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Ribociclib in combination with endocrine therapy in patients with estrogen receptor-positive and HER2-negative” breast cancer with high risk of recurrence

Phase 1
Conditions
Patients with primary operable stage II, grade 2 or 3, Ki67 =20%, HR+/HER2- breast cancer to evaluate safety and long-term efficacy of a non-chemo treatment in patients biologically responders to neoadjuvant ribociclib and letrozole.
Therapeutic area: Diseases [C] - Cancer [C04]
Registration Number
EUCTR2021-002322-24-ES
Lead Sponsor
SOLTI
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised-recruitment may be ongoing or finished
Sex
All
Target Recruitment
530
Inclusion Criteria

1- Signed Informed Consent Form prior to any study-specific procedure. 2- Note: Candidate patients in France must be affiliated to a Social Security System (or equivalent).3- Male (=18 years old) or pre-menopausal women (=40 years old) or post-menopausal women. Premenopausal/male patients will receive LHRH agonists 2 weeks before C1D1 and during treatment. 4- Histologically confirmed invasive breast carcinoma, confirmed by the local pathologist. 5-Breast cancer eligible for primary surgery. 6-Available pre-treatment FFPE core (tru-cut) biopsy evaluable for PAM50 or possibility to obtain one. 7-Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1. 8- Adequate hematological, renal and hepatic function. 9-A male participant must agree to use a contraception as detailed in Appendix 1 of this protocol during the adjuvant chemotherapy period (only non-responder cohort) and for at least 21 days, corresponding to time needed to eliminate any study treatments plus an additional 120 days (a spermatogenesis cycle) after the last dose of chemotherapy and refrain from donating sperm during this period. 10-A female participant is eligible to participate if she is not pregnant, not breastfeeding.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 300
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 230

Exclusion Criteria

1. Any prior treatment for primary invasive breast cancer. Letrozole or other drugs used during the preservation of ovarian function are permitted if administered after baseline biopsy. 2. Inoperable breast cancer. 3. Patients with Stage I, III or IV breast cancer are not eligible.
4. Bilateral invasive breast cancer. 5. Patients who have undergone sentinel lymph node biopsy prior to study treatment. 6. Inability or unwillingness to swallow pills. 7. Malabsorption syndrome or other condition that would interfere with enteric absorption of study drugs. 8. Participation in a prior investigational study within 30 days prior to enrolment or within 5 half-lives of the investigational product, whichever is longer. 9. Patient with a Child-Pugh score B or C. 10. Patient has active cardiac disease or a history of cardiac dysfunction including any of the following: a. History of acute coronary syndromes (including myocardial infarction, unstable angina, coronary artery bypass grafting, coronary angioplasty or stenting) or symptomatic pericarditis within 12 months prior to screening. b. History of documented congestive heart failure (New York Heart Association functional classification III-IV). c. Documented cardiomyopathy.
d. Patient has a Left Ventricular Ejection Fraction (LVEF) <50% as determined by Multiple Gated acquisition (MUGA) scan or echocardiogram (ECHO). e. Clinically significant cardiac arrhythmias.
f. Long QT Syndrome or family history of idiopathic sudden death or congenital long QT syndrome or any of the following:
g. Risk factors for Torsades de Pointe (TdP) including uncorrected hypokalemia or hypomagnesemia, history of cardiac failure or history of clinically significant/symptomatic bradycardia.
h. QTc >500 msec or conduction abnormality in the previous 12 months. i. On screening 12-lead ECG, any of the following cardiac parameters: bradycardia (resting heart rate <50), tachycardia (resting heart rate >90), PR interval >220 msec, QRS interval >109 msec, or QTcF interval =450 msec (using Fridericia’s correction).
j. Uncontrolled hypertension (Systolic blood pressure >160 mmHg or <90 mmHg and/or diastolic >100 mmHg).
11. Active infection requiring intravenous (IV) antibiotics.
12. Prior story of pneumonitis of any cause.
13. Prior thromboembolic events not attributable to a clear trigger cause. 14. Known human immunodeficiency virus (HIV) infection.
15. Any other diseases, active or uncontrolled pulmonary dysfunction, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug, that may compromise compliance with the protocol, that may affect the interpretation of the results, or renders the patients at high risk from treatment complications. 16. Significant traumatic injury within 3 weeks prior to initiation of study treatment. 17. Major surgical procedure (not including minor procedures such as lymph node biopsy, tumor core biopsy, fine needle aspiration or bilateral oophorectomy) within 3 weeks prior to initiation of study treatment or not fully recovered from any side effects of previous procedures.
18. Any psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol and follow-up schedule.
19. Patients with a history of any malignancy are ineligible except for the following circumstances:
• Patients with a malignancy history other

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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