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Adjuvant Chemotherapy for Triple Negative Breast Cancer Patients With Residual Disease After Neoadjuvant Chemotherapy

Phase 2
Recruiting
Conditions
Triple Negative Breast Cancer
Interventions
Registration Number
NCT04437160
Lead Sponsor
Chinese Academy of Medical Sciences
Brief Summary

This study will evaluate the efficacy and safety of antharcycline-based adjuvant chemotherapy compared with observation in triple negative breast cancer (TNBC) patients with residual invasive disease after platinum and taxanes based neoadjuvant chemotherapy.

Detailed Description

This study is a multi-center, randomized, phase II study. TNBC patients with residual invasive disease (invasive breast tumor size≥1cm and/or positive axillary lymph nodes) after platinum and taxanes based neoadjuvant chemotherapy are enrolled (n = 286). Patients are assigned to the chemotherapy group or the observation group at a 1:1 ratio randomly 4-6 weeks after surgery. Patients in the chemotherapy group are given anthracycline combined with cyclophosphamide regimen for 4 cycles. At the same time, the blood and tissue samples are collected for relevant tests. Follow up every 3-6 months and record recurrences and deaths.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
286
Inclusion Criteria
  • Patients with histologically confirmed invasive adenocarcinoma of the breast.
  • Triple negative breast cancer: hormone receptor negative (ER < 10% and PgR < 10%) and HER2 negative (IHC 0/1+ or ISH non-amplified), as defined by the local pathology laboratory.
  • Clinical stage at presentation: T1-4, N0-3, M0, with indications for neoadjuvant chemotherapy.
  • Patient must have received platinum and taxanes neoadjuvant chemotherapy for at least 4 cycles and no tumor progression occurred.
  • Patients should have undergone adequate tumor excision in the breast and lymph nodes after neoadjuvant chemotherapy.
  • Residual invasive disease must be ≥1cm in the breast, and/or have positive axillary lymph nodes observed on pathologic exam after neoadjuvant chemotherapy.
  • ECOG Performance Status: 0-1.
  • Patients without severe heart, lung, liver and kidney disease.
  • Adequate hematologic and end-organ function.
  • No more than 6 weeks may elapse between definitive breast surgery and randomization.
Exclusion Criteria
  • Previous neoadjuvant chemotherapy with anthracycline or other drugs (except platinum and taxanes).
  • Previous neoadjuvant chemotherapy with platinum or taxanes alone.
  • Patients have received other adjuvant therapy.
  • Comprehensive medical examinations have revealed distant metastases before randomization.
  • Patients who are not suitable for anthracycline evaluated by investigators.
  • Prior history of other malignancy (except carcinoma in situ).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Adjuvant chemotherapyEpirubicin or PirarubicinAdjuvant chemotherapy for triple negative breast cancer with residual invasive disease (invasive breast tumor size≥1cm and/or positive axillary lymph nodes) after taxanes and platinum based neoadjuvant chemotherapy. Adjuvant chemotherapy regiments: Epirubicin 80-90mg/m2 IV or Pirarubicin 50mg/m2 IV + Cyclophosphamide 600mg/m2 IV, q21d\*4cycles.
Adjuvant chemotherapyCyclophosphamideAdjuvant chemotherapy for triple negative breast cancer with residual invasive disease (invasive breast tumor size≥1cm and/or positive axillary lymph nodes) after taxanes and platinum based neoadjuvant chemotherapy. Adjuvant chemotherapy regiments: Epirubicin 80-90mg/m2 IV or Pirarubicin 50mg/m2 IV + Cyclophosphamide 600mg/m2 IV, q21d\*4cycles.
Primary Outcome Measures
NameTimeMethod
RFSmedian 5 years

RFS defined as the time from randomization to the first recurrence event or death through the end of study

Secondary Outcome Measures
NameTimeMethod
OSmedian 5 years

OS defined as the time from randomization to all-cause death through the end of study

Percentage of patients with adverse events2-3 years

To assess the toxicity of adjuvant chemotherapy by CTCAE v5.0

Changes in patient-reported quality of life2-3 years

To assess the mean changes from baseline score in patient-reported quality of life using EORTC QLQ-C30

Trial Locations

Locations (1)

Cancer Hospital & Institute Chinese Academy of Medical Sciences (CAMS)

🇨🇳

Beijing, Beijing, China

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