A Study of a Medicine Called Atirmociclib in Combination With Giredestrant in Adult Participants With ER-positive, HER2-negative Early-stage Breast Cancer

November 5, 2026 updated by: Pfizer

AN INTERVENTIONAL, DOUBLE-BLIND, PLACEBO CONTROLLED, RANDOMIZED, MULTICENTER PHASE 3 STUDY OF ATIRMOCICLIB (PF-07220060) PLUS GIREDESTRANT COMPARED TO GIREDESTRANT MONOTHERAPY AS ADJUVANT TREATMENT IN ADULT PARTICIPANTS WITH ESTROGEN RECEPTOR (ER)-POSITIVE, HER2-NEGATIVE EARLY-STAGE BREAST CANCER WITH MEDIUM OR HIGH RISK OF RECURRENCE (FOURLIGHT-4)

This Phase 3 study will evaluate whether atirmociclib plus giredestrant improves invasive breast cancer-free survival compared with giredestrant alone in adults with ER-positive, HER2-negative early breast cancer at medium or high risk of recurrence.

This is a Phase 3, double blind, placebo controlled study of atirmociclib plus giredestrant vs. giredestrant monotherapy as adjuvant treatment in adult patients with ER+, HER2- early breast cancer. The study plans to enroll 3800 participants randomized 1:1 into one of two treatment arms (Arm A - investigational: atirmociclib plus giredestrant taken continuously in a 28-day cycle) or (Arm B - comparator: placebo plus giredestrant taken continuously in a 28-day cycle). Participants may be treated with atirmociclib/placebo up to 3 years and giredestrant up to 5 years followed by long term follow up for survival and evaluation of recurrence of disease.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

3800

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

KEY INCLUSION CRITERIA

  1. Histologically confirmed unilateral primary adenocarcinoma of the breast

    • ER-positive by local assessment
    • documented HER2-negative
  2. Node positive or node negative as defined by:

    • Pathological node positive (microscopic and/or macroscopic tumor involvement >/=pN1)

    • pN0 and pT >1cm with at least one of the following:

      1. pT4N0 or
      2. histologically Grade 3 disease or
      3. high-risk classification based on genomic assay
  3. Randomization within 16 months of definitive breast surgery

  4. If indicated, completed adjuvant and/or neoadjuvant chemotherapy, adjuvant radiation therapy >/= 21 days prior to randomization

KEY EXCLUSION CRITERIA

  1. Distant metastases of breast cancer beyond regional lymph nodes

  2. Multicentric or multifocal breast cancer if any tumor foci meet pathologic criteria for ER(-) or HER2(+)

  3. Clinically significant cardiovascular disease or cardiac repolarization abnormality for 6 months prior to randomization; resting heart rate <50bpm

  4. Has received the following prior systemic anti-cancer therapy for breast cancer

    • prior atirmociclib, giredestrant, other investigational anti-cancer agent
    • prior treatment with olaparib

    NOTES:

    • short course of prior neo/adjuvant CDK4/6 inhibitor treatment (</=8 weeks) is permitted; 10-day washout period required
    • short course of prior neoadjuvant and/or adjuvant ET (</=18 weeks) is permitted; 35-day washout period for tamoxifen is required
  5. Prior treatment with investigational product within 30 days or 5 half-lives

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Arm A : Atirmociclib + giredestrant

Atirmociclib tablet given orally twice daily, plus giredestrant capsule given orally once per day

Atirmociclib tablet given orally twice daily, plus giredestrant capsule given orally once per day

Other Names:
  • PF-07220060

giredestrant capsule given once a day

Active Comparator: Arm B: Placebo for atirmociclib + giredestrant

Placebo atirmociclib tablets given orally twice a day plus giredestrant capsule given once a day

giredestrant capsule given once a day

Atirmociclib placebo tablet given twice a day

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Invasive Breast Cancer Free Survival (iBCFS)
Time Frame: From randomization to first iBCFS event, up to 16 years

iBCFS is defined as the time from the date of randomization to the date of first documented occurrence of invasive ipsilateral breast tumor recurrence, local-regional invasive breast cancer recurrence, invasive contralateral breast cancer, distant recurrence, or death from any cause, as determined by investigator assessment per STEEP v2.0 criteria

From randomization to first iBCFS event, up to 16 years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Invasive Disease Free Survival (iDFS)
Time Frame: From randomization to first iDCFS event, up to 16 years

iDFS defined as the time from the date of randomization to the date of first documented occurrence of invasive ipsilateral breast tumor recurrence, local-regional invasive breast cancer recurrence, invasive contralateral breast cancer, distant recurrence, second primary invasive non-breast cancer, or death from any cause, as determined by investigator assessment per STEEP v2.0 criteria

From randomization to first iDCFS event, up to 16 years
Disease Recurrence Free Survival (DRFS)
Time Frame: From randomization to first DRFS event, up to 16 years

DRFS as per investigator assessment, defined as the time from the date of randomization to the date of distant recurrence as determined by investigator assessment or death from any cause, whichever occurs first

From randomization to first DRFS event, up to 16 years
Overall survival (OS)
Time Frame: From randomization to death from any cause, up to 16 years

OS is defined as the time from the date of randomization to the date of death due to any cause

From randomization to death from any cause, up to 16 years
Number and percentage of Participants with Treatment-Emergent Adverse Events (AEs)
Time Frame: From start of treatment until 28 days after last dose of study treatment, up to 5 years

Type, incidence, severity of AE graded by NCI CTCAE v 5.0, seriousness and relationship to study intervention

From start of treatment until 28 days after last dose of study treatment, up to 5 years
Percentage of participants With Clinical Laboratory Abnormalities
Time Frame: From start of treatment until 28 days after last dose of study treatment, up to 5 years
From start of treatment until 28 days after last dose of study treatment, up to 5 years
Percentage of Participants With ECG abnormalities
Time Frame: From start of treatment until 28 days after last dose of study treatment, up to 5 years
From start of treatment until 28 days after last dose of study treatment, up to 5 years
Patient Reported Outcomes (PRO)
Time Frame: From start of treatment until 28 days after last dose of study treatment, up to 5 years

Change from baseline in participant reported total score, well-being subscales and symptoms scores and TOI per FACT-ES

From start of treatment until 28 days after last dose of study treatment, up to 5 years
Pre-dose Plasma Concentration (Ctrough) of atirmociclib
Time Frame: Cycle 1 Day 15, Cycle 2 Day 1, and Cycle 3 Day 1; Cycle is defined as 28 days
Cycle 1 Day 15, Cycle 2 Day 1, and Cycle 3 Day 1; Cycle is defined as 28 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Study Director: Pfizer CT.gov Call Center, Pfizer

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

December 1, 2026

Primary Completion (Estimated)

April 13, 2032

Study Completion (Estimated)

August 20, 2042

Study Registration Dates

First Submitted

October 16, 2026

First Submitted That Met QC Criteria

October 16, 2026

First Posted (Actual)

October 22, 2026

Study Record Updates

Last Update Posted (Actual)

November 10, 2026

Last Update Submitted That Met QC Criteria

November 5, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • C4391026

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

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