E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Hormone Receptor Positive, HER2 negative Locoregionally Recurrent or Metastatic Breast Cancer with No Prior Systemic Therapy in This Disease Setting |
Receptores hormonales positivos y HER2 negativo, en cáncer de mama localmente recurrente o metastásicono tratadas previamente con ninguna terapia sistémica para esta enfermedad |
|
E.1.1.1 | Medical condition in easily understood language |
Metastatic Breast Cancer |
Cancer de mama metastasico |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 17.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10027475 |
E.1.2 | Term | Metastatic breast cancer |
E.1.2 | System Organ Class | 100000004864 |
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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 |
The primary objective of Study I3Y-MC-JPBM is to compare treatment with LY2835219 plus NSAI therapy versus placebo plus NSAI therapy with respect to PFS in postmenopausal women with HR+, HER2- locoregionally recurrent or metastatic breast cancer who have not received prior systemic therapy in this disease setting. |
El objetivo principal del estudio I3Y-MC-JPBM es comparar el tratamiento con LY2835219 y un IANE con la administración de placebo y un IANE, en términos de SSP, en mujeres postmenopáusicas con cáncer de mama localmente recurrente o metastásico HR+, HER2-, que no hayan recibido ninguna terapia sistémica para esta enfermedad. |
|
E.2.2 | Secondary objectives of the trial |
The secondary objectives of the study are to compare the combination treatment of LY2835219 and NSAI therapy versus placebo plus NSAI therapy with respect to the following: ? OS ? OS rate at 1, 2, and 3 years; ? ORR (CR + PR); ? Duration of response (CR + PR); ? DCR (CR + PR + SD); ? CBR (CR + PR + SD ?6 months); ? Safety and tolerability; ? Change in symptom burden from baseline using the EORTC QLQ-C30, EORTC QLQ-BR23 (breast) questionnaire, and health status scores from the EQ-5D 5L; ? PK of LY2835219, its metabolites, and NSAI therapy |
Los objetivos secundarios del estudio son comparar el tratamiento politerápico con LY2835219 y un IANE con la administración de placebo y un IANE, en relación con los siguientes parámetros: ? Supervivencia global [SG]; ? Tasa de SG al cabo de 1, 2 y 3 años; ? TRO (respuesta completa [RC] + RP); ? Duración de la respuesta [DdR] (RC + RP); ? TCE (RC + RP + EE); ? TBC (RC + RP + EE ? 6 meses); ? Seguridad y tolerabilidad. ? Variación en la carga sintomática, de acuerdo con el Cuestionario de Calidad de Vida Core 30 de la Organización Europea para la Investigación y el Tratamiento del Cáncer (EORTC QLQ-C30) y el Cuestionario EORTC QLQ-BR23 (mama), así como con las puntuaciones del estado de salud del cuestionario EuroQol 5- Dimensiones 5 Niveles (EQ-5D 5L). ? Farmacocinética (FC) de LY2835219, sus metabolitos y del tratamiento con el IANE. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
? have a diagnosis of HR+, HER2- breast cancer; ? have locoregionally recurrent disease not amenable to resection or radiation therapy with curative intent or metastatic disease; ? have postmenopausal status due to either surgical/natural menopause or amenorrheic (non-treatment-induced) for at least 12 months; ? have either measurable disease or nonmeasurable bone-only disease; ? have a performance status ?1 on the Eastern Cooperative Oncology Group (ECOG) scale; ? have adequate organ function; ? have discontinued previous localized radiotherapy for palliative purposes or for lytic lesions at risk of fracture prior to randomization and recovered from the acute effects of therapy; ? are female and ?18 years of age; ? are able to swallow capsules; |
1) presentar diagnóstico de cáncer de mama HR+, HER2-; 2) presentar enfermedad localmente recurrente que no sea resecable o no pueda tratarse con radioterapia (con fines curativos), o enfermedad metastásica; 3) haber entrado en la menopausia (menopausia quirúrgica o natural) o no presentar menstruaciones (y que ello no haya sido inducido por el tratamiento) desde hace al menos 12 meses; 4) presentar bien enfermedad mensurable o únicamente enfermedad ósea no mensurable; 5) presentar una categoría funcional ? 1 en la escala del Eastern Cooperative Oncology Group (ECOG); 6) presentar una función orgánica adecuada; 7) haber interrumpido antes de la aleatorización cualquier radioterapia localizada previa administrada con fines paliativos o para tratar lesiones líticas con riesgo de fractura, y haberse recuperado de los efectos agudos del tratamiento; 8) ser mujer y tener ? 18 años de edad; 9) ser capaz de ingerir cápsulas; 10) haber proporcionado el consentimiento informado antes de realizar cualquiera de los estudios específicos del estudio; 11) ser responsable y estar disponible durante el estudio, y estar dispuesto a realizar los procedimientos del estudio. |
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E.4 | Principal exclusion criteria |
? have visceral crisis, lymphangitic spread, or leptomeningeal carcinomatosis. Visceral crisis is not the mere presence of visceral metastases but implies severe organ dysfunction as assessed by symptoms and signs, laboratory studies, and rapid progression of the disease. ? have inflammatory breast cancer. ? have clinical evidence or a history of CNS metastasis. Screening is not required for enrollment. ? are currently receiving or have previously received endocrine therapy for locoregionally recurrent or metastatic breast cancer. [Note: A patient may be enrolled if she received prior (neo)adjuvant endocrine therapy (including , but not limited to anti-estrogens or aromatase inhibitors) for localized disease. In addition, a patient may be enrolled if she has received ?2 weeks of NSAI in this disease setting immediately preceding screening and agrees to discontinue NSAI until study treatment initiation.] ? have received prior (neo)adjuvant endocrine therapy (e.g., anti-estrogens or aromatase inhibitors) with a disease-free interval ?12 months from completion of treatment. ? are currently receiving or have previously received chemotherapy for locoregionally recurrent or metastatic breast cancer. [Note: Patients may be enrolled if they received prior (neo)adjuvant chemotherapy for localized disease.] ? have received prior treatment with everolimus ? have received prior treatment with any CDK4/6 inhibitor (or participated in any CDK4/6 inhibitor clinical trial for which treatment assignment is still blinded) ? have initiated bisphosphonates or approved RANK ligand (RANK-L) targeted agents (for example, denosumab) <7 days prior to randomization ? are currently receiving an investigational drug in a clinical trial or participating in any other type of medical research judged not to be scientifically or medically compatible with this study. If a patient is currently enrolled in a clinical trial involving non-approved use of a device, then agreement with the investigator and Lilly clinical research physician (CRP) is required to establish eligibility. ? have received treatment with a drug that has not received regulatory approval for any indication within 14 or 21 days of randomization for a nonmyelosuppressive or myelosuppressive agent, respectively. ? have had major surgery within 14 days prior to randomization to allow for post-operative healing of the surgical wound and site(s). ? have received recent (within 28 days prior to randomization) yellow fever vaccination. ? have serious preexisting medical conditions that, in the judgment of the investigator, would preclude participation in this study (for example, history of major surgical resection involving the stomach or small bowel, or preexisting Crohn?s disease or ulcerative colitis). ? have a personal history within the last 12 months of any of the following conditions: syncope of cardiovascular etiology, ventricular tachycardia, ventricular fibrillation, or sudden cardiac arrest. |
12) presentar crisis visceral, diseminación linfangítica o carcinomatosis meníngea; 13) presentar cáncer de mama inflamatorio; 14) presentar indicios clínicos o antecedentes de metástasis en el sistema nervioso central (SNC); 15) estar recibiendo en la actualidad o haber recibido anteriormente terapia endocrina para tratar el cáncer de mama localmente recurrente o metastásico; 16) haber recibido terapia endocrina (neo)adyuvante y que el período sin enfermedad desde la finalización del tratamiento sea ? 12 meses; 17) estar recibiendo en la actualidad o haber recibido previamente tratamiento quimioterápico para el cáncer de mama localmente recurrente o metastásico; 18) haber recibido tratamiento previo con everolimus; 19) haber recibido tratamiento previo con cualquier inhibidor de las CDK4/6 (o haber participado en cualquier ensayo clínico en el que se evalúe un inhibidor de las CDK4/6 y cuyo tratamiento aún esté enmascarado); 20) haber comenzado a recibir bifosfonatos o un fármaco aprobado dirigido al ligando RANK (RANK-L) < 7 días antes de la aleatorización; 21) estar recibiendo en la actualidad un fármaco en fase de investigación en un ensayo clínico, o estar participando en cualquier otro tipo de investigación médica que se considere que no es compatible con el estudio, desde un punto de vista científico o médico; 22) haber recibido tratamiento, en los 14 o 21 días previos a la aleatorización, con un fármaco sin actividad mielodepresora o con efecto mielodepresor, espectivamente, que no haya recibido aprobación por parte de las autoridades reguladoras para ninguna indicación; 23) haberse sometido a una intervención de cirugía mayor en el transcurso de los 14 días previos a la aleatorización; 24) haber recibido recientemente (en el transcurso de los 28 días previos a la aleatorización) vacunación contra la fiebre amarilla; 25) presentar enfermedades preexistentes graves que, en opinión del investigador, podrían impedir su participación en este estudio; 26) presentar antecedentes personales de cualquiera de las siguientes enfermedades: síncope de etiología cardiovascular, taquicardia ventricular, fibrilación ventricular o paro cardiaco súbito; 27) presentar antecedentes de cualquier otro cáncer (excepto cáncer de piel no melanomatoso o carcinoma in situ de cuello uterino), a menos que haya permanecido en remisión completa al menos durante 3 años, sin ningún tipo de tratamiento; 28) haber recibido un alotrasplante o autotrasplante de hemocitoblastos; 29) presentar infecciones bacterianas o fúngicas activas o infecciones víricas detectables. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Progression Free Survival (PFS) |
Supervivencia lire de progresion |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
Baseline up to Measured Progressive Disease or Death from Any Cause (Approximately 34 Months) |
Desde el inicio hasta progresion de la enfermedad o muerte por cualquier causa (Aproximadamente 34 meses) |
|
E.5.2 | Secondary end point(s) |
? Overall Survival (OS) ? Objective Response Rate (ORR) ? Duration of Response (DoR) ? Disease Control Rate (DCR): ? Clinical Benefit Rate (CBR) ? Safety and tolerability endpoints (e.g. physical examination, adverse event collection, lab tests, dosing information) ? Change in symptom burden using EORTC QLQ-C30, EORTC QLQ-BR23 questionnaire ? Change in health status using the EQ-5D 5L ? Pharmacokinetics (PK): Area Under the Concentration Curve (AUC) of LY2835219, its Metabolites, and NSAI Therapy: |
- Supervivencia global (SG) - Tasa de respuestas objetivas (TRO) - Duración de la respuesta (DdR) - Tasa de control de la enfermedad (TCE) - Tasa de beneficio clínico (TBC) - Variación en la carga sintomática, de acuerdo con el Cuestionario de Calidad de Vida Core 30 de la Organización Europea para la Investigación y el Tratamiento del Cáncer (EORTC QLQ-C30) y el Cuestionario EORTC QLQ-BR23 (mama), - Variacion en las puntuaciones del estado de salud del cuestionario EuroQol 5- Dimensiones 5 Niveles (EQ-5D 5L). - Farmacocinética (FC) de LY2835219, sus metabolitos y del tratamiento con el IANE |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
OS: Baseline to approximately 82 Months
ORR, DoR, CBR, safety and tolerability endpoints (e.g. physical examination, adverse event collection, lab tests, dosing information change in symptom burden using the EORTC QLQ-C30, EORTC QLQ-BR23, change in health status using the EQ-5D 5L: Baseline to approximately 34 mont
PK: Baseline up to approximately 4 months |
SP: DEsde El inicio hasta aproximadamente 82 meses Tasa de respuestas objetivas (TRO) - Duración de la respuesta (DdR) - Tasa de control de la enfermedad (TCE) - Tasa de beneficio clínico (TBC) - Variación en la carga sintomática, de acuerdo con el Cuestionario de Calidad de Vida Core 30 de la Organización Europea para la Investigación y el Tratamiento del Cáncer (EORTC QLQ-C30) y el Cuestionario EORTC QLQ-BR23 (mama), - Variacion en las puntuaciones del estado de salud del cuestionario EuroQol 5- Dimensiones 5 Niveles (EQ-5D 5L). |
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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 | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
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) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
All patients will receive NSAI (anastrozole or letrozole) |
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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 | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 45 |
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 |
Australia |
Austria |
Canada |
France |
Germany |
Israel |
Italy |
Japan |
Korea, Republic of |
Mexico |
Netherlands |
Russian Federation |
Slovakia |
Spain |
Sweden |
Taiwan |
United Kingdom |
United States |
|
E.8.7 | Trial has a data monitoring committee | Yes |
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
|
LVLS |
ultimo paciente ultima visita |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 7 |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 7 |
E.8.9.2 | In all countries concerned by the trial months | 10 |
E.8.9.2 | In all countries concerned by the trial days | 0 |