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RecruitingNCT04993014HER2CellUpdated Aug 6, 2021

Circulating Tumor Cells and Treatment De-escalation After Neoadjuvant Therapy for HER2 Positive Breast Cancer

A Phase 2 interventional study of Pertuzumab and Trastuzumab in Breast Neoplasms, HER2-positive Breast Cancer and Circulating Tumor Cell, sponsored by AC Camargo Cancer Center. Recruiting at 1 site in Brazil. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-08-06.

Sponsored by AC Camargo Cancer Center · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
80
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Phase II unicentric randomized trial which will include early HER2 positive breast cancer patients, candidate to neoadjuvant therapy with trastuzumab and pertuzumab. Circulating tumor cells will be collected at neoadjuvant therapy baseline.

Patients with pathological complete response will be randomized in 1:1 ratio for adjuvant trastuzumab (arm A) versus trastuzumab + pertuzumab (arm B) in a two factorial design: group A, with HER2 positive CTCs and group B, with HER2 negative/absent CTCs.

Read the detailed description

Patients with HER2 positive breast cancer (hormone receptors positive or negative), which are candidate to neoadjuvant therapy with pertuzumab and trastuzumab will be included.

Blood samples will be collected at baseline (before neoadjuvant start) for the analysis of CTCs and its positivity for HER2 by IHC and ISH.

Patients with pathological complete response will be included in the randomization phase of the study. There will be 2 cohorts: HER2 positive CTCs at baseline and HER2 negative/absent CTCs at baseline. In each cohort, patients will be randomized in 1:1 ratio for adjuvant trastuzumab versus adjuvant trastuzumab + pertuzumab

02

Conditions studied

  • Breast Neoplasms
  • HER2-positive Breast Cancer
  • Circulating Tumor Cell
03

Who can participate

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

Inclusion criteria

  • HER2 positive breast cancer (hormone receptors positive or negative)
  • Stage I to III
  • Indication for neoadjuvant therapy with chemo (any regimen) + trastuzumab + pertuzumab
  • Breast surgery after neoadjuvant therapy
  • Preserved coagnition
  • ECOG 0-3
  • For the randomization phase: pathological complete response (ypT0/ypTis and ypN0)
  • Agreement on participation and signature of de ICF

Exclusion criteria

Exclusion Criteria:

  • Contradindication for trastuzumab or pertuzumab
  • Adjuvant chemotherapy. Hormone therapy is allowed
  • Second primary tumor \< 5 years, with an exception for treated non-melanoma skin cancer, and in situ cervical cancer
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Factorial assignment
Masking
None (open label)
Enrollment
80 participants (estimated)

Study arms

  • Active comparator
    Cohort 1, Arm A - trastuzumab

    Adjuvant trastuzumab for patients with HER2 positive CTCs at baseline

    Drug: Trastuzumab · Other: Circulating tumor cells

  • Experimental
    Cohort 1, Arm B - Trastuzumab + pertuzumab

    Adjuvant trastuzumab + pertuzumab for patients with HER2 positive CTCs at baseline

    Drug: Pertuzumab · Drug: Trastuzumab · Other: Circulating tumor cells

  • Active comparator
    Cohort 2, Arm A - trastuzumab

    Adjuvant trastuzumab for patients with HER2 negative/absent CTCs at baseline

    Drug: Trastuzumab · Other: Circulating tumor cells

  • Experimental
    Cohort 2, Arm B - Trastuzumab + pertuzumab

    Adjuvant trastuzumab + pertuzumab for patients with HER2 negative/absent CTCs at baseline

    Drug: Pertuzumab · Drug: Trastuzumab · Other: Circulating tumor cells

Interventions

  • DrugPertuzumab

    Adjuvant trastuzumab + pertuzumab (arm B of the 2 cohorts: 1: HER2 positive CTCs at baseline and 2: HER2 negative/absent CTCs at baseline)

    Also known as: Perjeta

  • DrugTrastuzumab

    Adjuvant trastuzumab (arm A of the 2 cohorts: 1: HER2 positive CTCs at baseline and 2: HER2 negative/absent CTCs at baseline) Association with pertuzumab in arm B of the 2 cohorts

    Also known as: Zedora

  • OtherCirculating tumor cells

    Blood sample collection for examination of CTCs at baseline of neoadjuvant therapy. Tests for HER2 positivity will be done.

    Also known as: CTCs

05

What researchers measure

Primary outcomes

  1. HER2 therapy disease-free survival

    To compare the disease-free survival between trastuzumab and trastuzumab + pertuzumab arms

    Time frame: From adjuvant therapy initiation to recurrence or death by any cause, whichever came first, assessed up to 5 years

  2. CTCs disease-free survival

    To compare the disease-free survival between patients with HER2 positive CTCs at baseline versus HER2 negative/absent CTCs

    Time frame: From adjuvant therapy initiation to recurrence or death by any cause, whichever came first, assessed up to 5 years

Secondary outcomes

  1. Prognostic factors for disease-free survival

    Time frame: At baseline and adjuvant therapy (18 months)

  2. Correlation of CTCs and pathological complete response

    To evaluate if there is a correlation of HER2 positivity and the number of CTCs/ml and the pathological response

    Time frame: At baseline

  3. Adverse events

    To compare the adverse events between trastuzumab and trastuzumab + pertuzumab

    Time frame: Adjuvant period (1 year)

06

Study locations

1 of 1 sites recruiting
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT04993014
Lead sponsor
AC Camargo Cancer Center
Responsible party
Marcelle Goldner Cesca (Clinical Oncologist, AC Camargo Cancer Center) — Principal investigator
First posted
Aug 6, 2021
Start date
Mar 1, 2021
Primary completion
Apr 30, 2024 (estimated)
Completion
Apr 30, 2028 (estimated)
Last update
Aug 6, 2021

Study contacts

Marcelle G Cesca, MD
Contact
marcelle.cesca@accamargo.org.br
+551121895000
Ludmilla TD Chinen, PhD
Contact
ludmilla.chinen@accamargo.org.br
+551121895000
Marcelle G Cesca, MD
principal investigator · A.C. Camargo Cancer Center

Oversight

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

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