Sequencing SG vs. T-DXd in HER2-Low/TROP2-High Metastatic Breast Cancer
- Sponsor
- Fudan University
- Study ID
- NCT07368543
- Phase
- PHASE2
- Status
- Not Yet Recruiting
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Conditions
Eligibility Criteria
- Sex
- ALL
- Age
- 18 Years - N/A
- Healthy Volunteers
- Not accepted
Interventions
- Sacituzumab Govitecan — DRUGRecommended Dose: 10 mg/kg administered by intravenous infusion on Days 1 and 8 of each 21-day treatment cycle. Continue treatment until disease progression or unacceptable toxicity.
- Trastuzumab Deruxtecan — DRUGDosage and Administration: The recommended dose is 5.4 mg/kg administered by intravenous infusion once every 3 weeks (21-day cycles). Continue treatment until disease progression or unacceptable toxicity.
Study Details
Currently, no phase III RCT has directly compared SG and T-DXd sequencing strategies, and the predictive role of biomarkers remains unclear. Additionally, there is no standard scoring system for Trop-2 expression. The ASCENT trial utilized an H-score method (H-score = 3×%IHC3+ + 2×%IHC2+ + 1×%IHC1+), with scores \<100, 100-200, and \>200 defining low, medium, and high Trop-2 expression, respectively.This prospective study aims to: 1) Evaluate the efficacy of SG vs. T-DXd in HER2-low/Trop-2-high metastatic breast cancer, prioritizing SG for Trop-2-high patients and T-DXd for others. 2) Compare sequential treatment outcomes-T-DXd after SG failure versus SG after T-DXd failure-to inform ADC sequencing in HER2-low disease. Up to one intervening therapy is allowed before sequencing. 3) Identify biomarkers of ADC efficacy and resistance through quantitative protein analysis to optimize patient selection.
Key Dates
- Start date
- Jan 16, 2026
- Status verified
- Jan 2026
- Primary completion
- Jun 1, 2027
- Completion
- Dec 1, 2028
Study Design
- Enrollment
- 216 participants (estimated)
- Allocation
- RANDOMIZED
- Intervention model
- PARALLEL
- Primary purpose
- TREATMENT
Arms
- Experimental: Cohort A (Triple-Negative Breast Cancer)Patients with HER2 IHC 1+ metastatic triple-negative breast cancer (TNBC);
- Experimental: Cohort B (HR+/HER2 IHC 1+ and Ultralow Metastatic Breast Cancer)Patients with HR-positive/HER2 IHC 1+ and HER2 ultralow metastatic breast cancer (MBC) who have failed endocrine therapy.
Primary Outcome Measure
Progression-Free Survival 1 (PFS1) [ Time Frame: Until progression, assessed up to approximately 24 months ]
Central Contacts
- Jian Zhang, MD8664175590
- Yanchun Meng, MD+8664175590
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