- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT02690480
Fulvestrant (F)+Placebo vs F+Palbociclib First Line for Postmenopausal Hormone Receptor+ Advanced Breast Cancer (FLIPPER)
Phase II Study to Compare Fulvestrant (F) 500mg Plus Placebo vs F 500mg Plus Palbociclib as First Line Treatment for Postmenopausal Women With Hormone Receptor Positive Advanced Breast Cancer Sensitive to Endocrine Therapy. GEICAM/2014-12
Přehled studie
Postavení
Podmínky
Intervence / Léčba
Detailní popis
Patients must have at least one lesion (measurable and/or non-measurable) that can be accurately assessed at baseline and is suitable for repeated assessment by CT, MRI or plan x-ray. Patients with bone-only disease must have a lytic or mixed (lytic + blastic) lesion, which has not been previously irradiated and can be accurately assessed by CT/MRI or x-ray. Approximately 190 patients will be randomized 1:1 between the experimental arm (approximately 95 patients treated with fulvestrant plus palbociclib) and the control arm (approximately 95 patients treated with fulvestrant plus placebo).
Primary Objective:
• To compare the efficacy of fulvestrant in combination with palbociclib versus fulvestrant plus placebo in terms of the rate of Progression-Free Survival (PFS) at 1 year in postmenopausal women with HR-positive/HER2-negative metastatic breast cancer previously treated with endocrine therapy for at least 5 years and remaining disease free for more than 12 months following its completion or have "de novo" metastatic disease
Typ studie
Zápis (Aktuální)
Fáze
- Fáze 2
Kontakty a umístění
Studijní místa
-
-
-
Cork, Irsko
- Bon Secours Hospital
-
Dublin, Irsko
- Beaumont Hospital
-
Dublin, Irsko
- Mater Misericordiae University Hospital
-
Galway, Irsko
- Galway University Hospital
-
Waterford, Irsko
- University Hospital Waterford
-
-
-
-
-
A Coruña, Španělsko, 15009
- Centro Oncológico de Galicia
-
Barcelona, Španělsko, 08003
- Hospital del Mar
-
Barcelona, Španělsko, 08916
- Hospital Universitario Germans Trias i Pujol
-
Barcelona, Španělsko, 08026
- Hospital de la Santa Creu y Sant Pau
-
Córdoba, Španělsko, 14004
- Hospital Universitario Reina Sofia
-
Jaen, Španělsko, 23007
- Complejo Hospitalario de Jaén
-
Leon, Španělsko, 24080
- Complejo Asistencial Universitario de León
-
Madrid, Španělsko, 28034
- Hospital Universitario Ramón y Cajal
-
Madrid, Španělsko, 28040
- Hospital Clinico Universitario San Carlos
-
Madrid, Španělsko, 28492
- Hospital Universitario de Fuenlabrada
-
Málaga, Španělsko, 29011
- Hospital Regional Universitario de Malaga
-
Sevilla, Španělsko, 41013
- Hospital Universitario Virgen del Rocio
-
Sevilla, Španělsko, 41009
- Hospital Universitario Virgen De La Macarena
-
Sevilla, Španělsko, 41014
- Hospital Universitario de Valme
-
Sevilla, Španělsko, 41013
- Hospital Quirón Sagrado Corazón de Sevilla
-
Valencia, Španělsko, 46010
- Hospital Clinico Universitario de Valencia
-
Valencia, Španělsko, 46014
- Hospital General Universitario Valencia
-
Valencia, Španělsko, 46026
- Hospital Universitario i Politecnic la Fe
-
Zaragoza, Španělsko, 50009
- Hospital Universitario Miguel Servet
-
-
Asturias
-
Oviedo, Asturias, Španělsko, 33011
- Hospital Universitario Central de Asturias
-
-
Baleares
-
Palma De Mallorca, Baleares, Španělsko, 07198
- Hospital Son Llatzer
-
Palma de Mallorca, Baleares, Španělsko, 07120
- Hospital Universitari Son Espases
-
-
Barcelona
-
Terrassa, Barcelona, Španělsko, 08221
- Hospital Universitario Mutua Terrassa
-
-
Madrid
-
Parla, Madrid, Španělsko, 28981
- Hospital Universitario Infanta Cristina
-
Pozuelo de Alarcón, Madrid, Španělsko, 28223
- Hospital Universitario Quiron de Madrid
-
-
Pontevedra
-
Vigo, Pontevedra, Španělsko, 36204
- Complejo Hospitalario Universitario Vigo
-
-
Tarragona
-
Reus, Tarragona, Španělsko, 43204
- Hospital Universitario Sant Joan Reus
-
-
Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
- The patient has signed and dated the informed consent document and it has been obtained before conducting any procedure specifically for the study.
- Availability of a tumor tissue sample, archival (primary tumour) or from the metastatic lesions (preferable) for the central ER, PgR and HER2 testing.
- Histological/cytological confirmation of breast cancer with evidence of metastatic disease (loco-regional or distant), not amenable to resection or radiation therapy with curative intent.
- Documented positive hormone receptor status (> or = 1% of tumour cells with oestrogen receptor [ER] and/or progesterone receptor [PgR] expression) based on central testing on the most recent tumour biopsy.
- Documented HER2-negative tumour based on central testing on the most recent tumour biopsy. HER2-negative tumour is determined as immunohistochemistry score 0/1+ or negative by in situ hybridization (FISH/CISH/SISH) defined as a HER2/CEP17 ratio <2 or for single probe assessment a HER2 copy number <4.
- Patients must have received at least 5 years of endocrine therapy in the adjuvant setting as treatment for early disease and remained disease free for more than 12 months following its completion or have "de novo" metastatic disease. Patients that have been scheduled 5 years with adjuvant endocrine therapy and stopped treatment, by patient's own decision, after completing at least 3 years of treatment, can be also be included as long as they have remained free of disease 3 years after discontinuing the endocrine therapy.
- Patients must have at least one lesion (measurable and/or non-measurable) that can be accurately assessed at baseline and is suitable for repeated assessment by CT, MRI, plan x-ray or physical examination. Clinical lesions will only be considered measurable when they are superficial and ≥10mm diameter as assessed using callipers (e.g. skin nodules). Patients with bone-only disease must have a lytic or mixed (lytic + blastic) lesion, which has not been previously irradiated and can be accurately assessed by CT/MRI according to RECIST version 1.1.
Postmenopausal patient, defined as a woman fulfilling any one of the following criteria (based on the NCCN definition of menopause [National Comprehensive Cancer Network 2008]):
- Prior bilateral oophorectomy.
- Age > 60 years.
- Age ≤ 60 years and with amenorrhea for 12 or more months in the absence of chemotherapy, tamoxifen, toremifene, or ovarian suppression and follicle stimulating hormone and estradiol in the postmenopausal range.
- Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) 0, 1 or 2.
- At least 18 years of age.
- Life expectancy ≥ 12 weeks.
Adequate organ and bone marrow function:
- ANC ≥ 1,500/mm3 (1.5x109/L);
- Platelets ≥ 100,000/mm3 (100x109/L);
- Haemoglobin (Hgb) ≥ 9g/dL (90g/L);
- Serum creatinine ≤ 1.5xUpper Limit of Normal (ULN) or estimated creatinine clearance ≥ 60ml/min as calculated using the method standard for the institution;
- Total serum bilirubin ≤ 1.5xULN (<3xULN if Gilbert´s disease);
- AST and/or ALT ≤ 3xULN (≤5xULN if liver metastases present);
- Alkaline Phosphatase (AP) ≤ 2.5xULN (≤5xULN if bone or liver metastases present).
- Patients consent to biological sample provision for biomarker exploratory analysis.
- Willingness and ability to comply with scheduled visits, treatment plan, laboratory tests and other study procedures.
Exclusion Criteria:
- Prior systemic therapy for metastatic disease. Note: patients with a local recurrent disease treated with surgery (R0) and receiving a "second hormonal adjuvant therapy for five years" will be allowed, provided they have remained disease free for more than 12 months following its completion.
- Have "de novo" locally advanced disease.
- Current use of food or drugs known to be potent CYP3A4 inhibitors, drugs known to be potent CYP3A4 inducers, and drugs that are known to prolong the QT interval.
- Presence of life-threatening metastatic visceral disease, defined as extensive hepatic involvement, or any degree of brain or leptomeningeal involvement (past or present), or symptomatic pulmonary lymphangitis spread, or any known bone marrow infiltration due to breast cancer. Patients with discrete pulmonary parenchymal metastases are eligible, provided their respiratory function is not significantly compromised as a result of disease.
- Treatment with a non-approved or experimental drug within 4 weeks before randomization.
- Prior treatment with any CDK4/6 inhibitor or fulvestrant.
- Current or prior malignancy within previous 5 years (other than breast cancer or adequately treated basal cell or squamous cell carcinoma of the skin or in-situ carcinoma of the cervix).
History of:
- Bleeding diathesis (i.e., disseminated intravascular coagulation [DIC], clotting factor deficiency) or long-term (>6 months) anticoagulant therapy (other than antiplatelet therapy and low dose coumarin derivatives provided that the International Normalised Ratio (INR) is less than 1.6). Hypersensitivity to active or inactive excipients of fulvestrant, palbociclib/placebo or castor oil.
- Any severe concomitant condition which makes it undesirable for the patient to participate in the trial or which would jeopardize compliance with the trial protocol, e.g. uncontrolled cardiac disease or uncontrolled diabetes mellitus.
- QTc interval > 480msec, family or personal history of long or short QT syndrome, Brugada syndrome or known history of QTc prolongation or Torsade de Pointes.
- Uncontrolled electrolyte disorders that can compound the effects of a QTc-prolonging drug (eg, hypocalcaemia, hypokalaemia, hypomagnesaemia).
- Impairment of gastro-intestinal (GI) function or GI disease that may significantly alter the absorption of palbociclib, such as history of GI surgery which may result in intestinal blind loops and patients with clinically significant gastro-paresis, short bowel syndrome, unresolved nausea, vomiting, active inflammatory bowel disease or diarrhoea of CTCAE grade > 1.
- Prior hematopoietic stem cell or bone marrow transplantation.
- Known human immunodeficiency virus infection.
- Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the patient inappropriate for entry into this study.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Trojnásobný
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
---|---|
Experimentální: PD-0332991(Palbociclib)+fulvestrant(FaslodexTM)
Fulvestrant 500mg, on days 1, 15 (±3 days) of Cycle 1, and then on Day 1 of each subsequent 28 day cycle (±3 days) in combination with Palbociclib, 125 mg, orally once daily from day 1 to day 21 followed by 7 days off treatment on every 28 days cycles.
|
Palbociclib, 125 mg, orally once daily from day 1 to day 21 followed by 7 days off treatment on every 28 days cycles. Patients will continue to receive their assigned treatment until objective disease progression, clinical progression (under investigator criteria), unacceptable toxicity, death or withdrawal of consent, whichever occurs first
Ostatní jména:
Fulvestrant 500mg, two 5ml intramuscular injections (one in each buttock), on days 1, 15 (±3 days) of Cycle 1, and then on Day 1 of each subsequent 28 day cycle (±3 days) Patients will continue to receive their assigned treatment until objective disease progression, clinical progression (under investigator criteria), unacceptable toxicity, death or withdrawal of consent, whichever occurs first
Ostatní jména:
|
Aktivní komparátor: Placebo+fulvestrant(FaslodexTM)
Fulvestrant 500mg on days 1, 15 (±3 days) of Cycle 1, and then on Day 1 of each subsequent 28 day cycle (±3 days) in combination with Placebo orally once daily from day 1 to day 21 followed by 7 days off treatment on every 28 days cycles.
|
Fulvestrant 500mg, two 5ml intramuscular injections (one in each buttock), on days 1, 15 (±3 days) of Cycle 1, and then on Day 1 of each subsequent 28 day cycle (±3 days) Patients will continue to receive their assigned treatment until objective disease progression, clinical progression (under investigator criteria), unacceptable toxicity, death or withdrawal of consent, whichever occurs first
Ostatní jména:
Placebo orally once daily from day 1 to day 21 followed by 7 days off treatment on every 28 days cycles. Patients will continue to receive their assigned treatment until objective disease progression, clinical progression (under investigator criteria), unacceptable toxicity, death or withdrawal of consent, whichever occurs firs |
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
---|---|---|
Efficacy in terms of the rate of Progression-Free Survival (PFS)
Časové okno: at 1 year
|
assessed according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 by the investigator
|
at 1 year
|
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
---|---|---|
Progression-Free Survival (PFS)
Časové okno: an average of 40-44 months since FPFV (approximately Ago2019)
|
the time from the date of randomization to the first documented progressive disease, using RECIST version 1.1, or death from any cause, whichever occurs first
|
an average of 40-44 months since FPFV (approximately Ago2019)
|
Objective Response Rate (ORR)
Časové okno: at 1 year and to be updated with further analyses
|
the percentage of patients with a complete or partial response out of the patients who had measurable disease at baseline.
|
at 1 year and to be updated with further analyses
|
Clinical Benefit Rate (CBR)
Časové okno: at 1 year and to be updated with further analyses
|
Complete Response (CR) plus Partial Response (PR) plus stable disease (SD) lasting ≥ 24 weeks (+/- 2 weeks) according to RECIST version 1.1.
|
at 1 year and to be updated with further analyses
|
Overall Survival (OS).
Časové okno: an average of 40-44 months since FPFV(approximately Ago2019). A formal analysis will be performed when at least 60% of patients have died (2021)
|
the time from the date of randomization to the date of death from any cause.
|
an average of 40-44 months since FPFV(approximately Ago2019). A formal analysis will be performed when at least 60% of patients have died (2021)
|
1 year and 2 year survival probabilities
Časové okno: 1 year and 2 year
|
the percentage of patients without death from any cause out of the randomised patients (calculated using the Kaplan-Meier technique).
|
1 year and 2 year
|
Incidence of adverse events occurring during the study, and their relatedness to the study drug/medications (safety and tolerability).
Časové okno: at 1 year and to be updated with further analyses
|
Safety will be assessed by standard clinical and laboratory tests.
Adverse events will be graded according to NCI-CTCAE version 4.0
|
at 1 year and to be updated with further analyses
|
Patient reported outcomes of health-related quality of life based on EORTC QLQ-C30 Global Health Status/Quality of Life and Physical Function
Časové okno: at 1 year and to be updated with further analyses
|
Generic aspects of quality of life will be assessed.
Changes (mean score) from baseline and time to deterioration will be analyzed.Health Status/QoL and Physical Function and EORTC QLQ-BR23 Breast Module from baseline
|
at 1 year and to be updated with further analyses
|
Patient reported outcomes of health-related quality of life based on EORTC QLQ-BR23 Breast Module.
Časové okno: at 1 year and to be updated with further analyses
|
Disease-specific treatment measurements will be assessed.
Changes (mean score) from baseline and time to deterioration will be analyzed.
|
at 1 year and to be updated with further analyses
|
Další výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
---|---|---|
Biomarker analyses
Časové okno: Up to 5 years
|
Identify promising biomarkers of response to fulvestrant plus palbociclib and fulvestrant plus placebo.
|
Up to 5 years
|
Spolupracovníci a vyšetřovatelé
Spolupracovníci
Vyšetřovatelé
- Ředitel studie: Study Director, Hospital del Mar
Publikace a užitečné odkazy
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Aktuální)
Dokončení studie (Očekávaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Odhad)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
- Kožní choroby
- Novotvary
- Novotvary podle místa
- Nemoci prsu
- Novotvary prsu
- Fyziologické účinky léků
- Molekulární mechanismy farmakologického působení
- Inhibitory enzymů
- Antineoplastická činidla
- Hormony, hormonální náhražky a antagonisté hormonů
- Antineoplastická činidla, Hormonální
- Inhibitory proteinkinázy
- Antagonisté hormonů
- Antagonisté estrogenu
- Antagonisté estrogenových receptorů
- Fulvestrant
- Palbociclib
Další identifikační čísla studie
- GEICAM/2014-12
- 2015-002437-21 (Číslo EudraCT)
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .
Klinické studie na Novotvary prsu
-
Tianjin Medical University Cancer Institute and...Guangxi Medical University; Sun Yat-sen University; Chinese PLA General Hospital a další spolupracovníciDokončenoPrůvodce klinickou aplikací Conebeam Breast CTČína
-
Gangnam Severance HospitalNáborHER2 Enriched Subtype Cancer Breast, Herzuma, PAM50 StudyKorejská republika
-
BioNTech SESeventh Framework ProgrammeDokončenoRakovina prsu (Triple Negative Breast Cancer (TNBC))Švédsko, Německo
-
Jonsson Comprehensive Cancer CenterNational Cancer Institute (NCI); National Institutes of Health (NIH)Zatím nenabírámeAnatomický karcinom prsu stadia II AJCC v8 | Anatomický karcinom prsu stadia III AJCC v8 | Rané stadium karcinomu prsu | Anatomic Stage I Breast Cancer American Joint Committee on Cancer (AJCC) v8Spojené státy
-
Emory UniversityNational Cancer Institute (NCI)StaženoPrognostický karcinom prsu stadia IV AJCC v8 | Metastatický maligní novotvar v mozku | Metastatický karcinom prsu | Anatomic Stage IV Breast Cancer American Joint Committee on Cancer (AJCC) v8
-
NRG OncologyNational Cancer Institute (NCI)Aktivní, ne náborAnatomický karcinom prsu stadia IV AJCC v8 | Prognostický karcinom prsu stadia IV AJCC v8 | Metastatický maligní novotvar v kosti | Metastatický maligní novotvar v lymfatických uzlinách | Metastatický maligní novotvar v játrech | Metastatický karcinom prsu | Metastatický maligní novotvar v plicích | Metastatický... a další podmínkySpojené státy, Kanada, Saudská arábie, Korejská republika
Klinické studie na PD-0332991 (Palbociclib)
-
PfizerDokončeno
-
PfizerDokončeno
-
PfizerDokončenoHealthy, Hepatic InsufficiencySpojené státy
-
PfizerDokončeno
-
PfizerDokončeno
-
German Breast GroupPfizer; AGO Study Group; Breast International Group; NSABP Foundation IncDokončenoRakovina prsu | Pozitivní hormonální receptor | Her2-normální | Postneoadjuvantní léčba s CDK 4/6 inhibitorem | Skóre CPS-EGSpojené státy, Austrálie, Rakousko, Kanada, Francie, Německo, Irsko, Japonsko, Korejská republika, Španělsko, Spojené království
-
PfizerDokončeno
-
Institut BergoniéDokončenoPokročilé gastrointestinální stromální nádoryFrancie
-
UNC Lineberger Comprehensive Cancer CenterPfizerUkončenoMetastatický uroteliální karcinom (UC)Spojené státy
-
PfizerDokončenoNovotvary | Lymfom, Non-HodgkinSpojené státy