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This study is a prospective, single-center, open-label, umbrella-shaped phase II clinical study for patients with HR+/HER2- endocrine-resistant advanced breast cancer.
Seven precision treatment cohorts, which targeting NF1 mutation, gBRCA mutation,HER2 mutation, FDGFRb mutation PAM pathway mutations, CD8 and AR, as long as an epigenetic therapy cohort and a combined immunization cohort were initially set up based on gene expression profiles and molecular pathways. The main purpose is to screen valuable treatment cohorts and prepare for subsequent randomized controlled phase III clinical studies with larger sample size.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NF1 mutated | Experimental | If a patient were NF1 mutated, she would receive SHR7390(MEK1/2 inhibitor) and Faminitib. |
|
| gBRCA mutated | Experimental | If a patient were gBRCA mutated, she would receive SHR3162 (PARP inhibitor)and SHR6390(CDK4/6 inhibitor) . |
|
| HER2 activated mutated | Experimental | If a patient were HER2 activated mutated and had not previously used capecitabine, she would receive Pyrotinib and Capecitabine , while if the patient have previously used capecitabine, she would only use pyrotinib as a single agent. |
|
| PDGFRb mutated | Experimental | If a patient were PDGFRb mutated, she would receive Faminitib. |
|
| CD8 ≥10% | Experimental | In the arm which IHC showed CD8 ≥10%, this arm will be subdivided into 6 sub-arms, in which Arm 5A-4D, we choose the patients who had CDK4/6 inhibitor before while in Arm 5E, we choose the patients who secondarily resistant to adjuvant endocrine therapy , and in Arm 5FF, we choose the patients who is in stage IV without precious treatment or sensitively recurrence. A patient would receive SHR1210(PD-1 antibody) ,nab-paclitaxel and Faminitib in Arm-5A. A patient would receive SHR1210(PD-1 antibody) and VEGF inhibitor in Arm-5B. A patient would receive SHR1701(PD-L1/TGF-βRII inhibitor) in Arm-5C. A patient would receive SHR1701(PD-L1/TGF-βRII inhibitor) and SHR6390(CDK4/6 inhibitor) in Arm-5D. A patient would receive SHR1210(PD-1 antibody) and SHR6390(CDK4/6 inhibitor) and SERD in Arm-5E. A patient would receive SHR1210(PD-1 antibody) and SHR6390(CDK4/6 inhibitor) and AI in Arm-5F. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SHR7390 | Drug | MEK1/2 inhibitor |
| |
| Famitinib |
| Measure | Description | Time Frame |
|---|---|---|
| ORR | The proportion of participants whose best outcome is complete remission or partial remission (according to RECIST1.1) | Randomization until the first occurrence of disease progression or death from any cause, which ever occurs first, through the end of study (approximately 5 years) |
| Measure | Description | Time Frame |
|---|---|---|
| CBR | the percentage of subjects with CR+PR+SD and last more than 24 weeks in all of the evaluable subjects | Randomization until the first occurrence of disease progression or death from any cause, which ever occurs first, through the end of study (approximately 5 years) |
| PFS |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Zhi-Ming Shao | Contact | 86-021-64175590 | 8888 | zhimingshao@yahoo.com |
| Zhong-Hua Wang | Contact | +86 021-64175590 | zhonghuawang95@hotmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Zhi-Ming Shao | Fudan University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cancer Hospital Affiliated to Fudan University | Recruiting | Shanghai | Shanghai Municipality | 200032 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33570247 | Derived | Chen MK. Efficacy of PARP inhibition combined with EZH2 inhibition depends on BRCA mutation status and microenvironment in breast cancer. FEBS J. 2021 May;288(9):2884-2887. doi: 10.1111/febs.15730. Epub 2021 Feb 11. |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D009362 | Neoplasm Metastasis |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
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| ID | Term |
|---|---|
| C584390 | famitinib |
| C000722917 | fluzoparib |
| C000622954 | pyrotinib |
| D000069287 | Capecitabine |
| C000631724 | camrelizumab |
| D000068338 | Everolimus |
| D013660 | Taxes |
| C000723862 | SHR-1701 |
| ID | Term |
|---|---|
| D003841 | Deoxycytidine |
| D003562 | Cytidine |
| D011741 | Pyrimidine Nucleosides |
| D011743 | Pyrimidines |
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|
| PAM pathway mutated | Experimental | If a patient had any PAM pathway mutation, she would receive Everolimus(mTOR inhibitor) combined with nab-paclitaxel. |
|
| AR≥10% | Experimental | If a patient's IHC showed AR≥10% , she would receive SHR2554(EZH2 inhibitor) and SHR3680(AR inhibitor). |
|
| Epigenetic Cohort | Experimental | In this cohort, a patient would receive SHR2554(EZH2 inhibitor) and SHR3162 (PARP inhibitor). |
|
| Combined Immunity Cohort | Experimental | In this cohort, a patient would receive SHR6390(CDK4/6 inhibitor) combined with SHR1701(anti-PD-L1/TGF-βRII bifunctional fusion protein) . |
|
| Drug |
Multi-target tyrosine kinase inhibitor |
|
| SHR3162 | Drug | PARP inhibitor |
|
| Pyrotinib | Drug | HER1 / HER2 receptor tyrosine kinase inhibitor |
|
| Capecitabine | Drug | In Arm III, if the patient had not previously used capecitabine,she would receive pyrotinib and capecitabine, if the patients have previously used capecitabine, she would only used pyrotinib as a single agent. |
|
| SHR1210 | Drug | PD-1 antibody |
|
| Everolimus | Drug | mTOR inhibitor |
|
| Nab paclitaxel | Drug | Albumin bound paclitaxel |
|
| SHR2554 | Drug | EZH2 inhibitor |
|
| SHR3680 | Drug | AR inhibitor |
|
| SHR6390 | Drug | CDK4/6 inhibitor |
|
| SHR1701 | Drug | anti-PD-L1/TGF-βRII bifunctional fusion protein |
|
| SERD | Drug | Fulvestrant |
|
| AI | Drug | aromatase inhibitor |
|
| VEGFi | Drug | Bevacizumab |
|
time to progressive disease (according to RECIST1.1) |
| Randomization until the first occurrence of disease progression or death from any cause, which ever occurs first, through the end of study (approximately 5 years) |
| OS | time to death due to any cause | Randomization to death from any cause, through the end of study (approximately 5 years) |
| D017437 |
| Skin and Connective Tissue Diseases |
| D009385 | Neoplastic Processes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D006573 |
| Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D005472 | Fluorouracil |
| D014498 | Uracil |
| D011744 | Pyrimidinones |
| D003853 | Deoxyribonucleosides |
| D009705 | Nucleosides |
| D009706 | Nucleic Acids, Nucleotides, and Nucleosides |
| D020123 | Sirolimus |
| D018942 | Macrolides |
| D007783 | Lactones |
| D009930 | Organic Chemicals |
| D004467 | Economics |
| D004472 | Health Care Economics and Organizations |