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RecruitingNCT05918328Updated Mar 7, 2025

Comparing the Efficacy of Nab-PH+Pyrrolitinib and TCbHP in the Neoadjuvant Treatment of HER2 Positive BC

A Phase 2 interventional study of Albumin paclitaxel+trastuzumab+pyrrolitinib and Docetaxel+Carboplatin+trastuzumab+Parstuzumab in Breast Cancer and HER2-positive Breast Cancer, sponsored by Henan Cancer Hospital. Recruiting at 1 site in China. Open to female participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2025-03-07.

Sponsored by Henan Cancer Hospital · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Dec 2025, 10 months ago, but the record still lists the study as recruiting.
  • Started May 2023; still recruiting 3 years 5 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
610
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
Female
01

Study summary

At present, the incidence rate of breast cancer has exceeded that of lung cancer, becoming the largest cancer in the world. HER2 overexpression breast cancer accounts for about 20%\~30% of all breast cancer patients. HER2 is an important prognostic indicator and therapeutic target for breast cancer. Targeted therapy for HER2 protein is the core treatment of this type of breast cancer. Previous studies have confirmed that TKI drugs can reverse the resistance of large molecule monoclonal antibodies to a certain extent; Moreover, due to the complementarity of therapeutic targets, monoclonal antibodies are associated with TKI Drugs have synergistic effects. TCbHP is one of the preferred neoadjuvant chemotherapy schemes recommended by NCCN guidelines for HER2 positive breast cancer, but its incidence of adverse reactions such as vomiting, diarrhea, anemia, thrombocytopenia is significantly higher than that of the scheme without platinum. In the GeparOcto study and Geparsixto study, based on anthracycline+purple shirt+double target, the addition of carboplatin did not further improve the PCR rate of HER2 positive breast cancer neoadjuvant therapy. GeparSepto research showed that compared to the solvent based paclitaxel group, albumin paclitaxel increased the pCR rate by 8.2% and the IDFS by 7.3%. In the CA024 study, compared to docetaxel, albumin paclitaxel also significantly increased ORR and PFS. In the study by Lavasani SM et al., the neoadjuvant therapy of albumin paclitaxel combined with topiramate achieved a PCR rate of 64%. Therefore, we assume that the new adjuvant treatment scheme of Nab PH+pyrrolitinib can not be inferior to the efficacy of TCbHP, and has a lower incidence of adverse reactions, which may become a new adjuvant treatment option for HER2 positive breast cancer patients.

Read the detailed description

At present, the incidence rate of breast cancer has exceeded that of lung cancer, becoming the largest cancer in the world. HER2 overexpression breast cancer accounts for about 20%\~30% of all breast cancer patients. HER2 is an important prognostic indicator and therapeutic target for breast cancer. Targeted therapy for HER2 protein is the core treatment of this type of breast cancer. Previous studies have confirmed that TKI drugs can reverse the resistance of large molecule monoclonal antibodies to a certain extent; Moreover, due to the complementarity of therapeutic targets, monoclonal antibodies are associated with TKI Drugs have synergistic effects. TCbHP is one of the preferred neoadjuvant chemotherapy schemes recommended by NCCN guidelines for HER2 positive breast cancer, but its incidence of adverse reactions such as vomiting, diarrhea, anemia, thrombocytopenia is significantly higher than that of the scheme without platinum. In the GeparOcto study and Geparsixto study, based on anthracycline+purple shirt+double target, the addition of carboplatin did not further improve the PCR rate of HER2 positive breast cancer neoadjuvant therapy. GeparSepto research showed that compared to the solvent based paclitaxel group, albumin paclitaxel increased the pCR rate by 8.2% and the IDFS by 7.3%. In the CA024 study, compared to docetaxel, albumin paclitaxel also significantly increased ORR and PFS. In the study by Lavasani SM et al., the neoadjuvant therapy of albumin paclitaxel combined with topiramate achieved a PCR rate of 64%. Therefore, we assume that the new adjuvant treatment scheme of Nab PH+pyrrolitinib can not be inferior to the efficacy of TCbHP, and has a lower incidence of adverse reactions, which may become a new adjuvant treatment option for HER2 positive breast cancer patients. This study aims to explore the efficacy and safety of TCbHP * 6 and Nab-PH+pyrrolitinib * 6 as two new adjuvant treatment regimens in HER2 positive patients through a randomized controlled trial.

02

Conditions studied

  • Breast Cancer
  • HER2-positive Breast Cancer

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Keywords

  • HER2-positive Breast Cancer
  • pathologic complete response
  • Pyrrolitinib
  • Disease-free survival
03

In context

Breast Neoplasms

12,544 studies on the registry are indexed under Breast Neoplasms; 2,892 are open to participants now.

This study's planned enrollment of 610 is above the median of 72 across 9,302 interventional studies indexed under Breast Neoplasms.

Browse Breast Neoplasms studies →

Lead sponsor

Henan Cancer Hospital is the lead sponsor of 228 studies on the registry; 130 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  1. Age: 18-65 years old, ECOG 0-1 point.
  2. Clinical T2-T4d, or T1c with axillary LN+.
  3. HER2+, invasive breast cancer confirmed by histopathology;(HER2 positive expression means that there is at least one case of tumor cell immunohistochemical staining intensity of 3+or positive confirmed by fluorescence in situ hybridization [FISH] in the pathological test/review of the primary focus conducted by the Pathology Department of the Research Center Hospital).
  4. Having clinically measurable lesions: measurable lesions displayed on ultrasound, mammography, or MR (optional) within the first month of randomization.
  5. Organ and bone marrow function tests within one month before chemotherapy indicate no contraindications to chemotherapy:Absolute value of neutrophil count ≥ 2.0 × 109/L; Hemoglobin ≥ 90g/L; Platelet count ≥ 100 × 109/L;Total bilirubin\<1.5 ULN (upper limit of normal value); Creatinine\<1.5 × ULN; AST/ALT \< 1.5 × ULN.
  6. Cardiac ultrasound: Left ventricular ejection fraction (LVEF ≥ 55%).
  7. Women of childbearing age tested negative for serum pregnancy test 14 days before randomization.
  8. Sign an informed consent form.

Exclusion criteria

Exclusion Criteria:

  1. Stage IV (metastatic) breast cancer.
  2. Has received chemotherapy, endocrine therapy, targeted therapy, reflex therapy, etc. for this disease.
  3. The patient has a second primary malignant tumor, except for fully treated skin cancer.
  4. The patient had undergone major surgical procedures unrelated to breast cancer within 4 weeks before enrollment, or the patient has not fully recovered from such surgical procedures.
  5. Serious heart disease or discomfort, including but not limited to the following diseases:Confirmed history of heart failure or systolic dysfunction (LVEF\<50%); High risk uncontrolled arrhythmias, such as atrial tachycardia, resting heart rate>100 bpm, significant ventricular arrhythmias (such as ventricular tachycardia), or higher-level atrioventricular block; Angina pectoris requiring treatment with anti angina drugs; Clinically significant heart valve disease; ECG shows transmural myocardial infarction; Poor control of hypertension (systolic blood pressure>180 mmHg and/or diastolic blood pressure>100 mmHg).
  6. Due to serious and uncontrollable other medical diseases, researchers believe that there are contraindications to chemotherapy.
  7. Individuals with a known history of allergies to the drug components of this protocol; Having a history of immunodeficiency, including HIV testing positive, or suffering from other acquired or congenital immunodeficiency diseases, or having a history of organ transplantation.
05

Study design

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

Study arms

  • Experimental
    Nab-PH+pyrrolitinib regimen group

    Drug dose of Nab PH+pyrrolitinib scheme: albumin paclitaxel (260mg/㎡ every 3 weeks or 125mg/㎡ weekly)+trastuzumab (initial loading dose 8 mg/kg, sequential maintenance dose 6 mg/kg, once every 3 weeks)+pyrrolitinib (320mg, QD), 3 weeks as one cycle.

    Drug: Albumin paclitaxel+trastuzumab+pyrrolitinib

  • Placebo comparator
    TCbHP regimen group

    The drug dose of TCbHP protocol: docetaxel 75 mg/m2+carboplatin (AUC=6)+trastuzumab (initial load dose 8 mg/kg, sequential maintenance dose 6 mg/kg)+patuzumab (initial load dose 840mg, sequential maintenance dose 420 mg), one cycle every 21 days.

    Drug: Docetaxel+Carboplatin+trastuzumab+Parstuzumab

Interventions

  • DrugAlbumin paclitaxel+trastuzumab+pyrrolitinib

    albumin paclitaxel (260mg/㎡ every 3 weeks or 125mg/㎡ weekly)+trastuzumab (initial loading dose 8 mg/kg, sequential maintenance dose 6 mg/kg, once every 3 weeks)+pyrrolitinib (320mg, QD), 3 weeks as one cycle.

    Also known as: Nab-PH+pyrrolitinib regimen

  • DrugDocetaxel+Carboplatin+trastuzumab+Parstuzumab

    Docetaxel 75 mg/m2+carboplatin (AUC=6)+trastuzumab (initial loading dose 8 mg/kg, sequential maintenance dose 6 mg/kg)+patuzumab (initial loading dose 840mg, sequential maintenance dose 420 mg), one cycle every 21 days

    Also known as: TCbHP regimen

06

What researchers measure

Primary outcomes

  1. Pathological complete response rate (pCR rate)

    After neoadjuvant chemotherapy and surgery, the resected specimen (breast + axilla) was free of any invasive cancer (ie, ypT0/is, ypN0)

    Time frame: immediately after the intervention

Secondary outcomes

  1. Event-Free Survival (EFS)

    EFS was defined as the time from randomization to any of the following events: disease progression during neoadjuvant therapy, local or distant recurrence, second primary malignancy (breast or other cancer), or death from any cause.

    Time frame: 5-10 years after surgery

  2. DFS

    Disease-free Survival,From the date of surgery to the first local, regional, contralateral or distant recurrence, and death from any cause

    Time frame: 5-10 years after surgery

  3. Distant Disease Free Survival (DDFS)

    DDFS is defined as the time from surgery to distant recurrence or death from any cause

    Time frame: 5-10 years after surgery

  4. Objective Response Rate (ORR)

    ORR is defined as the number of target lesion responders as assessed by MRI

    Time frame: Preoperative

  5. number of adverse events

    Evaluate the nature, incidence and severity of chemotherapy adverse events according to CTCAE 5.0

    Time frame: during each cycle of chemotherapy (21 days as 1 cycle)

Other outcomes

  1. Multiple gene testing

    Exploring Multiple Gene Prediction Models for PCR Influencing Different Neoadjuvant Therapy Schemes

    Time frame: immediately after surgery

07

Study locations

1 of 1 sites recruiting
  • Henan cancer hospital
    Zhengzhou, Henan, China
    • Zhen Liu · Contact · 18603723729
    Recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 7, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT05918328
Lead sponsor
Henan Cancer Hospital
Responsible party
Sponsor
First posted
Jun 26, 2023
Start date
May 3, 2023
Primary completion
Dec 2025 (estimated)
Completion
Dec 2026 (estimated)
Last update
Mar 7, 2025

Study contacts

Zhenzhen Liu
Contact
liuzhenzhen73@126.com
13603862755
Dechuang Jiao
Contact
jiaodechuang@163.com
13598004327
Zhenzhen Liu
principal investigator · Study Principal Investigator

Oversight

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

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