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A Neoadjuvant Study of Abemaciclib (LY2835219) in Postmenopausal Women With Hormone Receptor Positive, HER2 Negative Breast Cancer

Phase 2
Completed
Conditions
Breast Cancer
Early-Stage Breast Carcinoma
Hormone Receptor Positive Tumor
Interventions
Registration Number
NCT02441946
Lead Sponsor
Eli Lilly and Company
Brief Summary

The purpose of this study is to evaluate the biological effects of abemaciclib in combination with anastrozole and compare those to the effects of abemaciclib alone and anastrozole alone in the tumors of postmenopausal women with hormone receptor positive (HR+), human epidermal growth factor receptor 2 (HER2) negative breast cancer.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
224
Inclusion Criteria
  • Have postmenopausal status.
  • Adenocarcinoma of the breast.
  • Breast tumor ≥1 centimeter (cm) in diameter, HR+, HER2-.
  • Neoadjuvant endocrine monotherapy is deemed to be a suitable therapy.
  • Primary breast cancer that is suitable for baseline core biopsy.
  • Have adequate organ function.
Exclusion Criteria
  • Bilateral invasive breast cancer.
  • Metastatic breast cancer (local spread to axillary lymph nodes is permitted).
  • Inflammatory breast cancer.
  • Prior systemic therapy or radiotherapy for invasive or non-invasive breast cancer in the same breast as currently being treated.
  • Prior radiotherapy to the ipsilateral chest wall for any malignancy.
  • Prior anti-estrogen therapy.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Abemaciclib + AnastrozoleAbemaciclibAbemaciclib (150 milligrams \[mg\]) was given orally every 12 hours (Q12H) plus anastrozole (1 mg) orally once daily (QD) for 2 weeks. Loperamide was given as a prophylaxis for 4 weeks and then at physician discretion. All participants received abemaciclib (150 mg) orally Q12H plus anastrozole (1 mg) QD for an additional 14 weeks. Total treatment duration was 16 weeks.
Abemaciclib + AnastrozoleLoperamideAbemaciclib (150 milligrams \[mg\]) was given orally every 12 hours (Q12H) plus anastrozole (1 mg) orally once daily (QD) for 2 weeks. Loperamide was given as a prophylaxis for 4 weeks and then at physician discretion. All participants received abemaciclib (150 mg) orally Q12H plus anastrozole (1 mg) QD for an additional 14 weeks. Total treatment duration was 16 weeks.
Abemaciclib + AnastrozoleAnastrozoleAbemaciclib (150 milligrams \[mg\]) was given orally every 12 hours (Q12H) plus anastrozole (1 mg) orally once daily (QD) for 2 weeks. Loperamide was given as a prophylaxis for 4 weeks and then at physician discretion. All participants received abemaciclib (150 mg) orally Q12H plus anastrozole (1 mg) QD for an additional 14 weeks. Total treatment duration was 16 weeks.
AbemaciclibLoperamideAbemaciclib (150 mg) was given orally Q12H for 2 weeks. Loperamide was given as a prophylaxis for 4 weeks and then at physician discretion. All participants received abemaciclib (150 mg) orally Q12H plus anastrozole (1 mg) QD for an additional 14 weeks. Total treatment duration was 16 weeks.
AbemaciclibAbemaciclibAbemaciclib (150 mg) was given orally Q12H for 2 weeks. Loperamide was given as a prophylaxis for 4 weeks and then at physician discretion. All participants received abemaciclib (150 mg) orally Q12H plus anastrozole (1 mg) QD for an additional 14 weeks. Total treatment duration was 16 weeks.
AnastrozoleAbemaciclibAnastrozole (1 mg) is given orally QD for 2 weeks. All participants received abemaciclib (150 mg) orally Q12H plus anastrozole (1 mg) QD for an additional 14 weeks. Loperamide was given as a prophylaxis for the first 2 weeks of the combination treatment and then at physician discretion. Total treatment duration was 16 weeks.
AbemaciclibAnastrozoleAbemaciclib (150 mg) was given orally Q12H for 2 weeks. Loperamide was given as a prophylaxis for 4 weeks and then at physician discretion. All participants received abemaciclib (150 mg) orally Q12H plus anastrozole (1 mg) QD for an additional 14 weeks. Total treatment duration was 16 weeks.
AnastrozoleLoperamideAnastrozole (1 mg) is given orally QD for 2 weeks. All participants received abemaciclib (150 mg) orally Q12H plus anastrozole (1 mg) QD for an additional 14 weeks. Loperamide was given as a prophylaxis for the first 2 weeks of the combination treatment and then at physician discretion. Total treatment duration was 16 weeks.
AnastrozoleAnastrozoleAnastrozole (1 mg) is given orally QD for 2 weeks. All participants received abemaciclib (150 mg) orally Q12H plus anastrozole (1 mg) QD for an additional 14 weeks. Loperamide was given as a prophylaxis for the first 2 weeks of the combination treatment and then at physician discretion. Total treatment duration was 16 weeks.
Primary Outcome Measures
NameTimeMethod
Percent Change From Baseline to 2 Weeks in Ki67 ExpressionBaseline, 2 Weeks

Tumor tissue collected through a core biopsy at baseline and at the end of cycle 1 was used to determine Ki67 expression. Ki67 expression is defined as the percent of cells staining positive by validated central assay.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Pathologic Complete Response (pCR)From Start of Treatment Up to 16 Weeks

pCR is defined as absence of invasive cancer in the breast and sampled regional lymph nodes.

Percentage of Participants With Complete Response (CR) or Partial Response (PR): Clinical Objective ResponseFrom Start of Treatment to Objective Progression or Start of New Anticancer Therapy (Up to 16 Weeks)

Clinical objective response is defined as the percentage of participants with the best overall response rate (ORR) with a best OR of CR or PR, according to Response Evaluation Criteria in Solid Tumors Criteria (RECIST) v1.1. ORR is recorded from the start of the study treatment until the earliest of objective progression or start of new anticancer therapy. A responder depends on target and non-target disease and the appearance of new lesions. CR is defined as the disappearance of all non-target lesions. PR is at least a 30% decrease in the sum of diameter of target lesions, taking as reference the baseline sum diameters. All lymph nodes are non-pathological or normal in size (\<10mm short axis). Progressive disease (PD) is a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study, a relative increase of 20%, the sum must also demonstrate an absolute increase of 5 mm.

Percentage of Participants With Complete Radiologic Response or Partial Radiological Response: Radiological ResponseFrom Start of Treatment to Objective Progression or Start of New Anticancer Therapy (Up to 16 Weeks)

Radiological response is the percentage of participants with CR or, PR according to RECIST v.1.1. A responder is defined as any participant who exhibits a CR or PR. CR is the disappearance of all target lesions. PR is a 30% decrease in the sum of diameter of target lesions, taking as reference the baseline sum diameters. PD is 20% increase in the sum of diameters of target lesions taking as reference the smallest sum and the appearance of 1 or more new lesions.

Change From Baseline to Week 2 in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30)Baseline, 2 Weeks

EORTC QLQ-C30 v3.0 was a self-administered questionnaire with multidimensional scales that measures 5 functional domains (physical, role, emotional, cognitive, or social functioning), global health status and symptom scales of fatigue, pain, nausea/vomiting, dyspnea, insomnia, appetite loss, constipation, diarrhea, or financial difficulties. A linear transformation is applied to standardize the raw scores to range between 0 and 100 per developer guidelines. For functional domains and global health status, higher scores represent a better level of functioning. For symptoms scales, higher scores represented a greater degree of symptoms.

Pharmacokinetics (PK): Apparent Clearance of AbemaciclibCycle(C)1, Day(D)1: 2 to 4 Hours (Hrs) Postdose; C1D14: 4 Hrs Postdose, 7 Hrs Postdose; C3D1: Predose, 3 Hrs Postdose, C4D1 & C5D1, Predose, C5D28: Predose, 3 Hrs Postdose

Abemaciclib apparent clearance (CL/F) was calculated by population nonlinear mixed effects modeling (NONMEM) using all available data spanning cycles 1 and cycles 3-5.

PK: Apparent Volume of Distribution of AbemaciclibCycle(C)1, Day(D)1: 2 to 4 Hours (Hrs) Postdose; C1D14: 4 Hrs Postdose, 7 Hrs Postdose; C3D1: Predose, 3 Hrs Postdose, C4D1 & C5D1, Predose, C5D28: Predose, 3 Hrs Postdose

Abemaciclib apparent volume of distribution was calculated by population NONMEM using all available data spanning cycles 1 and cycles 3-5.

Trial Locations

Locations (31)

Millennium Oncology

🇺🇸

Houston, Texas, United States

For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri, 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST) or speak with your personal physician.

🇨🇳

Taipei, Taiwan

Holy Cross Hospital Inc.

🇺🇸

Fort Lauderdale, Florida, United States

Memorial Regional Hospital/Joe Dimaggio Childrens Hospital

🇺🇸

Hollywood, Florida, United States

SMO TRIO -Translational Research

🇺🇸

Los Angeles, California, United States

University of California-San Diego

🇺🇸

La Jolla, California, United States

Comprehensive Blood and Cancer Center

🇺🇸

Bakersfield, California, United States

UCLA Medical Center

🇺🇸

Los Angeles, California, United States

Sansum Medical Research Foundation

🇺🇸

Santa Barbara, California, United States

Central Coast Medical Oncology Corporation

🇺🇸

Santa Monica, California, United States

Stanford University

🇺🇸

Stanford, California, United States

St Mary's Hospital Regional Cancer Center

🇺🇸

Grand Junction, Colorado, United States

Florida Cancer Research Institute

🇺🇸

Plantation, Florida, United States

Weill Cornell Medical College

🇺🇸

New York, New York, United States

For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.

🇰🇷

Seongnam, Korea, Republic of

Nebraska Hematology-Oncology

🇺🇸

Lincoln, Nebraska, United States

The West Clinic

🇺🇸

Germantown, Tennessee, United States

Kaiser Foundation Hospitals

🇺🇸

Honolulu, Hawaii, United States

Cancer Care Associates Medical Group

🇺🇸

Redondo Beach, California, United States

Northeast Georgia Cancer Care, LLC

🇺🇸

Athens, Georgia, United States

University of Massachusetts Medical Center

🇺🇸

Worcester, Massachusetts, United States

St. Charles Health System

🇺🇸

Bend, Oregon, United States

For additional information regarding investigative sites for this trial, contact 1-888-545-5972 Mon - Fri, 9 AM to 4 PM or 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri, 9 AM to 5 PM Eastern Time or speak with your personal physician.

🇨🇦

Ottawa, Canada

For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician

🇰🇷

Songpa-gu, Korea, Republic of

Columbia Basin Hematology & Oncology

🇺🇸

Kennewick, Washington, United States

Georgia Regents University

🇺🇸

Augusta, Georgia, United States

SMO Pharmatech Oncology Inc

🇺🇸

Denver, Colorado, United States

Oncology and Radiation Associates

🇺🇸

Miami, Florida, United States

Orlando Health, Inc

🇺🇸

Orlando, Florida, United States

Walter Reed National Military Medical Center

🇺🇸

Bethesda, Maryland, United States

Utah Cancer Specialists

🇺🇸

Salt Lake City, Utah, United States

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