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Completed

NCT Number: NCT02742051

A Trial of Neoadjuvant Everolimus Plus Letrozole Versus FEC in Women With ER-positive, HER2-negative Breast Cancer

This open, randomized pilot feasibility trial is to evaluate the feasibility and effect of neoadjuvant everolimus plus letrozole versus neoadjuvant fluorouracil, epirubicin plus cyclophosphamide (FEC) in treating postmenopausal women with ER-positive, HER2-negative breast cancer. Forty postmenopausal stage M0, ER-positive, HER2-negative invasive breast cancer women who had a primary tumor > 2cm by imaging or an axillary lymph node > 2cm by imaging were randomly (1:1) enrolled to receive neoadjuvant everolimus plus letrozole for 18 weeks or neoadjuvant FEC for 6 cycles before surgery. The primary objective is to determine the feasibility of neoadjuvant everolimus plus letrozole in postmenopausal patients with ER-positive, HER2-negative breast cancer. Secondary aims are to compare the ultrasound response rate, pathological complete response (pCR) rate, breast-conserving surgery rate, toxicities, and changes in the percentages or counts of peripheral blood CD4+ T cells, CD8+ T cells, tumor-specific CTLs, T helper cells (Th), regulatory T cells (Treg), and NK cells and changes in tumor Ki67 index (pre- versus post- neoadjuvant therapy).

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Key information

Age range

18 year–70 year

Sex eligibility

Female

Study type

Interventional

Phase

Phase 2

Primary location

Sun-Yat-Sen Memorial Hospital of Sun-Yat-Sen University

Guangzhou, Guangdong, 510120, China

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • The patients signed the written informed consent
  • The patients present with non-metastatic unilateral invasive ER-positive, HER2-negative breast cancer with a primary breast tumor > 2cm by imaging or an axillary lymph node > 2cm by imaging.
  • Postmenopausal women with age less than 70 years old.
  • The patients have no history of hormone therapy, chemotherapy, breast cancer surgery and radiotherapy.
  • The patients have normal cardiac functions by echocardiography.
  • The patients' ECOG scores are ≤2.
  • The patients can swallow pills.
  • The results of patients' blood tests are as follows:
  • Hb≥90g/L;
  • WBC≥4E+9/L;
  • Plt≥100E+9/L;
  • Neutrophils≥1.5E+9/L;
  • ALT and AST ≤ triple of normal upper limit;
  • TBIL ≤ 1.5 times of normal upper limit;
  • Creatinine ≤ 1.5 times of normal upper limit.

Exclusion criteria

  • The patients have other cancers at the same time or have the history of other cancers except controlled skin basal cell carcinoma or skin squamous cell carcinoma or carcinoma in situ of cervix uterus;
  • The patients have active infections that were not suitable for chemotherapy;
  • The patients have severe non-cancerous diseases.
  • The patients have bilateral breast cancers or multifocal breast cancers or inflammatory breast cancers.
  • The patients have a history of previous treatment with mTOR inhibitors.
  • The patients are undergoing current administration of anti-cancer therapies, or are attending other clinical trials.
  • The patients are in some special conditions that they cannot understand the written informed consent, such as they are demented or hawkish.
  • The patients have allergic history or contraindication of any of the interventional drugs.

Treatment and study plan

Everolimus

Drug

Neoadjuvant endocrine therapy

Other names: RAD001

letrozole

Drug

Neoadjuvant endocrine therapy

Other names: Femara

Fluorouracil

Drug

Neoadjuvant chemotherapy

Other names: 5-Fu

Epirubicin

Drug

Neoadjuvant chemotherapy

Other names: EPB

Cyclophosphamide

Drug

Neoadjuvant chemotherapy

Other names: CTX

Primary outcomes

  1. Feasibility of the trial

    Time frame: during on-neoadjuvant therapy period (defined as the period from the first dose of study medication up to 30 days of the last dose)

Secondary outcomes

  1. Ultrasound response rate

    Time frame: at definitive surgery (18-20 weeks after the first dose of study medication)

  2. Pathological complete response (pCR) rate

    Time frame: at definitive surgery (18-20 weeks after the first dose of study medication)

  3. Breast-conserving surgery rate

    Time frame: at definitive surgery (18-20 weeks after the first dose of study medication)

  4. Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

    Time frame: during on-neoadjuvant therapy period (defined as the period from the first dose of study medication up to 30 days of the last dose)

  5. Peripheral blood CD8+ T cell percentage change in relation to neoadjuvant therapy

    Time frame: at definitive surgery (18-20 weeks after the first dose of study medication)

  6. Peripheral blood T helper cell percentage change in relation to neoadjuvant therapy

    Time frame: at definitive surgery (18-20 weeks after the first dose of study medication)

  7. Peripheral blood regulatory T cell percentage change in relation to neoadjuvant therapy

    Time frame: at definitive surgery (18-20 weeks after the first dose of study medication)

  8. Peripheral blood NK cell percentage change in relation to neoadjuvant therapy

    Time frame: at definitive surgery (18-20 weeks after the first dose of study medication)

  9. Blood tumor-specific CTLs count change in relation to neoadjuvant therapy

    Time frame: at definitive surgery (18-20 weeks after the first dose of study medication)

  10. Peripheral blood CD4+ T cell percentage change in relation to neoadjuvant therapy

    Time frame: at definitive surgery (18-20 weeks after the first dose of study medication)

  11. Tumor Ki67 index change in ralation to neoadjuvant therapy

    Time frame: at definitive surgery (18-20 weeks after the first dose of study medication)

Sponsors and collaborators

Lead sponsor

Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University

Other

Registry information

Official study title

A Randomised Pilot Study of Neoadjuvant Everolimus Plus Letrozole Compared With FEC in Postmenopausal Patients With ER-positive, HER2-negative Breast Cancer

Important dates

Study start
2016
Primary completion
2020
Study completion
2020
First posted
Apr 18, 2016
Registry last updated
Sep 23, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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