Chemotherapy Omission in HR-positive/HER2-negative Breast Cancer With Lymph Node Negative Disease Receiving Adjuvant Endocrine Therapy and CDK4/6 Inhibitor

NCT ID: NCT06996093

Last Updated: 2025-05-30

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

Clinical Phase

PHASE3

Total Enrollment

2508 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-06-02

Study Completion Date

2034-06-01

Brief Summary

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This is a prospective, randomized, open-label, multicenter phase III study to explore chemotherapy omission in hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer with lymph node negative disease receiving adjuvant endocrine therapy and cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitor.

Detailed Description

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This is a prospective, randomized, open-label, multicenter phase III study to explore chemotherapy omission in hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer with lymph node negative disease receiving adjuvant endocrine therapy and cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitor.

In this study, patient eligible will be randomized into either standard endocrine therapy plus CDK4/6 inhibitor without chemotherapy or standard endocrine therapy plus CDK4/6 inhibitor following 4 cycles of TC (docetaxel + cyclophosphamide) adjuvant chemotherapy.The safety and efficacy of each group will be assessed through invasive disease free survival (iDFS), disease-free survival (DFS), distant disease free survival (DDFS), overall survival (OS) and adverse effects (AE) as graded by Common Terminology Criteria for Adverse Events (CTCAE) 5.0 and patient reported outcome (PRO).

Conditions

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Breast Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Arm #1: standard endocrine therapy plus CDK4/6 inhibitor without chemotherapy Arm #2: 4 cycles of TC (docetaxel + cyclophosphamide) adjuvant chemotherapy, followed by standard endocrine therapy plus CDK4/6 inhibitor
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm #1: Endocrine+CDK4/6i

aromatase inhibitor (± ovarian suppression) plus CDK4/6 inhibitor without chemotherapy

Group Type EXPERIMENTAL

aromatase inhibitor (± ovarian suppression) plus CDK4/6 inhibitor

Intervention Type DRUG

aromatase inhibitor (± ovarian suppression) plus CDK4/6 inhibitor

Arm #2: TC*4-Endocrine+CDK4/6i

4 cycles of TC (docetaxel + cyclophosphamide) adjuvant chemotherapy, followed by aromatase inhibitor (± ovarian suppression) plus CDK4/6 inhibitor

Group Type ACTIVE_COMPARATOR

4 cycles of TC (docetaxel + cyclophosphamide) adjuvant chemotherapy

Intervention Type DRUG

4 cycles of TC (docetaxel + cyclophosphamide) adjuvant chemotherapy

aromatase inhibitor (± ovarian suppression) plus CDK4/6 inhibitor

Intervention Type DRUG

aromatase inhibitor (± ovarian suppression) plus CDK4/6 inhibitor

Interventions

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4 cycles of TC (docetaxel + cyclophosphamide) adjuvant chemotherapy

4 cycles of TC (docetaxel + cyclophosphamide) adjuvant chemotherapy

Intervention Type DRUG

aromatase inhibitor (± ovarian suppression) plus CDK4/6 inhibitor

aromatase inhibitor (± ovarian suppression) plus CDK4/6 inhibitor

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Females and males aged 18-70 years;
* ECOG performance status 0-1;
* Early-stage breast cancer, with postoperative pathology confirming invasive carcinoma, HR-positive and HER2-negative (In this study, HR-positive is defined as: ER-positive by IHC with \>10% tumor cells staining positive; HER2-negative defined as HER2 0-1+ by IHC or HER2++ with negative FISH result, without amplification);
* Postoperative pathological stage pT2N0M0 and:

Histological grade 3, or Histological grade 2 with Ki67 ≥ 20% or high-risk multigene assay results;

* No prior neoadjuvant therapy received;
* Good postoperative recovery, with randomization occurring no more than 8 weeks after surgery;
* Normal function of major organs, meeting the following criteria:

Hematological tests must meet: HB ≥90 g/L (no transfusion within 14 days); ANC ≥1.5×10⁹/L; PLT ≥100×10⁹/L; Biochemical tests must meet: TBIL ≤1.5×ULN (upper limit of normal); ALT and AST ≤3×ULN; serum Cr ≤1.5×ULN;

* Contraception required for male participants and women of childbearing potential during treatment;
* Participants voluntarily enroll in the study, sign informed consent, demonstrate good compliance, and cooperate with follow-up.

Exclusion Criteria

* Bilateral breast cancer or carcinoma in situ (DCIS/LCIS);
* Metastasis at any site;
* Clinical or imaging suspicion of malignancy in the contralateral breast requiring biopsy (unless ruled out);
* Prior neoadjuvant therapy, including chemotherapy, radiotherapy, or endocrine therapy;
* Use of tamoxifen, raloxifene, or aromatase inhibitors (AIs) for breast cancer risk reduction ("chemoprevention") and/or osteoporosis treatment within the past 2 years;
* History of other malignancies within the past 5 years (except basal cell carcinoma of the skin or carcinoma in situ of the cervix), including contralateral breast cancer;
* Concurrent participation in another clinical trial;
* Severe systemic diseases and/or uncontrolled infections that preclude study participation;
* Severe cardiovascular or cerebrovascular events within 6 months before randomization (e.g., unstable angina, chronic heart failure, uncontrolled hypertension \>150/90 mmHg, myocardial infarction, or stroke);
* Known hypersensitivity to the study drugs;
* Men and women of childbearing potential unwilling to use contraception during treatment and for 8 weeks after treatment completion;
* Pregnant or lactating women;
* Positive pregnancy test before study drug administration (for women of childbearing potential);
* Psychiatric disorders, cognitive impairment, or inability to comprehend the trial protocol, adverse effects, or comply with study procedures and follow-up (requires systematic evaluation before enrollment);
* Individuals lacking personal freedom or legal capacity for independent civil conduct.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fudan University

OTHER

Sponsor Role lead

Responsible Party

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Zhimin Shao

Professor (MD, PhD)

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Zhimin Shao, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Fudan University

Locations

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Fudan University Shanghai Cancer Center

Shanghai, Shanghai Municipality, China

Site Status

Countries

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China

Central Contacts

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Zhimin Shao, MD, PhD

Role: CONTACT

+86-021-64175590 ext. 8808

Wenjia Zuo, MD

Role: CONTACT

+86-18017312648 ext. 67724

Facility Contacts

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Zhimin Shao, MD, PhD

Role: primary

+86-021-64175590 ext. 8808

Wenjia Zuo, MD

Role: backup

+86-18017312648

Other Identifiers

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SCHBCC-N087

Identifier Type: -

Identifier Source: org_study_id

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