Combining Apatinib with CDK4/6 inhibitors for advanced HR+/HER2- breast cancer treatment

Study of Efficacy of Apatinib Combined With cdk4/6i in First-line Treatment for HR+/HER2- SNF4 Subtype Advanced Breast Cancer (Open, Randomized, Phase III)

Phase 3 Interventional Fudan University · NCT06447623

This study is testing if adding Apatinib to standard hormone therapy can help people with advanced HR+/HER2- breast cancer feel better and have better treatment results.

Quick facts

PhasePhase 3
Study typeInterventional
Enrollment184 (estimated)
Ages18 Years to 75 Years
SexFemale
SponsorFudan University Academic / other
Drugs / interventionschemotherapy, immunotherapy, radiation, Apatinib
Locations1 site (Shanghai, Shanghai Municipality)
Trial IDNCT06447623 on ClinicalTrials.gov

What this trial studies

This phase III clinical trial investigates the effectiveness and safety of Apatinib when used alongside standard first-line endocrine therapy in patients with HR+/HER2- SNF4 subtype advanced breast cancer. The study is randomized and controlled, aiming to determine if this combination can improve treatment outcomes compared to standard therapies alone. Participants will receive Apatinib, a CDK4/6 inhibitor, and either an aromatase inhibitor or Fulvestrant. The trial focuses on patients who have not received prior treatment for their advanced condition.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 to 75 with pathologically confirmed HR+/HER2- breast cancer of the SNF4 subtype and no prior treatment for advanced disease.

Not a fit: Patients with HER2-positive breast cancer or those who have previously received treatment for advanced breast cancer may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment approach could provide a more effective option for patients with advanced HR+/HER2- breast cancer.

How similar studies have performed: Other studies have shown promising results with similar combinations of targeted therapies in breast cancer, suggesting potential for success in this approach.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Inclusion Criteria:
* Patients need to meet all of the following conditions

  * Patients must be ≥18 and ≤ 75 years of age;
  * Pathologically confirmed breast cancer is HR+/HER2- breast cancer (IHC ER \>10%, or/and PR\>10%, HER 0 OR +, if HER2++, FISH negative);
  * SNF4 subtype definition: SNF4 subtype confirmed by digital pathology of H\&E sections;
  * Locally advanced breast cancer (radical local therapy is not possible) or metastatic breast cancer (without using adjuvant CDK4/6 inhibitors in the past, or one year after adjuvant CDK4/6 inhibitor therapy has ended);
  * No prior therapy (chemotherapy, targeted therapy, etc.) for advanced or metastatic breast cancer;
  * Patients with at least one measurable lesion that has not previously received radiation therapy and can be evaluated repeatedly according to RECIST 1.1;
  * The functions of the main organs are basically normal, and the following conditions are met:

    1. Blood routine examination standards should meet: HB≥90g/L (no blood transfusion within 14 days); ANC≥1.5×109/L; PLT≥75×109/L;
    2. Biochemical examination shall meet the following standards: TBIL≤1.5×ULN (upper limit of normal value); ALT and AST≤3 x ULN; In case of liver metastasis, ALT and AST≤5×ULN; Serum Cr ≤1.5×ULN, endogenous creatinine clearance \> 50ml/min (Cockcroft-Gault formula);
  * ECOG performance status 0 or 1; The expected survival is more than 3 months;
  * Fertile female is required to use a medically approved contraceptive during study treatment and for at least 3 months after the last use of the study drug;
  * Patients voluntarily join the study, sign the informed consent, have good compliance, and cooperate with follow-up.

Exclusion Criteria:

* Patients with any of the following conditions were excluded from the study

  * Patients with central nervous system metastasis out of control (symptoms need to use glucocorticoids or mannitol).
  * A history of clinically significant or uncontrolled heart disease, including congestive heart failure, angina pectoris, myocardial infarction within the last 6 months, or ventricular arrhythmia;
  * Radiotherapy, chemotherapy, surgery, other targeted therapy, and immunotherapy for advanced HR+/HER2- breast cancer within 4 weeks before the first administration of drugs used in this study.
  * Pregnant or lactating patients;
  * Other malignancies within the previous 3 years, excluding cured skin basal cell carcinoma and cervical carcinoma in situ;
  * Significant comorbid medical conditions, including mental illnesses that the investigator or sponsor believes would adversely affect the patient\'s participation in the study;
  * Allergic physique, or known allergic history of the drug components of this program; Or allergic to other monoclonal antibodies;
  * The investigator does not consider the patient suitable for participation in any other circumstances of the study.

Where this trial is running

Shanghai, Shanghai Municipality

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Advanced Breast CancerHR+/HER2- Breast CancerHR+/HER2- breast cancer
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.