Description:
Trial to evaluate efficacy of dual blockade with two anti-HER2 agents with or without chemotherapy backbone within the ADAPT trial.
Trial to evaluate efficacy of dual blockade with two anti-HER2 agents with or without chemotherapy backbone within the ADAPT trial.
Recruiting
Phase 2
Drug | Synonyms | Arms |
---|---|---|
Trastuzumab | Herceptin | Arm A |
Pertuzumab | Arm A | |
Paclitaxel | Arm B |
Name | Type | Description | Interventions |
---|---|---|---|
Arm A | Experimental | Trastuzumab + Pertuzumab |
|
Arm B | Active Comparator | Trastuzumab + Pertuzumab + Paclitaxel |
|
Inclusion Criteria: - Female patients, age at diagnosis 18 years and above (consider patients at 70 years and above for ADAPT Elderly) - Histologically confirmed unilateral primary invasive carcinoma of the breast - Clinical T1 - T4 (except inflammatory breast cancer) - All clinical N (cN) - No clinical evidence for distant metastasis (M0) - Known HR status and HER2 status (local pathology) Tumor block available for central pathology review - Performance Status ECOG ≤ 1 or KI ≥ 80% - Negative pregnancy test (urine or serum) within 7 days prior to start of induction treatment in premenopausal patients - Written informed consent prior to beginning specific protocol procedures, including expected cooperation of the patients for the treatment and follow-up, must be obtained and documented according to the local regulatory requirements - The patient must be accessible for treatment and follow-up Additional Inclusion criteria for participation in the HR-/HER2+ sub-protocol: - Confirmed ER and PR negative and HER2+ by central pathology - Clinical cT1c - T4a-c (participation of patients with tumors >cT2 is strongly recommended) - All clinical N (participation of patients with cN0, if at least cT1c is strongly recommended) - Patients must qualify for neoadjuvant treatment - LVEF > 50%; LVEF within normal limits of each institution measured by echocardiography and normal ECG (within 42 days prior to induction treatment) Exclusion Criteria: - Known hypersensitivity reaction to the compounds or incorporated substances - Prior malignancy with a disease-free survival of < 10 years, except curatively treated basalioma of the skin, pTis of the cervix uteri - Non-operable breast cancer including inflammatory breast cancer - Previous or concurrent treatment with cytotoxic agents for any reason after consultation with the sponsor - Concurrent treatment with other experimental drugs. Participation in another clinical trial with any investigational not marketed drug within 30 days prior to study entry - Male breast cancer - Concurrent pregnancy; patients of childbearing potential must implement a highly effective (less than 1% failure rate) non-hormonal contraceptive measures during the study treatment - Breast feeding woman - Sequential breast cancer - Reasons indicating risk of poor compliance Patient not able to consent Additional Exclusion Criteria for participation in the HER2+/HR- sub-protocol: - Known polyneuropathy ≥ grade 2 - Severe and relevant co-morbidity that would interact with the application of cytotoxic agents or the participation in the study - Inadequate organ function (e.g. hepatic impairment, pulmonary disease, etc.) - Uncompensated cardiac function (current unstable ventricular arrhythmia requiring treatment, history of symptomatic CHF NYHA classes II-IV), history of myocardial infarction or unstable angina pectoris within 6 months of enrollment, history of severe hypertension, CAD - coronary artery disease) - Severe dyspnea - Abnormal blood values: - Thrombocytopenia > CTCAE grade 1 - Increases in ALT/AST > CTCAE grade 1 - Hypokalaemia > CTCAE grade 1 - Neutropenia > CTCAE grade 1 - Anaemia > CTCAE grade 1
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | Female |
Healthy Volunteers: | No |
Measure: | Definition of a biomarker (profile) characterizing "good responders" to dual blockade T and P anti-HER2 blockade that have similar pCR rates as patients treated with identical dual anti-HER2 blockade + taxane backbone |
Time Frame: | After 12 weeks of therapy |
Safety Issue: | |
Description: | pCR will be measured after 12 weeks of randomized treatment. |
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | West German Study Group |
July 23, 2019