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JOURNAL ONKOLOGIE – STUDIE

A Phase III Randomised Study to Evaluate Dato-DXd and Durvalumab for Neoadjuvant/Adjuvant Treatment of Triple-Negative or Hormone Receptor-low/HER2-negative Breast Cancer

Rekrutierend

NCT-Nummer:
NCT06112379

Studienbeginn:
November 2023

Letztes Update:
19.04.2024

Wirkstoff:
Dato-DXd, Durvalumab, Pembrolizumab, Doxorubicin, Epirubicin, Cyclophosphamide, Paclitaxel, Carboplatin, Capecitabine, Olaparib

Indikation (Clinical Trials):
Breast Neoplasms

Geschlecht:
Alle

Altersgruppe:
Erwachsene (18+)

Phase:
Phase 3

Sponsor:
AstraZeneca

Collaborator:
Daiichi Sankyo

Kontakt

AstraZeneca Clinical Study Information Center
Kontakt:
Phone: 1-877-240-9479
E-Mail: information.center@astrazeneca.com
» Kontaktdaten anzeigen

Studienlocations
(3 von 334)

Research Site
10967 Berlin
(Berlin)
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13125 Berlin
(Berlin)
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06847 Dessau-Roßlau
(Sachsen-Anhalt)
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01307 Dresden
(Sachsen)
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91054 Erlangen
(Bayern)
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45130 Essen
(Nordrhein-Westfalen)
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73730 Esslingen am Neckar
(Baden-Württemberg)
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60431 Frankfurt am Main
(Hessen)
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79106 Freiburg
(Baden-Württemberg)
GermanySchwebend» Google-Maps
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79110 Freiburg
(Baden-Württemberg)
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30559 Hannover
(Niedersachsen)
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30625 Hannover
(Niedersachsen)
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69120 Heidelberg
(Baden-Württemberg)
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24105 Kiel
(Schleswig-Holstein)
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55131 Mainz
(Rheinland-Pfalz)
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68167 Mannheim
(Baden-Württemberg)
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80637 München
(Bayern)
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48149 Münster
(Nordrhein-Westfalen)
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54290 Trier
(Rheinland-Pfalz)
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36526 Daphne
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85054 Phoenix
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85711 Tucson
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72401 Jonesboro
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72758 Rogers
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93309 Bakersfield
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92835 Fullerton
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90033 Los Angeles
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90095 Los Angeles
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92868 Orange
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93105 Santa Barbara
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90505 Torrance
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91405 Van Nuys
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80045 Aurora
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80528 Fort Collins
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80504 Longmont
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06606 Bridgeport
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33901 Fort Myers
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32224 Jacksonville
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34952 Port Saint Lucie
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32308 Tallahassee
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33401 West Palm Beach
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30322 Atlanta
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30342 Atlanta
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41017 Edgewood
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40202 Louisville
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70817 Baton Rouge
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21401 Annapolis
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02215 Boston
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48202 Detroit
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55337 Burnsville
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55407 Minneapolis
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65212 Columbia
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68130 Omaha
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89074 Henderson
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08103 Camden
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08901 New Brunswick
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11725 Commack
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10065 New York
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11776 Port Jefferson Station
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28204 Charlotte
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27710 Durham
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44710 Canton
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97401 Eugene
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97223 Portland
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19044 Horsham
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19104 Philadelphia
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15212 Pittsburgh
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37203 Nashville
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78731 Austin
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75231 Dallas
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75390-8843 Dallas
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79902 El Paso
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75028 Flower Mound
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76104 Fort Worth
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77030 Houston
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78240 San Antonio
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77598 Webster
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22042 Falls Church
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23502 Norfolk
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24014 Roanoke
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2010 Darlinghurst
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6800 Libramont-Chevigny
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71681-603 Brasilia
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80440-220 Curitiba
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60336-045 Fortaleza
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86015-520 Londrina
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90035-000 Porto Alegre
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90035-903 Porto Alegre
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14051-140 Ribeirão Preto
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09060-650 Santo Andre
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01246-000 São Paulo
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12030-200 Taubaté
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29043-260 Vitória
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A1B 3V6 St. John's
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050020 Shijiazhuang
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41076 Caen Cedex 5
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63011 Clermont Ferrand
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44805 Saint Herblain
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54519 Vandoeuvre les Nancy
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94805 Villejuif Cedex
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00000 Hong Kong
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999077 Hong Kong
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999077 Kwai Chung
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4400 Nyíregyháza
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3100 Salgótarján
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695011 Thiruvananthapuram
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673-8558 Akashi-shi
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811-1395 Fukuoka-shi
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960-1295 Fukushima-shi
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350-1298 Hidaka-shi
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573-1191 Hirakata-shi
JapanNoch nicht rekrutierend» Google-Maps
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730-0011 Hiroshima-shi
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734-8551 Hiroshima-shi
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860-8556 Kumamoto-shi
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830-0011 Kurume-shi
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791-0280 Matsuyama-shi
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460-0001 Nagoya-shi
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466-8560 Nagoya-shi
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467-0001 Nagoya-shi
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951-8566 Niigata-shi
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060-8648 Sapporo-shi
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980-8574 Sendai-shi
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142-8666 Shinagawa-ku
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160-0023 Shinjuku-ku
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162-8655 Shinjuku-ku
JapanNoch nicht rekrutierend» Google-Maps
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241-8515 Yokohama-shi
JapanNoch nicht rekrutierend» Google-Maps
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10990 George Town
MalaysiaNoch nicht rekrutierend» Google-Maps
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50586 Kuala Lumpur
MalaysiaNoch nicht rekrutierend» Google-Maps
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97-200 Tomaszów Mazowiecki
PolandNoch nicht rekrutierend» Google-Maps
Research Site
08907 Hospitalet deLlobregat
SpainNoch nicht rekrutierend» Google-Maps
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15706 Santiago de Compostela
SpainNoch nicht rekrutierend» Google-Maps
Research Site
CH-5405 Baden
SwitzerlandNoch nicht rekrutierend» Google-Maps
Research Site
8501 Frauenfeld
SwitzerlandNoch nicht rekrutierend» Google-Maps
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B15 2TG Birmingham
United KingdomNoch nicht rekrutierend» Google-Maps
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CF14 2TL Cardiff
United KingdomNoch nicht rekrutierend» Google-Maps
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NN1 5BD Northampton
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OX3 7LE Oxford
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700000 Ho Chi Minh city
VietnamNoch nicht rekrutierend» Google-Maps
Alle anzeigen

Studien-Informationen

Detailed Description:

The primary objectives of the study are to demonstrate superiority of neoadjuvant Dato-DXd

plus durvalumab followed by adjuvant durvalumab with or without chemotherapy relative to

neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab with or

without chemotherapy in participants with previously untreated TNBC or hormone receptor

low/HER2-negative breast cancer, by central assessment of pCR and/or to demonstrate

superiority of neoadjuvant Dato-DXd plus durvalumab followed by adjuvant durvalumab with or

without chemotherapy relative to neoadjuvant pembrolizumab plus chemotherapy followed by

adjuvant pembrolizumab with or without chemotherapy in participants with previously untreated

TNBC or hormone receptor-low/HER2-negative breast cancer, by investigator assessment of EFS

Ein-/Ausschlusskriterien

Inclusion Criteria:

- Participant must be ≥ 18 years, at the time of signing the ICF.

- Histologically confirmed Stage II or III unilateral or bilateral primary invasive TNBC

or hormone receptor-low/HER2-negative breast cancer

- ECOG PS of 0 or 1

- Provision of acceptable tumor sample

- Adequate bone marrow reserve and organ function

- Contraceptive use by males or females should be consistent with local regulations

regarding the methods of contraception for those participating in clinical studies.

Exclusion criteria:

- History of another primary malignancy except for malignancy treated with curative

intent with no known active disease within 3 years before randomization and of low

potential risk for recurrence.

- Evidence of distant disease.

- Clinically significant corneal disease.

- Has active or uncontrolled hepatitis B or C virus infection.

- Known HIV infection that is not well controlled.

- Uncontrolled infection requiring i.v. antibiotics, antivirals or antifungals;

suspected infections; or inability to rule out infections.

- Known to have active tuberculosis infection

- Resting ECG with clinically significant abnormal findings.

- Uncontrolled or significant cardiac disease.

- History of non-infectious ILD/pneumonitis

- Any prior or concurrent surgery, radiotherapy or systemic anticancer therapy for TNBC

or hormone receptor-low/HER2-negative breast cancer

- For females only: is pregnant (confirmed with positive serum pregnancy test) or

breastfeeding, or planning to become pregnant.

- Female participants should refrain from breastfeeding from enrolment throughout the

study and for at least 7 months after last dose of study intervention, or as dictated

by local PI for SoC if longer.

Studien-Rationale

Primary outcome:

1. Pathologic Complete Response (pCR) in the experimental vs control arms (Time Frame - At the time of definitive surgery):
pCR rate is defined as the proportion of participants who have no evidence by haematoxylin and eosin staining of residual invasive disease at the time of definitive surgery in the complete resected breast specimen and all sampled regional lymph nodes (ypT0/Tis ypN0) by blinded central evaluation. The analysis will include all randomised participants, as randomised, regardless of whether the participant withdraws from randomised therapy or receives another anticancer therapy. The measure of interest will be the difference between the pCR rates.

2. Event-free survival (EFS) in the experimental vs control arms (Time Frame - Date of randomization to date of the EFS event, up to 68 months after the first subject randomized):
EFS is defined as the time from the date of randomisation until the date of the first occurrence of any of the following events: disease progression precluding surgery, disease recurrence (local, regional, distant, or contralateral), second primary non-breast invasive cancer (other than squamous or basal cell skin cancer), or death by any cause (in the absence of recurrence). The analysis will include all randomised participants, as randomised, regardless of whether the participant withdraws from randomised therapy or receives another anticancer therapy. The measure of interest will be the Hazard Ratio of EFS.

Secondary outcome:

1. Overall Survival (OS) in the experimental vs control arms (Time Frame - Date of randomization to date of death due to any cause, up to 82 months after the first subject randomized):
OS is defined as the time from the date of randomisation until the date of death due to any cause. The analysis will include all randomised participants, as randomised, regardless of whether the participant withdraws from randomised therapy or receives another anticancer therapy. The measure of interest will be the Hazard Ratio of OS.

2. Distant disease-free survival (DDFS) in the experimental vs control arms (Time Frame - Date of randomization to date of the DDFS event, up to 68 months after the first subject randomized):
DDFS is defined as the time from the date of randomisation until the date of the first occurrence of any of the following events: distant metastasis, occurrence of second primary non-breast invasive cancer (other than squamous or basal cell skin cancer), or death by any cause (in the absence of recurrence). The analysis will include all randomised participants, as randomised, regardless of whether the participant withdraws from randomised therapy or receives another anticancer therapy. The measure of interest will be the Hazard Ratio of DDFS.

3. Participant-reported breast and arm symptoms in the experimental vs. control arms (Time Frame - From Cycle 1 Day 1 of neoadjuvant treatment until pre-surgery safety FU visit (for approximately 24 weeks) or EOT - whichever occurs first.):
Breast and arm symptoms measured by the EORTC IL116. The analysis will include all randomised participants, as randomised, regardless of whether the participant withdraws from randomised therapy or receives another anticancer therapy. The measure of interest is the mean between-arm difference in breast and arm symptom scores.

4. Participant-reported physical function in the experimental vs. control arms (Time Frame - From Cycle 1 Day 1 of neoadjuvant treatment until pre-surgery safety FU visit (for approximately 24 weeks) or EOT - whichever occurs first, and then from Cycle 1 Day 1 of adjuvant treatment until EOT (for approximately 27 weeks).):
Physical function measured by the PROMIS Physical Function Short Form 8c. The analysis will include all dosed participants. The measure of interest is the mean between-arm difference in physical function scores.

5. Participant-reported fatigue in the experimental vs. control arms (Time Frame - From Cycle 1 Day 1 of neoadjuvant treatment until pre-surgery safety FU visit (for approximately 24 weeks) or EOT - whichever occurs first, and then from Cycle 1 Day 1 of adjuvant treatment until EOT (for approximately 27 weeks).):
Fatigue measured by the PROMIS Fatigue Short Form 7a. The analysis will include all dosed participants. The measure of interest will be the difference on the proportions of participants reporting different levels of fatigue and mean between-arm difference in the fatigue scores.

6. Participant-reported Global health status/Quality of life (GHS/QoL)in the experimental vs. control arms (Time Frame - From Cycle 1 Day 1 of neoadjuvant treatment until pre-surgery safety FU visit (for approximately 24 weeks) or EOT - whichever occurs first, and then from Cycle 1 Day 1 of adjuvant treatment until EOT (for approximately 27 weeks).):
Global health status/Quality of life measured by EORTC IL172. The analysis will include all randomised participants, as randomised, regardless of whether the participant withdraws from randomised therapy or receives another anticancer therapy. The measure of interest is the mean between-arm difference in GHS/QoL scores.

7. Pharmacokinetics of Dato-DXd (in combination with durvalumab) (Time Frame - Day 1 of cycles 1,2,4,8 (Each cycle is 21 days) and at pre-surgery safety follow up visit):
Plasma concentrations of Dato-DXd (ug/ml )

8. Pharmacokinetics of Dato-DXd (in combination with durvalumab) (Time Frame - Day 1 of cycles 1,2,4,8 (Each cycle is 21 days) and at pre-surgery safety follow up visit):
Plasma concentrations of total anti-TROP2 antibody (ug/ml )

9. Pharmacokinetics of Dato-DXd (in combination with durvalumab) (Time Frame - Day 1 of cycles 1,2,4,8 (Each cycle is 21 days) and at pre-surgery safety follow up visit):
Plasma concentrations of DXd (MAAA-1181a) (ng/ml)

10. Immunogenicity of Dato-DXd (in combination with durvalumab) (Time Frame - Day 1 of cycles 1,2,4,8 (Each cycle is 21 days) and at pre-surgery safety follow up visit):
Presence of antidrug antibodies (ADAs) for Dato-DXd (confirmatory results: positive or negative, titres).

11. Safety of Dato-DXd (in combination with durvalumab) (Time Frame - Randomization to final safety follow-up visit, either 90 days after last dose of study intervention for those who complete planned study intervention or 90 days after date of discontinuation for those who discontinue study intervention prematurely):
Safety and tolerability will be evaluated in terms of AEs graded by CTCAE version 5.0

Studien-Arme

  • Experimental: Dato-DXd plus durvalumab
    Participants receive durvalumab every 3 weeks (Q3W) + Dato-DXd Q3W as neoadjuvant therapy prior to surgery; followed by 9 cycles of durvaluamb Q3W as adjuvant therapy post-surgery. Adjuvant chemotherapy may be given in combination with durvalumab only if participants have residual disease. Olaparib may be given for participants with gBRCA-positive tumours and residual disease Adjuvant chemotherapy may be one of these: Doxorubicin (Q3W) or epirubicin (Q3W) + cyclophosphamide (Q3W) for 4 cycles (12 weeks) followed by paclitaxel (weekly) and carboplatin (weekly or Q3W) for 4 cycles (12 weeks); Doxorubicin (Q3W) or epirubicin (Q3W) + cyclophosphamide (Q3W) for 4 cycles (12 weeks) followed by paclitaxel (weekly) for 4 cycles (12 weeks); Carboplatin (weekly or Q3W) + paclitaxel (weekly) for 4 cycles (12 weeks); Capecitabine (Q3W) for 8 cycles.
  • Active Comparator: Pembrolizumab plus chemotherapy
    Participants receive pembrolizumab every 3 weeks (Q3W) + paclitaxel weekly + carboplatin (weekly or Q3W) x 4 cycles, followed by pembrolizumab Q3W + (doxorubicin OR epirubicin) + cyclophosphamide Q3W x 4 cycles as neoadjuvant therapy prior to surgery; followed by 9 cycles of pembrolizumab Q3W as adjuvant therapy post-surgery. Adjuvant capecitabine (Q3W) for 8 cycles may be given in combination with pembrolizumab only if participants have residual disease. Olaparib may be given for participants with gBRCA-positive tumours and residual disease.

Geprüfte Regime

  • Dato-DXd (Datopotamab deruxtecan (Dato-DXd, DS-1062a)):
    Experimental drug IV infusion
  • Durvalumab (MEDI4736):
    Experimental drug IV Infusion
  • Pembrolizumab (KEYTRUDA®):
    IV Infusion Active comparator
  • Doxorubicin:
    IV infusion Experimental/Active Comparator
  • Epirubicin:
    IV Infusion Experimental/Active Comparator
  • Cyclophosphamide:
    IV infusion Experimental/Active Comparator
  • Paclitaxel:
    IV infusion Experimental/Active Comparator
  • Carboplatin:
    IV infusion Experimental/Active Comparator
  • Capecitabine (XELODA®, Capecitabine Cell Pharm, Capecitabine EG, Capecitabine Accord):
    Tablet Oral route of administration Experimental/Active Comparator
  • Olaparib (LYNPARZA®):
    Tablet Oral route of administration Experimental/Active Comparator

Quelle: ClinicalTrials.gov


Sie können folgenden Inhalt einem Kollegen empfehlen:

"A Phase III Randomised Study to Evaluate Dato-DXd and Durvalumab for Neoadjuvant/Adjuvant Treatment of Triple-Negative or Hormone Receptor-low/HER2-negative Breast Cancer"

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