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Brief Title: Liquid-biopsy Informed Platform Trial to Evaluate CDK4/6-inhibitor Resistant ER+/HER2- Metastatic Breast Cancer
Official Title: A Liquid-biopsy Informed Platform Trial to Evaluate Treatment in CDK4/6-inhibitor Resistant ER+/HER2- Metastatic Breast Cancer
Study ID: NCT05601440
Brief Summary: This study is being done to answer the following question: Can testing breast cancer for DNA abnormalities or "biomarkers" help predict which patients are most likely to be helped by certain treatments? The pre-study screening is being done to test a sample of blood (or tumour tissue) for biomarkers to see if patients can participate in the study
Detailed Description: This is a 2-stage master protocol with multiple substudies testing investigational drugs/drug combinations in patients with CDK4/6-inhibitor resistant ER+/HER2- metastatic breast cancer. First line endocrine therapy (1LET, aromatase inhibitors; AI) improve clinical outcomes, but are not curative, and acquired resistance develops (median \~2 years). CDK4/6i-resistant MBC is a clinical unmet need, and is marked by numerous potential resistance alterations / mechanisms. Currently, most patients receive second line (2L) ET (e.g., fulvestrant) which has a median progression-free survival (PFS) of \~2 months in this setting. Circulating tumour DNA (ctDNA) and circulating tumour cells (CTCs) are detectable in peripheral blood in \>90% of patients with MBC. Patients who wish to participate but progression has not yet occurred may be enrolled in the monitoring substudy and followed until progression. This monitoring component of IND.241 aims to characterize the molecular and clinical features of CDK4/6i resistance as it occurs after first line CDK4/6i + AI. Besides addressing the principal objectives described above (ctDNA genotyping and evaluation of dynamic changes in ctDNA and CTC levels), banked samples will create a biorepository for interrogation of emerging assays (e.g., DNA methylation, CTC protein or single cell analyses) that may have prognostic or predictive application. These data will inform future efforts that may consider intervention prior to clinical treatment failure.
Minimum Age:
Eligible Ages: CHILD, ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
BCCA - Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada
BCCA - Vancouver Cancer Centre, Vancouver, British Columbia, Canada
QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
Kingston Health Sciences Centre, Kingston, Ontario, Canada
Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
University Health Network, Toronto, Ontario, Canada
Name: David Cescon
Affiliation: University Health Network, Princess Margaret Hospital, Toronto ON Canada
Role: STUDY_CHAIR
Name: John Hilton
Affiliation: Ottawa Hospital Research Institute
Role: STUDY_CHAIR
Name: Nathalie Levasseur
Affiliation: BCCA - Vancouver Cancer Centre
Role: STUDY_CHAIR
Name: Stephen Chia
Affiliation: BCCA - Vancouver Cancer Centre
Role: STUDY_CHAIR