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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/study/NCT03969121




Registration number
NCT03969121
Ethics application status
Date submitted
13/05/2019
Date registered
31/05/2019
Date last updated
10/03/2023

Titles & IDs
Public title
Neoadjuvant Hormonal Therapy Plus Palbociclib in Operable, Hormone Sensitive and HER2-Negative Primary Breast Cancer
Scientific title
A Phase III Randomized, Double-Blind, Neoadjuvant Study of Hormonal Therapy Plus Palbociclib Versus Hormonal Therapy Plus Placebo in Women With Operable, Hormone Sensitive and HER2-Negative Primary Breast Cancer
Secondary ID [1] 0 0
OOTR-N016/KBCRN-B-003/HT-PAB
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Breast Cancer Female 0 0
Hormone Receptor Positive Malignant Neoplasm of Breast 0 0
Condition category
Condition code
Cancer 0 0 0 0
Breast

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Palbociclib
Treatment: Drugs - Endocrine therapy

Active comparator: Placebo + Endocrine therapy - Endocrine therapy for 16 weeks plus placebo

Active comparator: Palbociclib + Endocrine therapy - Endocrine therapy for 16 weeks plus Palbociclib


Treatment: Drugs: Palbociclib
Palbociclib will be administered orally once a day for 21 days every 28-day cycle followed by 7 days off treatment

Treatment: Drugs: Endocrine therapy
Pre- and peri-menopausal women will be receiving Ovarian Function Suppression (OFS) by either leuprorelin subcutaneous 3.75 mg q28days or goserelin subcutaneous 3.6 mg q28days plus tamoxifen 20 mg QD in 28-day cycles. Post-menopausal women will receive letrozole 2.5 mg QD in 28-day cycles.
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Pre-operative Endocrine Prognostic Index (PEPI Score)
Timepoint [1] 0 0
4 months
Primary outcome [2] 0 0
EndoPredict™ EPclin Score
Timepoint [2] 0 0
4 months
Secondary outcome [1] 0 0
Clinical Response Rate
Timepoint [1] 0 0
4 months
Secondary outcome [2] 0 0
Ki67 change
Timepoint [2] 0 0
4 months
Secondary outcome [3] 0 0
pathological response rate
Timepoint [3] 0 0
4 months
Secondary outcome [4] 0 0
Breast conserving rate
Timepoint [4] 0 0
4 months
Secondary outcome [5] 0 0
Number of Participants With Abnormal Laboratory Values and/or Adverse Events That Are Related to Treatment as Assessed by CTCAE v4.03
Timepoint [5] 0 0
4 months

Eligibility
Key inclusion criteria
1. Pre/peri- or post-menopausal women 18 years and older (or local legal age, whichever is higher)
2. Primary tumor greater than 15 mm in diameter
3. Histologically proven invasive breast cancer
4. Positive hormone receptor (ER and/or PgR =1% in proportion of positive staining score)
5. Negative HER-2 receptor (based on 2018 ASCO/CAP Guideline)
6. Ki67 index equal to or greater than 14% (Ki67 = 14%) by central assessment using actual or virtual slides
7. Eastern Cooperative Oncology Group Performance Status (ECOG PS) = 1
8. No previous history of radiotherapy or systemic therapy including chemotherapy and hormone therapy for breast cancer
9. Laboratory values must be as follows:

Absolute neutrophil count: = 1,500/mm3

Platelets: = 100,000/mm3

Hemoglobin: = 9 g/dL

Bilirubin: = 1.5 × upper limits of normal (ULN)

Serum Creatinine: = 1.5 × ULN

Alkaline phosphatase: = 2 × ULN

AST and ALT: = 2 × ULN

Cardiac function: Normal finding of Electrocardiogram (ECG) QTc = 480 msec (based on the mean value of the triplicate ECGs).
10. Able to give written informed consent form
11. Willingness and ability to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures
Minimum age
18 Years
Maximum age
No limit
Sex
Females
Can healthy volunteers participate?
No
Key exclusion criteria
1. Male
2. Locally advanced breast cancer ( Any T4 or Any N2, N3), or distant metastasis
3. Multicentric breast cancer (Note: Multifocal breast cancer,located in one quadrant/are is eligible)
4. Prior treatment with chemotherapy, radiotherapy and/or endocrine therapy
5. Previous use of SERMs such as raloxifene.
6. Prior therapy with any CDK4/6 inhibitor or with everolimus, or any agent whose mechanism of action is to inhibit the PI3K-mTOR pathway.
7. Prior history of other malignancy within 5 years of study entry, aside from basal cell carcinoma of the skin or carcinoma-in-situ of the uterine cervix
8. Major surgery within 3 weeks of first study treatment
9. Patients treated within the last 7 days prior to randomization with:

* Food or drugs that are known strong and moderate CYP3A4 inhibitors (e.g., amprenavir, aprepitant, atazanavir, boceprevir, casopitant, cimetidine, ciprof-loxacin, clarithromycin, conivaptan, cobicistat, crizotinib, cyclosporine, da-runavir, diltiazem, dronedarone, elvitegravir, erythromycin, fluconazole, fosamprenavir, imatinib, indinavir, isavuconazole, istradefylline, itraconazole,ketoconazole, letermovir, lopinavir, mibefradil, miconazole, nefazodone, nelfinavir, nilotinib, posaconazole, ritonavir, saquinavir, schisandra sphenan-thera extract, telaprevir, telithromycin, tofisopam, verapamil, voriconazole, and grapefruit, grapefruit juice or any product containing grapefruit);
* Drugs that are known strong and moderate CYP3A4 inducers (e.g., bosentan, carbamazepine, efavirenz, etravirine, modafinil, phenobarbital, phenytoin, ri-fampin, rifapentin, and St. John's wort);
10. Any of the following in the previous 6 months of randomization: myocardial in-farction, severe/unstable angina, ongoing cardiac dysrhythmias of NCI CTCAE version 4.03 grade = 2, atrial fibrillation of any grade, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident in-cluding transient ischemic attack, or symptomatic pulmonary embolism
11. Family or personal history of long or short QT syndrome, Brugada syndrome or known history of QTc prolongation, or Torsade de Pointes (TdP).
12. Uncontrolled electrolyte disorders (eg, hypocalcemia, hypokalemia, hypomag-nesemia) that can compound the effects of a QTc-prolonging drug.
13. Active inflammatory bowel disease or chronic diarrhea. Short bowel syndrome. Upper gastrointestinal surgery including gastric resection.
14. Prior hematopoietic stem cell or bone marrow transplantation.
15. Known abnormalities in coagulation such as bleeding diathesis, or treatment with anticoagulants precluding subcutaneous injections of leuprorelin or goserelin.
16. Hepatitis B and/or hepatitis C carriers (Patients with HBsAg+ or HBV-DNA+ who need antiviral treatment during any anti-cancer therapy based on guidelines are excluded even if the patient's hepatic function is normal. Patients with HCVAb+, whose HCV-RNA is positive (+) are excluded.)
17. Known human immunodeficiency virus (HIV) infection
18. Known hypersensitivity to anti-aromatase drugs, tamoxifen or any cell cycle in-hibitor.
19. Patients who are pregnant or lactating. Patients of childbearing potential and/or her partner who are unwilling or unable to use a method of highly effective non-hormonal contraception throughout the study and continue for at least 21 days in patients after the last dose of investigational drug.
20. Other severe acute or chronic medical or psychiatric condition, or laboratory ab-normality that would impart, in the judgment of the investigator, excess risk as-sociated with study participation or study drug administration, or which, in the judgment of the investigator, would make the patient inappropriate for entry into this study
21. Patients who are investigational site staff members or relatives of those site staff OOTR-N016/KBCRN-B-003/HT-PAB Protocol (version 1.2 dated Oct 11, 2018) 24 members or patients who are the sponsor employees directly involved in the con-duct of the trial.
22. Participation in other studies involving investigational drug (s) (Phases 1-4) within 2 weeks before randomization and/or until a visit at 4 weeks (+7 days) after operation.

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
Intervention assignment
Parallel
Other design features
Phase
Phase 3
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
16/07/2019
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
23/12/2021
Sample size
Target
Accrual to date
Final
141
Recruitment in Australia
Recruitment state(s)
Recruitment hospital [1] 0 0
Monash Health - Clayton
Recruitment hospital [2] 0 0
Peter MacCallum Cancer Centre - Melbourne
Recruitment postcode(s) [1] 0 0
3168 - Clayton
Recruitment postcode(s) [2] 0 0
- Melbourne
Recruitment outside Australia
Country [1] 0 0
Hong Kong
State/province [1] 0 0
Hong Kong
Country [2] 0 0
Japan
State/province [2] 0 0
Hyogo
Country [3] 0 0
Japan
State/province [3] 0 0
Ibaraki
Country [4] 0 0
Japan
State/province [4] 0 0
Fukuoka
Country [5] 0 0
Japan
State/province [5] 0 0
Kagoshima
Country [6] 0 0
Japan
State/province [6] 0 0
Kobe
Country [7] 0 0
Japan
State/province [7] 0 0
Kyoto
Country [8] 0 0
Japan
State/province [8] 0 0
Nagoya
Country [9] 0 0
Japan
State/province [9] 0 0
Osaka
Country [10] 0 0
Japan
State/province [10] 0 0
Saitama
Country [11] 0 0
Japan
State/province [11] 0 0
Tokyo
Country [12] 0 0
Japan
State/province [12] 0 0
Yokohama
Country [13] 0 0
Korea, Republic of
State/province [13] 0 0
Gyeonggi-do
Country [14] 0 0
Korea, Republic of
State/province [14] 0 0
Seongnam
Country [15] 0 0
Korea, Republic of
State/province [15] 0 0
Seoul
Country [16] 0 0
Taiwan
State/province [16] 0 0
Changhua
Country [17] 0 0
Taiwan
State/province [17] 0 0
Kaohsiung
Country [18] 0 0
Taiwan
State/province [18] 0 0
Taipei

Funding & Sponsors
Primary sponsor type
Other
Name
Kyoto Breast Cancer Research Network
Address
Country
Other collaborator category [1] 0 0
Commercial sector/industry
Name [1] 0 0
Pfizer
Address [1] 0 0
Country [1] 0 0

Ethics approval
Ethics application status

Summary
Brief summary
The study is a randomized, double blind, placebo controlled, Phase 3 clinical trial with the primary objective of demonstrating the efficacy of palbociclib in combination with Endocrine therapy over Endocrine therapy alone measured by PEPI and EndoPredict™ EPclin Score in women with operable HR+, HER2 negative breast cancer . The Clinical Response Rate, drop in Ki67 index = 2.7% and Breast conserving rate will be compared between two arms.
Trial website
https://clinicaltrials.gov/study/NCT03969121
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Masakazu Toi, MD,PhD
Address 0 0
Kyoto University, Professor of Breast Surgery Department
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/study/NCT03969121