ClinicalTrials.gg
Active, not recruitingNCT03820063TRAIN-3Updated Oct 5, 2026

Image-guided De-escalation of Neo-adjuvant Chemotherapy in HER2-positive Breast Cancer: the TRAIN-3 Study

A Phase 2 interventional study of PTC-Pz in Breast Cancer, sponsored by Borstkanker Onderzoek Groep. Active, not recruiting at 52 sites in Netherlands. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-05.

Sponsored by Borstkanker Onderzoek Groep · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
462
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 390 studies in Breast Neoplasms with a site in Netherlands — 71 open to participants now, 117 under way, 35 of them phase 3. Breast Neoplasms · Netherlands.

Planned enrollment
82nd of 314
462 · median 189
Started
2019
with 16 others
Phase 2
63 of 390
10 open now
Primary completion
2022-11
later than 6 of 116 live
Registered
255th of 390
by date

Among the 390 studies in Breast Neoplasms with a site in Netherlands, this one is the 82nd largest by planned enrollment of the 314 interventional ones that give a count, is one of 17 that started in 2019, is one of 63 in phase 2, reaches primary completion later than 6 of the 116 other live ones, and was the 255th registered.

Breast Neoplasms

14,825 studies on the registry are indexed under Breast Neoplasms; 3,319 are open to participants now.

Browse Breast Neoplasms studies →

Open to participants now

71 of the 390 studies in Breast Neoplasms with a site in Netherlands are open now. Recruiting first, the newest first:

66 more — sign in →

All 71 open studies →

A study can be open while its sites in Netherlands have not opened yet or have stopped. Only those recruiting at a site in Netherlands →

Who these studies take

Of the 2,400 Breast Neoplasms studies recruiting now, 1,572 (66%) set no upper age limit and 591 (25%) stop at 75 or younger; 103 take children under 18; 214 take healthy volunteers.

This study: 18 Years and older · all sexes · no healthy volunteers.

The full table on the hub →

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02

Study summary

This is a multicenter, single arm, phase II study evaluating the efficacy of image-guided de-escalating neoadjuvant treatment with paclitaxel, Herceptin® (trastuzumab), carboplatin, and pertuzumab (PTC-Ptz) in stage II-Ill HER2-positive breast cancer.

Read the detailed description

High pathological complete response (pCR)-rates are seen using different neoadjuvant chemotherapy schedules with trastuzumab and pertuzumab in HER2-positive stage II - III breast cancer patients. Total pCR rates in breast and axilla have been described as high as 64%, and with an even higher rate of >80% in patients with HER2-positive and hormone receptor (HR) negative tumors. PCR is associated with better long-term outcomes in patients with HER2-positive breast cancer. Three year progression-free survival ranges between 85-90%. Neoadjuvant treatment of HER2-positive breast cancer typically consists of six to nine cycles of treatment. Longer duration of treatment is associated with higher pCR-rates but gives more toxicity. Pathological complete responses are sometimes seen after only 10-12 days of neoadjuvant treatment. It is therefore important to investigate which patients can safely be treated with less than six cycles of chemotherapy and who requires more than six cycles for maximum activity.

The radiologic response of a breast tumor after neoadjuvant therapy is predictive of the pathologic response, although the accuracy differs between breast cancer subtypes. It is hypothesized that patients with an early complete radiologic response may not benefit from additional chemotherapy and can be referred for early surgery. Patients who have not achieved pCR after early surgery despite radiologic complete response (rCR) are candidates for further adjuvant chemotherapy to complete the initially planned number of treatment cycles and maintain maximum treatment activity. Imaged guided de-escalation in which the number of treatment cycles is determined by the radiologic response could thus reduce toxicity in neoadjuvant treatment while maintaining activity.

This study will evaluate the efficacy of image-guided de-escalation of neoadjuvant chemotherapy in patients with HER2-positive breast cancer.

To maintain efficacy, patients who do not achieve pCR will complete a total of nine cycles taxane-containing chemotherapy followed by 14 cycles of treatment with adjuvant T-DM1. Patients who achieve early pCR will continue treatment with Herceptin® and pertuzumab to complete one full year of treatment.

03

Conditions studied

  • Breast Cancer

Browse trials for

Keywords

  • neo adjuvant
  • HER2 positive
  • de-escalation
04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. confirmed primairy infiltrating breast cancer.
  2. Stage II or Ill disease.
  3. Overexpression and/or amplification of in an invasive component of the core .
  4. Age \<:18
  5. Group performance status
  6. >50% measured by echocardiography, MRI or MUGA
  7. Known HR-status ( in percentages)

Exclusion criteria

Exclusion Criteria:

  1. Previous radiation therapy of chemotherapy
  2. Pregnancy or breastfeeding
  3. Evidence of distant
  4. Evidence of bilateral infiltrating breast cancer
  5. Concurrent anti-cancer treatment or another drug
Terms in these criteria, in plain language(7)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

HER2

HER2 is a protein, made from the ERBB2 gene, that drives the growth of some cancers. A study may look for a level of the protein, extra copies of the gene, or a particular change in it.

In breast cancer, protein tests are read as HER2-positive, HER2-low or HER2-negative; other cancers use their own rules. Check which test result the study requires.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

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

Study arms

  • Experimental
    PTC-Pz

    * Paclitaxel 80mg/m2 administered intravenously on day 1 and day 8 * Herceptin® 6mg/kg administered intravenously on day 1 (loading dose 8mg/kg) or Herceptin® administered subcutaneously 600mg on day 1 * Carboplatin AUC 6mg•ml/min administered intravenously on day 1 * Pertuzumab 420mg administered intravenously on day 1 (loading dose 840mg) * Treatment cycles are repeated on day 22 Patients who do not achieve pCR will complete a total of nine cycles taxane-containing chemotherapy followed by 14 cycles of treatment with adjuvant T-DM1.

    Drug: PTC-Pz

Interventions

  • DrugPTC-Pz

    * Paclitaxel 80mg/m2 administered intravenously on day 1 and day 8 * Herceptin® 6mg/kg administered intravenously on day 1 (loading dose 8mg/kg) or Herceptin® administered subcutaneously 600mg on day 1 * Carboplatin AUC 6mg•ml/min administered intravenously on day 1 * Pertuzumab 420mg administered intravenously on day 1 (loading dose 840mg) * Treatment cycles are repeated on day 22 In case of non pCR; Adjuvant T-DM1, 3.6mg/kg Q 22 days, for 14 cycles.

This study also gives Pertuzumab, Ado-Trastuzumab Emtansine. No intervention listed here names it: that was found by reading the record.

06

What researchers measure

Primary outcomes

  1. Event free survival at three years

    Number of patients without progression of disease recurrence, second primary or death

    Time frame: 3 years

Secondary outcomes

  1. Overall survival at three years

    Number of patients alive at three years

    Time frame: 3 years

  2. Pathologic complete response in breast and axilla

    Number of patients with absence of invasive tumor cells in breast and axilla at surgery

    Time frame: an average of 6 months

  3. Radiologic complete response

    Number of patients with absence of pathologic enhancement on MRI

    Time frame: an average of 6 months

  4. Number of neoadjuvant chemotherapy cycles administered

    Number of neoadjuvant chemotherapy cycles administered per patient

    Time frame: an average of 1 year

  5. Number of radical and non-radical resections

    Number of patients with radical and non-radical resections

    Time frame: an average of 6 months

  6. Incidence and severity of adverse events

    Number of patients with toxicity grade \>= 3 (CTCAE v5.0) until 30 days after last adjuvant administration

    Time frame: an average of 1 year

  7. Incidence and severity of cardiotoxicity and neuropathy

    Number of patients with cardiotoxicity and neuropathy grade \>= 2 (CTCAE v5.0) until 30 days after last adjuvant administration

    Time frame: an average of 1 year

  8. Incidence of symptomatic LVSD (heart failure),

    Number of patients with an asymptomatic decline in LVEF requiring treatment or leading to discontinuation of pertuzumab and Herceptin, or a decrease ≥10 percentage points from baseline to a LVEF \<50%

    Time frame: an average of 1 year

  9. Grade ≥3 laboratory test abnormalities

    Number of patients with Grade ≥3 laboratory test abnormalities

    Time frame: an average of 1 year

  10. Incidence of number of tumor positive Vacuum Assisted Core Biopsy

    Number of patients with tumor present at Vacuum Assisted Core Biopsy at the moment of radiological complete response on MRI

    Time frame: an average 6 months

07

Study locations

52 sites
08

References and documents

Publications

  • Louis FM, van der Voort A, van Ramshorst MS, Daletzakis A, Mandjes IA, Kemper I, Agterof MJ, van der Steeg WA, Heijns JB, van Bekkum ML, Siemerink EJM, Kuijer PM, Scholten A, Wesseling J, Vrancken Peeters MTFD, Egeler MD, van de Poll-Franse LV, Mann RM, Sonke GS; Dutch Breast Cancer Research Group (BOOG). MRI-based personalisation of neoadjuvant chemotherapy duration in HER2-positive early breast cancer (TRAIN-3): primary results from a multicentre, single-arm, phase 2 study. Lancet Oncol. 2026 Mar;27(3):349-360. doi: 10.1016/S1470-2045(25)00707-7. Epub 2026 Feb 16. PubMed 41713473 ↗
  • van der Voort A, Louis FM, van Ramshorst MS, Kessels R, Mandjes IA, Kemper I, Agterof MJ, van der Steeg WA, Heijns JB, van Bekkum ML, Siemerink EJ, Kuijer PM, Scholten A, Wesseling J, Vrancken Peeters MTFD, Mann RM, Sonke GS; Dutch Breast Cancer Research Group. MRI-guided optimisation of neoadjuvant chemotherapy duration in stage II-III HER2-positive breast cancer (TRAIN-3): a multicentre, single-arm, phase 2 study. Lancet Oncol. 2024 May;25(5):603-613. doi: 10.1016/S1470-2045(24)00104-9. Epub 2024 Apr 5. PubMed 38588682 ↗
09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Feb 2019 to primary completion in Nov 2022, 44 months.

Of 1,070 non-industry phase 2 interventional studies under Breast Neoplasms, half reached primary completion within 56 months of starting (the median), counting those still running; a quarter within 34 and three quarters within 87. This study's 44 months is below that.

Counting every sponsor, half of 1,302 studies reached it within 51 months; a quarter within 30 and three quarters within 82.

How these figures are worked out, and which studies are left out of them.

Registered
Jan 25, 2019
First posted
Jan 29, 2019
StartActual
Feb 27, 2019
Primary completionActual
Nov 15, 2022
CompletionEst.
May 1, 2032
Last update
Oct 5, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Minor edits
Nothing that changes what the study is or who can join. Edited: verification date and oversight details
1 update, last Oct 5, 2026
Show all 1 update
  1. Oct 5, 2026
    Minor edits only
    + 2 other changes: verification date and oversight details

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT03820063
Lead sponsor
Borstkanker Onderzoek Groep
Collaborators
Roche Pharma AG, BOOG Study Center
Responsible party
Sponsor
First posted
Jan 29, 2019
Start date
Feb 27, 2019
Primary completion
Nov 15, 2022
Completion
May 1, 2032 (estimated)
Last update
Oct 5, 2026

Study contacts

G S Sonke, MD
principal investigator · NKI-AvL
A E van Leeuwen- Stok, PhD
study director · BOOG Study Center

Oversight

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

Not currently enrolling

This study is active, not recruiting, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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