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The purpose of the study is evaluate the efficacy and safety of tucidinostat in combination with fulvestrant in patients with hormone-receptor positive advanced breast cancer.
Hormone-receptor positive breast cancer is the most common subtype in breast cancer. Tucidinostat is an oral subtype-selective histone deacetylase inhibitor, which showed preliminary signs of encouraging anti-tumour activity in patients with advanced hormone-receptor positive breast cancer in the previous studies. The aim of this study is to evaluate the efficacy and safety of Tucidinostat in combination with fulvestrant in patients with recurrent or metastatic hormone-receptor positive breast cancer.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Tucidinostat + Fulvestrant | Experimental | Patients receive 30 mg Chidamide twice per week. Fulvestrant 500mg (2 syringes of Fulvestrant 250mg), Fulvestrant 500 mg i.m. every 28 (+/- 3) days plus an additional 500 mg on day 14 (+/-3) of first month only. Courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tucidinostat | Drug | 30 mg, administered orally twice per week (BIW) |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Progression Free Survival (PFS) | PFS was defined as the time from treatment until objective disease progression according to Response Evaluation Criteria in Solid Tumours version 1.1 (RECIST 1.1), or death by any cause, whichever is first met. | From date of treatment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 3 years. |
| Measure | Description | Time Frame |
|---|---|---|
| overall survival (OS) | Defined as from the date of treatment to date of death, irrespective of cause. | Time from treatment to death from any cause, assessed up to 3 years. |
| Objectivel response rate (ORR) |
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Inclusion Criteria:
Female patients aged 18-75 years (including cutoff value);
The disease condition is inoperable, recurrent breast cancer, or metastatic breast cancer;
Histological or cytological confirmation of hormone receptor-positive [estrogen receptor (ER) positive and progesterone receptors (PgR) positive or negative] breast cancer;
At least one measurable lesion according to RECIST 1.1;
Prior treatment: have not received systemic chemotherapy for recurrent or metastatic breast cancer;
Eastern Cooperative Oncology Group Performance Status of 0-1;
Adequate function of major organs meets the following requirements):
Absolute Neutrophils countā„ 1.5Ć10^9/L; Platelets countā„ 90Ć10^9/L; Hemoglobin ā„ 90g/L; Total bilirubin⤠1.5 Ć the upper limit of normal (ULN); ALT and AST ⤠2.5 Ć ULN; BUN and Cr ⤠1.5 Ć ULN; Left ventricular ejection fraction (LVEF) ā„ 50%; QTcF(Fridericia correction) ⤠470 ms; International normalized ratio(INR)ā¤1.5 Ć ULN; activated partial thromboplastin time(APTT) ⤠1.5 Ć ULN;
Life expectancy ā„ 3 months;
Have signed informed consent.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Anqin Zhang | Contact | 020-39151519 | sfyrxzx@163.com |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20887199 | Background | Osborne CK, Schiff R. Mechanisms of endocrine resistance in breast cancer. Annu Rev Med. 2011;62:233-47. doi: 10.1146/annurev-med-070909-182917. | |
| 21499573 | Background | Saxena NK, Sharma D. Epigenetic Reactivation of Estrogen Receptor: Promising Tools for Restoring Response to Endocrine Therapy. Mol Cell Pharmacol. 2010;2(5):191-202. |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
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| ID | Term |
|---|---|
| C547816 | N-(2-amino-5-fluorobenzyl)-4-(N-(pyridine-3-acrylyl)aminomethyl)benzamide |
| D000077267 | Fulvestrant |
| ID | Term |
|---|---|
| D004958 | Estradiol |
| D004963 | Estrenes |
| D004962 | Estranes |
| D013256 | Steroids |
| D000072473 |
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| Fulvestrant |
| Drug |
Fulvestrant was supplied as a castor oil based solution in clear neutral glass pre-filled syringes. Each syringe will contain 250 mg of fulvestrant in 5 ml. |
|
Defined as numbers of patients achieved complete response and partial response of treatment.
| Response is assessed once every 8 weeks, from the day of treatment to the date of first documented progression, assessed up to 3 years. |
| Duration of response (DOR) | Defined as from the first date when criteria for response is met until the first date when the criteria for progression or death is met. | From the day of treatment to the date of first documented progression, assessed up to 3 years. |
| 4.Clinical Benefit Rate (CBR) | ORR is defined as percentage of participants with Complete Response, Partial Response or Stable Diseaseā„24 weeks, assessed by the investigators according to the RECIST v1.1. | From the day of treatment to the date of first documented progression, assessed up to 3 years. |
| Adverse event(AE) | Adverse event related to treatment. | From the day of treatment to the date of first documented progression, assessed up to 3 years. |
| 26030518 | Background | Turner NC, Ro J, Andre F, Loi S, Verma S, Iwata H, Harbeck N, Loibl S, Huang Bartlett C, Zhang K, Giorgetti C, Randolph S, Koehler M, Cristofanilli M; PALOMA3 Study Group. Palbociclib in Hormone-Receptor-Positive Advanced Breast Cancer. N Engl J Med. 2015 Jul 16;373(3):209-19. doi: 10.1056/NEJMoa1505270. Epub 2015 Jun 1. |
| 28968163 | Background | Goetz MP, Toi M, Campone M, Sohn J, Paluch-Shimon S, Huober J, Park IH, Tredan O, Chen SC, Manso L, Freedman OC, Garnica Jaliffe G, Forrester T, Frenzel M, Barriga S, Smith IC, Bourayou N, Di Leo A. MONARCH 3: Abemaciclib As Initial Therapy for Advanced Breast Cancer. J Clin Oncol. 2017 Nov 10;35(32):3638-3646. doi: 10.1200/JCO.2017.75.6155. Epub 2017 Oct 2. |
| 25131830 | Background | Falkenberg KJ, Johnstone RW. Histone deacetylases and their inhibitors in cancer, neurological diseases and immune disorders. Nat Rev Drug Discov. 2014 Sep;13(9):673-91. doi: 10.1038/nrd4360. Epub 2014 Aug 18. |
| 27629931 | Background | Jones PA, Issa JP, Baylin S. Targeting the cancer epigenome for therapy. Nat Rev Genet. 2016 Sep 15;17(10):630-41. doi: 10.1038/nrg.2016.93. |
| 26105599 | Background | Shi Y, Dong M, Hong X, Zhang W, Feng J, Zhu J, Yu L, Ke X, Huang H, Shen Z, Fan Y, Li W, Zhao X, Qi J, Huang H, Zhou D, Ning Z, Lu X. Results from a multicenter, open-label, pivotal phase II study of chidamide in relapsed or refractory peripheral T-cell lymphoma. Ann Oncol. 2015 Aug;26(8):1766-71. doi: 10.1093/annonc/mdv237. Epub 2015 Jun 23. |
| 30700929 | Background | Zhang Q, Wang T, Geng C, Zhang Y, Zhang J, Ning Z, Jiang Z. Exploratory clinical study of chidamide, an oral subtype-selective histone deacetylase inhibitor, in combination with exemestane in hormone receptor-positive advanced breast cancer. Chin J Cancer Res. 2018 Dec;30(6):605-612. doi: 10.21147/j.issn.1000-9604.2018.06.05. |
| 31036468 | Background | Jiang Z, Li W, Hu X, Zhang Q, Sun T, Cui S, Wang S, Ouyang Q, Yin Y, Geng C, Tong Z, Cheng Y, Pan Y, Sun Y, Wang H, Ouyang T, Gu K, Feng J, Wang X, Wang S, Liu T, Gao J, Cristofanilli M, Ning Z, Lu X. Tucidinostat plus exemestane for postmenopausal patients with advanced, hormone receptor-positive breast cancer (ACE): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2019 Jun;20(6):806-815. doi: 10.1016/S1470-2045(19)30164-0. Epub 2019 Apr 27. |
| 24092810 | Background | Sabnis GJ, Goloubeva OG, Kazi AA, Shah P, Brodie AH. HDAC inhibitor entinostat restores responsiveness of letrozole-resistant MCF-7Ca xenografts to aromatase inhibitors through modulation of Her-2. Mol Cancer Ther. 2013 Dec;12(12):2804-16. doi: 10.1158/1535-7163.MCT-13-0345. Epub 2013 Oct 3. |
| D017437 |
| Skin and Connective Tissue Diseases |
| Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D045166 | Estradiol Congeners |
| D012739 | Gonadal Steroid Hormones |
| D042341 | Gonadal Hormones |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |