A Prospective, Phase II Trial Using ctDNA to Initiate Post-operation Boost Therapy After Adjuvant Chemotherapy in TNBC (Artemis)
Overview
- Phase
- Phase 2
- Intervention
- capecitabine
- Conditions
- Breast Cancer
- Sponsor
- Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
- Enrollment
- 260
- Locations
- 1
- Primary Endpoint
- Invasive Disease Free Survival(IDFS)
- Status
- Recruiting
- Last Updated
- 3 years ago
Overview
Brief Summary
Circulating tumor DNA (ctDNA) has been demonstrated to be an effective prognostic marker in breast cancer. Various studies have shown that early TNBC breast cancer patients with positive ctDNA have high risk of cancer recurrence and worse prognosis. This study aimed to identify TNBC patients with positive ctDNA and initiate boost therapy in these high risk patients.
Investigators
Liu Qiang
Principal Investigator
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Eligibility Criteria
Inclusion Criteria
- •Patient is ≥ 18 years-old at the time of consent to participate this trial
- •Stage II - III primary triple negative breast cancer patients(TNBC), TNBC is defined as ER \<=1%, PR \<=1%；HER2 receptor IHC=1, or IHC=2 and FISH negative.
- •positive ctDNA after curative surgery and/or adjuvant chemotherapy
- •If indicated, patient agree to receive adjuvant radiotherapy according to the institutional guidelines
- •Patient receives adjuvant chemotherapy according to the NCCN guidelines
- •Patient has available tumor tissue from the surgical specimen for next generation sequencing(NCS)
- •Patient agrees to give blood samples for ctDNA tests every 3 months in 5 years
Exclusion Criteria
- •Patient has previously received any PD1/PDL1 blockage treatment
- •Pregnant or breast-feeding (lactating) women or women who plan to become pregnant or breast-feed during the trial
- •Patient with distant metastases of breast cancer beyond regional lymph nodes (stage IV according to AJCC 8th edition)
- •Patient participates another interventional clinical trial
- •Patient has a concurrent invasive malignancy or a prior invasive malignancy whose treatment was completed within 3 years before randomization
- •Patient with autoimmune disease preventing the use of camrelizumab
- •Patient has any other concurrent severe and/or uncontrolled medical condition that would, in the Investigator's judgment, cause unacceptable safety risks, contraindicate patient participation in the clinical trial or compromise compliance with the protocol
Arms & Interventions
Capecitabine
Patients assigned to this group will receive oral capecitabine at a dose of 650 mg/m2 twice a day by mouth for 1 year
Intervention: capecitabine
Capecitabine + Apatinib + Camrelizumab
Patients assigned to this group will receive oral capecitabine at a dose of 650 mg/m2 twice a day, Camrelizumab 200mg intravenously, once every two weeks (Q2W), oral apatinib, 250mg, PO, qd for 1 year
Intervention: capecitabine + camrelizumab + apatinib
Outcomes
Primary Outcomes
Invasive Disease Free Survival(IDFS)
Time Frame: 60 months
Invasive Disease-Free Survival for capecitabine versus capecitabine + apatinib + camrelizumab in ctDNA-positive stage II-III TNBC patients, using STEEP criteria
Secondary Outcomes
- Distant disease-free survival(DDFS)(60 months)
- Overall Survival(60 months)
- Brain metastasis rate(60 months)
- The rate of adverse effects(AEs)(60 months)