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HER-2 Positive Breast CancerPhase 2UC HERNCT07565324

Phase II Study of Ultrasound and ctDNA Guided Neoadjuvant Systemic Therapy for Patients With HER2-positive Early Breast Cancer (UC HER Trial)

A Phase 2 study testing Lipo-Dox®, Cyclophosphamide and Trastuzumab (Herceptin) in people with HER-2 Positive Breast Cancer, run by National Taiwan University Hospital at 1 site in Taiwan.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

Although neoadjuvant dual anti-HER2-targeted therapy, pertuzumab and trastuzumab, combined with taxanes increased the pCR rate for patients with early-stage HER2-positive breast cancer when compared with single blockade combined with chemotherapy, certain patients did not achieve pCR after receiving dual blockade or… Read more about this study

Who is it for?
Ages 20 years and older, women only
Conditions the study is for
HER-2 Positive Breast Cancer
What is being tested?
Lipo-Dox®, Cyclophosphamide and Trastuzumab (Herceptin)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
54 participants
Where
1 siteTaiwan
Study dates
30 Apr 2026to 31 Dec 2032
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 20 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Diagnosis: HER2-positive Primary Invasive Breast Cancer
  • Patients must meet the following criteria for study entry:
  • Histologically confirmed invasive breast carcinoma
  • HER2-positive breast carcinoma
  • HER2-positive status will be based on pretreatment biopsy material and defined as an immunohistochemistry (IHC) score of 3+ and/or positive by fluorescence in situ hybridization (FISH) prospectively confirmed by a pathology laboratory before study enrollment.
  • FISH positivity is defined as a ratio of ≥ 2.0 for the number of HER2 gene copies to the number of signals for chromosome 17 copies.
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  • Clinical stage at presentation: T1-4, N0-3, M0 (T1N0M0 tumors will not be eligible)
  • Patients must be willing to receive preoperative systemic chemotherapy with taxanes and HER-2-targeting treatment for at least 4 to 6 cycles.
  • Systemic therapy must consist of at least 4 to 6 cycles of chemotherapy with taxanes plus trastuzumab (TH) or
  • Systemic therapy must consist of at least 4 to 6 cycles of chemotherapy with taxanes plus trastuzumab and pertuzumab (THP).
  • After completion of 4 to 6 cycles of TH or THP, if the following clinical features and pathological characteristics are eligible for Lipo-Dox® and cyclophosphamide plus trastuzumab and pertuzumab:
  • c.1 Core biopsy showed the residual invasive breast cancer. c.2 Breast echo or other imaging studies disclosed no complete remission. c.3 Complete remission of core biopsy or breast echo or other imaging studies, but positive for ctDNA.
  • Age ≥ 20 years.
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
  • Adequate organ function during screening, included:
  • Absolute neutrophil count ≥ 1,200 cells/mm3
  • Platelet count ≥ 100,000 cells/ mm3
  • Hemoglobin ≥ 9.0 g/dL;
  • Serum creatinine < 1.5 × upper limit of normal (ULN)
  • International normalized ratio (INR) and activated partial thromboplastin time (aPTT) ≤ 1.5 ×ULN
  • Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 1.5 ×ULN
  • Serum total bilirubin (TBILI) ≤ 1.0 ×ULN (within normal limits)
  • Serum alkaline phosphatase (ALK) ≤ 1.5 ×ULN
  • Screening LVEF ≥ 50% on echocardiogram (ECHO) or multiple-gated acquisition (MUGA) before receiving neoadjuvant chemotherapy with 4 to 6 courses of TH or THP and no decrease in LVEF by more than 10% absolute points from the pre-chemotherapy LVEF after 4 to 6 courses of TH or THP.
  • For women who are not postmenopausal (≥ 12 months of non-therapy-induced amenorrhea) or surgically sterile (absence of ovaries and/or uterus): agreement to remain abstinent or use single or combined contraceptive methods that result in a failure rate of < 1% per year during the treatment period and for at least 7 months after the last dose of study drug.
  • Documentation of hepatitis B virus (HBV) and hepatitis C virus (HCV) serologies is required: this includes HB surface antigen (HBsAg) and/or total HB core antibody (anti-HBc) in addition to HCV antibody testing. If positive for HBsAg or positive for Anti-HBc, DNA testing for HBV will be performed. If active HBV infection is ruled out, the patient may be eligible. The most recent serologic testing must have occurred within 3 months prior to initiation of neoadjuvant therapy. If such testing has not been done, it must be performed during screening.
  • They should receive examination of HBV DNA to document no active HBV activation (if HBeAg-positive, or HBeAg-negative but abnormal liver function accompanied by ALT ≥ 2 normal limits during the half a year and HBV DNA > 2000 IU/ml: indication of HBV activation). If test of HBsAg is positive and inactive, and they should receive prophylactic anti-HBV drugs during the enrollment period of this clinical trial.

Who cannot join

  • Stage IV (metastatic) breast cancer.
  • History of any prior (ipsilateral- or contralateral) breast cancer except lobular carcinoma in situ.
  • History of other malignancy within the last 5 years, except for appropriately treated carcinoma in situ (CIS) of the cervix, non-melanoma skin carcinoma, stage I uterine cancer, or other non-breast malignancies with an outcome similar to those mentioned above.
  • Patients for whom radiotherapy would be recommended for breast cancer treatment, but for whom it is contraindicated because of medical reasons (e.g., connective tissue disorder or prior ipsilateral breast radiation).
  • Current NCI common terminology criteria for adverse events (CTCAE) (Version 4.0): Grade ≥ 2 peripheral neuropathy.
  • Cardiopulmonary dysfunction as defined by any of the following:
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  • History of NCI CTCAE (Version 4.0): Grade ≥ 3 symptomatic congestive heart failure (CHF) or New York Heart Association (NYHA) criteria Class ≥ II.
  • Prior treatment with anthracycline or Lipo-Dox®
  • Current severe, uncontrolled systemic disease (e.g., clinically significant cardiovascular, pulmonary, or metabolic disease; wound healing disorders; ulcers).
  • For female patients, current pregnancy and/or lactation. 10. Any known active liver disease, for example, due to HBV, HCV, autoimmune hepatic disorders, or sclerosing cholangitis.
  • Patients who have positive HBV or HCV serologies without known active disease must meet the eligibility criteria for liver function on at least two consecutive occasions, separated by at least 1 week, within the 30 days-screening period.

Trial locations and contacts

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

Sung-Hsin Kuo, M.D.,Ph.D. contact

+886-972651671

shkuo101@ntu.edu.tw

Chiun-Sheng Huang, M.D.,Ph.D. contact

huangcs@ntu.edu.tw

Taiwan1 site
  • National Taiwan University Hospital

    Taipei, 100

Other trials in Taiwan

About this study

Official title: Phase II Study of Ultrasound and ctDNA Guided Neoadjuvant Systemic Therapy for Patients With HER2-positive Early Breast Cancer

Although neoadjuvant dual anti-HER2-targeted therapy, pertuzumab and trastuzumab, combined with taxanes increased the pCR rate for patients with early-stage HER2-positive breast cancer when compared with single blockade combined with chemotherapy, certain patients did not achieve pCR after receiving dual blockade or single blockade targeting HER2 combined with taxanes.

Based on the cardiac safety and promising ORR rate of the regimens consisting of PLD and cyclophosphamide and trastuzumab in treating patients with HER2-positive breast cancer in the neoadjuvant or metastatic setting, the investigators hypothesized that dual blockades targeting HER2, trastuzumab and pertuzumab, combined with PLD and cyclophosphamide, will not only increase the pCR rate but also cause less cardiotoxicity for participants with residual cancer via core biopsy or non-clinical CR after receiving taxanes plus trastuzumab and pertuzumab or taxanes plus trastuzumab. The investigators also showed that ctDNA served as the surrogate prognostic marker for participants with HER2-positive EBC who received neoadjuvant trastuzumab-based regimens.

In this study, the investigators will explore whether the combination of PLD (Lipo-Dox®, Liposomal Doxorubicin Injection), cyclophosphamide, trastuzumab, and pertuzumab can increase the pCR rate of participants with HER2-positive EBC if they have residual cancers (core biopsy, non-clinical CR, or positive ctDNA) after receiving a trastuzumab and taxanes-based NAT regimen. In addition, the cardiac safety, adverse effects, and clearance of ctDNA will be explored for these patients. The investigators further assess the feasibility of VAB (before operation) in these participants who achieved negative ctDNA after receiving Lipo-Dox® plus cyclophosphamide, trastuzumab, and pertuzumab.

Being tested
Lipo-Dox®, Cyclophosphamide, Trastuzumab (Herceptin), Pertuzumab
Keywords
HER2, Breast cancer, Lipodox, Cyclophosphamide, Trastuzumab, Pertuzumab
Medical subject headings
Breast Neoplasms

What participants receive

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

  • Lipo-Dox®Drug

    Lipo-Dox®: 37.5 mg/m² on D1; every 21 days is one cycle, for a total of 4 cycles.

  • CyclophosphamideDrug

    Cyclophosphamide 600 mg/m² on D1, ; every 21 days is one cycle, for a total of 4 cycles.

  • Trastuzumab (Herceptin)Drug

    Trastuzumab 6 mg/kg on D2; every 21 days is one cycle, for a total of 4 cycles.

  • PertuzumabDrug

    Pertuzumab 420 mg on D2; every 21 days is one cycle, for a total of 4 cycles.

Study groups in NCT07565324
Study groupRoleWhat they receive
Ultrasound and ctDNA Guided Neoadjuvant Systemic Therapy for HER2-positive Breast Cancer PatientsExperimentalNot described
Receives: Drug: Lipo-Dox®; Drug: Cyclophosphamide; Drug: Trastuzumab (Herceptin); Drug: Pertuzumab

What is being measured

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

  1. Pathological complete remission rate (pCR)

    Assessment of pathological specimens to determine when no cancer cells are detected in tissue samples (breast and lymph nodes) removed during surgery following preoperative treatment, such as chemotherapy.

    Measured: From enrollment to the end of operation.

Secondary outcomes (4)
  1. Number of participants with Lipodox-containing regimen-related adverse events of cardiac function as assessed by CTCAE v4.0

    Cardiac echo to assess the left ventricle ejection fractions before and after completion of Lipo-Dox®-containing regimen

    Measured: From enrollment, before and after completion of Lipodox plus cyclophosphamide, trastuzumab, and pertuzumab, and 12 months after operation.

  2. Clearance rate of circulating tumor DNA [ctDNA]

    Circulating tumor DNA (ctDNA) clearance refers to the transition from a detectable level of tumor-specific mutations in the bloodstream to undetectable levels following neoadjuvant treatment, including TH or THP regimen, or Lipodox plus cyclophosphamide, trastuzumab, and pertuzumab.

    Measured: From enrollment, completion of TH or THP regimens, completion of Lipodox plus cyclophosphamide, trastuzumab, and pertuzumab, and at the end of operation.

  3. Number of participants with treatment with Lipo-Dox®-containing regimen-related adverse events as assessed by CTCAE v4.0.

    Adverse events of Lipodox plus cyclophosphamide, trastuzumab, and pertuzumab.

    Measured: From starting a Lipo-Dox®-containing regimen to the end of treatment at 4 weeks.

  4. Percentage of patients with complete removal of lesion via vacuum-assisted biopsy

    Comparison of the percentage of patients with a lack of pathology at the surgery between vacuum-assisted biopsy and surgical operation (ctDNAs are negative after completion of neoadjuvant chemotherapy).

    Measured: After completion of neoadjuvant chemotherapy regimens.

Timeline

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

  1. First posted4 May 2026
  2. Study start30 Apr 2026 (estimated)
  3. Primary completion31 Dec 2029 (estimated)
  4. Study completion31 Dec 2032 (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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
54 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07565324
Sponsor's protocol ID
202509103MINB
Acronym
UC HER
Status last verified
Apr 2026
First submitted
19 Apr 2026
Last updated
4 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: It is not yet known if there will be a plan to make IPD available.

Publications

  • Gianni L, Pienkowski T, Im YH, Roman L, Tseng LM, Liu MC, Lluch A, Staroslawska E, de la Haba-Rodriguez J, Im SA, Pedrini JL, Poirier B, Morandi P, Semiglazov V, Srimuninnimit V, Bianchi G, Szado T, Ratnayake J, Ross G, Valagussa P. Efficacy and safety of neoadjuvant pertuzumab and trastuzumab in women with locally advanced, inflammatory, or early HER2-positive breast cancer (NeoSphere): a randomised multicentre, open-label, phase 2 trial. Lancet Oncol. 2012 Jan;13(1):25-32. doi: 10.1016/S1470-2045(11)70336-9. Epub 2011 Dec 6.

    PubMed 22153890
  • van der Voort A, van Ramshorst MS, van Werkhoven ED, Mandjes IA, Kemper I, Vulink AJ, Oving IM, Honkoop AH, Tick LW, van de Wouw AJ, Mandigers CM, van Warmerdam LJ, Wesseling J, Vrancken Peeters MT, Linn SC, Sonke GS. Three-Year Follow-up of Neoadjuvant Chemotherapy With or Without Anthracyclines in the Presence of Dual ERBB2 Blockade in Patients With ERBB2-Positive Breast Cancer: A Secondary Analysis of the TRAIN-2 Randomized, Phase 3 Trial. JAMA Oncol. 2021 Jul 1;7(7):978-984. doi: 10.1001/jamaoncol.2021.1371.

    PubMed 34014249
  • Tseng LM, Chen FM, Chen ST, Cheng FT, Chao TY, Dai MS, Kao WY, Yeh MH, Chen DR, Liu LC, Wang HC, Chang HT, Wang BW, Yu JC, Chen SC, Liao GS, Hou MF. Comparison of the Efficacy, Safety, and Quality of Life of Pegylated Liposomal Doxorubicin-Cyclophosphamide versus Epirubicin-Cyclophosphamide in Patients with Early-Stage HER2-Negative Breast Cancer: A Prospective, Randomized, Multicenter, Phase II Study. Oncol Res Treat. 2024;47(10):484-495. doi: 10.1159/000540369. Epub 2024 Jul 19.

    PubMed 39033747
  • Lin PH, Tsai LW, Lo C, Kuo SH, Ni CC, Yu CH, Huang CS. ctDNA Detected after Neoadjuvant Therapy for HER2-Positive Breast Cancer Is Associated with Inferior Outcomes and May Inform Adjuvant Therapy. Cancer Res Commun. 2026 Jan 1;6(1):105-114. doi: 10.1158/2767-9764.CRC-24-0234.

    PubMed 41543393

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Lipo-Dox®, Cyclophosphamide and Trastuzumab (Herceptin) in people with HER-2 Positive Breast Cancer, run by National Taiwan University Hospital at 1 site in Taiwan.

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 27 inclusion and 11 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: opening soon, as of the sponsor's last update on 4 May 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 Taiwan. 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 Sung-Hsin Kuo, M.D.,Ph.D. (+886-972651671, shkuo101@ntu.edu.tw), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pathological complete remission rate (pCR) (time frame: From enrollment to the end of operation.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07565324, which also lists 4 linked publications.

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 4 May 2026.

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