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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04873362
Registration number
NCT04873362
Ethics application status
Date submitted
21/04/2021
Date registered
5/05/2021
Titles & IDs
Public title
A Study Evaluating the Efficacy and Safety of Adjuvant Atezolizumab or Placebo and Trastuzumab Emtansine for Participants With HER2-Positive Breast Cancer at High Risk of Recurrence Following Preoperative Therapy
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Scientific title
A Phase III, Randomized, Double-Blind, Placebo-Controlled Clinical Trial to Evaluate the Efficacy and Safety of Adjuvant Atezolizumab or Placebo and Trastuzumab Emtansine for HER2-Positive Breast Cancer at High Risk of Recurrence Following Preoperative Therapy
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Secondary ID [1]
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2020-003681-40
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Secondary ID [2]
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WO42633
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Universal Trial Number (UTN)
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Trial acronym
Astefania
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Breast Cancer
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Condition category
Condition code
Cancer
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Breast
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Other
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Research that is not of generic health relevance and not applicable to specific health categories listed above
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Atezolizumab
Treatment: Drugs - Trastuzumab Emtansine
Treatment: Drugs - Placebo
Treatment: Drugs - Trastuzumab
Active comparator: Arm A: Placebo + Trastuzumab Emtansine - Participants will receive an intravenous (IV) infusion of placebo prior to the IV infusion of trastuzumab emtansine on Day 1 of each 21-day cycle for a total of 14 cycles.
Experimental: Arm B: Atezolizumab + Trastuzumab Emtansine - Participants will receive an IV infusion of atezolizumab prior to the IV infusion of trastuzumab emtansine on Day 1 of each 21-day cycle for a total of 14 cycles.
Treatment: Drugs: Atezolizumab
Atezolizumab will be administered at a dose of 1200 mg every three weeks (Q3W) for 14 cycles.
Treatment: Drugs: Trastuzumab Emtansine
Trastuzumab emtansine will be administered at a dose of 3.6 mg/kg Q3W for 14 weeks.
Treatment: Drugs: Placebo
Placebo matched to atezolizumab will be administered at a dose of 1200 mg Q3W for 14 cycles.
Treatment: Drugs: Trastuzumab
Trastuzumab will be used to complete 14 cycles of study treatment if trastuzumab emtansine is discontinued for toxicity not considered to be related to the trastuzumab component of the drug.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Invasive Disease-free Survival (IDFS) in the Full Analysis Set (FAS)
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Assessment method [1]
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IDFS event is defined as the time from randomization to the first occurrence of the following events: ipsilateral invasive breast tumor recurrence, ipsilateral local-regional invasive breast cancer recurrence, contralateral invasive breast cancer, distant recurrence, death from any cause.
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Timepoint [1]
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From baseline until the first occurrence of iDFS event or death, through primary analysis data cut off (approximately 7 years)
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Secondary outcome [1]
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IDFS Including Second Primary Non-breast Invasive Cancer
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Assessment method [1]
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Timepoint [1]
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From baseline until the first occurrence of iDFS event or death, through the end of study (approximately 10 years from last participant in [LPI])
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Secondary outcome [2]
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IDFS in the PD-L1-positive and the PD-L1-negative Population
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Assessment method [2]
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Defined as all randomized participants from the ITT population with a centrally assessed PD-L1-positive \[i.e., PD-L1 status of IC1/2/3\] or PD-L1-negative status \[i.e.,PD-L1 status of IC0\] at randomization as per corresponding stratification factors recorded in the interactive web-based response system (IWRS).
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Timepoint [2]
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From baseline until the first occurrence of iDFS event or death, through the end of study (approximately 10 years from LPI)
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Secondary outcome [3]
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Disease-free Survival (DFS)
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Assessment method [3]
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Timepoint [3]
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From baseline until the first occurrence of DFS event or death, through the end of study (approximately 10 years from LPI)
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Secondary outcome [4]
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Overall Survival (OS)
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Assessment method [4]
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Timepoint [4]
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From baseline to death from any cause through the end of study (approximately 10 years from LPI)
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Secondary outcome [5]
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Distant Recurrence-free Interval (DRFI)
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Assessment method [5]
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Timepoint [5]
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From baseline until distant disease recurrence, through the end of study (approximately 10 years from LPI)
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Secondary outcome [6]
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Number of Participants with Clinically Meaningful Deterioration in Global Health Status/Quality of Life (GHS/QoL) Physical, Role, and Cognitive Function
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Assessment method [6]
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Clinically Meaningful Deterioration will be Measured by Scales of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire for Cancer (EORTC QLQ C30)
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Timepoint [6]
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From baseline until 2 years after study treatment completion/discontinuation visit (approximately 3 years)
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Secondary outcome [7]
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Mean Absolute Scores in GHS/QoL, Physical, Role, and Cognitive Function, as Assessed Using the EORTC QLQ-C30
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Assessment method [7]
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The European Organisation for Research and Treatment of Cancer Quality of Life-Core 30 Questionnaire (EORTC QLQ-C30) is a self-reported measure. Functioning and symptoms items are scored on a 4-point scale: 1=Not at all, 2=A little, 3=Quite a bit, 4=Very much. GHS and QoL items are scored on a 7-point scale: 1=Very poor, 2, 3, 4, 5, 6, 7=Excellent. Scores will be transformed to a range of 0 to 100, with higher scores (i.e. closer to 100) reflecting better functioning, better GHS/QoL, and worse symptoms.
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Timepoint [7]
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From baseline until 2 years after study treatment completion/discontinuation visit (approximately 3 years)
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Secondary outcome [8]
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Mean Change From Baseline Scores in GHS/QoL, Physical, Role, and Cognitive Function, as Assessed Using the EORTC QLQ-C30
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Assessment method [8]
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The European Organisation for Research and Treatment of Cancer Quality of Life-Core 30 Questionnaire (EORTC QLQ-C30) is a self-reported measure. Functioning and symptoms items are scored on a 4-point scale: 1=Not at all, 2=A little, 3=Quite a bit, 4=Very much. GHS and QoL items are scored on a 7-point scale: 1=Very poor, 2, 3, 4, 5, 6, 7=Excellent. Scores will be transformed to a range of 0 to 100, with higher scores (i.e. closer to 100) reflecting better functioning, better GHS/QoL, and worse symptoms.
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Timepoint [8]
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From baseline until 2 years after study treatment completion/discontinuation visit (approximately 3 years)
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Secondary outcome [9]
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Percentage of Participants with Adverse Events (AEs) According to National Cancer Institute Common Terminology Criteria for Adverse Events Version 5.0 (NCI CTCAE v5.0)
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Assessment method [9]
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Timepoint [9]
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From baseline up to 10 years
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Secondary outcome [10]
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Maximum Serum Concentrations (Cmax) for Atezolizumab
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Assessment method [10]
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Timepoint [10]
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Day 1 of Cycles 1 and 4 pre-infusion, Day 1 of Cycles 1 and 4 after 30 minutes post-infusion, Day 1 of Cycles 2, 3 and 8 pre-infusion (cycle=21 days) and at study treatment completion/discontinuation visit (approximately 11 months after Cycle 1 Day 1)
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Secondary outcome [11]
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Cmax for Trastuzumab Emtansine
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Assessment method [11]
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Timepoint [11]
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Day 1 of Cycles 1 and 4 pre-infusion, Day 1 of Cycles 1 and 4 after 30 minutes post-infusion, (cycle=21 days) and at study treatment completion/discontinuation visit (approximately 11 months after Cycle 1 Day 1)
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Secondary outcome [12]
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Cmax for Total Trastuzumab
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Assessment method [12]
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Timepoint [12]
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Day 1 of Cycles 1 and 4 pre-infusion, Day 1 of Cycles 1 and 4 after 30 minutes post-infusion, (cycle=21 days) and at study treatment completion/discontinuation visit (approximately 11 months after Cycle 1 Day 1)
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Secondary outcome [13]
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Cmax for DM1
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Assessment method [13]
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DM1 = a thiol-containing maytansinoid anti-microtubule agent; N2'-deacetyl-N2'-(3-mercapto-1-oxopropyl)-maytansine
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Timepoint [13]
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Day 1 of Cycles 1 and 4 pre-infusion, Day 1 of Cycles 1 and 4 after 30 minutes post-infusion, (cycle=21 days) and at study treatment completion/discontinuation visit (approximately 11 months after Cycle 1 Day 1)
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Secondary outcome [14]
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Minimum Serum Concentrations (Cmin) for Atezolizumab
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Assessment method [14]
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Timepoint [14]
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Day 1 of Cycles 1 and 4 pre-infusion, Day 1 of Cycles 1 and 4 after 30 minutes post-infusion, Day 1 of Cycles 2, 3 and 8 (cycle=21 days) and at study treatment completion/discontinuation visit (approximately 11 months after Cycle 1 Day 1)
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Secondary outcome [15]
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Percentage of Participants with Anti-drug Antibodies (ADAs) to Atezolizumab
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Assessment method [15]
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Timepoint [15]
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Day 1 of Cycles 1 and 4 pre-infusion, Day 1 of Cycles 1 and 4 after 30 minutes post-infusion, Day 1 of Cycles 2, 3 and 8 (cycle=21 days) and at study treatment completion/discontinuation visit (approximately 11 months after Cycle 1 Day 1)
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Secondary outcome [16]
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Percentage of Participants with ADAs to Trastuzumab Emtansine
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Assessment method [16]
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Timepoint [16]
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Day 1 of Cycles 1 and 4 pre-infusion, Day 1 of Cycles 1 and 4 after 30 minutes post-infusion, (cycle=21 days) and at study treatment completion/discontinuation visit (approximately 11 months after Cycle 1 Day 1)
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Eligibility
Key inclusion criteria
* Histologically confirmed invasive breast carcinoma
* Centrally-confirmed human epidermal growth factor receptor 2 (HER2)-positive invasive breast cancer
* Centrally confirmed PD-L1 and hormone receptor status
* Clinical stage at disease presentation (prior to neoadjuvant therapy): cT4/anyN/M0, any cT/N2-3/M0, or cT1-3/N0-1/M0 (participants with cT1mi/T1a/T1b/N0 are not eligible)
* Completion of pre-operative systemic chemotherapy including at least 9 weeks of taxane and 9 weeks of trastuzumab (anthracycline and/or additional HER2-targeted agents are permitted)
* <=12 weeks between primary surgery and randomization
* Eastern Cooperative Oncology Group (ECOG) Performance Status 0 or 1
* Screening left ventricular ejection fraction (LVEF) >= 50% and no decrease in LVEF by >15% from the pre-chemotherapy LVEF. If no pre-chemotherapy LVEF, screening LVEF >= 55%
* Life expectancy >= 6 months
* Adequate hematologic and end organ function
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Stage IV breast cancer
* An overall response of disease progression according to the investigator at the conclusion of preoperative systemic therapy
* Prior treatment with T-DM1, or atezolizumab, or other immune checkpoint inhibitors
* History of exposure to various cumulative doses of anthracyclines
* History of other malignancy within 5 years prior to screening, except for appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, Stage I uterine cancer, or ductal carcinoma in situ (DCIS)
* Current grade >=2 peripheral neuropathy
* History of idiopathic pulmonary fibrosis, organizing pneumonia, or pneumonitis
* History of or active autoimmune disease or immune deficiency
* Treatment with immunostimulatory or immunosuppressive agents
* Cardiopulmonary dysfunction
* Any known active liver disease
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
4/05/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
2/10/2034
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Actual
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Sample size
Target
1150
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,VIC
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Recruitment hospital [1]
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Macarthur Cancer Therapy Centre - Campbelltown
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Recruitment hospital [2]
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Kinghorn Cancer Centre; St Vincents Hospital - Darlinghurst
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Recruitment hospital [3]
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Royal North Shore Hospital; Department of Medical Oncology - St Leonards
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Recruitment hospital [4]
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Princess Alexandra Hospital; Cancer Trials Unit - Woolloongabba
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Recruitment hospital [5]
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Peter MacCallum Cancer Centre; Medical Oncology - Melbourne
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Recruitment postcode(s) [1]
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2560 - Campbelltown
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Recruitment postcode(s) [2]
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2010 - Darlinghurst
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Recruitment postcode(s) [3]
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2065 - St Leonards
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Recruitment postcode(s) [4]
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4102 - Woolloongabba
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Recruitment postcode(s) [5]
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3000 - Melbourne
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Recruitment outside Australia
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Alabama
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California
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Florida
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Georgia
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Iowa
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Louisiana
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Maine
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Maryland
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Michigan
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Mississippi
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Argentina
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Buenos aires
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Caba
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Austria
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Innsbruck
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Austria
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Linz
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Hasselt
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Brazil
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CE
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Brazil
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GO
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RS
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China
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Praha 2
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Czechia
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Herlev
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Vejle
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Dominican Republic
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Santiago de Los Caballeros
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France
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Avignon
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Caen
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France
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Creil Cedex 1
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France
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Lyon
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France
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Nimes
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France
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Paris
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France
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Poitiers
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France
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Saint-Cloud
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Germany
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Augsburg
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Germany
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Aurich
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Germany
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Bad Homburg vdH
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Germany
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Bad Nauheim
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Germany
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Berlin
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Germany
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Bonn
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Germany
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Bottrop
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Russian Federation
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Russian Federation
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Russian Federation
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Russian Federation
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Russian Federation
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Pretoria
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Alicante
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Songkla
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Turkey
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Adana
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Turkey
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Antalya
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Turkey
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Turkey
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Ukraine
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Ukraine
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Kirovograd
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Ukraine
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Kyiv
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Walsall
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Hanoi
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Ho Chi Minh City
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Vietnam
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Hochiminh city
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Hoffmann-La Roche
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
This is a Phase III, two-arm, randomized, double-blind placebo-controlled study in participants with HER2-positive primary breast cancer who have received preoperative chemotherapy and HER2-directed therapy, including trastuzumab followed by surgery, with a finding of residual invasive disease in the breast and/or axillary lymph nodes. As of June 4, 2024, this study is no longer accepting any newly screened participants.
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Trial website
https://clinicaltrials.gov/study/NCT04873362
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Trial related presentations / publications
Hurvitz SA, Bachelot T, Bianchini G, Harbeck N, Loi S, Park YH, Prat A, Gilham L, Boulet T, Gochitashvili N, Monturus E, Lambertini C, Nyawira B, Knott A, Restuccia E, Schmid P. ASTEFANIA: adjuvant ado-trastuzumab emtansine and atezolizumab for high-risk, HER2-positive breast cancer. Future Oncol. 2022 Oct;18(32):3563-3572. doi: 10.2217/fon-2022-0485. Epub 2022 Nov 16.
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Public notes
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Contacts
Principal investigator
Name
0
0
Clinical Trials
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Address
0
0
Hoffmann-La Roche
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Country
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0
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Phone
0
0
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Fax
0
0
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Email
0
0
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Contact person for public queries
Name
0
0
Reference Study ID Number: WO42633 https://forpatients.roche.com/
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Address
0
0
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Country
0
0
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Phone
0
0
888-662-6728 (U.S. and Canada)
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Fax
0
0
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Email
0
0
[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Qualified researchers may request access to individual patient level data through the clinical study data request platform (www.vivli.org). Further details on Roche's criteria for eligible studies are available here (https://vivli.org/ourmember/roche/). For further details on Roche's Global Policy on the Sharing of Clinical Information and how to request access to related clinical study documents, see here (https://www.roche.com/research_and_development/who_we_are_how_we_work/clinical_trials/our_commitment_to_data_sharing.htm).
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04873362