Neoadjuvant TCHP Versus THP in Patients With HER2-positive Breast Cancer (neoCARHP Study)

Neoadjuvant TCHP Versus THP in Patients With Human Epidermal Growth Factor Receptor 2-positive Breast Cancer (neoCARHP) : a Randomized, Open-label, Multicenter, Phase III Trial

The neoCARHP study was a randomized, open-label, multicenter, phase III, neoadjuvant trial. This study aimed to compare the efficacy and safety of TCHP with THP neoadjuvant setting for HER2-positive breast cancer. Patients will be randomized at a 1:1 ratio into TCHP or THP, respectively, and will be treated every 3 weeks before surgery.The primary endpoint was the percentage of pCR (ypT0/is, ypN0), which was defined as the absence of any residual invasive cancer in both the breast and axillary lymph nodes.

Study Overview

• Status: Recruiting
• Conditions: Neoadjuvant Therapies for HER2+ Breast Cancer
• Intervention / Treatment: Drug: investigator-selected taxane/trastuzumab/pertuzumab (THP); Drug: investigator-selected taxane/carboplatin/trastuzumab/pertuzumab (TCHP)

• Study Type: Interventional
• Enrollment (Estimated): 774
• Phase: Phase 3

Contacts and Locations

• Study Contact: Name: Kun Wang, Phd; Phone Number: 13922118086; Email: gzwangkun@126.com

Study Locations

• China
  • Guangdong
    • Guangzhou, Guangdong, China, 510080
      • Recruiting
      • Guangdong Provincial People's Hospital
      • Contact: Kun Wang, Phd; Phone Number: 13922118086; Email: gzwangkun@126.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• To take part in the trial, patients must be aged > 18 years old and supply a signed informed consent form.

Patients must also have breast cancer meeting the following criteria:

• Histologically confirmed invasive breast carcinoma
• Clinical stage II-IIIC at presentation. HER2-positive breast cancer scored as 3+ by immunohistochemistry (IHC) in > 10% of immunoreactive cells, or HER2 gene amplification (ratio of HER2 gene signals to centromere 17 signals ≥2.0) by in situ hybridization (ISH).

Known hormone receptor status (ER and PR). Eastern Cooperative Oncology Group (ECOG) Performance Status 0 or 1. Completed all necessary baseline laboratory and radiologic examinations prior to randomization.

Baseline left ventricular ejection fraction (LVEF)≥55% measured by echocardiography (ECHO).

Women who are not postmenopausal (≥12 months of amenorrhea) or surgically sterile (absence of ovaries and/or the uterus) must agree to remain abstinent or to use one highly effective form of non-hormonal contraception or two effective forms of non-hormonal contraception during the treatment period and for at least 6 months after the last dose of study treatment.

Clinical diagnosis of Alzheimer's Disease. Must be able to swallow tablets. All patients must be able to comply with the study protocol, according to the investigator's judgment.

Exclusion Criteria:

• Stage IV (metastatic) breast cancer Inflammatory breast cancer Previous anti-cancer therapy or radiotherapy for any malignancy. A history of other malignancies, except for carcinoma in situ of the cervix or squamous or basal cell carcinoma.

Concurrent anti-cancer treatment in another clinical trial, including hormone therapy, bisphosphonate therapy, or immunotherapy.

Received a major non-breast cancer-related surgical procedure within the 4 weeks before randomization or from which the patient has not fully recovered.

A serious cardiac illness or medical condition, including but not limited to the following:

Documented history heart failure or systolic dysfunction (LVEF < 50%). High-risk uncontrolled arrhythmia, such as atrial tachycardia with a heart rate >100 bpm at rest, significant ventricular arrhythmia (e.g., ventricular tachycardia), or higher-grade atrioventricular (AV) block (i.e., Mobitz II second-degree AV block or third-degree AV block).

Angina pectoris requiring anti-angina medication. Clinically significant valvular heart disease. Evidence of transmural infarction on ECG Poorly controlled hypertension (systolic blood pressure > 180 mmHg and/or diastolic blood pressure > 100 mmHg) Other concurrent serious diseases that may interfere with planned treatment, including severe pulmonary conditions/illness.

Any of the following abnormal laboratory tests immediately prior to randomization:

Total bilirubin > 1.5 × upper limit of normal (ULN) or, for cases of known Gilbert's syndrome, total bilirubin > 2 × ULN Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) > 1.25 × ULN Alkaline phosphatase > 2.5 × ULN Serum creatinine > 1.5 × ULN Total white blood cell (WBC) count < 2500 cells/uL Absolute neutrophil count <1500 cells/uL Platelet count <100,000 cells/uL Sensitivity to any of the study medications, any of the ingredients or excipients of these medications, or benzyl alcohol Pregnant or lactating: a negative serum pregnancy test is required for all women who are not postmenopausal (≥ 12 months of amenorrhea).

Insulin dependent diabetes. Thyroid disease.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: THP	Drug: investigator-selected taxane/trastuzumab/pertuzumab (THP); investigator-selected taxane/trastuzumab/pertuzumab (THP)
Active Comparator: TCHP	Drug: investigator-selected taxane/carboplatin/trastuzumab/pertuzumab (TCHP); investigator-selected taxane/carboplatin/trastuzumab/pertuzumab (TCHP)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
pathological complete response(ypT0/is,ypN0, pCR)	defined as the absence of invasive tumor cells in breast and axilla, ypT0/is ypN0	18 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinical response during neoadjuvant therapy	Clinical response during neoadjuvant therapy, according to RECIST v1.1.	18 weeks
The percentage of patients who underwent breast-conserving surgery		18 weeks
Event-free survival (EFS)	Event-free survival (EFS), defined as the time from randomization to the first report of one of the following events: Disease progression (before surgery), as determined by the investigator according to RECIST v1.1. Any evidence of in situ contralateral disease will not be identified as progressive disease (PD). Any evidence of invasive contralateral disease will be considered as disease progression; Disease recurrence (local, regional, distant, or contralateral) after surgery.; Death from any cause.	until disease progression or recurrence or until 5 years after randomization of the last patient, which ever occurs first.
Disease-free survival (DFS)	Disease-free survival (DFS), defined as the time from the first date of no disease (i.e., date of surgery) to the first documentation of one of the following events: Disease recurrence (local, regional, distant, or contralateral) after surgery; Death from any cause	until disease progression or recurrence or until 5 years after randomization of the last patient, which ever occurs first.
Safety Outcome Measures	The safety outcome measures for this study are the incidence, type, and severity of adverse events and serious adverse events.	until disease progression or recurrence or until 5 years after randomization of the last patient, which ever occurs first.
Overall survival, defined as the time from randomization to death from any cause.	Overall survival, defined as the time from randomization to death from any cause.	from randomization to death from any cause.

Collaborators and Investigators

• Sponsor: Guangdong Provincial People's Hospital

Study record dates

Study Major Dates

• Study Start (Actual): April 30, 2021
• Primary Completion (Estimated): April 30, 2024
• Study Completion (Estimated): April 30, 2025

Study Registration Dates

• First Submitted: April 18, 2021
• First Submitted That Met QC Criteria: April 23, 2021
• First Posted (Actual): April 26, 2021

Study Record Updates

• Last Update Posted (Actual): November 7, 2023
• Last Update Submitted That Met QC Criteria: November 3, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Skin Diseases; Neoplasms; Neoplasms by Site; Breast Diseases; Breast Neoplasms; Antineoplastic Agents; Antineoplastic Agents, Immunological; Carboplatin; Trastuzumab; Taxane; Pertuzumab
• Other Study ID Numbers: 20201101

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No