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Triple-negative breast cancer (TNBC) is a special subtype of breast cancer that lacks the expression of ER, PR, and Her-2 proteins, accounting for 15%-20% of all breast cancers.TNBC patients do not benefit from endocrine therapy or HER-2-targeted therapy, but are sensitive to cytotoxic drug therapy.Although the survival of TNBC patients has improved significantly compared with the past, it is still the type with the worst prognosis among all subtypes of breast cancer. Methods and drugs to further improve the therapeutic effect of TNBC patients are still being explored.
Camrelizumab, a PD-1 inhibitor produced by Hengrui, has been approved for the treatment of various malignant tumors including advanced lung cancer, advanced liver cancer and advanced esophageal cancer. Shows good therapeutic effect and safety.
Therefore, this study intends to explore the superiority of camrelizumab on the basis of the less toxic anthracycline-free TCb regimen.In order to provide more effective and safe neoadjuvant therapy for lymph node-positive TNBC patients.
This study mainly compared the efficacy and safety of 6*TCb (docetaxel+carboplatin)+carrelizumab regimen and 6*TCb regimen in neoadjuvant chemotherapy for triple-negative breast cancer.
Patients who met the inclusion criteria were randomly assigned to the experimental group and the control group in a 2:1 ratio.
The efficacy and safety of the two chemotherapy regimens on neoadjuvant chemotherapy for triple-negative breast cancer were evaluated by PCR, EFS, DFS, DDFS and ORR after surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| (Carrelizumab + TCb) regimen | Experimental | The experimental group received 6 cycles of TCb+carrelizumab (docetaxel 75mg/m2 on the first day + carboplatin AUC=6, on the first day; camrelizumab 200mg on the third day) regimen neoadjuvant chemotherapy, every 21 days is a cycle. |
|
| TCb regimen | Placebo Comparator | The control group received 6 cycles of TCb (docetaxel 75mg/m2 on the first day + carboplatin AUC=6 on the first day) regimen neoadjuvant chemotherapy, every 21 days as a cycle. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| (Carrelizumab + TCb) regimen | Drug | Carrelizumab +docetaxel + carboplatin regimen |
|
| Measure | Description | Time Frame |
|---|---|---|
| Pathological complete response rate (pCR rate) | After neoadjuvant chemotherapy and surgery, the resected specimen (breast + axilla) was free of any invasive cancer (ie, ypT0/is, ypN0) | up to 24 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Event-Free Survival (EFS) | EFS was defined as the time from randomization to any of the following events: disease progression during neoadjuvant therapy, local or distant recurrence, second primary malignancy (breast or other cancer), or death from any cause. | 5-10 years after surgery. |
| DFS |
| Measure | Description | Time Frame |
|---|---|---|
| Expression of PD-L1 | Differences in the benefits of carelizumab under different PD-L1 expression status | up to 24 weeks |
| gene mutation rate | Predictive value of polygenic analysis in the population benefiting from camrelizumab |
Inclusion Criteria:
Age: 18-70 years old
cT2 - cT4d, or cT1c with axillary lymph node metastasis confirmed clinically and pathologicallyï¼›
Pathologically proven triple negative breast cancer:
Triple-negative breast cancer is defined as:
Has clinically measurable lesions:Measurable lesions on ultrasound, mammography, or MR (optional) within 1 month before randomizationï¼›
Organ and bone marrow function tests within 1 month before chemotherapy suggest no contraindications to chemotherapyï¼›
Cardiac ultrasound EF value ≧55%;
Females of childbearing age, with a negative serum pregnancy test 14 days before randomization;
ECOG score≤1 point;
Sign informed consentï¼›
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Zhenzhen Liu | Contact | 13603862755 | liuzhenzhen73@126.com | |
| Dechuang Jiao | Contact | 13598004327 | jiaodechuang@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Zhenzhen Liu | Study Principal Investigator | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Henan cancer hospital | Recruiting | Zhengzhou | Henan | China |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D064726 | Triple Negative Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
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| ID | Term |
|---|---|
| C000631724 | camrelizumab |
| D016190 | Carboplatin |
| D000077143 | Docetaxel |
| ID | Term |
|---|---|
| D056831 | Coordination Complexes |
| D009930 | Organic Chemicals |
| D043823 | Taxoids |
| D043822 | Cyclodecanes |
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The enrolled patients were randomly assigned to the experimental group and the control group in a ratio of 2:1.
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| TCb regimen | Drug | docetaxel + carboplatin regimen |
|
|
Disease-free Survival,From the date of surgery to the first local, regional, contralateral or distant recurrence, and death from any cause |
| 5-10 years after surgery |
| Distant Disease Free Survival (DDFS) | DDFS is defined as the time from surgery to distant recurrence or death from any cause | 5-10 years after surgery |
| Objective Response Rate (ORR) | ORR is defined as the number of target lesion responders as assessed by MRI | Preoperative |
| number of adverse events | Evaluate the nature, incidence and severity of chemotherapy adverse events according to CTCAE 5.0 | After each cycle of chemotherapy (21 days as 1 cycle) |
| up to 24 weeks |
| D017437 |
| Skin and Connective Tissue Diseases |
| D003516 |
| Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D004224 | Diterpenes |
| D013729 | Terpenes |