ClinicalTrials.gg
Active, not recruitingNCT04335669Updated Sep 12, 2025

NordicTrip, a Translational Study of Preoperative Chemotherapy in TNBC

A Phase 3 interventional study of epirubicin, cyclophosphamide, paclitaxel, carboplatin, pembrolizumab and epirubicin, cyclophosphamide, capecitabine, paclitaxel, carboplatin, pembrolizumab in Breast Cancer and Triple Negative Breast Neoplasms, sponsored by Lund University Hospital. Active, not recruiting at 24 sites in 2 countries. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2025-09-12.

Primary conditionTriple Negative Breast NeoplasmsRegistry: Breast NeoplasmsReclassifiedWhy we changed it
Registry
Breast Neoplasms — the first condition term the registry derived for this study.
ClinicalTrials.gg
Triple Negative Breast Neoplasms
Why
  1. The study's listed conditions name Triple Negative Breast Neoplasms, a narrower term within Breast Neoplasms.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Lund University Hospital · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
325
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

Primary aim: To compare the effect on pathologic complete response (pCR) rate of adding capecitabine to carboplatin based preoperative chemotherapy in early ER-negative and HER2-negative breast cancer. Pembrolizumab is allowed in both arms after approval for TNBC 2022.

Read the detailed description

Primary aim: Pathological complete response rate after preoperative chemotherapy is the primary end-point of the study, which will be evaluated by comparing the effects of neoadjuvant administration of a carboplatin-based treatment and treatment adding capecitabine on pCR. After the approval of pembrolizumab in the preoperative treatment of early TNBC in 2022 the study will consist of two cohorts, one (cohort 1) without the addition of pembrolizumab, and one (cohort 2) with the addition of pembrolizumab to both study arms. The primary evaluation will be performed on the entire study population including both cohorts.

Primary translational aim: To investigate if the effects of the treatments depend on homologous repair deficiency (HRD)-status. More specifically, the aim is to test for differential effect of the two treatments on pCR for HRD-negative (HRD low and intermediate by oncoscan) and HRD-positive (HRD high by oncoscan) patients.

02

Conditions studied

  • Breast Cancer
  • Triple Negative Breast Neoplasms

Keywords

  • Breast neoplasms
  • Triple negative breast neoplasms
  • Neoadjuvant treatment
  • Translational research
  • Pathologic response
  • Pathologic complete response
  • epirubicin
  • cyclophosphamide
  • paclitaxel
  • carboplatin
  • capecitabine
  • Survival outcomes
  • Homologous repair deficiency
  • pembrolizumab
03

In context

Triple Negative Breast Neoplasms Reclassified

1,219 studies on the registry are indexed under Triple Negative Breast Neoplasms; 446 are open to participants now.

This study's planned enrollment of 325 is above the median of 60 across 1,053 interventional studies indexed under Triple Negative Breast Neoplasms.

Browse Triple Negative Breast Neoplasms studies →

Lead sponsor

Lund University Hospital is the lead sponsor of 66 studies on the registry; 15 are open to participants now.

Compared within Triple Negative Breast Neoplasms, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Breast Neoplasms. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
18 Years to 75 Years
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. Signed written approved by the Ethical Review Board (IRB).
  2. Age ≥ 18 to \< 76 years.
  3. confirmed unilateral adenocarcinoma of the breast where chemotherapy followed by definitive surgery is planned.
  4. Node positive disease (N1-3) or if clinically N0 Tumor size >20 mm. When deciding T-stage the following hierarchy applies,

    1. MRI
    2. Ultrasound
    3. Mammography
    4. Clinical examination
  5. ER negative tumor defined by at least one the following:

    1. ER \< 1% cells positive by immunohistochemistry (IHC) or ER ≤ 10% cells positive by IHC and basal-like subtype using gene expression analysis
    2. ER \< 10% cells positive by IHC and PgR \< 10% cells positive by IHC
  6. -normal tumor defined according to applicable national guidelines
  7. Consent for germline mutation screening for BRCA1, BRCA2 and other inherited breast cancer associated genes.
  8. 0 or 1.
  9. Negative pregnancy test in women of (premenopausal or \<12 months of amenorrhea and who have not undergone surgical sterilization).
  10. Willingness of female patients of childbearing potential, male patients, and their sexual partners to use an effective means of during the treatment period and at least 6 months thereafter.
  11. Willingness by the patient to undergo treatment and study related procedures according to the protocol.

Exclusion criteria

Exclusion Criteria:

  1. Clinical or radiological signs of disease.
  2. History of other within the last 5 years, except for carcinoma in situ of the cervix or non-melanoma skin cancer.
  3. Previous chemotherapy for cancer or other malignant disease.
  4. Charlson comorbidity index, excluding score for malignancy: (CCI) > 2, Comment: In patients 70-75 a CCI = 3 is allowed, see appendix B.
  5. Inadequate organ function, suggested by the following laboratory results:

    a \< 1,5 x 109/L

    b count \< 100 x 109/L

    c \< 90 g/L

    d Total greater than the (ULN) unless the patient has documented Gilbert´s syndrome

    e ASAT () and/or ALAT (SGPT) > 2,5 x ULN

    f ASAT (SGOT) and/or ALAT (SGPT) > 1,5 x ULN with concurrent serum alkaline phosphatase (ALP) > 2,5 x ULN

    g Serum \< 50 ml/min

  6. Concurrent peripheral neuropathy of grade 3 or greater (, Version 5.0).
  7. Patient who is actively breast feeding.
  8. Assessed by the Investigator to be unable or unwilling to comply with the requirements of the protocol.
  9. Patients with known deficiency of the DPD-enzyme who completely lack DPD.
Terms in these criteria, in plain language(18)

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.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

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.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

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.

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.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Metastases

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

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
325 participants (estimated)

Study arms

  • Active comparator
    Arm A (Platinum-based dose dense EC):

    ddEC x 4 + pembrolizumab→ PK x 4 + pembrolizumab, Two-weekly epirubicin/cyclophosphamide (EC) x 4 (epirubicin 90 mg/m2 and cyclophosphamide 600 mg/m2), followed after a three-week interval by three-weekly carboplatin x 4 (AUC = 5) together with weekly paclitaxel x 12 (80 mg/m2). Pembrolizumab is given as a 400 mg iv dosis every 6 weeks for the duration of preoperative chemotherapy.\*

    Drug: epirubicin, cyclophosphamide, paclitaxel, carboplatin, pembrolizumab

  • Experimental
    Arm B (Platinum-based with capecitabine):

    CEX x 4→ PK x 4, Three-weekly cyclophosphamide/epirubicin/capecitabine (CEX) (epirubicin 75 mg/m2, cyclophosphamide 600 mg/m2 and capecitabine 900 mg/m2) x 4, followed after a three-week interval by three-weekly carboplatin x 4 (AUC = 5) together with weekly paclitaxel x 12 (80 mg/m2).Pembrolizumab is given as a 400 mg iv dosis every 6 weeks for the duration of preoperative chemotherapy.\* \*The addition of pembrolizumab is strongly recommended to all participating patients. However, patients with a documented contraindication, or unwilling to receive immunotherapy may be included in the study without the administration of pembrolizumab.

    Drug: epirubicin, cyclophosphamide, capecitabine, paclitaxel, carboplatin, pembrolizumab

Interventions

06

What researchers measure

Primary outcomes

  1. Pathological complete response rate.

    Rate of pathological complete response, allowing residual dcis, at surgery after preoperative chemotherapy.

    Time frame: Immediately after surgery

  2. Primary translational outcome.

    Pathological complete response rate, allowing residual dcis, stratified for homologous repair deficiency.

    Time frame: Immediately after surgery

Secondary outcomes

  1. Invasive Disease Free Survival (IDFS)

    Invasive disease-free survival

    Time frame: Throughout the study, an average of 3 years

  2. Overall Survival (OS)

    Overall survival

    Time frame: Throughout the study, an average of 5 years

  3. Breast Cancer Specific Survival (BCSS)

    Breast cancer specific survival

    Time frame: Throughout the study, an average of 3 years

  4. Distant Recurrence Free Survival (DRFS)

    Distant recurrence free survival.

    Time frame: Throughout the study, an average of 3 years

  5. Dose intensity

    Actual dosis/dosis per protocol

    Time frame: Immediately after surgery

  6. Toxicity according to CTCAE version 5.0

    Rate of included patients with toxicity grade 3 or greater during study treatment

    Time frame: Immediately after surgery

Other outcomes

  1. Subset characterization (histological subtypes)

    Distribution of different histopathological subsets of Triple Negative Breast Cancer (TNBC).

    Time frame: Immediately after surgery

  2. Subset characterization (germline mutations)

    Distribution of subsets of Triple Negative Breast Cancer (TNBC) associated with different inherited breast cancer genes (BRCA1, BRCA2, PALB2, TP53, CHEK2, ATM, RAD51 C and RAD51D).

    Time frame: Immediately after surgery

  3. Subset characterization (somatic mutations)

    Distribution of subsets of Triple Negative Breast Cancer (TNBC) associated with somatic mutations, (Eg BRCA1, BRCA2, PALB2, TP53, and other).

    Time frame: Immediately after surgery

  4. Subset characterization (epigenetic alterations)

    Distribution of different subsets of Triple Negative Breast Cancer (TNBC) defined based on epigenetic alterations associated with silencing of BRCA1, RAD51 and related HRD-associated genes.

    Time frame: Immediately after surgery

  5. pCR and long term outcome in histologic subsets of TNBC

    pCR rate in different histopathological subsets of Triple Negative Breast Cancer (TNBC).

    Time frame: Immediately after surgery

  6. pCR and long term outcome in subsets of TNBC defined based on occurrence of germline genetic alterations

    pCR rate in subsets of Triple Negative Breast Cancer (TNBC) associated with different inherited breast cancer genes (BRCA1, BRCA2, PALB2, TP53, CHEK2, ATM, RAD51 C and RAD51D).

    Time frame: Immediately after surgery

  7. pCR and long term outcome in subsets of TNBC defined based on occurrence of somatic genetic alterations

    pCR rate in subsets of Triple Negative Breast Cancer (TNBC) associated with somatic mutations, (Eg BRCA1, BRCA2, PALB2, TP53, and other).

    Time frame: Immediately after surgery

  8. pCR and long term outcome in subsets of TNBC defined on epigenetic alterations

    pCR rate in different subsets of Triple Negative Breast Cancer (TNBC) based on epigenetic alterations associated with silencing of BRCA1, RAD51 and related HRD-associated genes.

    Time frame: Immediately after surgery

  9. pCR and long term outcome in immun marker defined subsets of TNBC

    pCR rate in subsets of Triple Negative Breast Cancer (TNBC) associated with the expression of PDL1.

    Time frame: Immediately after surgery

07

Study locations

24 sites
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking 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

Started Dec 2019 (actual). Primary completion is estimated for Sep 2035, 189 months after the start.

Of 60 phase 3 interventional studies under Triple Negative Breast Neoplasms, half reached primary completion within 65 months of starting (the median), counting those still running; a quarter within 39 and three quarters within 103. This study's planned 189 months is above that.

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

Registered
Dec 2, 2019
First posted
Apr 6, 2020
StartActual
Dec 20, 2019
Primary completionEst.
Sep 2035
CompletionEst.
Sep 2035
Last update
Sep 12, 2025
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.
No changes since tracking began. The registry record was last updated on Sep 12, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04335669
Lead sponsor
Lund University Hospital
Collaborators
Swedish Breast Cancer Group, Danish Breast Cancer Cooperative Group
Responsible party
Sponsor
First posted
Apr 6, 2020
Start date
Dec 20, 2019
Primary completion
Sep 2035 (estimated)
Completion
Sep 2035 (estimated)
Last update
Sep 12, 2025

Study contacts

Niklas Loman, MD, PhD
study director · Lund University Hospital

Oversight

Data monitoring committee
Yes
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 2025. You cannot join it, but the record below documents what was studied.

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Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

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Studies of the drugs tested here: Epirubicin · Cyclophosphamide · Capecitabine · Paclitaxel · Carboplatin · Pembrolizumab

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