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Brief Title: A Phase II Randomized Study Evaluating the Biological and Clinical Effects of the Combination of Palbociclib With Letrozole as Neoadjuvant Therapy in Post-Menopausal Women With Estrogen-Receptor Positive Primary Breast Cancer
Official Title: A Phase II Randomized Study Evaluating the Biological and Clinical Effects of the Combination of Palbociclib With Letrozole as Neoadjuvant Therapy in Post-Menopausal Women With Estrogen-Receptor Positive Primary Breast Cancer
Study ID: NCT02296801
Brief Summary: This study will look at effects the combination of palbociclib and letrozole may have on estrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer tumors which have not yet been treated. Letrozole is a type of endocrine therapy called an aromatase inhibitor (AI) and is standard treatment for post-menopausal women with ER-positive/HER2-negative breast cancer.
Detailed Description: The FB-11 study is a Phase II, randomized, open label, four arm study to examine the biological and clinical effect of neoadjuvant letrozole with or without palbociclib in the first-line treatment of estrogen-receptor (ER) positive, HER2-negative early invasive breast cancer. The co-primary aims of this study are to to compare the changes in the proliferation marker Ki67, and to compare clinical response after 14 weeks of therapy with letrozole with or without palbociclib. The FB-11 study initiative is a joint partnership between the NSABP Foundation, Inc. (NSABP) Department of Site and Study Management (DSSM) and United Kingdom (UK) co-investigators at the Royal Marsden NHS Foundation Trust and the Institute of Cancer Research (ICR). Parallel protocols will be conducted in the US and Canada (FB-11), and the UK (PALLET) with joint analysis of interim and final data. Postmenopausal women, newly diagnosed with ER-positive/HER2-negative early breast cancer, who are suitable candidates for neoadjuvant endocrine therapy will be invited to join the FB-11/PALLET trial. Approximately 306 patients will be accrued to this study. Each collaborative group will recruit at least 1/3 and no more than 2/3 of the target accrual. Patients will be randomized to one of four treatment arms (3:2:2:2 ratio). Treatment in the first 14 weeks of neoadjuvant therapy will be:Arm A Letrozole alone; Arm B Letrozole for 2 weeks followed by letrozole + palbociclib to week 14; Arm C Palbociclib for 2 weeks followed by letrozole + palbociclib to week 14; Arm D Letrozole + palbociclib to week 14. Letrozole will be administered orally as a 2.5mg daily tablet. Palbociclib will be administered orally as 125mg capsules, daily on a schedule of 3 weeks (21 days) on, 1 week (7 days) off of a 4 week \[28 day\] cycle. The end of study therapy for patients in Arm A will be completion of week 14. Patients in Arms B, C, and D will complete study therapy following 14 days of palbociclib in the final treatment cycle past 14 weeks if treatment delays have occurred. Note: After week 14 (end of study therapy) all patients should continue letrozole until surgery. Letrozole is not considered study therapy beyond completion of week 14 for Arm A or after 14 days of palbociclib in the final treatment cycle for patients in Arms B, C, and D. Following completion of study therapy, surgery will be scheduled for 15-18 weeks post-randomization. Post-surgical treatment will be at discretion of treating clinician, following local protocols, and not influenced by allocation of treatment within the FB-11/PALLET study. Toxicity will be graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v4.0).
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: FEMALE
Healthy Volunteers: No
Long Beach Memorial Medical Center-Todd Cancer Institute, Long Beach, California, United States
University of Miami Hospital and Clinics - Sylvester Comprehensive Cancer Center, Miami, Florida, United States
Cancer Care Specialists of Central Illinois, Decatur, Illinois, United States
Norton Healthcare Pavillion, Louisville, Kentucky, United States
Norton Cancer Institute - Suburban, Norton Medical Plaza II, Louisville, Kentucky, United States
Norton Cancer Institute - Brownsboro Medical Plaza I, Louisville, Kentucky, United States
Metro-Minnesota CCOP, Saint Louis Park, Minnesota, United States
Hope Women's Cancer Centers, Asheville, North Carolina, United States
Providence Oncology and Hematology Clinic, Portland, Oregon, United States
Pinnacle Health Ortenzio Cancer Center, Mechanicsburg, Pennsylvania, United States
Allegheny General Hospital, Pittsburgh, Pennsylvania, United States
University of Pittsburgh, Pittsburgh, Pennsylvania, United States
Women and Infants Hospital of Rhode Island, Providence, Rhode Island, United States
Baylor College of Medicine, Houston, Texas, United States
Joe Arrington Cancer Research and Treatment Center, Lubbock, Texas, United States
Sentara Martha Jefferson Hospital-Phillips Family Cancer Center, Charlottesville, Virginia, United States
Virginia Commonwealth University, Richmond, Virginia, United States
Swedish Cancer Institute, Seattle, Washington, United States
West Virginia University, Morgantown, West Virginia, United States
Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada
Jewish General Hospital, Montreal, Quebec, Canada
McGill University Health Center, Montreal, Quebec, Canada
CHU de Quebec - Universite Laval, Quebec City, Quebec, Canada
Milton Keynes Hospital, Milton Keynes, Buckinghamshire, United Kingdom
Hinchingbrooke Hospital, Huntingdon, Cambridgeshire, United Kingdom
Royal Cornwall Hospital, Treliske, Truro, Cornwall, United Kingdom
Royal Devon and Exeter Hospital, Exeter, Devon, United Kingdom
Royal Sussex County Hospital, Brighton, East Sussex, United Kingdom
Southend Hospital, Westcliff-on-Sea, Essex, United Kingdom
Darent Valley Hospital, Dartford, Kent, United Kingdom
Maidstone Hospital, Maidstone, Kent, United Kingdom
Royal Liverpool University Hospital, Liverpool, Merseyside, United Kingdom
James Paget University Hospital, Great Yarmouth, Norfolk, United Kingdom
Musgrove Park Hospital, Taunton, Somerset, United Kingdom
Weston General Hospital, Weston-Super-Mare, Somerset, United Kingdom
The Royal Marsden Hospital, Sutton, Surrey, United Kingdom
Salisbury Hospital, Salisbury, Wiltshire, United Kingdom
Kidderminster Hospital, Kidderminster, Worcestershire, United Kingdom
Alexandra Hospital, Redditch, Worcestershire, United Kingdom
Worcestershire Royal Hospital, Worcester, Worcestershire, United Kingdom
Belfast City Hospital, Belfast, , United Kingdom
Royal Bournemouth Hospital, Bournemouth, , United Kingdom
Western General Hospital (Edinburgh Cancer Centre), Edinburgh, , United Kingdom
St James' University Hospital, Leeds, , United Kingdom
Barnet Hospital, London, , United Kingdom
Whittington Hospital, London, , United Kingdom
University College London Hospitals, London, , United Kingdom
The Royal Marsden Hospital, London, , United Kingdom
Charing Cross Hospital, London, , United Kingdom
Nottingham University Hospitals NHS Trust, City Campus, Nottingham, , United Kingdom
Derriford Hospital, Plymouth, , United Kingdom
Singleton Hospital, Swansea, , United Kingdom
Name: Norman Wolmark, MD
Affiliation: NSABP Foundation Inc
Role: PRINCIPAL_INVESTIGATOR