CClinicalTrials.gg
Status unknownNCT03497702NeoChAIUpdated Apr 13, 2018

Neo-adjuvant Chemotherapy With Letrozole in Patients With Estrogen Receptor Positive/HER-2 Negative Breast Cancer

A Phase 2 interventional study of Doxorubicin and Cyclophosphamide in Breast Cancer and Invasive Breast Cancer, sponsored by National Cancer Center, Korea. Status unknown at 1 site in Korea, Republic of. Open to female participants aged 19 Years to 70 Years. Per ClinicalTrials.gov, last updated 2018-04-13.

Sponsored by National Cancer Center, Korea · Phase 2, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Apr 2018), so the status shown — last known as Recruiting — may be out of date.
Phase
Phase 2
Study type
Interventional
Enrollment
114
Allocation
Not applicable
Ages
19 Years to 70 Years
Sex
Female
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Study summary

This is an exploratory interventional study that initiates chemotherapy with letrozole in patients with estrogen receptor positive/HER2-negative breast cancer preoperably.

Read the detailed description

STUDY RATIONALE: Patients with ER+/HER2- operable breast cancers who are candiate of neoadjuant chemotherapy generally receive chemotherapy alone before operation, followed by adjuvant endocrine therapy. Because endocrine therapy is primarily delivered in the postoperative setting, the ability to add the efficacy of aromatase inhibitors combined with chemotherapy is lost. This study offers the unique opportunity to assess the synergistic or additive responsiveness of breast tumors to endocrine therapy plus chemotherapy while the tumors are still in vivo by treating patients with an aromatast inhibitor combined with chemotherapy before surgery and assessing pCR rates.

PRIMARY OBJECTIVE: The primary objective is to determine the frequency of pCR in breast and axilla.

02

Conditions studied

  • Breast Cancer
  • Invasive Breast Cancer

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03

Who can participate

Ages eligible
19 Years to 70 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Pathologically proven breast cancer patients who are candidate of neoadjuvant chemotherapy with AC followed by Docetaxel
  • Age: 19-70 years
  • ER or PR positive ,cT2-3N0 or cT1-3/N+ M0 (ER-positive ≥1% nuclear staining by immunohistochemistry , Allred score≥3 )
  • Available FFPE tissue for biomarker study
  • HER2-negative by ASCO/CAP guideline
  • Patients who agree to adequate contraception
  • ECOG scores of 0-2
  • Normal or acceptable kidney, liver, cardiovascular, and bone marrow functions
  • Patients who provide consent

Exclusion criteria

Exclusion Criteria:

  • Inflammatory breast cancer
  • Distant metastasis
  • Cerebral vascular accidents including transient ischemic attack
  • Pulmanary thromboembolism or deep vein thrombosis with 6 months; however, patients who received more than 6 weeks of anticoagulation within 6 months and remains asymptomatic are eligible.
  • With a history of malignant tumor or complicated with other malignant tumors in addition to breast cancer, except for non-melanoma skin cancer, curatively resected early gastric cancer, differentiated thyoid cancer \< 1 cm, or other cured malignant tumor without recurrence for at least 3 years
  • Ejection Fraction \<55% by MUGA scan / Echo CG
  • No available tissue for biomarker study
  • Pregnant or lactating women
  • Patients with other serious diseases or medical conditions: Pituitary adenoma, Malabsorption syndrome, Major resection of gastrointestinal tract, Corrected QT interval > 480 msec, Congestive heart failure or unstable angina pectoris, myocardial infarction, stent insertion, angioplasty, coronary bypass surgery, symptomatic peripheral artery disease within 6 months before the enrollment
  • NYHA class III or IV congestive heart failure
  • Uncontrolled hypertension and uncontrolled high-risk arrhythmia considered by the investigator
  • Major surgery, major trauma, and/or unhealed wound, fracture, or ulcer within 4 weeks
  • Acute hemorrhage or hemorrhagic tendency
  • Obvious neurological or psychiatric disorders, including psychosis, epileptic dementia and other diseases which may affect the understanding and sign of the informed consent
  • Uncontrolled acute infection
  • Patients with allergic constitution and any known or suspected drug allergy
  • Concurrent use of other investigational drugs; or participating in other clinical trials involving investigational drugs within 30 days before this study
  • Patients with mental illness or other conditions affecting the patient compliance
  • Not suitable for the trial considered by the investigator
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Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
114 participants (estimated)

Study arms

  • Experimental
    Experimental

    Patients receive neoadjuvant chemotherapy (doxorubicin 60mg/m2 IV and cyclophosphamide 600mg/m2 IV on day 1 every 3 weeks for 4 cycles followed by docetaxel 75mg/m2 IV on day 1 every 3 weeks for 4 cycles) plus letrozole with or without leuproelin depending on menopausal status

    Drug: Doxorubicin · Drug: Cyclophosphamide · Drug: Docetaxel · Drug: Letrozole · Drug: leuprorelin

Interventions

  • DrugDoxorubicin

    60mg/m2 IV every 3 weeks for 4 cycles

  • DrugCyclophosphamide

    600mg/m2 IV every 3 weeks for 4 cycles

  • DrugDocetaxel

    75mg/m2 IV every 3 weeks for 4 cycles

  • DrugLetrozole

    2.5 mg once daily preoperably

  • Drugleuprorelin

    3.75 mg SC every 4 weeks for premenopausal patients

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What researchers measure

Primary outcomes

  1. pathologic complete remission (pCR)

    pCR defined as no invasive residuals in breast and lymph nodes (ypT0/Tis, ypN0 \[MD Anderson definition\])

    Time frame: within 6 weeks following the last dose of chemotherapy

Secondary outcomes

  1. Adverse events

    Frequency and severity of hematological and non-hematological adverse events and laboratory abnormalities according to Common Terminology Criteria for Adverse Events (CTCAE) v4.0

    Time frame: during 6 months of neoadjuvant chemotherapy

  2. Response rate

    Overall objective clinical response rate = CR + PR rate, measured by MRI (or US) and assessed by RECIST criteria.

    Time frame: during 6 months of neoadjuvant chemotherapy

  3. Downstaging to breast conserving surgery (BCS)

    Ratio of the number of patients with breast conserving surgery converted from planned mastectomy over the number of patients with initially planned mastectomy

    Time frame: within 6 weeks following the last dose of chemotherapy

  4. Disease free survival

    Disease-free survival (DFS) following operation.

    Time frame: Patients will be followed up to 6 years

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Study locations

1 of 1 sites recruiting
  • National Cancer Center
    Goyang-si, Korea, Republic of
    • Keun Seok Lee, MD, PhD · Contact
    Recruiting
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

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Registry details

Key details

Study ID
NCT03497702
Lead sponsor
National Cancer Center, Korea
Responsible party
Keun Seok Lee (Head, Center for Breast Cancer, National Cancer Center, Korea) — Principal investigator
First posted
Apr 13, 2018
Start date
May 8, 2017
Primary completion
Nov 2023 (estimated)
Completion
Jan 2024 (estimated)
Last update
Apr 13, 2018

Study contacts

Keun Seok Lee, MD, PhD
Contact
kslee@ncc.re.kr
+82-31-920-1220
Keun Seok Lee, MD, PhD
principal investigator · National Cancer Center

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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