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NOT YET RECRUITING
NCT07106632
PHASE3

Optimising Adjuvant Chemotherapy Prescription in Young Patients With Hormone-dependent Breast Cancer Using Genomic Tests

Sponsor: UNICANCER

View on ClinicalTrials.gov

Summary

Rationale: Around 70 to 80% of breast cancers are so-called "hormone-dependent" (HR+)/HER2-. For more than 50 years, studies have shown that chemotherapy and optimised hormonal treatments (hormone therapy), including a drug associated with ovarian suppression (OFS), improve survival in patients with these cancers, which are characterised by a high risk of relapse. However, younger patients suffer more side effects than older women, particularly from chemotherapy. This can affect their quality of life and reduce their ability to work. For post-menopausal women, genetic tests exist to assess whether chemotherapy is really necessary in addition to hormonal treatment. However, for high-risk premenopausal patients, chemotherapy is still systematically recommended, as no study has proved that it can be safely avoided. Clinical trials based on risk stratification using genetic tests have not been conclusive, but the majority of premenopausal women included had not received optimal hormone treatment. It is possible that the beneficial effect of chemotherapy is partly due to the artificial menopause it induces. Some experts believe that, for patients with a high clinical risk but a low genetic risk, an optimised hormonal treatment (drug + OFS) could suffice, without the need for chemotherapy. Objectives: Main objective: The aim of the study is to determine whether the use of a genetic test (Prosigna®) to decide whether or not to administer chemotherapy produces results as good as standard treatment (systematic chemotherapy) in premenopausal women with hormone-dependent (HR+) breast cancer/HER2-, by assessing their risk of cancer recurrence. The secondary objectives include verifying whether, in patients with a low Prosigna® score (around 70% of cases), optimised hormonal treatment (including suppression of ovarian function) is as effective as chemotherapy combined with hormonal in treatment preventing cancer recurrence. The study also seeks to compare the efficacy of treatment Prosigna®-guided versus systematic chemotherapy in terms of recurrence and quality of life, as well as economic aspects. Finally, the aim is to understand patients' concerns about the concept of reducing treatment (therapeutic de-escalation) and the way in which this information is communicated to them. The primary endpoint of the study is to measure the time elapsed between the start of participation in the study and the appearance of an event indicating a return of the cancer. This includes the return of cancer in the same breast or neighbouring areas, the spread of cancer to other parts of the body, the appearance of new cancer in the other breast or death from any cause. Trial Population: The study includes women major premenopausal diagnosed with invasive, hormone receptor-positive (ER+) and HER2-negative breast cancer. Patients must have undergone breast and axillary surgery recent and have a tumour sample suitable for analysis by the testProsigna® . They must be able to receive the study treatments Postmenopausal women, women with stage IV breast cancer, women who have already received adjuvant systemic treatment (except short neoadjuvant hormone therapy), women with a recent history of invasive cancer, pregnant women or women who are breast-feeding will not be able to take part in the study. Interventions: After agreeing to take part, patients will enter the pre-inclusion period (up to 28 days before randomisation), during which the investigator will carry out all the necessary tests to assess their eligibility. The investigator will then randomise the patients to find out which treatment they have been assigned, no more than 2 weeks later: the experimental group will receive a treatment decided on the basis of the results of a genomic test: either chemotherapy and hormone therapy, or hormone therapy alone. The control group will receive the standard treatment. The treatment and follow-up phases are the same as for standard care. Information on the quality of life patient's will and other information (associated costs, perception of their participation in the study, etc.) also be collected by means of questionnaires completed by the patients during the 5 years following randomisation.

Official title: Optimal Personalized Treatment of Early Breast Cancer Using Multi-parameter Analysis: Focus on YOUNGer Women

Key Details

Gender

FEMALE

Age Range

35 Years - 45 Years

Study Type

INTERVENTIONAL

Enrollment

3380

Start Date

2026-04-01

Completion Date

2038-08-15

Last Updated

2026-03-24

Healthy Volunteers

No

Interventions

DRUG

test-directed treatment: allocated treatment will depend on the PAM50 score result (centrally assessed) : chemo-endocrine therapy or endocrine therapy alone

In this experimental arm, the treatment is driven by the score of the Prosigna test. If the score is superior to 60, the patient is considered at hight risk so the patient will receive chemo-endocrine therapy. If the result is under or equal to 60, only endocrine therapy will be prescribed to the patient.

DRUG

In the control arm, the treatment will be as standard of care : chemo-endocrine therapy

Standard treatment: Chemotherapy followed by endocrine therapy

Locations (105)

Institut Jules Bordet

Brussels, Belgium

Cliniques Universitaires Saint-Luc

Brussels, Belgium

Grand Hôpital de Charleroi

Charleroi, Belgium

CHU Helora Hôpital de La Louvière - Site Jolimont

Haine-Saint-Paul, Belgium

CHU UCL Namur - Site Sainte Elisabeth

Namur, Belgium

Clinique Saint Pierre

Ottignies, Belgium

CHR Verviers

Verviers, Belgium

Centre Hospitalier d'Auxerre

Auxerre, France

Sainte Catherine - Institut du Cancer Avignon-Provence

Avignon, France

Centre Hospitalier de la Côte Basque

Bayonne, France

Centre Hospitalier Simone Veil de Beauvais

Beauvais, France

Hôpital de Blois

Blois, France

Avicenne Hospital (APHP)

Bobigny, France

Clinique Tivoli

Bordeaux, France

Centre Hospitalier Fleyriat Bourg en Bresse

Bourg-en-Bresse, France

Clinique Pasteur - CFRO

Brest, France

Groupement Hospitalier Est - Hospices Civils de Lyon

Bron, France

Centre Francois Baclesse

Caen, France

Centre Hospitalier Métropole Savoie

Chambéry, France

CH Cholet

Cholet, France

Pôle Santé République

Clermont-Ferrand, France

Centre Jean Perrin

Clermont-Ferrand, France

Centre Léonard De Vinci

Dechy, France

Centre Georges François Leclerc

Dijon, France

CH Annecy Genevois

Épagny Metz-Tessy, France

Centre Hospitalier Intercommunal de Fréjus Saint Raphael

Fréjus, France

Groupe Hospitalier Mutualiste de Grenoble

Grenoble, France

Centre Hospitalier Le Mans - Centre De Cancérologie De La Sarthe

Le Mans, France

Centre Oscar Lambret

Lille, France

CHU de Limoges

Limoges, France

Hôpital de la croix Rousse - Hospices Civils de Lyon

Lyon, France

Centre Léon Bérard

Lyon, France

Hôpital Européen

Marseille, France

Hôpital Privé Clairval

Marseille, France

Institut Paoli Calmettes

Marseille, France

Hôpital Privé Nancy Lorraine

Nancy, France

Hôpital Privé du Confluent

Nantes, France

Centre Hospitalier de Pau

Pau, France

Hôpital Lyon Sud-Hospices Civils de Lyon

Pierre-Bénite, France

Hôpital NOVO - Site de Pontoise

Pontoise, France

Institut Godinot

Reims, France

CLCC Eugène Marquis

Rennes, France

Centre Henri Becquerel

Rouen, France

Clinique Mutualiste de l'Estuaire

Saint-Nazaire, France

CHU de Saint Etienne

Saint-Priest-en-Jarez, France

Clinique Médico Chirurgicale Charcot

Sainte-Foy-lès-Lyon, France

Strasbourg Oncologie Libérale - Clinique Sainte Anne

Strasbourg, France

Hôpitaux du Léman

Thonon-les-Bains, France

Oncopole Claudius Regaud, IUCT-Oncopole

Toulouse, France

Clinique Pasteur

Toulouse, France

CHU Tours

Tours, France

Centre de cancérologie Les Dentellières

Valenciennes, France

Institut de Cancérologie de Lorraine

Vandœuvre-lès-Nancy, France

Institut Gustave Roussy

Villejuif, France

University Hospital 'Aretaieio'

Athens, Greece

University General Hospital 'Attikon'

Athens, Greece

Hygeia Hospital

Athens, Greece

IASO Hospital

Athens, Greece

Metropolitan Hospital

Athens, Greece

Cork University Hospital

Cork, Ireland

Mater Misericordiae University Hospital

Dublin, Ireland

Mater Private Hospital

Dublin, Ireland

St James's Hospital

Dublin, Ireland

University Hospital Limerick

Limerick, Ireland

Midland Regional Hospital Tullamore

Tullamore, Ireland

University Hospital Waterford

Waterford, Ireland

Centro Di Riferimento Oncologico Di Aviano

Aviano, Italy

ASS Territoriale Papa Giovanni XXIII

Bergamo, Italy

AUSL di Modena - Ospedale B. Ramazzini

Carpi, Italy

ASST Ospedale Maggiore di Crema

Crema, Italy

Azienda Ospedaliero Universitaria Careggi

Florence, Italy

IRCCS Ospedale Policlinico San Martino

Genova, Italy

ASST Lecco - P.O. A. Manzoni

Lecco, Italy

IRCCS Istituto Romagnolo per lo Studio Dei Tumori (IRST) "Dino Amadori"

Meldola, Italy

Fondazione IRCCS Istituto Nazionale Dei Tumori

Milan, Italy

A.O.U Policlinico di Modena

Modena, Italy

IRCCS San Gerardo

Monza, Italy

A.O.U. Federico II - Policlinico

Naples, Italy

IRCCS Istituto Nazionale Tumori Fondazione Pascale

Naples, Italy

Istituto Oncologico Veneto

Padova, Italy

A.O.U. di Parma

Parma, Italy

A.O. di Perugia - Ospedale S. Maria della Misericordia

Perugia, Italy

"OSPEDALE P. PEDERZOLI" Casa di Cura Privata S.p.A.

Peschiera del Garda, Italy

AUSL Della Romagna

Ravenna, Italy

AUSL - IRCCS di Reggio Emilia

Reggio Emilia, Italy

AUSL della Romagna - Ospedale Infermi di Rimini

Rimini, Italy

A.O.U. Policlinico Umberto I

Roma, Italy

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Roma, Italy

Klinika Onkologii I Radioterapii Universeryteckie Centrum Kliniczne- Gdansk

Gdansk, Poland

MSC National Research Institute Of Oncology

Gliwice, Poland

Instytut Centrum Zdrowia Matki Polki

Lodz, Poland

ZP ZOZ Opolskie Centrum Onkologii im.prof. Tadeusza Koszarowskiego

Opole, Poland

Oncology Clinic, University Clinical Hospital in Pozan, Medical University

Poznan, Poland

Zachodniopomorskie Centrum Onkologii

Szczecin, Poland

Militray Institute of Medicine

Warsaw, Poland

Hospital General Universitario Dr. Balmis

Alicante, Spain

Hospital Clinic De Barcelona

Barcelona, Spain

Consorcio Hospitalario Provincial De Castellon

Castillón, Spain

Hospital Universitario Virgen De Las Nieves

Granada, Spain

Hospital Universitario Ramon Y Cajal

Madrid, Spain

Althaia Xarxa Assistencial Universitaria De Manresa Fundacio Privada

Manresa, Spain

University Hospital Son Espases

Palma, Spain

Hospital Universitario Virgen De La Macarena

Seville, Spain

University Hospital Virgen Del Rocio

Seville, Spain

Hospital General Universitario De Valencia

Valencia, Spain