Description:
This is a prospective, single-arm, phase II study of 32 evaluable patients treated with
NEOADjuvant Aromatase inhibitor and Pertuzumab/Trastuzumab (NEOADAPT) without chemotherapy
for hormone receptor positive (HR+), [i.e. Estrogen Receptor positive (ER+) and/or
Progesterone Receptor positive (PR+)] HER2+ localized, non-metastatic stage I - IIb breast
cancer.
Title
- Brief Title: NEOADjuvant Aromatase Inhibitor and Pertuzumab/Trastuzumab for Women With Breast Cancer
- Official Title: A Phase II Study of NEOADjuvant Aromatase Inhibitor and Pertuzumab/Trastuzumab (NEOADAPT)
Clinical Trial IDs
- ORG STUDY ID:
MZ2016006
- SECONDARY ID:
ML30001
- NCT ID:
NCT02689921
Conditions
Interventions
Drug | Synonyms | Arms |
---|
Exemestane | Aromasin | Neoadjuvant Biological Therapy |
Letrozole | Femara | Neoadjuvant Biological Therapy |
Anastrozole | Arimidex | Neoadjuvant Biological Therapy |
Leuprolide Acetate | Lupron, Lupron Depot | Neoadjuvant Biological Therapy |
Pertuzumab | Perjeta | Neoadjuvant Biological Therapy |
Trastuzumab | Herceptin | Neoadjuvant Biological Therapy |
Purpose
This is a prospective, single-arm, phase II study of 32 evaluable patients treated with
NEOADjuvant Aromatase inhibitor and Pertuzumab/Trastuzumab (NEOADAPT) without chemotherapy
for hormone receptor positive (HR+), [i.e. Estrogen Receptor positive (ER+) and/or
Progesterone Receptor positive (PR+)] HER2+ localized, non-metastatic stage I - IIb breast
cancer.
Trial Arms
Name | Type | Description | Interventions |
---|
Neoadjuvant Biological Therapy | Experimental | Subjects will receive an aromatase inhibitor for the duration of the study [exemestane (tablet, oral, 25 mg/day), letrozole (tablet, oral, 2.5 mg/day) or anastrozole (tablet, oral, 1 mg/day)]. Premenopausal subjects will receive leuprolide acetate (11.25 mg, intramuscular injection, 3-month intervals).
Pertuzumab will be given by intravenous infusion in 3-week cycles until disease progression (Cycle 1 Day 0: 840 mg, infused over 60-90 minutes; subsequent cycles: 420 mg, infused over 30-60 minutes).
Trastuzumab will be given by intravenous infusion in 3-week cycles until disease progression (Cycle 1 Day 0: 8 mg/kg, infused over 60-90 minutes; subsequent cycles: 6 mg/kg, infused over 30-60 minutes) | - Exemestane
- Letrozole
- Anastrozole
- Leuprolide Acetate
- Pertuzumab
- Trastuzumab
|
Eligibility Criteria
Inclusion Criteria:
- Ability to provide signed, written informed consent
- Histologically or cytologically confirmed non-metastatic adenocarcinoma of the breast
(stage I-II)
- Candidate for curative-intent treatment
- ER+ and/or PR+ and HER2-positive (Fluorescence In Situ Hybridization-positive or 3+ by
Immunohistochemistry staining)
- Life expectancy greater than 5 years
- Left Ventricular Ejection Fraction > 50% at baseline (within 30 days of day 0)
- Eastern Cooperative Oncology Group performance status ≤2
- Absolute Neutrophil Count >1000/µL
- Platelets ≥50,000/µL
- Hemoglobin >8.0 g/dL,
- Creatinine ≤3.0 x upper limit of normal (ULN)
- Bilirubin ≤3.0 x ULN
- Aspartate aminotransferase or Alanine aminotransferase <5.0 x ULN
- Negative serum pregnancy test for women <12 months after the onset of menopause unless
surgically sterilized
- Agreement by women of childbearing potential and male participants with partners of
childbearing potential to use a "highly effective", non-hormonal form of contraception
or two "effective" forms of non-hormonal contraception by the patient and/or partner.
Exclusion Criteria:
- Active infection
- Presence of known metastases (stage IV disease)
- Pregnant or lactating women
- Prior chemotherapy or radiation therapy for the primary breast cancer
- Concomitant malignancies or previous malignancies within the last 5 years except
adequately treated basal or squamous cell carcinoma of the skin or carcinoma in situ
of the cervix.
- History of significant cardiac disease, cardiac risk factors or uncontrolled
arrhythmias
- Current severe, uncontrolled systemic disease (e.g., clinically significant
cardiovascular, pulmonary or metabolic disease including diabetes, wound healing
disorders, ulcers or bone fractures)
- Major surgical procedure or significant traumatic injury within 28 days prior to study
treatment start or anticipated need for major surgery during the course of study
treatment
- Current known infection with Human Immunodeficiency Virus (HIV), Hepatitis B virus
(HBV) or Hepatitis C Virus (HCV)
- Receipt of intravenous antibiotics for infection within 14 days prior to receiving
study treatment
- Current chronic daily treatment with corticosteroids (dose >10 mg/day
methylprednisolone equivalent) except inhaled steroids
- Known hypersensitivity to any of the study drugs
- Assessment by the investigator to be unable or unwilling to comply with the
requirements of the protocol
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Evidence of Pathological Response |
Time Frame: | One year |
Safety Issue: | |
Description: | The presence of residual invasive cancer on hematoxylin and eosin evaluation of the complete resected breast specimen and all sampled regional lymph nodes following completion of neoadjuvant systemic therapy. Pathological complete response (pCR) is defined as the absence of residual invasive cancer. |
Secondary Outcome Measures
Measure: | Duration of Treatment |
Time Frame: | One year |
Safety Issue: | |
Description: | Median number of days between Day 0 (first treatment of trastuzumab and pertuzumab) and three weeks after the last dose of neoadjuvant trastuzumab and pertuzumab on treatment protocol. |
Measure: | Evidence of Radiographic Response |
Time Frame: | Assessed every 12 weeks up to one year |
Safety Issue: | |
Description: | Change in dimensions (millimeters) of target lesions (along long axis) and non-target lesions (along long axis for non-lymphatic lesions and short axis for lymph nodes) as observed by Magnetic Resonance Imaging and quantified by modified RECIST 1.1 criteria. |
Measure: | Measurement of Left Ventricular Ejection Fraction (LVEF) |
Time Frame: | Assessed every 12 weeks up to one year |
Safety Issue: | |
Description: | Determination of cardiac function as measured by echocardiogram or multi-gated acquisition scan (MUGA). |
Measure: | Mammaprint Genomic Analysis |
Time Frame: | One year or up to 3 months after definitive surgery |
Safety Issue: | |
Description: | Mammaprint will estimate the risk level of the subject's tumor. |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Unknown status |
Lead Sponsor: | Midwestern Regional Medical Center |
Last Updated
September 28, 2018