進行乳癌の日本人男性および閉経後女性におけるアルペリシブとフルベストラントによる治療の有効性と安全性を評価する研究
PIK3CA 変異ホルモン受容体(HR)陽性、HER2 陰性、進行乳癌または日本でのアロマターゼ阻害剤(AI)治療後
The purpose of this study is to assess the safety and efficacy of alpelisib plus fulvestrant in men and postmenopausal women with hormone receptor (HR) positive, human epidermal growth factor 2 (HER2)-negative, advanced breast cancer harboring a PIK3CA mutation in Japan, whose disease has progressed on or after aromatase inhibitor (AI) treatment regardless of prior CDK4/6 inhibitor use.
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
This is a Phase II open-label, 2-Part, multi-center study in Japan. The study will be conducted in two parts: Part 1 (Cohort 1) includes participants regardless of prior CDK4/6 inhibitor use and is designed to determine the recommended dose (RD), evaluate the tolerability and safety of alpelisib in combination with fulvestrant. Part 2 consists of 2 cohorts (the CDK4/6 inhibitor naive participants are in Cohort 2 and the CDK4/6 inhibitor pre-treated participants are in Cohort 3) which are designed to assess the efficacy and safety of alpelisib in combination with fulvestrant, will start once the RD of alpelisib is established.
Participants will be treated until disease progression, unacceptable toxicity, death or discontinuation from the study treatment for any other reason and will be followed for survival regardless of treatment discontinuation reason (except if consent is withdrawn or participant is lost to follow up).
研究の種類
研究の種類
入学 (実際)
入学
段階
段階
- フェーズ2
連絡先と場所
研究場所
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Niigata、日本、951-8566
- Novartis Investigative Site
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Aichi-ken
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Nagoya、Aichi-ken、日本、4668560
- Novartis Investigative Site
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Nagoya、Aichi-ken、日本、4678602
- Novartis Investigative Site
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Nagoya、Aichi-ken、日本、4648681
- Novartis Investigative Site
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Chiba
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Kashiwa、Chiba、日本、2778577
- Novartis Investigative Site
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Kanagawa
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Isehara、Kanagawa、日本、2591193
- Novartis Investigative Site
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Yokohama、Kanagawa、日本、2418515
- Novartis Investigative Site
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Kumamoto
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Kumamoto、Kumamoto、日本、8608556
- Novartis Investigative Site
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Miyagi
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Sendai、Miyagi、日本、9808574
- Novartis Investigative Site
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Osaka
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Osaka、Osaka、日本、5418567
- Novartis Investigative Site
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Osaka、Osaka、日本、5400006
- Novartis Investigative Site
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Suita、Osaka、日本、5650871
- Novartis Investigative Site
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Tokyo
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Bunkyo Ku、Tokyo、日本、1138677
- Novartis Investigative Site
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Koto Ku、Tokyo、日本、1358550
- Novartis Investigative Site
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Meguro-ku、Tokyo、日本、1528902
- Novartis Investigative Site
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参加基準
適格基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Japanese man or postmenopausal woman
- Participant has adequate tumor tissue for the analysis of PIK3CA mutational status by a Novartis designated laboratory.
- Participant has identified PIK3CA mutation (as determined by a Novartis designated laboratory)
- Participant has a histologically and/or cytologically confirmed diagnosis of ER+ and/or PgR+ breast cancer by local laboratory
- Participant has HER2-negative breast cancer defined as a negative in situ hybridization test or an IHC status of 0, 1+ or 2+. If IHC is 2+, a negative in situ hybridization (FISH, CISH or SISH) test is required by local laboratory testing
- Participant has measurable disease, i.e., at least one measurable lesion as per RECIST 1.1
- Participant has advanced breast cancer
- Participant has ECOG performance status 0 or 1
Exclusion Criteria:
- Participant with symptomatic visceral disease or any disease burden that makes the participant ineligible for endocrine therapy per the investigator's best judgment
- Participant has received prior treatment;
- with chemotherapy (except for neoadjuvant/ adjuvant chemotherapy), fulvestrant, any PI3K, mTOR or AKT inhibitor for Cohort 1 and 3
- with chemotherapy (except for neoadjuvant/ adjuvant chemotherapy), fulvestrant, any PI3K, mTOR, AKT inhibitor or CDK 4/6 inhibitor for Cohort 2
- Participant has a known hypersensitivity to alpelisib or fulvestrant, or to any of the excipients of alpelisib or fulvestrant
- Participant with inflammatory breast cancer at screening
- Participant is concurrently using other anti-cancer therapy
- Participant has had surgery within 14 days prior to starting study drug or has not recovered from major side effects
- Participant with an established diagnosis at screening of diabetes mellitus type I or not controlled type II (based on FPG and HbA1c)
- Participant has currently documented pneumonitis /interstitial lung disease
- History of acute pancreatitis within 1 year of screening or past medical history of chronic pancreatitis
- Participant with unresolved osteonecrosis of the jaw
- Participant has a history of severe cutaneous reactions
Other protocol-defined inclusion/exclusion criteria may apply
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:非ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
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実験的:Cohort 1:CDK4/6 inhibitor naive or pre-treated (Part 1)
Participants regardless of prior CDK4/6 inhibitor will be treated at escalating doses (200 mg, 250 mg and 300 mg, orally) of BYL719 in combination with Fulvestrant (500 mg, intramuscular). |
[Part 1] Alpelisib administered at 200 mg (DL 1), 250 mg (DL 2) or 300mg (DL 3) orally once daily on a continuous dosing schedule starting on Cycle 1 Day 1 in a 28 day cycle. If DL 1 is tolerated, the alpelisib doses of 250 mg will be investigated. If DL 2 is tolerated, the alpelisib doses of 300 mg will be investigated. [Part 2] In the Part 2, participants will be enrolled into Cohort 2 (CDK4/6 inhibitor naive) and Cohort 3 (CDK4/6 inhibitor pre-treated) in parallel and alpelisib will be administered at the recommended dose identified in Part 1.
他の名前:
Fulvestrant is administered at a dose of 500 mg intramuscular on Cycle 1 Day 1, Day 15, and Day 1 of every cycle thereafter (where a cycle is 28 days).
他の名前:
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実験的:Cohort 2: CDK4/6 inhibitor naive (Part 2)
Participants who are CDK4/6 inhibitor naive will be treated with BYL719 at the recommended dose identified in Part 1 in combination with Fulvestrant (500 mg, intramuscular). |
[Part 1] Alpelisib administered at 200 mg (DL 1), 250 mg (DL 2) or 300mg (DL 3) orally once daily on a continuous dosing schedule starting on Cycle 1 Day 1 in a 28 day cycle. If DL 1 is tolerated, the alpelisib doses of 250 mg will be investigated. If DL 2 is tolerated, the alpelisib doses of 300 mg will be investigated. [Part 2] In the Part 2, participants will be enrolled into Cohort 2 (CDK4/6 inhibitor naive) and Cohort 3 (CDK4/6 inhibitor pre-treated) in parallel and alpelisib will be administered at the recommended dose identified in Part 1.
他の名前:
Fulvestrant is administered at a dose of 500 mg intramuscular on Cycle 1 Day 1, Day 15, and Day 1 of every cycle thereafter (where a cycle is 28 days).
他の名前:
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実験的:Cohort 3: CDK4/6 inhibitor pre-treated (Part 2)
Participants who are CDK4/6 inhibitor pre-treated will be treated with BYL719 at the recommended dose identified in Part 1 in combination with Fulvestrant (500 mg, intramuscular). |
[Part 1] Alpelisib administered at 200 mg (DL 1), 250 mg (DL 2) or 300mg (DL 3) orally once daily on a continuous dosing schedule starting on Cycle 1 Day 1 in a 28 day cycle. If DL 1 is tolerated, the alpelisib doses of 250 mg will be investigated. If DL 2 is tolerated, the alpelisib doses of 300 mg will be investigated. [Part 2] In the Part 2, participants will be enrolled into Cohort 2 (CDK4/6 inhibitor naive) and Cohort 3 (CDK4/6 inhibitor pre-treated) in parallel and alpelisib will be administered at the recommended dose identified in Part 1.
他の名前:
Fulvestrant is administered at a dose of 500 mg intramuscular on Cycle 1 Day 1, Day 15, and Day 1 of every cycle thereafter (where a cycle is 28 days).
他の名前:
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この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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[Part 1] The incidence of Dose Limiting Toxicities (DLTs) of alpelisib in combination with fulvestrant
時間枠:From Cycle 1 Day 1 to Cycle 2 Day 28 (Cycle = 28 days)
|
A DLT is defined as an AE or abnormal laboratory value assessed as unrelated to disease, disease progression, inter-current illness, or concomitant medications that occurs within the first 2 cycles (the first 56 days) of treatment with alpelisib in combination with fulvestrant and meets any of the criteria specified in the protocol . |
From Cycle 1 Day 1 to Cycle 2 Day 28 (Cycle = 28 days)
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[Part 2] Overall Response Rate (ORR) in CDK4/6 inhibitor naive participants
時間枠:Up to approximately 36 months
|
ORR is defined as the proportion of participants with best overall response (BOR) of confirmed complete response (CR) or confirmed partial response (PR) based on local investigator assessment per RECIST 1.1. |
Up to approximately 36 months
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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[Part 1] Number of participants with Adverse Events (AEs) and Serious Adverse Events (SAEs)
時間枠:Up to approximately 37 months
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Safety is determined by incidence, type, and severity of adverse events per CTCAE v4.03 criteria including changes in laboratory values, vital signs, liver assessments, renal and cardiac assessments. |
Up to approximately 37 months
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[Part 1] Number of participants with dose adjustments
時間枠:Up to approximately 37 months
|
The number of participants with dose adjustments (reductions, interruption, or permanent discontinuation) and the reasons |
Up to approximately 37 months
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[Part 1] Dose intensity for alpelisib and fulvestrant
時間枠:Up to approximately 37 months
|
The dose intensity (computed as the ratio of actual cumulative dose received and actual duration of exposure) and the relative dose intensity (computed as the ratio of dose intensity and planned dose intensity) |
Up to approximately 37 months
|
|
[Part 1] Duration of exposure for alpelisib and fulvestrant
時間枠:Up to approximately 37 months
|
The duration of exposure (in months) to alpelisib and fulvestrant |
Up to approximately 37 months
|
|
[Part 1] Plasma concentrations of alpelisib in combination with fulvestrant
時間枠:Cycle 1 Day 8 (pre-dose), 15 (pre-dose, post-dose 1 hour, 3 hours) and Day 1 of Cycles 2, 4, 6, 8 (pre-dose) (Cycle = 28 days)
|
Summary statistics of alpelisib plasma concentrations by time point and dose level |
Cycle 1 Day 8 (pre-dose), 15 (pre-dose, post-dose 1 hour, 3 hours) and Day 1 of Cycles 2, 4, 6, 8 (pre-dose) (Cycle = 28 days)
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|
[Part 2] Overall Response Rate (ORR) for CDK4/6 inhibitor pre-treated participants
時間枠:Up to approximately 36 months
|
ORR is defined as the proportion of participants with best overall response (BOR) of confirmed complete response (CR) or confirmed partial response (PR) based on local investigator assessment per RECIST 1.1. |
Up to approximately 36 months
|
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[Part 2] Progression Free Survival (PFS)
時間枠:Up to approximately 36 months
|
PFS is defined as the time from the date of first administration of study treatment until the date of the first documented progression or death due to any cause. PFS will be assessed based on local investigator assessment per RECIST 1.1. |
Up to approximately 36 months
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[Part 2] Overall Survival (OS)
時間枠:Up to approximately 60 months
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OS is defined as the time from date of first administration of study treatment until date of death due to any cause. |
Up to approximately 60 months
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[Part 2] Clinical Benefit Rate (CBR)
時間枠:Up to approximately 36 months
|
CBR is defined as the proportion of participants with a best overall response of confirmed CR, or confirmed PR, or an overall response of confirmed stable disease (SD), lasting for a duration of at least 24 weeks. CR, PR, and SD are defined based on local investigator assessment per RECIST 1.1. |
Up to approximately 36 months
|
|
[Part 2] Duration of Response (DOR)
時間枠:Up to approximately 36 months
|
DOR only applies to participants whose best overall response is CR or PR based on local investigator assessment per RECIST 1.1. The start date is the date of first documented response of CR or PR (i.e. the start date of response, not the date when response was confirmed), and the end date is defined as the date of the first documented progression or death due to underlying cancer. |
Up to approximately 36 months
|
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[Part 2] Time to Response (TTR)
時間枠:Up to approximately 36 months
|
TTR is defined as the time from the date of first administration of study treatment until the date of the first documented response of either CR or PR, which must be subsequently confirmed (although date of initial response is used, not date of confirmation). |
Up to approximately 36 months
|
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[Part 2] Time to definitive deterioration of Eastern Cooperative Oncology Group (ECOG) performance status
時間枠:Up to approximately 36 months
|
Time to definitive deterioration in ECOG performance status is defined as the time from the date of first administration to the date when ECOG performance status has definitively deteriorated by at least one category compared with baseline. Deterioration is considered definitive if there is no subsequent improvement in ECOG performance status back to the baseline category or above. |
Up to approximately 36 months
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[Part 2] Number of participants with Adverse Events (AEs) and Serious Adverse Events (SAEs)
時間枠:Up to approximately 37 months
|
Incidence, type, and severity of adverse events per CTCAE v4.03 criteria including changes in laboratory values, vital signs, liver assessments, renal and cardiac assessments |
Up to approximately 37 months
|
|
[Part 2] Number of participants with dose adjustments
時間枠:Up to approximately 37 months
|
The number and percentage of participants with dose interruptions and dose reductions |
Up to approximately 37 months
|
|
[Part 2] Dose intensity for alpelisib and fulvestrant
時間枠:Up to approximately 37 months
|
The dose intensity (computed as the ratio of actual cumulative dose received and actual duration of exposure) and the relative dose intensity (computed as the ratio of dose intensity and planned dose intensity) |
Up to approximately 37 months
|
|
[Part 2] Duration of exposure for alpelisib and fulvestrant
時間枠:Up to approximately 37 months
|
The duration of exposure (in months) to alpelisib and fulvestrant |
Up to approximately 37 months
|
|
[Part 2] Plasma concentrations of alpelisib in combination with fulvestrant
時間枠:Cycle 1 Day 8 (pre-dose), 15 (pre-dose, post-dose 1 hour, 3 hours) and Day 1 of Cycles 2, 4, 6, 8 (pre-dose) (Cycle= 28 days)
|
Summary statistics of alpelisib plasma concentrations by time point and dose level |
Cycle 1 Day 8 (pre-dose), 15 (pre-dose, post-dose 1 hour, 3 hours) and Day 1 of Cycles 2, 4, 6, 8 (pre-dose) (Cycle= 28 days)
|
協力者と研究者
捜査官
捜査官
- スタディディレクター:Novartis Pharmaceuticals、Novartis Pharmaceuticals
研究記録日
主要日程の研究
研究開始 (実際)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- CBYL719C1201
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
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
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。