Trastuzumab Deruxtecan (T-DXd) Alone or in Sequence With THP, Versus Standard Treatment (ddAC-THP), in HER2-positive Early Breast Cancer
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ClinicalTrials.gov Identifier: NCT05113251 |
Recruitment Status :
Recruiting
First Posted : November 9, 2021
Last Update Posted : March 9, 2023
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Breast Neoplasms Breast Cancer HER2-positive Early Breast Cancer | Drug: Trastuzumab Deruxtecan Drug: Paclitaxel Drug: Trastuzumab Drug: Pertuzumab Drug: Doxorubicin Drug: cyclophosphamide | Phase 3 |
The target population of interest in this study is participants with high-risk HER2-positive early-stage breast cancer. The purpose of this study is to determine the efficacy and safety of T-DXd neoadjuvant therapy.
Participants will be randomised to one of 3 arms: T-DXd monotherapy (Arm A), T-DXd followed by THP (Arm B), or ddAC-THP (Arm C).
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 624 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Intervention Model Description: | Participants are assigned to one of three arms in parallel for the duration of the study. |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | A Phase 3 Open-label Trial of Neoadjuvant Trastuzumab Deruxtecan (T-DXd) Monotherapy or T-DXd Followed by THP Compared to ddAC-THP in Participants With High-risk HER2-positive Early-stage Breast Cancer (DESTINY-Breast11) |
Actual Study Start Date : | October 25, 2021 |
Estimated Primary Completion Date : | February 5, 2024 |
Estimated Study Completion Date : | June 26, 2026 |

Arm | Intervention/treatment |
---|---|
Experimental: Arm A
Trastuzumab deruxtecan
|
Drug: Trastuzumab Deruxtecan
administered by intravenous infusion
Other Names:
|
Experimental: Arm B
T-DXd, followed by THP
|
Drug: Trastuzumab Deruxtecan
administered by intravenous infusion
Other Names:
Drug: Paclitaxel administered by intravenous infusion
Other Names:
Drug: Trastuzumab administered by intravenous infusion
Other Names:
Drug: Pertuzumab administered by intravenous infusion
Other Name: Perjeta |
Active Comparator: Arm C
doxorubicin and cyclophosphamide, followed by THP
|
Drug: Paclitaxel
administered by intravenous infusion
Other Names:
Drug: Trastuzumab administered by intravenous infusion
Other Names:
Drug: Pertuzumab administered by intravenous infusion
Other Name: Perjeta Drug: Doxorubicin administered by intravenous infusion
Other Names:
Drug: cyclophosphamide administered by intravenous infusion
Other Names:
|
- rate of pathologic complete response (pCR) [ Time Frame: Up to 32 months after study start ]Proportion of participants who have no evidence by H&E staining of residual invasive disease
- Event-Free Survival [ Time Frame: Up to 62 months after study start ]
- Invasive Disease-Free Survival (IDFS) [ Time Frame: Up to 62 months after study start ]
- Overall Survival [ Time Frame: Up to 62 months after study start ]

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Key Inclusion Criteria:
- Patients must be at least 18 years of age.
- Histologically documented HER2-positive early breast cancer (EBC) participants, including clinical stage at presentation (based on mammogram or breast MRI assessment): T0-4 (inclusive of inflammatory breast cancer), N1-3, M0 or ≥ T3, N0, M0 as determined by the AJCC staging system, 8th edition
- ECOG performance status of 0 or 1 at randomization
- Adequate organ and bone marrow function
- LVEF ≥ 50% within 28 days before randomization
- FFPE tissue block (2 cores) or 20 freshly-cut, serial tumor slides for HER2 assessment by central lab. If blocks are incomplete or fewer than 20 slides are available, participants may be eligible following discussion with the AstraZeneca Study Physician
Exclusion Criteria:
- prior history of invasive breast cancer
- stage IV breast cancer (determined by AJCC staging system)
- any primary malignancy within 3 years (except resected non-melanoma skin cancer, curatively treated in situ disease) Note: This includes a second current breast primary malignancy (ie, bilateral breast cancer)
- history of DCIS (except those treated with mastectomy >5 years prior to current diagnosis)
- History of, or current, ILD/pneumonitis
- Prior systemic therapy for the treatment of breast cancer
- Previous treatment with anthracyclines, cyclophosphamide or taxanes for any malignancy

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05113251
Contact: AstraZeneca Clinical Study Information Center | 1-877-240-9479 | information.center@astrazeneca.com |

Responsible Party: | AstraZeneca |
ClinicalTrials.gov Identifier: | NCT05113251 |
Other Study ID Numbers: |
D967RC00001 |
First Posted: | November 9, 2021 Key Record Dates |
Last Update Posted: | March 9, 2023 |
Last Verified: | March 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Yes |
Plan Description: | Qualified researchers can request access to anonymized individual patient data from AstraZeneca Group of Companies, sponsored clinical trials via the request portal. All requests will be evaluated as per the AZ Disclosure Commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure |
Supporting Materials: |
Study Protocol Statistical Analysis Plan (SAP) |
Time Frame: | AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please refer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure |
Access Criteria: | When a request has been approved, AstraZeneca will provide access to the de-identified patient level data in an approved sponsor tool. Signed Data Sharing Agreements (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Trastuzumab Trastuzumab Deruxtecan (T-DXd; DS-8201a) DESTINY-BREAST11 Receptor, ErbB-2 breast neoplasms Antineoplastic Agents, Phytogenic |
Antineoplastic Agents;Molecular Mechanisms of Pharmacological Action DB11 Enhertu HER2 (human epidermal growth factor receptor 2) breast cancer |
Breast Neoplasms Neoplasms by Site Neoplasms Breast Diseases Skin Diseases Paclitaxel Cyclophosphamide Doxorubicin Trastuzumab Pertuzumab Antineoplastic Agents, Phytogenic Antineoplastic Agents Tubulin Modulators Antimitotic Agents |
Mitosis Modulators Molecular Mechanisms of Pharmacological Action Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Antirheumatic Agents Antineoplastic Agents, Alkylating Alkylating Agents Myeloablative Agonists Antibiotics, Antineoplastic Topoisomerase II Inhibitors Topoisomerase Inhibitors Enzyme Inhibitors Antineoplastic Agents, Immunological |