On July 29, 2025 Natera, Inc. (NASDAQ: NTRA), a global leader in cell-free DNA and precision medicine, reported the launch of the TEODOR trial (Neoadjuvant TrEatment Optimization driven by ctDNA and endOcrine Responsiveness) (Press release, Natera, JUL 29, 2025, View Source [SID1234654619]). TEODOR is a Phase II, multicenter, randomized controlled trial (RCT) that aims to replace chemotherapy with endocrine therapy prior to surgery for a subset of women with hormone receptor-positive (HR+), HER2-negative breast cancer, who are endocrine responsive and test negative with Signatera.
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Sponsored by the Austrian Breast & Colorectal Cancer Study Group (ABCSG), TEODOR expects to enroll approximately 250 patients across 15 sites in Austria. Previous studies have demonstrated that patients who test Signatera-negative at diagnosis and then receive chemotherapy have excellent outcomes, with risk of recurrence at less than 5%. In an effort to reduce pre-operative chemotherapy, which can carry significant side effects, this study is designed to evaluate the efficacy of endocrine therapy compared to chemotherapy in patients who are Signatera-negative.
After a four-week course of endocrine therapy, patients who are Signatera-negative and show a favorable endocrine sensitivity as measured by the Ki-67 proliferation index will be randomized to receive either additional endocrine therapy or chemotherapy. The primary endpoint of the study is the rate of neoadjuvant therapy response, assessed via pathological complete response (pCR) and modified Preoperative Endocrine Prognostic Index (PEPI) score across the endocrine therapy and chemotherapy arms of the trial. Secondary endpoints include long-term outcomes such as breast cancer recurrence and overall survival.
"TEODOR is designed to examine whether we can use endocrine responsiveness and ctDNA status to optimize systemic therapy in the neoadjuvant setting," said ABCSG President, Michael Gnant, M.D., FACS, FEBS, who serves as professor of surgery, Comprehensive Cancer Center, Medical University of Vienna, and principal investigator of the TEODOR trial. "This study marks a critical step toward more personalized medicine, leveraging the latest technologies to improve patient care."
"With the TEODOR trial, our goal is to identify patients who may be able to safely forgo chemotherapy," said Angel Rodriguez, M.D., medical director of oncology at Natera. "We are proud to collaborate with ABCSG on this important trial, and we hope this study will support the role of Signatera in guiding neoadjuvant therapy in breast cancer."