RECRUITING

NeoTAILOR: ABiomarker-directed Approach to Guide Neoadjuvant Therapy for Patients With Stage II/III ER-positive, HER2-negative Breast Cancer

Conditions

Breast Cancer Cancer of the Breast postmenopausal women Ki67 PAM50 subtype breast cancer disparities

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This study aims to utilize a novel biomarker-driven approach to guide neoadjuvant treatment selection. It is the hypothesis that this will improve clinical response for postmenopausal women with clinical stage II/III ER-positive, HER2-negative breast cancer and identify those who may not require neoadjuvant chemotherapy, with a primary focus on outcomes in Black patients.

Official Title

NeoTAILOR: A Phase II Biomarker-directed Approach to Guide Neoadjuvant Therapy for Patients With Stage II/III ER-positive, HER2-negative Breast Cancer

Quick Facts

Study Start:2024-05-30

Study Completion:2027-11-30

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT05837455

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years

Sexes Eligible for Study:FEMALE

Accepts Healthy Volunteers:No

Standard Ages:ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
* Histologically or cytologically confirmed newly diagnosed clinical stage II or III (by AJCC 8th edition - at least T2, any N, M0 or if N1+ then any T) ER-positive (ER \> 10%), any PR, and HER2-negative breast cancer with complete surgical excision of the breast cancer after neoadjuvant therapy as the treatment goal. * HER2 negative must be assessed by FISH or IHC staining 0 or 1+ according to ASCO/CAP guidelines. * Tumor size ≥2 cm in one dimension by clinical or radiographic examination (WHO criteria), if clinically axillary lymph node negative. Patients with histologically confirmed resectable locoregional nodal involvement may enroll regardless of tumor size. A palpable mass is not required as long as the mass is at least 2 cm in one dimension by radiographic exam. * ECOG performance status 0 or 1. * Eligible to receive neoadjuvant aromatase inhibitor, as per treating physician. * Eligible to receive neoadjuvant standard of care anthracycline- and/or taxane-based chemotherapy regimen, as per treating physician. * Able to tolerate breast MRI with intravenous contrast administration. Must be able to complete the applicable MRI screening evaluation form. * Adequate bone marrow and organ function, as determined by the treating physician. * Known history of hepatitis C virus (HCV) infection is permissible provided the patient has been treated and cured. * At least 18 years of age. * Postmenopausal status, defined as one of the following: * Age ≥ 60 years * Age \< 60 with intact uterus and amenorrhea for 12 consecutive months or more * Status post bilateral oophorectomy, total hysterectomy * Ability to understand and willingness to sign an IRB approved written informed consent document (or that of legally authorized representative, if applicable), and willing and able to comply with scheduled visits and treatment schedule.	* Inflammatory breast cancer (cT4d disease as per AJCC 8th edition). * Locally recurrent or metastatic disease (cM1 disease as per AJCC 8th edition). * Bilateral breast cancer. * Prior systemic therapy for the indexed breast cancer. * Pre-existing Grade ≥2 neuropathy. * Uncontrolled intercurrent illness that would limit compliance with study requirements. * A history of other malignancy ≤5 years prior to the indexed breast cancer diagnosis with the exception of basal cell or squamous cell carcinoma of the skin which were treated with local resection only or adequately treated carcinoma in situ of the cervix. * Concurrent participation in any investigational therapeutic trial for treatment of breast cancer. * Contraindication to breast MRI, such as: * Prior allergic reaction to gadolinium-based MR contrast agents. * Renal insufficiency (glomerular filtration rate (GFR) \< 30 mL/min/1.73 m\^2) measured within the past 60 days which precludes safe administration of the contrast agent. * Known HIV positivity that in the judgement of the treating physician would impact safety of chemotherapy receipt. * A history of allergic reactions attributed to compounds of similar chemical or biologic composition to anastrozole, taxanes (paclitaxel or nab-paclitaxel), anthracyclines (doxorubicin or epirubicin) or cyclophosphamide. * Evidence of uncontrolled ongoing or active infection, requiring parenteral anti-bacterial, anti-viral, or anti-fungal therapy ≤ 7 days prior to administration of study treatment. Patients receiving prophylactic antibiotics (e.g., for prevention of a urinary tract infection or chronic obstructive pulmonary disease) are eligible. * Any uncontrolled medical condition that in the opinion of the Investigator would pose a risk to participant safety or interfere with study participation or interpretation of individual participant results.

Inclusion Criteria

Exclusion Criteria

* Histologically or cytologically confirmed newly diagnosed clinical stage II or III (by AJCC 8th edition - at least T2, any N, M0 or if N1+ then any T) ER-positive (ER \> 10%), any PR, and HER2-negative breast cancer with complete surgical excision of the breast cancer after neoadjuvant therapy as the treatment goal.
* HER2 negative must be assessed by FISH or IHC staining 0 or 1+ according to ASCO/CAP guidelines.
* Tumor size ≥2 cm in one dimension by clinical or radiographic examination (WHO criteria), if clinically axillary lymph node negative. Patients with histologically confirmed resectable locoregional nodal involvement may enroll regardless of tumor size. A palpable mass is not required as long as the mass is at least 2 cm in one dimension by radiographic exam.
* ECOG performance status 0 or 1.
* Eligible to receive neoadjuvant aromatase inhibitor, as per treating physician.
* Eligible to receive neoadjuvant standard of care anthracycline- and/or taxane-based chemotherapy regimen, as per treating physician.
* Able to tolerate breast MRI with intravenous contrast administration. Must be able to complete the applicable MRI screening evaluation form.
* Adequate bone marrow and organ function, as determined by the treating physician.
* Known history of hepatitis C virus (HCV) infection is permissible provided the patient has been treated and cured.
* At least 18 years of age.
* Postmenopausal status, defined as one of the following:
* Age ≥ 60 years
* Age \< 60 with intact uterus and amenorrhea for 12 consecutive months or more
* Status post bilateral oophorectomy, total hysterectomy
* Ability to understand and willingness to sign an IRB approved written informed consent document (or that of legally authorized representative, if applicable), and willing and able to comply with scheduled visits and treatment schedule.

* Inflammatory breast cancer (cT4d disease as per AJCC 8th edition).
* Locally recurrent or metastatic disease (cM1 disease as per AJCC 8th edition).
* Bilateral breast cancer.
* Prior systemic therapy for the indexed breast cancer.
* Pre-existing Grade ≥2 neuropathy.
* Uncontrolled intercurrent illness that would limit compliance with study requirements.
* A history of other malignancy ≤5 years prior to the indexed breast cancer diagnosis with the exception of basal cell or squamous cell carcinoma of the skin which were treated with local resection only or adequately treated carcinoma in situ of the cervix.
* Concurrent participation in any investigational therapeutic trial for treatment of breast cancer.
* Contraindication to breast MRI, such as:
* Prior allergic reaction to gadolinium-based MR contrast agents.
* Renal insufficiency (glomerular filtration rate (GFR) \< 30 mL/min/1.73 m\^2) measured within the past 60 days which precludes safe administration of the contrast agent.
* Known HIV positivity that in the judgement of the treating physician would impact safety of chemotherapy receipt.
* A history of allergic reactions attributed to compounds of similar chemical or biologic composition to anastrozole, taxanes (paclitaxel or nab-paclitaxel), anthracyclines (doxorubicin or epirubicin) or cyclophosphamide.
* Evidence of uncontrolled ongoing or active infection, requiring parenteral anti-bacterial, anti-viral, or anti-fungal therapy ≤ 7 days prior to administration of study treatment. Patients receiving prophylactic antibiotics (e.g., for prevention of a urinary tract infection or chronic obstructive pulmonary disease) are eligible.
* Any uncontrolled medical condition that in the opinion of the Investigator would pose a risk to participant safety or interfere with study participation or interpretation of individual participant results.

Contacts and Locations

Study Contact

Nusayba A Bagegni, M.D.

CONTACT

314-273-3022

nbagegni@wustl.edu

Principal Investigator

Nusayba Bagegni, M.D.

PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Study Locations (Sites)

Washington University School of Medicine

Saint Louis, Missouri, 63110

United States

Collaborators and Investigators

Sponsor: Washington University School of Medicine

Nusayba Bagegni, M.D., PRINCIPAL_INVESTIGATOR, Washington University School of Medicine

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2024-05-30

Study Completion Date2027-11-30

Study Record Updates

Study Start Date2024-05-30

Study Completion Date2027-11-30

Terms related to this study

Keywords Provided by Researchers

breast cancer
postmenopausal women
Ki67
PAM50 subtype
breast cancer disparities

Additional Relevant MeSH Terms

Breast Cancer
Cancer of the Breast