ClinicalTrials.gg
RecruitingNCT07150208THUMBUpdated Sep 25, 2026

T-DXd With or Without Bevacizumab for HER2-low Breast Cancer With Brain Metastasis

A Phase 2 interventional study of Bevacizumab (Bev) and Trastuzumab Deruxtecan (T-DXd) in Breast Cancer With Brain Metastasis and HER2-low Expressing Breast Cancer, sponsored by Fudan University. Recruiting at 1 site in China. Open to female participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-09-25.

Sponsored by Fudan University · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Oct 2025; still recruiting 1 year later.
Updated Sep 25, 2026Now RecruitingSite recruiting status changed+1 moreGo to Updates ↓

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Phase
Phase 2
Study type
Interventional
Enrollment
140
Allocation
Randomized
Ages
18 Years to 70 Years
Sex
Female
01

Where this study stands

Counted across the records on this site · 2026-11-14

Among 131 studies testing bevacizumab in Breast Neoplasms — 9 open to participants now, 10 under way, none of them phase 3. Bevacizumab · Breast Neoplasms.

Planned enrollment
32nd of 130
140 · median 58
Started
2025
with 1 other
Phase 2
89 of 131
6 open now
Registered
129th of 131
by date

Among the 131 studies testing bevacizumab in Breast Neoplasms, this one is the 32nd largest by planned enrollment of the 130 interventional ones that give a count, is one of 2 that started in 2025, is one of 89 in phase 2, and was the 129th registered.

Breast Neoplasms

14,832 studies on the registry are indexed under Breast Neoplasms; 3,320 are open to participants now.

Browse Breast Neoplasms studies →

Open to participants now

9 of the 131 studies testing bevacizumab in Breast Neoplasms are open now, in 12 countries. Recruiting first, the newest first:

3 more — sign in →

By country, each count listing its studies:

All 9 open studies →

About bevacizumab

Bevacizumab: first FDA approval 2004 (AVASTIN), first EMA approval 2005. What it is approved for, and how studies give it, is on its page →

Who these studies take

Of the 2,399 Breast Neoplasms studies recruiting now, 1,570 (65%) set no upper age limit and 592 (25%) stop at 75 or younger; 103 take children under 18; 215 take healthy volunteers.

This study: 18 Years to 70 Years · female · no healthy volunteers.

The full table on the hub →

This tab as a report to print or save as PDF → With an account.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 131 studies testing bevacizumab in Breast Neoplasms, or all of them as a file.
02

Study summary

A phase II, open-label, multicenter, randomized controlled trial exploring the efficacy and safety of Trastuzumab Deruxtecan combined with or without Bevicizumab in HER2-low breast cancer with brain metastasis.

Read the detailed description

This is a Phase II, open-label, multicenter, randomized controlled trial (THUMB study) comparing the efficacy and safety of trastuzumab deruxtecan (T-DXd) with or without bevacizumab for HER2-low expressing breast cancer with brain metastases. Patients receiving treatment in the metastatic setting must not have received more than 3 lines of therapy (HR-positive patients must have received a CDK4/6 inhibitor). Participants are randomized in a 1:1 ratio to receive treatment with T-DXd combined or not combined with bevacizumab.

03

Conditions studied

  • Breast Cancer With Brain Metastasis
  • HER2-low Expressing Breast Cancer

Keywords

  • Breast Cancer with Brain Metastasis
  • HER2-low Expressing Breast Cancer
  • Trastuzumab Deruxtecan
  • Bevacizumab
04

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
Female
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. score of 0 to 1.
  2. Expected survival period greater than 12 weeks.
  3. confirmed invasive -low expressing breast cancer (specific definition: breast cancer patients with low expression of human epidermal growth factor receptor 2 (HER-2) as determined by pathological testing. Specifically: HER2 IHC 1+ or HER2 IHC++ with FISH/CISH negative. All specimens must be verified by the pathology department of the research participating center.
  4. Tumor stage: recurrent or breast cancer; local recurrence must be confirmed by the researcher to be unable to undergo radical surgical resection.
  5. Patients must have at least one lesion that has not previously received radiation therapy (measurable and/or non-measurable).
  6. MRI or CT shows and meets one of the following conditions:

    i) Untreated brain parenchymal metastasis found by imaging screening; ii) Previously locally treated stable or progressive brain parenchymal metastasis and meets one of the following conditions:a) Imaging stability ≥4 weeks; b) New brain parenchymal metastasis found by MR or CT.

  7. Received no more than 2 after metastasis.
  8. HR-positive patients must have previously received CDK4/6 inhibitor treatment, whether in the treatment phase or in the recurrent metastatic phase.
  9. Never used T-DXd or bevacizumab before.
  10. The main organ functions are basically normal, meeting the following conditions:
  11. Blood routine examination standards must comply with: HB≥90g/L (not transfused within 14 days); ≥1.5×10\^9/L; ≥75×10\^9/L;
  12. Biochemical examination must comply with the following standards: ≤1.5× (upper limit of normal); and AST≤3×ULN; if there is liver metastasis, ALT and AST≤5×ULN; serum Cr ≤1.5×ULN, endogenous rate ≥30mL/min.
  13. Allowed to use mannitol, hormone therapy before enrollment, but the drug treatment dose can be stable for at least one week without the need for an increase.
  14. Female subjects with reproductive capacity need to use one medically recognized method during the study treatment period and for at least 3 months after the last use of the study drug.
  15. Subjects voluntarily join this study, sign an form, have good compliance, and cooperate with follow-up.

Exclusion criteria

Exclusion Criteria:

  1. Received more than 2 .
  2. Used T-DXd or bevacizumab.
  3. Meningeal .
  4. requiring emergency intervention treatment, or brain metastasis requiring treatment with more than 3mg/d of dexamethasone or equivalent medication.
  5. Clinical significant or uncontrolled cardiac disease history, including congestive heart failure, angina, myocardial infarction within the past 6 months, or ventricular arrhythmia.
  6. Ongoing adverse reactions of grade >1 due to previous treatment. The exception is alopecia or those that the researcher believes should not be excluded. Such cases should be clearly documented in the investigator's notes.
  7. Pregnant patients.
  8. History of other within the past 5 years, excluding cured cervical carcinoma in situ, skin basal cell carcinoma, or skin squamous cell carcinoma.
  9. Inability to swallow, chronic diarrhea, and intestinal obstruction, with multiple factors affecting drug intake and absorption.
  10. Third space fluid accumulation (such as massive pleural effusion and ascites) that cannot be controlled by drainage or other methods.
  11. Participated in another antitumor drug clinical trial within 4 weeks before the first administration of the study drug.
  12. Long-term non-healing wounds or incompletely healed fractures.
  13. Known or infection during the active phase or HBV DNA ≥500, or chronic phase with abnormal liver function.
  14. Active primary immunodeficiency, known test positive.
  15. Uncontrolled infection requiring intravenous antibiotics, antiviral drugs, or antifungal drugs.
  16. History of (non-infectious) ILD/pneumonia requiring , currently having ILD/pneumonia, or unable to exclude suspected ILD/pneumonia on imaging during screening.
  17. Pulmonary criteria:
  18. pulmonary comorbidities, including but not limited to any underlying pulmonary disease (e.g., pulmonary embolism, severe asthma, severe , restrictive lung disease, pleural effusion, etc.) within 3 months of study recruitment.
  19. Any disease, connective tissue disease, or inflammatory disease (e.g., rheumatoid arthritis, Sjögren's syndrome, sarcoidosis, etc.) with recorded or suspected pulmonary involvement during screening. All detailed information about the disease should be recorded in the CRF for participants in the study.
  20. Previous total pneumonectomy.
  21. Allergic constitution, or known history of allergy to any component of the study regimen, or allergic to other monoclonal antibodies.
  22. History of gastrointestinal bleeding within the past 6 months or a clear tendency for gastrointestinal bleeding, such as: esophageal varices at risk of bleeding, local active ulcer lesions, fecal occult blood ≥ (++) not eligible for enrollment; if fecal occult blood (+), gastroscopy is required;
  23. Abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 28 days before participating in this study;
  24. Urinalysis shows urine protein ≥++ or confirmed 24-hour urine protein quantitative >1.0g;
  25. Hypertension, and blood pressure cannot be lowered to the normal range with antihypertensive drugs (systolic blood pressure >140mmHg, diastolic blood pressure >90mmHg).
  26. Substance abuse or medical conditions that the researcher believes may interfere with the subject's participation in the clinical study or the assessment of the clinical study results.
Terms in these criteria, in plain language(23)

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.

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.

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.

Metastases

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

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

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.

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.

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.

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.

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.

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.

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.

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.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

05

Study design

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

Study arms

  • Active comparator
    T-DXd

    T-DXd: 5.4mg/kg intravenously (IV) every 3 weeks (Q3W).

    Drug: Trastuzumab Deruxtecan (T-DXd)

  • Experimental
    T-DXd+Bevacizumab

    T-DXd: 5.4mg/kg intravenously (IV) every 3 weeks (Q3W). Bevacizumab: 15mg/kg intravenously (IV) every 3 weeks (Q3W).

    Drug: Bevacizumab (Bev) · Drug: Trastuzumab Deruxtecan (T-DXd)

Interventions

  • Bevacizumab is a drug that targets vascular endothelial growth factor (VEGF) and inhibits tumor angiogenesis, thereby inhibiting tumor growth and spread. In the treatment of breast cancer, Bevacizumab can be used in combination with chemotherapy to improve treatment outcomes and extend patients' progression-free survival and overall survival.

    Also known as: HLX04

  • Trastuzumab deruxtecan (T-DXd) is an antibody-drug conjugate (ADC) composed of an anti-HER2 monoclonal antibody (trastuzumab), a cleavable linker, and a topoisomerase I inhibitor (an exatecan derivative). It targets and binds to HER2-positive tumor cells, internalizes, and releases cytotoxic drugs to induce DNA damage and apoptosis. It also has a "bystander effect" that can kill neighboring tumor cells with low HER2 expression, enhancing anti-tumor activity. T-DXd has shown significant efficacy in HER2-positive advanced breast cancer, with key clinical trials (such as DESTINY-Breast03) confirming that its progression-free survival (PFS) and overall survival (OS) are superior to traditional second-line treatments, with a median PFS reaching 28.8 months. Additionally, for HER2-low-expressing (IHC 1+ or 2+/ISH-) metastatic breast cancer (in the DESTINY-Breast04 study), T-DXd can extend PFS and OS, becoming the first targeted therapy to alter the survival outcomes of such patients.

    Also known as: DS8201

06

What researchers measure

Primary outcomes

  1. Progression Free Survival(PFS)

    Time to progressive disease (according to RECIST1.1)

    Time frame: 12 months

Secondary outcomes

  1. CNS Progression-free survival (CNS-PFS)

    Time from enrollment to the first radiographic documented disease progression (PD) of all CNS target lesions (RANO-BM criteria) or death from any cause without progression was recorded.

    Time frame: 12 months

  2. Objective response rate (ORR)

    Partial response is defined as a decrease by 30% or more in sums of longest diameter of measurable target lesions

    Time frame: 12 months

  3. CNS Objective response rate (CNS-ORR)

    The proportion of patients with complete response (CR) and partial response (PR) evaluated as the best response observed from enrollment to progression of all CNS target lesions assessed according to RANO-BM criteria among the total number of patients who could be evaluated.

    Time frame: 12 months

  4. Overall survival (OS)

    Time from the enrollment to death of any cause

    Time frame: 12 months

  5. Safety and Tolerability

    Safety and Tolerability Will be Assessed According to Standard (CTCAE Version 5.0) Toxicity Reporting Criteria.

    Time frame: 12 months

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it movedSimilar 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 Oct 2025 (actual). Primary completion is estimated for Sep 2027, 23 months after the start.

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 89. This study's planned 23 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.

Start moved once since we started tracking on Sep 25, 2026: Sep 2025 → Oct 2025, on Sep 25, 2026.

Earlier changes are on the record history on ClinicalTrials.gov ↗

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

Registered
Aug 24, 2025
First posted
Sep 2, 2025
StartActual
Oct 20, 2025was Sep 2025
Primary completionEst.
Sep 2027
CompletionEst.
Sep 2028
Last update
Sep 25, 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.
Status
Not yet recruiting→Recruiting
changed Sep 25, 2026
Sites
Fudan University Shanghai Cancer Center is now Recruiting
Sep 25, 2026
Start date
Sep 2025→Oct 20, 2025 (actual)
Sep 25, 2026
Site contacts
Changed at 1 site. See the sites
Show the site
  • Fudan University Shanghai Cancer Center · Shanghai, ChinaContact added l•••@126.com
Sep 25, 2026
Show all 1 update
  1. Sep 25, 2026
    Not yet recruiting→Recruiting
    Fudan University Shanghai Cancer Center is now Recruiting
    Start date Sep 2025→Oct 20, 2025 (now actual)
    Site contacts Changed at 1 site. See the sites
    Show the site
    • Fudan University Shanghai Cancer Center · Shanghai, ChinaContact added l•••@126.com
    + 1 other change: verification date

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
NCT07150208
Lead sponsor
Fudan University
Responsible party
Zhimin Shao (Professor, Fudan University) — Principal investigator
First posted
Sep 2, 2025
Start date
Oct 20, 2025
Primary completion
Sep 2027 (estimated)
Completion
Sep 2028 (estimated)
Last update
Sep 25, 2026

Study contacts

Zhimin Shao, Professor
Contact
zhimingshao@yahoo.com
08664175590 Ext. 88807
Guantian Lang, Doctor
Contact
langguantian@126.com
08664175590 Ext. 65277

Oversight

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

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Studies of the drug tested here: Bevacizumab

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