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Pyrotinib Versus Pertuzumab in Combination With Neoadjuvant Trastuzumab and Nab-Paclitaxel in HER2+ Early or Locally Advanced Breast Cancer (Pyramid)

19 mei 2021 bijgewerkt door: Tianjin Medical University Cancer Institute and Hospital
The study is being conducted to evaluate the efficacy, and safety of pyrotinib versus pertuzumab in combination with trastuzumab and nab-paclitaxel for neoadjuvant treatment in HER2+ early or locally advanced breast cancer patients. To explore whether pyrotinib regimen could provide better clinical results compared with pertuzumab in the study population.

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

This study is a multi-center, randomized, open-label, controlled trial. Eligible patients will be randomized to neoadjuvant pyrotinib or pertuzumab containing regimen every 3 weeks for four cycles before surgery. Randomization was stratified by the following factors: hormone receptor status and primary tumor size. After completing four cycles of neoadjuvant treatment, all patients who are eligible for surgery will undergo surgery and have their pathologic response evaluated. Following surgery, patients will receive 90-100 mg/m2 epirubicin and 600 mg/m2 cyclophosphamide every 3 weeks for 4 cycles. Clinicians will select subsequent treatments for patients based on guidelines as well as clinical practice at each site.

Studietype

Ingrijpend

Inschrijving (Verwacht)

490

Fase

  • Fase 2

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

  • Naam: Jin Zhang, MD, Professor
  • Telefoonnummer: 2121 0086-22-23340123
  • E-mail: zhangjin@tjmuch.com

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar tot 75 jaar (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Vrouw

Beschrijving

Inclusion Criteria:

  • female patients, treatment-naïve, aged ≥ 18 years and ≤ 75 years;
  • ECOG score 0-1 (ECOG, Eastern Cooperative Oncology Group);
  • Histologically confirmed invasive breast cancer (early stage or locally advanced) :Primary tumor greater than 2 cm diameter and cT2-cT4/cN0-cN3/cM0 (clinical stage II and III);
  • HER2 expression positive breast cancer confirmed by pathological examination,
  • known hormone receptor status (ER and PR);
  • the level of major organ function must meet the following requirements: blood routine test: neutrophil (ANC) ≥ 1.5 × 109/L; platelet count (PLT) ≥ 90 × 109/L; hemoglobin (Hb) ≥ 90g/L; blood biochemistry test: total bilirubin (TBIL) ≤ 2.5 × ULN (upper normal limit); alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 1.5 × ULN; alkaline phosphatase ≤ 2.5 × ULN; blood urea nitrogen (BUN) and creatinine (Cr) ≤ 1.5 × ULN; echocardiography: LVEF ((Left Ventricular Ejection Fraction) ≥ 55%; 12 ECG: QT interval corrected by Fridericia method (QTcF) < 470 ms in women
  • Female subjects who have not yet experienced menopausal or not surgically sterile agree to practice abstinence or use effective methods of contraception for at least 7 months during and after the last dose of study drug;
  • Sign the informed consent form and are willing to cooperate in the follow-up.

Exclusion Criteria:

  • breast cancer of both sides, stage IV breast cancer or metastatic breast cancer;
  • inflammatory breast cancer;
  • History of other malignancy, or previous anti-cancer therapy or radiotherapy for any malignancy, excluding cured carcinoma in situ of the cervix or squamous or basal cell carcinoma.
  • simultaneously participated in other clinical trials;
  • Major surgical procedure unrelated to breast cancer within 4 weeks prior to randomization or from which the patient has not fully recovered
  • blood transfusion, or received colony-stimulating factor treatments before randomization;
  • known history of allergy to any of the study medications and any of the ingredients or excipients of these medications;
  • history of immunodeficiency, including positive HIV test, or suffering from other acquired, congenital immunodeficiency diseases, or history of organ transplantation.
  • had any heart disease, including: (1) angina pectoris; (2) arrhythmia that is clinically significant or required medication; (3) myocardial infarction; (4) heart failure; (5) any other heart disease judged by the investigator as not suitable for this trial.
  • pregnant or lactating
  • Other concurrent serious diseases that are serious hazards to the patient's safety or may interfere with planned treatment (including but not limited to hypertension, severe diabetes, active infection, thyroid disease, etc.) ;
  • Inability to swallow, chronic diarrhea, bowel obstruction, and other factors affecting medication intake and absorption.
  • Any other condition that, in the opinion of the investigator, makes the subject unsuitable for this study.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: pyrotinib + trastuzumab + nab-paclitaxel
Geneesmiddel: pyrotinib + trastuzumab + nab-paclitaxel
patients will be treated every 3 weeks for four cycles prior to surgery at following doses: pyrotinib: 400 mg/day, orally, qd trastuzumab: IV infusion on Day 1 every 3 weeks with loading dose of 8 mg/kg in Cycle 1, and 6 mg/kg in Cycles 2-4 nab-paclitaxel: 260 mg/m2 IV infusion on Day 1 every 3 weeks, or 125 mg/m2 IV infusion on Days 1, 8 and 15 every 3 weeks (the nab-paclitaxel administration cycle was determined by investigator at each site)
Actieve vergelijker: pertuzumab + trastuzumab + nab-paclitaxel
Geneesmiddel: pertuzumab + trastuzumab + nab-paclitaxel
patients will be treated every 3 weeks for four cycles prior to surgery at following doses: pertuzumab: IV infusion on Day 1 every 3 weeks with loading dose of 840 mg for Cycle 1, followed by 420 mg for Cycles 2-4 trastuzumab: IV infusion on Day 1 every 3 weeks with loading dose of 8 mg/kg in Cycle 1, and 6 mg/kg in Cycles 2-4 nab-paclitaxel: 260 mg/m2 IV infusion on Day 1 every 3 weeks, or 125 mg/m2 IV infusion on Days 1, 8 and 15 every 3 weeks (the nab-paclitaxel administration cycle was determined by investigator at each site)

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
tpCR (totally pathological Complete Response) assessed by the IRC(Independent Review Committee)
Tijdsspanne: Pathologic response will be evaluated right after surgery, which will be performed within 14 days after the completion neoadjuvant therapy (four cycles, 21 days per cycle).
defined as the absence of any residual invasive cancer on hematoxylin and eosin evaluation of the resected breast specimen and all sampled ipsilateral lymph nodes following completion of neoadjuvant therapy and surgery.
Pathologic response will be evaluated right after surgery, which will be performed within 14 days after the completion neoadjuvant therapy (four cycles, 21 days per cycle).

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
iDFS (Invasive disease-free survival)
Tijdsspanne: from the date of surgery till two years after study-defined treatment.

iDFS, 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:

  1. Disease recurrence (local, regional, distant, or contralateral) after surgery
  2. Death from any cause
from the date of surgery till two years after study-defined treatment.
EFS (event free survival)
Tijdsspanne: from the date of surgery till two years after study-defined treatment.

EFS, defined as time from randomization to the first documentation of one of the following events:

  1. Disease progression (before surgery), as determined by the investigator using 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 disease progression
  2. Disease recurrence (local, regional, distant, or contralateral) after surgery
  3. Death from any cause
from the date of surgery till two years after study-defined treatment.
ORR (Objective Response Rate)
Tijdsspanne: At the end of neoadjuvant therapy (four cycles, 21 days per cycle).
the proportion of patients who achieved Complete Response (CR) or Partial Response (PR) during Cycles 1-4, according to RECIST v1.1
At the end of neoadjuvant therapy (four cycles, 21 days per cycle).
the rate of adopting breast-conserving surgery
Tijdsspanne: evaluated right after surgery, which will be performed within 14 days after the completion neoadjuvant therapy (four cycles, 21 days per cycle).
the proportion of patients who have undergone breast-conserving surgery
evaluated right after surgery, which will be performed within 14 days after the completion neoadjuvant therapy (four cycles, 21 days per cycle).

Andere uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Incidence of serious adverse events and other adverse events of special interest
Tijdsspanne: through study completion, an average of 2.5 years.
Assess the incidence of serious adverse events (SAEs) and other adverse events.
through study completion, an average of 2.5 years.
Exploratory biomarker analyses
Tijdsspanne: through study completion, an average of 2.5 years.
The correlation between baseline molecular biomarkers and efficacy outcomes will be evaluated. Biomarkers may include blood lipids and metabolomics profiles based on Nuclear Magnetic Resonance techniques.
through study completion, an average of 2.5 years.

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Tianjin Medical University Cancer Institute and Hospital

Medewerkers

Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Verwacht)

1 mei 2021

Primaire voltooiing (Verwacht)

1 december 2023

Studie voltooiing (Verwacht)

1 december 2025

Studieregistratiedata

Eerst ingediend

28 april 2021

Eerst ingediend dat voldeed aan de QC-criteria

19 mei 2021

Eerst geplaatst (Werkelijk)

25 mei 2021

Updates van studierecords

Laatste update geplaatst (Werkelijk)

25 mei 2021

Laatste update ingediend die voldeed aan QC-criteria

19 mei 2021

Laatst geverifieerd

1 april 2021

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • MA-BC-II-020

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Ja

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

product vervaardigd in en geëxporteerd uit de V.S.

Ja

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