Status:

RECRUITING

Neoadjuvant Trastuzumab, Pertuzumab and Tucatinib Without Chemotherapy in HER2-positive Breast Cancer: the TRAIN-4 Study

Lead Sponsor:

The Netherlands Cancer Institute

Collaborating Sponsors:

Seagen Inc.

Conditions:

Breast Cancer

Eligibility:

All Genders

18+ years

Phase:

PHASE1

Brief Summary

This is a single-center, phase 1b study evaluating the safety and feasibility of a neoadjuvant treatment with tucatinib, trastuzumab and pertuzumab in stage II-IIIA HER2-positive breast cancer.

Detailed Description

High pathological complete response (pCR)-rates are seen using different neoadjuvant chemotherapy schedules with trastuzumab and pertuzumab in HER2-positive stage II - III breast cancer patients. Howe...

Eligibility Criteria

Inclusion

  • Signed written informed consent
  • Histologically confirmed primary invasive breast cancer
  • Stage II - IIIA primary breast cancer according to TNM-staging (8th edition, AJCC); (largest tumor diameter on DCE-MRI ≥ 2cm (cT2-3) and/or cN1-2 confirmed with FNA or histology)
  • HER2 overexpression defined as circumferential membrane staining that is complete, intense and in \>10% of invasive tumor cells (IHC 3+) on pre-treatment biopsy
  • Known estrogen- and progesterone-receptor expression of the invasive tumor
  • a. ER-negative or PR-negative is defined as \<10% of invasive tumor cell nuclei are immunoreactive in the presence of evidence that the sample can express ER and/or PR
  • WHO performance status 0-1
  • Age ≥ 18 years
  • LVEF ≥50% measured by echocardiography or MUGA
  • Eligible for neoadjuvant treatment
  • Laboratory requirements within 21 days prior to enrollment:
  • Adequate bone marrow function (ANC ≥1.5 x 109/l, platelets ≥100 x 109/l);
  • Adequate hepatic function (ALAT, ASAT and bilirubin ≤2.5 times upper limit of normal). Subjects with Gilbert's syndrome may have a total bilirubin ≥2.5 × the ULN range, if no evidence of biliary obstruction exists.
  • Adequate renal function: creatinine clearance \>50 ml/min estimated using the Cockcroft-Gault equation or MDRD equation, or based on a 24-hour urine collection measurement.

Exclusion

  • Current pregnancy or breastfeeding
  • Current or previous other malignancy unless treated without systemic therapy and more than five years ago
  • Psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol and follow-up schedule
  • Use of a strong CYP3A4 or CYP2C8 inhibitor within five half-lives of the inhibitor, or used a strong CYP3A4 or CYP2C8 inducer within five days prior to first dose of study treatment
  • Known chronic liver disease
  • History of inflammatory bowel disease or bowel resection
  • Contraindications for MRI
  • Inflammatory breast cancer, cT4 and/or cN3 tumors
  • Occult breast cancer (cT0)

Key Trial Info

Start Date :

December 18 2023

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

May 1 2036

Estimated Enrollment :

30 Patients enrolled

Trial Details

Trial ID

NCT06162559

Start Date

December 18 2023

End Date

May 1 2036

Last Update

January 11 2024

Active Locations (1)

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1

Netherlands Cancer Institute

Amsterdam, Netherlands, 1066CX