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