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Breast CancerPhase 2NCT05837455

NeoTAILOR: ABiomarker-directed Approach to Guide Neoadjuvant Therapy for Patients With Stage II/III ER-positive, HER2-negative Breast Cancer

A Phase 2 study testing VENTANA MIB-1 Ki67 assay, Oncotype DX® Recurrence Score and PAM50-based Prosigna breast cancer gene signature assay in people with Breast Cancer and Cancer of the Breast, run by Washington University School of Medicine at 1 site 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

This study aims to utilize a novel biomarker-driven approach to guide neoadjuvant treatment selection. It is the hypothesis that this will improve clinical response for postmenopausal women with clinical stage II/III ER-positive, HER2-negative breast cancer and identify those who may not require neoadjuvant… Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Breast Cancer, Cancer of the Breast
What is being tested?
VENTANA MIB-1 Ki67 assay, Oncotype DX® Recurrence Score and PAM50-based Prosigna breast cancer gene signature assay
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
81 participants
Where
1 siteUnited States
Study dates
30 May 2024to 30 Nov 2027
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
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically or cytologically confirmed newly diagnosed clinical stage II or III (by AJCC 8th edition - at least T2, any N, M0 or if N1+ then any T) ER-positive (ER > 10%), any PR, and HER2-negative breast cancer with complete surgical excision of the breast cancer after neoadjuvant therapy as the treatment goal.
  • HER2 negative must be assessed by FISH or IHC staining 0 or 1+ according to ASCO/CAP guidelines.
  • A palpable mass is not required; however, tumor size must be either:
  • ≥2 cm in one dimension by clinical or radiographic examination (WHO criteria), if clinically axillary lymph node negative OR
  • Measureable (≥10 mm) by modified RECIST v1.1 for breast MRI (see Section 9.0), if histologically confirmed resectable locoregional nodal involvement.
  • ECOG performance status 0 or 1.
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  • Eligible to receive neoadjuvant aromatase inhibitor, as per treating physician.
  • Eligible to receive neoadjuvant standard of care anthracycline- and/or taxane-based chemotherapy regimen, as per treating physician.
  • Able to tolerate breast MRI with intravenous contrast administration. Must be able to complete the applicable MRI screening evaluation form.
  • Adequate bone marrow and organ function, as determined by the treating physician.
  • Known history of hepatitis C virus (HCV) infection is permissible provided the patient has been treated and cured.
  • At least 18 years of age.
  • Postmenopausal status, defined as one of the following:
  • Age ≥ 60 years
  • Age < 60 with intact uterus and amenorrhea for 12 consecutive months or more
  • Status post bilateral oophorectomy, total hysterectomy
  • Ability to understand and willingness to sign an IRB approved written informed consent document (or that of legally authorized representative, if applicable), and willing and able to comply with scheduled visits and treatment schedule.

Who cannot join

  • Inflammatory breast cancer (cT4d disease as per AJCC 8th edition).
  • Locally recurrent or metastatic disease (cM1 disease as per AJCC 8th edition).
  • Bilateral breast cancer.
  • Prior systemic therapy for the indexed breast cancer.
  • Pre-existing Grade ≥2 neuropathy.
  • Uncontrolled intercurrent illness that would limit compliance with study requirements.
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  • A history of other malignancy ≤5 years prior to the indexed breast cancer diagnosis with the following exceptions:
  • Basal cell or squamous cell carcinoma of the skin which were treated with local resection only
  • Adequately treated carcinoma in situ of the cervix.
  • Prior or concurrent malignancy whose natural history or treatment will not interfere with the safety or efficacy assessments of the indexed breast cancer. In this event, review and approval by the study PI is required.
  • Concurrent participation in any investigational therapeutic trial for treatment of breast cancer.
  • Known HIV positivity that in the judgement of the treating physician would impact safety of chemotherapy receipt.
  • A history of allergic reactions attributed to compounds of similar chemical or biologic composition to anastrozole, taxanes (paclitaxel or nab-paclitaxel), anthracyclines (doxorubicin or epirubicin) or cyclophosphamide.
  • Evidence of uncontrolled ongoing or active infection, requiring parenteral anti-bacterial, anti-viral, or anti-fungal therapy ≤ 7 days prior to administration of study treatment. Patients receiving prophylactic antibiotics (e.g., for prevention of a urinary tract infection or chronic obstructive pulmonary disease) are eligible.
  • Any uncontrolled medical condition that in the opinion of the Investigator would pose a risk to participant safety or interfere with study participation or interpretation of individual participant results.

Trial locations and contacts

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

Nusayba A Bagegni, M.D. contact

314-273-3022

nbagegni@wustl.edu

United States1 site, 1 recruiting
  • Washington University School of Medicine

    St Louis, Missouri, 63110

    Nusayba A Bagegni, M.D., 314-273-3022, nbagegni@wustl.edu

    Nusayba A Bagegni, M.D.

    Recruiting

Other trials in United States

About this study

Official title: NeoTAILOR: A Phase II Biomarker-directed Approach to Guide Neoadjuvant Therapy for Patients With Stage II/III ER-positive, HER2-negative Breast Cancer

This study aims to utilize a novel biomarker-driven approach to guide neoadjuvant treatment selection. It is the hypothesis that this will improve clinical response for postmenopausal women with clinical stage II/III ER-positive, HER2-negative breast cancer and identify those who may not require neoadjuvant chemotherapy, with a primary focus on outcomes in Black patients.

Read the detailed description

Risk category is defined as follows:

  • Low risk:
  • Baseline Ki67 ≤ 10% (OR)
  • Luminal A molecular intrinsic subtype by PAM50
  • High risk:
  • Non-Luminal A molecular intrinsic subtype by PAM50 (OR)
  • In cases of non-diagnostic PAM50 molecular intrinsic subtype, patients will enroll in the high-risk group and undergo Week 4 tumor biopsy.
Being tested
VENTANA MIB-1 Ki67 assay, Oncotype DX® Recurrence Score, PAM50-based Prosigna breast cancer gene signature assay, Anastrozole, Combination anthracycline and/or taxane based treatment
Keywords
breast cancer, postmenopausal women, Ki67, PAM50 subtype, breast cancer disparities
Medical subject headings
Breast Neoplasms

What participants receive

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

  • VENTANA MIB-1 Ki67 assayDevice

    Ki67 scoring determination (standard of care) utilizing the Ki67 MIB-1 assay (clone 30-9) (VENTANA) will be performed at baseline, Week 4 (+/- 14 days - high-risk group only), and at time of surgery in accordance with the International Ki67 in Breast Cancer Working Group guidelines.

  • Oncotype DX® Recurrence ScoreDevice

    Oncotype DX® Recurrence Score (RS) testing - assessing expression of 21 genes including 16 cancer-related genes and 5 reference genes - will be performed as standard of care in a central laboratory (Exact Sciences) on RNA extracted from formalin-fixed paraffin-embedded core-biopsy samples.

  • PAM50-based Prosigna breast cancer gene signature assayDevice

    This PAM50-based Prosigna breast cancer gene signature assay for intrinsic molecular subtype determination will be performed on formalin-fixed, paraffin-embedded (FFPE) core-biopsy samples.

  • AnastrozoleDrug

    Standard of care. All patients must start on anastrozole at time of enrollment but may switch to another aromatase inhibitor (letrozole or exemestane) due to toxicity or financial/other concerns at discretion of investigator after a discussion with the PI. Every effort to minimize interruption of aromatase inhibitor (AI) therapy is recommended.

  • Combination anthracycline and/or taxane based treatmentDrug

    Standard of care

Study groups in NCT05837455
Study groupRoleWhat they receive
Low-risk groupExperimental* Baseline breast MRI and research specimen collection prior to the start of treatment with standard of care anastrozole. All patients will have one 28-day cycle of anastrozole, followed by determination of breast cancer risk category by incorporating results from baseline Ki67, Oncotype DX RS, and molecular intrinsic subtype by PAM50. * An additional blood draw for research purposes at Week 4 (no breast tumor biopsy at this time point) and continue to receive 5 additional 28-day cycles of anastrozole. * After completion of ~6 months of neoadjuvant treatment, will undergo post-treatment breast MRI followed by standard of care surgery.
Receives: Device: VENTANA MIB-1 Ki67 assay; Device: Oncotype DX® Recurrence Score; Device: PAM50-based Prosigna breast cancer gene signature assay; Drug: Anastrozole
High-risk endocrine-sensitive groupExperimental* Baseline breast MRI and research specimen collection prior to the start of treatment with standard of care anastrozole. All patients will have one 28-day cycle of anastrozole, followed by determination of breast cancer risk category by incorporating results from baseline Ki67, Oncotype DX RS, and molecular intrinsic subtype by PAM50. * An additional blood draw and breast tumor tissue collection at Week 4 to assess Ki67. Patients with Week 4 Ki67 ≤10% (the high-risk endocrine-sensitive group) will continue to receive 5 additional 28-day cycles of anastrozole. * After completion of ~6 months of neoadjuvant treatment, will undergo post-treatment breast MRI followed by standard of care surgery.
Receives: Device: VENTANA MIB-1 Ki67 assay; Device: Oncotype DX® Recurrence Score; Device: PAM50-based Prosigna breast cancer gene signature assay; Drug: Anastrozole
High-risk endocrine-resistant groupExperimental* Baseline breast MRI and research specimen collection prior to the start of treatment with standard of care anastrozole. All patients will have one 28-day cycle of anastrozole, followed by determination of breast cancer risk category by incorporating results from baseline Ki67, Oncotype DX RS, and molecular intrinsic subtype by PAM50. * An additional blood draw and breast tumor tissue collection at Week 4 to assess Ki67. Patients with Week 4 Ki67 >10% (the high-risk endocrine-resistant group) will receive escalated therapy with ~5-6 additional months of standard of care chemotherapy (combination anthracycline- and/or taxane-based at the discretion of their physician). * After completion of ~6 months of neoadjuvant treatment, will undergo post-treatment breast MRI followed by standard of care surgery.
Receives: Device: VENTANA MIB-1 Ki67 assay; Device: Oncotype DX® Recurrence Score; Device: PAM50-based Prosigna breast cancer gene signature assay; Drug: Combination anthracycline and/or taxane based treatment

What is being measured

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

  1. Objective response rate (ORR) by breast MRI in the combined low-risk plus high-risk endocrine-sensitive groups (pooled endocrine therapy-responders)

    • ORR is defined as patients achieving clinical complete response (CR) or partial response (PR) according to RECIST v1.1.
    • Complete Response (CR): disappearance of all target and non-target lesions. Residual lesions thought to be non-malignant should be further investigated before CR can be accepted.
    • Partial Response (PR): ≥30% decrease in the sum of measures of target lesions, taking as reference the baseline sum of diameters. Non-target lesions must be non-PD.

    Measured: Through completion of treatment (estimated to be 6 months)

Secondary outcomes (4)
  1. Breast conservation surgery (BCS) conversion rate by cohort and treatment assignment

    Measured: Through completion of surgery (estimated to be 6 months)

  2. Proportion of patients who will require oncoplastic breast reduction surgery before and after neoadjuvant treatment

    Measured: Through completion of surgery (estimated to be 6 months)

  3. Objective response rate (ORR) by breast MRI in the high-risk endocrine-sensitive group

    • ORR is defined as patients achieving clinical complete response (CR) or partial response (PR) according to modified RECIST v1.1.
    • Complete Response (CR): disappearance of all target and non-target lesions. Residual lesions thought to be non-malignant should be further investigated before CR can be accepted.
    • Partial Response (PR): ≥30% decrease in the sum of measures of target lesions, taking as reference the baseline sum of diameters. Non-target lesions must be non-PD.

    Measured: Through completion of treatment (estimated to be 6 months)

  4. Objective response rate (ORR) by breast MRI in the high-risk endocrine-resistant group (high risk patients with week 4 Ki67 > 10% post anastrozole)

    • ORR is defined as patients achieving clinical complete response (CR) or partial response (PR) according to modified RECIST v1.1.
    • Complete Response (CR): disappearance of all target and non-target lesions. Residual lesions thought to be non-malignant should be further investigated before CR can be accepted.
    • Partial Response (PR): ≥30% decrease in the sum of measures of target lesions, taking as reference the baseline sum of diameters. Non-target lesions must be non-PD.

    Measured: Through completion of treatment (estimated to be 6 months)

Timeline

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

  1. First posted1 May 2023
  2. Study start30 May 2024
  3. Primary completion30 Nov 2027 (estimated)
  4. Study completion30 Nov 2027 (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
81 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05837455
Sponsor's protocol ID
202305007
Status last verified
Apr 2026
First submitted
18 Apr 2023
Last updated
13 Apr 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing VENTANA MIB-1 Ki67 assay, Oncotype DX® Recurrence Score and PAM50-based Prosigna breast cancer gene signature assay in people with Breast Cancer and Cancer of the Breast, run by Washington University School of Medicine at 1 site 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 15 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 13 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site 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 Nusayba A Bagegni, M.D. (314-273-3022, nbagegni@wustl.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Objective response rate (ORR) by breast MRI in the combined low-risk plus high-risk endocrine-sensitive groups (pooled endocrine therapy-responders) (time frame: Through completion of treatment (estimated to be 6 months)). 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 13 Apr 2026.

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