Pre-Treatment DCE-MRI AI Models Predict Neoadjuvant Chemotherapy Response in HR+/HER2- Breast Cancer

July 13, 2026 updated by: Fujian Cancer Hospital

A Multicenter Prospective Observational Cohort Study: Predicting Neoadjuvant Chemotherapy Response Using Pre-Treatment DCE-MRI-Based AI Models in HR+/HER2- Breast Cancer

This study is a multicenter, prospective, observational cohort study to evaluate the predictive performance of pre-treatment DCE-MRI-based artificial intelligence (AI) models for neoadjuvant chemotherapy benefit in HR+/HER2- breast cancer. The study plans to enroll eligible HR+/HER2- breast cancer patients receiving routine standard neoadjuvant chemotherapy and stratify participants into high-benefit and low-benefit subgroups via the established AI model based on baseline breast DCE-MRI images.

All enrolled patients will undergo systematic collection of baseline clinical-pathological data, pre-treatment DCE-MRI scans, neoadjuvant chemotherapy regimens, postoperative residual cancer burden (RCB) classification, objective response rate (ORR), and long-term survival endpoints including disease-free survival (DFS) and overall survival (OS). The primary objective compares the rate of RCB 0-1 between AI-defined high-benefit patients and published historical control data; secondary analyses compare ORR, RCB 0-1 proportion, DFS and OS between AI-stratified high-benefit and low-benefit subgroups to comprehensively verify the clinical value of this imaging AI model for individualized neoadjuvant chemotherapy selection.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Estimated)

100

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • China
    • Fujian
      • Fuzhou, Fujian, China
        • Recruiting
        • Fujian Cancer Hospital
        • Contact:
      • Fuzhou, Fujian, China
        • Recruiting
        • Fujian Provincial Hospital
        • Contact:
      • Quanzhou, Fujian, China
        • Recruiting
        • The Second Affiliated Hospital of Fujian Medical University
        • Contact:
    • Ningde
      • Ningde, Ningde, China
        • Recruiting
        • Ningde First Hospital
        • Contact:
    • Sanming
      • Sanming, Sanming, China
        • Recruiting
        • Sanming Second Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

This study population consists of female patients aged 18 years or older with histologically confirmed stage II-III HR+/HER2-negative invasive breast cancer according to the 8th AJCC staging system. All participants receive routine standard neoadjuvant chemotherapy in multi-center breast cancer departments, complete standardized pre-treatment DCE-MRI with qualified imaging data, have ECOG performance status 0-1 and intact vital organ function. Subjects must satisfy all inclusion criteria, without meeting any exclusion criteria, and sign written informed consent voluntarily. Approximately 100 eligible patients will be consecutively enrolled from participating hospitals.

Description

Inclusion Criteria:

  1. Female patients aged ≥ 18 years old.
  2. Histopathologically confirmed invasive breast carcinoma.
  3. Hormone receptor positive (ER and/or PR ≥1%), HER2-negative status (IHC 0-1+, or IHC 2+ with negative FISH result).
  4. Clinical stage II-III breast cancer per the 8th AJCC staging system, with clinical indication for neoadjuvant chemotherapy or primary surgery.
  5. Standard pre-treatment breast DCE-MRI performed before neoadjuvant chemotherapy, with image quality eligible for AI model analysis.
  6. ECOG performance status 0 or 1; adequate function of major vital organs to tolerate planned clinical treatment.
  7. Voluntary participation with written informed consent obtained.

Exclusion Criteria:

  1. Prior systemic anti-tumor therapy for breast cancer other than planned neoadjuvant chemotherapy.
  2. Inflammatory breast cancer or distant metastatic disease (M1).
  3. Concurrent active malignant tumors of other origins.
  4. Contraindications to MRI examination or unqualified MRI images that cannot support model analysis.
  5. Severe comorbidities incompatible with neoadjuvant chemotherapy or surgical resection.
  6. Any other conditions judged ineligible for enrollment by the investigator.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
HR+/HER2- Breast Cancer Cohort Receiving Neoadjuvant Chemotherapy
Multicenter prospective observational cohort of patients with HR+/HER2- invasive breast cancer who receive routine standard neoadjuvant chemotherapy. All participants undergo pre-treatment DCE-MRI scanning, and an MRI-based AI model is applied to stratify patients into high and low chemotherapy benefit subgroups.
Diagnostic test: Pre-treatment DCE-MRI-based AI model
Preoperative dynamic contrast-enhanced MRI images are input into an artificial intelligence prediction model to stratify HR+/HER2- breast cancer patients into high and low neoadjuvant chemotherapy benefit subgroups.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incidence of Residual Cancer Burden (RCB) 0-1
Time Frame: After completion of neoadjuvant chemotherapy and definitive surgery (approximately 3-6 months after enrollment)
Compare the incidence of RCB 0-1 among HR+/HER2- breast cancer patients stratified as high chemotherapy benefit by pre-treatment DCE-MRI AI model against published historical control data to verify the predictive value of the imaging AI model.
After completion of neoadjuvant chemotherapy and definitive surgery (approximately 3-6 months after enrollment)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Objective response rate (ORR) of AI-defined high neoadjuvant chemotherapy benefit group
Time Frame: Imaging assessment after completion of neoadjuvant chemotherapy and prior to surgery
Compare the objective response rate (ORR) assessed by imaging after neoadjuvant chemotherapy before surgery in patients of AI-identified high chemotherapy benefit subgroup with historical control data.
Imaging assessment after completion of neoadjuvant chemotherapy and prior to surgery
Between-subgroup differences in RCB 0-1 rate
Time Frame: RCB classification obtained after definitive surgical resection, approximately 3-6 months after enrollment
Compare RCB 0-1 incidence between AI-stratified high benefit subgroup and low benefit subgroup.
RCB classification obtained after definitive surgical resection, approximately 3-6 months after enrollment
Between-subgroup differences in objective response rate (ORR)
Time Frame: ORR imaging assessment after neoadjuvant chemotherapy before surgery
Compare ORR between AI-stratified high benefit subgroup and low benefit subgroup.
ORR imaging assessment after neoadjuvant chemotherapy before surgery
Disease-free survival (DFS) between high and low chemotherapy benefit subgroups
Time Frame: From the date of surgery until the first recurrence, metastasis, or death, whichever came first, assessed up to 60 months
Compare DFS (time interval from the date of surgery to first recurrence, metastasis or death) between AI-stratified high and low chemotherapy benefit subgroups to explore the correlation between AI imaging stratification and long-term survival prognosis.
From the date of surgery until the first recurrence, metastasis, or death, whichever came first, assessed up to 60 months
Overall survival (OS) between high and low chemotherapy benefit subgroups
Time Frame: From the date of surgery until death from any cause, assessed up to 60 months
Compare OS between AI-stratified high and low chemotherapy benefit subgroups to explore the correlation between AI imaging stratification and long-term survival prognosis.
From the date of surgery until death from any cause, assessed up to 60 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Fujian Cancer Hospital

Investigators

  • Principal Investigator: Chuangui Song, doctor, Fujian Cancer Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 1, 2026

Primary Completion (Estimated)

April 30, 2027

Study Completion (Estimated)

June 30, 2027

Study Registration Dates

First Submitted

July 6, 2026

First Submitted That Met QC Criteria

July 13, 2026

First Posted (Actual)

July 14, 2026

Study Record Updates

Last Update Posted (Actual)

July 14, 2026

Last Update Submitted That Met QC Criteria

July 13, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • K2026-219-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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