Hormone receptor positive, HER2-low expression metastatic breast cancer is the main type of breast cancer, accounting for about 50% - 60%. However, this type of patients lack ideal therapeutic drugs after the failure of first-line standard endocrine therapy, and the median overall survival time is only 30 months. Therefore, finding more efficient and safe therapeutic drugs for these patients has become a big clinical challenge at present. Disitamab Vedotin (DV), as a new class I Antibody-Drug Conjugates drug, can achieve high efficiency and precise tumor killing effect with low toxicity. According to previous study with same sample size, DV also showed good efficacy in metastatic breast cancer with Hormone receptor positive and HER2- low expression as a posterior line treatment.Therefore, we intend to explore the efficacy and safety of DV in the treatment of HER2-low expressioin /Hormone receptor positive metastatic breast cancer patients with endocrine resistance through a scientifically designed, randomized, phase III clinical study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
288
Disitamab Vedotin 2mg/kg was injected every 2 weeks,
Doctors choose endocrine therapy independently
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
Guangzhou, Guangdong, China
RECRUITINGThe Second Affiliated Hospital, Shantou University Medical College
Shantou, Guangdong, China
RECRUITINGHainan Qionghai People's Hospital
Qionghai, Hainan, China
RECRUITINGProgression free survival (PFS)
The interval from the date of randomization to the first imaging confirmed progression of disease or death from any cause.
Time frame: 24 months
Overall survival (OS)
The time interval from the date of randomization to death due to any cause.
Time frame: 36 months
Objective response rate (ORR)
According to recist1.1 standard, the proportion of patients whose best remission was CR or PR accounted for the total number of evaluable patients.
Time frame: 12 months
Disease Control Rate (DCR)
According to recist1.1 standard, the proportion of patients whose best remission was CR or PR or SD accounted for the total number of evaluable patients.
Time frame: 12 months
Clinical Benefit Rate (CBR)
According to recist1.1 standard, the proportion of patients whose best remission was CR or PR or SD ≥ 24 weeks accounted for the total number of evaluable patients.
Time frame: 12 months
Quality of life assessed by EORTC-C30
Quality of life will be collected using the following questionnaire: EORTC-C30
Time frame: 12 months
Psychological condition assessed by GAD-7
Time frame: 12 months
Pittsburgh Sleep Scale
Time frame: 12 months
Incidence of adverse events(AE)
From the date of enrollment to one year, the incidence of adverse events in the fulvestrant combined with pyrotinib group was compared with that of capecitabine combined with pyrotinib group.
Time frame: from the date of enrollment to one year
Biomarkers and treatment sensitivity analysis
Cox univariate and multivariate analysis will be used to explore the correlation between endocrine and HER2 pathway related biomarkers and treatment sensitivity(The biomarkers to be analyzed included 324 tumor related genes included in the FoundationOne CDx, and ER/PR/HER2/ki67 in IHC)
Time frame: 12 months
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