A Trial to Evaluate Efficacy and Safety of Ribociclib With Endocrine Therapy as Adjuvant Treatment in Patients With HR+/HER2- Early Breast Cancer
- Conditions
- Early Breast Cancer
- Interventions
- Other: Endocrine Therapy
- Registration Number
- NCT03701334
- Lead Sponsor
- Novartis Pharmaceuticals
- Brief Summary
A phase III multi-center, randomized, open-label trial to evaluate efficacy and safety of ribociclib with endocrine therapy as adjuvant treatment in patients with HR+/HER2- Early Breast Cancer (EBC)
- Detailed Description
The trial will include pre and postmenopausal women and men with HR-positive, HER2-negative EBC, with an Anatomic Stage Group III, IIB or a subset of Stage IIA cases, after adequate surgical resection, radiotherapy (if indicated), adjuvant or neoadjuvant chemotherapy (if indicated), and who are deemed to be eligible for adjuvant ET for at least 60 months of duration.
Approximately 5,000 patients will be randomized (using an Interactive Response Technology system \[IRT\]) into two treatment arms in a 1:1 ratio.
The trial will include screening, treatment, and follow up phases.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 5101
- Patient is ≥ 18 years-old at the time of PICF signature
- Patient is female with known menopausal status at the time of randomization or initiation of adjuvant ET (whichever occurs earlier), or male.
- Patient with histologically confirmed unilateral primary invasive adenocarcinoma of the breast with a date of initial cytologic or histologic diagnosis within 18 months prior to randomization.
- Patient has breast cancer that is positive for ER and/or PgR
- Patient has HER2-negative breast cancer
- Patient has available archival tumor tissue from the surgical specimen
- Patient after surgical resection where tumor was removed completely, with the final surgical specimen microscopic margins free from tumor, and belongs to one of the following categories: anatomic stage group II or III
- If indicated, patient has completed adjuvant and/or neoadjuvant chemotherapy according to the institutional guidelines
- If indicated, patient has completed adjuvant radiotherapy according to the institutional guidelines
- Patient has an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1.
- Patient has no contraindication for the adjuvant ET in the trial and is planned to be treated with ET for 5 years
- Patient has received any CDK4/6 inhibitor
- Patient has received prior treatment with tamoxifen, raloxifene or AIs for reduction in risk ("chemoprevention") of breast cancer and/or treatment for osteoporosis within the last 2 years prior to randomization. Patient is concurrently using hormone replacement therapy.
- Patient has received prior treatment with anthracyclines at cumulative doses of 450 mg/m² or more for doxorubicin, or 900 mg/m² or more for epirubicin.
- Patient with a known hypersensitivity to any of the excipients of ribociclib and/or ET
- Patient with distant metastases of breast cancer beyond regional lymph nodes (stage IV according to AJCC 8th edition) and/or evidence of recurrence after curative surgery.
- Patient is concurrently using other anti-neoplastic therapy with the exception of adjuvant ET
- Patient has had major surgery, chemotherapy or radiotherapy within 14 days prior to randomization
- Patient has not recovered from clinical and laboratory acute toxicities related to prior anti-cancer therapies
- Patient has a concurrent invasive malignancy or a prior invasive malignancy whose treatment was completed within 2 years before randomization
- Patient has known HIV infection, Hepatitis B or C infection
- Clinically significant, uncontrolled heart disease and/or cardiac repolarization abnormality
- Patient is currently receiving any of the following substances within 7 days before randomization - Concomitant medications, herbal supplements, and/or fruits that are known as strong inhibitors or inducers of CYP3A4/5 or Medications that have a narrow therapeutic window and are predominantly metabolized through CYP3A4/5
- is currently receiving or has received systemic corticosteroids ≤ 2 weeks prior to starting trial treatment
- Patient has impairment of GI function or GI disease that may significantly alter the absorption of the oral trial treatments
- Patient has any other concurrent severe and/or uncontrolled medical condition that would, in the Investigator's judgment, cause unacceptable safety risks, contraindicate patient participation in the clinical trial or compromise compliance with the protocol
- Participation in other studies involving investigational drug(s) within 30 days prior to randomization or within 5 half-lives of the investigational drug(s) (whichever is longer), or participation in any other type of medical research judged not to be scientifically or medically compatible with this trial.
- Pregnant or breast-feeding (lactating) women or women who plan to become pregnant or breast-feed during the trial
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Endocrine Therapy Endocrine Therapy Participants will receive endocrine therapy only once daily continuously Ribociclib + Endocrine Therapy Ribociclib Participants will receive ribociclib 400 mg once daily on days 1-21 of a 28-day cycle and endocrine therapy once daily continuously Ribociclib + Endocrine Therapy Endocrine Therapy Participants will receive ribociclib 400 mg once daily on days 1-21 of a 28-day cycle and endocrine therapy once daily continuously
- Primary Outcome Measures
Name Time Method Invasive Disease-Free Survival (iDFS) Up to approximately 91 months iDFS using STEEP criteria (Standardized Definitions for Efficacy End Points in Adjuvant Breast Cancer Trials), as assessed by Investigator. iDFS is defined as time from the date of randomization to the date of the first event of local invasive breast recurrence, regional invasive recurrence, distant recurrence, death (any cause), contralateral invasive BC, or second primary non-breast invasive cancer (excluding basal and squamous cell carcinomas of the skin).
- Secondary Outcome Measures
Name Time Method Change from baseline in the physical functioning sub-scale score as assessed by EORTC QLQ-C30 Up to approximately 91 months The EORTC QLQ-C30 contains functional scales, symptom scales, single items scale and a global health status/QoL scale. All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level.
PK parameters: Ctrough and other applicable parameters for ribociclib Cycle 1 Day 15 Pharmacokinetics of ribociclib: Ctrough and other applicable parameters
Recurrence-free survival (RFS) Up to approximately 91 months RFS using STEEP criteria (Standardized Definitions for Efficacy End Points in Adjuvant Breast Cancer Trials). RFS is defined as the time from date of randomization to date of first event of local invasive breast recurrence, regional invasive recurrence, distant recurrence, or death (any cause).
Distant disease-free survival (DDFS) Up to approximately 91 months DDFS using STEEP criteria. DDFS is defined as the time from date of randomization to date of first event of distant recurrence, death (any cause), or second primary non-breast invasive cancer (excluding basal and squamous cell carcinomas of the skin).
Overall Survival (OS) Up to approximately 91 months OS is defined as the time from date of randomization to date of death due to any cause.
Change from baseline in the global health status Quality of life scale score as assessed by EORTC QLQ-C30 Up to approximately 91 months The EORTC QLQ-C30 contains functional scales, symptom scales, single items scale and a global health status/QoL scale. All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level.
Trial Locations
- Locations (72)
University of Alabama at Birmingham-Kirklin Clinic
🇺🇸Birmingham, Alabama, United States
Cancer Treatment Centers of America
🇺🇸Zion, Illinois, United States
Comprehensive Blood and Cancer
🇺🇸Bakersfield, California, United States
Encino Research Center
🇺🇸Encino, California, United States
St. Jude Heritage Medical Group
🇺🇸Fullerton, California, United States
UCLA Hematology Oncology
🇺🇸Laguna Hills, California, United States
Southern CA Oncology Rsrch Alliance
🇺🇸Los Angeles, California, United States
Stanford University Medical Center
🇺🇸Palo Alto, California, United States
UCLA Pasadena HC Hemato Onco
🇺🇸Pasadena, California, United States
UCLA Porter Ranch Hemato and Onco
🇺🇸Porter Ranch, California, United States
Sharp Memorial Hospital
🇺🇸San Diego, California, United States
UCSF
🇺🇸San Francisco, California, United States
Central Coast Medical Oncology Corporation
🇺🇸Santa Maria, California, United States
UCLA Santa Monica Hematology Oncology
🇺🇸Santa Monica, California, United States
Lundquist Inst BioMed at Harbor
🇺🇸Torrance, California, United States
UCLA Cancer Center Westlake Village
🇺🇸Westlake Village, California, United States
University Of Colorado Hospital
🇺🇸Aurora, Colorado, United States
Rocky Mountain Cancer Centers
🇺🇸Longmont, Colorado, United States
Hospital of Central Connecticut
🇺🇸New Britain, Connecticut, United States
Yale University School Of Medicine
🇺🇸New Haven, Connecticut, United States
Norwalk Hospital
🇺🇸Norwalk, Connecticut, United States
Eastern Connecticut Hematology and Oncology Associates
🇺🇸Norwich, Connecticut, United States
Holy Cross Hospital-Ft. Lauderdale
🇺🇸Fort Lauderdale, Florida, United States
Florida Cancer Specialists
🇺🇸West Palm Beach, Florida, United States
Memorial Cancer Institute
🇺🇸Hollywood, Florida, United States
Orlando Health Clinical Trials
🇺🇸Orlando, Florida, United States
Florida Cancer Specialists-North
🇺🇸Saint Petersburg, Florida, United States
Winship Cancer Institute of Emory University
🇺🇸Atlanta, Georgia, United States
Cancer Care Center
🇺🇸New Albany, Indiana, United States
Norton Cancer Institute
🇺🇸Louisville, Kentucky, United States
Mercy Medical Center
🇺🇸Baltimore, Maryland, United States
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States
University of Michigan Cancer Center
🇺🇸Ann Arbor, Michigan, United States
Metro Minnesota CCOP
🇺🇸Saint Louis Park, Minnesota, United States
Park Nicollet Institute
🇺🇸Saint Louis Park, Minnesota, United States
HCA Midwest Division
🇺🇸Kansas City, Missouri, United States
St Vincent Frontier Cancer Center
🇺🇸Billings, Montana, United States
Saint Francis Medical Center
🇺🇸Grand Island, Nebraska, United States
Comprehensive Cancer Cntr Of Nevada
🇺🇸Henderson, Nevada, United States
Saint Barnabas Medical Center
🇺🇸Livingston, New Jersey, United States
Randolph Medical Associates
🇺🇸Asheboro, North Carolina, United States
Cone Health Cancer Center
🇺🇸Greensboro, North Carolina, United States
Kaiser Permanente NW Region
🇺🇸Clackamas, Oregon, United States
Penn State Hershey Cancer Institute
🇺🇸Hershey, Pennsylvania, United States
The West Clinic
🇺🇸Germantown, Tennessee, United States
Sarah Cannon Research Institute
🇺🇸Nashville, Tennessee, United States
Baylor Charles A Sammons Cancer Cnt
🇺🇸Dallas, Texas, United States
Ctr For Cancer And Blood Disorders
🇺🇸Fort Worth, Texas, United States
MD Anderson Cancer Center University of Texas
🇺🇸Houston, Texas, United States
Utah Cancer Specialists
🇺🇸Salt Lake City, Utah, United States
Virginia Cancer Specialists
🇺🇸Fairfax, Virginia, United States
Virginia Cancer Institute
🇺🇸Richmond, Virginia, United States
Fred Hutchinson Cancer Center
🇺🇸Seattle, Washington, United States
University of Wisconsin Paul P Carbone Comp Cancer Center
🇺🇸Madison, Wisconsin, United States
St Bernards Medical Center
🇺🇸Jonesboro, Arkansas, United States
UCLA Beverly Hills
🇺🇸Beverly Hills, California, United States
UCLA Burbank
🇺🇸Burbank, California, United States
Cancer Care Associates Medical Grp
🇺🇸Redondo Beach, California, United States
UCLA Valencia
🇺🇸Valencia, California, United States
Valley Breast Care
🇺🇸Van Nuys, California, United States
Baptist MD Anderson Cancer Center
🇺🇸Jacksonville, Florida, United States
University of Miami
🇺🇸Miami, Florida, United States
Florida Cancer Specialists Pan
🇺🇸Tallahassee, Florida, United States
Southeastern Regional Medical Center
🇺🇸Newnan, Georgia, United States
University of Kansas Cancer Center
🇺🇸Westwood, Kansas, United States
Cancer Center of Kansas
🇺🇸Wichita, Kansas, United States
Fairview Health Services
🇺🇸Maple Grove, Minnesota, United States
Saint Lukes Hospital of Kansas City
🇺🇸Kansas City, Missouri, United States
David C Pratt Cancer Center
🇺🇸Saint Louis, Missouri, United States
Perlmutter Cancer Centre
🇺🇸New York, New York, United States
Cancer Treatment Centers of America Eastern Regional Medical Center
🇺🇸Philadelphia, Pennsylvania, United States
Novartis Investigative Site
🇬🇧Stoke-on-Trent, United Kingdom