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OncoMatch/Clinical Trials/NCT06643585

A Randomized Secondary Adjuvant Treatment Intervention Study Comparing Trastuzumab-Deruxtecan to SOC Therapy in eBC Patients With Molecular Relapse

Is NCT06643585 recruiting? Yes, currently enrolling (Jun 2026). This Phase 3 trial studies Trastuzumab-Deruxtecan for breast cancer.

Phase 3RecruitingProf. Wolfgang JanniNCT06643585Data as of Jun 2026Location: Germany

Treatment: Trastuzumab-DeruxtecanProspective, multi-center, randomized, open label comparative Phase III study in patients with intermediate to high-risk (as defined in the SURVIVE trial) HER2-positive or HER2-low early breast cancer, who participate in the SURVIVE trial and experience a molecular relapse, as assessed based on a positive circulating tumor DNA (ctDNA) result, with 2:1 allocation to: * Arm A: Trastuzumab-Deruxtecan (i.v. 5,4 mg/kg, q3w) + endocrine therapy (if hormonal-receptor-positive) for 16 cycles or until relapse, if earlier * Arm B: Continuous treatment of physician's choice (may include endocrine treatment, CDK4/6-Inhibition, T-DM1, Olaparib, Trastuzumab, Pertuzumab, Capecitabine or Neratinib)

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Extracted eligibility criteria

Treatments studied

Targeted therapy

Trastuzumab-Deruxtecan

Cancer type

Breast Carcinoma

Biomarker criteria

Required: HER2 (ERBB2) overexpression (IHC 3+ and/or ISH+ (for IHC 2+))

HER2-positive defined as an immunohistochemistry (IHC) score of 3+ and/or positive by in situ hybridization (ISH) in Her2 2+ tumors

Required: HER2 (ERBB2) low expression (IHC 1+ or IHC 2+ with ISH-)

HER2-low defined as an immunohistochemistry (IHC) score of 1+ or an IHC score of 2+ with a mandatory negative in situ hybridization (ISH)

Allowed: ESR1 expression

HR-positive status defined by either positive estrogen receptor (ER) and/or positive progesterone receptor (PR) status

Allowed: PR (PGR) expression

HR-positive status defined by either positive estrogen receptor (ER) and/or positive progesterone receptor (PR) status

Disease stage

Excluded: Stage IV

Performance status

ECOG 0–1(Restricted strenuous activity)

Demographics

Ages ≤ 75

Prior therapy

Must have received: surgery — adjuvant/neoadjuvant

Completion of surgery, (neo-)adjuvant chemotherapy (if applicable) and radiation therapy (if applicable, whichever occurred last) at least 6 months before randomization

Cannot have received: antibody-drug conjugate (trastuzumab deruxtecan, T-DXd)

Prior treatment with T-DXd

Lab requirements

Blood counts

Adequate organ and bone marrow function within 28 days before randomization as described in table 1. Transfusion (red blood cell or platelet) or G-CSF administration is not allowed within 2 weeks prior to the day on which marrow function is assessed.

Kidney function

Adequate organ and bone marrow function within 28 days before randomization as described in table 1

Liver function

Adequate organ and bone marrow function within 28 days before randomization as described in table 1

Cardiac function

Left ventricular ejection fraction (LVEF) ≥50% within 28 days prior to randomization. No history of MI within 6 months before first exposure to study intervention, no symptomatic CHF (NYHA II-IV), QTcF ≤ 470 msec (females) or ≤ 450 msec (males)

Left ventricular ejection fraction (LVEF) ≥50% within 28 days prior to randomization. Adequate organ and bone marrow function within 28 days before randomization as described in table 1. Transfusion (red blood cell or platelet) or G-CSF administration is not allowed within 2 weeks prior to the day on which marrow function is assessed. Corrected QT interval (QTcF) prolongation to > 470 msec (females) or > 450 msec (males) based on average of the screening triplicate 12-lead ECG [excluded].

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

Frequently asked questions

Is NCT06643585 currently recruiting?

Yes, this trial is currently recruiting patients.

Are there prior therapy exclusions?

Yes. Prior antibody-drug conjugate disqualifies patients from enrollment.

Does this trial require ERBB2?

Yes, ERBB2 overexpression is a required biomarker for enrollment.

Does this trial require ERBB2?

Yes, ERBB2 low expression is a required biomarker for enrollment.

Is there an age limit?

Yes. Patients must be 75 years or younger.

Could you qualify for this trial?

Enter your biomarker results to see how this trial's eligibility criteria match your specific cancer profile.

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