| E.1 Medical condition or disease under investigation |
| E.1.1 | Medical condition(s) being investigated |
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| E.1.1.1 | Medical condition in easily understood language |
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| 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 | 20.0 |
| 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 |
To evaluate the efficacy, in terms of Progression Free Survival (PFS), in patients with metastatic breast cancer for: •Abemaciclib 150 mg Q12H plus tamoxifen •Abemaciclib 150 mg Q12H •Abemaciclib 200 mg Q12H plus primary prophylactic loperamide
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| E.2.2 | Secondary objectives of the trial |
•To evaluate the efficacy of abemaciclib monotherapy and in combination with tamoxifen, in terms of Objective Response Rate (ORR), Duration of Response (DoR), and Overall Survival (OS) •To assess the safety profile of abemaciclib monotherapy and in combination with tamoxifen •To characterize the PK of abemaciclib and its metabolites; in addition to tamoxifen and its active metabolite endoxifen •To compare self-reported evaluate impact on pain, pain interference, , disease symptom burdens, health status and overall quality of life
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| E.2.3 | Trial contains a sub-study | Yes |
| E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Protocol Addendum I3Y-MC-JPCG(7) 15 JAN 2019 A Randomized, Open-Label, Phase 2 Study of Abemaciclib plus Tamoxifen or Abemaciclib Alone, in Women with Previously Treated Hormone Receptor-Positive, HER2-Negative, Metastatic Breast Cancer
The primary objective of the tissue addendum is to profile the molecular changes after a prolonged response to treatment |
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| E.3 | Principal inclusion criteria |
•Have a diagnosis of HR+, HER2- breast cancer •Relapsed or progressed following endocrine therapy •Have received prior treatment with at least 2 chemotherapy regimens, of which 1 but no more than 2 have been administered in the metastatic setting •Have the presence of measureable disease as defined by the Response Evaluation Criteria in Solid Tumors (RECIST 1.1) •Have a performance status ≤1 on the ECOG scale •Have discontinued previous therapies for cancer (including specifically, aromatase inhibitors, anti-estrogens, chemotherapy, radiotherapy, and immunotherapy) for at least 21 days for myelosuppressive agents or 14 days for nonmyelosuppressive agents prior to receiving study drug, and recovered from the acute effects of therapy (until the toxicity resolves to either baseline or at least Grade 1) except for residual alopecia or peripheral neuropathy •Have adequate organ function •Have negative serum pregnancy test within 7 days prior to randomization and agree to use medically approved precautions to prevent pregnancy during the study and for 12 weeks following last dose of study treatment •Are able to swallow oral medication
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| E.4 | Principal exclusion criteria |
•Have clinical evidence or history of central nervous system metastasis •Have received treatment with a drug that has not received regulatory approval for any indication within 14 or 21 days prior to randomization of study drug for a nonmyelosuppressive or myelosuppressive agent, respectively •Have had major surgery within 14 days prior to randomization of study drug to allow for post-operative healing of the surgical wound and site(s) •Have a personal history of any of the following conditions: presyncope or syncope of either unexplained or cardiovascular etiology, ventricular tachycardia, ventricular fibrillation, or sudden cardiac arrest •Have active bacterial or fungal infection, or detectable viral infection •Have received treatment with a prior cyclin-dependent kinase (CDK4) and CDK 6 inhibitor •Have a preexisting chronic condition resulting in persistent diarrhea •Have a history of any other cancer (except nonmelanoma skin cancer or carcinoma in-situ of the cervix or breast), unless in complete remission with no therapy for a minimum of 3 years
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| E.5 End points |
| E.5.1 | Primary end point(s) |
Progression Free Survival: baseline to measured progressive disease or death from any cause
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| E.5.1.1 | Timepoint(s) of evaluation of this end point |
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| E.5.2 | Secondary end point(s) |
•Percentage of participants achieving complete response (CR) or partial response (PR), time frame from baseline to objective disease progression: Objective Response Rate •Duration of CR and PR: Duration of Response •Overall Survival •Pharmacokinetics: mean steady state exposure of abemaciclib and its metabolites •Pharmacokinetics: mean steady state exposure of tamoxifen and endoxifen •Change from baseline to end of study in pain and symptom burden assessment on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) •Change from baseline to end of study in pain and symptom burden assessment on the Modified Brief Pain Inventory-Short Form (mBPI-sf) |
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| E.5.2.1 | Timepoint(s) of evaluation of this end point |
•Baseline to objective disease progression (approximately 14 months) •Duration of CR and PR (approximately 14 months) •Overall survival (approximately 36 months) •Pharmacokinetics of abemaciclib and its metabolites, postdose cycle 1, day 1 through postdose cycle 3, day 1 •Pharmacokinetics of tamoxifen and endoxifen, postdose cycle 1, day 1 through postdose cycle 3, day 1: •Change from baseline in pain and symptom burden assessment on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) (approximately 14 months) •Change from baseline in pain and symptom burden assessment on the Modified Brief Pain Inventory-Short Form (mBPI-sf) (approximately 14 months) |
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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 | 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) | Yes |
| E.7.3 | Therapeutic confirmatory (Phase III) | No |
| 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 | Yes |
| E.8.1.3 | Single blind | No |
| E.8.1.4 | Double blind | No |
| 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 | No |
| E.8.2.3 | Other | No |
| E.8.2.4 | Number of treatment arms in the trial | 3 |
| 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 | 5 |
| E.8.5 | The trial involves multiple Member States | Yes |
| E.8.5.1 | Number of sites anticipated in the EEA | 30 |
| 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 |
| Austria |
| Belgium |
| Brazil |
| Canada |
| Czech Republic |
| France |
| Germany |
| Italy |
| Mexico |
| Russian Federation |
| Spain |
| Taiwan |
| Turkey |
| 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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| E.8.9 Initial estimate of the duration of the trial |
| E.8.9.1 | In the Member State concerned years | 3 |
| E.8.9.1 | In the Member State concerned months | 0 |
| E.8.9.1 | In the Member State concerned days | 0 |
| E.8.9.2 | In all countries concerned by the trial years | 3 |
| E.8.9.2 | In all countries concerned by the trial months | 0 |
| E.8.9.2 | In all countries concerned by the trial days | 0 |