ClinicalTrials.gg
RecruitingNCT05020860RESPONSEUpdated Feb 27, 2025

Correlation of Clinical Response to Pathologic Response in Patients With Early Breast Cancer

A Phase 2 interventional study of Paclitaxel and Carboplatin in Breast Cancer, Breast Neoplasm and Breast Cancer Female, sponsored by Baylor Breast Care Center. Recruiting at 2 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-02-27.

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 Baylor Breast Care Center · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Apr 2023; still recruiting 3 years 6 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
185
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is to learn whether clinical response (the amount a tumor shrinks based on imaging or tumor measurements obtained by physical exam) predicts pathologic response (the amount of tumor remaining when surgery is performed) in participants with breast cancer who are receiving chemotherapy prior to surgery.

Read the detailed description

Neoadjuvant therapy was first introduced to improve surgical outcomes of breast cancer and to be able to assess the pathological responsiveness to therapy at the time of surgery. Over time, it became a useful experimental platform in clinical research in breast cancer, and in recent years became an important part of standard management of certain subtypes and clinical stages in breast cancer.

It has been long established that patients who achieve pathologic complete response (pCR, i.e., the absence of any cancer in the tissue removed during surgery) after receiving neoadjuvant treatment have better outcomes than those who don't, especially in HER2+, and triple-negative breast cancer (TNBC). Many reports add aggressive ER+ breast cancer to these groups. So far, the only way to know whether a patient achieved pCR is to give them a full course of therapy and then proceed to surgery.

One of the areas that has attracted significant research interest has been the effort to develop early predictors of pCR. This way, treatment can be tailored in the future to each patient and each tumor and can spare patients ineffective therapy. Some of these predictors include tissue biomarkers, blood based biomarkers, and imaging biomarkers.

It has been observed in neoadjuvant clinical trials that many patients have an impressive early clinical response to treatment after 1-2 cycles of treatment. Anecdotally, many of those patients go on to have a pCR at the time of surgery. This observation, if validated in a prospective clinical trial, may lead to a simple, inexpensive way to assess tumor responsiveness and predict pCR using clinical exam and simple imaging.

Using imaging or molecular changes to predict pCR will also be explored in this study. A consortium of investigators will be studying image analysis and proteogenomic changes early in the course of treatment to predict clinical response specifically in participants with TNBC. Only participants with TNBC will be required to undergo a research biopsy and research MRI prior to starting treatment, and again after the first cycle of treatment.

The investigators therefore hypothesize that absence of early clinical response, defined as at least a 30% reduction in the size of the breast tumor by Day 21 of treatment (as measured by either imaging or clinical exam), will be associated with absence of pCR at the time of surgery, in 3 subtypes of breast cancer - TNBC, HER2+, high-risk ER+.

All treatment in this study is standard of care (non-investigational).

02

Conditions studied

  • Breast Cancer
  • Breast Neoplasm
  • Breast Cancer Female
  • Breast Cancer Invasive
  • Breast Cancer Stage II
  • Breast Cancer Stage III
  • Triple Negative Breast Cancer
  • Hormone Receptor-positive Breast Cancer
  • HER2-positive Breast Cancer
  • Triple Negative Breast Neoplasms
  • Estrogen Receptor-positive Breast Cancer

Browse trials for

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 185 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

Baylor Breast Care Center is the lead sponsor of 16 studies on the registry; 1 is 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 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

  • At least 18 years of age, and legally able to provide . Both men and women are eligible.
  • confirmed, invasive breast cancer. Tumor may be triple negative (as defined by ASCO-CAP guidelines), -positive (as defined by ASCO-CAP guidelines), or high-risk estrogen receptor positive (as defined by ASCO-CAP guidelines).

To be considered "high risk," at least 2 of the following criteria must be met: 1) histologic grade 3; 2) patient age 50 or less; 3) ER Allred score \< 6; 4) Ki-67 ≥ 30%.

  • Tumors must be at least 2 cm by clinical exam or ultrasound
  • Bilateral breast cancers are allowed if the following criteria are met: 1) A lesion on one side (meeting the criteria above) is designated as the index lesion on which study assessments will be performed, and 2) the same treatment regimen is appropriate for both cancers as determined by the treating physician.
  • performance status of 0 or 1
  • (LVEF) ≥ the institutional lower limit of normal, as assessed by echocardiogram or Multigated Acquisition (MUGA )scan.
  • Adequate organ function, as determined by the following parameters:

    • (ANC) ≥ 1200/mm3
    • ≥ 100,000/mm3
    • ≥ 9 g/dL
    • Total ≤ institutional (ULN), unless patient has Gilbert's disease or similar syndrome
    • Alkaline phosphatase (ALP) ≤ 2.5 x institutional ULN
    • (AST)/alanine aminotransferase (ALT) ≤ 1.5 x institutional ULN
    • Serum creatinine ≤ institutional ULN
  • The participant, if of , is willing to use effective, non-hormonal while on treatment.
  • Participation in a concurrent clinical trial is permitted, with Principal Investigator approval.

Exclusion criteria

Exclusion Criteria:

  • Definitive clinical or radiologic evidence of Stage IV disease
  • Inflammatory breast cancer
  • Participants who are pregnant or lactating
  • History of an excisional or lumpectomy performed prior to study entry
  • Prior treatment with anthracyclines for any .
  • Prior treatment for currently diagnosed breast cancer (i.e., endocrine therapy, chemotherapy, targeted therapy, or radiation.
  • History of cardiac disease that would preclude the use of drugs included in these treatment regimens. This includes, but is not limited to:

    • Angina pectoris requiring the use of anti-anginal medication
    • Ventricular arrhythmias except for benign premature ventricular contractions
    • Supraventricular and nodal arrhythmias requiring a pacemaker or not controlled with medication
    • Conduction abnormality requiring a pacemaker
    • Valvular disease with documented compromise in cardiac function
    • Symptomatic pericarditis
    • Documented cardiomyopathy
    • History of documented congestive heart failure (CHF)
    • Myocardial infarction documented by elevated cardiac enzymes, or persistent regional wall abnormalities on assessment of left ventricular function.
  • Current , , or infection
  • History of non-breast malignancies (with the exception of in situ cancers treated only by local excision, and basal cell or squamous cell carcinoma of the skin) within 5 years prior to enrollment.
  • Any other non-malignant systemic disease that would preclude treatment with any of the treatment regimens or prevent required follow-up.
  • Any psychiatric or addictive disorders, adverse social situations, or other medical conditions that, in the opinion of the investigator, would preclude the patient from meeting study requirements.
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.

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.

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.

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.

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.

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.

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.

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.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
185 participants (estimated)

Study arms

  • Active comparator
    Triple Negative Breast Cancer (for tumors > 5 cm)

    Paclitaxel IV plus carboplatin IV (+/- pembrolizumab IV) (4 cycles total), followed by doxorubicin IV plus cyclophosphamide IV (+/- pembrolizumab IV) (4 cycles total)

    Drug: Paclitaxel · Drug: Carboplatin · Drug: Doxorubicin · Drug: Cyclophosphamide · Drug: Pembrolizumab

  • Active comparator
    Triple Negative Breast Cancer (for tumors < 5 cm)

    Paclitaxel IV (4 cycles total), followed by doxorubicin IV plus cyclophosphamide IV (4 cycles total)

    Drug: Paclitaxel · Drug: Doxorubicin · Drug: Cyclophosphamide

  • Active comparator
    HER2-Positive Breast Cancer

    Paclitaxel IV plus Trastuzumab IV plus Pertuzumab IV (or PHESGO) (4 cycles total), followed by doxorubicin IV plus cyclophosphamide IV administered (4 cycles total)

    Drug: Paclitaxel · Drug: Trastuzumab · Drug: Pertuzumab · Drug: Doxorubicin · Drug: Cyclophosphamide · Drug: Pertuzumab/Trastuzumab/Hyaluronidase-zzxf

  • Active comparator
    Hormone Receptor Positive Breast Cancer

    Paclitaxel IV plus Carboplatin IV (4 cycles total), followed by doxorubicin IV plus cyclophosphamide IV (4 cycles total)

    Drug: Paclitaxel · Drug: Doxorubicin · Drug: Cyclophosphamide

Interventions

  • 80 mg/m2 IV administered on Days 1, 8, 15 of each 21-day cycle

    Also known as: Taxol

  • Carboplatin AUC 1.5 IV administered on Days 1, 8, 15 of each 21-day cycle

  • Trastuzumab 8 mg/kg loading dose, followed by 6 mg/kg maintenance dose, administered on Day 1 of each 21-day cycle

    Also known as: Herceptin

  • Pertuzumab 840 mg loading dose, followed by 420 mg maintenance dose, administered on Day 1 of each 21-day cycle

    Also known as: Perjeta

  • 60 mg/m2 IV administered on Day 1 of each 14-day cycle

    Also known as: Adriamycin

  • 600 mg/m2 IV administered on Day 1 of each 14-day cycle

    Also known as: Cytoxan

  • Either 200 mg IV administered on Day 1 of Cycles 1-4, or 400 mg IV administered on Day 1 of Cycles 1 and 3 of the paclitaxel/carboplatin regimen. 400 mg on Day 1 of Cycles 1 and 4 of the dose-dense AC regimen.

    Also known as: Keytruda

  • DrugPertuzumab/Trastuzumab/Hyaluronidase-zzxf

    Drug page: Pertuzumab/Trastuzumab/Hyaluronidase-zzxf

    Can be used in place of separate IV formulations of pertuzumab and trastuzumab. 1200 mg pertuzumab/600 mg trastuzumab/30,000 U hyaluronidase administered subcutaneously on Day 1 of the first cycle, followed by a maintenance dose of 600 mg pertuzumab/600 mg trastuzumab/20,000 U hyaluronidase administered subcutaneously every 3 weeks.

    Also known as: PHESGO

06

What researchers measure

Primary outcomes

  1. Change in Clinical Tumor Measurement vs. Pathologic Response

    Clinical tumor measurements are tumor measurements obtain via imaging (mammogram or ultrasound) or by physical exam. Pathologic response is the amount of tumor remaining at the time of surgery, as determined by the pathologist.

    Time frame: Baseline and at surgery (after 20 weeks)

Secondary outcomes

  1. Pathologic Complete Response Rate in each Breast Cancer Subtype

    A pathologic complete response (pCR) means that there is no residual invasive cancer identified in the tissue removed at surgery. The frequency of pCR will be estimated for each breast cancer subtype (triple negative, hormone receptor positive, and HER2-positive)

    Time frame: 20 weeks

  2. Predictive value of clinical response following 1 cycle of chemotherapy to predict pathologic complete response

    This aims to determine whether a 30 percent reduction in tumor size (as measured by physical exam or imaging) following one cycle of chemotherapy can predict whether a patient will have no residual invasive cancer at the time of surgery

    Time frame: 20 weeks

Other outcomes

  1. Change in circulating tumor DNA (ctDNA) levels from baseline to surgery

    ctDNA is DNA from a tumor circulating in a patient's bloodstream. The goal of this is to determine whether a decrease in ctDNA levels (as measured from baseline to surgery) correlates to clinical and/or pathologic response

    Time frame: 20 weeks

07

Study locations

2 of 2 sites recruiting
  • Harris Health System - Smith Clinic
    Houston, Texas 77054, United States
    Recruiting
  • O'Quinn Medical Tower - McNair Campus - Dan L Duncan Comprehensive Cancer Center
    Houston, Texas 77054, United States
    Recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 27, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT05020860
Lead sponsor
Baylor Breast Care Center
Responsible party
Mothaffar Rimawi (Professor, Baylor Breast Care Center) — Principal investigator
First posted
Aug 25, 2021
Start date
Apr 18, 2023
Primary completion
Aug 2027 (estimated)
Completion
Nov 2029 (estimated)
Last update
Feb 27, 2025

Study contacts

Maria Rodriguez
Contact
bcc-clinicalresearch@bcm.edu
(713) 798-8347
Mothaffar Rimawi, MD
principal investigator · Baylor College of Medicine

Oversight

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

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