E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
patients with hormone receptor positive / HER2-negative resected isolated locoregional recurrence of breast cancer |
Pacientes, mujeres y varones, con recidiva locorregional aislada (RLRA) de cáncer de mama extirpado con RH positivo y HER2 negativo con confirmación histológica |
|
E.1.1.1 | Medical condition in easily understood language |
Patients with breast cancer in the operated breast, the surgical scar, the chest wall or the regional lymph nodes |
Pacientes con cáncer de mama en la mama operada, la cicatriz quirúrgica, la pared torácica o los ganglios linfáticos regionales |
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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 | PT |
E.1.2 | Classification code | 10006198 |
E.1.2 | Term | Breast cancer recurrent |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
|
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10070575 |
E.1.2 | Term | Estrogen receptor positive breast cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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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 determine whether treatment with 3 years of palbociclib plus standard endocrine therapy for at least 3 years prolongs iDFS compared to treatment with standard endocrine therapy alone for at least 3 years in patients with HR-positive / HER2-negative resected isolated locoregional recurrence (ILRR) of breast cancer. |
Determinar si el tratamiento con 3 años de palbociclib más la hormonoterapia habitual durante al menos 3 años prolonga la supervivencia sin cáncer invasivo (SSCi) en comparación con el tratamiento con hormonoterapia habitual sola durante al menos 3 años en pacientes con recidiva locorregional aislada (RLRA) de cáncer de mama extirpado con receptor hormonal positivo y HER2 negativo. |
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E.2.2 | Secondary objectives of the trial |
To assess the tolerability of 3 years of palbociclib in combination with standard endocrine therapy compared to standard endocrine therapy alone, as measured by adverse events. To assess whether treatment with 3 years of palbociclib plus standard endocrine therapy for at least 3 years prolongs other measures of efficacy as compared to treatment with standard endocrine therapy alone for at least 3 years in this patient population. |
Evaluar la tolerabilidad de 3 años de palbociclib combinado con la hormonoterapia habitual en comparación con la hormonoterapia habitual sola, medida por los acontecimientos adversos.
Evaluar si el tratamiento con 3 años de palbociclib más la hormonoterapia habitual durante al menos 3 años prolonga otras medidas de eficacia en comparación con el tratamiento con la hormonoterapia habitual sola durante al menos 3 años en esta población de pacientes |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Histologically confirmed invasive breast cancer, defined as first proven ipsilateral local and/or regional recurrence in at least one of the sites below: – Breast – Chest wall including mastectomy scar and/or skin – Axillary or internal mammary lymph nodes Completion of locoregional therapy: – Completion of gross excision of recurrence within 6 months prior to randomization – Completion of radiotherapy (if given) more than 2 weeks prior to randomization Negative or microscopically involved margins Female or male aged 18 years or older ECOG performance status 0 or 1 Recurrent tumor must be hormone receptor positive: ER+ and/or PgR+ ≥1% by IHC Recurrent tumor must be HER2-negative (0, 1+, 2+ by IHC and/or ISH/FISH not amplified) Tumor with HER2 status 2+ by IHC must also be negative (not amplified) by ISH/FISH Normal hematological, renal, and liver function The patient agrees to make tumor (diagnostic core biopsy or surgical specimen of ILRR) available for submission for central pathology review Patients must either be planned to initiate, or have already started, endocrine therapy for ipsilateral isolated locoregional recurrence Written Informed Consent (IC) prior to randomization |
Cáncer de mama invasivo con confirmación histológica, definido como la primera recidiva local y/o regional ipsilateral demostrada en al menos una de las localizaciones siguientes: – Mama – Pared torácica incluida la piel y/o la cicatriz de la mastectomía – Ganglios linfáticos axilares o intramamarios Finalización del tratamiento locorregional: – Finalización de la extirpación macroscópica de la recidiva en los 6 meses anteriores a la aleatorización – Finalización de la radioterapia (si se administra) más de 2 semanas antes de la aleatorización Márgenes negativos o afectados microscópicamente Mujer o varón de 18 años o más Categoría funcional ECOG 0 o 1 El tumor recidivante debe ser receptor hormonal positivo: ER+ y/o RPG+ ≥1% por IHQ El tumor recidivante debe ser HER2 negativo (0, 1+, 2+ por IHQ y/o HIS/HISF no amplificada) Tumor con estado 2+ de HER2 por IHQ debe ser también negativo (no amplificado) por HIS/HISF Funciones hematológica, renal y hepática normales El paciente está de acuerdo en poner a disposición el tumor (biopsia diagnóstica con aguja gruesa o una pieza quirúrgica de RLRA) para enviarlo a la revisión de patología central Debe estar previsto que los pacientes inicien, o deben haber iniciado ya, la hormonoterapia para la recidiva locorregional ipsilateral aislada. Consentimiento informado por escrito previo a la aleatorización |
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E.4 | Principal exclusion criteria |
Recurrence of any size with direct extension to the chest wall and/or to the skin (ulceration or skin nodules) not surgically removable Evidence of distant metastasis as based on conventional staging examinations (physical, chest X-ray or CT, abdominal ultrasound or CT, bone scintigraphy or FDG-PET-CT). Bilateral invasive breast cancer (in situ carcinoma of the contralateral breast is allowed) Inflammatory breast cancer Patients with a history of malignancy, other than invasive breast cancer, with the following exceptions: – Patients diagnosed, treated and disease-free for at least 5 years and deemed by the investigator to be at low risk for recurrence of that malignancy are eligible – Patients with the following malignancies are eligible, even if diagnosed and treated within the past 5 years: ductal carcinoma in situ of the breast; cervical cancer in situ; thyroid cancer in situ; non-metastatic, non-melanomatous skin cancers Previous treatment with palbociclib or any other CDK 4/6 inhibitors Previous or planned chemotherapy or planned radiotherapy for the ipsilateral isolated locoregional recurrence (radiotherapy is allowed, but must be completed more than 2 weeks prior to randomization) Concurrent disease or condition that would make the patient inappropriate for study participation or any serious medical disorder that would interfere with the patient’s safety Contraindications or known hypersensitivity to the palbociclib or excipients Pregnant or lactating women; lactation has to stop before randomization |
Recidiva de cualquier tamaño con propagación directa a la pared torácica y/o a la piel (úlcera o nódulos cutáneos) no extirpable quirúrgicamente Signos de metástasis a distancia basados en las pruebas habituales de estadificación (exploración física, radiografía de tórax o TAC, ecografía abdominal o TAC, gammagrafía ósea o FDG-PET-TAC). Cáncer de mama bilateral invasivo (carcinoma in situ de la mama contralateral permitido) Cáncer de mama inflamatorio Pacientes con antecedentes de cáncer, que no sea cáncer de mama invasivo, con las siguientes excepciones: – Son idóneos los pacientes diagnosticados, tratados y sin cáncer durante al menos 5 años y considerados por el investigador de bajo riesgo de recidiva de dicho cáncer – Son idóneos los pacientes con los siguientes tipos de cáncer, incluso si han sido diagnosticados y tratados en los últimos 5 años: carcinoma ductal in situ de mama; cáncer de cuello uterino in situ; cáncer de tiroides in situ y cáncer de piel no metastásico y no melanometoso. El tratamiento previo con palbociclib o cualquier otro inhibidor CDC4/6. Quimioterapia previa o prevista o radioterapia prevista para la recidiva locorregional ipsilateral aislada (la radioterapia está permitida pero debe finalizar más de 2 semanas antes de la aleatorización) Enfermedad o afección simultánea por la que el paciente resulte adecuado para participar en el estudio o cualquier trastorno grave que pudiera interferir en la seguridad del paciente Contraindicaciones o hipersensibilidad conocida a palbociblib o a los excipientes Mujeres embarazadas o lactantes; debe interrumpirse la lactancia antes de la aleatorización |
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E.5 End points |
E.5.1 | Primary end point(s) |
Invasive disease-free survival (iDFS) |
Supervivencia libre de enfermedad invasiva (SSCi) |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
from randomization until first appearance of invasive local, regional, or distant recurrence |
desde la aleatorización hasta la primera aparición de recurrencias locales, regionales o distantes invasivas |
|
E.5.2 | Secondary end point(s) |
- Tolerability: Adverse events - Breast cancer-free interval (BCFI) - Distant recurrence-free interval (DRFI) - Overall survival (OS) |
- Tolerabilidad: Eventos adversos. - Intervalo sin cáncer de mama (ISCM) - Intervalo sin metástasis a distancia (ISMD)- - Supervivencia global (SG) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
-Adverse events: at occurance , from randomization until end of treatment visit - BCFI: time from randomization until first appearance of invasive local, regional, or distant recurrence - DRFI: time from randomization until first appearance of distant recurrence of breast cancer - OS: time from randomization until death from any cause |
Eventos adversos: en el momento en que ocurren, desde la aleatorización hasta el final de la visita al tratamiento - ISCM: tiempo desde la aleatorización hasta la primera aparición de recurrencias locales, regionales o distantes invasivas - ISMD: tiempo desde la aleatorización hasta la primera aparición de recurrencia a distancia de cáncer de mama - SG: tiempo desde la aleatorización hasta la muerte por cualquier causa |
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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 | 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 | 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 | 10 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 36 |
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 |
Austria |
France |
Hungary |
Italy |
Spain |
Switzerland |
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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
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LVLS |
última visita, último paciente |
|
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 | 6 |
E.8.9.1 | In the Member State concerned days | |
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 | 6 |