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Brief Title: Study of Efficacy of Ribociclib After Progression on CDK4/6 Inhibition in Patients With HR+ HER2- Advanced Breast Cancer
Official Title: A randoMized phAse II trIal of fulvestraNt wiTh or Without Ribociclib After Progression on AntI-estrogeN Therapy Plus Cyclin-dependent Kinase 4/6 Inhibition in Patients With Unresectable or Metastatic Hormone Receptor +, HER2 - Breast Cancer (MAINTAIN Trial)
Study ID: NCT02632045
Brief Summary: This is a randomized trial for patients with metastatic hormone receptor (HR)-positive human epidermal growth factor receptor 2 (HER2)-negative breast cancer who have progressed on an aromatase inhibitor plus a CDK4/6 inhibitor (either palbociclib or ribociclib) to either fulvestrant alone or fulvestrant with ribociclib (LEE-011). The purpose of the trial is to determine whether there is continued benefit for patients to remain on a CDK4/6 inhibitor at the time of switching anti-estrogen therapy. As ribociclib and palbociclib have a similar toxicity and drug profile and mechanism of action, we feel that it is appropriate for patients to receive either drug with an aromatase inhibitor prior to randomization.
Detailed Description: Despite advances in early detection and therapeutic options, unresectable or metastatic breast cancer remains incurable and is one of the leading causes of cancer-related mortality. Breast cancer is a molecularly heterogeneous disease. This study will be evaluating estrogen receptor (ER) expression positivity and/or progesterone receptor (PgR) positivity of breast cancer with the absence of over-expression or amplification of HER2. Inhibitors of the cyclin dependent kinases 4 and 6 (CDK4/6) have been developed and demonstrated impressive activity in patients with ER-positive HER2-negative breast cancer with marked improvements in progression free survival. This question is asking whether CDK 4/6 inhibition should be continued with hormone therapy in patients who will be switching their hormone therapy in the metastatic breast cancer setting.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
University of Alabama at Birmingham (UAB), Birmingham, Alabama, United States
Northside Hospital, Inc., Atlanta, Georgia, United States
Northwestern Medical Hospital, Chicago, Illinois, United States
The University of Kansas Cancer Center, Westwood, Kansas, United States
Albert Einstein University / Montefiore Medical Center, Bronx, New York, United States
Northwell Health/Monter Cancer Center, Lake Success, New York, United States
NYU Langone Medical Center, New York, New York, United States
Mount Sinai Medical Center, New York, New York, United States
Columbia University Medical Center, New York, New York, United States
Weill Cornell Medical Center, New York, New York, United States
Stony Brook Cancer Center, Stony Brook, New York, United States
Vanderbilt-Ingham Cancer Center, Nashville, Tennessee, United States
University of Wisconsin School of Medicine, Madison, Wisconsin, United States
Name: Melissa Accordino, MD
Affiliation: Columbia University
Role: PRINCIPAL_INVESTIGATOR