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Breast CancerPhase 2NCT07492394

Dalpiciclib With or Without Entinostat and Letrozole in HR+/HER2- Early Breast Cancer

A Phase 2 study testing entinostat, Dalpiciclib and Letrozole in people with Breast Cancer, run by Hebei Medical University Fourth Hospital at 1 site in China.

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

Brief Summary This is an open-label, randomized, phase II clinical study designed to evaluate neoadjuvant treatment regimens in patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) early breast cancer. Read more about this study

Who is it for?
Ages 18 to 75 years, women only
Conditions the study is for
Breast Cancer
What is being tested?
entinostat, Dalpiciclib and Letrozole
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
60 participants
Where
1 siteChina
Study dates
12 Sep 2025to 31 Dec 2031
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 to 75 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Inclusion Criteria
  • Female patients aged ≥18 and <75 years, including postmenopausal, premenopausal, or perimenopausal. Postmenopause is defined as:Prior bilateral oophorectomy, or age ≥60 years; orAge <60 years, natural postmenopause (spontaneous cessation of menses for ≥12 months without other pathological or physiological cause) with estradiol (E2) and FSH in postmenopausal range; orPremenopausal or perimenopausal women willing to receive LHRH agonist (OFS) therapy during the study.
  • Histologically confirmed estrogen receptor (ER)-positive (>10%) invasive breast cancer, regardless of PR expression, and HER2-negative according to the 2018 ASCO/CAP HER2 testing guidelines (IHC 0+ or IHC 2+ with ISH-negative, amplification ratio <2.0).
  • At least one measurable lesion according to RECIST 1.1; clinical stage T1c-T2, cN1-2, or T3-T4, cN0-2.
  • No prior anticancer therapy for breast cancer, including chemotherapy,endocrine therapy, or targeted therapy.
  • Ability to swallow oral medications.
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  • Baseline left ventricular ejection fraction (LVEF) ≥50%.
  • Adequate organ function:Hematology (within 1 week):Absolute neutrophil count (ANC) ≥1.5 × 10⁹/L;White blood cell count (WBC) ≥3.0 × 10⁹/L;Platelet count ≥90 × 10⁹/L;Hemoglobin ≥90 g/L Liver and kidney function (within 1 week):Total bilirubin (TBIL) ≤ upper limit of normal (ULN);ALT and AST ≤1.5 × ULNBUN and creatinine ≤1.5 × ULN, with creatinine clearance ≥60 mL/min (Cockcroft-Gault formula)
  • ECG: Corrected QT interval ≤470 ms (12-lead ECG)
  • Willingness and ability to undergo all required biopsy procedures.
  • Women of childbearing potential must have a negative pregnancy test before study entry and agree to use medically acceptable contraception during the study; postmenopausal women are exempt.
  • Voluntary participation with signed informed consent, good compliance, and willingness to adhere to follow-up requirements.

Who cannot join

  • Exclusion Criteria
  • Pregnant or breastfeeding women, or women with a positive pregnancy test at baseline; women of childbearing potential unwilling to use effective contraception during the study.
  • Bilateral breast cancer or inflammatory breast cancer.
  • Stage IV (metastatic) breast cancer at initial diagnosis.
  • History of congestive heart failure, unstable angina, significant arrhythmia, or myocardial infarction.
  • Active pulmonary disease, including interstitial lung disease, pneumonia, pulmonary fibrosis, or other acute lung conditions.
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  • Significant liver disease, such as acute or fulminant hepatitis, impaired coagulation factor synthesis, or other severe hepatic dysfunction.
  • For patients positive for HBsAg or HBV core antibody, peripheral blood HBV DNA must be <1×10³ IU/mL to be eligible.
  • Any concurrent disease or condition that may interfere with study participation or affect patient safety (e.g., active or uncontrolled infection).
  • Other invasive malignancies (including second primary breast cancer) that may interfere with study outcomes or compliance.
  • Prior chemotherapy, endocrine therapy, or biologic therapy for breast cancer (except diagnostic biopsy for primary breast cancer).
  • Major surgery within 4 weeks prior to study entry or unresolved significant medical conditions.
  • Tumors that are non-measurable during the study treatment.
  • Any other condition that, in the investigator's judgment, makes the subject unsuitable for participation.

Trial locations and contacts

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

Zhenchuan Song contact

18531117857

songzhch@hotmail.com

China1 site, 1 recruiting
  • The Fourth Hospital of Hebei Medical University

    Shijiazhuang, Hebei, 050000

    Zhenchuan Song, 185 31117857, songzhch@hotmail.com

    Recruiting

Other trials in China

About this study

Official title: An Open-Label, Randomized, Phase II Study of Dalpiciclib in Combination With Entinostat and Letrozole Versus Dalpiciclib Plus Letrozole as Neoadjuvant Therapy in Patients With HR-positive, HER2-negative Early Breast Cancer

Brief Summary This is an open-label, randomized, phase II clinical study designed to evaluate neoadjuvant treatment regimens in patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) early breast cancer.

A total of 60 premenopausal, perimenopausal, and postmenopausal patients with HR+/HER2- breast cancer who meet the inclusion criteria will be enrolled. During the study, clinical information will be collected according to standard practice, including demographic data, tumor imaging, and pathological results (e.g., Ki-67). Investigator-assessed outcomes will be used as the final results.

Read more

After 14 days of treatment, patients who provide consent will undergo a second biopsy to evaluate the rate of complete cell-cycle arrest. Safety assessments and imaging evaluations will be performed at treatment completion or upon study withdrawal. Informed consent must be obtained at each study center before participation.

Treatment arms:

Arm A (30 patients):

Dalpiciclib 125 mg orally once daily on Days 1-21 of each 28-day cycle (3 weeks on, 1 week off), for 6 cycles Letrozole 2.5 mg orally once daily continuously for 6 cycles Entinostat 3 mg orally once weekly (Days 1-28 of each 28-day cycle), for 6 cycles

Arm B (30 patients):

Dalpiciclib 150 mg orally once daily on Days 1-21 of each 28-day cycle, for 6 cycles Letrozole 2.5 mg orally once daily continuously for 6 cycles Premenopausal and perimenopausal women will also receive ovarian function suppression (OFS), such as with a GnRHa agent.

After signing informed consent, patients will begin neoadjuvant therapy with dalpiciclib plus entinostat and letrozole ± OFS. Ultrasound assessments will be conducted every two treatment cycles and before surgery under the same imaging conditions as baseline. Bone scans will be performed at the end of neoadjuvant treatment. MRI of the breast will be performed at baseline, after two cycles, and before surgery to assess treatment efficacy. Treatment discontinuation will occur if toxicity is intolerable, consent is withdrawn, or the investigator determines it is necessary.

Adjuvant therapy:

After surgery, patients will receive physician's choice of therapy (TPC).

Safety follow-up:

Patients will be followed until they start another anticancer therapy, all adverse events have resolved to Grade 0-1 or baseline level, or death-whichever occurs first.

Read the detailed description

For patients with HR-positive, HER2-negative early or locally advanced breast cancer, achieving a clinical complete response with traditional neoadjuvant chemotherapy is challenging, and treatment tolerance is often suboptimal. Endocrine therapy plays an important role in both early-stage and advanced HR+/HER2- breast cancer; however, its efficacy in the neoadjuvant setting remains to be further clarified. Existing studies have shown that, compared with neoadjuvant chemotherapy, neoadjuvant endocrine therapy in HR+/HER2- breast cancer yields comparable clinical complete response and breast-conserving surgery rates, with substantially lower toxicity. Therefore, strategies to further improve response to neoadjuvant endocrine therapy may be more meaningful than intensifying chemotherapy in this population.

With the clinical availability of CDK4/6 inhibitors, the efficacy of neoadjuvant endocrine therapy has been further improved. Results from DAWNA-1, DAWNA-2, and DAWNA-A have strengthened the evidence base supporting the use of the domestically developed CDK4/6 inhibitor dalpiciclib in the adjuvant treatment of breast cancer.

However, some studies have found that increased histone deacetylase (HDAC) activity in the estrogen receptor (ER) promoter region can suppress ER expression and lead to endocrine therapy resistance. Entinostat is an oral HDAC inhibitor that selectively inhibits class I (primarily HDAC1 and HDAC3) and class IV HDACs. In the phase III study EOC103A3101 conducted in China, entinostat significantly improved median progression-free survival (PFS) compared with placebo (6.32 vs. 3.72 months), reducing the risk of disease progression or death by 24% (HR 0.76). Median overall survival (OS) was also prolonged in the entinostat group (38.39 months), with a 17% reduction in mortality risk (HR 0.83), demonstrating clinically meaningful survival benefits.

Based on these findings, the present study aims to further evaluate whether the combination of dalpiciclib, entinostat, and letrozole as neoadjuvant therapy for patients with HR-positive, HER2-negative early breast cancer may provide an improved clinical strategy compared with current standards.

Conditions
Breast Cancer
Being tested
entinostat, Dalpiciclib, Letrozole
Medical subject headings
Breast Neoplasms

What participants receive

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

  • entinostatDrug

    Also called HDAC inhibitor

    Entinostat is added in the experimental arm, while the control arm does not receive Entinostat.

  • DalpiciclibDrug

    Dalpiciclib is both added in the experimental arm and control arm.

  • LetrozoleDrug

    Letrozole is both added in the experimental arm and control arm.

Study groups in NCT07492394
Study groupRoleWhat they receive
Dalpiciclib Plus Letrozole and Entinostat ArmExperimentalDalpiciclib: 125 mg orally once daily on Days 1-21 of each 28-day cycle (3 weeks on, 1 week off), for a total of 6 cycles. Letrozole: 2.5 mg orally once daily continuously, for a total of 6 cycles. Entinostat: 3 mg orally once weekly on Days 1-28 of each 28-day cycle, for a total of 6 cycles.
Receives: Drug: Dalpiciclib; Drug: Letrozole
Dalpiciclib Plus Letrozole ArmPlacebo comparatorDalpiciclib: 150 mg orally once daily on Days 1-21 of each 28-day cycle (3 weeks on, 1 week off), for a total of 6 cycles. Letrozole: 2.5 mg orally once daily continuously, for a total of 6 cycles.
Receives: Drug: entinostat; Drug: Dalpiciclib; Drug: Letrozole

What is being measured

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

  1. ORR

    Objective Response Rate (ORR) is defined as the proportion of participants who achieve a complete response (CR) or partial response (PR) as assessed according to RECIST v1.1 criteria. Tumor response must be confirmed by repeat imaging at least 4 weeks after the initial documentation of response.

    Measured: From baseline to end of neoadjuvant therapy (approximately 6 cycles, ~24 weeks

Secondary outcomes (3)
  1. tpCR

    Total pathological complete response (tpCR) is defined as the absence of residual invasive cancer in both the breast and axillary lymph nodes following neoadjuvant therapy, corresponding to ypT0/Tis, ypN0.

    Measured: At the time of definitive surgery (approximately 18-24 weeks after initiation of neoadjuvant therapy)

  2. Breast-conserving surgery (BCS) rate

    Breast-conserving surgery rate is defined as the proportion of participants who undergo breast-conserving surgery (lumpectomy) among all participants who proceed to definitive breast surgery after completion of neoadjuvant therapy. The classification of breast-conserving surgery is based on the operative report and pathology assessment.

    Measured: At the time of definitive surgery

  3. Proportion of participants achieving PEPI 0

    PEPI 0 (Preoperative Endocrine Prognostic Index score of 0) is defined as meeting all of the following criteria at surgery after completion of neoadjuvant endocrine-based therapy:

    Pathologic tumor size: ypT1 or smaller (≤2 cm)

    Nodal status: ypN0 (no metastatic involvement in regional lymph nodes)

    Ki-67 proliferation index: ≤2.7% in the surgical specimen

    Estrogen receptor (ER): Allred score of 3-8 (ER-positive)

    Participants meeting all components are classified as achieving PEPI score = 0, indicating an extremely low risk of relapse.

    Measured: At the time of definitive surgery

Timeline

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

  1. First posted25 Mar 2026
  2. Study start12 Sep 2025
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Dec 2031 (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
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07492394
Sponsor's protocol ID
OBU-BC-II-278
Status last verified
Mar 2026
First submitted
4 Dec 2025
Last updated
2 Apr 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing entinostat, Dalpiciclib and Letrozole in people with Breast Cancer, run by Hebei Medical University Fourth Hospital at 1 site in China.

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 12 inclusion and 14 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 2 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 China. 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. Some participants in this study may receive a placebo. 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 Zhenchuan Song (18531117857, songzhch@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

ORR (time frame: From baseline to end of neoadjuvant therapy (approximately 6 cycles, ~24 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 2 Apr 2026.

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