- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT07599137
Abemaciclib Dose Escalation in Early High-Risk Breast Cancer Adjuvant Therapy (ADES)
Study on the Safety and Efficacy of Abemaciclib Dose Escalation Strategy in Adjuvant Therapy for Early High-Risk Breast Cancer
Abemaciclib combined with endocrine therapy has become one of the important adjuvant treatment regimens for patients with HR+/HER2- high-risk early breast cancer. However, adverse events such as diarrhea, fatigue, neutropenia and elevated liver enzymes are concentrated in the early stage of adjuvant therapy, which often lead to dose reduction, temporary drug interruption or even permanent discontinuation. This further affects treatment adherence, relative dose intensity (RDI) and treatment completion rate.
Findings from the TRADE study suggest that a step-up dosing strategy, initiating at a lower dose followed by gradual titration to the standard dose, combined with standardized patient education and symptomatic management, may improve early treatment tolerance, reduce the burden of partial toxicities, and increase the likelihood of patients achieving and maintaining abemaciclib 150 mg twice daily. Based on the above evidence and clinical experience, step-up dosing has been adopted by some clinicians for real-world clinical practice.
Nevertheless, existing evidence is mainly derived from non-Chinese populations. There is still a lack of systematic real-world data on step-up dosing among Chinese breast cancer patients under routine outpatient management, including the early toxicity profile, dose escalation achievement rate at each stage, dose adjustment pathways (prolonged escalation, treatment pause or dose de-escalation), RDI distribution, correlation with quality of life, and baseline factors affecting treatment tolerance and dose target attainment. Therefore, it is necessary to conduct a real-world study focused on Chinese patients to fill the gap in local clinical evidence, and provide a basis for clinical pathway formulation, patient education, and subsequent multicenter validation studies.
연구 개요
연구 유형
등록 (추정된)
단계
- 4단계
연락처 및 위치
연구 연락처
- 이름: Lize Wang, Doctor
- 전화번호: +86-010-88197830
- 이메일: lize2010@163.com
참여기준
자격 기준
공부할 수 있는 나이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
설명
Inclusion Criteria:
- Aged ≥18 years;
- Pathologically confirmed breast cancer with ER and/or PR positive, HER2 negative;
- Completed radical mastectomy/radiacal breast surgery;
- Plan to receive abemaciclib combined endocrine therapy for at least 12 weeks, with abemaciclib administered via a step-up dosing regimen;
- ECOG performance status 0-1;
- Adequate organ function meeting medication requirements (routine blood test, liver and renal function, and other indicators consistent with clinical medication safety criteria);
- Signed written informed consent.
Exclusion Criteria:
- Previous exposure to any CDK4/6 inhibitor;
- Active infection or severe infection requiring systemic anti-infective treatment;
- Significant gastrointestinal diseases such as chronic diarrhea, inflammatory bowel disease, short bowel syndrome, which may affect drug absorption or increase the risk of diarrhea;
- Significant baseline hepatic or renal dysfunction, or uncontrolled severe comorbidities judged by the investigator to affect safety or treatment adherence;
- Pregnancy or lactation;
- Any other condition deemed ineligible for enrollment by the investigator.
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 방지
- 할당: 해당 없음
- 중재 모델: 단일 그룹 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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실험적: Dose escalation group
Patients receiving postoperative abemaciclib step-up dosing regimen.
Dose escalation schedule: 100 mg BID (Weeks 1-4), 100/150 mg daily (Weeks 5-8), 150 mg BID (Weeks 9-12).
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Patients receiving postoperative abemaciclib step-up dosing regimen.
Dose escalation schedule: 100 mg BID (Weeks 1-4), 100/150 mg daily (Weeks 5-8), 150 mg BID (Weeks 9-12).
Patients receiving postoperative abemaciclib step-up dosing regimen.
Dose escalation schedule: 100 mg BID (Weeks 1-4), 100/150 mg daily (Weeks 5-8), 150 mg BID (Weeks 9-12).
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Rate of inadequate dosing
기간: From enrollment to the end of treatment at 12 weeks
|
Proportion of patients with inadequate dosing from postoperative treatment initiation to week 12
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From enrollment to the end of treatment at 12 weeks
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Dose Target Attainment and Treatment Intensity
기간: From enrollment to the end of treatment at 12 weeks"
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Proportion of patients achieving 150 mg BID at Week 12.
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From enrollment to the end of treatment at 12 weeks"
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QoL deterioration rate
기간: From enrollment to the end of treatment at 12 weeks.
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Proportion of patients experiencing a deterioration in health-related quality of life defined as a decrease of ≥10 points from baseline through EORTC QLQ-C30.
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From enrollment to the end of treatment at 12 weeks.
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공동 작업자 및 조사자
간행물 및 유용한 링크
일반 간행물
- Johnston SRD, Harbeck N, Hegg R, Toi M, Martin M, Shao ZM, Zhang QY, Martinez Rodriguez JL, Campone M, Hamilton E, Sohn J, Guarneri V, Okada M, Boyle F, Neven P, Cortes J, Huober J, Wardley A, Tolaney SM, Cicin I, Smith IC, Frenzel M, Headley D, Wei R, San Antonio B, Hulstijn M, Cox J, O'Shaughnessy J, Rastogi P; monarchE Committee Members and Investigators. Abemaciclib Combined With Endocrine Therapy for the Adjuvant Treatment of HR+, HER2-, Node-Positive, High-Risk, Early Breast Cancer (monarchE). J Clin Oncol. 2020 Dec 1;38(34):3987-3998. doi: 10.1200/JCO.20.02514. Epub 2020 Sep 20.
- Mayer EL, Trapani D, Kim SE, Faggen M, Sinclair N, Sanz-Altamira P, Battelli C, Berwick S, Lo S, Acevedo J, Sinclair S, Malcolm A, Varella L, Sammons S, Schumer S, Poorvu PD, Wallace E, Pasternak E, Tayob N, Tolaney SM. TRADE: a phase II trial to assess the tolerability of abemaciclib dose escalation in early-stage HR-positive/HER2-negative breast cancer. Ann Oncol. 2026 Jan;37(1):117-124. doi: 10.1016/j.annonc.2025.09.141. Epub 2025 Oct 17.
- Goetz MP, Cicin I, Testa L, Tolaney SM, Huober J, Guarneri V, Johnston SRD, Martin M, Rastogi P, Harbeck N, Shahir A, Wei R, Andre V, Rugo HS, O'Shaughnessy J. Impact of dose reductions on adjuvant abemaciclib efficacy for patients with high-risk early breast cancer: analyses from the monarchE study. NPJ Breast Cancer. 2024 Apr 26;10(1):34. doi: 10.1038/s41523-024-00639-1.
- Johnston SRD, Toi M, O'Shaughnessy J, Rastogi P, Campone M, Neven P, Huang CS, Huober J, Jaliffe GG, Cicin I, Tolaney SM, Goetz MP, Rugo HS, Senkus E, Testa L, Del Mastro L, Shimizu C, Wei R, Shahir A, Munoz M, San Antonio B, Andre V, Harbeck N, Martin M; monarchE Committee Members. Abemaciclib plus endocrine therapy for hormone receptor-positive, HER2-negative, node-positive, high-risk early breast cancer (monarchE): results from a preplanned interim analysis of a randomised, open-label, phase 3 trial. Lancet Oncol. 2023 Jan;24(1):77-90. doi: 10.1016/S1470-2045(22)00694-5. Epub 2022 Dec 6.
연구 기록 날짜
연구 주요 날짜
연구 시작 (추정된)
기본 완료 (추정된)
연구 완료 (추정된)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
기타 연구 ID 번호
- BC-P40
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
IPD 계획 설명
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .
HR+/HER2- 유방암에 대한 임상 시험
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BeOne Medicines모병
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Second Affiliated Hospital, School of Medicine,...모병
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Novartis Pharmaceuticals모병고급 HR+/HER2- 유방암미국, 싱가포르
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Institut fuer FrauengesundheitLilly Deutschland GmbH Germany아직 모집하지 않음
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Nanjing Sanhome Pharmaceutical, Co., Ltd.모집하지 않고 적극적으로
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Institut fuer FrauengesundheitLilly Deutschland GmbH Germany; AGO-B Breast Study Group모병
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Avenzo Therapeutics, Inc.모병HR+/HER2- 유방암 | HR+, HER2-, 진행성 유방암미국
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Cancer Institute and Hospital, Chinese Academy...아직 모집하지 않음유방암 초기 유방암(1~3기) | HR 양성/HER2 저유방암중국
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Fondazione IRCCS Istituto Nazionale dei Tumori,...Fondazione Policlinico Universitario Agostino Gemelli IRCCS; Fondazione IRCCS Ca' Granda... 그리고 다른 협력자들모병유방암 | 유방 신생물 | 유방 질환 | 유방 신생물 | 유방 종양 | 유방 암종 | 유방 신생물, 남성 | 유방암 4기 | 유방의 호르몬 수용체 양성 악성 신생물 | HR 양성 유방암 | 호르몬 수용체 양성 유방암 | 호르몬 수용체(HR) 양성 유방암 | 호르몬 수용체 양성(HR+), HER2 음성 유방암 | 유방 선암종 | 호르몬 수용체 양성, HER2 음성 유방암 | 유방암, 전이성 | 유방암 | 호르몬 수용체 양성 HER-2 음성 유방암 | 호르몬 수용체 양성 유방 선암종 | HR 양성, HER2 음성 및 PIK3CA 돌연변이 진행성 유방암 | 호르몬 수용체 양성 유방암 | 호르몬 수용체 양성 유방암 | 호르몬 수용체... 그리고 다른 조건이탈리아
Dose escalation에 대한 임상 시험
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Baylor College of MedicineThe Methodist Hospital Research Institute; Center for Cell and Gene Therapy, Baylor College...아직 모집하지 않음
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Boston Medical CenterNational Cancer Institute (NCI)아직 모집하지 않음자궁 경부암 | 자궁경부암 검진
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Sciema UGInnovative Diabetes Treatment Studies LLC.모집하지 않고 적극적으로
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Jiangsu Province Centers for Disease Control and...Royal (Wuxi) Biological Co., LTD완전한
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Joris B.W. ElbersErasmus Medical Center; HollandPTC모병두경부 편평 세포 암종 | 방사선 요법 | 양성자 치료 | 저분할 | 면역 체계 억제네덜란드
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Innovent Biologics (Suzhou) Co. Ltd.정지된
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Third Affiliated Hospital, Sun Yat-Sen University알려지지 않은