Description:
Dose Escalation part of the study: To estimate the MTD(s) and/ or RP2D of LEE011 in
combination with everolimus + exemestane, and LEE011 in combination with exemestane, and to
characterize the safety and tolerability of the combinations of everolimus + exemestane +
LEE011 and LEE011 + exemestane in patients with ER+ HER2- advanced breast cancer
Dose Expansion part of the study: To characterize the safety and tolerability of the triplet
combination of LEE011 + everolimus + exemestane in patients naïve or refractory to CDK4/6
inhibitor based therapy, and the safety and tolerability of the doublet combination of LEE011
+ exemestane in patients refractory to CDK4/6 inhibitor based therapy (except patients
treated with prior LEE011 are not allowed in Group 3).
Title
- Brief Title: Phase Ib Trial of LEE011 With Everolimus (RAD001) and Exemestane in the Treatment of Hormone Receptor Positive HER2 Negative Advanced Breast Cancer
- Official Title: A Phase Ib Trial of LEE011 in Combination With Everolimus (RAD001) and Exemestane in the Treatment of Postmenopausal Women With Hormone Receptor Positive, HER2 Negative Locally Advanced or Metastatic Breast Cancer
Clinical Trial IDs
- ORG STUDY ID:
CLEE011X2106
- NCT ID:
NCT01857193
Conditions
Interventions
Drug | Synonyms | Arms |
---|
ribociclib (LEE011) | LEE011 | L-E arm |
Exemestane | | L-E arm |
Everolimus (RAD001) | RAD001 | L-R-E arm |
Purpose
Dose Escalation part of the study: To estimate the MTD(s) and/ or RP2D of LEE011 in
combination with everolimus + exemestane, and LEE011 in combination with exemestane, and to
characterize the safety and tolerability of the combinations of everolimus + exemestane +
LEE011 and LEE011 + exemestane in patients with ER+ HER2- advanced breast cancer
Dose Expansion part of the study: To characterize the safety and tolerability of the triplet
combination of LEE011 + everolimus + exemestane in patients naïve or refractory to CDK4/6
inhibitor based therapy, and the safety and tolerability of the doublet combination of LEE011
+ exemestane in patients refractory to CDK4/6 inhibitor based therapy (except patients
treated with prior LEE011 are not allowed in Group 3).
Detailed Description
The primary purpose of the phase Ib part of this study is to determine the maximum tolerated
dose(s) (MTD(s)) and/or recommended phase II dose (RP2D) of LEE011 + everolimus + exemestane
in patients with ER+ Her2- advanced breast cancer. This part of the study will also assess
safety, tolerability, and PK of the LEE011 + exemestane, LEE011 + everolimus + exemestane
combinations.
The Dose Expansion part of the study will evaluate the triple combination of LEE011 +
everolimus + exemestane and the double combination of LEE011 + exemestane for safety and
tolerability.
Trial Arms
Name | Type | Description | Interventions |
---|
L-R-E arm | Experimental | Participants who took ribociclib (LEE011), everolimus (RAD001) and exemestane triple combination | - ribociclib (LEE011)
- Exemestane
- Everolimus (RAD001)
|
L-E arm | Experimental | Participants who ribociclib (LEE011) and exemestane double combination | - ribociclib (LEE011)
- Exemestane
|
Eligibility Criteria
Inclusion Criteria:
- Adult women (≥ 18 years of age) with metastatic or locally advanced breast cancer
- Histological or cytological confirmation of ER+ breast cancer in dose escalation and
HR+ breast cancer in dose expansion
- A representative tumor specimen must be available for molecular testing.
- Postmenopausal women. Postmenopausal status is defined either by:
- Age ≥ 18 with prior bilateral oophorectomy
- Age ≥ 60 years
- Age <60 years with amenorrhea for at least 12 months and both follicle-stimulating
hormone (FSH) and estradiol levels are in postmenopausal range (according to the local
laboratory)
- Recurrence while on, or within 12 months of end of adjuvant treatment with letrozole
or anastrozole, or
- Progression while on, or within one month of end of letrozole or anastrozole treatment
for locally advanced or metastatic breast cancer.
- Patients must have:
- Measurable disease*: At least one lesion that can be accurately measured in at
least one dimension ≥ 20 mm with conventional imaging techniques or ≥ 10 mm with
spiral CT or MRI or
- Bone lesions: lytic or mixed (lytic + sclerotic) in the absence of measurable
disease as defined above.
- ECOG Performance Status 0-1.
- Fasting serum cholesterol ≤ 300 mg/dl or 7.75 mmol/L and fasting triglycerides ≤ 2.5 ×
ULN. In case one or both of these thresholds are exceeded, the patient can only be
included after initiation of statin therapy and when the above mentioned values have
been achieved
- Standard 12-lead ECG values defined as the mean of the triplicate ECGs and assessed by
the central laboratory.
- QTcF interval at screening < 450 msec (using Fridericia's correction).
- Resting heart rate 50-90 bpm
Exclusion Criteria:
- HER2-overexpressing patients by local laboratory testing (IHC 3+ staining or in situ
hybridization positive).
- Patients who received more than one chemotherapy line for advanced breast cancer.
- Previous treatment with exemestane or mTOR inhibitors* (Note:
Patients with disease refractory to prior LEE011 are excluded for dose expansion Group 3
only).
- History of brain or other CNS metastases.
- Clinically significant, uncontrolled heart disease and/or recent cardiac
repolarization abnormality including any of the following:
- History of myocardial infarction (MI), angina pectoris, symptomatic pericarditis, or
coronary artery bypass graft (CABG) within 6 months prior to study entry
- Documented cardiomyopathy
- Left ventricular ejection fraction (LVEF) < 50% as determined by Multiple Gated
acquisition scan (MUGA) or echocardiogram (ECHO)
- Long QT syndrome or family history of idiopathic sudden death or congenital long QT
syndrome, and etc.
- Clinically significant cardiac arrhythmias, complete left bundle branch block,
high-grade AV block
- Systolic Blood Pressure (SBP) >160 or <90 mmHg
- Patients who are currently receiving treatment with agents that are known to cause QTc
prolongation in humans
- Patients who are currently receiving treatment (within 7 days prior to starting study
treatment) with strong and moderate inhibitors or inducers of CYP3A4/5, substrates of
CYP3A4/5 with a narrow therapeutic index or Herbal preparations/medications (Refer to
Section 6.4 and Appendix 3)
Inclusion Criteria Exceptions for Phase Ib Dose Expansion patients:
Dose Expansion part of the study has 3 groups, following are the Inclusion Criteria
exceptions for these 3 groups
1. Group 1 - Patients must not have received prior treatment with any CDK4/6 inhibitors
2. Group 2 - Patients must have disease progression while on or within one month after
CDK4/6 inhibitor based therapy
3. Group 3 - Patients must have disease progression while on or within one month after
CDK4/6 inhibitor based therapy (except those patients who received prior LEE011 based
therapy).
Other protocol-defined Inclusion/Exclusion may apply.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | Female |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Dose Escalation: Incidence of Dose Limiting Toxicity (DLT) |
Time Frame: | At the end of Cycle 1 (each cycle is 28 days) |
Safety Issue: | |
Description: | DLT is defined as treatment-related toxicity (classified according Common Toxicity Criteria for Adverse Events (CTCAE) Version 4) occurring during the first 28 treatment days and meeting specific protocol-predefined criteria. |
Secondary Outcome Measures
Measure: | Dose Escalation: Number of participants with Adverse Events (AEs) and Serious Adverse Events (SAEs) |
Time Frame: | Approximately 6.5 years after FPFV |
Safety Issue: | |
Description: | Adverse events were collected for approximately 6.5 years for dose escalation including the 30 days safety follow-up period. |
Measure: | Dose Escalation and Expansion: Overall Response Rate (ORR) |
Time Frame: | Approximately 6.5 years for Dose Escalation and 4.5 years for Dose Espansion after FPFV |
Safety Issue: | |
Description: | Overall Response Rate (ORR) is defined as the proportion of participants with a best overall response of complete response or partial response. |
Measure: | Dose Escalation and Expansion: Disease Control Rate (DCR) |
Time Frame: | Approximately 6.5 years for Dose Escalation and 4.5 years for Dose expansion after FPFV |
Safety Issue: | |
Description: | Disease Control Rate (DCR) is the proportion of patients with a best overall response of Complete Response or Partial Response or Stable Disease. |
Measure: | Dose Escalation and Expansion: Clinical Benefit Rate (CBR) |
Time Frame: | Approximately 6.5 years for Dose Escalation and 4.5 years for Dose Espansion after FPFV |
Safety Issue: | |
Description: | Clinical Benefit Rate (CBR) is the Complete Response, Partial Response, or Stable Disease lasting 24 weeks or longer |
Measure: | Dose Expansion: Duration of Response (DOR) |
Time Frame: | Approximately 4.5 years for dose expansion after FPFV |
Safety Issue: | |
Description: | Duration of Response (DOR) is calculated as the time from the date of first documented response (complete response (CR) or partial response (PR)) to the first documented date of progression or death due to underlying cancer. The DOR is not applicable as none of the patients in the expansion treatment groups (triplet treatment naive, triplet treatment refractory and doublet treatment refractory) had a CR or PR |
Measure: | Dose Expansion: Progression Free Survival (PFS) |
Time Frame: | Approximately 4.5 years after FPFV |
Safety Issue: | |
Description: | Progression Free Survival (PFS) is defined as the time from date of randomization/start of treatment to the date of event defined as the first documented progression or death due to any cause. If a patient has not had an event, progression-free survival is censored at the date of last adequate tumor assessment. |
Measure: | Dose Escalation: Pharmacokinetics (PK) parameter: AUC0-24h at Day 1 of Cycle 1 |
Time Frame: | 6 Cycles of treatment (28 day cycles): Cycle 1 Day 1 |
Safety Issue: | |
Description: | AUC0-24h is the area under the drug concentration-time curve during a dosing interval (mass x time x volume-1). |
Measure: | Dose Escalation: Pharmacokinetics (PK) parameter: AUC0-24h at at Day 15 of Cycle 1 |
Time Frame: | 6 Cycles of treatment (28 day cycles): Cycle 1 Day 15 |
Safety Issue: | |
Description: | AUC0-24h is the area under the drug concentration-time curve during a dosing interval (mass x time x volume-1). |
Measure: | Dose Escalation: Pharmacokinetics (PK) parameter: Cmax at Day 1 of Cycle 1 |
Time Frame: | 6 Cycles of treatment (28 day cycles): Cycle 1 Day 1 |
Safety Issue: | |
Description: | Cmax is the maximum observed drug concentration after drug administration (mass x volume-1). |
Measure: | Dose Escalation: Pharmacokinetics (PK) parameter: Cmax at Day 15 of Cycle 1 |
Time Frame: | 6 Cycles of treatment (28 day cycles): Cycle 1 Day 15 |
Safety Issue: | |
Description: | Cmax is the maximum observed drug concentration after drug administration (mass x volume-1). |
Measure: | Dose Escalation: Pharmacokinetics (PK) parameter: Tmax at Day 1 of Cycle 1 |
Time Frame: | 6 Cycles of treatment (28 day cycles): Cycle 1 Day 1 |
Safety Issue: | |
Description: | Tmax is the time to reach maximum plasma/blood/serum drug concentration (time). |
Measure: | Dose Escalation: Pharmacokinetics (PK) parameter: Tmax at Day 15 of Cycle 1 |
Time Frame: | 6 Cycles of treatment (28 day cycles): Cycle 15 Day 1 |
Safety Issue: | |
Description: | Tmax is the time to reach maximum plasma/blood/serum drug concentration (time). |
Measure: | Dose Escalation: Pharmacokinetics (PK) parameter: Racc at Day 15 of Cycle 1 |
Time Frame: | 6 Cycles of treatment (28 day cycles): Cycle 15 Day 1 |
Safety Issue: | |
Description: | Racc is the accumulation ratio calculated as AUCtau,ss / AUCtau,sd |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Completed |
Lead Sponsor: | Novartis Pharmaceuticals |
Trial Keywords
- Open label
- dose escalation
- ER+
- LEE011
- CDK4/6
- everolimus
- advanced breast cancer
- mTOR
- HR positive
- HER2 negative
Last Updated
April 13, 2021