Studie k vyhodnocení účinnosti a bezpečnosti ribociklibu s endokrinní terapií jako adjuvantní léčba u pacientek s HR+/HER2- časným karcinomem prsu (NATALEE)
Multicentrická, randomizovaná, otevřená studie fáze III k vyhodnocení účinnosti a bezpečnosti ribociklibu s endokrinní terapií jako adjuvantní léčba u pacientek s časným karcinomem prsu s pozitivním hormonálním receptorem a negativním HER2 (nová adjuvantní studie s ribociklibem [LEE011] : NATALEE)
A phase III, multicenter, randomized, open-label trial to evaluate the efficacy and safety of ribociclib with Endocrine Therapy (ET) as an adjuvant treatment in women and men with Hormone Receptor positive (HR+), Human Epidermal Growth Factor Receptor 2 negative (HER2-) Early Breast Cancer (EBC).
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Detailní popis
The trial will include pre and postmenopausal women and men with HR-positive, HER2-negative EBC, with an Anatomic Stage Group III, IIB or a subset of Stage IIA cases, after adequate surgical resection, radiotherapy (if indicated), adjuvant or neoadjuvant chemotherapy (if indicated), and who are deemed to be eligible for adjuvant ET for at least 60 months of duration.
Approximately 5,000 patients will be randomized (using an Interactive Response Technology system [IRT]) into two treatment arms in a 1:1 ratio to:
• Investigational arm:
~ Ribociclib 400 mg by mouth once daily on days 1 to 21 of a 28-day cycle, for 36 months since randomization (approximately 39 cycles).
And
~ ET consisting of:
- For postmenopausal women: letrozole 2.5 mg by mouth once daily continuously or anastrozole 1 mg by mouth once daily continuously.
- For premenopausal women and men: letrozole 2.5 mg by mouth once daily continuously or anastrozole 1 mg by mouth once daily continuously, combined with goserelin 3.6 mg subcutaneously once every 4 weeks.
Duration of ET in the trial will be 60 months from the randomization date.
• Control arm:
~ ET: Same as in the Investigational arm.
In both arms, ET will be administered according to the local clinical guidelines and current local prescribing information. Subsequent ET (or any other anti-cancer treatment) given after the protocol-required 60 months of ET (or after premature discontinuation of ET in the trial) will be administered according to the Investigator's clinical judgment and is not considered a trial treatment.
Randomization will be stratified by the following factors:
- Menopausal status: premenopausal women and men vs. postmenopausal women
- AJCC 8th edition Anatomic Stage Group: Anatomic Stage Group II vs. Anatomic Stage Group III
- Prior neoadjuvant/adjuvant chemotherapy: yes vs. no
- Geographical region: North America/Western Europe/Oceania vs. rest of the world
Enrollment of patients with Anatomic Stage Group II is capped at approximately 2,000 patients.
The trial will include screening, treatment, and follow up phases. The trial includes an exploratory component that requires collection of tumor and blood samples (except for patients enrolled in China).
Typ studie
Typ studie
Zápis (Aktuální)
Zápis
Fáze
Fáze
- Fáze 3
Rozšířený přístup
Rozšířený přístup
Dostupný
- Dostupné: Pro tuto zkoumanou léčbu je v současné době k dispozici rozšířený přístup a pacienti, kteří nejsou účastníky klinické studie, mohou získat přístup k léku, biologickému nebo lékařskému zařízení. právě se studuje.
- Již není k dispozici: Rozšířený přístup byl pro tento zásah k dispozici dříve, ale v současnosti není dostupný a nebude dostupný ani v budoucnu.
- Dočasně nedostupné: Rozšířený přístup není v současné době pro tento zásah k dispozici, ale očekává se, že bude dostupný v budoucnu.
- Schváleno pro marketing: Zásah byla schválena americkým Úřadem pro kontrolu potravin a léčiv pro použití veřejností.
Kontakty a umístění
Studijní místa
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CABA, Argentina, C1419AHN
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Córdoba, Argentina, X5004FHP
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La Rioja, Argentina, 5300
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San Salvador de Jujuy, Argentina, Y4600EHA
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Santa Fe Province
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Rosario, Santa Fe Province, Argentina, S2000
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Sante Fe
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Rosario, Sante Fe, Argentina, S200KZE
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San Miguel Tucuman, Tucumán Province, Argentina, T4000IAK
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Viedma
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Rio Negro, Viedma, Argentina, 8500
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Darlinghurst, New South Wales, Austrálie, 2010
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Saint-Cloud, Hauts De Seine, Francie, 92210
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Rennes, Ille Et Vilaine, Francie, 35062
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Grenoble, Isere, Francie, 38028
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Misterbianco, CT, Itálie, 95045
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Roma, RM, Itálie, 00128
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Candiolo, TO, Itálie, 10060
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Incheon, Jižní Korea, 22332
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Incheon, Jižní Korea, 21565
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Seongnam Gyeonggi, Jižní Korea, 13496
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Seoul, Jižní Korea, 03080
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Seoul, Jižní Korea, 05505
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Seoul, Jižní Korea, 03722
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Seoul, Jižní Korea, 06351
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Seoul, Jižní Korea, 06591
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Ulsan, Jižní Korea, 44033
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Daegu
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Seoul, Daegu, Jižní Korea, 41404
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Wŏnju, Gangwon-do, Jižní Korea, 26426
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Bundang Gu, Gyeonggi-do, Jižní Korea, 13620
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Korea
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Gyeonggi-do, Korea, Jižní Korea, 10408
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Seoul, Korea, Jižní Korea, 02841
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North Chungcheong
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Cheongju-si, North Chungcheong, Jižní Korea, 28644
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Seoul, Yangcheon Gu, Jižní Korea, 07985
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Calgary, Alberta, Kanada, T2N 4N2
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Kelowna, British Columbia, Kanada, V1Y 5L3
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Greater Sudbury, Ontario, Kanada, P3E 5J1
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Saint Petersburg, Rusko, 198255
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Saint Petersburg, Rusko, 191104
- Novartis Investigative Site
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Tyumen, Rusko, 625041
- Novartis Investigative Site
-
Ufa, Rusko, 450054
- Novartis Investigative Site
-
Yaroslavl, Rusko, 150054
- Novartis Investigative Site
-
-
Russian Federation
-
Kazan', Russian Federation, Rusko, 420029
- Novartis Investigative Site
-
-
Sankt-Peterburg
-
Saint Petersburg, Sankt-Peterburg, Rusko, 195271
- Novartis Investigative Site
-
-
-
-
-
Cardiff, Spojené království, CF14 2TL
- Novartis Investigative Site
-
London, Spojené království, SE1 9RT
- Novartis Investigative Site
-
London, Spojené království, SW3 6JJ
- Novartis Investigative Site
-
London, Spojené království, NW1 2BU
- Novartis Investigative Site
-
Nottingham, Spojené království, NG5 1PB
- Novartis Investigative Site
-
Oxford, Spojené království, OX3 7LE
- Novartis Investigative Site
-
Preston, Spojené království, PR2 9HT
- Novartis Investigative Site
-
Stoke-on-Trent, Spojené království, ST4 6QG
- Novartis Investigative Site
-
-
Cornwall
-
Truro, Cornwall, Spojené království, TR1 3LJ
- Novartis Investigative Site
-
-
Surrey
-
Sutton, Surrey, Spojené království, SM2 5PT
- Novartis Investigative Site
-
-
-
-
Alabama
-
Birmingham, Alabama, Spojené státy, 35294-0006
- University of Alabama at Birmingham-Kirklin Clinic
-
-
Arizona
-
Goodyear, Arizona, Spojené státy, 85338
- Cancer Treatment Centers of America
-
-
Arkansas
-
Jonesboro, Arkansas, Spojené státy, 72401
- St Bernards Medical Center
-
-
California
-
Bakersfield, California, Spojené státy, 93309
- Comprehensive Blood and Cancer
-
Beverly Hills, California, Spojené státy, 90212
- UCLA Beverly Hills
-
Burbank, California, Spojené státy, 91505
- UCLA Burbank
-
Encino, California, Spojené státy, 91436
- Encino Research Center
-
Fullerton, California, Spojené státy, 92835
- St. Jude Heritage Medical Group
-
Laguna Hills, California, Spojené státy, 92653
- UCLA Hematology Oncology
-
Los Angeles, California, Spojené státy, 90057
- Southern CA Oncology Rsrch Alliance
-
Palo Alto, California, Spojené státy, 94304-1509
- Stanford University Medical Center
-
Pasadena, California, Spojené státy, 91105
- UCLA Pasadena HC Hemato Onco
-
Porter Ranch, California, Spojené státy, 91326
- UCLA Porter Ranch Hemato and Onco
-
Redondo Beach, California, Spojené státy, 90277
- Cancer Care Associates Medical Grp
-
San Diego, California, Spojené státy, 92123
- Sharp Memorial Hospital
-
San Francisco, California, Spojené státy, 94115
- UCSF
-
Santa Maria, California, Spojené státy, 93454
- Central Coast Medical Oncology Corporation
-
Santa Monica, California, Spojené státy, 90404
- UCLA Santa Monica Hematology Oncology
-
Torrance, California, Spojené státy, 90509-2910
- Lundquist Inst BioMed at Harbor
-
Valencia, California, Spojené státy, 91355
- UCLA Valencia
-
Van Nuys, California, Spojené státy, 91405
- Valley Breast Care
-
Westlake Village, California, Spojené státy, 91361
- UCLA Cancer Center Westlake Village
-
-
Colorado
-
Aurora, Colorado, Spojené státy, 80045
- University Of Colorado Hospital
-
Denver, Colorado, Spojené státy, 80218
- Rocky Mountain Cancer Centers
-
-
Connecticut
-
New Britain, Connecticut, Spojené státy, 06052
- Hospital of Central Connecticut
-
New Haven, Connecticut, Spojené státy, 06520
- Yale University School Of Medicine
-
Norwalk, Connecticut, Spojené státy, 06856
- Norwalk Hospital
-
Norwich, Connecticut, Spojené státy, 06360
- Eastern Connecticut Hematology and Oncology Associates
-
-
Florida
-
Fort Lauderdale, Florida, Spojené státy, 33308
- Holy Cross Hospital-Ft. Lauderdale
-
Fort Myers, Florida, Spojené státy, 33901
- Florida Cancer Specialists
-
Hollywood, Florida, Spojené státy, 33021
- Memorial Cancer Institute
-
Jacksonville, Florida, Spojené státy, 32207
- Baptist MD Anderson Cancer Center
-
Miami, Florida, Spojené státy, 33136
- University of Miami
-
Orlando, Florida, Spojené státy, 32806
- Orlando Health Clinical Trials
-
St. Petersburg, Florida, Spojené státy, 33705
- Florida Cancer Specialists-North
-
Tallahassee, Florida, Spojené státy, 32308
- Florida Cancer Specialists Pan
-
West Palm Beach, Florida, Spojené státy, 33401
- Florida Cancer Specialists
-
-
Georgia
-
Atlanta, Georgia, Spojené státy, 30322
- Winship Cancer Institute of Emory University
-
Newnan, Georgia, Spojené státy, 30265
- Southeastern Regional Medical Center
-
-
Illinois
-
Zion, Illinois, Spojené státy, 60099
- Cancer Treatment Centers of America
-
-
Indiana
-
New Albany, Indiana, Spojené státy, 47150
- Cancer Care Center
-
-
Kansas
-
Westwood, Kansas, Spojené státy, 66205
- University of Kansas Cancer Center
-
Wichita, Kansas, Spojené státy, 67214-3728
- Cancer Center of Kansas
-
-
Kentucky
-
Louisville, Kentucky, Spojené státy, 40202
- Norton Cancer Institute
-
-
Maryland
-
Baltimore, Maryland, Spojené státy, 21202
- Mercy Medical Center
-
-
Massachusetts
-
Boston, Massachusetts, Spojené státy, 02114
- Massachusetts General Hospital
-
-
Michigan
-
Ann Arbor, Michigan, Spojené státy, 48109
- University of Michigan Cancer Center
-
-
Minnesota
-
Maple Grove, Minnesota, Spojené státy, 55369
- Fairview Health Services
-
Saint Louis Park, Minnesota, Spojené státy, 55416
- Park Nicollet Institute
-
Saint Louis Park, Minnesota, Spojené státy, 55416
- Metro Minnesota CCOP
-
-
Missouri
-
Kansas City, Missouri, Spojené státy, 64132
- HCA Midwest Division
-
Kansas City, Missouri, Spojené státy, 64111
- Saint Lukes Hospital of Kansas City
-
St Louis, Missouri, Spojené státy, 63141
- David C Pratt Cancer Center
-
-
Montana
-
Billings, Montana, Spojené státy, 59102
- St Vincent Frontier Cancer Center
-
-
Nebraska
-
Grand Island, Nebraska, Spojené státy, 68803
- Saint Francis Medical Center
-
-
Nevada
-
Henderson, Nevada, Spojené státy, 89052
- Comprehensive Cancer Cntr Of Nevada
-
-
New Jersey
-
Livingston, New Jersey, Spojené státy, 07039
- Saint Barnabas Medical Center
-
-
New York
-
New York, New York, Spojené státy, 10016
- Perlmutter Cancer Centre
-
-
North Carolina
-
Asheboro, North Carolina, Spojené státy, 27204
- Randolph Medical Associates
-
Greensboro, North Carolina, Spojené státy, 27403
- Cone Health Cancer Center
-
-
Oregon
-
Clackamas, Oregon, Spojené státy, 97015
- Kaiser Permanente NW Region
-
-
Pennsylvania
-
Hershey, Pennsylvania, Spojené státy, 17033
- Penn State Hershey Cancer Institute
-
Philadelphia, Pennsylvania, Spojené státy, 19124
- Cancer Treatment Centers of America Eastern Regional Medical Center
-
-
Tennessee
-
Germantown, Tennessee, Spojené státy, 38138
- The West Clinic
-
Nashville, Tennessee, Spojené státy, 37203
- Sarah Cannon Research Institute
-
-
Texas
-
Dallas, Texas, Spojené státy, 75246
- Baylor Charles A Sammons Cancer Cnt
-
Fort Worth, Texas, Spojené státy, 76104
- Ctr For Cancer And Blood Disorders
-
Houston, Texas, Spojené státy, 77030
- MD Anderson Cancer Center University of Texas
-
-
Utah
-
Salt Lake City, Utah, Spojené státy, 84106
- Utah Cancer Specialists
-
-
Virginia
-
Fairfax, Virginia, Spojené státy, 22031
- Virginia Cancer Specialists
-
Richmond, Virginia, Spojené státy, 23230
- Virginia Cancer Institute
-
-
Washington
-
Seattle, Washington, Spojené státy, 98109
- Fred Hutchinson Cancer Center
-
-
Wisconsin
-
Madison, Wisconsin, Spojené státy, 53792-6164
- University of Wisconsin Paul P Carbone Comp Cancer Center
-
-
-
-
-
Changhua, Tchaj-wan, 50006
- Novartis Investigative Site
-
Taichung, Tchaj-wan, 40447
- Novartis Investigative Site
-
Taichung, Tchaj-wan, 407219
- Novartis Investigative Site
-
Tainan, Tchaj-wan, 704302
- Novartis Investigative Site
-
Taipei, Tchaj-wan, 10002
- Novartis Investigative Site
-
Taipei, Tchaj-wan, 11217
- Novartis Investigative Site
-
Taipei, Tchaj-wan, 10449
- Novartis Investigative Site
-
Taipei, Tchaj-wan, 103616
- Novartis Investigative Site
-
Taoyuan, Tchaj-wan, 33305
- Novartis Investigative Site
-
-
-
-
-
Beijing, Čína, 100021
- Novartis Investigative Site
-
Chongqing, Čína, 400016
- Novartis Investigative Site
-
Shanghai, Čína, 200032
- Novartis Investigative Site
-
Tianjin, Čína, 300480
- Novartis Investigative Site
-
Zhenjiang, Čína, 310009
- Novartis Investigative Site
-
-
Guangdong
-
Guangzhou, Guangdong, Čína, 510000
- Novartis Investigative Site
-
-
Hebei
-
Shijiazhuang, Hebei, Čína, 050011
- Novartis Investigative Site
-
-
Heilongjiang
-
Harbin, Heilongjiang, Čína, 150081
- Novartis Investigative Site
-
-
Henan
-
Zhengzhou, Henan, Čína, 450008
- Novartis Investigative Site
-
-
Hubei
-
Wuhan, Hubei, Čína, 430022
- Novartis Investigative Site
-
-
Jiangsu
-
Nanjing, Jiangsu, Čína, 210029
- Novartis Investigative Site
-
Suzhou, Jiangsu, Čína, 215004
- Novartis Investigative Site
-
-
Jilin
-
Changchun, Jilin, Čína, 130021
- Novartis Investigative Site
-
-
Sichuan
-
Chengdu, Sichuan, Čína, 610041
- Novartis Investigative Site
-
-
Zhejiang
-
Hangzhou, Zhejiang, Čína, 310016
- Novartis Investigative Site
-
-
-
-
-
A Coruña, Španělsko, 15009
- Novartis Investigative Site
-
A Coruña, Španělsko, 15006
- Novartis Investigative Site
-
Barcelona, Španělsko, 08035
- Novartis Investigative Site
-
Barcelona, Španělsko, 08036
- Novartis Investigative Site
-
Burgos, Španělsko, 09006
- Novartis Investigative Site
-
Castellon, Španělsko, 12002
- Novartis Investigative Site
-
Córdoba, Španělsko, 14004
- Novartis Investigative Site
-
Girona, Španělsko, 17007
- Novartis Investigative Site
-
Granada, Španělsko, 18016
- Novartis Investigative Site
-
Las Palmas GC, Španělsko, 35010
- Novartis Investigative Site
-
Madrid, Španělsko, 28034
- Novartis Investigative Site
-
Madrid, Španělsko, 28033
- Novartis Investigative Site
-
Madrid, Španělsko, 28040
- Novartis Investigative Site
-
Madrid, Španělsko, 28009
- Novartis Investigative Site
-
Madrid, Španělsko, 28222
- Novartis Investigative Site
-
Murcia, Španělsko, 30008
- Novartis Investigative Site
-
Málaga, Španělsko, 29010
- Novartis Investigative Site
-
Salamanca, Španělsko, 37007
- Novartis Investigative Site
-
Seville, Španělsko, 41009
- Novartis Investigative Site
-
Seville, Španělsko, 41013
- Novartis Investigative Site
-
Valencia, Španělsko, 46014
- Novartis Investigative Site
-
Valencia, Španělsko, 46010
- Novartis Investigative Site
-
Zaragoza, Španělsko, 50009
- Novartis Investigative Site
-
-
Alicante
-
Elche, Alicante, Španělsko, 03203
- Novartis Investigative Site
-
-
Andalusia
-
Granada, Andalusia, Španělsko, 18014
- Novartis Investigative Site
-
Huelva, Andalusia, Španělsko, 21005
- Novartis Investigative Site
-
Jaén, Andalusia, Španělsko, 23007
- Novartis Investigative Site
-
-
Araba
-
Vitoria-Gasteiz, Araba, Španělsko, 01009
- Novartis Investigative Site
-
-
Barcelona
-
Badalona, Barcelona, Španělsko, 08916
- Novartis Investigative Site
-
L'Hospitalet de Llobregat, Barcelona, Španělsko, 08907
- Novartis Investigative Site
-
Manresa, Barcelona, Španělsko, 08242
- Novartis Investigative Site
-
Sabadell, Barcelona, Španělsko, 08208
- Novartis Investigative Site
-
-
Bizkaia
-
Bilbao, Bizkaia, Španělsko, 48013
- Novartis Investigative Site
-
-
Extremadura
-
Badajoz, Extremadura, Španělsko, 06080
- Novartis Investigative Site
-
Cáceres, Extremadura, Španělsko, 10003
- Novartis Investigative Site
-
-
Galicia
-
Lugo, Galicia, Španělsko, 27003
- Novartis Investigative Site
-
-
Gipuzkoa
-
Donostia / San Sebastian, Gipuzkoa, Španělsko, 20014
- Novartis Investigative Site
-
-
Madrid
-
Fuenlabrada, Madrid, Španělsko, 28942
- Novartis Investigative Site
-
-
Murcia
-
El Palmar, Murcia, Španělsko, 30120
- Novartis Investigative Site
-
-
Navarre
-
Pamplona, Navarre, Španělsko, 31008
- Novartis Investigative Site
-
-
Pontevedra
-
Vigo, Pontevedra, Španělsko, 36212
- Novartis Investigative Site
-
-
Santa Cruz De Tenerife
-
San Cristóbal de La Laguna, Santa Cruz De Tenerife, Španělsko, 38320
- Novartis Investigative Site
-
-
Valencia
-
Alicante, Valencia, Španělsko, 03550
- Novartis Investigative Site
-
Valencia, Valencia, Španělsko, 46009
- Novartis Investigative Site
-
-
Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria
-
Signed and dated Patient Informed Consent Form (PICF) obtained prior to any trial-specific screening procedure.
-
Patient is ≥ 18 years-old at the time of PICF signature.
-
Patient is female with known menopausal status at the time of randomization or initiation of adjuvant ET (whichever occurs earlier), or male.
Postmenopausal status is defined as:
- Patient underwent bilateral oophorectomy, or
- Age ≥ 60 years, or
- Age < 60 years and amenorrhea for 12 or more months (in the absence of chemotherapy, tamoxifen, toremifene or ovarian suppression) and Follicle-stimulating hormone (FSH) and plasma estradiol are in the postmenopausal ranges per local normal ranges.
- If taking tamoxifen or toremifene and age <60 years, then FSH and plasma estradiol level in postmenopausal ranges.
Notes
- In women who are premenopausal at the beginning of adjuvant chemotherapy, amenorrhea is not a reliable indicator of menopausal status as ovarian function may still be intact or resume despite anovulation/amenorrhea. For these women with therapy-induced amenorrhea, serial measurements of FSH and/or estradiol per local clinical guidelines are required for determination of postmenopausal status.
- All women who do not meet the criteria for postmenopausal status are considered premenopausal for the purpose of this trial.
-
Patient with histologically confirmed unilateral primary invasive adenocarcinoma of the breast with a date of initial cytologic or histologic diagnosis (i.e. date of the pathology report that confirmed the BC diagnosis) within 18 months prior to randomization. Patient with a multicentric and/or multifocal tumor is eligible if all histopathologically examined lesions meet the pathologic criteria in inclusion criteria 5 and 6.
-
Patient has breast cancer that is positive for ER and/or PgR according to the local laboratory as determined on the most recently analyzed tissue sample.
-
Patient has HER2-negative breast cancer defined as a negative in situ hybridization test or an immunohistochemistry (IHC) status of 0 or 1+. If IHC is 2+, a negative in situ hybridization (FISH, CISH, or SISH) test is required to confirm the HER2-negative status (based on the most recently analyzed tissue sample tested by a local laboratory).
-
Patient (except those enrolled in China) has available archival tumor tissue from the surgical specimen, for submission to a central laboratory (Note: in patients that underwent neoadjuvant systemic therapy and had a pathologic complete response, archival tumor tissue at the time of the initial diagnosis or before the administration of neoadjuvant therapy is mandatory).
-
Patient, after surgical resection where tumor was removed completely, with the final surgical specimen microscopic margins free from tumor, and belongs to one of the following categories:
- Anatomic Stage Group III, or
- Anatomic Stage Group IIB, or
- Anatomic Stage Group IIA (subset)
Notes:
- For patients whose tumors are Anatomic Stage IIA, N0:
- If Grade is 1 or unknown (Gx), patient is not eligible.
- If Grade 2, the gene expression test results (by Oncotype DX, Prosigna/PAM50, MammaPrint or EndoPredict EPclin) or Ki67 levels should be used if obtained as per local practice (i.e. are not mandatory for the purpose of the trial). Results must be available at screening.
- Patients that received neoadjuvant treatment must meet the above criteria (for stage, and if Stage IIA, N0, also for grade and Ki67 or gene expression test) in any presurgical staging/sample and/or in the surgical specimen.
- Categorization into the AJCC 8th edition Anatomic Stage Groups requires determination of the T, N and M categories. ALND is the preferred method for axillary lymph node staging, however SLN dissection can be used to determine the N category in the following cases:
- No metastasis in SLN (patient is considered as pN0).
- Only micrometastasis in SLN (patient is considered as pN1mi).
- Patients with T1-2 and no clinically-evident nodes prior to surgery, no neoadjuvant chemotherapy, at least one macrometastasis in 1 or 2 SLNs, no matted nodes or gross extranodal disease at the time of SLN dissection (patient is considered as pN1).
In all other cases, ALND is required to determine the N category.
-
If indicated, patient has completed adjuvant and/or neoadjuvant chemotherapy according to the institutional guidelines, prior to screening.
-
If indicated, patient has completed adjuvant radiotherapy according to the institutional guidelines, prior to screening.
-
Patient has no contraindication for the adjuvant ET in the trial and is planned to be treated with ET for 5 years (since randomization date) or more.
-
Patient may have already received any standard neoadjuvant and/or adjuvant ET at the time of PICF signature, but randomization should occur within 12 months of the initial start date of ET. Ovarian suppression or short term ET for fertility preservation is not considered neoadjuvant/adjuvant ET. If patient was receiving tamoxifen or toremifene as adjuvant ET, a washout period of 5 half-lives (i.e. 35 days) prior to randomization is required (during that period patient can take AI).
-
Patient has an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1.
-
Patient has adequate bone marrow and organ function as defined by the following local laboratory values:
- Absolute neutrophil count (ANC) ≥ 1.5 × 109/L
- Platelets ≥ 100 × 109/L
- Hemoglobin ≥ 9.0 g/dL
- Estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73m2 according to the Modification of Diet in Renal Disease (MDRD) formula
- Alanine transaminase (ALT) < 2.5 × Upper Limit Normal (ULN)
- Aspartate transaminase (AST) < 2.5 × ULN
- Total serum bilirubin < ULN; or total bilirubin ≤ 3.0 × ULN or direct bilirubin ≤ 1.5 × ULN in patients with well documented Gilbert's Syndrome
- International normalized ratio (INR) ≤ 1.5 (unless the patient is receiving anticoagulants and the INR is within the therapeutic range of intended use for that anticoagulant within 7 days prior to randomization)
- Patient must have the following laboratory values within normal limits or corrected to within normal limits with supplements (the local laboratory value should be documented within normal limits after the correction) before randomization:
- Potassium
- Magnesium
- Total Calcium (corrected for serum albumin)
-
Standard 12-lead ECG values assessed by a central laboratory, as:
- QTcF interval (QT interval using Fridericia's correction) at screening < 450 milliseconds (msec)
- Resting heart rate 50-90 beats per minute (determined from the ECG)
-
Patient must be willing and able to comply with scheduled visits, treatment plans, laboratory tests, and other trial procedures.
-
Women of childbearing potential (CBP), defined as all women physiologically capable of becoming pregnant (see Inclusion Criterion #18 for additional information), must have confirmed negative serum pregnancy test (for β-hCG) within 14 days prior to randomization.
-
Women of CBP must be willing to use highly effective methods of contraception. Contraception must continue during the trial treatment and for 21 days after stopping the treatment. Highly effective contraception methods include:
- Total abstinence (when this is in line with the preferred and usual lifestyle of the patient). Periodic abstinence (e.g. calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception.
- Female sterilization (have had surgical bilateral oophorectomy with or without hysterectomy), total hysterectomy or tubal ligation at least 6 weeks before taking trial treatment. In case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow up hormone level assessment.
- Male partner sterilization (at least 6 months prior to randomization). For female patients on the trial the vasectomized male partner should be the sole partner for that patient. If vasectomy of the male partner is the highly effective method of contraception chosen, the success of the vasectomy should be medically confirmed according to local practice.
- Placement of an intrauterine device (IUD).
Notes:
- Use of oral (estrogen and progesterone), transdermal, injected, implanted, hormone containing intrauterine system or any other hormonal method of contraception is not allowed in this trial.
- Women are considered of CBP unless: they have had ≥ 12 months of natural (spontaneous) amenorrhea with an appropriate clinical profile (i.e. age appropriate, history of vasomotor symptoms) or have had surgical bilateral oophorectomy (with or without hysterectomy), total hysterectomy, or tubal ligation at least six weeks prior to randomization. In the case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow-up hormone level assessment she is considered not of CBP.
- After the end of trial treatment, patients should use effective contraception according to local guidelines.
Exclusion Criteria
-
Patient has received any CDK4/6 inhibitor.
-
Patient has received prior treatment with tamoxifen, raloxifene or AIs for reduction in risk ("chemoprevention") of breast cancer and/or treatment for osteoporosis within the last 2 years prior to randomization. Patient is concurrently using hormone replacement therapy.
-
Patient has received prior treatment with anthracyclines at cumulative doses of 450 mg/m² or more for doxorubicin, or 900 mg/m² or more for epirubicin.
-
Patient with a known hypersensitivity to any of the excipients of ribociclib and/or ET (e.g. rare hereditary problems of galactose intolerance, the Lapp lactase deficiency, glucose-galactose malabsorption, and soy allergy).
-
Patient with distant metastases of breast cancer beyond regional lymph nodes (stage IV according to AJCC 8th edition) and/or evidence of recurrence after curative surgery.
-
Patient is concurrently using other anti-neoplastic therapy with the exception of adjuvant ET (see Inclusion Criterion #12).
-
Patient has had major surgery, chemotherapy or radiotherapy within 14 days prior to randomization.
-
Patient has not recovered from clinical and laboratory acute toxicities related to prior anti-cancer therapies to a NCI CTCAE (National Cancer Institute Common Terminology Criteria for Adverse Events) version 4.03 Grade ≤1 at day of randomization. Exceptions to this criterion: patients with any grade of alopecia, amenorrhea, grade 2 neuropathy are allowed to enter the trial or other toxicities not considered a safety risk for the patient as per Investigator's discretion, are allowed to enter the trial.
-
Patient has a concurrent invasive malignancy or a prior invasive malignancy whose treatment was completed within 2 years before randomization. Note: Patients with adequately treated, basal or squamous cell skin carcinoma or curatively resected cervical cancer in situ are eligible.
-
Patient has known history of human immunodeficiency virus (HIV) infection (testing is not mandatory, unless required by local regulation).
-
Patient has known active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection (testing is not mandatory, unless required by local regulation).
-
Clinically significant, uncontrolled heart disease and/or cardiac repolarization abnormality, including any of the following:
- History of documented myocardial infarction (MI), angina pectoris, symptomatic pericarditis, or coronary artery bypass graft within 6 months prior to trial entry.
- Documented cardiomyopathy.
- Left Ventricular Ejection Fraction (LVEF) < 50% as determined by Multiple Gated acquisition (MUGA) scan or echocardiogram (ECHO) (testing not mandatory)
- Long QT syndrome or family history of idiopathic sudden death or congenital long QT syndrome, or any of the following:
- Risk factors for Torsades de Pointes (TdP) including uncorrected hypocalcemia, hypokalemia or hypomagnesemia, history of cardiac failure, or history of clinically significant/symptomatic bradycardia.
- Concomitant medication(s) with a known risk to prolong the QT interval and/or known to cause TdP that cannot be discontinued or replaced by safe alternative medication (e.g. within 5 half-lives or 7 days prior to starting trial treatment).
- Inability to determine the QTcF interval.
- Clinically significant cardiac arrhythmias (e.g. ventricular tachycardia), complete left bundle branch block, high-grade Atrioventricular (AV) block (e.g. bifascicular block, Mobitz type II and third degree AV block).
- Uncontrolled arterial hypertension with systolic blood pressure > 160 mmHg.
-
Patient is currently receiving any of the following substances within 7 days before randomization:
- Concomitant medications, herbal supplements, and/or fruits (e.g. grapefruit, pummellos, starfruit, Seville oranges) and their juices that are known as strong inhibitors or inducers of CYP3A4/5
- Medications that have a narrow therapeutic window and are predominantly metabolized through CYP3A4/5
-
Patient is currently receiving or has received systemic corticosteroids ≤ 2 weeks prior to starting trial treatment, or has not fully recovered from side effects of such treatment.
Note: The following uses of corticosteroids are permitted: a short duration (<5 days) of systemic corticosteroids; any duration of topical applications (e.g. for rash), inhaled sprays (e.g. for obstructive airways diseases), eye drops or local injections (e.g. intra-articular).
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Patient has impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of the oral trial treatments (e.g. uncontrolled ulcerative diseases, uncontrolled nausea, vomiting or diarrhea, malabsorption syndrome, or small bowel resection).
-
Patient has any other concurrent severe and/or uncontrolled medical condition that would, in the Investigator's judgment, cause unacceptable safety risks, contraindicate patient participation in the clinical trial or compromise compliance with the protocol (e.g. chronic pancreatitis, chronic active hepatitis, liver cirrhosis or any other significant liver disease, active untreated or uncontrolled fungal, bacterial or viral infections, active infection requiring systemic anti-bacterial therapy, etc.) or limit life expectancy to ≤5 years.
-
Participation in other studies involving investigational drug(s) within 30 days prior to randomization or within 5 half-lives of the investigational drug(s) (whichever is longer), or participation in any other type of medical research judged not to be scientifically or medically compatible with this trial. If the patient is enrolled or planned to be enrolled in another study that does not involve an investigational drug, the agreement of the Medical Monitor is required to establish eligibility.
-
Pregnant or breast-feeding (lactating) women or women who plan to become pregnant or breast-feed during the trial.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Žádné (otevřený štítek)
Počet zbraní
Zbraně a zásahy
Skupina účastníků / ArmSkupina účastníků / Arm |
Intervence / LéčbaIntervence / Léčba |
|---|---|
|
Experimentální: Ribociclib + Endocrine Therapy (ET)
Eligible participants will receive Ribociclib 400 mg once daily on days 1 to 21 of a 28-day cycle, followed by 7 days off ribociclib (Days 22 to 28). And Endocrine Therapy (ET) consisting of:
|
Ribociclib orally taken at 400 mg on days 1 to 21 of a 28-day cycle
Ostatní jména:
Endocrine Therapy (ET) will be administered according to the local clinical guidelines and current local prescribing information |
|
Aktivní komparátor: Endocrine Therapy (ET)
Eligible participants will receive Endocrine Therapy (ET) consisting of:
|
Endocrine Therapy (ET) will be administered according to the local clinical guidelines and current local prescribing information |
Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Invasive Disease-Free Survival (iDFS)
Časové okno: Up to approximately 139 months
|
Invasive Disease-Free Survival (iDFS) is defined as the time from the date of randomization to the date of the first event of local invasive breast recurrence, regional invasive recurrence, distant recurrence, death (any cause), contralateral invasive BC, or second primary non-breast invasive cancer (excluding basal and squamous cell carcinomas of the skin). iDFS will be assessed locally using STEEP criteria (Standardized Definitions for Efficacy End Points in Adjuvant Breast Cancer Trials). |
Up to approximately 139 months
|
Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Recurrence-free survival (RFS)
Časové okno: Up to approximately 139 months
|
Recurrence-free survival (RFS) is defined as the time from date of randomization to date of first event of local invasive breast recurrence, regional invasive recurrence, distant recurrence, or death (any cause) and will be assessed using STEEP criteria (Standardized Definitions for Efficacy End Points in Adjuvant Breast Cancer Trials). |
Up to approximately 139 months
|
|
Distant disease-free survival (DDFS)
Časové okno: Up to approximately 139 months
|
Distant disease-free survival (DDFS) is defined as the time from date of randomization to date of first event of distant recurrence, death (any cause), or second primary non-breast invasive cancer (excluding basal and squamous cell carcinomas of the skin) and will be assessed using STEEP criteria (Standardized Definitions for Efficacy End Points in Adjuvant Breast Cancer Trials). |
Up to approximately 139 months
|
|
Overall Survival (OS)
Časové okno: Up to approximately 139 months
|
Overall Survival (OS) is defined as the time from date of randomization to date of death due to any cause. |
Up to approximately 139 months
|
|
Change from baseline in the global health status Quality of life scale score as assessed by EORTC QLQ-C30
Časové okno: Up to approximately 139 months
|
The EORTC QLQ-C30 contains functional scales, symptom scales, single items scale and a global health status/QoL scale. All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level. |
Up to approximately 139 months
|
|
Change from baseline in the physical functioning sub-scale score as assessed by EORTC QLQ-C30
Časové okno: Up to approximately 139 months
|
The EORTC QLQ-C30 contains functional scales, symptom scales, single items scale and a global health status/QoL scale. All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level. |
Up to approximately 139 months
|
|
Trough Concentration on Day 15 (Ctrough,D1) of ribociclib
Časové okno: Cycle 1 Day 15 (0/Pre-dose, 2 and 4 hours post-dose)
|
Venous whole blood samples will be collected for activity-based pharmacokinetics characterization in a subset of participants. Ctrough,D15 of ribociclib will be listed and summarized using descriptive statistics. |
Cycle 1 Day 15 (0/Pre-dose, 2 and 4 hours post-dose)
|
Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Spolupracovníci
Spolupracovníci
Vyšetřovatelé
Vyšetřovatelé
- Ředitel studie: Novartis Pharmaceuticals, Novartis Pharmaceuticals
Publikace a užitečné odkazy
Obecné publikace
- Slamon D, Lipatov O, Nowecki Z, McAndrew N, Kukielka-Budny B, Stroyakovskiy D, Yardley DA, Huang CS, Fasching PA, Crown J, Bardia A, Chia S, Im SA, Ruiz-Borrego M, Loi S, Xu B, Hurvitz S, Barrios C, Untch M, Moroose R, Visco F, Afenjar K, Fresco R, Severin I, Ji Y, Ghaznawi F, Li Z, Zarate JP, Chakravartty A, Taran T, Hortobagyi G. Ribociclib plus Endocrine Therapy in Early Breast Cancer. N Engl J Med. 2024 Mar 21;390(12):1080-1091. doi: 10.1056/NEJMoa2305488.
- Slamon DJ, Fasching PA, Hurvitz S, Chia S, Crown J, Martin M, Barrios CH, Bardia A, Im SA, Yardley DA, Untch M, Huang CS, Stroyakovskiy D, Xu B, Moroose RL, Loi S, Visco F, Bee-Munteanu V, Afenjar K, Fresco R, Taran T, Chakravartty A, Zarate JP, Lteif A, Hortobagyi GN. Rationale and trial design of NATALEE: a Phase III trial of adjuvant ribociclib + endocrine therapy versus endocrine therapy alone in patients with HR+/HER2- early breast cancer. Ther Adv Med Oncol. 2023 May 29;15:17588359231178125. doi: 10.1177/17588359231178125. eCollection 2023.
- Fasching PA, Stroyakovskiy D, Yardley DA, Huang CS, Crown J, Bardia A, Chia S, Im SA, Martin M, Xu B, Loi S, Barrios C, Untch M, Moroose R, Visco F, Hortobagyi GN, Slamon DJ, Fresco R, Zarate JP, Li Z, Waters S, Hurvitz SA. Ribociclib Plus Endocrine Therapy in Hormone Receptor-Positive/ERBB2-Negative Early Breast Cancer: 4-Year Outcomes From the NATALEE Randomized Clinical Trial. JAMA Oncol. 2025 Nov 1;11(11):1364-1372. doi: 10.1001/jamaoncol.2025.3700.
- Ji Y, Wang C, Combes FP, Ho YY, Fasching PA, Untch M, Zarate JP, Crown J. Quantitative Pharmacology Justifying Ribociclib Dose in Early Breast Cancer. Clin Pharmacokinet. 2026 Aug;65(8):1217-1228. doi: 10.1007/s40262-026-01643-3. Epub 2026 Jun 23.
- Rugo HS, Harbeck N, Hortobagyi GN, O'Shaughnessy J, Huang CS, Martin M, Juric D, Pistilli B, Xu B, De Laurentiis M, Untch M, Afenjar K, Gao M, Li Z, Bolotova N, Waters S, Barrios C. Safety and treatment duration of ribociclib + nonsteroidal aromatase inhibitor in HR+/HER2- early breast cancer: a phase 3 randomized controlled trial (NATALEE). Breast Cancer Res. 2026 Aug 4;28(1):186. doi: 10.1186/s13058-026-02352-2.
- Slamon DJ, Hortobagyi GN, Stroyakovskiy D, Yardley DA, Huang CS, Crown J, Bardia A, Chia S, Im SA, Martin M, Loi S, Xu B, Hurvitz SA, Barrios CH, Fernandez AC, Untch M, Visco F, Perez AL, Miller M, Majumdar S, Peyrard S, Taran T, Fasching PA. Overall survival with adjuvant ribociclib plus nonsteroidal aromatase inhibitor in patients with high-risk HR+/HER2- early breast cancer: Six-year follow-up of the NATALEE trial. Ann Oncol. 2026 Oct 23:S0923-7534(26)08640-0. doi: 10.1016/j.annonc.2026.10.1288. Online ahead of print.
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Začátek studia
Primární dokončení (Odhadovaný)
Primární dokončení
Dokončení studie (Odhadovaný)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
Další identifikační čísla studie
- CLEE011O12301C
- 2023-510357-42-00 (Identifikátor registru: EU CT Number)
- TRIO033 (Jiný identifikátor: Translational Research in Oncology)
- 2023 (Grant/smlouva NIH USA)
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Popis plánu IPD
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations.
This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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