E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Breast cancer. |
Cáncer de mama. |
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E.1.1.1 | Medical condition in easily understood language |
Breast cancer. |
Cáncer de mama. |
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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 | 10006187 |
E.1.2 | Term | 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 amcenestrant once a day (QD) improves the invasive breast cancer-free survival (IBCFS) when compared to tamoxifen QD in patients with early breast cancer as adjuvant treatment. |
Determinar si amcenestrant una vez al día (1 v/d) mejora la supervivencia libre de cáncer de mama invasivo (IBCFS) en comparación con tamoxifeno 1 v/d en pacientes con cáncer de mama en etapa temprana como tratamiento adyuvante. |
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E.2.2 | Secondary objectives of the trial |
• To determine whether amcenestrant once a day (QD) improves the invasive disease-free survival (IDFS) when compared to tamoxifen QD in patients with early breast cancer as adjuvant treatment. • To evaluate the distant recurrence-free survival (DRFS) in both treatment arms. •To evaluate the locoregional recurrences-free survival (LRRFS) in both treatment arms. • To evaluate the overall survival (OS) in both treatment arms. • To evaluate the breast cancer-specific survival (BCSS) in both treatment arms. • To evaluate patient-reported overall treatment-related side effect bother, treatment-related symptoms, and quality of life in both treatment arms. • To evaluate safety in both treatment arms. • To characterize the pharmacokinetics (PK) of amcenestrant. |
• Determinar si amcenestrant una vez al día (1 v/d) mejora la supervivencia sin enfermedad invasiva (SSEI) en comparación con tamoxifeno 1 v/d en pacientes con cáncer de mama en etapa temprana como tratamiento adyuvante. • Evaluar la supervivencia sin recidiva a distancia (DRFS) en ambos grupos de tratamiento. • Evaluar la supervivencia sin recidiva locorregional (LRRFS) en ambos grupos de tratamiento. • Evaluar la supervivencia global (SG) en ambos grupos de tratamiento. • Evaluar la supervivencia específica de cáncer de mama (BCSS) en ambos grupos de tratamiento. • Evaluar los efectos secundarios relacionadas con el tratamiento en general notificados por el paciente, los síntomas relacionados con el tratamiento y la calidad de vida en ambos grupos de tratamiento. • Evaluar la seguridad en los dos grupos de tratamiento. • Caracterizar la farmacocinética (FC) de amcenestrant. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Adult participants with histologically confirmed diagnosis of adenocarcinoma of the breast with documentation of hormone receptor-positive status, irrespective of human epidermal growth factor 2 (HER2) status. NOTE: Participants with HER2-positive breast cancer are eligible only if they have completed their adjuvant anti-HER2 treatment and chemotherapy. - With Stage IIB or Stage III, early invasive breast cancer at diagnosis who have undergone breast surgery for the current malignancy. -Who have received prior aromatase inhibitors (AIs) (letrozole, anastrozole or exemestane or any sequence thereof) for at least 6 months and discontinued within 30 months from the initiation of the first AI administration due to AI treatment-related toxicity. - Absence of advanced/metastatic disease. - Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1. - Capable of giving signed informed consent. |
- Participantes adultos con diagnóstico confirmado histológicamente de adenocarcinoma de mama con documentación de estado receptor hormonal positivo, independientemente del estado del factor de crecimiento epidérmico humano 2 (HER2). NOTA: Participantes con cáncer de mama HER-2 positivo son elegibles solo si han completado todo su tratamiento adyuvante con anti-HER2 y quimioterapia. - Participantes con cáncer de mama invasivo en estadio IIB o III, cáncer de mama invasivo en etapa temprana en el diagnóstico que se han sometido a cirugía de mama adecuada (definitiva) para la neoplasia maligna actual. - Participantes que hayan recibido inhibidores de la aromatasa (IA) anteriores (letrozol, anastrozol, exemestano o cualquier secuencia de los mismos) al menos 6 meses de tratamientos adyuvantes que se suspendieron en un plazo de 30 meses desde el inicio de la primera administración de IA debido a toxicidad relacionada con el tratamiento. - Ausencia de enfermedad avanzada/metastásica. - Estado funcional (EF) según el Grupo Oncológico Cooperativo del Este (ECOG) 0-1. - Capacidad para otorgar el consentimiento informado firmado. |
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E.4 | Principal exclusion criteria |
- Medical history or ongoing gastrointestinal disorders potentially affecting the absorption of amcenestrant and/or tamoxifen. Participants unable to swallow normally and to take tablet and capsules. Predictable poor compliance to oral treatment. Active inflammatory bowel disease or chronic diarrhea, active hepatitis A/B/C, hepatic cirrhosis, short bowel syndrome, or any upper gastrointestinal surgery including gastric resection or banding procedures. - Prior breast cancer for which they received an AI. - Any other solid tumor or lymphoma diagnosis is not allowed except if the participant has been free from disease for > or =5 years. - Pregnant or nursing women, or women of child-bearing potential without a negative pregnancy test prior to randomization. - Participants with unrecovered acute toxic effects of prior AI therapy or surgical procedures. - Uncontrolled intercurrent illness, including psychiatric conditions that would limit compliance with study requirements. - Treatment with any another SERD, tamoxifen or toremifene are not allowed as prior adjuvant therapy but could have been used as neoadjuvant therapy for a total duration of 3 months. Participants who were treated with a SERD, tamoxifen or toremifene in the neoadjuvant setting and who experienced disease progression are not allowed. - Participant is receiving concurrent HER2 directed therapy. Appropriate wash out between the last dose of HER2 directed therapy and randomization should be at least 4 weeks. |
- Antecedentes médicos o trastornos gastrointestinales en curso que puedan afectar a la absorción de amcenestrant y/o tamoxifeno. Participantes que no puedan tragar de forma normal o tomar comprimidos o cápsulas. Previsión de cumplimiento inadecuado del tratamiento oral. Enfermedad intestinal inflamatoria activa o diarrea crónica, hepatitis* A/B/C activa, cirrosis hepática, síndrome del intestino corto o cualquier cirugía gastrointestinal superior, incluida la resección gástrica o procedimientos de banda. - Cáncer de mama previo para el que recibieron un tratamiento con IA. - No se permite ningún otro diagnóstico de tumor sólido o linfoma, excepto si el participante ha estado sin enfermedad durante > o = 5 años. - Mujeres embarazadas o en periodo de lactancia, o mujeres con posibilidad de concebir sin una prueba de embarazo negativa antes de la aleatorización. - Participantes con efectos tóxicos agudos no recuperados del tratamiento previo con IA o procedimientos quirúrgicos. - Enfermedad intercurrente no controlada, incluidas afecciones psiquiátricas que limitarían el cumplimiento de los requisitos del estudio. - No se permite el tratamiento con ningún otro SERD, tamoxifeno o toremifeno como tratamiento adyuvante previo, pero podría haberse utilizado como tratamiento neoadyuvante durante un máximo de 3 meses. No se permiten los participantes que recibieron tratamiento con un SERD, tamoxifeno o toremifeno en el entorno neoadyuvante y que experimentaron progresión de la enfermedad. - El participante está recibiendo tratamiento simultáneo dirigido a HER2. El lavado farmacológico adecuado entre la última dosis del tratamiento dirigido a HER2 y la aleatorización debe ser de al menos 4 semanas. |
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E.5 End points |
E.5.1 | Primary end point(s) |
1) Invasive breast cancer-free survival (IBCFS). |
1) Supervivencia libre de cáncer de mama invasivo (IBCFS). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1) From randomization up to approximately 10 years. |
1) Hasta un máximo de 10 años desde la aleatorización. |
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E.5.2 | Secondary end point(s) |
1) Invasive disease-free survival (IDFS). 2) Distant recurrence-free survival (DRFS). 3) Locoregional recurrences-free survival (LRRFS). 4) Overall survival (OS). 5) Breast cancer-specific survival (BCSS). 6) Patient-reported overall treatment-related side effect bother as measured by the Functional Assessment of Cancer Therapy Item GP-5 (FACT-GP5). 7) Patient-reported treatment-related symptoms as measured by the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Breast cancer module (EORTC QLQ-B23) systemic therapy side effects scale. 8) Patient-reported quality of life as measured by the EORTC Core Quality of Life Questionnaire (EORTC QLQ-C30) global health status/quality of life (GHQ) scale. 9) Number of participants with treatment emergent adverse events (TEAEs) and serious adverse events (SAEs). 10) PK parameter: Plasma concentration of Amcenestrant. |
1) Supervivencia libre de enfermedad invasiva (IDFS). 2) Supervivencia libre de recurrencia a distancia (DRFS). 3) Supervivencia libre de recurrencias locorregionales (LRRFS). 4) Supervivencia global (SG). 5) Supervivencia específica del cáncer de mama (BCSS). 6) Molestias por efectos secundarios generales relacionados con el tratamiento informados por el paciente según lo medido por el ítem de evaluación funcional del tratamiento para el cáncer GP-5 (FACT-GP5). 7) Síntomas relacionados con el tratamiento informados por el paciente medidos según la escala de efectos secundarios del tratamiento sistémico del módulo de cáncer de mama del cuestionario de la calidad de vida de la EORTC (EORTC-QLQ-BR23). 8) Calidad de vida informada por el paciente medida según la escala de estado de salud general/calidad de vida (GHQ) del cuestionario de la calidad de vida principal de la EORTC (EORTC QLQ-C30). 9) Número de participantes con acontecimientos adversos emergentes del tratamiento (TEAEs) y acontencimientos adversos graves (AAGs). 10) Parámetro farmacocinético: concentración plasmática de Amcenestrant. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1/2/3/4/5)From randomization up to approximately 10 years 6) From baseline up to 2 years after the end of treatment (up to approximately 7 years). 7) From baseline up to 2 years after the end of treatment (up to approximately 7 years). 8) From baseline up to 2 years after the end of treatment (up to approximately 7 years). 9) Up to 30 days after the end of treatment, approximately 5 years 10) Pre-administration day 1 of cycles 2, 7, 13 and 25 (each cycle is 28 days). |
1/2/3/4/5) Hasta un máximo de 10 años desde la aleatorización. 6) Desde el inicio hasta 2 años después del final del tratamiento (hasta aproximadamente 7 años). 7) Desde el inicio hasta 2 años después del final del tratamiento (hasta aproximadamente 7 años). 8) Desde el inicio hasta 2 años después del final del tratamiento (hasta aproximadamente 7 años). 9) Hasta 30 días después de finalizar el tratamiento, aproximadamente 5 años. 10) Pre-administración día 1 de los ciclos 2, 7, 13 y 25 (cada ciclo es de 28 días). |
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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) | 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 | 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 | 22 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 140 |
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 |
Australia |
Brazil |
Canada |
Chile |
China |
India |
Japan |
Korea, Republic of |
Mexico |
New Zealand |
Taiwan |
United States |
Austria |
Estonia |
France |
Sweden |
Spain |
Switzerland |
Germany |
Greece |
Italy |
Belgium |
Denmark |
Georgia |
Hungary |
Ireland |
Portugal |
Russian Federation |
Turkey |
Ukraine |
United Kingdom |
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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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LVLS. |
Última visita del último paciente. |
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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 | 12 |
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 | 12 |
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 |