Neoadjuvant Treatment of Breast Cancer

NCT ID: NCT05131893

Last Updated: 2021-11-23

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

NOT_YET_RECRUITING

Total Enrollment

300 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-03-31

Study Completion Date

2031-12-31

Brief Summary

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Observational investigation of participants who are given neoadjuvant treatment for invasive breast cancer. The scope of the study is to collect information on standardized treatment results, to explore the causes of dose modification and its effect on efficacy, to explore potential prognostic factors, and to explore the long-term side effects of different treatment modalities.

Detailed Description

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The purpose of the study is based on the uniform application of international guidelines in Hungarian conditions. The standardized circumstances may lead to optimization of neoadjuvant therapy, it may facilitate subsequent data analysis, provide a basis for prospective clinical questions, and demonstrate improvement in pathologic complete remission (pCR) and overall survival (OS) compared to historical control. It may make possible to collect real-life data on each therapeutic option: efficacy, side effects, dose reduction, dose intensity, long-term consequences. The main scope is to collect prospective data to explore prognostic and predictive factors. The auxiliary aim is the assessment and comparison of quality of life during specific treatments and their side effects.

Conditions

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Breast Cancer

Keywords

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Neoadjuvant systemic therapy

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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LuminalA

1. tamoxifen (+ LHRH analogue for premenopausal participant)
2. non-steroidal aromatase inhibitor (+ LHRH analogue for premenopausal participant)
3. Non-steroidal aromatase inhibitor in non-resectable tumor (+ LHRH analogue in premenopausal participant) + CDK4 / 6 inhibitor

Tamoxifen

Intervention Type DRUG

endocrine therapy

Goserelin

Intervention Type DRUG

endocrine therapy

Letrozole 2.5Mg Tab

Intervention Type DRUG

endocrine therapy

LuminalB (Her2 negative)

1. 12 times weekly paclitaxel (80 mg / m˄2) followed by 4 times every 3 weeks epirubicin (E) (90-100 mg / m˄2) + cyclophosphamide (C) (600) (preferred)
2. 4x 3 weekly E (90-100mg / m˄2) + C (600mg / m˄2), then

1. docetaxel (90-100 mg / m˄2) 4 times in every 3 weeks or
2. 12x weekly paclitaxel (80mg / m˄2)
3. 4x every 2 weeks Epirubicin (E) (90-100mg / m˄2) + Cyclophosphamid (C) (600mg / m˄2), then

1. 4 times every 2 weeks with paclitaxel (175 mg / m˄2) or
2. 12x weekly paclitaxel (80mg / m˄2)
4. TC: docetaxel (75 mg / m˄2) + cyclophosphamide (600 mg / m˄2) every 21 days with GCSF prevention (6 cycles)

Tamoxifen

Intervention Type DRUG

endocrine therapy

Goserelin

Intervention Type DRUG

endocrine therapy

Letrozole 2.5Mg Tab

Intervention Type DRUG

endocrine therapy

Epirubicin

Intervention Type DRUG

chemotherapy

cyclophosphamide

Intervention Type DRUG

chemotherapy

Docetaxel

Intervention Type DRUG

chemotherapy

paclitaxel

Intervention Type DRUG

chemotherapy

trastuzumab

Intervention Type DRUG

biological treatment

Her2 positive

1. 4x 3 weeks E (90-100mg / m˄2) + C (600mg / m˄2), then

1. 12 times weekly paclitaxel + trastuzumab (every week or 3 weekly) +/- pertuzumab (3 weekly) or
2. 4x 3 weekly docetaxel (100mg / m˄2) + trastuzumab +/- pertuzumab
2. Docetaxel (75 mg / m˄2) + carboplatin (AUC6) + trastuzumab +/- pertuzumab 6 times every 3 weeks c) E (90-100mg / m˄2) + C (600mg / m˄2) 4x every 2 weeks, then 12 times weekly paclitaxel + trastuzumab (every week or 3 weekly) +/- pertuzumab (3 weekly)

Tamoxifen

Intervention Type DRUG

endocrine therapy

Goserelin

Intervention Type DRUG

endocrine therapy

Letrozole 2.5Mg Tab

Intervention Type DRUG

endocrine therapy

Epirubicin

Intervention Type DRUG

chemotherapy

cyclophosphamide

Intervention Type DRUG

chemotherapy

Docetaxel

Intervention Type DRUG

chemotherapy

paclitaxel

Intervention Type DRUG

chemotherapy

trastuzumab

Intervention Type DRUG

biological treatment

pertuzumab

Intervention Type DRUG

biological treatment

Triple-negative breast cancer

1. Paclitaxel (80 mg / m˄2) +/- carboplatin (AUC2) 12 times weekly, then E (90-100 mg / m˄2) + C (600 mg / m˄2) 4 times three weekly (preferred)
2. 4x every 3 weeks E (90-100mg / m˄2) + C (600mg / m˄2), then

1. 4x docetaxel (90-100mg / m˄2) or
2. 12x weekly paclitaxel (80mg / m˄2) +/- carboplatin (AUC2 )
3. 4x every 2 weeks E (90-100mg / m˄2) + C (600mg / m˄2), then

1. 4 times every 2 weeks paclitaxel (175 mg / m˄2) or
2. 12x weekly paclitaxel (80mg / m˄2) +/- carboplatin (AUC2)

Epirubicin

Intervention Type DRUG

chemotherapy

cyclophosphamide

Intervention Type DRUG

chemotherapy

Docetaxel

Intervention Type DRUG

chemotherapy

paclitaxel

Intervention Type DRUG

chemotherapy

Capecitabine

Intervention Type DRUG

chemotherapy

Interventions

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Tamoxifen

endocrine therapy

Intervention Type DRUG

Goserelin

endocrine therapy

Intervention Type DRUG

Letrozole 2.5Mg Tab

endocrine therapy

Intervention Type DRUG

Epirubicin

chemotherapy

Intervention Type DRUG

cyclophosphamide

chemotherapy

Intervention Type DRUG

Docetaxel

chemotherapy

Intervention Type DRUG

paclitaxel

chemotherapy

Intervention Type DRUG

trastuzumab

biological treatment

Intervention Type DRUG

pertuzumab

biological treatment

Intervention Type DRUG

Capecitabine

chemotherapy

Intervention Type DRUG

Other Intervention Names

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letrozole

Eligibility Criteria

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Inclusion Criteria

1. Participant over 18 years of age .
2. Histologically confirmed (core biopsy) invasive breast tumor.
3. Tumor extent for the indication:

* regression must be achieved for radical surgical removal or
* regression is required for breast-conserving surgery or
* if hormone receptor (HR)-positive and Her2-: stage IIB (cT2N1 or cT3NO) - IIIC,
* if HR-negative: stage IIA (cT2N0 or cT0-1N1) - IIIC Note: In the case of a locally advanced, irresectable case, if the possibility of radical surgery later is a realistic goal, the participant may be included in the study.
4. Appropriate general condition: ECOG 0-1
5. Proper organ function

* Neutrophil count ≥ 1.5 G / l, platelet count ≥ 100 G / l, hemoglobin ≥ 10 g / dl
* Alanine aminotransferase (ALT) / aspartate aminotransferase (AST) is less than 1.5 times the upper limit of the normal range
* bilirubin less than 1.5 times the upper limit of the normal range (except Gilbert's disease, where less than 3 times)
* creatinine less than 1.5 times the upper limit of the normal range or estimated glomerular filtration rate (eGFR) higher than 60 ml / min

Exclusion Criteria

1. Proven or suspected distant metastasis.
2. No staging studies have been performed: at least chest x-ray, abdominal ultrasound. It is preferred to perform CT from the chest, abdomen, pelvic regions and bone isotope, or PET / CT if possible in case of lymph node involvement.
3. Known significant heart disease: major arrhythmia or significant conduction defect (grade 2 or more), infarction or unstable angina within 6 months, cardiac collapse without appropriate therapy, long QT syndrome, heart failure (≥New York Heart Association/NYHA II)
4. Other severe acute or chronic conditions (organic or psychiatric illness, laboratory abnormality) that, in the opinion of the treating physician, result in an unacceptable increase in the risk of chemotherapy and are contraindicated in routine clinical practice.
5. Pregnancy or if the participant does not agree to use an appropriate non-hormonal method of contraception.
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Oncology, Hungary

OTHER

Sponsor Role lead

Responsible Party

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Dr. Zoltan Matrai

Head of Surgical Oncology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Gabor Rubovszky

Role: PRINCIPAL_INVESTIGATOR

NIO Hungary

Locations

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National Institute of Oncolgy

Budapest, , Hungary

Site Status

Countries

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Hungary

Central Contacts

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gabor Rubovszky

Role: CONTACT

Phone: +3612248600

Email: [email protected]

Balazs Madaras

Role: CONTACT

Phone: +3612248600

Email: [email protected]

Facility Contacts

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Gabor Rubovszky, Ph D

Role: primary

Balazs Madaras

Role: backup

Other Identifiers

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PANONC-1 Version: 1.1

Identifier Type: -

Identifier Source: org_study_id