Kumorixilib Plus Capecitabine and Letrozole for Neoadjuvant Treatment of HR-Positive HER2-Negative Breast Cancer

Trial statusNot yet recruiting
Trial phasePhase 2
Trial typeInterventional
Biological sexFemale
Age18-75
SponsorFujian Cancer Hospital

About this trial

This study is a single-center, prospective, open-label exploratory clinical study to assess the efficacy and safety of kumorixilib combined with capecitabine and letrozole as neoadjuvant therapy in patients with HR+/HER2- stage II-III invasive breast cancer. The study plans to enroll 35 eligible patients, and all participants will receive the triple-drug combination regimen without randomization. The treatment regimen: kumorixilib 180 mg orally once daily, capecitabine 500 mg orally three times daily, and letrozole 2.5 mg orally once daily; each cycle lasts 28 days, for a total of 6 cycles. Breast MRI will be used to evaluate radiological tumor response. Surgical resection will be arranged 2-4 weeks after neoadjuvant treatment ends. The primary endpoint is the percentage change in Ki-67 score from baseline to Cycle 1 Day 28. Secondary endpoints include the complete cell cycle arrest rate (CCCA, Ki-67 ≤ 2.7%) on Day 28, the reduction rate of functional tumor volume (FTV), the proportion of patients with RCB 0-1, objective response rate (ORR), and treatment safety. Treatment will be discontinued upon disease progression, intolerable adverse events, withdrawal of consent, or investigator judgment.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Female patients with breast cancer aged ≥18 and ≤75 years, satisfying one of the following menopausal status criteria: (1) Bilateral oophorectomy in medical history, or age ≥60 years; (2) Age <60 years with natural menopause (defined as spontaneous cessation of regular menses for at least 12 consecutive months without other pathological or physiological causes), with postmenopausal levels of E2 and FSH; (3) Pre-menopausal or peri-menopausal female patients who are willing to receive LHRH agonist therapy throughout the study period.

Histopathologically confirmed estrogen receptor (ER)-positive (>10%) and/or progesterone receptor (PR)-positive (>10%), HER2-negative breast cancer, assessed in accordance with the 2018 ASCO-CAP guidelines. HER2 negativity is defined as immunohistochemistry (IHC) score of 0+, or IHC 2+ with negative in situ hybridization (ISH) test (ISH amplification ratio <2.0), verified by the pathological laboratory.

Accept core needle biopsy to provide initial tissue samples with Ki-67 ≥10% tested on the initial specimen; agree to provide tissue samples for tumor biomarker testing and peripheral blood samples for biomarker analysis.

Treatment-naïve breast cancer patients staged as Stage II-III per the 8th edition of the AJCC staging system.

Disqualifiers

Prior receipt of any form of anti-tumor therapy (including chemotherapy, radiotherapy, molecular targeted therapy, endocrine therapy, etc.).

Concurrent administration of other anti-tumor agents.

Bilateral breast cancer, inflammatory breast cancer, or occult breast cancer.

Stage IV breast cancer.

Trial design

Design model

Single group

Treatments tested in this trial

  • Kumorixilib 180mg

    Drug

    Kumorixilib: 180 mg orally once daily. One cycle lasts 28 consecutive days. The total treatment duration is 6 cycles.

  • Capecitabine 500mg

    Drug

    Capecitabine: 500 mg orally three times daily. One cycle lasts 28 consecutive days. The total treatment duration is 6 cycles.

  • Letrozole 2.5mg

    Drug

    Letrozole: 2.5 mg orally once daily. One cycle lasts 28 consecutive days. The total treatment duration is 6 cycles.

Treatment groups

35 Participants
are divided into 1 treatment group
Group A: Kumorixilib + Capecitabine + Letrozole Neoadjuvant TherapyExperimental treatment 3 interventions

Trial outcomes

Primary outcomes

1

Percentage change in Ki-67 score from baseline to Cycle 1 Day 28

The percentage reduction of Ki-67 proliferation index in tumor tissue between baseline and Cycle 1 Day 28 after treatment initiation.

Time frame
At the end of Cycle 1 (each cycle is 28 days)

Secondary outcomes

1

Complete cell cycle arrest (CCCA) rate at Cycle 1 Day 28

Proportion of patients with Ki-67 ≤ 2.7% in tumor tissue at Cycle 1 Day 28

Time frame
At the end of Cycle 1 (each cycle is 28 days)
2

Reduction rate of functional tumor volume (FTV)

Percentage shrinkage of functional tumor volume measured by breast MRI

Time frame
At the end of Cycle 6 (each cycle is 28 days), before breast surgery
3

Incidence of Residual Cancer Burden (RCB) 0-1

Proportion of patients with RCB grade 0 or 1 on postoperative pathological specimen

Time frame
After surgical resection (end of neoadjuvant treatment)
4

Objective Response Rate (ORR)

Proportion of patients achieving complete response (CR) or partial response (PR) assessed by breast MRI

Time frame
At the end of Cycle 6 (each cycle is 28 days), before breast surgery

Other outcomes

Sponsors and contacts

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