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A Prospective, Randomized Multicenter, Open-label Comparison of Preoperative Trastuzumab Emtansine (T-DM1) With or Without Standard Endocrine Therapy vs. Trastuzumab With Standard Endocrine Therapy Given for Twelve Weeks in Patients With Operable HER2+/HR+ Breast Cancer Within the ADAPT Protocol.


Phase 2
18 Years
75 Years
Open (Enrolling)
Female
Breast Cancer

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Trial Information

A Prospective, Randomized Multicenter, Open-label Comparison of Preoperative Trastuzumab Emtansine (T-DM1) With or Without Standard Endocrine Therapy vs. Trastuzumab With Standard Endocrine Therapy Given for Twelve Weeks in Patients With Operable HER2+/HR+ Breast Cancer Within the ADAPT Protocol.


the neoadjuvant therapy Patients with HER2+/HR+ (HER2+ and ER+ and/or PR+) tumor will
receive single agent T-DM1 for 12 weeks (3,6 mg/kg q3w) with or without standard endocrine
therapy (tamoxifen in premenopausal women and an aromatase inhibitor in postmenopausal
women, if not contraindications are present, in a standard daily dosage). The control group
will receive trastuzumab in 3-weekly schedule (8 mg/kg as loading dose and then 6 mg/kg q3w)
in combination with the same standard endocrine therapy, if no contraindications are
existent.


Inclusion Criteria:



- Female patients, age at diagnosis 18 - 75 years

- Histologically confirmed unilateral primary invasive carcinoma of the breast

- Clinical T1 - T4 (except inflammatory breast cancer)

- All clinical N (cN)

- No clinical evidence for distant metastasis (M0)

- Known HR status and HER2 status (local pathology) Tumor block available for central
pathology review

- Performance Status ECOG ≤ 1 or KI ≥ 80%

- Negative pregnancy test (urine or serum) within 7 days prior to start of inducion
treatment in premenopausal patients

- Written informed consent prior to beginning specific protocol procedures, including
expected cooperation of the patients for the treatment and follow-up, must be
obtained and documented according to the local regulatory requirements

- The patient must be accessible for treatment and follow-up

Additional Inclusion criteria for participation in the HER2+/HR+ sub-protocol:

- Confirmed ER and/or PR positive and HER2+ by central pathology

- Clinical cT1c - T4a-c (participation of patients with tumors >cT2 is strongly
recommended)

- All clinical N (participation of patients with cN0, if cT1c is strongly recommended)

- Patients must qualify for neoadjuvant treatment

- LVEF > 50%; LVEF within normal limits of each institution measured by
echocardiography and normal ECG (within 42 days prior to induction treatment)

Exclusion Criteria:

- Known hypersensitivity reaction to the compounds or incorporated substances

- Prior malignancy with a disease-free survival of < 10 years, except curatively
treated basalioma of the skin, pTis of the cervix uteri

- Non-operable breast cancer including inflammatory breast cancer

- Previous or concurrent treatment with cytotoxic agents for any reason after
consultation with the sponsor

- Concurrent treatment with other experimental drugs. Participation in another clinical
trial with any investigational not marketed drug within 30 days prior to study entry

- Male breast cancer

- Concurrent pregnancy; patients of childbearing potential must implement

- a highly effective (less than 1% failure rate) non-hormonal contraceptive measures
during the study treatment

- Breast feeding woman

- Sequential breast cancer

- Reasons indicating risk of poor compliance Patient not able to consent

Additional Exclusion Criteria for participation in the HER2+/HR+ sub-protocol:

- Known polyneuropathy ≥ grade 2

- Severe and relevant co-morbidity that would interact with the application of
cytotoxic agents or the participation in the study

- Inadequate organ function (e.g. hepatic impairment, pulmonary disease, etc.)

- Uncompensated cardiac function (current unstable ventricular arrhythmia

- requiring treatment, history of symptomatic CHF NYHA classes II-IV), history of
myocardial infarction or unstable angina pectoris within 6 months of enrollment,
history of severe hypertension, CAD - coronary artery disease)

- Severe dyspnea

- Pneumonitis

Abnormal blood values:

- Thrombocytopenia > CTCAE grade 1

- Increases in ALT/AST > CTCAE grade 1

- Hypokalaemia > CTCAE grade 1

- Neutropenia > CTCAE grade 1

- Anaemia > CTCAE grade 1

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Comparison of the pCR rates in patients with HER2+/HR+ breast cancer treated by preoperative T-DM1 with or without standard endocrine therapy or trastuzumab with endocrine therapy.

Outcome Description:

pCR will be measured after 12 weeks of randomized treatment.

Outcome Time Frame:

After 12 weeks

Safety Issue:

No

Principal Investigator

Nadia Harbeck, Prof. Dr.

Investigator Role:

Principal Investigator

Investigator Affiliation:

Breast Center of the University of Munich (LMU), Universitätsfrauenklinik Großhadern, Munich, Germany

Authority:

Germany: Federal Institute for Drugs and Medical Devices

Study ID:

WSG-AM06/ADAPT HER2+/HR+

NCT ID:

NCT01745965

Start Date:

November 2012

Completion Date:

October 2019

Related Keywords:

  • Breast Cancer
  • Breast Neoplasms

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