Premenopausal Patient With Hormone Responsive, HER2 Negative, Lymph Node Positive Breast Cancer

Study Overview
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Brief Summary
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The purpose of this study is to compare neo-adjuvant therapy of cytotoxic chemotherapy versus GnRHa with tamoxifen , of response rate(RR) in patients of hormone responsive and HER2 negative, lymph node positive, primary breast cancer in premenopausal women.

Detailed Description
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Primary objective : Response Rate-MRI and/or Caliper Secondary objectives Pathologic complete response Rate of conservation surgery Ki-67 changes and its relationship to treatment response Length of time to maximum response within the treatment period Tolerability of two treatments Disease-free survival(DFS) Overall survival

Official Title
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A Phase III, Open-Label, Prospective, Randomized, Multicenter, Neo-adjuvant Study of Chemotherapy Versus Endocrine Therapy in Premenopausal Patient With Hormone Responsive, HER2 Negative, Lymph Node Positive Breast Cancer

Conditions
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Breast Cancer

Intervention / Treatment
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* Drug: Adriamycin+Cyclophosphamide>Docetaxel
* Drug: GnRHa with Tamoxifen


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Histologically proven primary invasive breast cancer which is thought to be suitable for neo-adjuvant treatment Pathologically proven lymph node positive tumor(FNAB or Core biopsy) Tumor must be ER positive(eligible patients include Allred score 5 and more, Modified Allred 4 and more) and HER-2 negative(IHC score is 0-1+; If IHC score is 2+, the result of FISH or SISH is negative) Premenopausal women Premenopausal status as defined by : Last menses within 6 month of randomization or For patients who have had a unilateral oophorectomy, E2 ≥ 20PG/mL and FSH < 30mIU/Ml within 4 weeks of randomization over 20 years old Pre-treatment haematology and biochemistry values within acceptable limits : ANC ≥ 1.5 × 109/l Hb > 9g/dl Platelets ≥ 100 × 109/l AST/ALT ≤ 1.5 × ULN(Upper Limit of Normal) ALP ≤ 1.5 × ULN Serum bilirubin ≤ 1.5 × ULN Serum creatinine ≤ 1.5 × ULN ECOG PS of 0 or 1 No concomitant medical, psychiatric or geographic problems that might prevent completion of treatment or follow-up Before any study-specific procedures, the appropriate written informed consent must be obtained Exclusion Criteria: Inflammatory breast cancer Inoperable disease that is judged very unlikely to be rendered operable by neo-adjuvant treatment Known severe hypersensitivity to GnRHa treatment Bilateral invasive breast cancer Other serious illness or medical condition: congestive heart failure or unstable angina pectoris, previous history of myocardial infarction within 1 year from study entry, uncontrolled hypertension or high-risk uncontrolled arrhythmias history of significant neurologic or psychiatric disorders including psychotic disorders, dementia or seizures that would prohibit the understanding and giving of informed consent active uncontrolled infection HRT within 4 weeks of starting treatment Definite contra-indications for the use of corticosteroids. Last 10 years with a history of other malignant tumor (except in the case of basal cell carcinoma or cervical carcinoma in situ, and where treatment consisted solely of resection) Systemic metastatic (Tests for the diagnosis of systemic metastatic comply with the guideline in each institution) Pregnant or breastfeeding women Chronic oral treatment with corticosteroids unless initiated > 6 months prior to study entry and at low dose (≤ 20 mg methylprednisolone or equivalent).

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Chemotherapy Group<br>Chemotherapy Adriamycin+Cyclophosphamide>Docetaxel | Drug: Adriamycin+Cyclophosphamide>Docetaxel<br>* Adriamycin 60mg/m2 + Cyclophosphamide 600mg/m2 Route: by slow intravenous bolus Schedule: every 3weeks for 4 cycle Docetaxel 75mg/m2 Route: intravenous as per local practice Schedule: every 3weeks for 4 cycle<br>* Other names: Chemotherapy;|
| Experimental: Endocrine therapy group<br>Endocrine therapy(GnRHa with Tamoxifen) group | Drug: GnRHa with Tamoxifen<br>* Goserelin(GnRHa) 3.6mg Route: subcutaneously under the abdominal skin Schedule: every 4weeks for 6cycles (period of 34 days between 2 administrations must not be exceeded) Tamoxifen 20mg/day Route: Oral Schedule: everyday<br>* Other names: Endocrine Therapy;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Response Rate |  | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pathologic complete response |  | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Neoadjuvant, endocrine therapy, premenopausal, hormone responsive, HER2 negative, lymph node positive