An Exploratory Study to Evaluate the Efficacy and Safety of Kumorixilib Combined With Capecitabine and Letrozole as Neoadjuvant Therapy for HR-Positive, HER2-Negative Breast Cancer
An Exploratory Study to Evaluate the Efficacy and Safety of Kumorixilib Combined With Capecitabine and Letrozole as Neoadjuvant Therapy for HR-Positive, HER2-Negative Breast Cancer
This study is a single-center, prospective, open-label exploratory clinical study to assess the efficacy and safety of kumorixilib combined with capecitabine and letrozole as neoadjuvant therapy in patients with HR+/HER2- stage II-III invasive breast cancer. The study plans to enroll 35 eligible patients, and all participants will receive the triple-drug combination regimen without randomization. The treatment regimen: kumorixilib 180 mg orally once daily, capecitabine 500 mg orally three times daily, and letrozole 2.5 mg orally once daily; each cycle lasts 28 days, for a total of 6 cycles. Breast MRI will be used to evaluate radiological tumor response. Surgical resection will be arranged 2-4 weeks after neoadjuvant treatment ends. The primary endpoint is the percentage change in Ki-67 score from baseline to Cycle 1 Day 28. Secondary endpoints include the complete cell cycle arrest rate (CCCA, Ki-67 ≤ 2.7%) on Day 28, the reduction rate of functional tumor volume (FTV), the proportion of patients with RCB 0-1, objective response rate (ORR), and treatment safety. Treatment will be discontinued upon disease progression, intolerable adverse events, withdrawal of consent, or investigator judgment.
Inclusion Criteria:
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Patients who meet all of the following inclusion criteria are eligible for enrollment in this trial:
Female patients with breast cancer aged ≥18 and ≤75 years, satisfying one of the following menopausal status criteria: (1) Bilateral oophorectomy in medical history, or age ≥60 years; (2) Age <60 years with natural menopause (defined as spontaneous cessation of regular menses for at least 12 consecutive months without other pathological or physiological causes), with postmenopausal levels of E2 and FSH; (3) Pre-menopausal or peri-menopausal female patients who are willing to receive LHRH agonist therapy throughout the study period.
Histopathologically confirmed estrogen receptor (ER)-positive (>10%) and/or progesterone receptor (PR)-positive (>10%), HER2-negative breast cancer, assessed in accordance with the 2018 ASCO-CAP guidelines. HER2 negativity is defined as immunohistochemistry (IHC) score of 0+, or IHC 2+ with negative in situ hybridization (ISH) test (ISH amplification ratio <2.0), verified by the pathological laboratory.
Accept core needle biopsy to provide initial tissue samples with Ki-67 ≥10% tested on the initial specimen; agree to provide tissue samples for tumor biomarker testing and peripheral blood samples for biomarker analysis.
Treatment-naïve breast cancer patients staged as Stage II-III per the 8th edition of the AJCC staging system.
Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1.
Adequate organ function as defined below: Hematologic function: ① Absolute neutrophil count (ANC) ≥1.5×10⁹/L (no growth factor administered within 14 days prior to screening); ② Platelet count ≥100×10⁹/L (no corrective hematologic therapy within 7 days prior to screening); ③ Hemoglobin ≥100 g/L (no corrective hematologic therapy within 7 days prior to screening).
Hepatic and renal function: ① Total bilirubin ≤1×upper limit of normal (ULN); ② Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤3×ULN (ALT and AST ≤5×ULN for patients with liver metastases); ③ Blood urea nitrogen and serum creatinine ≤1.5×ULN, with creatinine clearance ≥50 mL/min (calculated by the Cockcroft-Gault formula).
Cardiac function on echocardiogram: left ventricular ejection fraction (LVEF) ≥50%. 12-lead electrocardiogram (ECG): QT interval ≤480 ms.
Able to provide written informed consent prior to any study-related procedures.
Exclusion Criteria:
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Patients presenting with any of the following conditions are ineligible for enrollment in this study:
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