A Global Study to Compare the Effects of Fulvestrant and Arimidex in a Subset of Patients With Breast Cancer. (FALCON)
A Randomised, Double-blind, Parallel-group, Multicentre, Phase III Study to Compare the Efficacy and Tolerability of Fulvestrant (FASLODEX) 500 mg With Anastrozole (ARIMIDEX) 1 mg as Hormonal Treatment for Postmenopausal Women With Hormone Receptor-Positive Locally Advanced or Metastatic Breast Cancer Who Have Not Previously Been Treated With Any Hormonal Therapy.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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La Rioja, Argentina, 5300
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Mar del Plata, Argentina, B7600CTO
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Pergamino, Argentina, B2700CPM
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Rosario, Argentina, S2000KZE
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Porto Alegre, Brazil, 91350-200
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Santo André, Brazil, 09060-870
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British Columbia
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Abbotsford, British Columbia, Canada, V2S0C2
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Vancouver, British Columbia, Canada, V5Z 4E6
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Ontario
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Kitchener, Ontario, Canada, N2G 1G3
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Thunder Bay, Ontario, Canada, P7B 6V4
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Quebec
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Montreal, Quebec, Canada, H4A 3J1
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Montreal, Quebec, Canada, H3T 1E2
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Chengdu, China, 610041
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Dalian, China, 116011
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Fuzhou, China, 350025
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Guangzhou, China, 510060
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Shanghai, China, 200032
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Shenyang, China, 110001
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Suzhou, China, 215004
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Tianjin, China, 300060
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Prague, Czechia, 150 06
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Příbram, Czechia, 261 01
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Avellino, Italy, 83100
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Bari, Italy, 70124
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Benevento, Italy, 82100
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Catania, Italy, 95126
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Genova, Italy, 16128
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Pisa, Italy, 56100
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Roma, Italy, 00144
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Roma, Italy, 00161
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Roma, Italy, 00100
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Treviglio, Italy, 24047
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Fukuoka, Japan, 811-1395
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Hamamatsu, Japan, 430-0906
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Kagoshima, Japan, 892-0833
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Kumamoto, Japan, 860-8556
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Matsuyama, Japan, 791-0280
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Mitaka-shi, Japan, 181-8611
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Nishinomiya-shi, Japan, 663-8501
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Osaka, Japan, 540-0006
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Sakaishi, Japan, 590-0064
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Suita-shi, Japan, 565-0871
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Mexico City, Mexico, 6760
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Monterrey, Mexico, 64710
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Monterrey, Mexico, 64000
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Monterrey, Mexico, 64060
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Mérida, Mexico, 97000
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Lima, Peru, LIMA 27
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Lima, Peru, LIMA 41
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Lima, Peru, Lima 18
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Lima, Peru, LIMA 33
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Katowice, Poland, 40-635
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Lodz, Poland, 90-242
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Lublin, Poland, 20-718
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Brăila, Romania, 810325
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Craiova, Romania, 200347
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Onești, Romania, 601048
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Timișoara, Romania, 300239
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Barnaul, Russia, 656052
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Moscow, Russia, 115478
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Omsk, Russia, 644013
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Ryazan, Russia, 390046
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Saint Petersburg, Russia, 197758
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Saint Petersburg, Russia, 191014
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Saint Petersburg, Russia, 197022
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Saint Petersburg, Russia, 195271
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Tomsk, Russia, 634028
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Bardejov, Slovakia, 085 01
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Bratislava, Slovakia, 833 10
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Bratislava, Slovakia, 814 65
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Trenčín, Slovakia, 91171
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Cape Town, South Africa, 7700
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Cape Town, South Africa, 7570
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Cape Town, South Africa, 7925
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Pietermaritzburg, South Africa, 3201
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Pretoria, South Africa, 0081
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Pretoria, South Africa, 0001
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Madrid, Spain, 28034
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Madrid, Spain, 28050
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Pamplona, Spain, 31008
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Pozuelo de Alarcón, Spain, 28223
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Sabadell, Spain, 8208
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Seville, Spain, 41009
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Seville, Spain, 41013
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Seville, Spain, 41014
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Valencia, Spain, 46026
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Valencia, Spain, 46014
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Taichung, Taiwan, 40447
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Taipei, Taiwan, 235
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Taipei, Taiwan, 10449
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Taipei, Taiwan, 112
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Ankara, Turkey (Türkiye), 06100
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Gaziantep, Turkey (Türkiye), 27310
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Cherkasy, Ukraine, 18009
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Dnipro, Ukraine, 49102
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Donetsk, Ukraine, 83092
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Ivano-Frankivsk, Ukraine, 76014
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Kharkiv Region, Ukraine, 61070
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Kyiv, Ukraine, 3115
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Lviv, Ukraine, 79031
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Mariupol, Ukraine, 87500
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Uzhhorod, Ukraine, 88000
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Vinnytsia, Ukraine, 21029
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Airdrie, United Kingdom, ML6 0JS
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Derby, United Kingdom, DE22 3NE
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Stoke-on-Trent, United Kingdom, ST4 6QG
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California
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Modesto, California, United States, 95355
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Georgia
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Savannah, Georgia, United States, 31405
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Maine
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Auburn, Maine, United States, 04212
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Massachusetts
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Worcester, Massachusetts, United States, 01608
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Michigan
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Detroit, Michigan, United States, 48202
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Missouri
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St Louis, Missouri, United States, 63110
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Nebraska
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Lincoln, Nebraska, United States, 68506
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New Jersey
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Somerset, New Jersey, United States, 08873
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Ohio
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Columbus, Ohio, United States, 43202
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Montgomery, Ohio, United States, 45242
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Tennessee
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Memphis, Tennessee, United States, 38120
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Utah
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Salt Lake City, Utah, United States, 84107
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Histological confirmation of breast cancer in post menopausal women (age >=60). Positive hormone receptor status (ER +ve and/or PgR +ve) of primary or metastatic tumour tissue based on local laboratory assessment.
- EITHER locally advanced disease (1 line of chemotherapy allowed only if remain unsuitable for therapy of curative intent) OR Metastatic disease. (1 line of chemotherapy for breast cancer allowed only if subsequent evidence of further progressive disease)
- At least 1 lesion (measurable and/or non-measurable) that can be accurately assessed at baseline and is suitable for repeated assessment.
Postmenopausal women, fulfilling 1 of:
- Prior bilateral oophorectomy
- Age >60 years
- Age < 60 years and amenorrheic for 12+months in the absence of chemotherapy, tamoxifen, toremifene, or ovarian suppression and FSH and oestradiol in the postmenopausal range
Exclusion Criteria:
- Presence of life-threatening metastatic disease
Any of:
- Extensive hepatic involvement
- involving brain or meninges
- symptomatic pulmonary lymph spread
- Discrete lung metastases are acceptable if respiratory function is not significantly compromised
- Prior systemic therapy for breast cancer other than one line of cytotoxic chemotherapy (the last dose of chemotherapy must have been received more than 28 days prior to randomisation)
- Radiation therapy if not completed within 28 days prior to randomisation (with the exception of radiotherapy given for control of bone pain, started prior to randomisation). Prior hormonal treatment for breast cancer.
- Current or prior malignancy within previous 3 years (other than breast cancer or adequately treated basal cell or squamous cell carcinoma of the skin or in situ carcinoma of the cervix).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Experimental: faslodex+placebo
Blinded: Fulvestrant 500mg intramuscular injection (2x250mg) plus dummy Anastrozole tablets
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2 x intramuscular injections at day 1, 14, 28 and every 28 days thereafter
oral tablet 1 daily
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Active Comparator: arimidex +placebo
Blinded: Anastrozole 1mg tablets plus dummy Fulvestrant intramuscular injection (2x0mg)
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oral tablet 1 daily
2 x intramuscular injections at day 1, 14, 28 and every 28 days thereafter
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Comparison of Progression-Free Survival (PFS) in Patients Treated With Fulvestrant With Those Treated With Anastrozole
Time Frame: Baseline RECIST 1.1 assessments (Day 0) and then every 12 weeks until the earliest of disease progression evident, patient dies or has surgery/radiotherapy for their disease (up to approximately 38 months)
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PFS was defined as the time from randomisation until objective disease progression according to Response Evaluation Criteria in Solid Tumours version 1.1 (RECIST 1.1), surgery or radiotherapy to manage worsening of disease or death by any cause (in the absence of progression).
Outcome measure is reported as median time from randomisation to PFS, calculated using the Kaplan-Meier technique.
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Baseline RECIST 1.1 assessments (Day 0) and then every 12 weeks until the earliest of disease progression evident, patient dies or has surgery/radiotherapy for their disease (up to approximately 38 months)
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Comparison of Overall Survival (OS) in Patients Treated With Fulvestrant With Those Treated With Anastrozole; Percentage of Patients With Events
Time Frame: Baseline (Day 0) up to data cut-off for final analysis (up to approximately 116 months). Following disease progression, patients were to be contacted at 12 weekly intervals to determine survival status
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OS was defined as the time from randomisation until death by any cause.
The current OS data correspond to that of the final analysis and the outcome measure is reported as percentage of patients with events.
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Baseline (Day 0) up to data cut-off for final analysis (up to approximately 116 months). Following disease progression, patients were to be contacted at 12 weekly intervals to determine survival status
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Objective Response Rate (ORR) for Fulvestrant Treatment Versus Anastrozole Treatment
Time Frame: Baseline RECIST 1.1 assessments (Day 0) and then every 12 weeks until disease progression or treatment discontinuation (up to approximately 38 months)
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ORR was defined as the percentage patients with an objective response (i.e.
those recording a partial response [PR] or complete response [CR]) at some point during the study, prior to disease progression.
ORR was assessed in patients with measurable disease at baseline only.
The determination of measurable disease at baseline was done using baseline RECIST data.
CR was disappearance of all target lesions since baseline; was any pathological lymph nodes selected as target lesions (TL) to have a reduction in short axis to <10 millimeter.
PR was at least a 30% decrease in the sum of the diameters of TL, taking as reference the baseline sum of diameters.
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Baseline RECIST 1.1 assessments (Day 0) and then every 12 weeks until disease progression or treatment discontinuation (up to approximately 38 months)
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Duration of Response (DoR) for Fulvestrant Treatment Versus Anastrozole Treatment
Time Frame: Baseline RECIST 1.1 assessments (Day 0) and then every 12 weeks until disease progression or treatment discontinuation (up to approximately 38 months)
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DoR was defined only for patients who had an objective response, as the time in days from date of first documentation of response (CR/PR) until date of disease progression.
CR was disappearance of all target lesions since baseline; any pathological lymph nodes selected as TL to have a reduction in short axis to <10 mm.
At least a 30% decrease in the sum of the diameters of TL, taking as reference the baseline sum of diameters.
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Baseline RECIST 1.1 assessments (Day 0) and then every 12 weeks until disease progression or treatment discontinuation (up to approximately 38 months)
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Expected Duration of Response (EDoR) for Fulvestrant Treatment Versus Anastrozole Treatment
Time Frame: Baseline RECIST 1.1 assessments and then every 12 weeks until disease progression or treatment discontinuation (up to approximately 38 months)
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EDoR was estimated using the formula EDoR = p Efp(x), where x = DoR, p = proportion of responders, and Efp(x) = mean duration of response for responders.
The estimation was completed by using the maximum likelihood estimates of p and Efp(x), as described by Ellis (Ellis S et al.
Analysis of duration of response in oncology trials, Contemp Clin Trials 2008; 29:456-65).
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Baseline RECIST 1.1 assessments and then every 12 weeks until disease progression or treatment discontinuation (up to approximately 38 months)
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Clinical Benefit Rate (CBR) for Fulvestrant Treatment Versus Anastrozole Treatment
Time Frame: Baseline RECIST 1.1 assessments (Day 0) and then every 12 weeks until disease progression or treatment discontinuation (up to approximately 38 months)
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CBR was defined as the percentage of patients who had a clinical benefit (i.e.
best objective response of CR, PR or stable disease), that was maintained for at least 24 weeks, prior to any evidence of progression.
Note that a minimum duration of 22 weeks for CBR was applicable in the analysis (rather than 24 weeks) to allow for the protocolled window of +/-2 weeks.
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Baseline RECIST 1.1 assessments (Day 0) and then every 12 weeks until disease progression or treatment discontinuation (up to approximately 38 months)
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Duration of Clinical Benefit (DoCB) for Fulvestrant Treatment Versus Anastrozole Treatment
Time Frame: Baseline RECIST 1.1 assessments (Day 0) and then every 12 weeks until disease progression or treatment discontinuation (up to approximately 38 months)
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DoCB was defined only for patients who had clinical benefit, as the time in days from date of randomisation until the date of disease progression.
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Baseline RECIST 1.1 assessments (Day 0) and then every 12 weeks until disease progression or treatment discontinuation (up to approximately 38 months)
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Expected Duration of Clinical Benefit (EDoCB) for Fulvestrant Treatment Versus Anastrozole Treatment
Time Frame: Baseline RECIST 1.1 assessments (Day 0) and then every 12 weeks until disease progression or treatment discontinuation (up to approximately 38 months)
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EDoCB was estimated using the formula EDoCB = p Efp(x), where x = EDoCB, p = proportion of responders, and Efp(x) = mean duration of response for responders.
The estimation was completed by using the maximum likelihood estimates of p and Efp(x), as described by Ellis (Ellis S et al.
Analysis of duration of response in oncology trials, Contemp Clin Trials 2008; 29:456-65).
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Baseline RECIST 1.1 assessments (Day 0) and then every 12 weeks until disease progression or treatment discontinuation (up to approximately 38 months)
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Comparison of the Effect of Fulvestrant Treatment Versus Anastrozole Treatment on Time to Deterioration of Health-Related Quality of Life (HRQoL)
Time Frame: Quality of life questionnaires administered at 3 months post objective disease progression, then at 6-monthly intervals (approximately 75 months)
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The Functional Assessment of Cancer Therapy - Breast (FACT-B) questionnaire was the instrument selected to assess HRQoL and comprised of following subscales: physical well-being (PWB), functional well-being (FWB), social well-being, emotional well-being, and breast cancer subscale (BCS).
The main outcome measure from the FACT-B questionnaire was the Trial Outcome Index (TOI), which was a summary of the following subscales: PWB, FWB, and BCS.
Outcome measure is reported as median time to deterioration, defined as the interval from the date of baseline of final analysis to the first assessment of worsened without an improvement in the next 12 weeks in FACT-B TOI, or the date of death (by any cause in the absence of symptom deterioration).
Time to deterioration as measured by FACT-B total score was derived similarly and is also reported.
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Quality of life questionnaires administered at 3 months post objective disease progression, then at 6-monthly intervals (approximately 75 months)
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Shankar S, MD, AstraZeneca
- Principal Investigator: John Robertson, MD, Graduate Medicine and Health School, University of Nottingham, UK
- Principal Investigator: Matthew Ellis, DM, Washington University School of Medicine, USA
Publications and helpful links
General Publications
- Robertson JFR, Cheung KL, Noguchi S, Shao Z, Degboe A, Lichfield J, Thirlwell J, Fazal M, Ellis MJ. Health-related quality of life from the FALCON phase III randomised trial of fulvestrant 500 mg versus anastrozole for hormone receptor-positive advanced breast cancer. Eur J Cancer. 2018 May;94:206-215. doi: 10.1016/j.ejca.2018.02.026. Epub 2018 Mar 22.
- Robertson JFR, Bondarenko IM, Trishkina E, Dvorkin M, Panasci L, Manikhas A, Shparyk Y, Cardona-Huerta S, Cheung KL, Philco-Salas MJ, Ruiz-Borrego M, Shao Z, Noguchi S, Rowbottom J, Stuart M, Grinsted LM, Fazal M, Ellis MJ. Fulvestrant 500 mg versus anastrozole 1 mg for hormone receptor-positive advanced breast cancer (FALCON): an international, randomised, double-blind, phase 3 trial. Lancet. 2016 Dec 17;388(10063):2997-3005. doi: 10.1016/S0140-6736(16)32389-3. Epub 2016 Nov 29.
- Ellis MJ, Llombart-Cussac A, Feltl D, Dewar JA, Jasiowka M, Hewson N, Rukazenkov Y, Robertson JF. Fulvestrant 500 mg Versus Anastrozole 1 mg for the First-Line Treatment of Advanced Breast Cancer: Overall Survival Analysis From the Phase II FIRST Study. J Clin Oncol. 2015 Nov 10;33(32):3781-7. doi: 10.1200/JCO.2015.61.5831. Epub 2015 Sep 14.
- Robertson JFR, Shao Z, Noguchi S, Bondarenko I, Panasci L, Singh S, Subramaniam S, Ellis MJ. Fulvestrant Versus Anastrozole in Endocrine Therapy-Naive Women With Hormone Receptor-Positive Advanced Breast Cancer: Final Overall Survival in the Phase III FALCON Trial. J Clin Oncol. 2025 May;43(13):1539-1545. doi: 10.1200/JCO.24.00994. Epub 2025 Jan 7.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Neoplastic Processes
- Pathological Conditions, Signs and Symptoms
- Neoplasms
- Neoplasm Metastasis
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Organic Chemicals
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Azoles
- Polycyclic Compounds
- Steroids
- Fused-Ring Compounds
- Nitriles
- Estradiol
- Estrenes
- Estranes
- Estradiol Congeners
- Gonadal Steroid Hormones
- Gonadal Hormones
- Triazoles
- Fulvestrant
- Anastrozole
Other Study ID Numbers
Other Study ID Numbers
- D699BC00001
- 2011-006326-24 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
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