Optimal Application Timing of ADC Drugs for Advanced Breast Cancer
A Prospective, Randomized Controlled Phase II Trial Investigating the Optimal Timing of Antibody Drug Conjugates in Advanced HER2-Negative Breast Cancer Patients
This study plans to initiate a prospective, randomized controlled trial to investigate the optimal timing of antibody drug conjugate (ADC) therapy in the management of advanced Human Epidermal Growth Factor Receptor 2 (HER2)-negative breast cancer.
Primary Objective:
To compare the difference in PFS2 (Time from randomization to disease progression after second therapy) between antibody-drug conjugate (ADC) followed by chemotherapy versus chemotherapy followed by ADC in the treatment of advanced HER2-negative breast cancer.
Secondary Objectives:
To compare overall survival (OS), adverse events, patient-reported outcomes, and cost-effectiveness between the two treatment sequences. Additionally, to identify potential biomarkers predictive of benefit from frontline ADC therapy.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Dan Lyu
- Telefonnummer: 0086-19800367870
- E-mail: lvdan9303@163.com
Studiesteder
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-
Liaoning
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Shenyang, Liaoning, Kina
- Rekruttering
- Liaoning Cancer Hospital & Institute
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Kontakt:
- Liaoning Cancer Hospital & Institute
- Telefonnummer: 86-19800367870
- E-mail: lvdan9303@163.com
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Female patients aged 18-75 years;
- Histologically confirmed advanced HER2-negative breast cancer, including IHC 2+/ISH-, IHC 1+/ISH-, and IHC 0/ISH- subtypes;
- Completed first-line combination chemotherapy for advanced/metastatic disease (specific regimen not restricted), with disease progression (PD) evaluated per RECIST criteria (HR-positive patients must have received at least one line of endocrine therapy);
- Electrocorticography (ECOG) performance status < 2;
- Estimated life expectancy ≥ 12 weeks;
Adequate bone marrow function, defined as:
- ANC ≥ 1.5 × 10⁹/L
- Platelets ≥ 90 × 10⁹/L
- Hemoglobin ≥ 90 g/L
Adequate hepatic and renal function, defined as:
- Total bilirubin ≤ 1.5 × upper limit of normal (ULN)
- AST or ALT ≤ 2.5 × ULN (≤ 5 × ULN for patients with liver metastases)
- Creatinine clearance ≥ 60 mL/min
- Signed informed consent obtained prior to any study-related procedures or treatments, confirming the patient's willingness to participate and comply with study requirements.
Exclusion Criteria:
- Prior treatment with an ADC after disease recurrence or metastasis;
- Pregnant or breastfeeding women;
- No evaluable recurrent or metastatic lesions as defined by RECIST 1.1 criteria;
- Symptomatic brain parenchymal and/or leptomeningeal metastases with symptoms not adequately controlled by treatment;
- History of other malignancies within the past 5 years, except for adequately treated carcinoma in situ of the cervix, cutaneous squamous cell carcinoma, or well-controlled localized basal cell carcinoma of the skin;
- Psychiatric disorders or other conditions that may interfere with patient compliance;
- Recent history of serious and uncontrolled systemic diseases, such as clinically significant cardiovascular disease, pulmonary disease, metabolic disorders, or arterial/venous thromboembolic events;
- Concurrent use of other investigational drugs, or participation in another clinical trial within 30 days prior to enrollment;
- Known or suspected allergy to any study drug or its excipients;
- Any other condition that, in the opinion of the investigator, renders the patient unsuitable for participation in this trial.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: ADC followed by chemotherapy group
Patients will receive an ADC agent as second-line treatment until disease progression or unacceptable toxicity, followed by physician's choice of chemotherapy as third-line treatment
|
The selection of ADC agents will be based on the patient's molecular subtype.
For Hormone receptor (HR)+/HER2-low patients, anti-HER2 ADCs such as trastuzumab deruxtecan may be used.
For HR+/HER2-zero patients, TROP-2-targeted ADCs such as sacituzumab govitecan are preferred.
For HR-/HER2-low patients, either anti-HER2 ADCs or Trophoblast cell surface antigen 2 (TROP-2) ADCs may be considered.
For HR-/HER2-zero patients, TROP-2 ADCs will be used.
The specific ADC regimen will be determined at the discretion of the investigators.
The chemotherapy regimen will consist of standard second-line agents such as capecitabine, eribulin, vinorelbine, or gemcitabine.
The specific chemotherapy regimen will be determined at the discretion of the investigators.
|
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Aktiv komparator: Chemotherapy followed by ADC group
Patients will receive physician's choice of chemotherapy as second-line treatment until disease progression or unacceptable toxicity, followed by an ADC agent as third-line treatment.
|
The selection of ADC agents will be based on the patient's molecular subtype.
For Hormone receptor (HR)+/HER2-low patients, anti-HER2 ADCs such as trastuzumab deruxtecan may be used.
For HR+/HER2-zero patients, TROP-2-targeted ADCs such as sacituzumab govitecan are preferred.
For HR-/HER2-low patients, either anti-HER2 ADCs or Trophoblast cell surface antigen 2 (TROP-2) ADCs may be considered.
For HR-/HER2-zero patients, TROP-2 ADCs will be used.
The specific ADC regimen will be determined at the discretion of the investigators.
The chemotherapy regimen will consist of standard second-line agents such as capecitabine, eribulin, vinorelbine, or gemcitabine.
The specific chemotherapy regimen will be determined at the discretion of the investigators.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Progression-free survival 2 (PFS2)
Tidsramme: Up to approximately 20 months
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Progression-free survival 2 (PFS2) is defined as the time from randomization to disease progression or death (whichever occurs first) following the second treatment.
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Up to approximately 20 months
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Overall Survival (OS)
Tidsramme: Up to approximately 40 months
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Defined as the time from randomization to death from any cause.
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Up to approximately 40 months
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Patient-Reported Outcomes (PROs)
Tidsramme: Up to approximately 20 months
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Defined as reports directly from patients regarding their health status, functional status, and treatment experience during the period from randomization to disease progression, without interpretation by clinicians or others.
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Up to approximately 20 months
|
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Time to Progression (TTP)
Tidsramme: Up to approximately 20 months
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Defined as the time from randomization to disease progression.
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Up to approximately 20 months
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Adverse event
Tidsramme: Up to approximately 20 months
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Defined as the occurrence of adverse events after enrollment, evaluated according to NCI CTCAE version 5.0.
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Up to approximately 20 months
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Andre resultatmål
Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Cost-effectiveness
Tidsramme: Up to approximately 20 months
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Defined as the total treatment-related costs incurred after patient enrollment.
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Up to approximately 20 months
|
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Exploratory Endpoint
Tidsramme: Up to approximately 20 months
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The correlation between baseline tumor mutation burden level and progression-free survival 2 (PFS2).
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Up to approximately 20 months
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Tao Sun, Liaoning Cancer Hospital & Institute
- Ledende efterforsker: Bo Lan, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Neoplasmer efter sted
- Neoplasmer
- Hudsygdomme
- Brystsygdomme
- Hud- og bindevævssygdomme
- Brystneoplasmer
- Immunologiske faktorer
- Lægemidlers fysiologiske virkninger
- Aminosyrer, peptider og proteiner
- Proteiner
- Terapeutik
- Farmakologiske handlinger
- Kemiske handlinger og anvendelser
- Antistoffer
- Immunoglobuliner
- Blodproteiner
- Serum globuliner
- Globuliner
- Immunkonjugater
- Lægemiddelterapi
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- OPTIMA-BC
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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