Description:
This open, randomized pilot feasibility trial is to evaluate the feasibility and effect of
neoadjuvant everolimus plus letrozole versus neoadjuvant fluorouracil, epirubicin plus
cyclophosphamide (FEC) in treating postmenopausal women with ER-positive, HER2-negative
breast cancer. Forty postmenopausal stage M0, ER-positive, HER2-negative invasive breast
cancer women who had a primary tumor > 2cm by imaging or an axillary lymph node > 2cm by
imaging were randomly (1:1) enrolled to receive neoadjuvant everolimus plus letrozole for 18
weeks or neoadjuvant FEC for 6 cycles before surgery. The primary objective is to determine
the feasibility of neoadjuvant everolimus plus letrozole in postmenopausal patients with
ER-positive, HER2-negative breast cancer. Secondary aims are to compare the ultrasound
response rate, pathological complete response (pCR) rate, breast-conserving surgery rate,
toxicities, and changes in the percentages or counts of peripheral blood CD4+ T cells, CD8+ T
cells, tumor-specific CTLs, T helper cells (Th), regulatory T cells (Treg), and NK cells and
changes in tumor Ki67 index (pre- versus post- neoadjuvant therapy).
Title
- Brief Title: A Trial of Neoadjuvant Everolimus Plus Letrozole Versus FEC in Women With ER-positive, HER2-negative Breast Cancer
- Official Title: A Randomised Pilot Study of Neoadjuvant Everolimus Plus Letrozole Compared With FEC in Postmenopausal Patients With ER-positive, HER2-negative Breast Cancer
Clinical Trial IDs
- ORG STUDY ID:
50102016015
- NCT ID:
NCT02742051
Conditions
Interventions
Drug | Synonyms | Arms |
---|
Everolimus | RAD001 | Everolimus+Letrozole |
Letrozole | Femara | Everolimus+Letrozole |
Fluorouracil | 5-Fu | Fluorouracil+epirubicin+cyclophosphamide |
Epirubicin | EPB | Fluorouracil+epirubicin+cyclophosphamide |
Cyclophosphamide | CTX | Fluorouracil+epirubicin+cyclophosphamide |
Purpose
This open, randomized pilot feasibility trial is to evaluate the feasibility and effect of
neoadjuvant everolimus plus letrozole versus neoadjuvant fluorouracil, epirubicin plus
cyclophosphamide (FEC) in treating postmenopausal women with ER-positive, HER2-negative
breast cancer. Forty postmenopausal stage M0, ER-positive, HER2-negative invasive breast
cancer women who had a primary tumor > 2cm by imaging or an axillary lymph node > 2cm by
imaging were randomly (1:1) enrolled to receive neoadjuvant everolimus plus letrozole for 18
weeks or neoadjuvant FEC for 6 cycles before surgery. The primary objective is to determine
the feasibility of neoadjuvant everolimus plus letrozole in postmenopausal patients with
ER-positive, HER2-negative breast cancer. Secondary aims are to compare the ultrasound
response rate, pathological complete response (pCR) rate, breast-conserving surgery rate,
toxicities, and changes in the percentages or counts of peripheral blood CD4+ T cells, CD8+ T
cells, tumor-specific CTLs, T helper cells (Th), regulatory T cells (Treg), and NK cells and
changes in tumor Ki67 index (pre- versus post- neoadjuvant therapy).
Trial Arms
Name | Type | Description | Interventions |
---|
Everolimus+Letrozole | Experimental | everolimus 10mg/d,po + letrozole 2.5mg/d,po * 18 weeks | |
Fluorouracil+epirubicin+cyclophosphamide | Active Comparator | Fluorouracil 600mg/m2,iv,d1 + epirubicin 90mg/m2,iv,d1 + cyclophosphamide 600mg/m2,iv,d1 * 6 cycles (every 21 days per cycle) | - Fluorouracil
- Epirubicin
- Cyclophosphamide
|
Eligibility Criteria
Inclusion Criteria:
- The patients signed the written informed consent
- The patients present with non-metastatic unilateral invasive ER-positive,
HER2-negative breast cancer with a primary breast tumor > 2cm by imaging or an
axillary lymph node > 2cm by imaging.
- Postmenopausal women with age less than 70 years old.
- The patients have no history of hormone therapy, chemotherapy, breast cancer surgery
and radiotherapy.
- The patients have normal cardiac functions by echocardiography.
- The patients' ECOG scores are ≤2.
- The patients can swallow pills.
- The results of patients' blood tests are as follows:
- Hb≥90g/L;
- WBC≥4E+9/L;
- Plt≥100E+9/L;
- Neutrophils≥1.5E+9/L;
- ALT and AST ≤ triple of normal upper limit;
- TBIL ≤ 1.5 times of normal upper limit;
- Creatinine ≤ 1.5 times of normal upper limit.
Exclusion Criteria:
- The patients have other cancers at the same time or have the history of other cancers
except controlled skin basal cell carcinoma or skin squamous cell carcinoma or
carcinoma in situ of cervix uterus;
- The patients have active infections that were not suitable for chemotherapy;
- The patients have severe non-cancerous diseases.
- The patients have bilateral breast cancers or multifocal breast cancers or
inflammatory breast cancers.
- The patients have a history of previous treatment with mTOR inhibitors.
- The patients are undergoing current administration of anti-cancer therapies, or are
attending other clinical trials.
- The patients are in some special conditions that they cannot understand the written
informed consent, such as they are demented or hawkish.
- The patients have allergic history or contraindication of any of the interventional
drugs.
Maximum Eligible Age: | 70 Years |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | Female |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Feasibility of the trial |
Time Frame: | during on-neoadjuvant therapy period (defined as the period from the first dose of study medication up to 30 days of the last dose) |
Safety Issue: | |
Description: | |
Secondary Outcome Measures
Measure: | Ultrasound response rate |
Time Frame: | at definitive surgery (18-20 weeks after the first dose of study medication) |
Safety Issue: | |
Description: | |
Measure: | Pathological complete response (pCR) rate |
Time Frame: | at definitive surgery (18-20 weeks after the first dose of study medication) |
Safety Issue: | |
Description: | |
Measure: | Breast-conserving surgery rate |
Time Frame: | at definitive surgery (18-20 weeks after the first dose of study medication) |
Safety Issue: | |
Description: | |
Measure: | Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 |
Time Frame: | during on-neoadjuvant therapy period (defined as the period from the first dose of study medication up to 30 days of the last dose) |
Safety Issue: | |
Description: | |
Measure: | Peripheral blood CD8+ T cell percentage change in relation to neoadjuvant therapy |
Time Frame: | at definitive surgery (18-20 weeks after the first dose of study medication) |
Safety Issue: | |
Description: | |
Measure: | Peripheral blood T helper cell percentage change in relation to neoadjuvant therapy |
Time Frame: | at definitive surgery (18-20 weeks after the first dose of study medication) |
Safety Issue: | |
Description: | |
Measure: | Peripheral blood regulatory T cell percentage change in relation to neoadjuvant therapy |
Time Frame: | at definitive surgery (18-20 weeks after the first dose of study medication) |
Safety Issue: | |
Description: | |
Measure: | Peripheral blood NK cell percentage change in relation to neoadjuvant therapy |
Time Frame: | at definitive surgery (18-20 weeks after the first dose of study medication) |
Safety Issue: | |
Description: | |
Measure: | Blood tumor-specific CTLs count change in relation to neoadjuvant therapy |
Time Frame: | at definitive surgery (18-20 weeks after the first dose of study medication) |
Safety Issue: | |
Description: | |
Measure: | Peripheral blood CD4+ T cell percentage change in relation to neoadjuvant therapy |
Time Frame: | at definitive surgery (18-20 weeks after the first dose of study medication) |
Safety Issue: | |
Description: | |
Measure: | Tumor Ki67 index change in ralation to neoadjuvant therapy |
Time Frame: | at definitive surgery (18-20 weeks after the first dose of study medication) |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University |
Last Updated
March 18, 2020