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NCT04578106

Omission of Surgery in Clinically Low-risk HER2positive Breast Cancer With High HER2 Addiction and a Complete Response Following Standard Anti-HER2-based Neoadjuvant Therapy

Version 1 to 2 · Fundacio Clinic Barcelona

Patch inspector

Version 1 to 2

6 operations 3 path groups ctgov_internal_history
ClinicalTrials.gov
Severity is deterministic uncalibrated triage metadata, not validated review priority. Operation-level severity is inferred from deterministic path rules. Rule matches shown per operation are approximate previews (they skip the pipeline's suppression passes); the authoritative classification is the stored event record.
Plain-language summary

Manual review pending.

Rules fired
eligibility_criteria_change
Value signals
[
  {
    "path": "/protocolSection/statusModule/primaryCompletionDateStruct/date",
    "signal": "timeline_major_slip",
    "category": "timeline_major_slip",
    "new_type": "ESTIMATED",
    "old_type": "ESTIMATED",
    "severity": "medium",
    "direction": "later",
    "new_value": "2023-12",
    "old_value": "2022-09",
    "delta_days": 456,
    "date_struct": "primaryCompletionDateStruct",
    "new_precision": "month",
    "old_precision": "month"
  },
  {
    "path": "/protocolSection/statusModule/completionDateStruct/date",
    "signal": "timeline_major_slip",
    "category": "timeline_major_slip",
    "new_type": "ESTIMATED",
    "old_type": "ESTIMATED",
    "severity": "medium",
    "direction": "later",
    "new_value": "2026-12",
    "old_value": "2025-09",
    "delta_days": 456,
    "date_struct": "completionDateStruct",
    "new_precision": "month",
    "old_precision": "month"
  }
]
Provenance
Source
ctgov_internal_history
Fetched
2026-06-18 19:14:25+00
Raw hash
7549dd50219bb917ec7e3d6438a48fe8a3c3fa6563feebb5e78a3d17613ce62f
Payload
Source URL
Eligibility Criteria and population definition changes. Triage: High 1 ops
replace /protocolSection/eligibilityModule/eligibilityCriteria
Triage: High
Eligibility Change Operation 6
Matched rules
  • eligibility_criteria_change Eligibility criteria changes can alter the studied population.
Before
<p>Inclusion Criteria:</p><ol><li>Female participants who are at least 40 years of age on the day of signing the informed consent form with histologically confirmed diagnosis of breast cancer.</li><li>A participant is eligible to participate if she is not pregnant, not breastfeeding.</li><li>The participant (or legally acceptable representative if applicable) provides written informed consent for the trial.</li><li><p>Histologically confirmed invasive adenocarcinoma of the breast, with all of the following characteristics:</p><ul><li>HER2-positive status by local determination according to 2018 ASCO&#x2F;CAP guidelines.</li><li>PAM50 HER2-enriched subtype and ERBB2-high as predefined cutoff as per central determination.</li><li>Unifocal invasive carcinoma: only 1 invasive focus can be observed (the tumor focus containing or not containing an in situ component)</li><li>Tumor largest diameter ≤2 cm as defined by breast MRI.</li><li>No nodal involvement (i.e.
cN0).
Any suspicious axillary node by ultrasound must be biopsied.
If the biopsy or the FNA is negative of tumor cells, patient is eligible.</li><li>No evidence of distant metastasis (M0) by routine clinical assessment.</li></ul></li><li>Patient must have known ER and PR status locally determined prior to study entry.</li><li>Eligible for taxane therapy.</li><li>Willingness of the patient to omit surgery if all criteria are met following neoadjuvant therapy.</li><li>Estimated life expectancy of at least 5 years irrespective of the diagnosis of breast cancer.</li><li>Breast cancer eligible for primary surgery</li><li>Have provided archival tumor tissue sample or newly obtained core.
Formalin-fixed,paraffin embedded (FFPE) tissue blocks are mandatory.
Available pre-treatment FFPE core biopsy evaluable for PAM50 or possibility to obtain one.</li><li>Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.</li><li>Ability and willingness to comply with study visits, treatment, testing and to comply with the protocol.</li><li>Have adequate organ function.</li></ol><p>Exclusion Criteria:</p><ol><li>Has received prior anti-cancer therapy, including investigational agents, or treatment for primary invasive breast cancer.</li><li>Known hypersensitivity to any of the excipients of trastuzumab, pertuzumab, TDM1 or paclitaxel.</li><li>Clinical stage II, III or IV.</li><li>History of radiotherapy in the ipsilateral breast or axilla.</li><li>History of surgery of the ipsilateral axilla.</li><li>Bilateral invasive breast cancer.</li><li>Infiltrating lobular carcinoma.</li><li>Multicentric or multifocal breast cancer, defined as the presence of two or more foci of cancer in the same or different quadrants of the same breast.</li><li>Patients who have undergone sentinel lymph node biopsy prior to study treatment.</li><li>Patient has active cardiac disease or a history of cardiac dysfunction</li><li>Has an active infection requiring systemic therapy.</li></ol><p>13. Patients with a history of previous breast cancer are excluded.</p>
After
<p>Inclusion Criteria:</p><ol><li>Female participants who are at least 40 years of age on the day of signing the informed consent form with histologically confirmed diagnosis of breast cancer.</li><li>A participant is eligible to participate if she is not pregnant, not breastfeeding.</li><li>The participant (or legally acceptable representative if applicable) provides written informed consent for the trial.</li><li><p>Histologically confirmed invasive adenocarcinoma of the breast, with all of the following characteristics:</p><ul><li>HER2-positive status by local determination according to 2018 ASCO&#x2F;CAP guidelines.</li><li>PAM50 HER2-enriched subtype and ERBB2-high as predefined cutoff as per central determination.</li><li>Unifocal invasive carcinoma: only 1 invasive focus can be observed (the tumor focus containing or not containing an in situ component)</li><li>Tumor largest diameter ≤4 cm as defined by breast MRI.</li><li>No nodal involvement (i.e.
cN0).
Any suspicious axillary node by ultrasound must be biopsied.
If the biopsy or the FNA is negative of tumor cells, patient is eligible.</li><li>No evidence of distant metastasis (M0) by routine clinical assessment.</li></ul></li><li>Patient must have known ER and PR status locally determined prior to study entry.</li><li>Eligible for taxane therapy.</li><li>Willingness of the patient to omit surgery if all criteria are met following neoadjuvant therapy.</li><li>Estimated life expectancy of at least 5 years irrespective of the diagnosis of breast cancer.</li><li>Breast cancer eligible for primary surgery</li><li>Have provided archival tumor tissue sample or newly obtained core.
Formalin-fixed,paraffin embedded (FFPE) tissue blocks are mandatory.
Available pre-treatment FFPE core biopsy evaluable for PAM50 or possibility to obtain one.</li><li>Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.</li><li>Ability and willingness to comply with study visits, treatment, testing and to comply with the protocol.</li><li>Have adequate organ function.</li></ol><p>Exclusion Criteria:</p><ol><li>Has received prior anti-cancer therapy, including investigational agents, or treatment for primary invasive breast cancer.</li><li>Known hypersensitivity to any of the excipients of trastuzumab, pertuzumab, TDM1 or paclitaxel.</li><li>Clinical stage II, III or IV.</li><li>History of radiotherapy in the ipsilateral breast or axilla.</li><li>History of surgery of the ipsilateral axilla.</li><li>Bilateral invasive breast cancer.</li><li>Infiltrating lobular carcinoma.</li><li>Multicentric or multifocal breast cancer, defined as the presence of two or more foci of cancer in the same or different quadrants of the same breast.</li><li>Patients who have undergone sentinel lymph node biopsy prior to study treatment.</li><li>Patient has active cardiac disease or a history of cardiac dysfunction</li><li>Has an active infection requiring systemic therapy.</li></ol><p>13. Patients with a history of previous breast cancer are excluded.</p>
Timeline Start, primary completion, and completion date movement. Triage: Medium 2 ops
replace /protocolSection/statusModule/primaryCompletionDateStruct/date
Triage: Medium
Timeline Shift Operation 2
Matched rules
  • primary_completion_timeline_change Primary completion date changes are operational timeline signals.
Before
2022-09
After
2023-12
replace /protocolSection/statusModule/completionDateStruct/date
Triage: Medium
Timeline Shift Operation 3
Matched rules
  • completion_timeline_change Completion date changes are operational timeline signals.
Before
2025-09
After
2026-12
Other registry fields Changes outside the current high-signal rule families. Triage: Uncategorized 3 ops
replace /protocolSection/statusModule/statusVerifiedDate
Triage: Uncategorized
Uncategorized Operation 1
Before
2020-09
After
2022-01
replace /protocolSection/statusModule/lastUpdateSubmitDate
Triage: Uncategorized
Uncategorized Operation 4
Before
2021-03-31
After
2022-01-23
replace /protocolSection/statusModule/lastUpdatePostDateStruct/date
Triage: Uncategorized
Uncategorized Operation 5
Before
2021-04-01
After
2022-01-25
Raw JSON Patch
[
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/statusVerifiedDate",
    "value": "2022-01"
  },
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/primaryCompletionDateStruct/date",
    "value": "2023-12"
  },
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/completionDateStruct/date",
    "value": "2026-12"
  },
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/lastUpdateSubmitDate",
    "value": "2022-01-23"
  },
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/lastUpdatePostDateStruct/date",
    "value": "2022-01-25"
  },
  {
    "op": "replace",
    "path": "/protocolSection/eligibilityModule/eligibilityCriteria",
    "value": "<p>Inclusion Criteria:</p><ol><li>Female participants who are at least 40 years of age on the day of signing the informed consent form with histologically confirmed diagnosis of breast cancer.</li><li>A participant is eligible to participate if she is not pregnant, not breastfeeding.</li><li>The participant (or legally acceptable representative if applicable) provides written informed consent for the trial.</li><li><p>Histologically confirmed invasive adenocarcinoma of the breast, with all of the following characteristics:</p><ul><li>HER2-positive status by local determination according to 2018 ASCO&#x2F;CAP guidelines.</li><li>PAM50 HER2-enriched subtype and ERBB2-high as predefined cutoff as per central determination.</li><li>Unifocal invasive carcinoma: only 1 invasive focus can be observed (the tumor focus containing or not containing an in situ component)</li><li>Tumor largest diameter ≤4 cm as defined by breast MRI.</li><li>No nodal involvement (i.e.\ncN0).\nAny suspicious axillary node by ultrasound must be biopsied.\nIf the biopsy or the FNA is negative of tumor cells, patient is eligible.</li><li>No evidence of distant metastasis (M0) by routine clinical assessment.</li></ul></li><li>Patient must have known ER and PR status locally determined prior to study entry.</li><li>Eligible for taxane therapy.</li><li>Willingness of the patient to omit surgery if all criteria are met following neoadjuvant therapy.</li><li>Estimated life expectancy of at least 5 years irrespective of the diagnosis of breast cancer.</li><li>Breast cancer eligible for primary surgery</li><li>Have provided archival tumor tissue sample or newly obtained core.\nFormalin-fixed,paraffin embedded (FFPE) tissue blocks are mandatory.\nAvailable pre-treatment FFPE core biopsy evaluable for PAM50 or possibility to obtain one.</li><li>Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.</li><li>Ability and willingness to comply with study visits, treatment, testing and to comply with the protocol.</li><li>Have adequate organ function.</li></ol><p>Exclusion Criteria:</p><ol><li>Has received prior anti-cancer therapy, including investigational agents, or treatment for primary invasive breast cancer.</li><li>Known hypersensitivity to any of the excipients of trastuzumab, pertuzumab, TDM1 or paclitaxel.</li><li>Clinical stage II, III or IV.</li><li>History of radiotherapy in the ipsilateral breast or axilla.</li><li>History of surgery of the ipsilateral axilla.</li><li>Bilateral invasive breast cancer.</li><li>Infiltrating lobular carcinoma.</li><li>Multicentric or multifocal breast cancer, defined as the presence of two or more foci of cancer in the same or different quadrants of the same breast.</li><li>Patients who have undergone sentinel lymph node biopsy prior to study treatment.</li><li>Patient has active cardiac disease or a history of cardiac dysfunction</li><li>Has an active infection requiring systemic therapy.</li></ol><p>13. Patients with a history of previous breast cancer are excluded.</p>"
  }
]