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The objective of this study is to evaluate the efficacy and safety of chemotherapy plus toripalimab, with or without JS004,as neoadjuvant therapy for patients with triple-negative breast cancer (TNBC). TNBC patients were randomly assigned in a 2:2:1 ratio to receive either JS004 plus toripalimab plus chemotherapy, toripalimab plus chemotherapy, or chemotherapy alone.Surgery will be performed within 5 weeks after the last dose of neoadjuvant treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| JS004+Toripalimab+chemotherapy | Experimental |
| |
| Toripalimab+chemotherapy | Experimental |
| |
| chemotherapy | Other |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| JS004 in combination with toripalimab and chemotherapy | Drug | BTLA inhibitor (JS004):200mg, IV infusion , d1, Q3W;(1-24 week) Toripalimab:240mg, IV infusion , d1, Q3W;(1-24 week) Carboplatin: IV infusion,AUC=5, d1,q3w(OR AUC=1.5,d1,qw);(1-12 week) Paclitaxel:IV infusion,80 mg/m2,qw;(1-12 week) Doxorubicin:IV infusion,60 mg/m2,q3w(OR Epirubicin:IV infusion,90 mg/m2,q3w);(13-24 week) Cyclophosphamide:IV infusion,600 mg/m2,q3w(13-24 week) |
| Measure | Description | Time Frame |
|---|---|---|
| Pathologic complete response (pCR) rate | PCR rate is defined as the proportion of participants who have achieved pathologic complete response (on routine hematoxylin and eosin staining, no tumor cell can be found in tumor bed or lymph node) in all participants. | Up to 30 months |
| Measure | Description | Time Frame |
|---|---|---|
| Objective response rate (ORR) | ORR is defined according to the RECIST v1.1 criteria. | Up to 30 months |
| Breast pathologic complete response (bpCR) | The bpCR is defined as the histological evidence of no malignancy in the primary lesion of breast cancer, or only carcinoma in situ (i.e., ypT0/Tis, in accordance with current AJCC staging system). |
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Inclusion Criteria:
Subjects must voluntarily participate in this study, sign the informed consent form, demonstrate good compliance, and cooperate with follow-up visits.
Age ≥ 18 years.
ECOG score ≤ 1.
Newly diagnosed, non-metastatic breast cancer of stage II-III, confirmed by histopathology or cytopathology (T1c-2 cN1-2 (≥2cm) or T3-4 cN0-2).
Pathologically confirmed hormone receptor-negative (ER and PR negative) and HER2-negative advanced breast cancer. In cases of multiple pathological results, the definition of triple-negative breast cancer is based on the final molecular subtype result from the last biopsy pathology. (ER negativity: immunohistochemical staining in <1% of tumor cells; PR negativity: immunohistochemical staining in <1% of tumor cells; HER2 negativity: immunohistochemical score of 0, 1+, or FISH/CISH negative).
Have at least one measurable lesion according to the RECIST v1.1 criteria.
Functional levels of vital organs must meet the following requirements (without any corrective treatment with blood components or cytokine growth factors within 14 days before the first dose):
Within 7 days before the first dose, women of reproductive potential must have a negative serum pregnancy test and agree to use effective contraceptive measures during the study drug administration and for 6 months after the last dose. For this protocol, women of reproductive potential are defined as sexually mature women who: 1) have not undergone hysterectomy or bilateral oophorectomy, and 2) have not experienced spontaneous menstruation cessation for a continuous period of 24 months (amenorrhea following cancer treatment does not exclude fertility) (i.e., menstruation has occurred at any time within the previous 24 consecutive months). For male patients with female partners of reproductive potential, they must agree to use effective contraceptive measures during the study drug administration and for 6 months after the last dose.
Voluntarily participate in this study, sign the informed consent form, demonstrate good compliance, and be willing to cooperate with visits and study-related procedures.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Nan Niu | Contact | 86-18940256668 | niunannancy@163.com | |
| Caigang Liu | Contact | 86-18940254967 | liucg@sj-hospital.org |
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|
| Toripalimab and chemotherapy | Drug | Toripalimab:240mg, IV infusion , d1, Q3W;(1-24 week) Carboplatin: IV infusion,AUC=5, d1,q3w(OR AUC=1.5,d1,qw);(1-12 week) Paclitaxel:IV infusion,80 mg/m2,qw;(1-12 week) Doxorubicin:IV infusion,60 mg/m2,q3w(OR Epirubicin:IV infusion,90 mg/m2,q3w);(13-24 week) Cyclophosphamide:IV infusion,600 mg/m2,q3w(13-24 week) |
|
| Chemotherapy | Drug | Carboplatin: IV infusion,AUC=5, d1,q3w(OR AUC=1.5,d1,qw);(1-12 week) Paclitaxel:IV infusion,80 mg/m2,qw;(1-12 week) Doxorubicin:IV infusion,60 mg/m2,q3w(OR Epirubicin:IV infusion,90 mg/m2,q3w);(13-24 week) Cyclophosphamide:IV infusion,600 mg/m2,q3w(13-24 week) |
|
| Up to 30 months |
| Residual Cancer Burden (RCB) 0-1 | Rate of RCB 0-1 at time of surgery | Up to 30 months |
| Event-free Survival (EFS) | Event free survival (EFS) is defined as the time from randomization to first EFS event. For subjects who had breast cancer surgery, EFS events were post-surgery breast cancer relapse, second primary malignancy or death without recurrence. For subjects who did not have breast cancer surgery, EFS events were death during clinical follow-up or non-completion of any neoadjuvant investigational product due to disease progression | Up to 30 months |
| Incidence of adverse event | Including type, incidence, severity, time and so on of adverse events | Up to 30 months |
| ID | Term |
|---|---|
| D064726 | Triple Negative Breast Neoplasms |
| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| ID | Term |
|---|---|
| C000656314 | toripalimab |
| D004358 | Drug Therapy |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
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