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Media Release

4 February = World Cancer Day


DECRESCENDO, a new large clinical trial to test a less intensive chemotherapy treatment for patients with HER2-positive breast cancer


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Brussels (Belgium), 4 February 2022 - A new international clinical study was recently opened in France and Belgium – with the first patient enrolled on 17 January – to assess if it is possible to give a less intensive chemotherapy treatment, and reduce related side effects, without increasing the risk of cancer recurrence, for patients with HER2-positive, hormone receptor-negative breast cancer.

DECRESCENDO, a large phase II multicentre study, is being sponsored by the Institut Jules Bordet and conducted by its Clinical Trials Support Unit (IJB-CTSU, Brussels, Belgium), in collaboration with the Breast International Group (BIG), and will involve a total of 1,065 patients from about 164 hospitals in 12 countries worldwide.

HER2-positive breast cancer is an aggressive form of the disease that accounts for about 15-20% of all breast cancer cases1. Patients with early HER2-positive disease usually receive a combination of multiple chemotherapy drugs and surgery, combined with an anti-HER2 treatment, and continue with the latter for up to one year after surgery. While results are encouraging, with more than 90% of the patients alive and free of cancer recurrence after five years2, the combination of chemotherapy and HER2 blockade can cause adverse side effects – such as hair loss, nausea, vomiting, fatigue or even cardiac toxicity –, most of which can be attributed to chemotherapy. 

In DECRESCENDO, patients will receive a less intensive chemotherapy treatment prior to surgery (one drug instead of the conventional 2 to 4 drugs). In addition, clinicians will identify patients whose tumours show a complete response to treatment after surgery and who can be spared further chemotherapy and receive only the anti-HER2 treatment. The goal of this study is to show that this new treatment regimen is as effective as the conventional one, but with less potential to cause side effects.

“With more and more ‘weapons’ targeting the Achille’s heel of this cancer – namely the HER2 receptor –, it makes sense to cautiously simplify chemotherapy, which causes most of the treatment side effects… and this is the goal pursued by DECRESCENDO”, says Professor Martine Piccart, Co-Principal Investigator of the study, Scientific Director at the Institut Jules Bordet, Brussels, Belgium, Co-founder of the Breast International Group and President of BIG against breast cancer.

“I think DECRESCENDO may be a practice-changing study. If our hypothesis is correct, we will significantly reduce the incidence of potentially serious side effects due to chemotherapy, such as heart failure. At the same time, patients will receive a treatment that is as effective as current standards, but almost entirely targeted against the biological weaknesses of the cancer, thus avoiding much of the toxicity often associated with chemo drugs”, says Professor Gabriele Zoppoli, Co-Principal Investigator of the study and Assistant Medical Director at the Ospedale Policlinico San Martino, Genova, Italy, and Member of the Board of Directors, Gruppo Oncologico Italiano di Ricerca Clinica (GOIRC).

Towards better personalised treatments
BIG’s de-escalation studies, including DECRESCENDO, contribute to breast cancer treatments being tailored more precisely to individual patient needs. These trials test the possibility to safely reduce the amount and/or the duration of some breast cancer treatments – or avoid them entirely –without increasing the risk of the cancer coming back or affecting a patient’s quality of life.

The prospect of safely de-escalating breast cancer treatment is of great interest to patients, who can receive an optimal therapy with fewer side effects that is better tailored to their individual condition. Likewise, reducing the incidence of severe side effects also benefits healthcare systems, thanks to the optimised allocation of resources and reduced use of the facilities for unnecessary emergencies.

The DECRESCENDO trial is being led by academic research groups, as part of a clinical research collaboration with Roche (providing study drug and funding).

Download the full press release in English, French, or Dutch


For further information and/or interview requests, please contact:

BIG                                                                              
Oriana Spagnolo
Communications Manager
Tel: +32 479 814831
Email: communications@bigagainstbc.org

IJB
Alexandra Cazan
Head of Communication
Tel: +32 (0)2 541.38.89
Email: alexandra.cazan@bordet.be


References

  1. Loibl, S and Gianni, L. HER2-positive breast cancer. The Lancet 389, 2415–2429 (2017)
  2. Patel A, Unni N and Peng Y. The Changing Paradigm for the Treatment of HER2-Positive Breast Cancer. Cancers (Basel). 2020 Aug; 12(8): 2081.