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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 (May 2026). This Phase 3 trial studies Trastuzumab-Deruxtecan for breast cancer.

Phase 3RecruitingProf. Wolfgang JanniNCT06643585Data as of May 2026

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

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)

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.

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