A Prospective, Multi-cohort, Exploratory Phase II Study of Trilaciclib Combined With Standard Chemotherapy in The Adjuvant Treatment of Hormone Receptor (HR) Negative Breast Cancer
试验速览
- 阶段
- 2 期
- 状态
- 招募中
- 发起方
- 入组人数
- 116
- 试验地点
- 1
- 主要终点
- Occurrence of Grade 3/4 neutropenia
研究概览
简要总结
The goal of this multicenter, two-cohort, exploratory clinical trial is to evaluate patients with early stage hormone receptor-negative breast cancer receiving standard adjuvant chemotherapy after surgery. The main question it aims to answer is:
• The efficacy and safety of trilaciclib administered before standard adjuvant chemotherapy regimen using the incidence of grade 3/4 neutropenia as the primary efficacy endpoint.
Participants will divide into two treatment cohorts according to molecular typing type:
- Cohort A will be planned to include post-operative triple-negative breast cancer(TNBC) patients with lymph node positive or tumor > 2 cm treated with trilaciclib combined with epirubicin and cyclophosphamide followed by weekly paclitaxel;
- Cohort B will be planned to include HER2-positive/HR-negative breast cancer patients with axillary node positive or tumor > 2 cm treated with trilaciclib combined with docetaxel, carboplatin and trastuzumab with or without pertuzumab.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •age ≥ 18 years;
- •breast cancer meets the following criteria:
- •Histologically or cytologically confirmed and adequately resected non-metastatic primary invasive breast cancer;
- •Cohort A only: ER, PR negative (< 1% nuclear staining as assessed by immunohistochemistry [IHC]), HER2 negative (HER2/CEP17 ratio < 2.0 or mean HER2 gene copy number < 4 signals/nucleus detected by IHC 0 or 1 + or in situ hybridization [ISH]); patients with concurrent bilateral invasive disease met the inclusion criteria if both lesions were HR negative/HER2 negative.
- •Cohort B only: ER, PR negative (< 1% nuclear staining as assessed by immunohistochemistry [IHC]); HER2 positive: HER2/CEP17 ratio ≥ 2.0 or HER2 gene copy number ≥ 4 signals/nucleus detected by IHC 3 + and ISH; HER2 gene copy number ≥ 6 signals/nucleus detected by IHC 3 + or 2 + and ISH); patients with concurrent bilateral invasive disease met the inclusion criteria if both lesions were HR negative/HER2 positive.
- •Subjects must have positive lymph nodes or tumors > 2 cm;
- •The interval between radical surgery and the first dose ≤ 60 days;
- •Eastern Cooperative Oncology Group (ECOG) performance score 0-1;
- •have appropriate organ function, meet the following criteria: (1) have appropriate bone marrow function: Hb ≥ 100 g/L (no ESA and blood transfusion within 14 days before the first dose); absolute neutrophil count (ANC) ≥ 2 × 10^9/L (no G-CSF within 14 days before the first dose); platelet count ≥ 100 × 10^9/L (no rhTPO/rhIL-11 and platelet transfusion within 14 days before the first dose); (2) appropriate liver and kidney function: alanine aminotransferase (ALT) ≤ 2.5 × upper limit of normal (ULN), aspartate aminotransferase (AST) ≤ 2.5 × ULN, total bilirubin (TBIL) ≤ 1.5 × ULN, serum creatinine ≤ 1.5 × ULN, endogenous creatinine clearance > 50 ml/min (Cockcroft-Gault formula); (3) appropriate cardiac function: left ventricular ejection fraction (LVEF) ≥ 55%;
- •Non-hematologic toxicities from prior surgical procedures recovered to ≤ Grade 1 or baseline (except alopecia);
- •Females of childbearing potential agree to practice reliable contraception during the clinical trial and have a negative serum or urine pregnancy test within 7 days prior to dosing;
- •Voluntarily join this study and sign informed consent, have good compliance and are willing to cooperate with follow-up.
排除标准
- •Prior neoadjuvant therapy (including chemotherapy, targeted therapy, immunotherapy, or radiotherapy);
- •History of other malignancy within 5 years prior to first dose, except basal cell carcinoma and cervical carcinoma in situ;
- •Any T4 or N2 or known N3 or M1 breast cancer;
- •Subjects who cannot receive or tolerate postoperative chemotherapy for various reasons;
- •Heart disease ineligible for epirubicin, docetaxel, trastuzumab/pertuzumab:
- •Any documented history of myocardial infarction, congestive heart failure
- •Angina pectoris requiring antianginal medication
- •Grade 3 or 4 cardiac arrhythmia (NCI CTCAEv5.0)
- •Clinically significant valvular heart disease;
- •Poorly controlled hypertension (systolic blood pressure > 180 mmHg and/or diastolic blood pressure > 100 mmHg)
- •Known history of hypersensitivity to the drug components of this protocol;
- •Any other condition that, in the opinion of the investigator, would make the patient inappropriate for participation in this study.
研究组 & 干预措施
Cohort A: Triple-negative Breast Cancer
Cohort A Administered Trilaciclib in Combination with Chemotherapy(EC-wP)
干预措施: Trilaciclib (Drug)
Cohort A: Triple-negative Breast Cancer
Cohort A Administered Trilaciclib in Combination with Chemotherapy(EC-wP)
干预措施: Epirubicin (Drug)
Cohort A: Triple-negative Breast Cancer
Cohort A Administered Trilaciclib in Combination with Chemotherapy(EC-wP)
干预措施: Cyclophosphamide (Drug)
Cohort A: Triple-negative Breast Cancer
Cohort A Administered Trilaciclib in Combination with Chemotherapy(EC-wP)
干预措施: Paclitaxel (Drug)
Cohort B: ER-negative PR-negative Her2-positive Breast Cancer
Cohort B Administered Trilaciclib in Combination with Chemotherapy(TCbH±P)
干预措施: Trilaciclib (Drug)
Cohort B: ER-negative PR-negative Her2-positive Breast Cancer
Cohort B Administered Trilaciclib in Combination with Chemotherapy(TCbH±P)
干预措施: Docetaxel (Drug)
Cohort B: ER-negative PR-negative Her2-positive Breast Cancer
Cohort B Administered Trilaciclib in Combination with Chemotherapy(TCbH±P)
干预措施: Carboplatin (Drug)
Cohort B: ER-negative PR-negative Her2-positive Breast Cancer
Cohort B Administered Trilaciclib in Combination with Chemotherapy(TCbH±P)
干预措施: Trastuzumab (Drug)
Cohort B: ER-negative PR-negative Her2-positive Breast Cancer
Cohort B Administered Trilaciclib in Combination with Chemotherapy(TCbH±P)
干预措施: Pertuzumab (Drug)
结局指标
主要结局
Occurrence of Grade 3/4 neutropenia
时间窗: Up to 24 weeks
Proportion of subjects with at least one absolute neutrophil count (ANC) \< 1.0 × 10\^9/L enrolled and treated with at least one dose of trilaciclib
次要结局
- Myeloprotective Effects(Up to 24 months)
- Safety and tolerability(Up to 24 months)
- Red blood cell(RBC) -related myeloprotective effects(Up to 24 weeks)
- Neutrophil-related myeloprotective effects(Up to 24 weeks)
- Platelet-related myeloprotective effects(Up to 24 weeks)
研究者
wang shusen
Director of Breast Disease Department
Sun Yat-sen University
