The Study of Trilaciclib Combined With Chemotherapy On The Neoadjuvant Therapy of TNBC

Trilaciclib indication: Trilaciclib, a CDK4/6 inhibitor, was used before chemotherapy to reduce the incidence of bone marrow suppression and approved by the FDA for small cell lung cancer patients in 2021.

Inclusion criteria

• Newly treated patients aged ≥ 18 years;
• ECOG score 0-1;
• Breast cancer meets the following standards:

• Histologically confirmed invasive breast cancer
• Tumor staging: cT2-4, cNany, cM0 or cT1, cN1-3, cM0;
• Hormone (estrogen and progesterone) receptor negative tumors confirmed by histological or cytological records (defined as nuclear staining rate<1% based on immunohistochemistry [IHC] evaluation) and Her-2 negative, non overexpressing tumors (based on IHC [0 or 1+] or in situ hybridization [ratio<2.0] or average Her-2 gene copy number<4 signals/nucleus);
• Within the first two weeks of the screening period, no G-CSF, TPO, IL-11, ESA, iron, platelet transfusion, or blood transfusion have been used.
• The functional level of the main organs must meet the following requirements:

• Blood routine: Neutrophils (ANC)≥1.5×109/L, platelet count (PLT)≥90×109/L, hemoglobin (Hb)≥90g/L
• Blood biochemistry: alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5×ULN, serum creatinine (Cr)≤1.5×ULN, bilirubin<1.5 ULN;
• For female patients who have not undergone menopause or surgical sterilization: During the treatment period and at least 7 months after the last dose in the study treatment, consent to abstinence or use effective contraceptive methods.
• Volunteer join this study, sign an informed consent form, have good compliance, and are willing to cooperate with follow-up.

Exclusion criteria

• Previously received anti-tumor treatment for any malignant tumor;
• Subjects who are unable to accept or tolerate preoperative chemotherapy due to various reasons;
• The patient has undergone major surgical procedures unrelated to breast cancer within 4 weeks before enrollment, or has not fully recovered from such surgical procedures;
• Serious heart disease or discomfort, including but not limited to the following diseases:

• A confirmed history of heart failure or systolic dysfunction (LVEF<50%);
• High risk uncontrolled arrhythmias, such as atrial tachycardia, resting heart rate>100bpm, significant ventricular arrhythmias (such as ventricular tachycardia) or higher-level atrioventricular block (such as Mobitz II second degree atrioventricular block or third degree atrioventricular block);
• Angina pectoris requiring treatment with anti angina drugs;
• Heart valve disease with clinical significance;
• ECG shows transmural myocardial infarction;
• Poor control of hypertension (systolic blood pressure>180mmHg and/or diastolic blood pressure>100mmHg)
• Those with a known history of allergies to the drug components of this protocol;
• Breastfeeding female patients, those with fertility and positive baseline pregnancy test results, or those of childbearing age who are unwilling to take effective contraceptive measures during the entire trial period and within 7 months after the last study medication;
• Any other circumstances in which the researcher believes that the patient is not suitable to participate in this study.