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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/study/NCT02675231




Registration number
NCT02675231
Ethics application status
Date submitted
3/02/2016
Date registered
5/02/2016
Date last updated
19/03/2024

Titles & IDs
Public title
A Study of Abemaciclib (LY2835219) in Women With HR+, HER2+ Locally Advanced or Metastatic Breast Cancer
Scientific title
monarcHER: A Phase 2, Randomized, Multicenter, 3-Arm, Open-Label Study to Compare the Efficacy of Abemaciclib Plus Trastuzumab With or Without Fulvestrant to Standard-of-Care Chemotherapy of Physician's Choice Plus Trastuzumab in Women With HR+, HER2+ Locally Advanced or Metastatic Breast Cancer
Secondary ID [1] 0 0
I3Y-MC-JPBZ
Secondary ID [2] 0 0
15804
Universal Trial Number (UTN)
Trial acronym
monarcHER
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Hormone Receptor Positive Breast Cancer 0 0
HER-2 Positive Breast Cancer 0 0
Condition category
Condition code
Cancer 0 0 0 0
Breast

Intervention/exposure
Study type
Interventional(has expanded access)
Description of intervention(s) / exposure
Treatment: Drugs - Abemaciclib
Treatment: Drugs - Trastuzumab
Treatment: Drugs - Fulvestrant
Treatment: Drugs - Standard of Care Single Agent Chemotherapy

Experimental: 150 mg Abemaciclib + 8 mg/kg Trastuzumab + 500 mg Fulvestrant - 150 milligram (mg) abemaciclib given orally every 12 hours (Q12H) of a 21-day cycle; plus 8 milligram per kilogram (mg/kg) trastuzumab intravenous (IV) infusion on Day 1 of the cycle then a 6 mg/kg maintenance dose IV infusion on Day 1 of each subsequent cycle; plus 500 mg fulvestrant intramuscularly (IM) on day 1, 15 and 29 and then once every 4 weeks thereafter.

Experimental: 150 mg Abemaciclib + 8 mg/kg Trastuzumab - 150 mg abemaciclib given orally Q12H of a 21-day cycle; plus 8 mg/kg trastuzumab IV infusion on Day 1 of the cycle then a 6 mg/kg maintenance dose IV infusion on Day 1 of each subsequent cycle.

Active comparator: 8 mg/kg Trastuzumab + Standard of Care Chemotherapy - 8 mg/kg trastuzumab IV infusion on Day 1 of a 21-day cycle then a 6 mg/kg maintenance dose IV infusion on Day 1 of each subsequent cycle plus standard of care single agent chemotherapy of physician's choice administered according to product label


Treatment: Drugs: Abemaciclib
Administered Orally

Treatment: Drugs: Trastuzumab
Administered IV

Treatment: Drugs: Fulvestrant
Administered IM

Treatment: Drugs: Standard of Care Single Agent Chemotherapy
Standard-of-care single-agent chemotherapy of physician's choice administered according to product label
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Progression Free Survival (PFS)
Timepoint [1] 0 0
Baseline to Progressive Disease or Death from Any Cause (Up To 36 Months)
Secondary outcome [1] 0 0
Overall Survival (OS)
Timepoint [1] 0 0
Baseline to Death from Any Cause (Estimated up to 48 Months)
Secondary outcome [2] 0 0
Percentage of Participants Achieving Complete Response (CR) or Partial Response (PR): Objective Response Rate (ORR)
Timepoint [2] 0 0
Baseline to Objective Disease Progression (Up To 36 Months)
Secondary outcome [3] 0 0
Duration of Response (DoR)
Timepoint [3] 0 0
Date of CR or PR to Date of Objective Disease Progression or Death from Any Cause (Up To 36 Months)
Secondary outcome [4] 0 0
Percentage of Participants With a Best Overall Response of CR, PR, or Stable Disease (SD): Disease Control Rate (DCR)
Timepoint [4] 0 0
Baseline to Objective Disease Progression (Up To 36 Months)
Secondary outcome [5] 0 0
Percentage of Participants With Best Overall Response of CR, PR, or SD With Duration of SD for at Least 6 Months: Clinical Benefit Rate (CBR)
Timepoint [5] 0 0
Date of CR, PR or SD to 6 Months Post CR, PR or SD (Up To 36 Months)
Secondary outcome [6] 0 0
Change From Baseline in Pain and Symptom Burden Assessment on the Modified Brief Pain Inventory-Short Form (mBPI-sf)
Timepoint [6] 0 0
Baseline, 30 Days After Treatment Discontinuation (Up To 36 Months)
Secondary outcome [7] 0 0
Change From Baseline in Symptom Burden on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30)
Timepoint [7] 0 0
Baseline, 30 Days After Treatment Discontinuation (Up To 36 Months)
Secondary outcome [8] 0 0
Change From Baseline on the EuroQol 5-Dimension, 5-Level Questionnaire (EQ-5D-5L) Index Score
Timepoint [8] 0 0
Baseline, 30 Days After Treatment Discontinuation (Up To 36 Months)
Secondary outcome [9] 0 0
Change From Baseline on the EuroQol 5-Dimension, 5-Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS)
Timepoint [9] 0 0
Baseline, 30 Days After Treatment Discontinuation (Up To 36 Months)
Secondary outcome [10] 0 0
Pharmacokinetics (PK): Minimum Steady State Concentration (Cmin,ss) of Abemaciclib and Its Metabolites (M2 and M20)
Timepoint [10] 0 0
Cycle(C)1 Day(D)1,C1D15, C2D1, C2D8, C3D1,C3D15, C4D1, C5D1:pre-dose; C1D1, C2D1, C3D1, C4D1, C5D1:post-dose

Eligibility
Key inclusion criteria
* diagnosis of HR+, HER2+ breast cancer (BC)
* unresectable locally advanced recurrent BC or metastatic BC
* adequate tumor tissue available prior to randomization
* measurable and/or non-measurable disease according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1
* previously received:

* at least 2 HER2-directed therapies for advanced disease
* participant must have received trastuzumab emtansine (T-DM1) in any disease setting
* must have received a taxane in any disease setting
* may have received any endocrine therapy (excluding fulvestrant)
* have postmenopausal status due to surgical / natural menopause or chemical ovarian suppression
* performance status (PS) of 0 to 1 on the Eastern Cooperative Oncology Group scale
* left ventricular ejection fraction (LVEF) of 50% or higher at baseline
* adequate organ function
* negative serum pregnancy test at baseline (within 14 days prior to randomization) and agree to use medically approved precautions to prevent pregnancy during the study and for 12 weeks following the last dose of abemaciclib if menopause induced by gonadotropin-releasing hormone (GnRH) agonist or radiation
* discontinued previous localized radiotherapy for palliative purposes or for lytic lesions at risk of fracture at least 2 weeks prior to randomization and recovered from the acute effects of therapy
* discontinued all previous therapies for cancer (including chemotherapy, radiotherapy, immunotherapy, and endocrine therapy), except trastuzumab, for at least 21 days for myelosuppressive agents or 14 days for nonmyelosuppressive agents prior to receiving study drug, and recovered from the acute effects of therapy
* are able to swallow capsules
Minimum age
18 Years
Maximum age
No limit
Sex
Females
Can healthy volunteers participate?
No
Key exclusion criteria
* have visceral crisis
* known central nervous system (CNS) metastases that are untreated, symptomatic, or require steroids to control symptoms
* had major surgery within 14 days prior to randomization
* received prior treatment with any cyclin-dependent kinase (CDK) 4 and CDK 6 inhibitor
* received treatment with a drug that has not received regulatory approval for any indication within 14 or 21 days of randomization for a nonmyelosuppressive or myelosuppressive agent, respectively
* have serious preexisting medical conditions that, in the judgment of the investigator, would preclude participation in this study
* history within the last 6 months of symptomatic congestive heart failure, myocardial infarction, or unstable angina
* history within the last 12 months of any of the following conditions: syncope of cardiovascular etiology, ventricular tachycardia, ventricular fibrillation, or sudden cardiac arrest
* history of any other cancer (except non-melanoma skin cancer or carcinoma in-situ of the cervix), unless in complete remission with no therapy for a minimum of 3 years
* active bacterial, fungal infection, or detectable viral infection
* have received any recent (within 28 days prior to randomization) live virus vaccination
* hypersensitivity to trastuzumab, murine proteins, fulvestrant, or to any of the excipients

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
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
Phase
Phase 2
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
23/05/2016
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
9/11/2023
Sample size
Target
Accrual to date
Final
237
Recruitment in Australia
Recruitment state(s)
Recruitment hospital [1] 0 0
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. - Kurralta Park
Recruitment hospital [2] 0 0
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. - Nedlands
Recruitment hospital [3] 0 0
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. - St. Leonards
Recruitment postcode(s) [1] 0 0
5037 - Kurralta Park
Recruitment postcode(s) [2] 0 0
6009 - Nedlands
Recruitment postcode(s) [3] 0 0
2065 - St. Leonards
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
California
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United States of America
State/province [2] 0 0
Colorado
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United States of America
State/province [3] 0 0
Florida
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United States of America
State/province [4] 0 0
Georgia
Country [5] 0 0
United States of America
State/province [5] 0 0
Indiana
Country [6] 0 0
United States of America
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Kentucky
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Massachusetts
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Minnesota
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Montana
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New York
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Pennsylvania
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Tennessee
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Texas
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Washington
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Argentina
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Buenos Aires
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Argentina
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Caba
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Argentina
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Cordoba
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Argentina
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La Rioja
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Rosario
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Argentina
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San Miguel De Tucuman
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Argentina
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Viedma
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Belgium
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Charleroi
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Belgium
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Gent
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Belgium
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Leuven
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Belgium
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Namur
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Brazil
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Porto Alegre
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Brazil
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Rio de Janeiro
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Brazil
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Sao Paulo
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Brazil
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São Paulo
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Canada
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Calgary
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Canada
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Newmarket
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Canada
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Ottawa
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France
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Angers
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France
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Besancon
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France
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Lyon
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France
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Montpellier
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France
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Nice
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France
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Paris
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France
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Saint Cloud
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France
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Villejuif
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Germany
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Frankfurt am Main
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Freiburg
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Hamburg
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München
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Greece
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Achaia
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Greece
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Athens
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Italy
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Genova
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Italy
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Milano
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Italy
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Sora
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Korea, Republic of
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Daegu
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Goyang-si
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Seongnam-si
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Seoul
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Barcelona
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Madrid
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Sevilla
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Leicester
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Manchester
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United Kingdom
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Sutton

Funding & Sponsors
Primary sponsor type
Commercial sector/industry
Name
Eli Lilly and Company
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
The purpose of this study is to evaluate the effectiveness of abemaciclib plus trastuzumab with or without fulvestrant versus trastuzumab plus physicians choice standard of care chemotherapy in women with hormone receptor positive (HR+), human epidermal growth factor receptor 2 positive (HER2+) locally advanced or metastatic breast cancer after prior exposure to at least two HER2-directed therapies for advanced disease.
Trial website
https://clinicaltrials.gov/study/NCT02675231
Trial related presentations / publications
Tolaney SM, Wardley AM, Zambelli S, Hilton JF, Troso-Sandoval TA, Ricci F, Im SA, Kim SB, Johnston SR, Chan A, Goel S, Catron K, Chapman SC, Price GL, Yang Z, Gainford MC, Andre F. Abemaciclib plus trastuzumab with or without fulvestrant versus trastuzumab plus standard-of-care chemotherapy in women with hormone receptor-positive, HER2-positive advanced breast cancer (monarcHER): a randomised, open-label, phase 2 trial. Lancet Oncol. 2020 Jun;21(6):763-775. doi: 10.1016/S1470-2045(20)30112-1. Epub 2020 Apr 27. Erratum In: Lancet Oncol. 2021 Mar;22(3):e92. doi: 10.1016/S1470-2045(21)00032-2. Lancet Oncol. 2021 Nov;22(11):e472. doi: 10.1016/S1470-2045(21)00587-8.
Public notes

Contacts
Principal investigator
Name 0 0
Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST)
Address 0 0
Eli Lilly and Company
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/NCT02675231