E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
hormone receptor positive breast cancer, hormone naive, breast, cancer, neoplasm breast cancer, metastatic, tumour, neoplasm |
Receptor Hormonal positivo de cancer , mama, cancer, cancer de mama neoplasico, metastastásico, tumor, neoplasico |
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E.1.1.1 | Medical condition in easily understood language |
hormone receptor positive breast cancer, hormone naive, breast, cancer, neoplasm, metastatic, tumour |
Receptor Hormonal positivo de cancer, mama. cancer, neoplasico, estastasico, tumor |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To demonstrate superior progression free survival for patients treated with fulvestrant 500mg versus patients treated with anastrozole 1mg |
demostrar la SSP superior de las pacientes tratadas con fulvestrant 500 mg en comparación con las tratadas con anastrozol 1 mg |
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E.2.2 | Secondary objectives of the trial |
To compare the overall survival, objective responses, clinical benefit responses, quality of life and safety profile for study patients |
Demostrar la supervivencia global, respuesta objetiva, respuesta clinica objetiva, calidad de vida y perfil de seguridad para las pacientes del estudio. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1 Histological confirmation of breast cancer in post menopausal women (age >=60)
2 Positive hormone receptor status (ER +ve and/or PgR +ve) of primary or metastatic tumour tissue based on local laboratory assessment.
3 EITHER locally advanced disease (1 line of chemotherapy allowed only if remain unsuitable for therapy of curative intent) OR Metastatic disease. (1 line of chemotherapy for breast cancer allowed only if subsequent evidence of further progressive disease)
4 At least 1 lesion (measurable and/or non-measurable) that can be accurately assessed at baseline and is suitable for repeated assessment.
5 Postmenopausal woman, fulfilling 1 of: Prior bilateral oophorectomy/Age ?60 years/Age <60 years and amenorrheic for 12+months in the absence of chemotherapy, tamoxifen, toremifene, or ovarian suppression and FSH and oestradiol in the postmenopausal range |
1. Confirmación histológica del cáncer de mama.
2. Receptores hormonales positivos (RE+, RPg+ o ambos) en tejido tumoral primario o metastásico, según la evaluación del laboratorio local.
3. Presencia de:
- Enfermedad localmente avanzada que no se preste a cirugía o radioterapia con intención curativa. Las pacientes pueden haber recibido una línea de quimioterapia citotóxica, tras de la cual deben seguir sin ser aptas para recibir tratamiento con intención curativa.
O BIEN
- Enfermedad metastásica.
Las pacientes podrán haber recibido una línea de quimioterapia citotóxica como tratamiento previo del cáncer de mama, pero deben presentar progresión de la enfermedad antes de la inclusión.
4. Al menos una lesión que pueda evaluarse con exactitud en el momento basal y sea adecuada para ser objeto de evaluaciones.
5. Mujer posmenopáusica, definida como la que cumpla alguno de los criterios siguientes
- Ovariectomía bilateral previa.
- Edad ? 60 años.
- Edad < 60 años y amenorrea durante 12 meses o más en ausencia de quimioterapia, tamoxifeno, toremifeno o supresión ovárica y concentraciones de FSH y estradiol en intervalos posmenopáusicos. |
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E.4 | Principal exclusion criteria |
1 Presence of life-threatening metastatic disease - Any of: Extensive hepatic involvement/ involving brain or meninges/ symptomatic pulmonary lymph spread. Discrete lung metastases are acceptable if respiratory function is not significantly compromised
2 Prior systemic therapy for breast cancer other than one line of cytotoxic chemotherapy (the last dose of chemotherapy must have been received more than 28 days prior to randomisation).
3 Radiation therapy if not completed within 28 days prior to randomisation (with the exception of radiotherapy given for control of bone pain, started prior to randomisation).
4 Prior hormonal treatment for breast cancer.
5 Current or prior malignancy within previous 3 years (other than breast cancer or adequately treated basal cell or squamous cell carcinoma of the skin or in situ carcinoma of the cervix). |
1. Presencia de enfermedad visceral metastásica potencialmente mortal, definida como afectación hepática extensa, cualquier grado de afectación encefálica o leptomeníngea o diseminación linfangítica pulmonar sintomática. Podrán participar las pacientes con metástasis parenquimatosas pulmonares definidas siempre que su función respiratoria no se encuentre significativamente afectada como consecuencia de la enfermedad según el criterio del investigador.
2. Tratamiento sistémico previo contra el cáncer de mama distinto de una línea de quimioterapia citotóxica (la última dosis de quimioterapia tendrá que haberse recibido más de 28 días antes de la aleatorización).
3. Radioterapia, en caso de no haberse finalizado en los 28 días previos a la aleatorización (excepto la radioterapia administrada para controlar el dolor óseo, que debe haber terminado antes del día de la aleatorización).
4. Tratamiento previo con un fármaco para el cáncer de mama.
5. Neoplasia maligna actual o previa (distinta del cáncer de mama o de un carcinoma basocelular o espinocelular de piel o un carcinoma in situ de cuello uterino debidamente tratado), salvo que se haya tratado con intención curativa y no haya habido indicios de enfermedad durante los 3 años previos. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Compare the progression free survival (PFS) in patients treated with fulvestrant with those treated with anastrozole |
Comparar la progresion sin supervivencia en pacientes tratadas con fulvestrant con aquellas tratadas con anastrazol. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Baseline RECIST 1.1 assessments and then every 12 weeks until the earliest of disease progression evident, patient dies or has surgery/radiotherapy for their disease. |
Valoracion RECIST 1.1 y luego cada 12 semanas hasta la primer evidencia de progresion de la enfermedad, pacientes fallecidas o tienen cirugia/radioterapia para su enfermedad. |
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E.5.2 | Secondary end point(s) |
1 Compare the Overall Survival (OS, death due to any cause) in patients treated with fulvestrant with those treated with anastrozole when 50% of patients are recorded as having died.
2 Measure objective response rate (ORR) for fulvestrant treatment versus anastrozole. (ORR =% of patients recording partial (PR) or complete response (CR)
3 Measure the duration of response (DoR) for fulvestrant treatment versus anastrozole. (DoR = days from PR/CR response to objective disease progression)
4 Measure expected duration of response (EDoR) for fulvestrant treatment versus anastrozole. (EDoR = p Efp(x), where x=DoR, p=proportion of responders, Efp(x) is mean duration of response)
5 Measure clinical benefit rate (CBR) for fulvestrant treatment versus anastrozole. (CBR= proportion of patients recording RECIST assessments of CR/PR or stable disease (SD) over at least 154 days
6 Measure the duration of clinical benefit (DoCB) for fulvestrant versus anastrozole treatment. (DoCB = for patients recording clinical benefit responses only; days from randomization to date of disease progression)
7 Measure expected duration of clinical benefit (EDoCB) for fulvestrant treatment versus anastrozole. (EDoCB = p Efp(x), where x=DoCB, p=proportion of responders, Efp(x) is mean duration of clinical benefit)
8 Compare the effect of fulvestrant treatment versus anastrozole treatment on Health Related Quality of Life (HRQoL)
9 Compare the safety of fulvestrant treatment versus anastrozole by assessing a panel of adverse events measures: physical examination, electrocardiogram, pulse and blood pressure, weight and haematology and clinical chemistry assessments |
1. Comparar la supervivencia global (SG, de muerte por cualquier causa) en pacientes tratadas con fulvestrant versus aquellas tratadas con anastrazol cuando el 50% de las pacientes estas registradas como fallecidas.
2. Medir la tasa de respuestas objetiva (ORR) para el tratamiento con fulvestrant versus anastrazol. (ORR=% de pacientes con respuesta parcial (PR) o respuesta completa (CR))
3. Medir la duracion de la respuesta (DoR) para el tratamiento con fulvestrant versus tratamiento con anastrazol (DoR= dias desde respuesta PR/PC a progresion objetiva de la enfermedad)
4. Medir la duracion estimada de respuesta (EDoR) para tratamiento con fulvestrant versus anastrazol (EDoR= pEfp(x), donde p= proporcion de pacientes que responden, Efp(x) es la duracion de la respuesta.)
5. Medir la duracion del beneficio clínico (CBR) para el tratamiento con fulvestrant versus anastrazol. (CBR= proporcion de pacientes registrados mediante valoracion RECIST de CR/PR o enfermedad estable (SD) al menos sobre 154 dias)
6. Medir la duracion estimada del beneficio clinico (EDoCB) para tramiento de fulvestrant versus tratamiento de anastrazol. (DoCB=para pacientes registrados solo con respuesta clinica beneficiosa; dias desde randomizacion hasta fecha de proigresion de la enfermedad)
7. Medir la duracio estimada del beneficio clinico (EDoCB) para tratamiento de fulvestrant versus anastrazol.(EDoCB=pEfp(x), donde x= DoCB, p=proporcion de pacientes que responden, Efp(x) es la duracion del beneficio clinico)
8. Comparar el efecto del tratamiento de fulvestrant versus tratamiento de anastrazol
9. Comparar la seguridad del tratamiento de fulvestrant versus anastrazol por valoracion de medida de eventos adversos: examen fisico, electrocardiograma, pulso y presion sanguinea, peso y valoraciones de hematologia y quimica clinica. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1 Following progression, patients will be contacted at 12 weekly intervals to determine survival status
Nos 2-7 Baseline RECIST 1.1 assessments and then every 12 weeks
8 Quality of life questionnaires completed at baseline, 12 weekly whilst on treatment, or 24 weekly for patients being followed for survival
9 Up to the primary analysis: Adverse event will be collected from consent to 56 days after final injection. Vital signs will be collected at each on-treatment visit; ECGs, clinical chemistry and haematology collected from randomization and every 12 weeks until 35 days after final injection. Following the primary analysis, only serious adverse events are recorded. |
1 seguimiento de la progresion, pacientes seran contactadas cada 12 semanas para determinar el estado de supervivencia.
Numeros 2-7, momento basal valoraciones RECIST 1.1 y cada 12 semanas
8 Cuestionarios de calidad de vida completados en el momento basal, cada 12 semanas con tratamiento, o 24 semanas para pacientes que estan siendo seguidas para la supervivencia
9. Hasta el analisis primario: eventos adversos seran recogidos desde el consentimiento hasta 56 dias despues de la ultima inyeccion. Signos viyales seran recogidos en cada visita de tratamiento; ECGs, quimica clinica y hematologia recogida desde la randomizacion y cada 12 semanas hasta 35 dias despues de la ultima inyeccion. Seguimiento de analisis primario, solo los acontecimientos graves son registrados. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 12 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 44 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Argentina |
Brazil |
Canada |
China |
Czech Republic |
India |
Italy |
Japan |
Mexico |
Peru |
Poland |
Russian Federation |
Slovakia |
South Africa |
Spain |
Taiwan |
Turkey |
Ukraine |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The study database will close after the last patient assessment/visit contributing to the overall survival analysis, which will be conducted when approximately 50% patients have died. The end of the study is defined as the last visit of the last patient, occurring when the last patient has discontinued study therapy |
La base de datos del estudio se cerrará despues de la ultima visita/valoracion del ultimo paciente copntribuyendo al analisis de supervivencia global, el cual se realizará cuando aproximadamente el 50% de las pacientes hayan fallecido. El final del estudio esta definido como la ultima visita del ultimo paciente, ocurrida cuando el ultimo paciente has discontinuado la terapia del estudio. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 9 |
E.8.9.2 | In all countries concerned by the trial days | 0 |