Breast CancerPhase 3NCT04335669
NordicTrip, a Translational Study of Preoperative Chemotherapy in TNBC
A Phase 3 study testing epirubicin, cyclophosphamide, paclitaxel, carboplatin, pembrolizumab and epirubicin, cyclophosphamide, capecitabine, paclitaxel, carboplatin, pembrolizumab in people with Breast Cancer and Triple Negative Breast Neoplasms, run by Lund University Hospital at 24 sites in 2 countries.
Trial summary
Primary aim: To compare the effect on pathologic complete response (pCR) rate of adding capecitabine to carboplatin based preoperative chemotherapy in early ER-negative and HER2-negative breast cancer. Pembrolizumab is allowed in both arms after approval for TNBC 2022. Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Breast Cancer, Triple Negative Breast Neoplasms
- What is being tested?
- epirubicin, cyclophosphamide, paclitaxel, carboplatin, pembrolizumab and epirubicin, cyclophosphamide, capecitabine, paclitaxel, carboplatin, pembrolizumab
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 325 participants
- Where
- 24 sitesin 2 countries
- Study dates
- 20 Dec 2019to Sep 2035
- Phase
- Phase 3
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Signed written informed consent approved by the Ethical Review Board (IRB).
- Age ≥ 18 to < 76 years.
- Histologically confirmed unilateral adenocarcinoma of the breast where neoadjuvant chemotherapy followed by definitive surgery is planned.
- Node positive disease (N1-3) or if clinically N0 Tumor size >20 mm. When deciding T-stage the following hierarchy applies,
- MRI
- Ultrasound
Show all 17Show fewer
- Mammography
- Clinical examination
- ER negative tumor defined by at least one the following:
- ER < 1% cells positive by immunohistochemistry (IHC) or ER ≤ 10% cells positive by IHC and basal-like subtype using gene expression analysis
- ER < 10% cells positive by IHC and PgR < 10% cells positive by IHC
- HER2-normal tumor defined according to applicable national guidelines
- Consent for germline mutation screening for BRCA1, BRCA2 and other inherited breast cancer associated genes.
- WHO performance status 0 or 1.
- Negative pregnancy test in women of childbearing potential (premenopausal or <12 months of amenorrhea post-menopause and who have not undergone surgical sterilization).
- Willingness of female patients of childbearing potential, male patients, and their sexual partners to use an effective means of contraception during the treatment period and at least 6 months thereafter.
- Willingness by the patient to undergo treatment and study related procedures according to the protocol.
Who cannot join
- Clinical or radiological signs of metastatic disease.
- History of other malignancy within the last 5 years, except for carcinoma in situ of the cervix or non-melanoma skin cancer.
- Previous chemotherapy for cancer or other malignant disease.
- Charlson comorbidity index, excluding score for malignancy: (CCI) > 2, Comment: In patients 70-75 a CCI = 3 is allowed, see appendix B.
- Inadequate organ function, suggested by the following laboratory results:
- a Absolute neutrophil count < 1,5 x 109/L
Show all 16Show fewer
- b Platelet count < 100 x 109/L
- c Hemoglobin < 90 g/L
- d Total bilirubin greater than the upper limit of normal (ULN) unless the patient has documented Gilbert´s syndrome
- e ASAT (SGOT) and/or ALAT (SGPT) > 2,5 x ULN
- f ASAT (SGOT) and/or ALAT (SGPT) > 1,5 x ULN with concurrent serum alkaline phosphatase (ALP) > 2,5 x ULN
- g Serum creatinine clearance < 50 ml/min
- Concurrent peripheral neuropathy of grade 3 or greater (NCI-CTCAE, Version 5.0).
- Patient who is actively breast feeding.
- Assessed by the Investigator to be unable or unwilling to comply with the requirements of the protocol.
- Patients with known deficiency of the DPD-enzyme who completely lack DPD.
Trial locations and contacts
24 sites in 2 countries.
24 sites in 2 countries
Sweden16 sites
Södra Älvsborgs Hospital
Borås, 501 82
Gävle hospital, Department of Oncology
Gävle, 803 24
Sahlgrenska University Hospital, Department of Oncology
Gothenburg, 413 46
Halmstad Hospital, Department of Surgery
Halmstad, 302 33
Ryhov Hospital
Jönköping, 551 85
Karlstad Hospital
Karlstad, 652 30
Centralsjukhuset i Kristianstad
Kristianstad, Skåne County, 291 85
Skåne University Hospital, Department of Oncology
Malmö, 20501
Örebro University Hospital, Department of Oncology
Örebro, 701 85
Capio S:t Göran Hospital, Department of Oncology
Stockholm, 112 19
Södersjukhuset, Department of Oncology
Stockholm, 118 61
Sundsvall hospital
Sundsvall, 851 86
Norrland University Hospital, Department of Oncology
Umeå, 907 37
Academical Hospital, Department of Oncology
Uppsala, 753 09
Västmanlands Hopsital Västerås
Västerås, 721 89
Växjö Hospital, Department of Oncology
Vaxjo, 352 34
Denmark8 sites
Aalborg Universitetshospita
Aalborg, 9000
Rigshospitalet
Copenhagen, 2100
Sydvestjysk Sygehus
Esbjerg, 6700
Nordsjællands Hospital
Hillerød, 3400
Regionsjælland Næstved Sygehus
Næstved, 4700
Sønderborg sygehus
Sønderborg, 6300
Vejle Hospital
Vejle, Region Syd, 7100
Vejle syghus
Vejle, 7100
About this study
Official title: A Translational Randomized Phase III Study Exploring the Effect of the Addition of Capecitabine to Carboplatine Based Chemotherapy in Early "Triple Negative" Breast Cancer
Primary aim: To compare the effect on pathologic complete response (pCR) rate of adding capecitabine to carboplatin based preoperative chemotherapy in early ER-negative and HER2-negative breast cancer. Pembrolizumab is allowed in both arms after approval for TNBC 2022.
Read the detailed description
Primary aim: Pathological complete response rate after preoperative chemotherapy is the primary end-point of the study, which will be evaluated by comparing the effects of neoadjuvant administration of a carboplatin-based treatment and treatment adding capecitabine on pCR. After the approval of pembrolizumab in the preoperative treatment of early TNBC in 2022 the study will consist of two cohorts, one (cohort 1) without the addition of pembrolizumab, and one (cohort 2) with the addition of pembrolizumab to both study arms. The primary evaluation will be performed on the entire study population including both cohorts.
Primary translational aim: To investigate if the effects of the treatments depend on homologous repair deficiency (HRD)-status. More specifically, the aim is to test for differential effect of the two treatments on pCR for HRD-negative (HRD low and intermediate by oncoscan) and HRD-positive (HRD high by oncoscan) patients.
- Conditions
- Breast Cancer, Triple Negative Breast Neoplasms
- Being tested
- epirubicin, cyclophosphamide, paclitaxel, carboplatin, pembrolizumab, epirubicin, cyclophosphamide, capecitabine, paclitaxel, carboplatin, pembrolizumab
- Keywords
- Breast neoplasms, Triple negative breast neoplasms, Neoadjuvant treatment, Translational research, Pathologic response, Pathologic complete response, epirubicin, cyclophosphamide, paclitaxel, carboplatin, capecitabine, Survival outcomes, Homologous repair deficiency, pembrolizumab
- Medical subject headings
- Breast Neoplasms, Triple Negative Breast Neoplasms, Pathologic Complete Response
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
epirubicin, cyclophosphamide, paclitaxel, carboplatin, pembrolizumabDrug
Also called anthracycline, taxane, platinum
Cytotoxic agents.
epirubicin, cyclophosphamide, capecitabine, paclitaxel, carboplatin, pembrolizumabDrug
Also called anthracycline, taxane, antimetabolite, platinum
Cytotoxic agents.
| Study group | Role | What they receive |
|---|---|---|
| Arm A (Platinum-based dose dense EC): | Active comparator | ddEC x 4 + pembrolizumab→ PK x 4 + pembrolizumab, Two-weekly epirubicin/cyclophosphamide (EC) x 4 (epirubicin 90 mg/m2 and cyclophosphamide 600 mg/m2), followed after a three-week interval by three-weekly carboplatin x 4 (AUC = 5) together with weekly paclitaxel x 12 (80 mg/m2). Pembrolizumab is given as a 400 mg iv dosis every 6 weeks for the duration of preoperative chemotherapy.* Receives: Drug: epirubicin, cyclophosphamide, paclitaxel, carboplatin, pembrolizumab |
| Arm B (Platinum-based with capecitabine): | Experimental | CEX x 4→ PK x 4, Three-weekly cyclophosphamide/epirubicin/capecitabine (CEX) (epirubicin 75 mg/m2, cyclophosphamide 600 mg/m2 and capecitabine 900 mg/m2) x 4, followed after a three-week interval by three-weekly carboplatin x 4 (AUC = 5) together with weekly paclitaxel x 12 (80 mg/m2).Pembrolizumab is given as a 400 mg iv dosis every 6 weeks for the duration of preoperative chemotherapy.*
*The addition of pembrolizumab is strongly recommended to all participating patients. However, patients with a documented contraindication, or unwilling to receive immunotherapy may be included in the study without the administration of pembrolizumab. Receives: Drug: epirubicin, cyclophosphamide, capecitabine, paclitaxel, carboplatin, pembrolizumab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pathological complete response rate.
Rate of pathological complete response, allowing residual dcis, at surgery after preoperative chemotherapy.
Measured: Immediately after surgery
Primary translational outcome.
Pathological complete response rate, allowing residual dcis, stratified for homologous repair deficiency.
Measured: Immediately after surgery
Secondary outcomes (6)
Invasive Disease Free Survival (IDFS)
Invasive disease-free survival
Measured: Throughout the study, an average of 3 years
Overall Survival (OS)
Overall survival
Measured: Throughout the study, an average of 5 years
Breast Cancer Specific Survival (BCSS)
Breast cancer specific survival
Measured: Throughout the study, an average of 3 years
Distant Recurrence Free Survival (DRFS)
Distant recurrence free survival.
Measured: Throughout the study, an average of 3 years
Dose intensity
Actual dosis/dosis per protocol
Measured: Immediately after surgery
Toxicity according to CTCAE version 5.0
Rate of included patients with toxicity grade 3 or greater during study treatment
Measured: Immediately after surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Apr 2020
- Study start20 Dec 2019
- Primary completionSep 2035 (estimated)
- Study completionSep 2035 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 325 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Lund University Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- Swedish Breast Cancer Group, Danish Breast Cancer Cooperative Group
- Responsible party
- Sponsor
- Investigators
- Niklas Loman, MD, PhD, Study director, Lund University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04335669
- Sponsor's protocol ID
- NBG-19-01; SWEBCG 19-01
- Status last verified
- Sep 2025
- First submitted
- 2 Dec 2019
- Last updated
- 12 Sep 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 12 Sep 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Translational Randomized Phase III Study Exploring the Effect of the Addition of Capecitabine to Carboplatine Based Chemotherapy in Early "Triple Negative" Breast Cancer
- ClinicalTrials.gov ID
- NCT04335669
- Acronym / sponsor ID
- NBG-19-01; SWEBCG 19-01
- Conditions
- Breast Cancer, Triple Negative Breast Neoplasms
- Keywords
- Breast neoplasms, Triple negative breast neoplasms, Neoadjuvant treatment, Translational research, Pathologic response, Pathologic complete response, epirubicin, cyclophosphamide
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 325 participants (estimated)
- Lead sponsor
- Lund University HospitalUniversity, hospital or other
- Collaborators
- Swedish Breast Cancer Group, Danish Breast Cancer Cooperative Group
- Study start
- 20 Dec 2019 (actual)
- Primary completion
- Sep 2035 (estimated)
- Study completion
- Sep 2035 (estimated)
- First posted
- 6 Apr 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Primary aim: To compare the effect on pathologic complete response (pCR) rate of adding capecitabine to carboplatin based preoperative chemotherapy in early ER-negative and HER2-negative breast cancer. Pembrolizumab is allowed in both arms after approval for TNBC 2022.
Detailed description
Primary aim: Pathological complete response rate after preoperative chemotherapy is the primary end-point of the study, which will be evaluated by comparing the effects of neoadjuvant administration of a carboplatin-based treatment and treatment adding capecitabine on pCR. After the approval of pembrolizumab in the preoperative treatment of early TNBC in 2022 the study will consist of two cohorts, one (cohort 1) without the addition of pembrolizumab, and one (cohort 2) with the addition of pembrolizumab to both study arms. The primary evaluation will be performed on the entire study population including both cohorts.
Primary translational aim: To investigate if the effects of the treatments depend on homologous repair deficiency (HRD)-status. More specifically, the aim is to test for differential effect of the two treatments on pCR for HRD-negative (HRD low and intermediate by oncoscan) and HRD-positive (HRD high by oncoscan) patients.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Arm A (Platinum-based dose dense EC): | Active comparator | Drug: epirubicin, cyclophosphamide, paclitaxel, carboplatin, pembrolizumabddEC x 4 + pembrolizumab→ PK x 4 + pembrolizumab, Two-weekly epirubicin/cyclophosphamide (EC) x 4 (epirubicin 90 mg/m2 and cyclophosphamide 600 mg/m2), followed after a three-week interval by three-weekly carboplatin x 4 (AUC = 5) together with weekly paclitaxel x 12 (80 mg/m2). Pembrolizumab is given as a 400 mg iv dosis every 6 weeks for the duration of preoperative chemotherapy.* |
| Arm B (Platinum-based with capecitabine): | Experimental | Drug: epirubicin, cyclophosphamide, capecitabine, paclitaxel, carboplatin, pembrolizumabCEX x 4→ PK x 4, Three-weekly cyclophosphamide/epirubicin/capecitabine (CEX) (epirubicin 75 mg/m2, cyclophosphamide 600 mg/m2 and capecitabine 900 mg/m2) x 4, followed after a three-week interval by three-weekly carboplatin x 4 (AUC = 5) together with weekly paclitaxel x 12 (80 mg/m2).Pembrolizumab is given as a 400 mg iv dosis every 6 weeks for the duration of preoperative chemotherapy.* *The addition of pembrolizumab is strongly recommended to all participating patients. However, patients with a documented contraindication, or unwilling to receive immunotherapy may be included in the study without the administration of pembrolizumab. |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (17 listed)
- Signed written informed consent approved by the Ethical Review Board (IRB).
- Age ≥ 18 to < 76 years.
- Histologically confirmed unilateral adenocarcinoma of the breast where neoadjuvant chemotherapy followed by definitive surgery is planned.
- Node positive disease (N1-3) or if clinically N0 Tumor size >20 mm. When deciding T-stage the following hierarchy applies,
- ER negative tumor defined by at least one the following:
Key exclusion criteria (16 listed)
- Clinical or radiological signs of metastatic disease.
- History of other malignancy within the last 5 years, except for carcinoma in situ of the cervix or non-melanoma skin cancer.
- Previous chemotherapy for cancer or other malignant disease.
- Charlson comorbidity index, excluding score for malignancy: (CCI) > 2, Comment: In patients 70-75 a CCI = 3 is allowed, see appendix B.
- Inadequate organ function, suggested by the following laboratory results:
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| epirubicin, cyclophosphamide, paclitaxel, carboplatin, pembrolizumabAlso: anthracycline, taxane, platinumCytotoxic agents. | Drug | Arm A (Platinum-based dose dense EC): |
| epirubicin, cyclophosphamide, capecitabine, paclitaxel, carboplatin, pembrolizumabAlso: anthracycline, taxane, antimetabolite, platinumCytotoxic agents. | Drug | Arm B (Platinum-based with capecitabine): |
Primary outcome
Pathological complete response rate.
Time frame: Immediately after surgery
Rate of pathological complete response, allowing residual dcis, at surgery after preoperative chemotherapy.
Primary translational outcome.
Time frame: Immediately after surgery
Pathological complete response rate, allowing residual dcis, stratified for homologous repair deficiency.
6 secondary outcomes
Invasive Disease Free Survival (IDFS)
Time frame: Throughout the study, an average of 3 years
Overall Survival (OS)
Time frame: Throughout the study, an average of 5 years
Breast Cancer Specific Survival (BCSS)
Time frame: Throughout the study, an average of 3 years
Distant Recurrence Free Survival (DRFS)
Time frame: Throughout the study, an average of 3 years
Dose intensity
Time frame: Immediately after surgery
Toxicity according to CTCAE version 5.0
Time frame: Immediately after surgery
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Sep 2025.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Niklas Loman, MD, PhD study director
Lund University Hospital
24 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing epirubicin, cyclophosphamide, paclitaxel, carboplatin, pembrolizumab and epirubicin, cyclophosphamide, capecitabine, paclitaxel, carboplatin, pembrolizumab in people with Breast Cancer and Triple Negative Breast Neoplasms, run by Lund University Hospital at 24 sites in 2 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 17 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 12 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 24 sites in Sweden, Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pathological complete response rate. (time frame: Immediately after surgery). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Sep 2025.