A Single Arm Phase II Study of ADjuvant Endocrine Therapy, Pertuzumab, and Trastuzumab for Patients With Anatomic Stage I Hormone Receptor-positive, HER2-positive Breast Cancer

NCT ID: NCT04569747

Last Updated: 2025-11-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

375 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-11

Study Completion Date

2030-09-01

Brief Summary

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This research study is studying a combination of HER2-directed therapies (trastuzumab and pertuzumab) and hormonal therapy as a treatment after surgery for hormone receptor positive breast cancer.

The study drugs involved in this study are:

* A combination of trastuzumab and pertuzumab given as an injection under the skin (PHESGO)
* Hormonal (endocrine) Treatment

Detailed Description

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The research study procedures include screening for eligibility and study treatment including laboratory evaluations, physical exams, questionnaires, and follow up visits.

* Participants will receive HER2-directed treatment for 1 year and hormonal therapy for approximately 5 years.
* It is expected that about 375 people will take part in this research study.

This research study is a Phase II clinical trial. Phase II clinical trials test the safety and effectiveness of an investigational drug combination to learn whether the drug works in treating a specific disease. "Investigational" means that the drug combination is being studied.

The drugs trastuzumab and pertuzumab are both monoclonal antibodies, which are disease-fighting proteins made by cloned immune cells. The U.S. Food and Drug Administration (FDA) has approved trastuzumab, pertuzumab, and trastuzumab + pertuzumab subcutaneous fixed dose combination (PHESGO) as treatment for HER2 positive breast cancer. The FDA has also approved hormonal therapies as treatment for hormone receptor positive breast cancer.

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Conditions

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HER2-positive Breast Cancer Invasive Carcinoma of the Breast Breast Cancer Node Negative Breast Cancer Micrometastasis Breast Cancer Hormone Receptor Positive Breast Cancer

Keywords

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HER2-positive Breast Cancer Invasive Carcinoma of the Breast Breast Cancer Node Negative Breast Cancer Micrometastasis Breast Cancer Hormone Receptor Positive Breast Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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PERTUZUMAB + TRASTUZUMAB + ADJUVANT ENDOCRINE THERAPY

Study treatment will be administered in 21-day (3- week, +/- 3 days) cycles for one year (18 cycles).

* Trastuzumab + Pertuzumab SC fixed dose combination
* Hormonal therapy- oral, daily per cycle (may add LHRH agonist per investigator discretion)

Group Type EXPERIMENTAL

Pertuzumab+TRASTUZUMAB

Intervention Type COMBINATION_PRODUCT

Trastuzumab + pertuzumab SC FDC (PHESGO) will be administered on Day 1 of each 21-day cycle , subcutaneous, fixed dose

ADJUVANT ENDOCRINE THERAPY

Intervention Type DRUG

Oral, daily per cycle

Interventions

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Pertuzumab+TRASTUZUMAB

Trastuzumab + pertuzumab SC FDC (PHESGO) will be administered on Day 1 of each 21-day cycle , subcutaneous, fixed dose

Intervention Type COMBINATION_PRODUCT

ADJUVANT ENDOCRINE THERAPY

Oral, daily per cycle

Intervention Type DRUG

Other Intervention Names

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PHESGO Letrozole Anastrozole Exemestane Tamoxifen Leuprolide, or other LHRH agonist (per investigator discretion)

Eligibility Criteria

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Inclusion Criteria

* HER2-positive T1 histologically confirmed invasive carcinoma of the breast. Patients must have node-negative (N0) or micrometastases (N1mi) breast cancer according to the AJCC 8th edition anatomic staging table.

* If the patient has had a negative sentinel node biopsy, then no further axillary dissection is required, and the patient is determined to be node-negative. Axillary nodes with single cells or tumor clusters ≤ 0.2 mm by either H\&E or immunohistochemistry (IHC) will be considered node-negative.
* Any axillary lymph node with tumor clusters between 0.02 and 0.2cm is considered a micrometastasis. Patients with a micrometastasis are eligible. An axillary dissection is not required to be performed in patients with a micrometastasis found by sentinel node evaluation. In cases where the specific pathologic size of lymph node involvement is subject to interpretation, the Sponsor-Investigator will make the final determination as to eligibility. The investigator must document approval in the patient medical record.
* Patients who have one or more foci of T1aN0, ER+ (defined as \>10%), HER2-negative cancer in the ipsilateral breast, in addition to their primary HER2-positive tumor, are eligible.
* For unifocal disease, all invasive disease must have been tested for ER and PR (for multifocal disease, see below). Either ER or PR must be positive, defined as ER ≥10% or PR ≥10%. ER- and PR-assays should be performed by immunohistochemical methods according to the local institution standard protocol.
* HER2-positive by ASCO CAP 2018 guidelines.
* Bilateral breast cancers that individually meet eligibility criteria are allowed.
* Patients with multifocal or multicentric disease are eligible as long as each tumor individually meets eligibility criteria.
* Patients with a history of ipsilateral DCIS are eligible as long as the patient has not received prior hormonal therapy. Patients with a history of contralateral DCIS are not eligible unless contralateral DCIS was diagnosed at least 15 years ago
* ≤ 95 days between the date of protocol registration and the patient's most recent breast surgery for this breast cancer
* Patients must have undergone definitive breast surgery for the current malignancy. All tumor should be removed by either a modified radical mastectomy or a segmental mastectomy (lumpectomy), with either a sentinel node biopsy or axillary dissection

\-- All margins should be clear of invasive cancer or DCIS (i.e. no tumor on ink). The local pathologist must document negative margins of resection in the pathology report. If all other margins are clear, a positive posterior (deep) margin is permitted, provided the surgeon documents that the excision was performed down to the pectoral fascia and all tumor has been removed. Likewise, if all other margins are clear, a positive anterior (superficial; abutting skin) margin is permitted provided the surgeon documents that all tumor has been removed. Radiation therapy to the conserved breast is required.
* Patients may have received up to 8 weeks of hormonal therapy as adjuvant treatment for this cancer. Patients should otherwise not have received prior hormonal therapy with the exception that hormonal therapy administered for less than 8-week duration at least 15 years ago is allowed.
* Prior oophorectomy (including for cancer therapy) is allowed.
* Patients undergoing breast conservation therapy (i.e. lumpectomy) must not have any contraindications to radiation therapy.
* Patients who have participated in a window study (treatment with an investigational agent prior to surgery for ≤2 weeks) are eligible. Patients must have discontinued the investigational agent at least 14 days before participation in this study.
* Men and women with any menopausal status ≥18 years of age
* ECOG Performance Status 0 or 1
* Participants must have normal organ and marrow function as defined below:

* ANC ≥ 1000/mm3
* hemoglobin ≥8 g/dl
* platelets ≥ 75,000/mm3
* AST and ALT both \<5x institutional ULN
* Total bilirubin ≤ 1.5 mg/dL. For patients with Gilbert syndrome, the direct bilirubin should be \<institutional ULN
* Serum creatinine ≤ 2.0 mg/dL OR calculated GFR ≥ 30mL/min
* Left ventricular ejection fraction (LVEF) ≥ 50%
* Post-menopausal patients must meet one of the following criteria:

* Prior bilateral ovariectomy/oophorectomy
* Age ≥ 60 years
* Age \< 60 years with intact uterus and amenorrhoeic for ≥ 12 consecutive months prior to chemotherapy and/or endocrine therapy exposure (medication-induced amenorrhea is not acceptable to meet this criterion)
* Age \< 60 years hysterectomized and FSH and plasma estradiol levels in the postmenopausal range according to local policies prior to chemotherapy and/or endocrine therapy exposure.
* Willingness to discontinue contraceptive hormonal therapy, e.g. birth control pills, prior to registration and while on study
* Premenopausal patients with intact uterus must have a negative serum or urine pregnancy test, including women who have had a tubal ligation and women less than 12 months from their last menstrual period.
* Women of childbearing potential and men with partners of childbearing potential must be willing to use one highly effective form of nonhormonal contraception or two effective forms of nonhormonal contraception by the patient and/or partner and continue its use for the duration of the study treatment and for 7 months after the last dose of antibody treatment and 3 months after the last dose of hormonal treatment.
* Patients must be willing and able to sign informed consent.
* Patients must be willing to provide archival tissue for research purposes.
* If patient is English-speaking, must be willing to fill out patient questionnaires.

Exclusion Criteria

* Neoadjuvant or adjuvant chemotherapy for this breast cancer prior to enrollment is prohibited.
* Any of the following due to teratogenic potential of the study drugs:

* Pregnant women
* Nursing women
* Women of childbearing potential who are unwilling to employ adequate contraception (condoms, diaphragms, IUDS, surgical sterilization, abstinence, etc). Hormonal birth control methods are not permitted.
* Men who are unwilling to employ adequate contraception (condoms, surgical sterilization, abstinence, etc).
* Participants who are receiving any other investigational agents for treatment of breast cancer, unless specific approval is obtained from the Sponsor-Investigator.
* Locally advanced tumors at diagnosis, including tumors fixed to the chest wall, peau d'orange, skin ulcerations/nodules, or clinical inflammatory changes (diffuse brawny cutaneous induration with an erysipeloid edge)
* Patients with a history of previous invasive breast cancer.
* Individuals with a history of a different malignancy are ineligible except for the following circumstances:

* Individuals with a history of other malignancies are eligible if they have been disease-free for at least 5 years and are deemed by the investigator to be at low risk for recurrence of that malignancy.
* individuals with the following cancer are eligible regardless of when they were diagnosed and treated: cervical cancer in situ, and non-melanoma cancer of the skin.
* Intercurrent illness including, but not limited to: ongoing or active, unresolved systemic infection, renal failure requiring dialysis, active cardiac disease, prior myocardial infarction (asymptomatic changes on EKG suggestive of old MI is not an exclusion), history of CHF, current use of any therapy specifically for CHF, uncontrolled hypertension, significant psychiatric illness, or other conditions that in the opinion of the investigator limit compliance with study requirements.

Time and Motion Substudy Eligibility:

* Participant must be enrolled at Dana-Farber Cancer Institute
* Participant must not have discontinued pertuzumab following treatment cycle 1
* Participant must be able to tolerate subcutaneous administration following cycle 1
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Genentech, Inc.

INDUSTRY

Sponsor Role collaborator

Dana-Farber Cancer Institute

OTHER

Sponsor Role lead

Responsible Party

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Adrienne G. Waks

Sponsor Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Adrienne C Waks, MD

Role: PRINCIPAL_INVESTIGATOR

Dana-Farber Cancer Institute

Locations

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Stamford Hospital

Stamford, Connecticut, United States

Site Status RECRUITING

University of Miami- Sylvester Comprehensive Cancer Center

Miami, Florida, United States

Site Status RECRUITING

Winship Cancer Institute at Emory University Hospital Midtown

Atlanta, Georgia, United States

Site Status RECRUITING

Emory University - Winship Cancer Institute

Atlanta, Georgia, United States

Site Status RECRUITING

Winship Cancer Institute at Emory Saint Joseph's Hospital

Atlanta, Georgia, United States

Site Status RECRUITING

University of Chicago Medical Center

Chicago, Illinois, United States

Site Status RECRUITING

Indiana University Health Schwarz Cancer Center

Indianapolis, Indiana, United States

Site Status RECRUITING

Indiana University Health - Melvin and Bren Simon Cancer Center

Indianapolis, Indiana, United States

Site Status RECRUITING

Indiana University Sidney and Lois Eskenazi Hospital

Indianapolis, Indiana, United States

Site Status RECRUITING

Eastern Maine Medical Center (Northern Light)

Brewer, Maine, United States

Site Status RECRUITING

Dana Farber Cancer Institite

Boston, Massachusetts, United States

Site Status RECRUITING

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status RECRUITING

Dana-Farber Brigham Cancer Center - Foxborough

Foxborough, Massachusetts, United States

Site Status RECRUITING

Cape Cod Healthcare Center

Hyannis, Massachusetts, United States

Site Status RECRUITING

Dana-Farber at Milford

Milford, Massachusetts, United States

Site Status RECRUITING

Dana-Farber at South Shore Hospital

Weymouth, Massachusetts, United States

Site Status RECRUITING

Dana-Farber Cancer Insitute at Londonderry Hospital

Londonderry, New Hampshire, United States

Site Status RECRUITING

New York University Langone Hospital -Brooklyn

Brooklyn, New York, United States

Site Status RECRUITING

New York University Langone Hospital - Long Island

Mineola, New York, United States

Site Status RECRUITING

New York University Langone Health

New York, New York, United States

Site Status RECRUITING

UNC Rex Hematology Oncology Associated - Cary

Cary, North Carolina, United States

Site Status RECRUITING

University of North Carolina at Chapel Hill

Chapel Hill, North Carolina, United States

Site Status RECRUITING

UNC Rex Hematology Oncology Associates of Garner

Garner, North Carolina, United States

Site Status RECRUITING

UNC Rex Cancer Center

Raleigh, North Carolina, United States

Site Status RECRUITING

UNC Rex Cancer Center at Wakefield

Raleigh, North Carolina, United States

Site Status RECRUITING

The Christ Hospital

Cincinnati, Ohio, United States

Site Status RECRUITING

Ohio State University Comprehensive Cancer Center

Columbus, Ohio, United States

Site Status RECRUITING

Greco-Hainsworth Centers for Research/Tennessee Oncology

Nashville, Tennessee, United States

Site Status RECRUITING

SCRI Oncology Partners

Nashville, Tennessee, United States

Site Status RECRUITING

Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status RECRUITING

Baylor College of Medicine Medical Center

Houston, Texas, United States

Site Status RECRUITING

MD Anderson Cancer Center

Houston, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Adrienne Waks, MD

Role: CONTACT

Phone: 617-632-3800

Email: [email protected]

Facility Contacts

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K.M. Steve Lo, MD

Role: primary

Pretti Singh, MD

Role: primary

Carmen Calfa

Role: backup

Ashley Trumball

Role: primary

Jane Meisel, MD

Role: primary

Ashley Trumball

Role: primary

Roberto Flores Jr

Role: primary

Tarah Ballinger, MD

Role: primary

Tarah J Ballinger, MD

Role: primary

Tarah Ballinger, MD

Role: primary

Laurie Lewis

Role: primary

Adrienne Waks, MD

Role: primary

Nadine Tung, MD

Role: primary

Natalie Sinclair, MD

Role: primary

Christine Neely-Jones, RN

Role: primary

Natalie Sinclair, MD

Role: primary

Meredith Faggen, M.D.

Role: primary

Stefani Freeman, RN

Role: primary

Breast Cancer Center

Role: primary

Sylvia Adams, MD

Role: primary

Sylvia Adams, MD

Role: primary

Julia Rauch, MD

Role: primary

Taylor Pierce

Role: primary

Julia Rauch, MD

Role: primary

Julia Raugh, MD

Role: primary

Julia Rauch, MD

Role: primary

Julie Specht, MD

Role: primary

Role: backup

Nicole Williams, MD

Role: primary

PJ Patterson

Role: primary

Role: backup

Lisa Simons

Role: primary

Vandana Abramson, MD

Role: primary

Natalie Chen

Role: primary

Kristen Otte

Role: backup

Pamela Lewis

Role: primary

References

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Waks AG, Chen EL, Graham N, Frey AM, Almeida K, Attaya V, Ryding C, Abbass I, Fung A, Sussell J, Cortazar P, Harvey C, Leth D, Faggen M, Sinclair N, Walsh J, Tung N, Sinclair S, Lo S, Yardley D, Valero V, Meisel J, Ballinger TJ, Adams S, Carey LA, Rauch JK, Abramson VG, Williams NO, Chen WY, Leone JP, Schumer ST, Tayob N, Tolaney SM. Subcutaneous vs Intravenous Trastuzumab/Pertuzumab: A Time and Motion Substudy of a Phase II Trial of Adjuvant Trastuzumab/Pertuzumab for Stage I HER2+ Breast Cancer (ADEPT trial). JCO Oncol Pract. 2025 Mar;21(3):351-357. doi: 10.1200/OP.24.00021. Epub 2024 Jul 19.

Reference Type DERIVED
PMID: 39028923 (View on PubMed)

Other Identifiers

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20-347

Identifier Type: -

Identifier Source: org_study_id