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Investigator-initiated, international, multicentre, randomized, open-label, (neo)adjuvant phase III study in target population (stage III, HER2-negative, BRCA1-like breast cancer patients) comparing optimized standard-dose chemotherapy with intensified, alkylating chemotherapy with stem cell rescue.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ddAC-CP-Olaparib | Active Comparator | ddAC; doxorubicin 60 mg/m² as an i.v. bolus and cyclophosphamide 600 mg/m² as an i.v. bolus on day 1 every 2 weeks ddAC must be supported with prophylactic pegfilgrastim 6 mg s.c. given 24-48 hours after completion of administration of EVERY chemotherapy cycle CP; carboplatin/paclitaxel (CP) consisting of carboplatin (AUC 6) on day 1 and paclitaxel (80 mg/m2) on day 1,8 and 15 of a 21 days cycle. In total 4 courses of CP will be administered. Olaparib will be administered in Dutch centers only, as monotherapy for one year at a dose of 300 mg BID, starting 3 weeks after adjuvant radiotherapy, or, if radiotherapy is not indicated, 3-5 weeks after the last CP cycle. Patients without a (near) pCR will receive adjuvant capecitabine at a starting dose of 1000-1250 mg/m2, twice a day, on days 1-14 every 3 weeks for eight cycles. |
|
| ddAC-mini CTC | Active Comparator | ddAC; doxorubicin 60 mg/m² as an i.v. bolus and cyclophosphamide 600 mg/m² as an i.v. bolus on day 1 every 2 weeks ddAC must be supported with prophylactic pegfilgrastim 6 mg s.c. given 24-48 hours after completion of administration of EVERY chemotherapy cycle intensified alkylating 'mini' CTC (2x) cyclophosphamide 3000 mg/m2 day 1 mesna 500 mg (push) + 2000 mg in 24 hours day 1 carboplatin (400 mg/m2; (or AUC=5 in patients with a calculated creatinine-clearance of <100 ml/min)) days 1,2 thiotepa 250 mg/m2 day 2 Patients without a (near) pCR will receive adjuvant capecitabine at a starting dose of 1000-1250 mg/m2, twice a day, on days 1-14 every 3 weeks for eight cycles. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ddAC-CP-Olaparib | Drug | ddAC-CP-Olaparib |
| |
| ddAC-mini CTC |
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival in all patients | time from randomization to death from any cause in all patients | assessed up to 120 months |
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival in patients without a germline BRCA1/2 mutation | time from randomization to death from any cause in without a germline BRCA1/2 mutation | assessed up to 120 months |
| Recurrence free interval in all patients |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sabine Linn, Prof. MD | NKI-AvL | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institut Paoli Calmettes | Marseille | 13009 | France | |||
| Hopital Tenon, University Marie-Curie |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42372741 | Derived | Seefat RL, Vliek SB, de Jong VMT, Balduzzi S, Mandjes IA, Retel VP, Eekhout I, Delfos M, Schot M, Holtkamp MJ, van Rosmalen MM, Leeneman B, Blommestein H, Huitema ADR, Rosenberg EH, Nederlof PM, Chan TWS, van Rhenen A, Wondergem MJ, Schaap NPM, Snijders TJF, Van der Poel MWM, Plattel WJ, van Werkhoven E, van Tinteren H, Smidt ML, Wesseling J, Jonkers J, Rottenberg S, Vrancken Peeters MTFD, Voermans C, Maduro JH, Kroep JR, Schroder CP, Kuip EJM, Goncalves A, Nuver J, Wymenga ANM, Bijlsma RM, van der Wall E, Konings IRHM, Tjan-Heijnen VCG, Jongen-Lavrencic M, Jager A, Linn SC. Targeting homologous recombination deficiency with intensified chemotherapy versus standard chemotherapy followed by olaparib in stage III breast cancer (SUBITO): an open-label, randomised, controlled, phase 3 trial. Lancet Oncol. 2026 Jul;27(7):795-807. doi: 10.1016/S1470-2045(26)00131-2. |
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| Drug |
ddAC - mini CTC |
|
time from randomization to local recurrence, second primary, distant recurrence or death, whichever comes first in all patients
| assessed up to 120 months |
| Recurrence free interval in patients with an HR impaired tumor | time from randomization to local recurrence, second primary, distant recurrence or death, whichever comes first in patients with an HR impaired tumor | assessed up to 120 months |
| Incidence of toxicity, graded according to National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 4.03 | Incidence of toxicity, graded according to National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 4.03 | up to 30 days after end of treatment |
| cost-effectiveness measured by costs per quality-adjusted life years (QALYs) | cost-effectiveness measured by costs per quality-adjusted life years (QALYs) | assessed up to 120 months |
| Patient reported outcomes | Patient reported outcomes; including quality of life (QoL) determined by a comprehensive panel of QoL questionnaires | assessed up to 24 months |
| cost-effectiveness measured by incremental cost-effectiveness ratio (ICER) | cost-effectiveness measured by incremental cost-effectiveness ratio (ICER) | assessed up to 120 months |
| Paris |
| France |
| Medical spectrum Twente | Enschede | Overijssel | 7500 KA | Netherlands |
| Antoni van Leeuwenhoek | Amsterdam | 1066 CX | Netherlands |
| AZVU | Amsterdam | 1081 HV | Netherlands |
| University Medical Center Groningen | Groningen | Netherlands |
| LUMC | Leiden | 2333 ZA | Netherlands |
| Maastricht University Medical Center | Maastricht | Netherlands |
| Radboud UMC | Nijmegen | 6225GA | Netherlands |
| Erasmus Medical Center Cancer Institute | Rotterdam | 3015CE | Netherlands |
| University Medical Center Utrecht | Utrecht | 3584CX | Netherlands |
| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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