Study on the Safety and Effectiveness of Trastuzumab Deruxtecan vs. Palbociclib-Based Drug Combination for Advanced HR-Positive, HER2-Low Breast Cancer Patients

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What is this study about?

This clinical trial is focused on studying advanced breast cancer, specifically a type known as hormone receptor (HR)-positive and HER2-low/ultralow breast cancer. This type of cancer is characterized by certain proteins that are present in lower amounts on the surface of cancer cells. The study aims to compare the safety and effectiveness of a new treatment called trastuzumab deruxtecan (also known as DS-8201a) with a combination of existing treatments, which include CDK4/6 inhibitors and endocrine therapy. CDK4/6 inhibitors are a type of medication that helps stop cancer cells from growing, while endocrine therapy targets hormones that can fuel cancer growth.

The purpose of the study is to see if trastuzumab deruxtecan can better delay the progression of the disease compared to the current standard treatment. Participants in the study will be randomly assigned to receive either trastuzumab deruxtecan or the combination of CDK4/6 inhibitors and endocrine therapy. The study will monitor the participants over a period to assess how long the treatments can keep the cancer from getting worse. The study will also look at the overall safety and any side effects of the treatments.

Participants will receive their assigned treatment and will be regularly monitored by healthcare professionals. The study will involve various assessments, including imaging tests like MRI or CT scans, to track the cancer’s response to the treatment. The study is expected to continue until 2029, with recruitment starting in 2025. This research is important for understanding how to better treat this specific type of breast cancer and improve outcomes for patients in the future.

1 joining the study

Upon joining the study, you will be randomly assigned to one of two groups. One group will receive trastuzumab deruxtecan, and the other group will receive a combination of CDK4/6 inhibitor and endocrine therapy.

You will be informed about the specific treatment you will receive and the schedule for your medication.

2 treatment with trastuzumab deruxtecan

If you are in the group receiving trastuzumab deruxtecan, the medication will be administered through an intravenous infusion. This means the drug will be given directly into your vein.

The infusion will be scheduled at regular intervals, and the healthcare team will provide you with the exact timing and frequency.

3 treatment with CDK4/6 inhibitor and endocrine therapy

If you are in the group receiving CDK4/6 inhibitor and endocrine therapy, you will take these medications orally in the form of tablets.

The specific medications may include options like palbociclib, abemaciclib, or ribociclib, combined with endocrine therapies such as letrozole, anastrozole, exemestane, or fulvestrant.

The healthcare team will provide detailed instructions on the dosage and frequency of each medication.

4 monitoring and follow-up

Throughout the study, regular monitoring will be conducted to assess your health and the effectiveness of the treatment.

This may include physical examinations, blood tests, and imaging studies like CT scans or MRIs.

The healthcare team will inform you about the schedule for these assessments and any specific preparations required.

5 end of treatment

The study will continue until the estimated end date in October 2029, or until the treatment is no longer effective or safe for you.

At the end of the study, or if you decide to withdraw, the healthcare team will discuss the next steps and any further treatment options available.

Who Can Join the Study?

  • Patients must be able to understand the purpose of the study and have signed a written informed consent form before starting any specific procedures.
  • Patients must meet certain criteria related to hormone therapy resistance or sensitivity. This includes:
    • Disease progression during or shortly after hormone therapy.
    • Specific characteristics of the cancer, such as a certain percentage of estrogen receptor-positive cells, high tumor grade, or liver metastases.
  • No prior treatment with any systemic therapy for advanced disease. Patients who had certain treatments in the past and have been off them for a specified time may be eligible.
  • Patients must have adequate bone marrow, liver, and kidney function. This includes specific blood counts and liver enzyme levels.
  • Any side effects from previous cancer treatments must have resolved to a mild level, except for hair loss or other non-risky side effects.
  • Women who can become pregnant must have a negative pregnancy test before starting the study and agree to use effective birth control during the study and for a period after.
  • Men must use effective contraception if they have a partner who can become pregnant and must not donate sperm during the study and for a period after.
  • Patients must be available for treatment and follow-up appointments.
  • Patients must be at least 18 years old at the time of signing the consent form.
  • Patients must have an ECOG performance status of 0-1, which means they are fully active or have some symptoms but do not need bed rest.
  • Patients must have a life expectancy of at least 12 weeks at the time of screening.
  • Patients must have evidence of HER2-low or HER2-ultralow breast cancer, as determined by specific tests on tumor tissue.
  • Patients must have a non-luminal breast cancer subtype, as determined by specific tests on tumor tissue.
  • Patients must have HR-positive status, meaning their cancer cells have receptors for hormones like estrogen or progesterone.
  • Patients must have breast cancer that is locally recurrent or metastatic and cannot be surgically removed with the intent to cure.
  • Patients must have measurable disease according to specific criteria. Patients with only bone disease are not eligible, but those with bone metastases and soft tissue masses larger than 10 mm are eligible.

Who Cannot Join the Study?

  • Patients with unresectable (cannot be removed by surgery) locally recurrent or metastatic (cancer that has spread to other parts of the body) breast cancer that is hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-low/ultralow and classified as non-luminal by gene expression profiling cannot participate.
  • Patients who do not meet the age requirements specified for the study.
  • Patients who are part of a vulnerable population, which means they might need special protection or care, are not eligible.

Where you can join this trial?

Verified and Recommended Sites

No sites found in this category

Verified Sites

Other Sites

Site Name City Country Status
Istituto Oncologico Veneto Padua Italy
Haematologie-Onkologie im Zentrum MVZ GmbH Augsburg Germany
Centro Di Riferimento Oncologico Di Aviano Aviano Italy
Netherlands Cancer Institute Amsterdam The Netherlands
Istituto Europeo Di Oncologia S.r.l. Milan Italy
IRCCS Istituto Nazionale Tumori Fondazione Pascale Naples Italy
Azienda Ospedaliero Universitaria Di Modena Modena Italy
Azienda Unita Sanitaria Locale Di Piacenza Piacenza Italy
Universitair Ziekenhuis Gent Gent Belgium
Algemeen Ziekenhuis Klina Brasschaat Belgium
Klinikum Ernst von Bergmann gGmbH Potsdam Germany
Hospital General Universitario Gregorio Maranon Madrid Spain
Hospital Universitario Puerta De Hierro De Majadahonda Majadahonda Spain
Hospital Universitario 12 De Octubre Madrid Spain
Hospital Universitari Dexeus Grupo Quironsalud Barcelona Spain
Fundacion Instituto Valenciano De Oncologia Valencia Spain
Instytut Centrum Zdrowia Matki Polki Lodz Poland
Hospital San Pedro De Alcantara Caceres Spain
Instituto Portugues De Oncologia Do Porto Francisco Gentil E.P.E. Porto Portugal
Hospital Universitario De Jaen Jaen Spain
Unidade Local De Saude De Loures-Odivelas EPE Loures Portugal
Unidade Local De Saude De Amadora Sintra E.P.E. Amadora Portugal
Hospital Cuf Descobertas S.A. Lisbon Portugal
Hospital Clinico Universitario Lozano Blesa Zaragoza Spain
Hospital Universitario Basurto Bilbao Spain
Hospital Quironsalud Sagrado Corazon Sevilla Spain
Fondazione IRCCS San Gerardo Dei Tintori Monza Italy
Unidade Local De Saude Do Alto Ave E.P.E. Guimaraes Portugal
Ospedale Generale Provinciale Di Macerata Macerata Italy
Unidade Local De Saude De Tras-Os-Montes E Alto Douro E.P.E. Vila Real Portugal
Micancer Center S.L.P. Barcelona Spain
Hospital Quironsalud Zaragoza Zaragoza Spain
Hospital Universitario San Juan De Alicante Sant Joan D'alacant Spain
Virgen del Rocío University Hospital Sevilla Spain
Hospital Clinic De Barcelona Barcelona Spain
Klinikum Aschaffenburg-Alzenau gGmbH Aschaffenburg Germany
Hospital Da Luz S.A. Lisbon Portugal
Klinikum Worms gGmbH Worms Germany
Wojskowy Instytut Medyczny Panstwowy Instytut Badawczy Warsaw Poland
IRCCS Ospedale Policlinico San Martino Genoa Italy
University Clinical Hospital Virgen De La Arrixaca Murcia Spain
Universita’ Politecnica Delle Marche Ancona Italy
Universidade De Santiago De Compostela Santiago De Compostela Spain
Hospital Universitari Arnau De Vilanova De La Gerencia Territorial De Lleida Lleida Spain
Salut Sant Joan De Reus Reus Spain
Azienda Ospedaliero-Universitaria Maggiore Della Carita Novara Italy
Centro Hospitalar Do Baixo Vouga E.P.E. (CHBV E.P.E.) Aveiro Portugal
Kliniki Neuroradiochirurgii Sp. z o.o. Radom Poland
Centro Hospitalar Universitario De Santo Antonio E.P.E. Porto Portugal
CHU Helora La Louviere Belgium
Centre Hospitalier Lyon Sud Pierre Benite France
Centre Francois Baclesse Caen France
IRCCS Ospedale Sacro Cuore Don Calabria Negrar di Valpolicella Italy
Centro Oncologico De Galicia A Coruna Galicia Spain
Hospital Universitario Virgen De La Victoria Malaga Spain
Clzvcvlbe Uidmfcvqzdovtk Sxxfprasm Woluwe-Saint-Lambert Belgium
Bcfhlclb Uwnrsytngp Hzfcpuqs Cukkxc Besançon France
Kbsdzxcv Eboohpefctgyfkqubgzssdgb Hvnzexmodvywqgcie Essen Germany
Jtpxlgae Kqbpkx Undbhlznxd Linz Austria
Igrrkwov Czqkig Dvhcjuzgjubktrraz L'hospitalet De Llobregat Spain
Ijhxywmt dv Ccoiiavxmdku Hhkoihwleho Uyplrhcjspsfn dw Sbdvx Eueylah (rhwzgjo Saint Priest En Jarez France
Iaywrmfe Pntzyiyrsvyliqb Csxqdl Cyrsgz Marseille France
Hezpfkix Ukitukucpxves du A Ckfwnu A Coruna Galicia Spain

Want to learn more about this study or check if you can participate? Contact us.

Trial status

Country Status Recruitment Start
Austria Austria
Recruiting
14.05.2025
Belgium Belgium
Recruiting
14.05.2025
France France
Recruiting
14.05.2025
Germany Germany
Recruiting
14.05.2025
Italy Italy
Recruiting
14.05.2025
Poland Poland
Recruiting
14.05.2025
Portugal Portugal
Recruiting
14.05.2025
Spain Spain
Recruiting
14.05.2025
The Netherlands The Netherlands
Not yet recruiting
14.05.2025

Trial locations

Trastuzumab deruxtecan is a medication used in this clinical trial to treat advanced breast cancer. It is designed to target and attach to specific proteins on cancer cells, helping to deliver a powerful anti-cancer drug directly to the tumor. This targeted approach aims to kill cancer cells more effectively while minimizing damage to healthy cells.

CDK4/6 inhibitor-based endocrine therapy is another treatment option being studied in this trial. This therapy combines a type of medication known as a CDK4/6 inhibitor with hormone therapy. CDK4/6 inhibitors work by blocking certain proteins that cancer cells need to grow and divide. When used with hormone therapy, which targets hormone receptors on cancer cells, this combination aims to slow down or stop the growth of cancer cells in patients with hormone receptor-positive breast cancer.

Investigated diseases:

Unresectable Locally Recurrent or Metastatic Hormone Receptor-Positive and Human Epidermal Growth Factor Receptor 2-Low/Ultralow Breast Cancer – This type of breast cancer is characterized by its inability to be surgically removed and its recurrence in the local area or spread to other parts of the body. It is hormone receptor-positive, meaning the cancer cells grow in response to hormones like estrogen or progesterone. The cancer is also classified as HER2-low or ultralow, indicating low levels of the HER2 protein, which can affect the growth of cancer cells. The progression of this disease involves the continued growth and spread of cancer cells, which can invade nearby tissues or metastasize to distant organs. The classification as non-luminal by gene expression profiling suggests a specific pattern of gene activity that influences the cancer’s behavior. This type of breast cancer can be challenging to manage due to its advanced stage and specific biological characteristics.

Trial ID:
2024-512360-55-00
Protocol code:
MEDOPP556
NCT ID:
NCT06486883
Trial Phase:
Therapeutic exploratory (Phase II)

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