal contraception while on study and for 7 months after end of study treatment for female with fertility or male * Negative serum pregnancy test for women with fertility * Willing to obey the study protocol Exclusion Criteria: * Stage IV disease * Previous anti-cancer therapy or radiotherapy for any malignancy * History of other malignancy within 5 years prior to screening, except for appropriately-treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, or Stage I uterine cancer * Concurrent anti-cancer treatment in another investigational trial, including hormone therapy, bisphosphonate therapy, or immunotherapy * Major surgical procedure unrelated to breast cancer within 4 weeks prior to randomization or from which the participant has not fully recovered * Serious cardiac illness or medical condition * Other concurrent serious diseases that may interfere with planned treatment, including severe pulmonary conditions/illness * Any abnormalities in liver, kidney or hematologic function laboratory tests immediately prior to randomization * Sensitivity to any of the study medications, any of the ingredients or excipients of these medications, or benzyl alcohol * Not able to swallow the drug * Pregnant or lactating

Locations (1)

Ruijin Hospital, Shanghai Jiaotong University School of Medicine

Shanghai, Shanghai Municipality, China

Outcomes

Primary Outcomes

Percentage of Participants With Total Pathologic Complete Response (tpCR)

tpCR is defined as the absence of any residual invasive cancer on hematoxylin and eosin evaluation of the resected breast specimen and all sampled ipsilateral lymph nodes after completion of neoadjuvant therapy and surgery (that is, ypT0/is, ypN0, in accordance with the current American Joint Committee on Cancer \[AJCC\] staging system).The duration of one treatment cycle is 21 days.

Time frame: Cycle 4 . The duration of one treatment cycle is 21 days.

Secondary Outcomes

Percentage of Participants With Breast Pathologic Complete Response (bpCR)

bpCR is defined as the absence of any residual invasive cancer on the hematoxylin and eosin evaluation of the resected breast specimen after completion of neoadjuvant therapy and surgery (that is, ypT0/is, in accordance with current AJCC staging system).The duration of one treatment cycle is 21 days.

Time frame: Cycle 4 . The duration of one treatment cycle is 21 days.

Clinical response

Percentage of Participants With Complete Response, Partial Response, Stable Disease, or Progressive Disease During Cycles 1-4, According to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1. The duration of one treatment cycle is 21 days.

Time frame: Cycle 4 . The duration of one treatment cycle is 21 days.

Event-free survival (EFS)

EFS is defined as the time from randomization to the first documentation of one of the following events: Disease progression (before surgery) as determined by the investigator with use of RECIST v1.1 Any evidence of contralateral disease in situ was not identified as progressive disease; Disease recurrence (local, regional, distant, or contralateral) after surgery; Death from any cause.

Time frame: From Baseline to EFS event or date last known to be alive and event-free (up to 5 years)

Data from ClinicalTrials.gov

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