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Fudan University Shanghai Cancer Center Breast Cancer Precision Platform Series Study- Neoadjuvant Therapy

Fudan University Shanghai Cancer Center Breast Cancer Precision Platform Series Study- Neoadjuvant Therapy (FASCINATE-N)

Status
Recruiting
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05582499
Acronym
FASCINATE-N
Enrollment
716
Registered
2022-10-17
Start date
2022-11-01
Completion date
2028-09-30
Last updated
2025-08-22

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Breast Neoplasm, Breast Cancer, Breast Tumors, Triple-Negative Breast Cancer (TNBC), HER2-positive Breast Cancer, HER2-negative Breast Cancer, Hormone Receptor Positive Tumor, Hormone Receptor Negative Tumor, Early-stage Breast Cancer, Locally Advanced Breast Cancer

Brief summary

The purpose of this study is to establish a prospective, single-center platform research based on clinical subtypes to explore precision neoadjuvant therapy in patients with operable breast cancer who met the indications for neoadjuvant chemotherapy and by the update of basic translational research in the center, especially the refinement of typing, the discovery of new targets and the development of novel targeted drugs, verified the effectiveness of new targeted drugs in neoadjuvant therapy.

Detailed description

FASCINATE-N is a platform that will compare the efficacy of novel drugs alone or in combination with standard chemotherapy with the efficacy of standard therapy alone. The goal is to identify improved treatment regimens for subsets on the basis of clinical subtyping. In this trial, breast cancer patients eligible for inclusion can be randomly divided into the precision treatment group and conventional neoadjuvant chemotherapy group according to molecular typing and subtyping. The research therapy arm can be updated with the update of basic translational research in our center, especially the refinement of typing, the discovery of new targets and the development of novel targeted drugs. As described for previous adaptive trials, regimens that show to be more effective than standard therapy will graduate from the trial with their corresponding biomarker signature(s). Regimens will be dropped if they show a low probability of improved efficacy with any biomarker signature. New drugs will enter as those that have undergone testing complete their evaluation.

Interventions

DRUGPertuzumab

Pertuzumab

DRUGDalpiciclib

an oral cyclin-dependent kinases (CDK) 4/6 inhibitor

DRUGPyrotinib

an irreversible dual pan-erbb receptor tyrosine kinase receptor tyrosine kinase (ERBB) inhibitor

DRUGSHR-A1811

an anti-HER2 antibody-drug conjugate (ADC)

an anti-programmed death ligand 1 (PD-L1) antibody

DRUGCamrelizumab

an anti-programmed death-1 (PD1) antibody

Trophoblast cell-surface antigen 2 (TROP2) ADC

DRUGTrastuzumab

Trastuzumab

DRUGGoserelin

goserelin

DRUGLetrozole

letrozole

DRUGNab paclitaxel

Albumin paclitaxel

DRUGCarboplatin

Carboplatin

DRUGEpirubicin

Epirubicin

DRUGCyclophosphamide

Cyclophosphamide

DRUGFluzoparib

an original poly adenosine diphosphate-ribose polymerase (PARP) inhibitor

DRUGApatinib

tyrosine kinase inhibitors

DRUGFamitinib

tyrosine kinase inhibitors

DRUGHB1801

Albumin docetaxel

DRUGLEM

liposome-entrapped mitoxantrone

an anti-HER2 ADC

an anti-PDL1 antibody

DRUGAnlotinib

an tyrosine kinase inhibitor

DRUGTQB2868

anti-PD-1/TGF-βRII

DRUGIvonescimab

an anti-PD-1/VEGF bispecific antibody

DRUGJS207

an anti-PD-1/VEGF bispecific antibody

an anti-HER2 ADC

an HER2 inhibitor

an anti-HER2 ADC

DRUGpaclitaxel

paclitaxel

Sponsors

Fudan University
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
FEMALE
Age
18 Years to 70 Years
Healthy volunteers
No

Inclusion criteria

* Histologically confirmed invasive cancer of the breast and meet the clinical stage II(T2N0-1M0/T3N0M0)or III(T2N2M0/T3N1-2M0) criteria; * Age between18-70 years; * Eastern Cooperative Oncology Group (ECOG) performance status 0-1; * ER, PR and HER2 status were measured by immunohistochemistry (IHC); * LVEF≥55%; * Definition of SNF subtypes: SNF subtypes confirmed by digital pathology of H&E slices; * Triple negative subtyping: On the basis of triple-negative pathological diagnosis, AR, cluster of differentiation 8 (CD8) and Forkhead Box C1 (FOXC1) were combined to define the subtyping; * At least one measurable lesion according to RECIST version 1.1 * Normal organ and marrow function: Hemoglobin (HB) ≥90 g/L (No blood was transfused within 14 days), Absolute neutrophil count ≥ 1500/μL, Platelets ≥ 75,000/μL, Total bilirubin ≤ 1.5 x ULN), aspartate aminotransferase (AST) (SGOT) and alanine aminotransferase (ALT) (SGPT) ≤ 3 x ULN, creatinine \< 1 x ULN, endogenous creatinine clearance \> 50 ml/min (Cockcroft-Gault formula); * Non-pregnant and non-lactating, fertile female subjects were required to use a medically approved contraceptive method for the duration of the study treatment and at least 3 months after the last use of the study drug; * Ability to understand and willingness to sign a written informed consent

Exclusion criteria

* Previous cytotoxic chemotherapy, endocrine therapy, biological therapy or radiotherapy for any reason; * Patients with New York Heart Association (NYHA) grade II or above heart disease (including grade II); * Patients with severe systemic infections or other serious diseases; * Patients with known allergy or intolerance to the study drug or its excipients; * Other malignant tumors in the past 5 years, except cured cervical carcinoma in situ and non-melanoma skin cancer; * Pregnant or lactating patients of childbearing age who refused to take appropriate contraceptive measures during the course of the study; * Participated in other trial studies within 30 days before the administration of the first dose of the study drug; * Patients who were judged by the investigator to be unsuitable for this study.

Design outcomes

Primary

MeasureTime frameDescription
Pathological complete response rate (pCR)through study completion, up to 24 weeksPathological complete response rate

Secondary

MeasureTime frameDescription
invasive disease-free survival (iDFS)Three-year Post-surgery Follow-upTo determine three-year invasive disease-free survival (iDFS) among the treatment arms
Overall response rate (ORR)up to 24 weeksComplete response (CR) + partial response (PR)
CTCAE scale (V4.0)through study completion, an average of 1 year4\) To evaluate the rate of adverse effects of patient by the standard CTCAE scale (V4.0)
Evaluate gene expression profile during treatmentthrough study completion, up to 24 weeksTo measure gene expression profile of baseline and sequential tumor samples during treatment, through RNA-seq platform
Number of peripheral blood mononuclear cells (PBMC) count during treatmentthrough study completion, up to 24 weeksTo measure number of peripheral blood mononuclear cells (PBMC) count from baseline and sequential blood samples during treatment, through Flow CytoMetry platform

Countries

China

Contacts

Primary ContactZhimin Shao, Professor
zhimingshao@yahoo.com+86(021)64175590

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 7, 2026