COGNITION: Genomics-Guided Precision Oncology in Early High-Risk Breast Cancer

Recruiting now

Conditions studied: Early-Stage Breast Cancer, Neoadjuvant Therapy

In brief

The COGNITION diagnostic platform elucidates the biomarker profile of neoadjuvant chemotherapy-resistant residual bulk tumors in high risk early breast cancer patients. The major goal is to provide a framework for genomic profiling, which serves as infrastructure for systematic biomarker-screening and -stratification for concise therapy-arm allocation in the interventional clinical phase II trial COGNITION-GUIDE (NCT05332561). In patients, who display a poor response to standard-of-care neoadjuvant chemotherapy, tissue samples before and after neoadjuvant therapy are subjected together with blood samples to comprehensive genomic profiling to identify patients potentially benefiting from biomarker-guided interventions in COGNITION-GUIDE. Samples not required for standard-of-care clinical procedures or genomic profiling are systematically collected in a dedicated bio-repository to fuel translational scientific companion programs. The continuously growing comprehensive database serves as an integrative resource for systematic, prospective multidimensional data collection (clinical records, biomaterial, genomic data). In summary, the overarching goal is to generate a precision oncology platform i) to identify clinically-actionable biomarkers and drug targets that drive genomics-guided therapies and ii) to couple the observational, diagnostic registry platform to the independent, biomarker-stratified clinical therapy trial COGNITION-GUIDE.

Key facts

Study ID: NCT05906407
Run by: German Cancer Research Center
People needed: 2000
Starts: 2019-04-19
Expected to finish: 2028-12-31
Last updated by the study team: 2025-03-19

Who can join

Age: 18 and older, up to 80. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Female and male breast cancer patients aged ≥18 years.
Patients with primary early breast cancer (irrespective of subtypes) or - as an exception - patients with isolated loco-regional relapses that can be treated with a curative intention
Study entry is possible for patients with primary eBC at three timepoints:
Option A: patients planned to receive neoadjuvant chemotherapy are enrolled before starting the neoadjuvant treatment
Option B: patients with clinical non-complete response can be enrolled after the last cycle of neoadjuvant chemotherapy before surgery Note: Option A/B are strongly preferred entry time-points
Option C: eBC patients after surgery and planned or conducting standard-of-care (SoC) post-neoadjuvant chemotherapy can be enrolled after surgery until the last cycle of standard post-neoadjuvant chemotherapy, if they fulfill the following criteria
HER2+ BC or TNBC: non-pCR
HR+/HER2- BC: non-pCR and CPS-EG score ≥ 3 or non-pCR, ypN+ and CPS-EG-score ≥ 2 Note: Option C is not the preferred entry time-point Note: in case of loco-regional relapse, neoadjuvant treatment is not mandatory
Patients must be willing to donate a recent tumour sample to the registry Note: fresh tumour tissue is preferred
Patients, who agreed to and were able to sign the informed consent form (ICF).

You may not qualify if…

Patients who did not sign or withdrew the informed consent form (ICF).
Inability to retrieve tissue for molecular profiling Any physical or mental handicap or severe comorbidities that would hamper the adequate cooperation with the patient.

Where it is running

University Hospital Würzburg — Würzburg, Germany (enrolling)
Charité - Berlin — Berlin, Germany (enrolling)
University Hospital Ulm — Ulm, Germany (enrolling)
University Hospital Augsburg — Augsburg, Germany (enrolling)
Medical Faculty and University Hospital Carl Gustav Carus — Dresden, Germany (enrolling)
University Hospital Erlangen — Erlangen, Germany (enrolling)
National Center for Tumor Diseases (NCT) Heidelberg — Heidelberg, Germany (enrolling)
Caritas Hospital St. Josef — Regensburg, Germany (enrolling)
Robert Bosch Hospital Stuttgart — Stuttgart, Germany (enrolling)
University Hospital Tübingen — Tübingen, Germany (enrolling)
University Hospital Köln — Cologne, Germany
University Hospital Essen — Essen, Germany

Full record on ClinicalTrials.gov

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