Study to Assess the Safety and Efficacy of Ribociclib (LEE011) in Combination With Letrozole for the Treatment of Men and Pre/Postmenopausal Women With HR+ HER2- aBC

Study Description

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Brief Summary:

The purpose of this Phase IIIb study is to collect additional safety and efficacy data for the combination of ribociclib + letrozole in men and pre/postmenopausal women with HR+HER2- advanced breast cancer.

Condition or disease	Intervention/treatment	Phase
Breast Cancer	Drug: Ribociclib; Drug: Letrozole; Drug: Goserelin	Phase 3

Study Design

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Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	3258 participants
Intervention Model:	Single Group Assignment
Masking:	None (Open Label)
Primary Purpose:	Treatment
Official Title:	COMPLEEMENT-1: An Open-label, Multicenter, Phase IIIb Study to Assess the Safety and Efficacy of Ribociclib (LEE011) in Combination With Letrozole for the Treatment of Men and Pre/Postmenopausal Women With Hormone Receptor-positive (HR+) HER2-negative (HER2-) Advanced Breast Cancer (aBC) With no Prior Hormonal Therapy for Advanced Disease
Actual Study Start Date :	September 20, 2012
Estimated Primary Completion Date :	November 22, 2019
Estimated Study Completion Date :	November 22, 2019

Arms and Interventions

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Arm

Intervention/treatment

Experimental: Ribociclib + letrozole; Ribociclib oral (3 weeks on/1 week off) in combination with oral once daily letrozole: 600 mg ribociclib QD + 2.5 mg letrozole QD

Drug: Ribociclib; Ribociclib oral (3 weeks on/1 week off) in combination with oral once daily letrozole: 600 mg ribociclib QD + 2.5 mg letrozole QD; Other Name: LEE011; Drug: Letrozole; Ribociclib oral (3 weeks on/1 week off) in combination with oral once daily letrozole: 600 mg ribociclib QD + 2.5 mg letrozole QD; Drug: Goserelin; Only for men and premenopausal women: administered as an injectable subcutaneous implant on Day 1 of each 28 days cycle

Outcome Measures

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Primary Outcome Measures :

1. The number of participants with adverse events as a measure of safety and tolerability [ Time Frame: Up to approximately 36 months ]
   AEs, Grade 3/4 AEs & SAEs during treatment with ribociclib + letrozole

Secondary Outcome Measures :

1. Time-to-Progression (TTP) [ Time Frame: Up to approximately 36 months ]
   Time to progression (TTP) is defined as time from date of start of treatment to the date of event defined as the first documented progression or death due to underlying cancer.
2. Overall response rate (ORR) for patients with measurable disease [ Time Frame: Up to approximately 36 months ]
   Overall response rate (ORR) is defined as the proportion of patients with best overall response of complete response (CR) or partial response (PR) according to RECIST 1.1.
3. Clinical Benefit Rate (CBR) [ Time Frame: Up to approximately 36 months ]
   Clinical benefit rate (CBR) is defined as the proportion of patients with a best overall response of complete response (CR), or partial response (PR) or an overall lesion response of stable disease (SD), lasting as per local review, for a duration of at least 24 weeks. CR, PR and SD are defined according to RECIST 1.1.
4. Patient Reported Outcome (PRO) using scores from FACT-B questionaire [ Time Frame: Up to approximately 36 months ]
   FACT-B questionnaire will be used to collect patient reported outcome data in this trial. Descriptive statistics will be used to summarize the subscale and overall scores at each scheduled assessment time point. Additionally, change from baseline at the time of each assessment will be summarized. PRO data may be summarized by country/region.

Other Outcome Measures:

1. The number of participants with adverse events as a measure of safety and tolerability during Extension Phase [ Time Frame: Up to approximatley 30 months ]
   Frequency and severity of AEs and SAEs
2. Percentage of patients with clinical benefit during Extension Phase [ Time Frame: Up to approximately 30 months ]
   Clinical benefit is assessed by investigator

Eligibility Criteria

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Ages Eligible for Study:	18 Years and older (Adult, Older Adult)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

• Male or female advanced (locoregionally recurrent or metastatic) breast cancer not amenable to curative therapy.

• In the case of women, both pre/perimenopausal and postmenopausal patients are allowed to be included in this study; menopausal status is relevant for the requirement of goserelin to be used concomitantly with ribociclib and letrozole.

  1. Postmenopausal status is defined either by:

     I). Prior bilateral oophorectomy OR ii). Age ≥ 60 OR iii). Age < 60 and amenorrhea for 12 or more months (in the absence of chemotherapy, tamoxifen, toremifen, or ovarian suppression) and FSH and estradiol in the postmenopausal range per local normal range. If patient is taking tamoxifen or toremifene and age < 60, then FSH and plasma estradiol levels should be in post-menopausal range per local normal range.

     Note: For women with therapy-induced amenorrhea, serial measurements of FSH and/or estradiol are needed to ensure menopausal status.

  2. Premenopausal status is defined as either:

     I). Patient had last menstrual period within the last 12 months, OR ii). If on tamoxifen or toremifene within the past 14 days, plasma estradiol and FSH must be in the premenopausal range per local normal range, OR iii). In case of therapy induced amenorrhea, plasma estradiol and/or FSH must be in the premenopausal range per local normal range.

  3. Perimenopausal status is define as neither premenopausal nor postmenopausal Note: Throughout this document, perimenopausal and premenopausal status is grouped together and referred as "Premenopausal"
• Patient has a histologically and/or cytologically confirmed diagnosis of estrogen-receptor positive and/or progesterone receptor positive breast cancer by local laboratory.
• Patient has HER2-negative breast cancer defined as a negative in situ hybridization test or an IHC status of 0, 1+ or 2+. If IHC is 2+, a negative in situ hybridization (FISH, CISH, or SISH) test is required by local laboratory testing.
• Patient has an Eastern Cooperative Oncology Group (ECOG) performance status ≤2

• Patient has adequate bone marrow and organ function as defined by ALL of the following laboratory values (as assessed by local laboratory):

  • Absolute neutrophil count ≥ 1.5 × 10^9/L
  • Platelets ≥ 100 × 10^9/L
  • Hemoglobin ≥ 9.0 g/dL
  • Potassium, sodium, calcium corrected for serum albumin and magnesium within normal limits or corrected to within normal limits with supplements before first dose of the study medication
  • INR ≤1.5
  • Serum creatinine <1.5 mg/dl or creatinine clearance≥50 mL/min
  • In absence of liver metastases, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) should be below 2.5 × ULN. If the patient has liver metastases, ALT and AST should be < 5 × ULN.
  • Total serum bilirubin < ULN; or total bilirubin ≤ 3.0 × ULN with direct bilirubin within normal range in patients with well-documented Gilbert's Syndrome

• Patient must have a 12-lead ECG with ALL of the following parameters at screening:

  • QTcF interval at screening <450 msec (using Fridericia's correction)
  • Resting heart rate ≥ 50 bpm

Exclusion Criteria:

• Patient who received any CDK4/6 inhibitor
• Patient who received any prior systemic hormonal therapy for advanced breast cancer; no more than one prior regimen of chemotherapy for the treatment of metastatic disease is permitted

Note:

• Patients who received (neo) adjuvant therapy for breast cancer are eligible. If the prior neo (adjuvant) therapy included letrozole or anastrozole the disease free interval must be greater than 12 months from the completion of treatment until study entry.
• Patients who received ≤ 28 days of letrozole or anastrozole for advanced disease prior to inclusion in this trial are eligible.

• Any prior (neo) adjuvant anti-cancer therapy or prior chemotherapy for metastatic disease must be stopped at least 5 half-lives or 7 days, whichever is longer, before study inclusion.

  • Patient is concurrently using other anti-cancer therapy.

Contacts and Locations

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Sponsors and Collaborators

Novartis Pharmaceuticals

Investigators

Study Director:	Novartis Pharmaceuticals	Novartis Pharmaceuticals

More Information

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Responsible Party:	Novartis Pharmaceuticals
ClinicalTrials.gov Identifier:	NCT02941926 History of Changes
Other Study ID Numbers:	CLEE011A2404
First Posted:	October 21, 2016
Last Update Posted:	November 16, 2018
Last Verified:	November 2018

Keywords provided by Novartis ( Novartis Pharmaceuticals ):

HR-positive HER2-negative; advanced breast cancer; LEE011; ribociclib; letrozole; goserelin; CDK; CDK4	CDK6; CDK4/6; Phase IIIb; ER-positive; PR-positive; premenopausal; postmenopausal; men with advanced breast cancer

Additional relevant MeSH terms:

Breast Neoplasms; Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Letrozole; Goserelin; Antineoplastic Agents; Aromatase Inhibitors	Steroid Synthesis Inhibitors; Enzyme Inhibitors; Molecular Mechanisms of Pharmacological Action; Estrogen Antagonists; Hormone Antagonists; Hormones, Hormone Substitutes, and Hormone Antagonists; Physiological Effects of Drugs; Antineoplastic Agents, Hormonal