A Randomized, Open-label, Multi-center Phase IV Study Evaluating Palbociclib Plus Endocrine Treatment Versus a Chemotherapy-based Treatment Strategy in Patients With Hormone Receptor Positive / HER2 Negative Breast Cancer in a Real World Setting (GBG 93 - PADMA Study).
Overview
- Phase
- Phase 4
- Status
- Completed
- Sponsor
- German Breast Group
- Enrollment
- 130
- Locations
- 1
- Primary Endpoint
- Time-to-treatment failure (TTF)
Overview
Brief Summary
The goal of the study for patients with metastatic breast cancer (MBC) is to show that palbociclib + endocrine therapy shows a significant improvement in time-to-treatment failure over chemotherapy regimen (mono-chemotherapy with or without endocrine therapy). This would provide level 1 evidence from real world that palbociclib plus endocrine therapy is the first choice in MBC patients needing first-line therapy not only compared to endocrine therapy but also compared to chemotherapy with or without endocrine maintenance therapy.
In addition, we assume that patient-reported outcome as measured by FACT-B and a novel composite endpoint of well-being and healthcare utilization (DMTI) will be improved with palbociclib + endocrine treatment vs. chemotherapy regimen.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Written informed consent prior to beginning specific protocol procedures, including expected cooperation of the patients for the treatment and follow-up, willingness and ability to complete collection of data via wearable device and study mobile must be obtained and documented according to the local regulatory requirements.
- •Female or male patients.
- •Age ≥ 18 years old.
- •Metastatic invasive hormone receptor positive and HER2 negative breast cancer (histologically confirmed).
- •Patients who in the opinion of the treating physician are candidates suitable for randomization for mono-chemotherapy treatment, that has either an approved label in Europe and/or is supported by guidelines for the treatment of first-line advanced BC, which are based on evidence on safety and efficacy in this setting.
- •Symptomatic or asymptomatic metastatic breast cancer.
- •Resolution of all acute toxic effects of prior anti-cancer therapy or surgical procedures to NCI CTCAE version 4.0 grade ≤ 1 (except alopecia or other toxicities not considered a safety risk for the patient at investigator's discretion).
- •Life-expectancy \> 6 months.
- •For female patients: The patients need to be either A) of non-childbearing potential (documented postmenopausal or post hysterectomy) B) childbearing potential with negative serum or urinary pregnancy test (in this case patients need to use highly effective non-hormonal contraceptive methods).
Exclusion Criteria
- •Indication for poly-chemotherapy or single-agent endocrine therapy only or bevacizumab.
- •Asymptomatic oligometastases of the bone as the only site of metastatic disease.
- •Uncontrolled/untreated central nervous system lesions.
- •Patients who received treatment for metastatic/relapsed breast cancer.
- •Inadequate organ function as per physician's assessment immediate prior to randomization.
- •Treatment with preparations containing St. John´s Wort within the last 7 days prior to randomization and/or concurrent use.
- •Known severe hypersensitivity reactions to compounds or excipients similar to palbociclib, planned chemotherapy or planned endocrine therapy.
- •Existing contraindication against the use of palbociclib, planned chemotherapy or planned endocrine therapy.
- •Patients with hereditary problems of galactose intolerance, the Lapp lactase deficiency, and glucose-galactose malabsorption.
- •Female patients: pregnancy or lactation at the time of randomization or intention to become pregnant during the study and up to six months after treatment. Male patients: Intention to beget a child during the study and up to six months after treatment.
Arms & Interventions
Palbociclib + endocrine therapy
Experimental arm for testing palbociclib + endocrine therapy.
Intervention: Palbociclib / Chemotherapy (capecitabine, epirubicin, paclitaxel, vinorelbine) / Endocrine therapy (exemestane, fulvestrant, letrozole, tamoxifen) (Drug)
Chemotherapy +/- endocrine maintenance therapy
Chemotherapy +/- endocrine maintenance as comparator arm.
Intervention: Palbociclib / Chemotherapy (capecitabine, epirubicin, paclitaxel, vinorelbine) / Endocrine therapy (exemestane, fulvestrant, letrozole, tamoxifen) (Drug)
Outcomes
Primary Outcomes
Time-to-treatment failure (TTF)
Time Frame: 31 months
To compare the time-to-treatment failure (TTF) for patients randomized to receive pre-defined chemotherapy treatment strategy versus those randomized to receive palbociclib and endocrine therapy.
Secondary Outcomes
No secondary outcomes reported