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SHR-A1811 Monotherapy or Sequential THPy as Neoadjuvant Therapy for Stage II-III HER2-Positive Breast Cancer

24. August 2026 aktualisiert von: First Affiliated Hospital of Zhejiang University

A Prospective, Multicenter, Exploratory Clinical Study Evaluating the Efficacy and Safety of SHR-A1811 Monotherapy or Sequential THPy as Neoadjuvant Therapy in Stage II-III HER2-positive Breast Cancer

This is a prospective, open-label, phase II, multicenter exploratory clinical study. Eligible female patients aged 18-75 years with stage II-III HER2-positive breast cancer will receive 4 cycles of SHR-A1811 (4.8 mg/kg, intravenous infusion every 3 weeks). After 4 cycles, tumor response will be assessed per RECIST 1.1 criteria. Patients with a ≥50% reduction in tumor burden will continue with another 4 cycles of SHR-A1811 followed by definitive surgery. Patients with <50% reduction will receive 4 cycles of the THPy regimen (docetaxel + trastuzumab + pyrotinib) before surgery. Circulating tumor DNA (ctDNA) will be assessed for minimal residual disease (MRD) at baseline, after 4 cycles of treatment, and postoperatively. The primary endpoint is total pathological complete response (tpCR), assessed by an independent review committee (IRC). This study aims to evaluate the efficacy, safety, and feasibility of imaging- and MRD-guided neoadjuvant therapy in HER2-positive breast cancer.

Studienübersicht

Status

Noch keine Rekrutierung

Bedingungen

Intervention / Behandlung

Studientyp

Interventionell

Einschreibung (Geschätzt)

80

Phase

  • Phase 2

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Studienorte

    • Zhejiang
      • Hangzhou, Zhejiang, China, 310003
        • The First Affiliated Hospital, Zhejiang University School of Medicine
        • Hauptermittler:
          • Peifen Fu
        • Kontakt:
        • Hauptermittler:
          • Minya Yao

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Beschreibung

Inclusion Criteria:

  • Female aged ≥18 years and ≤75 years.
  • Histopathologically confirmed invasive breast cancer with no prior systemic anti-tumor therapy for breast cancer.
  • Histopathologically confirmed HER2-positive status in accordance with the 2018 ASCO-CAP HER2 testing guideline criteria: immunohistochemistry (IHC) score of 3+, or IHC 2+ with positive in situ hybridization (ISH) test (ISH amplification ratio ≥2.0); hormone receptor status must be available.
  • Stage II-III breast cancer per the 8th edition AJCC Breast Cancer Staging System.
  • At least one measurable target lesion according to RECIST Version 1.1.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Adequate function of major organs as defined below (no blood transfusion, granulocyte-stimulating factors or thrombopoietic agents administered within 2 weeks prior to screening):

    1. Hematology: absolute neutrophil count (ANC) >1.5×10⁹/L; platelet count (PLT) >75×10⁹/L; hemoglobin (Hb) >90 g/L.
    2. Serum biochemistry: total bilirubin (TBIL) <1.5×upper limit of normal (ULN); alanine aminotransferase (ALT) and aspartate aminotransferase (AST) <1.5×ULN; alkaline phosphatase <2.5×ULN; blood urea nitrogen (BUN)/urea and creatinine (Cr) <1.5×ULN.
    3. Echocardiogram: left ventricular ejection fraction (LVEF) ≥55%.
    4. 12-lead electrocardiogram: Fridericia-corrected QT interval (QTcF) <470 msec.
  • For premenopausal women of childbearing potential: serum or urine pregnancy test must be negative within 7 days before treatment initiation; not breastfeeding. All participants must use effective barrier contraception throughout treatment and for 6 months after completion of study treatment.
  • Voluntarily provide written informed consent, demonstrate good compliance and willingness to complete scheduled visits and study-related procedures.

Exclusion Criteria:

  • Stage IV breast cancer.
  • Inflammatory breast cancer.
  • Prior anti-tumor therapy or radiotherapy for any malignancy, or concurrent other malignant tumors, except cured carcinoma in situ of cervix, basal cell carcinoma or squamous cell carcinoma.
  • Concurrent receipt of anti-tumor therapy in another clinical trial, including but not limited to chemotherapy, endocrine therapy, biotherapy, bone-modifying agent therapy or immune checkpoint inhibitor therapy.
  • Major surgery unrelated to breast cancer performed within 4 weeks prior to the first dose of study drug, or participants who have not fully recovered from such surgery.
  • Severe cardiac disorders, including but not limited to:

    1. Confirmed history of heart failure or systolic dysfunction (LVEF <50%).
    2. High-risk uncontrolled arrhythmias, such as atrial tachycardia with resting heart rate >100 bpm, significant ventricular arrhythmia (e.g., ventricular tachycardia), or advanced atrioventricular block (Mobitz type II second-degree or third-degree atrioventricular block).
    3. Angina requiring anti-anginal medication.
    4. Electrocardiogram evidence of transmural myocardial infarction.
    5. Poorly controlled hypertension (systolic blood pressure >180 mmHg and/or diastolic blood pressure >100 mmHg) despite medical treatment.
  • Uncontrolled active infection requiring treatment; history of immunodeficiency including positive HIV test, other acquired or congenital immunodeficiency disorders, or history of organ transplantation.
  • Known hypersensitivity to any components of study drugs specified in this protocol.
  • Pregnant or breastfeeding women; women of childbearing potential with positive baseline pregnancy test; women of childbearing potential unwilling to use effective contraception throughout the study and for 6 months after the last study drug administration.
  • Known or suspected interstitial lung disease; moderate to severe pulmonary diseases that may interfere with detection or management of drug-related pulmonary toxicity and severely impair respiratory function within 3 months before the first dose, including but not limited to idiopathic pulmonary fibrosis, organizing pneumonia/bronchiolitis obliterans, pulmonary embolism, severe asthma, severe chronic obstructive pulmonary disease (COPD), obstructive/restrictive lung disease; any autoimmune, connective tissue or inflammatory diseases involving the lung such as rheumatoid arthritis, Sjogren's syndrome, sarcoidosis; or prior history of pneumonectomy.
  • Severe concomitant illnesses or other comorbidities that would interfere with planned treatment, or any other conditions rendering the participant unsuitable for participation in the study as judged by the investigator.

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: N / A
  • Interventionsmodell: Einzelgruppenzuweisung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: SHR-A1811 with Response-Guided Therapy
All participants receive an initial 4 cycles of SHR-A1811 (4.8 mg/kg, intravenous infusion every 3 weeks). After 4 cycles, tumor response is assessed per RECIST 1.1 criteria. Participants with ≥50% tumor regression continue with another 4 cycles of SHR-A1811, followed by definitive surgery. Participants with <50% regression switch to 4 cycles of the THPy regimen (docetaxel + trastuzumab + pyrotinib) before surgery. This is a single-arm, non-randomized, open-label, response-guided treatment strategy.
SHR-A1811, 4.8 mg/kg, intravenous infusion once every 3 weeks. All patients receive initial 4 cycles; responders continue additional 4 cycles before surgery.
Combined regimen of docetaxel, trastuzumab, and pyrotinib. Administered for 4 cycles to patients with insufficient tumor response after the initial 4 cycles of SHR-A1811 prior to definitive surgery.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Zeitfenster
Rate of total pathological complete response (tpCR)
Zeitfenster: At the time of definitive surgery (approximately 24 weeks after enrollment)
At the time of definitive surgery (approximately 24 weeks after enrollment)

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Zeitfenster
Rate of breast pathological complete response (bpCR)
Zeitfenster: At the time of definitive surgery (approximately 24 weeks after enrollment)
At the time of definitive surgery (approximately 24 weeks after enrollment)
Objective Response Rate (ORR)
Zeitfenster: After 2 cycles of study treatment (approximately 6 weeks after enrollment)
After 2 cycles of study treatment (approximately 6 weeks after enrollment)

Andere Ergebnismessungen

Ergebnis Maßnahme
Zeitfenster
Incidence and severity of Adverse Events (AEs)
Zeitfenster: From first study drug administration up to 30 days after the last dose of study treatment
From first study drug administration up to 30 days after the last dose of study treatment

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Geschätzt)

1. September 2026

Primärer Abschluss (Geschätzt)

1. April 2029

Studienabschluss (Geschätzt)

1. Oktober 2030

Studienanmeldedaten

Zuerst eingereicht

24. August 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

24. August 2026

Zuerst gepostet (Tatsächlich)

26. August 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

26. August 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

24. August 2026

Zuletzt verifiziert

1. August 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • 26-OBU-ZJ-BC-II-020

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

NEIN

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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