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OncoMatch/Clinical Trials/NCT06439693

The SAPPHO Study: Sequential Therapy With Curative Intent in de Novo HER2+ Metastatic Breast Cancer

Is NCT06439693 recruiting? Yes, currently enrolling (May 2026). This Phase 2 trial studies multiple treatments for breast cancer female.

Phase 2RecruitingDana-Farber Cancer InstituteNCT06439693Data as of May 2026

Treatment: Nab-Paclitaxel · Paclitaxel · Docetaxel · Phesgo · T-DM1 · Pertuzumab · Trastuzumab Deruxtecan · Trastuzumab Subcutaneous Subcutaneous · Tucatinib · TrastuzumabThe purpose of this study is to test the safety and effectiveness of a sequence of drugs (a Taxane plus Trastuzumab plus Pertuzumab followed by Trastuzumab Deruxtecan, followed by Tucatinib plus Ado-Trastuzumab Emtansine (T-DM1), followed by Trastuzumab plus Pertuzumab plus Tucatinib) in HER2+ Breast Cancer. The study will help investigators understand whether first intensifying therapy for a specific period and then stopping treatment is safe and effective for participants. The names of the study drugs involved in this study are: * Paclitaxel (a type of anti-microtubule agent) * Docetaxel (a type of anti-microtubule agent) * Nab-Paclitaxel (a type of anti-microtubule agent) * Trastuzumab (a type of IgG1 kappa monoclonal antibody) * Pertuzumab (a type of monoclonal antibody) * Trastuzumab Deruxtecan (a type of HER2-directed antibody drug conjugate) * Tucatinib (Tyrosine Kinase HER2 Inhibitor) * Ado-trastuzumab emtansine or T-DM1 (a type of HER2-targeted antibody-drug conjugate)

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Extracted eligibility criteria

Cancer type

Breast Carcinoma

Biomarker criteria

Required: HER2 (ERBB2) overexpression (IHC 3+ on both breast and metastatic biopsies, per ASCO/CAP guidelines) (IHC 3+)

Diagnosis of HER2-positive invasive breast carcinoma and 3+ by immunohistochemistry on both breast and metastatic biopsies, as defined by the current American Society of Clinical Oncology - College of American Pathologists (ASCO/CAP) guidelines

Disease stage

Required: Stage IV

Metastatic disease required

Performance status

ECOG 0–1(Restricted strenuous activity)

Prior therapy

Max 1 prior line

Must have received: HER2-targeted therapy (trastuzumab, pertuzumab, taxane) — first-line for metastatic disease

No prior systemic therapy for invasive breast cancer, aside from first-line trastuzumab/pertuzumab/taxane (THP) within 6 weeks from treatment start

Cannot have received: systemic therapy

Exception: first-line trastuzumab/pertuzumab/taxane (THP) within 6 weeks from treatment start

No prior systemic therapy for invasive breast cancer, aside from first-line trastuzumab/pertuzumab/taxane (THP) within 6 weeks from treatment start

Cannot have received: investigational agent

Treatment with any other investigational agents for this condition

Lab requirements

Blood counts

Hgb ≥9.0 g/dL; Absolute Neutrophil Count ≥ 1,000 /mm3; Platelets ≥100,000/mm3

Kidney function

Serum creatinine ≤ 1.5 x ULN (institutional) OR calculated GFR ≥60mL/min

Liver function

Total bilirubin ≤ 1.5 x ULN (institutional) or direct bilirubin within normal limits in patients with a history of Gilbert's syndrome. AST and ALT ≤ 2.5 x ULN (institutional) or ≤ 5 x ULN for participants with documented liver metastases

Cardiac function

Left ventricular ejection fraction (LVEF) ≥50%, as assessed by echocardiogram (ECHO) or multiple-gated acquisition scan (MUGA)

Participants must meet the following organ and marrow function as defined below within 28 days prior to registration: Hgb ≥9.0 g/dL; Absolute Neutrophil Count ≥ 1,000 /mm3; Platelets ≥100,000/mm3; Total bilirubin ≤ 1.5 x ULN (institutional) or direct bilirubin within normal limits in patients with a history of Gilbert's syndrome. AST and ALT ≤ 2.5 x ULN (institutional) or ≤ 5 x ULN for participants with documented liver metastases; Serum creatinine ≤ 1.5 x ULN (institutional) OR calculated GFR ≥60mL/min; Left ventricular ejection fraction (LVEF) ≥50%

Structured fields extracted by AI. May contain errors — verify against the official protocol.

US trial sites

  • Dana-Farber Cancer Institute · Boston, Massachusetts

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