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Breast CancerPhase 2RESPONSENCT05020860

Correlation of Clinical Response to Pathologic Response in Patients With Early Breast Cancer

A Phase 2 study testing Paclitaxel, Carboplatin and Trastuzumab in people with Breast Cancer and Breast Neoplasm, run by Baylor Breast Care Center at 2 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The purpose of this study is to learn whether clinical response (the amount a tumor shrinks based on imaging or tumor measurements obtained by physical exam) predicts pathologic response (the amount of tumor remaining when surgery is performed) in participants with breast cancer who are receiving chemotherapy prior to… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Paclitaxel, Carboplatin and Trastuzumab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
185 participants
Where
2 sitesUnited States
Study dates
18 Apr 2023to Nov 2029
Phase
Phase 2
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • At least 18 years of age, and legally able to provide informed consent. Both men and women are eligible.
  • Histologically confirmed, invasive breast cancer. Tumor may be triple negative (as defined by ASCO-CAP guidelines), HER2-positive (as defined by ASCO-CAP guidelines), or high-risk estrogen receptor positive (as defined by ASCO-CAP guidelines).
  • To be considered "high risk," at least 2 of the following criteria must be met: 1) histologic grade 3; 2) patient age 50 or less; 3) ER Allred score < 6; 4) Ki-67 ≥ 30%.
  • Tumors must be at least 2 cm by clinical exam or ultrasound
  • Bilateral breast cancers are allowed if the following criteria are met: 1) A lesion on one side (meeting the criteria above) is designated as the index lesion on which study assessments will be performed, and 2) the same treatment regimen is appropriate for both cancers as determined by the treating physician.
  • ECOG performance status of 0 or 1
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  • Left ventricular ejection fraction (LVEF) ≥ the institutional lower limit of normal, as assessed by echocardiogram or Multigated Acquisition (MUGA )scan.
  • Adequate organ function, as determined by the following parameters:
  • Absolute Neutrophil Count (ANC) ≥ 1200/mm3
  • Platelets ≥ 100,000/mm3
  • Hemoglobin ≥ 9 g/dL
  • Total bilirubin ≤ institutional upper limit of normal (ULN), unless patient has Gilbert's disease or similar syndrome
  • Alkaline phosphatase (ALP) ≤ 2.5 x institutional ULN
  • Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ≤ 1.5 x institutional ULN
  • Serum creatinine ≤ institutional ULN
  • The participant, if of childbearing potential, is willing to use effective, non-hormonal contraception while on treatment.
  • Participation in a concurrent clinical trial is permitted, with Principal Investigator approval.

Who cannot join

  • Definitive clinical or radiologic evidence of Stage IV disease
  • Inflammatory breast cancer
  • Participants who are pregnant or lactating
  • History of an excisional biopsy or lumpectomy performed prior to study entry
  • Prior treatment with anthracyclines for any malignancy.
  • Prior treatment for currently diagnosed breast cancer (i.e., endocrine therapy, chemotherapy, targeted therapy, or radiation.
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  • History of cardiac disease that would preclude the use of drugs included in these treatment regimens. This includes, but is not limited to:
  • Angina pectoris requiring the use of anti-anginal medication
  • Ventricular arrhythmias except for benign premature ventricular contractions
  • Supraventricular and nodal arrhythmias requiring a pacemaker or not controlled with medication
  • Conduction abnormality requiring a pacemaker
  • Valvular disease with documented compromise in cardiac function
  • Symptomatic pericarditis
  • Documented cardiomyopathy
  • History of documented congestive heart failure (CHF)
  • Myocardial infarction documented by elevated cardiac enzymes, or persistent regional wall abnormalities on assessment of left ventricular function.
  • Current HIV, hepatitis B, or hepatitis C infection
  • History of non-breast malignancies (with the exception of in situ cancers treated only by local excision, and basal cell or squamous cell carcinoma of the skin) within 5 years prior to enrollment.
  • Any other non-malignant systemic disease that would preclude treatment with any of the treatment regimens or prevent required follow-up.
  • Any psychiatric or addictive disorders, adverse social situations, or other medical conditions that, in the opinion of the investigator, would preclude the patient from meeting study requirements.

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

United States2 sites, 2 recruiting
  • Harris Health System - Smith Clinic

    Houston, Texas, 77054

    Maria Rodriguez, 713-798-8347, bcc-clinicalresearch@bcm.edu

    Mothaffar Rimawi, MD

    Recruiting
  • O'Quinn Medical Tower - McNair Campus - Dan L Duncan Comprehensive Cancer Center

    Houston, Texas, 77054

    Maria Rodriguez, 713-798-8347, bcc-clinicalresearch@bcm.edu

    Mothaffar Rimawi, MD

    Recruiting

Other trials in United States

About this study

Official title: A Phase II Trial to Correlate Early Clinical Response to Pathologic Outcome With Neoadjuvant Systemic Therapy in Patients With Early Stage Breast Cancer

The purpose of this study is to learn whether clinical response (the amount a tumor shrinks based on imaging or tumor measurements obtained by physical exam) predicts pathologic response (the amount of tumor remaining when surgery is performed) in participants with breast cancer who are receiving chemotherapy prior to surgery.

Read the detailed description

Neoadjuvant therapy was first introduced to improve surgical outcomes of breast cancer and to be able to assess the pathological responsiveness to therapy at the time of surgery. Over time, it became a useful experimental platform in clinical research in breast cancer, and in recent years became an important part of standard management of certain subtypes and clinical stages in breast cancer.

It has been long established that patients who achieve pathologic complete response (pCR, i.e., the absence of any cancer in the tissue removed during surgery) after receiving neoadjuvant treatment have better outcomes than those who don't, especially in HER2+, and triple-negative breast cancer (TNBC). Many reports add aggressive ER+ breast cancer to these groups. So far, the only way to know whether a patient achieved pCR is to give them a full course of therapy and then proceed to surgery.

One of the areas that has attracted significant research interest has been the effort to develop early predictors of pCR. This way, treatment can be tailored in the future to each patient and each tumor and can spare patients ineffective therapy. Some of these predictors include tissue biomarkers, blood based biomarkers, and imaging biomarkers.

It has been observed in neoadjuvant clinical trials that many patients have an impressive early clinical response to treatment after 1-2 cycles of treatment. Anecdotally, many of those patients go on to have a pCR at the time of surgery. This observation, if validated in a prospective clinical trial, may lead to a simple, inexpensive way to assess tumor responsiveness and predict pCR using clinical exam and simple imaging.

Using imaging or molecular changes to predict pCR will also be explored in this study. A consortium of investigators will be studying image analysis and proteogenomic changes early in the course of treatment to predict clinical response specifically in participants with TNBC. Only participants with TNBC will be required to undergo a research biopsy and research MRI prior to starting treatment, and again after the first cycle of treatment.

The investigators therefore hypothesize that absence of early clinical response, defined as at least a 30% reduction in the size of the breast tumor by Day 21 of treatment (as measured by either imaging or clinical exam), will be associated with absence of pCR at the time of surgery, in 3 subtypes of breast cancer - TNBC, HER2+, high-risk ER+.

All treatment in this study is standard of care (non-investigational).

Medical subject headings
Breast Neoplasms, Triple Negative Breast Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PaclitaxelDrug

    Also called Taxol

    80 mg/m2 IV administered on Days 1, 8, 15 of each 21-day cycle

  • CarboplatinDrug

    Carboplatin AUC 1.5 IV administered on Days 1, 8, 15 of each 21-day cycle

  • TrastuzumabDrug

    Also called Herceptin

    Trastuzumab 8 mg/kg loading dose, followed by 6 mg/kg maintenance dose, administered on Day 1 of each 21-day cycle

  • PertuzumabDrug

    Also called Perjeta

    Pertuzumab 840 mg loading dose, followed by 420 mg maintenance dose, administered on Day 1 of each 21-day cycle

  • DoxorubicinDrug

    Also called Adriamycin

    60 mg/m2 IV administered on Day 1 of each 14-day cycle

  • CyclophosphamideDrug

    Also called Cytoxan

    600 mg/m2 IV administered on Day 1 of each 14-day cycle

  • PembrolizumabDrug

    Also called Keytruda

    Either 200 mg IV administered on Day 1 of Cycles 1-4, or 400 mg IV administered on Day 1 of Cycles 1 and 3 of the paclitaxel/carboplatin regimen.

    400 mg on Day 1 of Cycles 1 and 4 of the dose-dense AC regimen.

  • Pertuzumab/Trastuzumab/Hyaluronidase-zzxfDrug

    Also called PHESGO

    Can be used in place of separate IV formulations of pertuzumab and trastuzumab. 1200 mg pertuzumab/600 mg trastuzumab/30,000 U hyaluronidase administered subcutaneously on Day 1 of the first cycle, followed by a maintenance dose of 600 mg pertuzumab/600 mg trastuzumab/20,000 U hyaluronidase administered subcutaneously every 3 weeks.

Study groups in NCT05020860
Study groupRoleWhat they receive
Triple Negative Breast Cancer (for tumors > 5 cm)Active comparatorPaclitaxel IV plus carboplatin IV (+/- pembrolizumab IV) (4 cycles total), followed by doxorubicin IV plus cyclophosphamide IV (+/- pembrolizumab IV) (4 cycles total)
Receives: Drug: Paclitaxel; Drug: Carboplatin; Drug: Doxorubicin; Drug: Cyclophosphamide; Drug: Pembrolizumab
Triple Negative Breast Cancer (for tumors < 5 cm)Active comparatorPaclitaxel IV (4 cycles total), followed by doxorubicin IV plus cyclophosphamide IV (4 cycles total)
Receives: Drug: Paclitaxel; Drug: Doxorubicin; Drug: Cyclophosphamide
HER2-Positive Breast CancerActive comparatorPaclitaxel IV plus Trastuzumab IV plus Pertuzumab IV (or PHESGO) (4 cycles total), followed by doxorubicin IV plus cyclophosphamide IV administered (4 cycles total)
Receives: Drug: Paclitaxel; Drug: Trastuzumab; Drug: Pertuzumab; Drug: Doxorubicin; Drug: Cyclophosphamide; Drug: Pertuzumab/Trastuzumab/Hyaluronidase-zzxf
Hormone Receptor Positive Breast CancerActive comparatorPaclitaxel IV plus Carboplatin IV (4 cycles total), followed by doxorubicin IV plus cyclophosphamide IV (4 cycles total)
Receives: Drug: Paclitaxel; Drug: Doxorubicin; Drug: Cyclophosphamide

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Clinical Tumor Measurement vs. Pathologic Response

    Clinical tumor measurements are tumor measurements obtain via imaging (mammogram or ultrasound) or by physical exam. Pathologic response is the amount of tumor remaining at the time of surgery, as determined by the pathologist.

    Measured: Baseline and at surgery (after 20 weeks)

Secondary outcomes (2)
  1. Pathologic Complete Response Rate in each Breast Cancer Subtype

    A pathologic complete response (pCR) means that there is no residual invasive cancer identified in the tissue removed at surgery. The frequency of pCR will be estimated for each breast cancer subtype (triple negative, hormone receptor positive, and HER2-positive)

    Measured: 20 weeks

  2. Predictive value of clinical response following 1 cycle of chemotherapy to predict pathologic complete response

    This aims to determine whether a 30 percent reduction in tumor size (as measured by physical exam or imaging) following one cycle of chemotherapy can predict whether a patient will have no residual invasive cancer at the time of surgery

    Measured: 20 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Aug 2021
  2. Study start18 Apr 2023
  3. Primary completionAug 2027 (estimated)
  4. Study completionNov 2029 (estimated)

Resources

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 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
185 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05020860
Sponsor's protocol ID
H-50349
Acronym
RESPONSE
Status last verified
Jan 2025
First submitted
19 Aug 2021
Last updated
27 Feb 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Paclitaxel, Carboplatin and Trastuzumab in people with Breast Cancer and Breast Neoplasm, run by Baylor Breast Care Center at 2 sites in United States.

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 20 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: looking for participants now, as of the sponsor's last update on 27 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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?

Contact Maria Rodriguez ((713) 798-8347, bcc-clinicalresearch@bcm.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Clinical Tumor Measurement vs. Pathologic Response (time frame: Baseline and at surgery (after 20 weeks)). 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 27 Feb 2025.

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