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Lo studio CDK4/6 Inhibitor Dosing Knowledge (CDK).

30 ottobre 2026 aggiornato da: American Society of Clinical Oncology

Confronto delle strategie di dosaggio dei farmaci per via orale nei pazienti anziani con carcinoma mammario metastatico per massimizzare la tolleranza e ridurre l'interruzione: lo studio CDK4/6 Inhibitor Dosing Knowledge (CDK)

The purpose of this study is to generate evidence on an alternative dosing strategy for CDK4/6 inhibitors to help more patients with Metastatic Breast Cancer (MBC) (age ≥ 60 years) tolerate side effects and stay on treatment longer, to derive the most clinical benefit from these drugs.

The primary objective of the CDK Study is to compare time to treatment discontinuation (TTD) on the approved dosing for palbociclib (125 mg orally daily on days 1-21 of 28-day cycle) or ribociclib (600 mg orally daily on days 1-21 of 28-day cycle) vs. TTD using titrated dosing approach with the same schedule but starting at a lower dose of palbociclib (100 mg or 75 mg) or ribociclib (400 mg or 200 mg) and escalating the dose if well-tolerated in combination with provider/patient choice endocrine therapy (aromatase inhibitor (AI) or fulvestrant) in patients age 60 or older with HR+/HER2- MBC. The secondary and exploratory objectives will generate evidence needed to personalize treatment decisions by comparing patient-centric secondary outcomes and evaluating baseline factors.

Together with their treating physician, participants will choose the CDK4/6 inhibitor (palbociclib or ribociclib) and which endocrine therapy (aromatase inhibitor or fulvestrant) of their choice but will be randomized to either Arm 1 (indicated dosing) or Arm 2 (titrated dosing).

Note: Telehealth visits are allowed at any time per institutional guidelines. In addition, the study allows for remote consenting per institutional guidelines.

Panoramica dello studio

Stato

Reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

The CDK4/6 Inhibitor Dosing Knowledge Study (CDK Study) will study CDK4/6 inhibitor dosing regimens in patients 60 or older with Metastatic Breast Cancer (MBC). The overarching goal of this pragmatic, randomized trial is to compare an "indicated" dosing approach, as listed on the FDA-approved drug label, that starts at the full dose of a CDK4/6 inhibitor (palbociclib or ribociclib) with dose reduction based on tolerability versus a "titrated" dosing approach that starts at a lower dose of a CDK4/6 inhibitor and then titrates up to full dose as tolerated. CDK4/6 inhibitors will be given in combination with endocrine therapy (either an aromatase inhibitor (AI) or fulvestrant) based on the choice of the treating clinician.

The primary endpoint will be time to treatment discontinuation (TTD), defined as the time from randomization to last dose of the CDK4/6 inhibitor. The hypothesis is that starting low and escalating as tolerated will help older patients (> 60 years) stay on therapy longer. Eligibility criteria are broad to allow patients who are not typically included in clinical trials to participate, allowing for a more representative sample of participants. The investigators will conduct sub-group analyses based on age (60-64 years vs. 65-74 years vs. ≥75 years) and baseline frailty scores. This study builds upon the lessons learned from prior studies with CDK4/6 inhibitors. The investigators will augment the standard assessment of treatment toxicities assessed by the health care team with prospectively collected patient-reported outcomes data to better reflect how participants tolerate the different dosing approaches.

Tipo di studio

Interventistico

Iscrizione (Stimato)

500

Fase

  • Fase 3

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Backup dei contatti dello studio

Luoghi di studio

    • Arizona
      • Chandler, Arizona, Stati Uniti, 85224
        • Reclutamento
        • Ironwood Cancer & Research Centers
        • Contatto:
        • Investigatore principale:
          • Sumeet Mendonca, MD
      • Gilbert, Arizona, Stati Uniti, 85297
        • Reclutamento
        • Ironwood Cancer & Research Centers
        • Contatto:
        • Investigatore principale:
          • Sumeet Mendonca, MD
      • Glendale, Arizona, Stati Uniti, 85306
        • Reclutamento
        • Ironwood Cancer & Research Centers
        • Contatto:
        • Investigatore principale:
          • Sumeet Mendonca, MD
      • Goodyear, Arizona, Stati Uniti, 85395
        • Reclutamento
        • Ironwood Cancer & Research Centers
        • Contatto:
        • Investigatore principale:
          • Sumeet Mendonca, MD
      • Mesa, Arizona, Stati Uniti, 85202
        • Reclutamento
        • Ironwood Cancer & Research Centers
        • Contatto:
        • Investigatore principale:
          • Sumeet Mendonca, MD
      • Mesa, Arizona, Stati Uniti, 85206
        • Reclutamento
        • Ironwood Cancer & Research Centers
        • Contatto:
        • Investigatore principale:
          • Sumeet Mendonca, MD
      • Phoenix, Arizona, Stati Uniti, 85028
        • Reclutamento
        • Ironwood Cancer & Research Centers
        • Contatto:
        • Investigatore principale:
          • Sumeet Mendonca, MD
      • Scottsdale, Arizona, Stati Uniti, 85260
        • Reclutamento
        • Ironwood Cancer & Research Centers
        • Contatto:
        • Investigatore principale:
          • Sumeet Mendonca, MD
    • California
      • Eureka, California, Stati Uniti, 95501
        • Reclutamento
        • Providence Medical Foundation
        • Contatto:
        • Investigatore principale:
          • Jarrod Holmes, MD
      • Santa Rosa, California, Stati Uniti, 95403
        • Reclutamento
        • Providence Medical Foundation
        • Contatto:
        • Investigatore principale:
          • Jarrod Holmes, MD
    • Colorado
      • Aurora, Colorado, Stati Uniti, 80045
        • Reclutamento
        • University of Colorado Anschutz Medical Campus
        • Contatto:
        • Contatto:
        • Investigatore principale:
          • Enrique Soto, MD
      • Denver, Colorado, Stati Uniti, 80206
      • Highlands Ranch, Colorado, Stati Uniti, 80129
    • Connecticut
      • Derby, Connecticut, Stati Uniti, 06418
        • Reclutamento
        • Smilow Cancer Hospital Care Center - Derby
        • Investigatore principale:
          • Maryam Lustberg, MD
        • Contatto:
      • Fairfield, Connecticut, Stati Uniti, 06824
        • Reclutamento
        • Smilow Cancer Hospital Care Center - Fairfield
        • Investigatore principale:
          • Maryam Lustberg, MD
        • Contatto:
      • Glastonbury, Connecticut, Stati Uniti, 06033
        • Reclutamento
        • Smilow Cancer Hospital at Glastonbury
        • Investigatore principale:
          • Maryam Lustberg, MD
        • Contatto:
      • Greenwich, Connecticut, Stati Uniti, 06830
        • Reclutamento
        • Smilow Cancer Hospital Care Center - Greenwich
        • Investigatore principale:
          • Maryam Lustberg, MD
        • Contatto:
      • Guilford, Connecticut, Stati Uniti, 06437
        • Reclutamento
        • Smilow Cancer Hospital Care Center - Guilford
        • Investigatore principale:
          • Maryam Lustberg, MD
        • Contatto:
      • Hartford, Connecticut, Stati Uniti, 06105
        • Reclutamento
        • Smilow Cancer Hospital at Saint Francis
        • Investigatore principale:
          • Maryam Lustberg, MD
        • Contatto:
      • New Haven, Connecticut, Stati Uniti, 06510
        • Reclutamento
        • Smilow Cancer Hospital - Yale New Haven Health
        • Contatto:
        • Investigatore principale:
          • Maryam Lustberg, MD, MPH
      • New Haven, Connecticut, Stati Uniti, 06510
        • Reclutamento
        • Yale University/Yale Cancer Center/Yale School of Medicine
        • Investigatore principale:
          • Maryam Lustberg, MD
        • Contatto:
      • North Haven, Connecticut, Stati Uniti, 06473
        • Reclutamento
        • Smilow Cancer Hospital Care Center - North Haven
        • Investigatore principale:
          • Maryam Lustberg, MD
        • Contatto:
      • Torrington, Connecticut, Stati Uniti, 06790
        • Reclutamento
        • Smilow Cancer Hospital Care Center - Torrington
        • Investigatore principale:
          • Maryam Lustberg, MD
        • Contatto:
      • Trumbull, Connecticut, Stati Uniti, 06611
        • Reclutamento
        • Smilow Cancer Hospital Care Center - Trumbull
        • Investigatore principale:
          • Maryam Lustberg, MD
        • Contatto:
      • Waterbury, Connecticut, Stati Uniti, 06708
        • Reclutamento
        • Smilow Cancer Hospital Care Center - Waterbury
        • Investigatore principale:
          • Maryam Lustberg
        • Contatto:
      • Waterford, Connecticut, Stati Uniti, 06385
        • Reclutamento
        • Smilow Cancer Hospital - Waterford
        • Investigatore principale:
          • Maryam Lustberg, MD
        • Contatto:
    • Florida
      • Miami, Florida, Stati Uniti, 33176
        • Reclutamento
        • Miami Cancer Institute
        • Investigatore principale:
          • Reshma Mahtani, DO
        • Contatto:
      • Plantation, Florida, Stati Uniti, 33324
        • Reclutamento
        • Miami Cancer Institute
        • Investigatore principale:
          • Reshma Mahtani, DO
        • Contatto:
    • Georgia
      • Atlanta, Georgia, Stati Uniti, 30322
        • Reclutamento
        • Emory University Winship Cancer Institute
        • Investigatore principale:
          • Kevin Kalinsky, MD
        • Contatto:
      • Hinesville, Georgia, Stati Uniti, 31313
        • Reclutamento
        • Liberty County Cancer Care
        • Contatto:
        • Investigatore principale:
          • Leonard Henry, MD
      • Pembroke, Georgia, Stati Uniti, 31321
        • Reclutamento
        • Pembroke Medical Oncology & St Joseph's/Candler Oncology Infusion Suite
        • Contatto:
        • Investigatore principale:
          • Leonard Henry, MD
      • Savannah, Georgia, Stati Uniti, 31405
        • Reclutamento
        • Lewis Cancer and Research Pavilion
        • Contatto:
        • Investigatore principale:
          • Leonard Henry, MD
      • Statesboro, Georgia, Stati Uniti, 30458
        • Reclutamento
        • Candler Medical Oncology Practice and Infusion
        • Contatto:
        • Investigatore principale:
          • Leonard Henry, MD
    • Indiana
      • Crown Point, Indiana, Stati Uniti, 46307
        • Reclutamento
        • Northwest Cancer Center
        • Contatto:
        • Investigatore principale:
          • Michael Tallarico, MD
      • Dyer, Indiana, Stati Uniti, 46311
        • Reclutamento
        • Northwest Cancer Center-Dyer
        • Contatto:
        • Investigatore principale:
          • Michael Tallarico, MD
      • Hobart, Indiana, Stati Uniti, 46342
        • Reclutamento
        • St. Mary Medical Center
        • Contatto:
        • Investigatore principale:
          • Michael Tallarico, MD
      • Munster, Indiana, Stati Uniti, 46321
        • Reclutamento
        • Powers Health Cancer Research Foundation
        • Contatto:
        • Investigatore principale:
          • Michael Tallarico, MD
      • Valparaiso, Indiana, Stati Uniti, 46383
        • Reclutamento
        • Northwest Cancer Center
        • Contatto:
        • Investigatore principale:
          • Michael Tallarico, MD
    • Kansas
      • Westwood, Kansas, Stati Uniti, 66205
        • Reclutamento
        • The University of Kansas Cancer Center
        • Contatto:
        • Investigatore principale:
          • Ryan Rader, MD
    • Maine
      • Augusta, Maine, Stati Uniti, 04330
        • Reclutamento
        • The Jackson Laboratory (JAX) - Harold Alfond Center for Cancer Care
        • Contatto:
        • Investigatore principale:
          • Erin Adler, DO
      • Brewer, Maine, Stati Uniti, 04412
        • Reclutamento
        • The Jackson Laboratory (JAX) - Northern Light Cancer Care
        • Contatto:
        • Investigatore principale:
          • Sarah Sinclair, DO
    • Massachusetts
      • Boston, Massachusetts, Stati Uniti, 02215
        • Reclutamento
        • Dana-Farber Cancer Institute
        • Investigatore principale:
          • Erica Mayer, MD
        • Contatto:
          • Call
          • Numero di telefono: 877-338-7425
      • Foxborough, Massachusetts, Stati Uniti, 02035
        • Reclutamento
        • Dana-Farber Brigham Cancer Center Foxborough
        • Contatto:
          • 877-DF-TRIAL
          • Numero di telefono: 877-338-7425
        • Investigatore principale:
          • Sudha Bolla, MD
      • Methuen, Massachusetts, Stati Uniti, 01844
        • Reclutamento
        • Dana-Farber Cancer Institute Merrimack Valley
        • Contatto:
          • 877-DF-TRIAL
          • Numero di telefono: 877-338-7425
        • Investigatore principale:
          • Ankur Mehta, MD
      • Milford, Massachusetts, Stati Uniti, 01757
        • Reclutamento
        • Dana-Farber Brigham Cancer Center at Milford Regional Medical Center
        • Investigatore principale:
          • Natalie Sinclair, MD
        • Contatto:
          • 877-DF-TRIAL
          • Numero di telefono: 8773387425
      • Weymouth, Massachusetts, Stati Uniti, 02190
        • Reclutamento
        • Dana-Farber Brigham Cancer Center at South Shore Health
        • Investigatore principale:
          • James Stoeckle, MD
        • Contatto:
          • 877-DF-TRIAL
          • Numero di telefono: 8773387425
    • New Hampshire
      • Londonderry, New Hampshire, Stati Uniti, 03053
        • Reclutamento
        • Dana-Farber/New Hampshire Oncology-Hematology
        • Investigatore principale:
          • Jeanna Walsh, MD
        • Contatto:
          • 877-DF-TRIAL
          • Numero di telefono: 877-338-7425
    • New Jersey
      • Englewood, New Jersey, Stati Uniti, 07631
        • Reclutamento
        • Englewood Hospital
        • Investigatore principale:
          • Jill Morrison, MD
        • Contatto:
      • Pennington, New Jersey, Stati Uniti, 08534
        • Reclutamento
        • Capital Health Medical Center - Hopewell
        • Contatto:
        • Investigatore principale:
          • Pamella Crilley, DO
      • Plainsboro, New Jersey, Stati Uniti, 08536
    • New Mexico
      • Albuquerque, New Mexico, Stati Uniti, 87110
        • Reclutamento
        • Presbyterian Kaseman Hospital
        • Investigatore principale:
          • Bernard Tawfik, MD
        • Contatto:
      • Albuquerque, New Mexico, Stati Uniti, 87109
        • Reclutamento
        • Lovelace Women's Hospital
        • Investigatore principale:
          • Bernard Tawfik, MD
        • Contatto:
      • Albuquerque, New Mexico, Stati Uniti, 87102
        • Reclutamento
        • Lovelace Medical Center - Saint Joseph Square
        • Investigatore principale:
          • Bernard Tawfik, MD
        • Contatto:
      • Albuquerque, New Mexico, Stati Uniti, 87131
        • Reclutamento
        • The University of New Mexico Comprehensive Cancer Center
        • Investigatore principale:
          • Bernard Tawfik, MD
        • Contatto:
      • Las Cruces, New Mexico, Stati Uniti, 88011
        • Reclutamento
        • Memorial Medical Center
        • Investigatore principale:
          • Bernard Tawfik, MD
        • Contatto:
      • Rio Rancho, New Mexico, Stati Uniti, 87124
        • Reclutamento
        • Presbyterian Rust Medical Center/Jorgensen Cancer Center
        • Investigatore principale:
          • Bernard Tawfik, MD
        • Contatto:
    • North Carolina
      • Albemarle, North Carolina, Stati Uniti, 28001
        • Reclutamento
        • Levine Cancer Institute
        • Investigatore principale:
          • Neelam Desai, MD
        • Contatto:
      • Charlotte, North Carolina, Stati Uniti, 28204
        • Reclutamento
        • Levine Cancer Institute
        • Investigatore principale:
          • Neelam Desai, MD
        • Contatto:
      • Charlotte, North Carolina, Stati Uniti, 28210
        • Reclutamento
        • Levine Cancer Institute
        • Investigatore principale:
          • Neelam Desai, MD
        • Contatto:
      • Charlotte, North Carolina, Stati Uniti, 28211
        • Reclutamento
        • Levine Cancer Institute
        • Investigatore principale:
          • Neelam Desai, MD
        • Contatto:
      • Charlotte, North Carolina, Stati Uniti, 28262
        • Reclutamento
        • Levine Cancer Institute
        • Investigatore principale:
          • Neelam Desai, MD
        • Contatto:
      • Charlotte, North Carolina, Stati Uniti, 28277
        • Reclutamento
        • Levine Cancer Institute
        • Investigatore principale:
          • Neelam Desai, MD
        • Contatto:
      • Concord, North Carolina, Stati Uniti, 28025
        • Reclutamento
        • Levine Cancer Institute
        • Investigatore principale:
          • Neelam Desai, MD
        • Contatto:
      • Forest City, North Carolina, Stati Uniti, 28043
        • Reclutamento
        • Levine Cancer Institute
        • Investigatore principale:
          • Neelam Desai, MD
        • Contatto:
      • Gastonia, North Carolina, Stati Uniti, 28054
        • Reclutamento
        • Levine Cancer Institute
        • Investigatore principale:
          • Neelam Desai, MD
        • Contatto:
      • Huntersville, North Carolina, Stati Uniti, 28078
        • Reclutamento
        • Levine Cancer Institute
        • Investigatore principale:
          • Neelam Desai, MD
        • Contatto:
      • Lincolnton, North Carolina, Stati Uniti, 28092
        • Reclutamento
        • Levine Cancer Institute
        • Investigatore principale:
          • Neelam Desai, MD
        • Contatto:
      • Matthews, North Carolina, Stati Uniti, 28104
        • Reclutamento
        • Levine Cancer Institute
        • Investigatore principale:
          • Neelam Desai, MD
        • Contatto:
      • Monroe, North Carolina, Stati Uniti, 28112
        • Reclutamento
        • Levine Cancer Institute
        • Investigatore principale:
          • Neelam Desai, MD
        • Contatto:
      • Shelby, North Carolina, Stati Uniti, 28150
        • Reclutamento
        • Levine Cancer Institute
        • Investigatore principale:
          • Neelam Desai, MD
        • Contatto:
    • Ohio
      • Cincinnati, Ohio, Stati Uniti, 45219
        • Reclutamento
        • University of Cincinnati Medical Center
        • Contatto:
        • Investigatore principale:
          • Mahmoud Charif, MD
      • West Chester, Ohio, Stati Uniti, 45069
        • Reclutamento
        • University of Cincinnati Medical Center - West Chester Hospital
        • Contatto:
        • Investigatore principale:
          • Mahmoud Charif, MD
    • Pennsylvania
      • Lancaster, Pennsylvania, Stati Uniti, 17601
        • Reclutamento
        • Penn Medicine - Lancaster General Hospital
        • Contatto:
        • Investigatore principale:
          • Ramy Sedhom, MD
      • Newton, Pennsylvania, Stati Uniti, 18940
        • Reclutamento
        • Capital Health Hematology Oncology Specialists
        • Contatto:
        • Investigatore principale:
          • Pamella Crilley, DO
      • Philadelphia, Pennsylvania, Stati Uniti, 19104
        • Reclutamento
        • Penn Medicine - Perelman Center for Advanced Medicine
        • Investigatore principale:
          • Ramy Sedhom, MD
        • Contatto:
      • Philidelphia, Pennsylvania, Stati Uniti, 19106
        • Reclutamento
        • Penn Medicine - Pennsylvania Hospital
        • Contatto:
        • Investigatore principale:
          • Ramy Sedhorn, MD
      • West Chester, Pennsylvania, Stati Uniti, 19380
        • Reclutamento
        • Penn Medicine - Chester County Hospital
        • Investigatore principale:
          • Ramy Sedhom, MD
        • Contatto:
    • Rhode Island
      • Westerly, Rhode Island, Stati Uniti, 02891
        • Reclutamento
        • Smilow Cancer Hospital - Westerly
        • Investigatore principale:
          • Maryam Lustberg, MD
        • Contatto:
    • South Carolina
      • Bluffton, South Carolina, Stati Uniti, 29910
        • Reclutamento
        • St. Joseph's Candler Bluffton Campus
        • Contatto:
        • Investigatore principale:
          • Leonard Henry, MD
      • Hilton Head Island, South Carolina, Stati Uniti, 29926
        • Reclutamento
        • SC Cancer Specialists - Hilton Head at St. Joseph's/Candler
        • Investigatore principale:
          • Leonard Henry, MD
        • Contatto:
      • Rock Hill, South Carolina, Stati Uniti, 29732
        • Reclutamento
        • Levine Cancer Institute
        • Investigatore principale:
          • Neelam Desai, MD
        • Contatto:
    • Tennessee
      • Memphis, Tennessee, Stati Uniti, 38120
        • Reclutamento
        • Baptist Memorial Healthcare
        • Investigatore principale:
          • Glenn Roma, MD
        • Contatto:
    • Washington
      • Bellevue, Washington, Stati Uniti, 98004
        • Reclutamento
        • Fred Hutchinson Cancer Center at Overlake Cancer Center
        • Investigatore principale:
          • Jennifer Specht, MD
        • Contatto:
          • Jennifer Specht, MD
          • Numero di telefono: 206-606-6889
          • Email: jspecht@uw.edu
      • Bonney Lake, Washington, Stati Uniti, 98391
        • Reclutamento
        • Northwest Medical Specialties
        • Investigatore principale:
          • Frank Senecal, MD
        • Contatto:
      • Federal Way, Washington, Stati Uniti, 98003
        • Reclutamento
        • Northwest Medical Specialties
        • Investigatore principale:
          • Frank Senecal, MD
        • Contatto:
      • Gig Harbor, Washington, Stati Uniti, 98332
        • Reclutamento
        • Northwest Medical Specialties
        • Investigatore principale:
          • Frank Senecal, MD
        • Contatto:
      • Kirkland, Washington, Stati Uniti, 98034
        • Reclutamento
        • Fred Hutchinson Cancer Center at EvergreenHealth
        • Investigatore principale:
          • Jennifer Specht, MD
        • Contatto:
          • Jennifer Specht, MD
          • Numero di telefono: 206-606-6889
          • Email: jspecht@uw.edu
      • Olympia, Washington, Stati Uniti, 98502
        • Reclutamento
        • Northwest Medical Specialties
        • Investigatore principale:
          • Frank Senecal, MD
        • Contatto:
      • Puyallup, Washington, Stati Uniti, 98373
        • Reclutamento
        • Northwest Medical Specialties
        • Investigatore principale:
          • Frank Senecal, MD
        • Contatto:
      • Seattle, Washington, Stati Uniti, 98109
        • Reclutamento
        • Fred Hutchinson Cancer Center
        • Investigatore principale:
          • Jennifer Specht, MD
        • Contatto:
          • Jennifer Specht, MD
          • Numero di telefono: 206-606-6889
          • Email: jspecht@uw.edu
      • Seattle, Washington, Stati Uniti, 98133
        • Reclutamento
        • Fred Hutchinson Cancer Center at University of Washington-Northwest
        • Investigatore principale:
          • Jennifer Specht, MD
        • Contatto:
          • Jennifer Specht, MD
          • Numero di telefono: 206-606-6889
          • Email: jspecht@uw.edu
      • Tacoma, Washington, Stati Uniti, 98405
        • Reclutamento
        • Northwest Medical Specialties
        • Investigatore principale:
          • Frank Senecal, MD
        • Contatto:

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

60 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  1. Hormone receptor positive (HR+) HER2 negative metastatic breast cancer. Cut-off values for positive/negative staining should be as per standard practice in accordance with ASCO/CAP (American Society of Clinical Oncology/College of American Pathologists) guidelines. Verification of histology is preferred at the time of recurrence and where not possible or necessary in the judgment of the treating physician, the study will accept histology from the initial diagnosis.

  2. Candidate for planned endocrine therapy in combination with 1st use of palbociclib or ribociclib, in the metastatic setting. The planned endocrine partner can be an aromatase inhibitor (letrozole, anastrozole, exemestane) or fulvestrant, selected through patient/provider choice.

  3. Aged 60 years or older

  4. Adequate bone marrow and organ function. Laboratory values must be within normal institutional limits, or within ranges as indicated below, or demonstrate minor abnormalities that are deemed clinically non-significant by the investigator.

    • Absolute neutrophil count ≥ 1,000/µL
    • Total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN) (participants with documented Gilbert's disease are allowed total bilirubin up to 5X ULN)
    • AST (SGOT)/ALT (SGPT) <3 x institutional ULN, or ≤ 5 x ULN for subjects with documented metastatic disease to the liver.
  5. Baseline QTc ≤ 480 ms (only for ribociclib patients)

  6. Ability to understand and the willingness to provide informed consent. Note: Remote consent is allowed per institutional guidelines.

Exclusion Criteria:

  1. Previous treatment with a CDK4/6 inhibitor for metastatic breast cancer, or previous treatment within the past 12 months with a CDK4/6 inhibitor in the neo/adjuvant breast cancer setting.
  2. Received greater than 60 days (in the metastatic setting) of the specific endocrine therapy agent planned as partner to the CDK4/6 inhibitor in the study at the time of randomization.
  3. Known history of intolerance or allergy to the planned agents used in this trial.
  4. Uncontrolled intercurrent illness that, as evaluated by the treating clinician, would hinder compliance with study requirements.
  5. Concurrent therapy with other investigational agents or anticancer therapy beyond aromatase inhibitors or fulvestrant. Note: radiation is allowed at any time.
  6. Rapidly progressive brain metastases. Note: only applies to patients with known brain metastases. Brain imaging not required for enrollment.
  7. Active or chronic Hepatitis B or C are eligible provided they meet liver function laboratory criteria and are not on medication with a known interaction with the study agents.
  8. Current use of drugs that have known potential to prolong the QT interval (e.g., antiarrhythmic drugs), for patients on ribociclib. Note: If concomitant use cannot be avoided, monitor ECG when initiating, during concomitant use, and as clinically indicated. Refer to crediblemeds.org as a resource.
  9. Prior or concurrent malignancies that are undergoing active treatment.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Arm 1: Indicated Dose

Arm 1 of the study is the indicated dosing regimen, provided in the FDA approved drug label: participants will start cycle 1 with either 125mg dose of palbociclib or 600mg dose of ribociclib, in combination with endocrine therapy (AI or fulvestrant).

Arm 1: Indicated dosing for palbociclib (125 mg orally daily on days 1-21 of 28-day cycle)

Arm 1: Indicated dosing of ribociclib (600 mg orally daily on days 1-21 of 28-day cycle)

Sperimentale: Arm 2: Titrated Dose

Arm 2 is the titrated dosing regimen: participants will start cycle 1 with either 100 mg or 75 mg dose of palbociclib or 400 mg or 200 mg dose of ribociclib, in combination with endocrine therapy (AI or fulvestrant). For cycle 2 and for subsequent cycles, escalation to the indicated dose will be based on treatment tolerance.

Arm 2: Titrated dosing approach with the same schedule but starting at a lower dose of ribociclib (400 mg or 200 mg) and escalating the dose if well-tolerated in combination with provider/patient choice of endocrine therapy.

Arm 2: Titrated dosing approach with the same schedule but starting at a lower dose of palbociclib (100 mg or 75 mg) and escalating the dose if well-tolerated in combination with provider/patient choice of endocrine therapy.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Time to Treatment Discontinuation (TTD)
Lasso di tempo: up to 48 months

Our primary outcome is time to CDK4/6 inhibitor discontinuation (TTD): the number of days between randomization and the last day the patient takes any dose of the same CDK4/6 inhibitor (regardless of drug holds, dose changes

up to 48 months

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Toxicity (grade 3-4 AEs)
Lasso di tempo: up to 48 months

Assessed in each arm of the study and study drug

up to 48 months
Event-Free survival (EFS)
Lasso di tempo: up to 48 months

Assessed in each arm of the study and study drug

up to 48 months
Quality of life assessed by patient reported outcomes
Lasso di tempo: up to 48 months

PROMIS-29 (3 domains of 12 questions, physical function, fatigue, participation in social activities), FACT-G Item GP5 (1 question)

up to 48 months
Time to dose reduction and escalation
Lasso di tempo: up to 48 months

For titrated arm. Assessed in each arm of the study and study drug

up to 48 months
Reason for not escalating
Lasso di tempo: up to 48 months

Assessed in each arm of the study and study drug

up to 48 months
Treatment received (missed doses, cumulative dose, etc.)
Lasso di tempo: up to 48 months

Assessed in each arm of the study and study drug

up to 48 months
Healthcare utilization (ED visits, hospital admissions, etc.)
Lasso di tempo: up to 48 months

ED visits, hospital admissions, etc., assessed in each arm of the study and study drug

up to 48 months
Body Mass Index
Lasso di tempo: up to 48 months

weight and height will be combined to report BMI in kg/m^2

up to 48 months

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Collaboratori

Investigatori

  • Investigatore principale: Julie Gralow, MD, American Society of Clinical Oncology

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

29 ottobre 2024

Completamento primario (Stimato)

31 agosto 2028

Completamento dello studio (Stimato)

1 settembre 2028

Date di iscrizione allo studio

Primo inviato

8 aprile 2024

Primo inviato che soddisfa i criteri di controllo qualità

17 aprile 2024

Primo Inserito (Effettivo)

22 aprile 2024

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

2 novembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

30 ottobre 2026

Ultimo verificato

1 ottobre 2026

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Altri numeri di identificazione dello studio

  • Pro00075309

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

Sì

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

prodotto fabbricato ed esportato dagli Stati Uniti

Sì

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .