SBRT, Chemotherapy, and AK112 Neoadjuvant Therapy for Luminal-type Breast Cancer

ConditionBreast Cancer
Trial statusRecruiting
Trial phasePhase 2
Trial typeInterventional
Biological sexFemale
Age18+
SponsorHubei Cancer Hospital

About this trial

Studies have indicated that the improvement in pathological complete response (pCR) is significantly correlated with luminal breast cancer patients' overall survival (OS). Patients with luminal breast cancer have poor efficacy for neoadjuvant chemotherapy. The combination of neoadjuvant therapy with immunotherapy and chemotherapy has been demonstrated to enhance the pCR rate of luminal-type breast cancer patients, increasing it from 13-15% to approximately 24%. Therefore, how to further improve the pCR rate of luminal-type breast cancer became the main objective of this study. Stereotactic radiotherapy (SBRT) not only kills tumor cells directly, but also kills the distant unirradiated tumor cells by promoting the cross-initiation of tumor-specific CD8+ T cells, a phenomenon known as the abscopal effect. Our research team has recently discovered that the triple therapy model of SBRT + anti-vascular targeting + anti-PD-1 was safe and efficacious in lung cancer patients. Ivonescimab (AK112) is an anti-PD-1/VEGF-A bispecific antibody. In order to improve the pCR, a single-arm, open, phase II clinical study was proposed to explore the safety and efficacy of SBRT+AK112+chemotherapy, a neoadjuvant treatment modality, in the treatment of luminal breast cancer.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

None

Disqualifiers

None

Trial design

Design model

Single group

Treatments tested in this trial

  • Lvonescimab (AK112)

    Drug

    8Gy×3 SBRT (continuous irradiation) to irradiate the primary lesion (for patients with axillary lymph node metastasis) or 6Gy×3 SBRT (continuous irradiation) to irradiate the primary lesion and axillary lymph node metastasis (for patients without axillary lymph node metastasis) will be administered at first. Then the first cycle of chemotherapy + AK112 will be given within 24 hours after the end of SBRT. The total eight cycles of preoperative chemotherapy combined with immunotherapy will be administered. Surgical resection will be performed within 4-6 weeks after the completion of the eighth cycle. The chemotherapy regimen consists of: Four cycles of doxorubicin 50 mg/m² (Q3W) + cyclophosphamide 600 mg/m² (Q3W), followed by Four cycles of albumin-bound paclitaxel 125 mg/m², Day 1 and Day 8 (every 28 days). The immunotherapy drug used is Ivonescimab (AK112) (20mg/kg) , administered every 3 weeks concurrently with chemotherapy for 8 cycles.

Treatment groups

50 Participants
are divided into 1 treatment group
Group A: luminal-type breast cancer patientsExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Complete pathologic remission (pCR) rate

pCR is defined as ypT0/Tis and ypN0

Time frame
Up to the 30 weeks

Secondary outcomes

1

Objective response rate (ORR)

Percentage of participants achieving complete response (CR) or partial response (PR), assessed by RECIST v1.1 and iRECIST.

Time frame
Up to the 30 weeks
2

Disease control rate (DCR)

Percentage of participants achieving CR, PR, or stable disease (SD), assessed by RECIST v1.1 and iRECIST.

Time frame
Up to 30 weeks
3

Residual Cancer Burden (RCB) score

Quantitative pathological assessment of residual disease in breast and lymph nodes.

Time frame
At time of surgery
4

Event-free survival (EFS)

Time from enrollment to disease progression, recurrence, or death.

Time frame
Up to 12 months after surgery

Other outcomes

1

Minimal residual disease (MRD) dynamics

MRD assessed at six time points: baseline, after 4 and 8 cycles of neoadjuvant therapy, and at 1, 6, 12 months post-surgery.

Time frame
Up to 12 months after surgery

Sponsors and contacts

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