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Breast cancer is the most common malignancy in women; approximately 5-10% are hereditary, with 14% of triple-negative breast cancers (TNBC) harboring BRCA mutations. BRCA1/2 are essential for homologous recombination repair of DNA double-strand breaks, whereas PARP mediates base-excision repair of single-strand breaks. PARP inhibitors (PARPi) exploit synthetic lethality to selectively eliminate BRCA-deficient tumor cells. Olaparib and talazoparib have demonstrated superior PFS and ORR versus chemotherapy in BRCA-mutated, HER2-negative advanced breast cancer, leading to FDA approval. In ovarian cancer, PARPi maintenance improves overall survival, with consistent benefits observed in Asian populations. The domestically developed PARPi fluzoparib, engineered with a trifluoromethyl moiety for enhanced stability and tissue penetration, showed in the phase III FABULOUS trial a median PFS of 6.7 vs 3.0 months and an ORR of 43.6% vs 23.3% compared with chemotherapy in gBRCA-mutated, HER2-negative breast cancer, with manageable safety. Data remain limited in Chinese patients and those with BRCA wild-type disease. This study aims to evaluate the efficacy and safety of fluzoparib maintenance monotherapy in advanced TNBC patients-either BRCA1/2-mutated or wild-type-who have derived clinical benefit from prior platinum-based therapy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Fluzoparib Maintenance Until Disease Progression or Intolerable Toxicity | Experimental | Patients with advanced triple-negative breast cancer who have achieved at least stable disease (SD) or partial response (PR) after ≥2 prior lines of therapy including a platinum-based regimen will receive fluzoparib 150 mg orally twice daily on days 1-28 of each 28-day cycle. Treatment continues until disease progression, unacceptable toxicity, withdrawal of consent, or death. Dose interruptions or reductions (to 100 mg BID or 50 mg BID) are allowed for predefined toxicities. No concurrent anticancer therapy is permitted. Efficacy assessments (CT/MRI) will be performed every 6 weeks (2 cycles) from the first dose. Exploratory biomarkers (PD-L1, TILs, CD4/8, cytokines) will be collected optionally for subgroup analyses. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fluzoparib Monotherapy | Drug | Fluzoparib is an oral poly (ADP-ribose) polymerase (PARP) inhibitor supplied as 50 mg capsules. Participants take 150 mg twice daily (total 300 mg/day) on days 1-28 of each 28-day cycle. Doses should be swallowed whole with water, approximately 12 hours apart, at approximately the same times each day. Treatment continues until disease progression, unacceptable toxicity, withdrawal of consent, or death. Dose interruptions or reductions (stepwise to 100 mg BID or 50 mg BID) are allowed for haematological or non-haematological toxicities graded ≥3 or as clinically indicated. No concurrent anticancer therapy is permitted during fluzoparib maintenance. |
| Measure | Description | Time Frame |
|---|---|---|
| Progression-free survival (PFS) | Time from first fluzoparib dose to first radiological disease progression (RECIST 1.1) or death from any cause, whichever occurs first. | From first dose of fluzoparib until disease progression or death, assessed every 6 weeks (2 cycles), up to approximately 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Second progression-free survival (PFS2) | Time from first dose of fluzoparib to the earliest of: radiological progression on next-line therapy, start of non-protocol anti-cancer treatment, or death from any cause. | From first fluzoparib dose until the above events, assessed every 6 weeks while on study and subsequently, up to approximately 24 months. |
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Inclusion Criteria:
Age 18-75 years (inclusive) at the time of informed consent.
Histologically confirmed triple-negative breast cancer (TNBC; ER <1%, PR <1%, HER2-negative).
Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
Received ≥2 prior lines of systemic therapy, including a platinum-based regimen (single-agent or combination); must have achieved partial response (PR) or stable disease (SD) during or after that platinum-based treatment.
Platinum-sensitive disease defined as: Objective response (complete or partial) or stable disease lasting ≥6 months while on platinum-based therapy, or Platinum-free interval (PFI) ≥6 months from the end of the last platinum-containing regimen to documented progression/relapse.
Estimated life expectancy ≥3 months.
At least one measurable lesion per RECIST 1.1 on CT/MRI; evidence of metastatic disease (soft-tissue and/or bone lesions) is required.
Willing to provide archived tumour tissue (core biopsy or excision) or fresh biopsy/blood for biomarker analyses.
Adequate organ function within 14 days (7 days for liver enzymes) before first dose:
Absolute neutrophil count ≥1.5 × 10⁹/L Platelets ≥100 × 10⁹/L Haemoglobin ≥80 g/L Total bilirubin ≤1.5 × upper limit of normal (ULN) ALT & AST ≤2.5 × ULN (≤5 × ULN if liver metastases present) Serum creatinine ≤1.25 × ULN and calculated creatinine clearance ≥60 mL/min
Toxicities from prior anti-cancer therapy resolved to Grade ≤1 per NCI-CTCAE v5.0 (except alopecia or other stable chronic toxicities deemed tolerable by the investigator).
Participants of reproductive potential and their partners must agree to use highly effective contraception from 30 days before the first dose until 120 days after the last dose of fluzoparib.
Signed written informed consent prior to any study-specific procedures.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Weipeng Zhao | Contact | +86+022-23109106 | maoxun1977@163.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tianjin Medical University Cancer Institute and Hospital | Tianjin | China |
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| Duration of response (DoR) | Time from first documented complete or partial response (CR/PR) to subsequent radiological disease progression (RECIST 1.1) or death from any cause, whichever occurs first, among patients who achieved CR/PR | From first CR/PR documentation until progression or death, assessed every 6 weeks while on fluzoparib, up to approximately 24 months. |
| Disease control rate (DCR) | Proportion of participants achieving complete response, partial response, or stable disease (CR + PR + SD) lasting ≥ 6 weeks, assessed by RECIST 1.1 | From first dose of fluzoparib until the 6-week tumor assessment, up to approximately 2 months. |
| Overall survival (OS) | Time from first dose of fluzoparib to death from any cause. | From first fluzoparib dose until death, assessed up to approximately 36 months. |
| Incidence and severity of adverse events (AE) | All adverse events will be recorded from first dose of fluzoparib until 30 days after last dose, graded by CTCAE v5.0. | From first fluzoparib dose up to 30 days after last dose, assessed throughout the study and during follow-up, expected up to approximately 36 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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