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Abstract OT2-04-05: Phase II trial of pre-operative stereotactic ablative radiotherapy (SABR) in early-stage breast cancer 摘要OT2-04-05:早期乳腺癌术前立体定向消融放疗(SABR)二期临床研究
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.SABCS18-OT2-04-05
C. Liveringhouse, R. Diaz, K. Ahmed, Marie Catherine Lee, B. Czerniecki, C. Laronga, N. Khakpour, R. Weinfurtner, M. Rosa, M. Montejo
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引用次数: 0
Abstract OT2-07-09: A phase Ib study of neratinib, pertuzumab, and trastuzumab with paclitaxel in patients with metastatic and locally advanced breast cancer OT2-07-09:一项Ib期研究,奈拉替尼、帕妥珠单抗和曲妥珠单抗联合紫杉醇治疗转移性和局部晚期乳腺癌患者
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.SABCS18-OT2-07-09
A. Al-Awadhi, M. Kono, An Marx, Tanya W. Moseley, J. Willey, Huiying Sun, M. Fu, G. Whitman, V. Valero, N. Ueno, B. Lim
Background: Neratinib, a potent irreversible pan-ErbB tyrosine kinase inhibitor that blocks signal transduction through HER1, HER2, and HER4, has demonstrated activity against metastatic HER2-positive breast cancer (HER2+ BC) in patients pretreated with trastuzumab. The FDA recently approved neratinib as an adjuvant treatment for HER2+ BC patients who have received trastuzumab for at least 1 year. Preclinical data demonstrate that trastuzumab-resistant BC cells remain sensitive to neratinib. Also, neratinib enhances responses to trastuzumab possibly by increasing trastuzumab9s internalization, immune-mediated action, and other mechanisms. Taken together, these findings provide the rationale for adding neratinib to the standard of care combination of trastuzumab and pertuzumab with paclitaxel to enhance anti-HER2 efficacy in advanced HER2+ BC. Here, we report on the phase Ib portion of an ongoing phase Ib/II trial of this drug combination. Trial Design: Patients with metastatic or locally advanced HER2+ BC will be enrolled in the phase Ib portion of the trial. Neratinib is given orally in 3-week cycles. The initial neratinib dose of 80 mg daily is increased to 120, 160, and 200 mg daily after safety assessments of each dose level. Other agents are administered as per the standard of care. Patients continue therapy with per-protocol dose escalation and de-escalation according to toxicity until the maximum tolerated dose (MTD) of neratinib is reached. The target maximum dose-limiting toxicity rate is 20%. All patients receive 4 cycles of the combination therapy. If patients do not have disease progression or excessive toxicity, they may receive 2-4 additional cycles at the treating physician9s discretion. During therapy, patients undergo blood tests every week and have clinical visits and restaging scans every 3 weeks. Because gastrointestinal toxicity, mainly diarrhea, is anticipated, patients receive prophylactic antidiarrheal medication (e.g., loperamide, budesonide) beginning with the first dose of neratinib. Eligibility Criteria: Eligible patients must have histologically confirmed metastatic or locally advanced HER2+ BC (BC may be inflammatory or non-inflammatory and have any hormone receptor status); an ECOG performance status score of 0 or 1; and adequate hematologic and organ function, including adequate cardiac function (as indicated by a left ventricle ejection fraction of ≥50%). Specific Aims: 1- To determine the MTD of neratinib in combination with paclitaxel, pertuzumab, and trastuzumab. 2- Pharmacodynamic markers will be measured on biologic specimens. Neratinib-induced changes in pEGFR and/or HER2 expression will be analyzed and compared between dose levels. Statistical Methods: The Bayesian modified toxicity probability interval is used to determine dose adjustment. Accrual: The target enrollment for the phase Ib cohort is 20 patients. The trial has enrolled 3 patients since its activation in January 2018. This trial is supported by
背景:Neratinib是一种有效的不可逆泛erbb酪氨酸激酶抑制剂,可阻断HER1, HER2和HER4的信号转导,已证明在曲妥珠单抗预处理的患者中对转移性HER2阳性乳腺癌(HER2+ BC)具有活性。FDA最近批准奈拉替尼作为接受曲妥珠单抗治疗至少1年的HER2+ BC患者的辅助治疗。临床前数据表明,曲妥珠单抗耐药的BC细胞仍然对奈拉替尼敏感。此外,neratinib可能通过增加曲妥珠单抗的内化、免疫介导的作用和其他机制来增强对曲妥珠单抗的应答。综上所述,这些发现为在曲妥珠单抗和帕妥珠单抗联合紫杉醇的标准治疗组合中加入奈拉替尼提供了理论依据,以增强晚期HER2+ BC的抗HER2疗效。在此,我们报告了该药物组合正在进行的Ib/II期试验的Ib期部分。试验设计:转移性或局部晚期HER2+ BC患者将被纳入试验的Ib期部分。Neratinib以3周为周期口服。在对每个剂量水平进行安全性评估后,每日80毫克的初始纳拉替尼剂量增加到每日120、160和200毫克。其他药剂按护理标准施用。患者根据毒性继续按方案剂量递增和递减治疗,直到达到奈拉替尼的最大耐受剂量(MTD)。目标最大剂量限制毒性率为20%。所有患者均接受4个周期的联合治疗。如果患者没有疾病进展或过度毒性,他们可以在治疗医师的判断下接受2-4个额外周期。在治疗期间,患者每周接受血液检查,每3周进行一次临床访问和重新扫描。由于预计会出现胃肠道毒性,主要是腹泻,因此患者从第一剂奈拉替尼开始接受预防性止泻药物(如洛哌丁胺、布地奈德)。资格标准:符合条件的患者必须有组织学证实的转移性或局部晚期HER2+ BC (BC可能是炎性的或非炎性的,并且有任何激素受体状态);ECOG性能状态得分为0或1;血液和器官功能正常,包括心功能正常(左心室射血分数≥50%)。1-确定奈拉替尼联合紫杉醇、帕妥珠单抗和曲妥珠单抗的MTD。将在生物标本上测量药效学标记物。将分析和比较奈拉替尼引起的pEGFR和/或HER2表达的变化。统计方法:采用贝叶斯修正毒性概率区间确定剂量调整。应计:Ib期队列的目标入组人数为20例。自2018年1月启动以来,该试验已招募了3名患者。这项试验是由彪马生物技术,侵略性乳腺癌研究计划资助。引用格式:Al-Awadhi A, Kono M, Marx A, Moseley T, Willey J, Sun H, Fu M, Whitman GJ, Valero V, Ueno NT, Lim B.奈拉替尼、帕妥珠单抗和曲妥珠单抗联合紫杉醇治疗转移性局部晚期乳腺癌的Ib期研究[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;中国癌症杂志,2019;79(4增刊):OT2-07-09。
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引用次数: 0
Abstract OT1-01-03: The WinPro study: A window of opportunity study of endocrine therapy with and without prometrium in postmenopausal women with early stage hormone receptor-positive breast cancer 摘要:WinPro研究:绝经后早期激素受体阳性乳腺癌妇女使用和不使用前体乳的内分泌治疗的机会之窗研究
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.sabcs18-ot1-01-03
Emma Carson, D. Segara, A. Parker, S. O'toole, A. Coates, B. Mann, G. Lindeman, W. Tilley, E. Lim
Background There is bidirectional interplay between PR and ER in human breast cancers (Lim et al, Endo Rel Can 2016). There is evidence for a reprogramming of ER chromatin binding sites with 470 genes differentially regulated by dual treatment with estrogen plus progestogen compared to estrogen alone in breast cancer cell lines (Mohammed et al, Nature 2015). Functionally, there was an additive anti-cancer effect with the addition of natural progesterone to endocrine therapy in preclinical breast cancer models. Trial Design This is a phase II multi-site, randomised, open-label, three-arm, study in 200 postmenopausal women with early-stage ER+, PR+, HER2-negative breast cancer. Eligible patients will be randomised 1:1:1 to receive 14 days of intervention with either letrozole 2.5mg PO daily (arm 1), letrozole 2.5mg + prometrium 300mg PO daily (arm 2) or tamoxifen 20mg + prometrium 300mg PO daily (arm 3), between diagnosis of breast cancer and definite surgery. Australian Clinical Trials Registry: ACTRN1261800092813 Eligibility Criteria Inclusion Criteria a) Histologically confirmed ER+ and PR+ breast cancers (≥10% positive staining cells) b) HER2/CEP17 ratio of c) Tumour size ≥1cm on ultrasound and/or mammogram d) Aged ≥18 years Exclusion Criteria a) Currently on hormone therapies (HRT and OCP) b) Locally advanced/inoperable and inflammatory breast cancer c) Clinical evidence of metastatic disease d) Received other preoperative systemic therapies e) Nut allergy (prometrium contains peanut oil) f) Prior history of uterine cancer, deep vein thrombosis, pulmonary embolism or clotting disorder g) Women who are pregnant/breast feeding Specific Aims a) Primary Endpoint The geometric mean suppression of the centrally assessed proliferation marker Ki67, after two weeks of intervention, compared with baseline. This will be obtained by comparing the mean difference in Ki67 staining between pre and post-treated samples in each intervention arm. b) Secondary Endpoint Safety and tolerability of combination therapy (NCI-CTCAE v4.0) c) Translational Endpoints 1. Define a gene set as a predictive biomarker for a reduction in Ki67 2. Evaluate changes in the apoptotic markers Bcl-2 and Caspase 3 in the tumors following intervention 3. Evaluate changes in ER, PR, AR, FoxA1, Cyclin D1 protein and mRNA expression in the tumors following intervention Statistical Methods The IMPACT study reported a geometric mean reduction in Ki67 after 2 weeks of preoperative tamoxifen of 59.5% and anastrazole of 76% (Dowsett et al, JNCI 2007). This allows estimation of power to detect differences between Arm 1 and either Arm 2 or Arm 3 with a p-value of 0.025. For the third possible comparison of Arm 2 vs Arm 3, there is no prior evidence, therefore this as a purely exploratory comparison. With a total trial recruitment of 200 and allowing 4% dropouts, this would give 80% power to detect an improvement in Ki67 suppression from 76% in the letrozole alone control arm to 92% in either exp
PR和ER在人类乳腺癌中存在双向相互作用(Lim et al, Endo Rel Can 2016)。有证据表明,在乳腺癌细胞系中,与单独使用雌激素相比,雌激素加孕激素双重治疗会对470个基因的内质网染色质结合位点进行重编程(Mohammed et al . Nature 2015)。在功能上,在临床前乳腺癌模型中,在内分泌治疗中加入天然孕酮具有附加的抗癌作用。这是一项II期多地点、随机、开放标签、三组研究,纳入200名绝经后早期ER+、PR+、her2阴性乳腺癌妇女。符合条件的患者将以1:1:1的比例随机分配,在乳腺癌诊断和确定手术之间接受14天的干预,即每天来曲唑2.5mg PO(第1组),每天来曲唑2.5mg + promeme 300mg PO(第2组)或他莫昔芬20mg + promeme 300mg PO(第3组)。澳大利亚临床试验登记处:ACTRN1261800092813入选标准纳入标准a)组织学证实的ER+和PR+乳腺癌(≥10%阳性染色细胞)b) HER2/CEP17比率c)超声和/或乳房x光检查肿瘤大小≥1cm d)年龄≥18岁排除标准a)目前正在接受激素治疗(HRT和OCP) b)局部晚期/不能手术和炎症性乳腺癌c)转移性疾病的临床证据d)接受其他术前全身治疗e) Nut过敏(prometrime含有f)既往有子宫癌、深静脉血栓形成、肺栓塞或凝血障碍史g)怀孕/哺乳期妇女特定目的a)主要终点干预两周后,与基线相比,中央评估的增殖标志物Ki67的几何平均抑制。这将通过比较每个干预组中处理前和处理后样本的Ki67染色的平均差异来获得。b)次要终点联合治疗的安全性和耐受性(NCI-CTCAE v4.0)定义一个基因集作为Ki67降低的预测性生物标志物2。评价干预3后肿瘤细胞凋亡标志物Bcl-2和Caspase 3的变化。评估干预后肿瘤中ER、PR、AR、FoxA1、Cyclin D1蛋白和mRNA表达的变化统计方法IMPACT研究报告,术前使用他莫昔芬2周后,Ki67的几何平均降低率为59.5%,阿纳特唑为76% (Dowsett et al, JNCI 2007)。这样就可以估计出Arm 1与Arm 2或Arm 3之间的差异,p值为0.025。对于Arm 2与Arm 3的第三种可能的比较,没有先前的证据,因此这是一个纯粹的探索性比较。总试验招募200人,允许4%的退出,这将使80%的能力检测到Ki67抑制的改善,从单独来曲唑对照组的76%提高到任一实验组的92%。应计人数:5人(1个站点开放)目标:200人(共8个站点)联系信息Elgene Lim, MBBS, FRACP, PhD。e.lim@garvan.com.au引文格式:Carson E, Segara D, Parker A, O9Toole S, Coates A, Mann B, Lindeman G, Tilley W, Lim E. WinPro研究:绝经后早期激素受体阳性乳腺癌患者使用和不使用promeium的内分泌治疗的机会之窗研究[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;中国癌症杂志,2019;79(4增刊):no . 1-01-03。
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引用次数: 0
Abstract OT1-12-03: RESCUE: Reaching for Evidence-baSed Chemotherapy Use in Endocrine sensitive breast cancer - A prospective health care study on risk assessment by the clinicomolecular test EndoPredict®and long-term patient outcome in early luminal breast cancer 摘要:拯救:在内分泌敏感性乳腺癌中寻求循证化疗-早期腔内乳腺癌临床分子检测endopdict®的风险评估和患者长期预后的前瞻性卫生保健研究
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.SABCS18-OT1-12-03
J. Ettl, J. Blohmer, C. Denkert, M. Keller, E. Klein, R. Kronenwett, P. Neuser, S. Paepke, C. Schade-Brittinger, K. Schnuppe, M. Untch, M. Wittenberg, M. Kiechle
Background: In node negative and 1-3 positive nodes breast cancer patients with hormone receptor positive (HR+), HER2-negative (HER2-) early-stage breast cancer the indication for chemotherapy is based on clinical and pathologic risk stratification (tumor size, nodal status, grading, quantitative ER, progesterone receptor and Ki67). For further decision-making, the EndoPredict test, which combines a molecular signature with the clinical risk factors tumor size and nodal status, stratifies patients into “low risk" or “high risk” groups. Level I-B- evidence demonstrates, that EndoPredict predicts the 10 year cumulative risk of relapse and metastases in patients with HR+/HER2- primary breast cancer with endocrine treatment. Aim: In the RESCUE-Trial we document distant metastasis-free survival (DMFS), disease free survival (DFS) and overall survival (OS) events in patients who had an EndoPredict test. The primary objective is to show that 10-year DMFS of patients tested as “low risk” by EndoPredict and treated with adjuvant endocrine therapy alone is >90 %. Secondary endpoints among others include DMFS, DFS, OS in patients with EPclin “low risk” versus “high risk”. Also the proportion of patients whose treatment was concordant and non-concordant with EndoPredict test results, will be analyzed for survival. The prognostic performance of classical prognostic factors (like tumor size, nodal status, grading, quantitative ER, progesterone receptor and Ki67 level) with respect to survival will also be assessed. Eligibility: Patient with HR+/HER2- primary invasive breast cancer stage I/II and T1 to T3 with 0 to 3 positive lymph nodes will be eligible, if they had an EndoPredict test within three months before inclusion. Methods: The EndoPredict test results, tumor board decision and anti-tumor therapy will be assessed. After one year, annually (for 10 years), patients will be evaluated for treatment compliance, recurrence, metastases, and survival. The primary endpoint will be analyzed by a Kaplan-Meyer estimate for which a one-sided lower 95 % confidence interval will be given. Several secondary endpoints will be assessed in three interim analyses after completion of the 1st, 3rd, 5th year and then finally after 10 years. Accrual: Start of accrual is planned for July 2018. At least 26 sites in Germany and one site in Switzerland will be active. Sponsor: The study is sponsored by the North-Eastern-German Society of Gynecological Oncology (NOGGO) e.V. Contact Information: For further information, contact NOGGO via studies@noggo.de or the leading physician Dr. Johannes Ettl via johannes.ettl@tum.de. Citation Format: Ettl J, Blohmer J-U, Denkert C, Keller M, Klein E, Kronenwett R, Neuser P, Paepke S, Schade-Brittinger C, Schnuppe K, Untch M, Wittenberg M, Kiechle M. RESCUE: Reaching for Evidence-baSed Chemotherapy Use in Endocrine sensitive breast cancer - A prospective health care study on risk assessment by the clinicomolecular test EndoPredict® and long-ter
背景:在激素受体阳性(HR+)、HER2阴性(HER2-)的早期乳腺癌淋巴结阴性和1-3阳性患者中,化疗的适应证是基于临床和病理风险分层(肿瘤大小、淋巴结状态、分级、定量ER、孕酮受体和Ki67)。为了进一步做出决策,endoppredict测试将分子特征与临床危险因素肿瘤大小和淋巴结状态相结合,将患者分为“低风险”组和“高风险”组。I-B级证据表明,endoppredict预测接受内分泌治疗的HR+/HER2-原发性乳腺癌患者10年复发和转移的累积风险。目的:在rescue -试验中,我们记录了接受endoppredict测试的患者的远端无转移生存(DMFS)、无疾病生存(DFS)和总生存(OS)事件。主要目的是显示经endoppredict检测为“低风险”并单独接受辅助内分泌治疗的患者的10年DMFS > 90%。次要终点包括EPclin“低风险”与“高风险”患者的DMFS、DFS、OS。此外,将对治疗与endoppredict测试结果一致和不一致的患者比例进行生存分析。经典预后因素(如肿瘤大小、淋巴结状态、分级、定量ER、孕酮受体和Ki67水平)与生存相关的预后表现也将被评估。资格:HR+/HER2-原发性浸润性乳腺癌I/II期和T1至T3期伴有0至3个阳性淋巴结的患者,如果他们在纳入前三个月内进行了endoppredict测试,将符合条件。方法:对endoppredict试验结果、肿瘤委员会决定和抗肿瘤治疗进行评估。1年后,每年(10年)评估患者的治疗依从性、复发、转移和生存。主要终点将通过Kaplan-Meyer估计进行分析,该估计将给出单侧较低的95%置信区间。几个次要终点将在完成第1年、第3年、第5年和最后10年后的三个中期分析中进行评估。应计项目:应计项目计划于2018年7月开始。德国至少有26个站点和瑞士的一个站点将处于活跃状态。赞助方:该研究由德国东北妇科肿瘤学会(NOGGO) e.V赞助。联系信息:欲了解更多信息,请通过studies@noggo.de与NOGGO联系,或通过johannes.ettl@tum.de与主治医师Johannes Ettl博士联系。引用格式:etttl J, Blohmer J- u, Denkert C, Keller M, Klein E, Kronenwett R, Neuser P, Paepke S, schde - brittinger C, Schnuppe K, Untch M, Wittenberg M, Kiechle M. RESCUE:在内分泌敏感乳腺癌中使用循证化疗——早期腔内乳腺癌临床分子检测endoprect®风险评估与患者长期预后的前瞻性卫生保健研究[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;中国癌症杂志,2019;79(4增刊):1-12-03。
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引用次数: 2
Abstract OT3-03-02: A phase 2, open-label, single-arm, multi-center study of talazoparib for neoadjuvant treatment of germlineBRCA1/2mutation patients with early-stage triple-negative breast cancer (TNBC) OT3-03-02: talazoparib用于生殖系brca1 /2突变早期三阴性乳腺癌(TNBC)患者新辅助治疗的2期、开放标签、单臂、多中心研究
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.SABCS18-OT3-03-02
J. Litton, F. Symmans, K. Gogineni, M. Saltzman, M. Telli, L. Usha, J. Chakrabarti, I. C. Tudor, R. Quek, A. Czibere
Background: Approximately 15% of all breast cancers are triple negative and deleterious BRCA1/2 mutations are found in ˜11% of unselected TNBC. In the phase 3 EMBRACA trial (NCT01945775), the poly (ADP-ribose) polymerase (PARP) inhibitor talazoparib was superior to chemotherapy in prolonging progression-free survival in BRCA1/2 mutation patients with advanced breast cancer. A recent pilot study (NCT02282345) of 20 patients, explored the feasibility of neoadjuvant talazoparib in BRCA1/2 mutation patients; pathologic complete response (pCR) was reported at 53% with 6 months of single agent talazoparib. Trial Design: This phase 2, single-arm, open-label, multi-center study has a Simon 2-stage design. Eligible pts have stage I-III invasive TNBC (ER and PR Funding: This study is sponsored by Pfizer, Inc. Citation Format: Litton J, Symmans F, Gogineni K, Saltzman M, Telli ML, Usha L, Chakrabarti J, Tudor IC, Quek RG, Czibere A. A phase 2, open-label, single-arm, multi-center study of talazoparib for neoadjuvant treatment of germline BRCA1/2 mutation patients with early-stage triple-negative breast cancer (TNBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT3-03-02.
背景:大约15%的乳腺癌是三阴性,有害的BRCA1/2突变在约11%的未选择的TNBC中被发现。在3期试验(NCT01945775)中,聚(adp -核糖)聚合酶(PARP)抑制剂talazoparib在延长BRCA1/2突变晚期乳腺癌患者的无进展生存期方面优于化疗。最近一项包含20名患者的试点研究(NCT02282345)探讨了BRCA1/2突变患者新辅助塔拉唑帕尼的可行性;单药talazoparib治疗6个月后,病理完全缓解率(pCR)为53%。试验设计:该2期、单臂、开放标签、多中心研究采用Simon 2期设计。符合条件的患者为I-III期浸润性TNBC (ER和PR)。引文格式:Litton J, Symmans F, Gogineni K, Saltzman M, Telli ML, Usha L, Chakrabarti J, Tudor IC, Quek RG, Czibere A. talazoparib新辅助治疗种系BRCA1/2突变早期三阴性乳腺癌(TNBC)的2期、开放标签、单臂、多中心研究[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;中国癌症杂志,2019;79(4增刊):no . 3-03-02。
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引用次数: 1
Abstract OT3-08-01: A phase Ib/II clinical trial investigating the efficacy of nitric oxide deprivation and docetaxel in triple negative breast cancer 摘要:一项Ib/II期临床试验研究一氧化氮剥夺和多西紫杉醇治疗三阴性乳腺癌的疗效
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.SABCS18-OT3-08-01
A. Chung, J. Ensor, Jorge Darcourt, A. Belcheva, T. Patel, Jenny C. Chang, P. Niravath
Triple negative breast cancer (TNBC) is an aggressive disease that currently lacks an efficacious form of therapy. Although chemotherapy is the current standard of care for metastatic TNBC, the 5-year prognosis remains grim with a high rate of disease recurrence. Cancer relapse is thought to be initiated by chemotherapy-resistant breast cancer stem cells (BCSCs). These BCSCs give rise to a diverse clonal population that results in a heterogeneous cancer, which complicates targeted therapeutic strategies. Our previous studies revealed that BCSCs utilize inducible nitric oxide synthase (iNOS)-derived nitric oxide to promote their proliferation, migration, and self-renewal capacity. In an effort to target the BCSC population, we found that iNOS inhibition with NG-monomethyl-L-arginine (L-NMMA) sensitized BCSCs to docetaxel in vivo in TNBC xenograft models, leading to decreased BCSC viability and tumor burden. These findings suggest that BCSC resist conventional therapy in a nitric oxide-dependent manner and that combination of L-NMMA with docetaxel will effectively target BCSCs to prevent further relapse. A phase Ib/II clinical trial was conducted to determine the maximum tolerated dose, recommended phase 2 dose (R2PD), dose-limiting toxicities (DLTs), and efficacy of the L-NMMA and docetaxel combination in TNBC patients with chemotherapy-refractory locally advanced or metastatic disease. For the phase Ib portion of the study, a standard Bayesian continual reassessment method is being used to investigate 7 dose levels of L-NMMA (5, 7.5, 10, 12.5, 15, 17.5, and 20 mg/kg) and two dose levels of docetaxel (75 and 100 mg/m2). Sixteen patients have been recruited to date, and based on current pharmacokinetics, pharmacodynamics, and safety data, the RP2D is expected to be docetaxel 100 mg/m2 (Day 1) and L-NMMA 20 mg/kg (Days 1-5) every 3 weeks. Two and three patients received 15 mg/kg L-NMMA + 75 mg/m2 docetaxel and 17.5 mg/kg L-NMMA + 100 mg/m2 docetaxel, respectively. Of these 5 patients, one partial responder completed 8 cycles before discontinuing treatment due to taxane-associated neuropathy. Among the five patients treated at the RP2D, only one taxane-associated DLT occurred. The overall response rate for patients treated at the higher doses was 22.2%. Early results of the phase Ib/II trial indicate the safety, tolerability, and promising activity of the first-in-class pan-NOS inhibitor L-NMMA in combination with chemotherapy in the treatment of chemotherapy-refractory TNBC. Citation Format: Chung AW, Ensor JE, Darcourt J, Belcheva A, Patel T, Chang JC, Niravath PA. A phase Ib/II clinical trial investigating the efficacy of nitric oxide deprivation and docetaxel in triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT3-08-01.
三阴性乳腺癌(TNBC)是一种侵袭性疾病,目前缺乏有效的治疗形式。虽然化疗是目前治疗转移性TNBC的标准,但由于疾病复发率高,5年预后仍然严峻。癌症复发被认为是由化疗耐药乳腺癌干细胞(BCSCs)引发的。这些BCSCs产生多样化的克隆群体,导致异质性癌症,使靶向治疗策略复杂化。我们之前的研究表明,BCSCs利用诱导型一氧化氮合酶(iNOS)衍生的一氧化氮来促进其增殖、迁移和自我更新能力。在针对BCSC人群的研究中,我们发现,在TNBC异种移植模型中,ng -单甲基- l-精氨酸(L-NMMA)抑制iNOS可使BCSC对多西紫杉醇增敏,从而降低BCSC的活力和肿瘤负担。这些研究结果表明,BCSC以一氧化氮依赖的方式抵抗常规治疗,L-NMMA联合多西他赛将有效靶向BCSC以防止进一步复发。进行了一项Ib/II期临床试验,以确定L-NMMA和多西他赛联合治疗化疗难治性局部晚期或转移性TNBC患者的最大耐受剂量、推荐2期剂量(R2PD)、剂量限制性毒性(dlt)和疗效。对于Ib期研究部分,正在使用标准贝叶斯连续重新评估方法来研究7个剂量水平的L-NMMA(5、7.5、10、12.5、15、17.5和20 mg/kg)和2个剂量水平的多西他赛(75和100 mg/m2)。到目前为止,已经招募了16名患者,根据目前的药代动力学、药效学和安全性数据,RP2D预计为每3周使用多西他赛100 mg/m2(第1天)和L-NMMA 20 mg/kg(第1-5天)。2例和3例患者分别接受15 mg/kg L-NMMA + 75 mg/m2多西他赛和17.5 mg/kg L-NMMA + 100 mg/m2多西他赛治疗。在这5例患者中,有1例部分缓解者完成了8个疗程后,因紫杉烷相关神经病变而停止治疗。在RP2D治疗的5例患者中,仅发生了一例紫杉烷相关的DLT。接受高剂量治疗的患者的总有效率为22.2%。Ib/II期试验的早期结果表明,同类首创的泛nos抑制剂L-NMMA联合化疗治疗化疗难治性TNBC的安全性、耐受性和有希望的活性。引用格式:Chung AW, Ensor JE, Darcourt J, Belcheva A, Patel T, Chang JC, Niravath PA。一项Ib/II期临床试验研究一氧化氮剥夺和多西紫杉醇治疗三阴性乳腺癌的疗效[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;中国癌症杂志,2019;79(4增刊):03-08-01。
{"title":"Abstract OT3-08-01: A phase Ib/II clinical trial investigating the efficacy of nitric oxide deprivation and docetaxel in triple negative breast cancer","authors":"A. Chung, J. Ensor, Jorge Darcourt, A. Belcheva, T. Patel, Jenny C. Chang, P. Niravath","doi":"10.1158/1538-7445.SABCS18-OT3-08-01","DOIUrl":"https://doi.org/10.1158/1538-7445.SABCS18-OT3-08-01","url":null,"abstract":"Triple negative breast cancer (TNBC) is an aggressive disease that currently lacks an efficacious form of therapy. Although chemotherapy is the current standard of care for metastatic TNBC, the 5-year prognosis remains grim with a high rate of disease recurrence. Cancer relapse is thought to be initiated by chemotherapy-resistant breast cancer stem cells (BCSCs). These BCSCs give rise to a diverse clonal population that results in a heterogeneous cancer, which complicates targeted therapeutic strategies. Our previous studies revealed that BCSCs utilize inducible nitric oxide synthase (iNOS)-derived nitric oxide to promote their proliferation, migration, and self-renewal capacity. In an effort to target the BCSC population, we found that iNOS inhibition with NG-monomethyl-L-arginine (L-NMMA) sensitized BCSCs to docetaxel in vivo in TNBC xenograft models, leading to decreased BCSC viability and tumor burden. These findings suggest that BCSC resist conventional therapy in a nitric oxide-dependent manner and that combination of L-NMMA with docetaxel will effectively target BCSCs to prevent further relapse. A phase Ib/II clinical trial was conducted to determine the maximum tolerated dose, recommended phase 2 dose (R2PD), dose-limiting toxicities (DLTs), and efficacy of the L-NMMA and docetaxel combination in TNBC patients with chemotherapy-refractory locally advanced or metastatic disease. For the phase Ib portion of the study, a standard Bayesian continual reassessment method is being used to investigate 7 dose levels of L-NMMA (5, 7.5, 10, 12.5, 15, 17.5, and 20 mg/kg) and two dose levels of docetaxel (75 and 100 mg/m2). Sixteen patients have been recruited to date, and based on current pharmacokinetics, pharmacodynamics, and safety data, the RP2D is expected to be docetaxel 100 mg/m2 (Day 1) and L-NMMA 20 mg/kg (Days 1-5) every 3 weeks. Two and three patients received 15 mg/kg L-NMMA + 75 mg/m2 docetaxel and 17.5 mg/kg L-NMMA + 100 mg/m2 docetaxel, respectively. Of these 5 patients, one partial responder completed 8 cycles before discontinuing treatment due to taxane-associated neuropathy. Among the five patients treated at the RP2D, only one taxane-associated DLT occurred. The overall response rate for patients treated at the higher doses was 22.2%. Early results of the phase Ib/II trial indicate the safety, tolerability, and promising activity of the first-in-class pan-NOS inhibitor L-NMMA in combination with chemotherapy in the treatment of chemotherapy-refractory TNBC. Citation Format: Chung AW, Ensor JE, Darcourt J, Belcheva A, Patel T, Chang JC, Niravath PA. A phase Ib/II clinical trial investigating the efficacy of nitric oxide deprivation and docetaxel in triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT3-08-01.","PeriodicalId":19476,"journal":{"name":"Ongoing Clinical Trials","volume":"112 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88070736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Abstract OT3-02-05: CORALLEEN: A phase 2 clinical trial of chemotherapy or letrozole plus ribociclib as neoadjuvant treatment for postmenopausal patients with luminal B/HER2-negative breast cancer 摘要:CORALLEEN:化疗或来曲唑联合核波西尼作为绝经后腔B/ her2阴性乳腺癌患者新辅助治疗的2期临床试验
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.sabcs18-ot3-02-05
J. Gavilá, C. Saura, M. Oliveira, E. Ciruelos, X. Gonzàlez, L. Peña, B. Heras, M. Muñoz, P. Fernandez, P. Villagrasa, V. Ortega, R. Lopez, Pamela Céliz, T. Pascual, A. Prat
Background: Dysregulation of cyclin D-CDK4/6-Rb pathway is associated with endocrine resistance in hormone receptor–positive (HR+) breast cancer. Recently, a CDK4/6 inhibitor has shown unprecedented efficacy in metastatic disease, leading to its regulatory approval. Several others are currently in clinical development for the management of HR+ breast cancer in the early and advanced settings. However, it is vital to gain insights into the molecular and biological effects of this class of agents and could identify patients who can benefit the most, delaying or avoiding the use of chemotherapy.The neoadjuvant setting provides an ideal scenario to carry out these investigations. Hence, we propose to conduct an exploratory study to evaluate the biological effects and the efficacy of ribociclib in patients with primary luminal B tumors. We hypothesize that the combination of ribociclib plus letrozole may offer clinical benefit in the preoperative setting. Methods: This is a parallel, multicenter, two-arm, randomized exploratory study in postmenopausal women with primary operable HR+/HER2-negative Luminal B breast cancer designed to evaluate the clinical benefit of ribociclib plus letrozole. Eligibility includes stage I-III operable breast cancer, Luminal B by PAM50, ECOG 0-1. They will be randomized 1:1 to receive either six 28-days cycles of ribociclib (600mg; 3-weeks-on/1-week-off) plus daily letrozole (2.5mg) or chemotherapy: four cycles of AC (doxorubicin 60 mg/m2, cyclophosphamide 600 mg/m2 every 21 days) followed by weekly paclitaxel during 12 weeks. Baseline, Day 15 on-treatment, and surgical specimens will be collected for molecular characterization and evaluation of response (decrease in Ki67, change to ROR low disease) The primary endpoint is the rate of Residual Cancer Burden (RCB) per MD Anderson Cancer Center procedures. A rate of RCB 0 and 1 score at surgery, with a rank between 20% to 25% with 47 evaluable patients by group of treatment will offer a precision between 11.5% and 12.4%, respectively (95%CI). Ninety-four patients will be enrolled in 21 sites across Spain. The trial was activated in July 2017. As of June 2018, 78 patients have been recruited. Citation Format: Gavila J, Saura C, Oliveira M, Ciruelos E, Gonzalez X, de la Pena L, Bermejo de las Heras B, Munoz M, Fernandez P, Villagrasa P, Ortega V, Lopez R, Celiz P, Pascual T, Prat A. CORALLEEN: A phase 2 clinical trial of chemotherapy or letrozole plus ribociclib as neoadjuvant treatment for postmenopausal patients with luminal B/HER2-negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT3-02-05.
背景:在激素受体阳性(HR+)乳腺癌中,周期蛋白D-CDK4/6-Rb通路失调与内分泌抵抗有关。最近,一种CDK4/6抑制剂在转移性疾病中显示出前所未有的疗效,并获得监管机构批准。其他一些药物目前正处于临床开发阶段,用于早期和晚期HR+乳腺癌的治疗。然而,至关重要的是要深入了解这类药物的分子和生物学效应,并确定哪些患者可以获益最多,推迟或避免使用化疗。新辅助设置为开展这些调查提供了理想的方案。因此,我们建议开展一项探索性研究,评估核素环尼在原发性B腔肿瘤患者中的生物学效应和疗效。我们假设核素昔布加来曲唑在术前可能会提供临床益处。方法:这是一项平行、多中心、双组、随机的探索性研究,研究对象是绝经后原发性可手术的HR+/ her2阴性Luminal B乳腺癌妇女,旨在评估核素昔布联合来曲唑的临床获益。资格包括I-III期可手术乳腺癌,Luminal B by PAM50, ECOG 0-1。他们将以1:1的比例随机接受6个28天周期的核糖环尼(600mg;3周开/1周停)加每日来曲唑(2.5mg)或化疗:4个周期AC(阿霉素60mg /m2,环磷酰胺600mg /m2每21天),然后每周紫杉醇12周。基线、治疗第15天和手术标本将被收集,用于分子表征和反应评估(Ki67降低,变为低ROR疾病)。主要终点是MD安德森癌症中心手术的残余癌症负担率(RCB)。手术时RCB评分为0和1的比率,评分在20%到25%之间,47名可评估的患者按治疗组划分,精确度分别在11.5%到12.4%之间(95%CI)。将在西班牙的21个地点招募94名患者。该试验于2017年7月启动。截至2018年6月,已招募78名患者。引用格式:Gavila J, Saura C, Oliveira M, Ciruelos E, Gonzalez X, de la Pena L, Bermejo de las Heras B, Munoz M, Fernandez P, Villagrasa P, Ortega V, Lopez R, Celiz P, Pascual T, Prat A. CORALLEEN:化疗或来曲唑联合核素西尼作为绝经后腔内B/ her2阴性乳腺癌新辅助治疗的2期临床研究[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;中国癌症杂志,2019;79(4增刊):OT3-02-05。
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引用次数: 0
Abstract OT2-07-06: Antibody-coupled T cell receptor (ACTR) engineered autologous T cells in combination with trastuzumab for the treatment of HER2-positive malignancies 摘要:抗体偶联T细胞受体(ACTR)工程化自体T细胞联合曲妥珠单抗治疗her2阳性恶性肿瘤
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.SABCS18-OT2-07-06
Katie O'Callaghan, John H. Shin, A. Cheung, Tooba A. Cheema, Casey Judge, A. Ranger, Heather A. Huet, S. Ettenberg, J. Sachs, M. Vasconcelles, Greg T. Motz
Antibody-Coupled T cell Receptor (ACTR) is an autologous engineered T cell therapy developed to combine with tumor-targeting antibodies to exert potent anti-tumor immune responses and tumor cell killing. The ACTR construct is composed of the extracellular domain of CD16 fused to CD3ζ signaling and T cell co-stimulatory domains. ACTR-expressing T cells are universal in that they can be paired with a therapeutic antibody to target specific antigens on tumors. Unum has two ACTR constructs, ACTR087 and ACTR707, currently in clinical testing. ACTR087 and ACTR707 are being tested in combination with rituximab in subjects with CD20+ B cell lymphoma in two separate trials (NCT02776813 and NCT03189836, respectively). Preliminary data with ACTR087 + rituximab has demonstrated clinical proof-of-concept and a dose-response relationship in subjects with relapsed/refractory B cell lymphoma. ACTR087 is also being tested in combination with a novel BCMA-targeting antibody in subjects with multiple myeloma (NCT03266692). While T cell therapies, such as chimeric antigen receptor (CAR) T cells, have demonstrated clinical activity in hematological cancers, the therapeutic potential of this approach has yet to be established in solid tumors. Challenges associated with targeting solid tumors with CAR-T cells include tumor antigen heterogeneity and antigen expression on normal tissues. HER2 is a well-established therapeutic target that is over-expressed in a number of cancer indications. HER2 is also expressed at low levels on normal epithelial cells, creating a risk for on-target/off-tumor toxicities of HER2-targeted CAR-T cells. Here we present nonclinical studies demonstrating that ACTR T cells in combination with trastuzumab have antigen density-dependent activity on HER2-expressing tumor cell lines, while trastuzumab-based CAR-T cells do not. We observed that ACTR + trastuzumab had robust activity against HER2-amplified tumor cells and more modest activity against non-amplified tumor cells, whereas HER2-targeting CAR-T cells had comparable activity against HER2-amplified and non-amplified tumor cells. On normal human primary cells, ACTR + trastuzumab had minimal activity in comparison to HER2 CAR-T cells, suggesting that ACTR + trastuzumab may exhibit a superior clinical therapeutic index. Furthermore, the activity of ACTR T cells against HER2-amplified tumor cells was titratable with antibody concentration, allowing for control of ACTR activity by modulation of trastuzumab concentration. Together, these data demonstrate the specificity of the ACTR T cell therapeutic approach to target HER2-amplified tumors and support clinical testing in combination with trastuzumab. A phase 1, multicenter, single-arm, open-label dose escalation study, ATTCK-34-01, is proposed to evaluate ACTR T cells in combination with trastuzumab in subjects with advanced HER2-positive malignancies. The primary study objectives are to assess the safety and tolerability of the combination, and
抗体偶联T细胞受体(ACTR)是一种自体工程化T细胞疗法,与肿瘤靶向抗体结合,发挥有效的抗肿瘤免疫反应和肿瘤细胞杀伤作用。ACTR结构由融合CD3ζ信号和T细胞共刺激结构域的CD16细胞外结构域组成。表达actr的T细胞是通用的,因为它们可以与针对肿瘤特异性抗原的治疗性抗体配对。Unum有两种ACTR构建物,ACTR087和ACTR707,目前正在临床试验中。ACTR087和ACTR707正在两项单独的试验(分别为NCT02776813和NCT03189836)中与美罗华联合治疗CD20+ B细胞淋巴瘤。初步数据显示,ACTR087 +利妥昔单抗在复发/难治性B细胞淋巴瘤患者中的临床概念验证和剂量-反应关系。ACTR087还在多发性骨髓瘤患者中与一种新型bcma靶向抗体(NCT03266692)联合进行测试。虽然T细胞疗法,如嵌合抗原受体(CAR) T细胞,已经在血液学癌症中证明了临床活性,但这种方法在实体肿瘤中的治疗潜力尚未建立。CAR-T细胞靶向实体瘤的挑战包括肿瘤抗原的异质性和抗原在正常组织中的表达。HER2是一个公认的治疗靶点,在许多癌症适应症中过度表达。HER2在正常上皮细胞上的表达水平也很低,这就造成了HER2靶向CAR-T细胞靶向/非肿瘤毒性的风险。在这里,我们提出的非临床研究表明,ACTR T细胞联合曲妥珠单抗对表达her2的肿瘤细胞系具有抗原密度依赖性活性,而基于曲妥珠单抗的CAR-T细胞则没有。我们观察到,ACTR +曲妥珠单抗对her2扩增的肿瘤细胞具有强大的活性,对非扩增的肿瘤细胞具有更温和的活性,而靶向her2的CAR-T细胞对her2扩增和非扩增的肿瘤细胞具有相当的活性。在正常的人原代细胞上,与HER2 CAR-T细胞相比,ACTR +曲妥珠单抗的活性最小,这表明ACTR +曲妥珠单抗可能具有优越的临床治疗指数。此外,ACTR T细胞对her2扩增的肿瘤细胞的活性可以用抗体浓度滴定,允许通过调节曲妥珠单抗浓度来控制ACTR活性。总之,这些数据证明了ACTR T细胞治疗方法靶向her2扩增肿瘤的特异性,并支持与曲妥珠单抗联合进行临床试验。一项1期、多中心、单臂、开放标签剂量递增研究ATTCK-34-01,旨在评估ACTR T细胞联合曲妥珠单抗在晚期her2阳性恶性肿瘤患者中的应用。研究的主要目的是评估联合用药的安全性和耐受性,并确定推荐的2期剂量组合以供进一步研究。其他目标包括评估抗肿瘤活性、ACTR T细胞持久性和曲妥珠单抗药代动力学。预计入学将于2019年初开始。引用格式:09 callaghan KM, Shin J, Cheung AS, Cheema T, Judge C, Ranger A, Huet HA, Ettenberg SA, Sachs J, Vasconcelles M, Motz G.抗体-联性T细胞受体(ACTR)工程自体T细胞联合曲珠单抗治疗her2阳性恶性肿瘤[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;中国癌症杂志,2019;79(4增刊):OT2-07-06。
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引用次数: 0
Abstract OT2-08-01: Personalized breast cancer screening in a population based study: Women Informed to Screen Depending On Measures of risk (WISDOM) 摘要OT2-08-01:在一项基于人群的研究中进行个性化乳腺癌筛查:根据风险指标(WISDOM)接受筛查的女性
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.sabcs18-ot2-08-01
I. Acerbi, Yiwey Shieh, L. Madlensky, J. Tice, E. Ziv, M. Eklund, Amie M. Blanco, D. DeRosa, B. Tong, D. Goodman, L. Nassereddine, N. Anderson, H. Harvey, T. Layton, H. Park, Antonia Petruse, S. Stewart, J. Wernisch, L. Risty, B. Koenig, S. Sarrafan, R. Firouzian, C. Kaplan, R. Hiatt, B. Parker, Neil S. Wenger, Vivian Lee, D. Heditsian, S. Brain, A. Fiscalini, A. Borowsky, H. Anton-Culver, A. Naeim, A. Kaster, M. Talley, L. V. Veer, Andrea Z. LaCroix, L. Esserman, Wisdom Study, Advocate Partners
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引用次数: 0
Abstract OT2-07-01: DETECT V/CHEVENDO – Comparison of dual HER2-targeted therapy with trastuzumab plus pertuzumab in combination with chemo- or endocrine therapy in addition with CDK4/6 inhibition in patients with HER2-positive and hormone-receptor positive metastatic breast cancer OT2-07-01: DETECT V/CHEVENDO -在her2阳性和激素受体阳性转移性乳腺癌患者中,曲妥珠单抗+帕妥珠单抗联合化疗或内分泌治疗以及CDK4/6抑制的双重her2靶向治疗的比较
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.SABCS18-OT2-07-01
Sabrina Krause, T. Friedl, T. Fehm, T. Romashova, P. Fasching, A. Schneeweiss, V. Müller, F. Taran, A. Polasik, M. Tzschaschel, A. D. Gregorio, F. Meier-Stiegen, W. Janni, J. Huober
Background: Metastatic breast cancer (MBC) is usually an incurable disease and maintenance of quality of life (QoL) is one of the main aims of therapy. In patients with HER2-positive MBC taxane-based chemotherapy in combination with dual HER2 targeted therapy with trastuzumab and pertuzumab,is the standard of care. Adverse events are well-known side effects of any cytostatic treatment and can seriously impact the patients9 QoL. The synergistic combination of dual HER2-targeted therapy with trastuzumab and pertuzumab plus endocrine therapy might offer a better treatment option for these patients. First clinical trials suggest an additional benefit when a CDK4/6 inhibitor is added to the combination of endocrine therapy and anti HER2 treatment. DETECT V is a randomized phase III study comparing the safety and efficacy of trastuzumab plus pertuzumab and the CDK 4/6 inhibitor ribociclib in combination with either endocrine therapy or chemotherapy. Trial design: Patients with HER2 positive and hormone-receptor positive MBC are 1:1 randomized to receive trastuzumab and pertuzumab combined with endocrine therapy and ribociclib or to chemotherapy with trastuzumab and pertuzumab followed by maintenance therapy with trastuzumab, pertuzumab, endocrine therapy and ribociclib. Chemotherapy and the endocrine agents can be chosen from a variety of available regimens according to the physicians discretion. Specific aims: The primary objective of this study is to compare safety and tolerability in both arms, as assessed by the occurrence of AEs during the treatment period. Secondary endpoints are progression free survival, overall survival, quality-adjusted survival using the quality-adjusted time without symptoms and toxicity (Q-TWiST) method. A translational program is included investigating detection and phenotyping of circulating tumor cells (CTC)-and the assessment of marker expression on CTCs in order to validate an endocrine responsiveness score. Present accrual and target accrual: The DETECT V trial started 2015 in the Dept. of Gynecology, University of Ulm and at the up to 120 sites in Germany. Until June 2018 97 patients with HER2-positive, hormone-receptor positive metastatic breast cancer have been enrolled. A sample size of 270 patients is planned. Contact information: Jens Huober, University of Ulm, Dept of Gynecology, Breast Center, jens.huober@uniklinik-ulm.de Sabrina Krause, University of Ulm, Dept of Gynecology, sabrina.krause@uniklinik-ulm.de Citation Format: Krause S, Friedl T, Fehm T, Romashova T, Fasching PA, Schneeweiss A, Muller V, Taran F-A, Polasik A, Tzschaschel M, De Gregorio A, Meier-Stiegen F, Janni W, Huober J. DETECT V/CHEVENDO – Comparison of dual HER2-targeted therapy with trastuzumab plus pertuzumab in combination with chemo- or endocrine therapy in addition with CDK4/6 inhibition in patients with HER2-positive and hormone-receptor positive metastatic breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cance
背景:转移性乳腺癌(MBC)通常是一种无法治愈的疾病,维持生活质量(QoL)是治疗的主要目的之一。在HER2阳性MBC患者中,紫杉烷为基础的化疗联合曲妥珠单抗和帕妥珠单抗的双重HER2靶向治疗是标准的护理。不良事件是任何细胞抑制剂治疗的众所周知的副作用,可严重影响患者的生活质量。双her2靶向治疗与曲妥珠单抗和帕妥珠单抗加内分泌治疗的协同联合可能为这些患者提供更好的治疗选择。首次临床试验表明,在内分泌治疗和抗HER2治疗的联合治疗中加入CDK4/6抑制剂会有额外的益处。DETECT V是一项随机III期研究,比较曲妥珠单抗+帕妥珠单抗和cdk4 /6抑制剂核糖环尼联合内分泌治疗或化疗的安全性和有效性。试验设计:HER2阳性和激素受体阳性MBC患者1:1随机接受曲妥珠单抗和帕妥珠单抗联合内分泌治疗和核波西尼,或曲妥珠单抗和帕妥珠单抗化疗,然后曲妥珠单抗、帕妥珠单抗、内分泌治疗和核波西尼维持治疗。化疗和内分泌药物可以根据医生的判断从各种可用的方案中选择。具体目的:本研究的主要目的是比较两组的安全性和耐受性,通过治疗期间不良事件的发生来评估。次要终点是无进展生存期、总生存期、质量调整生存期(使用无症状和毒性的质量调整时间)(Q-TWiST)方法。翻译程序包括研究循环肿瘤细胞(CTC)的检测和表型,以及CTC上标记物表达的评估,以验证内分泌反应性评分。当前累积和目标累积:2015年在乌尔姆大学妇科和德国多达120个地点开始了DETECT V试验。截至2018年6月,已有97例her2阳性、激素受体阳性转移性乳腺癌患者入组。计划样本量为270例。联系方式:Jens Huober,乌尔姆大学,妇科,乳房中心,jens.huober@uniklinik-ulm.de Sabrina Krause,乌尔姆大学,妇科,sabrina.krause@uniklinik-ulm.deKrause S, Friedl T, Fehm T, Romashova T, Fasching PA, Schneeweiss A, Muller V, Taran F-A, Polasik A, Tzschaschel M, De Gregorio A, Meier-Stiegen F, Janni W, Huober J. DETECT V/CHEVENDO - her2阳性和激素受体阳性转移性乳腺癌患者化疗或内分泌联合抑制CDK4/6的her2靶向治疗比较[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;中国癌症杂志,2019;79(4增刊):OT2-07-01。
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引用次数: 0
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