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Prospective Study to Evaluate the Clinical Utility of ctDNA Tumor Fraction (TF) for Detection of Estrogen Receptor 1 (ESR1) Mutations in (Human Epidermal Growth Factor Receptor) HR+/HER2- Metastatic Breast Cancer (MBC)

2 november 2026 uppdaterad av: Yale University

Prospective Study to Evaluate the Clinical Utility of ctDNA Tumor Fraction (TF) for Detection of ESR1 Mutations in HR-positive HER2-negative Metastatic Breast Cancer (MBC)

This is a prospective, single center, single-arm interventional study to evaluate the clinical utility of protocol-mandated diagnostic testing algorithm incorporating liquid biopsy and reflex tissue biopsy NGS for detection of ESR1 mutations in HR+/HER- metastatic breast cancer.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

Participants are prospectively assigned to undergo ctDNA testing with FoundationOne® Liquid CDx (F1LCDx) at protocol-defined clinical decision points. Participants with an indeterminate negative F1LCDx result (ctDNA TF <1% and negative for ESR1mut) are assigned to undergo reflex tissue biopsy NGS unless deemed medically unsafe. The protocol does not mandate treatment selection; treating clinicians retain full discretion regarding therapy.All research-related procedures will be performed at the time of standard of care clinical visits. No extra visits outside of routine care are required. For participants with algorithm-detected ESR1 mutations, serial Electronic Medical Record review will be performed for up to 2 years to track subsequent treatment patterns, progression events, and survival status to assess other clinical outcomes associated with subsequent SERD-based regimens compared with historical clinical trial benchmarks.

This study will guide clinical decision-making for acquiring new tissue specimens following an indeterminate negative ESR1mut result from liquid biopsy, which is a critical step to ensure accurate detection of actionable mutations and enable the selection of the most appropriate targeted therapy

Studietyp

Interventionell

Inskrivning (Beräknad)

155

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

    • Connecticut
      • New Haven, Connecticut, Förenta staterna, 06520
        • Yale New Haven Hospital - Yale Cancer Center

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • Diagnosis of metastatic breast cancer that is hormone receptor-positive (ER≥10%), HER2 low or negative (defined as HER2 Imunohistochemistry (IHC) 0, 1+ or IHC 2+/In Situ Hybridization (ISH)-).
  • Progression of metastatic breast cancer that is hormone receptor-positive (ER≥10%), HER2 low or negative (defined as HER2 IHC 0, 1+ or IHC 2+/ISH-) while on systemic therapy.
  • Currently receiving or have previously received aromatase inhibitor therapy.

Exclusion Criteria:

  • Patients with locally or regionally recurrent breast cancer without evidence of metastatic disease.
  • De novo metastatic breast cancer.
  • Presence of symptomatic metastatic visceral crisis.
  • Participants with inflammatory breast cancer.
  • Intact uterus with a history of endometrial intraepithelial neoplasia (atypical endometrial hyperplasia or higher-grade lesion).
  • Diagnosis of any other malignancy within 5 years before enrollment, except for adequately treated basal cell or squamous cell skin cancer, superficial bladder cancer, carcinoma in situ of the cervix, or second primary breast cancer.
  • Other conditions that, in the opinion of the treating investigator, would preclude the patient from meeting the study requirements or interfere with interpretation of study results.
  • Pregnant and breastfeeding women are excluded from the study

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Diagnostisk
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: HR+/HER- metastatic breast cancer at diagnosis or experiencing disease progression

Participants with ESR1 mutations in HR+/HER- metastatic breast cancer undergoing tissue biopsy for ctDNA Tumor Fraction (TF) testing using next-generation sequencing (NGS) after an indeterminate negative result in liquid biopsy (F1LCDx).

Blood test that analyzes cancer-related genes from a single blood draw

Reflex tissue biopsy using an Next-generation sequencing (NGS) test

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Number of participants with ESR1 mutations detected by reflex tissue NGS
Tidsram: From enrollment through study completion (up to 5 years)

Among participants with an indeterminate-negative liquid biopsy result (negative for ESR1 mutations and ctDNA tumor fraction below 1%), measure the number of participants with an ESR1 mutation detected by reflex tissue NGS performed according to the study algorithm.

From enrollment through study completion (up to 5 years)

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Progression-free survival (PFS)
Tidsram: Up to 2 years after positive ESR1 mutation detection

Time from initiation of the first selective estrogen receptor degrader (SERD) after ESR1 mutation detection until objective disease progression, assessed using RECIST version 1.1 when available, or death from any cause, whichever occurs first.

Up to 2 years after positive ESR1 mutation detection
Rate of ESR1 mutation detection by liquid biopsy and ctDNA tumor fraction
Tidsram: Throughout the study, up to 5 years

Rate of ESR1 mutation detection by FoundationOne Liquid CDx (F1LCDx), stratified by ctDNA tumor fraction below 1% versus 1% or greater.

Throughout the study, up to 5 years
Reflex Tissue NGS testing rate
Tidsram: Within the reflex testing time frame during the study, up to 5 years

Number of participants with an indeterminate-negative liquid biopsy result who undergo reflex tissue biopsy and NGS within the protocol-defined timeframe.

Within the reflex testing time frame during the study, up to 5 years
Number participants initiating Selective Estrogen Receptor Degraders (SERD) therapy
Tidsram: Throughout the study, up to 5 years

Number participants initiating SERD therapy after ESR1 mutation detection

Throughout the study, up to 5 years
Number participants SERD therapy by SERD agent
Tidsram: Throughout the study, up to 5 years

Number participants initiating SERD therapy after ESR1 mutation detection. Report counts by SERD agent, with FDA-approved SERDs grouped by class as applicable.

Throughout the study, up to 5 years
Actionable genomic alterations detected by liquid biopsy and tissue NGS.
Tidsram: Throughout the study, up to 5 years

Rtes of actionable genomic alterations detected by F1LCDx and tissue NGS.

Throughout the study, up to 5 years
Other genomic alterations detected at disease progression
Tidsram: At disease progression during the study, up to 5 years

Rates of driver and acquired genomic alterations detected at progression by F1LCDx or tissue NGS that were absent from prior tissue comprehensive genomic profiling (CGP). Acquired alterations are those absent from tissue CGP at diagnosis but newly detected at progression.

At disease progression during the study, up to 5 years
Correlation of HRR gene findings with variant origin and germline confirmation
Tidsram: During the study, when the relevant genomic and confirmatory testing results are available, up to 5 years

Assess the relationship between homologous recombination repair (HRR) gene detection, variant origin prediction, germline banner classification when F1LCDx is performed, and confirmation of germline alterations by orthogonal testing.

During the study, when the relevant genomic and confirmatory testing results are available, up to 5 years
Correlation of HER2 status with ERBB2 copy number
Tidsram: During the study, when the relevant HER2 status and genomic results are available, up to 5 years

Assess the relationship between HER2-low or HER2-negative status and ERBB2 copy number results when F1CDx is performed.

During the study, when the relevant HER2 status and genomic results are available, up to 5 years

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Samarbetspartners

Utredare

  • Huvudutredare: Jing Du, MD, Yale University

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 november 2026

Primärt slutförande (Beräknad)

1 oktober 2031

Avslutad studie (Beräknad)

1 oktober 2031

Studieregistreringsdatum

Först inskickad

26 oktober 2026

Först inskickad som uppfyllde QC-kriterierna

26 oktober 2026

Första postat (Faktisk)

2 november 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

5 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

2 november 2026

Senast verifierad

1 november 2026

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • 2000038562

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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