Biology Guided Therapy Recommendations for Treatment Determination of Hormone Receptor-Positive Advanced, Unresectable or Metastatic Breast Cancer, ENDORSE Trial
Pilot Study: Evaluation of Novel Data-Driven Outcomes Via Response-Guided Systems Medicine in Hormone Receptor-Positive Advanced Breast Cancer (ENDORSE)
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
- Procedura: Risonanza magnetica
- Procedura: Raccolta di campioni biologici
- Procedura: Tomografia ad emissione di positroni
- Procedura: Tomografia computerizzata
- Altro: Revisione del Fascicolo Sanitario Elettronico
- Procedura: Scintigrafia ossea
- Procedura: Procedura di biopsia
- Altro: Treatment Planning
- Altro: Treatment Regimen
Descrizione dettagliata
PRIMARY OBJECTIVE:
I. To assess the feasibility and utility of using a systems medicine approach to evaluate tumor tissue from patients with hormone receptor-positive HER2-negative unresectable metastatic breast cancer after progression on first line therapy to both predict estrogen dependence and aid in selection of effective standard of care therapy.
SECONDARY OBJECTIVES:
I. To determine the accrual rate (AR). II. To measure the clinical benefit rate (CBR). III. To compare progression free survival (PFS) based on concordance with recommended treatment.
IV. To determine the duration of response (DoR). V. To measure the therapy acceptance rate (TAR).
EXPLORATORY OBJECTIVES:
I. To obtain additional genomic, epigenomic, and transcriptomic data on resistance mechanisms that informs future validation studies, artificial intelligence (AI) model-selected next line of therapy selection with anticipated highest efficacy amongst available options, and advanced AI model development.
II. To assess obstacles to enrollment and pitfalls of the study design to guide future studies.
OUTLINE:
Patients have their tumor tissue analyzed. Their physician receives a report based on their tumor biology consisting of their predicted ongoing response to endocrine therapy, predicted ongoing response to endocrine therapy plus PIK3CA mutation or ESR1 mutation or HER2 mutation or mTOR sensitivity/resistance. The report includes treatment recommendations and the results of the specific tests completed on the tumor tissue. Physicians then determine a treatment regimen for the patient that may or may not include the treatment recommended in the report. Patients undergo blood sample collection and computed tomography (CT) scan or magnetic resonance imaging (MRI) and/or bone scan and/or positron emission tomography (PET) scan throughout the study. Patients may undergo tumor biopsy during screening and may optionally undergo at progression.
After completion of study intervention, patients are followed every 3 months until disease progression.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 1
Contatti e Sedi
Luoghi di studio
-
-
California
-
Duarte, California, Stati Uniti, 91010
- City of Hope Medical Center
-
Investigatore principale:
- Irene M. Kang
-
Contatto:
- Irene M. Kang
- Numero di telefono: 844-756-2047
- Email: ikang@coh.org
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Irvine, California, Stati Uniti, 92618
- City of Hope at Irvine Lennar
-
Investigatore principale:
- Irene M. Kang
-
Contatto:
- Irene M. Kang
- Numero di telefono: 844-756-2047
- Email: ikang@coh.org
-
-
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Participant must speak English
Documented informed consent of the participant and/or legally authorized representative.
- Assent, when appropriate, will be obtained per institutional guidelines
Agreement to allow the use of archival tissue from diagnostic tumor biopsies
- If unavailable, exceptions may be granted with study principal investigator (PI) approval
- Age: ≥ 18 years
- Patients must have histologically confirmed, unresectable or metastatic hormone receptor positive, HER2 breast cancer. Hormone receptor positive is defined as estrogen receptor >= 10% and/or progesterone receptor >= 10%. Her2 negative per American Society of Clinical Oncology/College of American Pathologists (ASCO-CAP) guidelines
Patient must have disease progression during or after prior endocrine therapy meeting one of the following criteria:
- Disease progression on 1st line endocrine therapy for advanced/metastatic breast cancer.
- Disease progression on or within 2 years of completion of treatment with a CDK4/6i in the adjuvant setting for early- stage breast cancer
- Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2
- Patient must have at least one lesion amenable to percutaneous core
- Clinically appropriate for biopsy
Exclusion Criteria:
- Prior treatment in the metastatic setting with capecitabine, phosphoinositide 3 kinase (PI3K) inhibitor, mechanistic target of rapamycin (mTOR) inhibitor, protein kinase B (Akt) inhibitor, selective estrogen receptor degrader (SERD), or HER2-targeted therapy, including neratinib
- Known or untreated, or active, brain or leptomeningeal metastases that are deemed inappropriate to pursue therapy guided by systems medicine approach. Enrolled patients may receive radiation or other loco regional therapy prior to initiating systemic therapy on study. History of malignancies other than adequately treated non-melanoma skin cancer, curatively treated in situ cancer of the cervix, or other solid tumors not requiring active therapy
- Life expectancy < 1 year
- Pregnant or breastfeeding
- Any other condition that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns with clinical study procedures
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: N / A
- Modello interventistico: Assegnazione di gruppo singolo
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Sperimentale: Treatment (Biology guided therapy report)
Patients have their tumor tissue analyzed.
Their physician receives a report based on their tumor biology consisting of their predicted ongoing response to endocrine therapy, predicted ongoing response to endocrine therapy plus PIK3CA mutation or ESR1 mutation or HER2 mutation or mTOR sensitivity/resistance.
The report includes treatment recommendations and the results of the specific tests completed on the tumor tissue.
Physicians then determine a treatment regimen for the patient that may or may not include the treatment recommended in the report.
Patients undergo blood sample collection and CT scan or MRI and/or bone scan and/or PET scan throughout the study.
Patients may undergo tumor biopsy during screening and may optionally undergo at progression.
|
Sottoponiti a risonanza magnetica
Altri nomi:
Sottoponiti al prelievo di campioni di sangue
Altri nomi:
Sottoponiti alla scansione PET
Altri nomi:
Sottoponiti a TAC
Altri nomi:
Studi accessori
Sottoponiti a scintigrafia ossea
Altri nomi:
Sotto la biopsia tumorale
Altri nomi:
Receive tumor biology report with predicted ongoing response
Receive treatment recommendations
Altri nomi:
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Turnaround time (feasibility)
Lasso di tempo: Up to 30 days.
|
Report consists of an Evaluation of Novel Data-driven Outcomes via Response-guided Systems Medicine in Hormone Receptor-positive Advanced Breast Cancer (ENDORSE) signature score, MTOR signature score and status of other Food and Drug Administration approved biomarkers, including ESR1 mutations, PIK3CA mutations and HER2 mutation/expression).
The turn-around time will be summarized by the range, mean, median, and standard deviation.
|
Up to 30 days.
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Accrual rate
Lasso di tempo: Up to 1 year
|
Defined as is the number of patients enrolled over the period of a month.
|
Up to 1 year
|
|
Clinical benefit rate
Lasso di tempo: At 6 months
|
Will be summarized as the percentage of patients with complete response (CR), partial response (PR), or at least stable disease (SD) at 6 months.
|
At 6 months
|
|
Median progression free survival
Lasso di tempo: From study registration to progression, symptomatic deterioration, or death due to any cause, up to 1 year
|
From study registration to progression, symptomatic deterioration, or death due to any cause, up to 1 year
|
|
|
Duration of overall response
Lasso di tempo: From the time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented, up to 1 year
|
From the time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented, up to 1 year
|
|
|
Therapy acceptance rate
Lasso di tempo: Up to 1 year
|
Defined as the proportion of cases in which the recommended therapy by the study was the same as what was recommended by the physician.
|
Up to 1 year
|
Collaboratori e investigatori
Sponsor
Sponsor
Collaboratori
Collaboratori
Investigatori
Investigatori
- Investigatore principale: Irene M Kang, City of Hope Medical Center
Studiare le date dei record
Studia le date principali
Inizio studio (Stimato)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
- Qualità, accesso e valutazione dell'assistenza sanitaria
- Tecniche investigative
- Terapie
- Tecniche di laboratorio clinico
- Tecniche e procedure diagnostiche
- Diagnosi
- Procedure chirurgiche, operative
- Tecniche citologiche
- Citodiagnosi
- Meccanismi di valutazione dell'assistenza sanitaria
- Qualità dell'assistenza sanitaria
- Tecniche diagnostiche, chirurgiche
- Tecniche di chimica, analitiche
- Analisi dello spettro
- Caratteristiche di studio epidemiologico
- Biopsia
- Gestione dei campioni
- Spettroscopia di risonanza magnetica
- Protocolli clinici
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- 24121 (Altro identificatore: City of Hope Comprehensive Cancer Center)
- P30CA033572 (Sovvenzione/contratto NIH degli Stati Uniti)
- NCI-2026-02741 (Identificatore di registro: CTRP (Clinical Trial Reporting Program))
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
prodotto fabbricato ed esportato dagli Stati Uniti
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