Neoadjuvant Complete Response Customized Treatment Approach for Definitive Management of Breast Cancer

NCT ID: NCT07217990

Last Updated: 2025-10-17

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

PHASE1/PHASE2

Total Enrollment

84 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-15

Study Completion Date

2027-12-31

Brief Summary

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This study will evaluate the efficacy and non-inferiority of a non-surgical approach for the treatment of patients with locally advanced breast cancer.

Detailed Description

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Primary Objective: To determine if a non-surgical approach to breast cancer patients with an exceptional response to NAC leads to similar recurrence rates compared to standard of care (SOC).

Exploratory Objectives

1. To study personalized predictive biomarkers of response to chemotherapy and predictors of residual disease from tumor samples and circulating biomarkers.
2. To validate our internally developed deep learning model to predict pathological complete response (pCR) postNAC in breast cancer patients.

Outline: This is a phase II trial that will accrue up to 84 participants. Patients will receive standard of care (SOC) neoadjuvant chemotherapy and will be evaluated for enhanced clinical complete response (ecCR) after treatment. The ecCR will be evaluated using a trimodal approach, which includes the use to Magnetic Resonance Imaging (MRI), image-guided biopsy, and circulating tumor DNA (ctDNA) analysis. Participants who achieve an ecCR will be placed in the non-surgical arm (Arm A), while those who do not achieve an ecCR will be placed in the surgical arm (Arm B).

Conditions

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Breast Cancer HER2-positive Breast Cancer Triple Negative Breast Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm A (eeCR, non-surgical)

Patients will receive standard of care (SOC) neoadjuvant chemotherapy and will be evaluated for enhanced clinical complete response (ecCR) after treatment. Participants who achieve an ecCR will be placed in the non-surgical arm. Participants will receive radiation therapy and routine and additional screening MRIs during follow up.

Group Type EXPERIMENTAL

Neoadjuvant Chemotherapy

Intervention Type DRUG

Participants will receive standard of care neoadjuvant chemotherapy

Radiation Therapy

Intervention Type RADIATION

Radiotherapy simulation parameters will be at the discretion of the treating physician to account for the patient's body habitus, tumor bed location, and tolerability of the prone or supine positions, however, the recommended approach will be whole-breast RT (WBRT) in the prone position, for cT1-3 N0 patients who achieve ecCR. For cT1-2 N1 patients who achieve ecCR WBRT with nodal inclusion and lymph node boost will be performed in the supine position.

MRI

Intervention Type PROCEDURE

Participants will undergo MRI

Biopsy

Intervention Type PROCEDURE

Participants undergo biopsy

Biospecimen collection

Intervention Type PROCEDURE

Participants undergo blood and plasma collection

Arm B (non-eeCR, surgical)

Patients will receive standard of care (SOC) neoadjuvant chemotherapy and will be evaluated for enhanced clinical complete response (ecCR) after treatment. Participants who do not achieve an ecCR will be placed in the surgical arm. Participants will undergo a lumpectomy or mastectomy, receive radiation therapy, and routine follow-up.

Group Type EXPERIMENTAL

Neoadjuvant Chemotherapy

Intervention Type DRUG

Participants will receive standard of care neoadjuvant chemotherapy

Radiation Therapy

Intervention Type RADIATION

Radiotherapy simulation parameters will be at the discretion of the treating physician to account for the patient's body habitus, tumor bed location, and tolerability of the prone or supine positions, however, the recommended approach will be whole-breast RT (WBRT) in the prone position, for cT1-3 N0 patients who achieve ecCR. For cT1-2 N1 patients who achieve ecCR WBRT with nodal inclusion and lymph node boost will be performed in the supine position.

MRI

Intervention Type PROCEDURE

Participants will undergo MRI

Breast Cancer Surgery

Intervention Type PROCEDURE

Participants will undergo surgery to treat their breast cancer. Either a lumpectomy or a mastectomy will be performed.

Biopsy

Intervention Type PROCEDURE

Participants undergo biopsy

Biospecimen collection

Intervention Type PROCEDURE

Participants undergo blood and plasma collection

Interventions

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Neoadjuvant Chemotherapy

Participants will receive standard of care neoadjuvant chemotherapy

Intervention Type DRUG

Radiation Therapy

Radiotherapy simulation parameters will be at the discretion of the treating physician to account for the patient's body habitus, tumor bed location, and tolerability of the prone or supine positions, however, the recommended approach will be whole-breast RT (WBRT) in the prone position, for cT1-3 N0 patients who achieve ecCR. For cT1-2 N1 patients who achieve ecCR WBRT with nodal inclusion and lymph node boost will be performed in the supine position.

Intervention Type RADIATION

MRI

Participants will undergo MRI

Intervention Type PROCEDURE

Breast Cancer Surgery

Participants will undergo surgery to treat their breast cancer. Either a lumpectomy or a mastectomy will be performed.

Intervention Type PROCEDURE

Biopsy

Participants undergo biopsy

Intervention Type PROCEDURE

Biospecimen collection

Participants undergo blood and plasma collection

Intervention Type PROCEDURE

Other Intervention Names

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Radiotherapy Magnetic Resonance Imaging Lumpectomy Mastectomy

Eligibility Criteria

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Inclusion Criteria

1. Provision of signed and dated informed consent form
2. Stated willingness to comply with all study procedures and availability for the duration of the study
3. Male or female, aged 18 years or older
4. Early-stage breast cancer diagnosis (cT1-3 N0 or cT1-2 N1) and a Human Epidermal Receptor 2 (HER2)-positive or triple negative breast cancer (TNBC) tumor molecular subtype
5. Planning to receive neoadjuvant chemotherapy (NAC) and radiation therapy (RT)

Exclusion Criteria

1. Pregnancy or lactation
2. Inmate or prisoner
3. Treatment with an investigational drug or other intervention throughout their breast cancer treatment
4. Patients with skin involvement and/or distant metastases
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gateway for Cancer Research

OTHER

Sponsor Role collaborator

Ohio State University Comprehensive Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Sachin Jhawar

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sachin Jhawar, MD

Role: PRINCIPAL_INVESTIGATOR

Ohio State University Comprehensive Cancer Center

Locations

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Ohio State University Comprehensive Cancer Center

Columbus, Ohio, United States

Site Status

Countries

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United States

Central Contacts

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The Ohio State University Comprehensive Cancer Center

Role: CONTACT

800-293-5066

Facility Contacts

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Sachin Jhawar, MD

Role: primary

Related Links

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Other Identifiers

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NCI-2025-07434

Identifier Type: REGISTRY

Identifier Source: secondary_id

OSU-25103

Identifier Type: -

Identifier Source: org_study_id

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