Breast Cancer Stage II, Breast Cancer Stage III
Conditions
Keywords
Hormone receptor (HR) positive, HER2 negative, neoadjuvant treatment, CDK4/6 inhibitors
Brief summary
To explore the efficacy and safety of CDK4/6 inhibitors combined with endocrine neoadjuvant therapy for stage II-III HR-positive/HER2-negative breast cancer. This study adopts a single-arm, open-label design, and plans to include 40 patients with stage II-III HR+/HER2- breast cancer.
Interventions
DRUGRibociclib; abemaciclib; palbociclib; Dalpiciclib
Neoadjuvant therapy: CDK4/6 inhibitor combined with endocrine, a total of 6 cycles, 1 cycle every 28 days. CDK4/6 inhibitors (choose one of the following four types): * Dalpiciclib 125 mg orally once a day d1-21 every 28 days for a cycle (3 weeks/1 week off) * Palbociclib 125 mg orally once a day, d1-21, every 28 days in cycles (3 weeks/1 week off) * Abemaciclib 150 mg orally twice daily in 28-day cycles (may be reduced to 100 mg orally twice daily if not tolerated) * Ribociclib 400 mg orally once a day in a 28-day cycle Endocrine therapy drugs: take according to the label. Premenopausal patients need to be treated for ovarian function suppression.
Sponsors
Hongmei Zheng, PhD
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age ≥ 18 years old. 2. Premenopausal and postmenopausal stage II-III females or males (patients with multicenter and/or multifocal early-invasive breast cancer) if all histopathological examination of tumors meet the pathological criteria of ER and/or PR\>10% and HER2- (HER2 expression 0 or 1+ or 2+ and negative FISH test). 3. Patients must have histologically confirmed ER and/or PR \>10%, HER2-, early invasive breast cancer. 4. Intolerance or insensitivity to neoadjuvant chemotherapy: 2 cycles of neoadjuvant chemotherapy, tumor evaluation PD/SD, advanced age, and inability to tolerate chemotherapy with underlying diseases. 5. ECOG PS score 0-2. 6. Patients must be able and willing to swallow and retain oral medications. 7. Premenopausal women within 14 days of enrollment, or women with amenorrhea for less than 12 months at the time of enrollment, must have a negative serum or urine pregnancy test. 8. Patients who have received neoadjuvant endocrine therapy are eligible for enrollment as long as they are enrolled within 6 months of initial histologic diagnosis and have completed no more than 2 months of neoadjuvant endocrine therapy. 9. Absolute neutrophil count ≥ 1500/µL, platelet ≥ 100000/mm3, hemoglobin ≥ 10g/dL
Exclusion criteria
1. Prior treatment with any CDK inhibitor. 2. Inflammatory breast cancer or stage IV breast cancer or bilateral breast cancer. 3. History of anaphylaxis caused by chemical or biologic components similar to dalsily. 4. Patients who have received any drugs or substances with effective CYP3A isoenzyme inhibitors or inducers within 7 days of enrollment. 5. Uncontrolled intercurrent illness that would limit compliance with study requirements. 6. Pregnant women or women of childbearing potential with a negative pregnancy test within 14 days prior to admission. 7. Patients with any history of malignancy are not eligible. 8. Patients who have received endocrine therapy within 5 years prior to the diagnosis of the current malignancy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Objective response rate (ORR) | At the end of Cycle 6 (each cycle is 28 days) | The main effect evaluation index was Objective response rate (ORR) after CDK4/6 inhibitor combined with endocrine, a total of 6 cycles. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Ki67 variations | At the end of Cycle 2(each cycle is 28 days) | Tumor samples were collected by surgical resection during the screening period (mandatory), at the time of treatment for 8 weeks (mandatory), and at the time of surgery (mandatory). Each test center was responsible for collecting samples, and the Hubei cancer Hospital determined the levels of Ki67. |
| complete cell cycle arrest (CCCA; Ki67 ≤ 2.7%) | 6 months | Ki67 levels were assessed through serial biopsies at baseline , before ET treatment and C2D28 after ET treatment |
| iDFS | 2 years | Disease free survival for 3 years and 5 years, which means the rate of patients without local recurrence and distant metastasis in the whole patients at the same group will be calculated with Kaplan Meier survival curves. |
| QoL | 1 year | Life quality score was evaluated by European Organization of Research and treatment of Cancer-Questionnaire of Life Quality-C30 Version 3 (EORTC-QLQ-C30 V3), which conduct a series of questions about the patients' physical condition, activity of daily life, adverse reaction and mood condition. The range in the questionnaire for the score is from 1 to 4, in which 1 stands for having no discomfort and 4 stands for having great discomfort. |
Contacts
Primary ContactHongmei Zheng, Doctor
Backup ContactXinhong Wu, Doctor
Outcome results
None listed