Abemaciclib in Treating Patients With Surgically Resectable, Chemotherapy Resistant, Triple Negative Breast Cancer
![]() |
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. |
ClinicalTrials.gov Identifier: NCT03979508 |
Recruitment Status :
Recruiting
First Posted : June 7, 2019
Last Update Posted : February 27, 2023
|
- Study Details
- Tabular View
- No Results Posted
- Disclaimer
- How to Read a Study Record
Condition or disease | Intervention/treatment | Phase |
---|---|---|
Anatomic Stage I Breast Cancer AJCC v8 Anatomic Stage IA Breast Cancer AJCC v8 Anatomic Stage IB Breast Cancer AJCC v8 Anatomic Stage II Breast Cancer AJCC v8 Anatomic Stage IIA Breast Cancer AJCC v8 Anatomic Stage IIB Breast Cancer AJCC v8 Anatomic Stage III Breast Cancer AJCC v8 Anatomic Stage IIIA Breast Cancer AJCC v8 Anatomic Stage IIIB Breast Cancer AJCC v8 Anatomic Stage IIIC Breast Cancer AJCC v8 Breast Ductal Carcinoma In Situ Breast Fibrocystic Change Breast Lobular Carcinoma In Situ Invasive Breast Carcinoma Prognostic Stage I Breast Cancer AJCC v8 Prognostic Stage IA Breast Cancer AJCC v8 Prognostic Stage IB Breast Cancer AJCC v8 Prognostic Stage II Breast Cancer AJCC v8 Prognostic Stage IIA Breast Cancer AJCC v8 Prognostic Stage IIB Breast Cancer AJCC v8 Prognostic Stage III Breast Cancer AJCC v8 Prognostic Stage IIIA Breast Cancer AJCC v8 Prognostic Stage IIIB Breast Cancer AJCC v8 Prognostic Stage IIIC Breast Cancer AJCC v8 Triple-Negative Breast Carcinoma | Drug: Abemaciclib Procedure: Therapeutic Conventional Surgery | Phase 2 |

Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 200 participants |
Allocation: | Non-Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Window Trial of Abemaciclib for Surgically Resectable, Chemotherapy-Resistant, Triple Negative Breast Cancer (a BEAUTY Study*) |
Actual Study Start Date : | January 10, 2020 |
Estimated Primary Completion Date : | July 31, 2023 |
Estimated Study Completion Date : | July 31, 2023 |

Arm | Intervention/treatment |
---|---|
Experimental: Cohort A Group 1; Cohort B Group 3 (surgery)
Patients undergo standard of care surgical resection.
|
Procedure: Therapeutic Conventional Surgery
Undergo standard of care surgical resection |
Experimental: Cohort A Group 2; Cohort B Group 4 (abemaciclib, surgery)
Patients receive abemaciclib PO BID on days 1-14 or days 1-21 in the absence of disease progression or unacceptable toxicity. Patients then undergo standard of care surgical resection no later than 12 weeks after the last dose of neoadjuvant chemotherapy.
|
Drug: Abemaciclib
Given PO
Other Names:
Procedure: Therapeutic Conventional Surgery Undergo standard of care surgical resection |
- Proportion of patients who have a CD8/FOXP3 ratio < 1.6 in their residual tumors after neoadjuvant chemotherapy (NAC) that convert to CD8/FOXP3 ratio >= 1.6 [ Time Frame: Up to 21 days ]A Simon optimum two stage phase II clinical trial design was chosen to test the null hypothesis that the rate of conversion to post-abemaciclib CD8/FOXP3 ratio of 1.6 or more is =< 5% against the alternative that rate of conversion to post-abemaciclib CD8/FOXP3 ratio of 1.6 or more is >= 20% with the target probability of a type I error and probability of a type II error set to 0.10. The probability of terminating after the first stage is 0.736, if the null hypothesis is true. A 90% confidence interval for this rate of conversion will be constructed using the Duffy-Santner approach taking into account the sequential nature of the study
- Incidence of adverse events [ Time Frame: Up to 60 days ]Adverse events will be monitored and graded with attribution assigned using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. For each type of adverse event (AE) reported, the proportion of patients experiencing a grade 2 or worse level of that AE will be determined.
- Changes in vimentin expression [ Time Frame: Up to 60 days ]Vimentin expression will be evaluated by immunohistochemistry (IHC) with using 0, 1+, 2+ or 3+ scoring scheme. A point estimate of the proportion of eligible patients whose post-NAC residual tumor Vimentin expression levels were 2+ or 3+ and then fell to 0 or 1+ after abemaciclib among the eligible patients whose began abemaciclib treatment after a post NAC residual tumor Vimentin expression level finding of 2+ or 3+ will be calculated. A 90% confidence interval for this proportion will be constructed using one-sample binomial confidence for proportions.
- Impact of length of treatment [ Time Frame: Up to 60 days ]Association between amount of abemaciclib received and the change in CD8/FOXP3 ratio after abemaciclib will be explored graphically. A plot of the change in change in CD8/FOXP3 ratio after abemaciclib and days of treatment will be constructed to visually assess for trends. Also, the a 90% confidence interval for the difference in binomial proportions will be constructed to assess whether the proportion of patients whose post abemaciclib CD8/FOXP3 ratio >= 1.6 after completing 14-21 days of abemaciclib differs between those who discontinued abemaciclib the day prior to surgery and who discontinued abemaciclib 2 or more days prior to surgery. A 90% binomial confidence interval for the proportion of women who failed to complete 14-21 days of abemaciclib or underwent surgery or breast biopsy 2 or more days after last dose of abemaciclib among the eligible women who began abemaciclib treatment.
- Changes in mitoses [ Time Frame: Up to 60 days ]Examined graphically overall and by triple negative breast cancer (TNBC) subtypes.
- Changes in nuclear pleomorphism [ Time Frame: Up to 60 days ]Examined graphically overall and by TNBC subtypes.
- Changes in tubule formation [ Time Frame: Up to 60 days ]Examined graphically overall and by TNBC subtypes.
- Changes in tumor Ki-67 [ Time Frame: Up to 60 days ]Examined graphically overall and by TNBC subtypes.
- Changes in serum tyrosine kinase inhibitor (TKI) [ Time Frame: Up to 60 days ]Examined graphically overall and by TNBC subtypes.
- Changes in SNAIL [ Time Frame: Up to 60 days ]Examined graphically overall and by TNBC subtypes.
- Changes in SLUG [ Time Frame: Up to 60 days ]Examined graphically overall and by TNBC subtypes.
- Changes in E-Cadherin [ Time Frame: Up to 60 days ]Examined graphically overall and by TNBC subtypes.
- Changes in tumor-infiltrating lymphocytes [ Time Frame: Up to 60 days ]Examined graphically overall and by TNBC subtypes.
- Effect of abemaciclib on tumor ribonucleic acid (RNA)-sequencing (seq) data [ Time Frame: Up to 60 days ]Effect of abemaciclib on tumor RNA sequencing followed by standard and customized pathway and enrichment analysis (e.g., Gene set enrichment analysis (GSEA) and CIBERSORT methods). The GSEA method determines whether an a priori set of genes are over-represented in the differential expression analysis of the pre- and post- drug response phenotypes. Similarly, CIBERSORT estimates cell composition from RNA transcriptomic data (e.g. immune cell populations).
- Effect of abemaciclib on the phenotype of peripheral blood mononuclear cells (PBMC) [ Time Frame: Up to 60 days ]Will be assessed using mass cytometry (e.g,. CyTOF) to analyze a panel of 29 cell surface markers optimized for identification of human immune cell subsets, including the following targets: CD45, CD195 (CCR6), CD19, CD127, CD38, IgD, CD11c, CD16, CD194 (CCR4), CD123/IL-3R, TCRgd, CD185 (CXCR5), CD3, CD45RA, CD27, CD29, CD66b, CD183 (CXCR3), CD161, CD45RO, CD197 (CCR7), CD8a, CD25/IL-2R, CD20, HLA-DR, CD4, CD14, CD56/NCAM. Identification of specific immune cell subsets will be assessed using consensus clustering methods of predefined combination of markers.
- Effect of abemaciclib on formalin-fixed paraffin-embedded (FFPE) tumor sections [ Time Frame: Up to 60 days ]Will include (imaging mass cytometry multiplex quantitative RNA/protein immune-based profilings, such as Hyperion TM, Nanostring GeoMX, Codex, and may include the examination of genes directly involved in tumor cell antigen presentation (e.g. B2M, HLA-A, HLA-B, HLA-C, TAP1, TAP2, TAPBP), interferon-stimulated genes (ISGs) that regulate antigen presentation (e.g. STAT1, NLRC5) and other ISGs (e.g. IRFs, OAS2), genes involved in double strand RNA response (e.g. DDX58, DHX58), genes encoding interferons, including type 3 IFNs (e.g. IFNL1, IFNL2, IFNL3), genes indicating a cytotoxic T cell response (e.g. PRF1, GZMB), regulatory T cell-specific transcription factor genes (e.g., FOXP3, IKZF2)
- Change in in frequency of JAK-2 amplifications [ Time Frame: Baseline up to time of surgery ]The collection of JAK-2 will be used to assess the difference in the frequency of JAK-2 amplification among patients whose post-abemaciclib CD8/FOXP3 ratio >= 1.6 and that among patients whose post-abemaciclib CD8/FOXP3 ratio < 1.6. A 95% binomial confidence for the difference in two independent proportions will be constructed for the difference in the percentage of patients with a post-abemaciclib CD8/FOXP3 ratio >= 1.6 among those with JAK-2 amplified TNBC and those with JAK-2 non-amplified TNBC.
- Change in microbiome with exposure to abemaciclib [ Time Frame: Baseline up to prior to surgery ]The collection of microbiome information via stool collection will be used to generate descriptive analyses about the study population, as the total number of samples is expected to be insufficient for full statistical analysis. Will explore putative mechanistic connections underlying bacteria-drug interactions in all patients and attempt to identify the biomolecular features within the gut (stool) microbiome and its association with the pharmacokinetics and pharmacodynamics of abemaciclib.

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | Female |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Women of age >=18 years
-
PRE-REGISTRATION: Clinical T1-4, N0-3, M0 breast cancer at diagnosis (prior to the start of neoadjuvant chemotherapy) by American Joint Committee on Cancer (AJCC) staging version 8.
- Note: Benign breast disease, lobular carcinoma in situ (LCIS) or ductal carcinoma in situ (DCIS) in the contralateral breast is allowed.
- Note: Contralateral invasive breast cancer is allowed if disease is of clinically lower stage, and the higher stage lesion will be the study lesion for all biopsies and tissue samples.
- PRE-REGISTRATION: Histological confirmation of triple negative invasive breast cancer (defined as estrogen receptor [ER] =< 10%, progesterone receptor [PR] =< 10% and HER2 not amplified by in situ hybridization [ISH] or immunohistochemistry [IHC] 0/1) at diagnosis.
-
PRE-REGISTRATION: Cohort A: Neoadjuvant chemotherapy (NAC) with one of the following regimens that was not discontinued early due to intolerability with less than 50% of planned treatment given due to disease progression or patient request:
-
Paclitaxel or docetaxel followed by one of the following: the combination of doxorubicin and cyclophosphamide (AC); the combination of epirubicin and cyclophosphamide (EC) or the combination of 5-fluorouracil, epirubicin and cyclophosphamide (FEC)
- Note: Carboplatin may be added to these regimens
-
AC or EC or FEC followed by docetaxel or paclitaxel
- Note: Carboplatin may be added to these regimens
- Docetaxel in combination with doxorubicin and cyclophosphamide (TAC)
- Docetaxel in combination with cyclophosphamide (TC) (for patients who are not candidates for anthracyclines)
- Carboplatin or cisplatin in combination with a taxane (paclitaxel, docetaxel, or nab-paclitaxel) (for patients who are not candidates for anthracyclines)
-
-
PRE-REGISTRATION: Cohort B: Neoadjuvant chemotherapy (NAC) with one of the following regimens in combination with pembrolizumab that was not discontinued early due to intolerability with less than 50% of planned treatment given due to disease progression or patient request:
- Paclitaxel or docetaxel followed by one of the following: the combination of doxorubicin and cyclophosphamide (AC); the combination of epirubicin and cyclophosphamide (EC) or the combination of 5-fluorouracil, epirubicin and cyclophosphamide (FEC) Note: Carboplatin may be added to these regimens
- AC or EC or FEC followed by docetaxel or paclitaxel [Note: Carboplatin may be added to these regimens]
- Docetaxel in combination with doxorubicin and cyclophosphamide (TAC)
- Docetaxel in combination with cyclophosphamide (TC)
- Carboplatin or cisplatin in combination with a taxane (paclitaxel, docetaxel, or nab-paclitaxel)
- PRE-REGISTRATION: Residual lesion/enhancement seen in the breast on breast imaging performed after completion of NAC.
- PRE-REGISTRATION: Able to swallow oral medication.
- PRE-REGISTRATION: Willing to undergo biopsy for research.
- PRE-REGISTRATION: Willing to provide tissue and blood samples for correlative research purposes.
- PRE-REGISTRATION: Willing to stop use of strong and moderate inducers and/or strong inhibitors of cytochrome P450 3A =< 7 days prior to registration.
- PRE-REGISTRATION: Provide written informed consent.
- REGISTRATION: Registration must occur =< 56 days after last dose of NAC.
- REGISTRATION: Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, or 2.
- REGISTRATION: COHORT A GROUP 2 AND COHORT B GROUP 4 ONLY: Absolute neutrophil count (ANC) >= 1500/mm^3 (obtained after completion of NAC but =< 14 days prior to registration).
- REGISTRATION: COHORT A GROUP 2 AND COHORT B GROUP 4 ONLY: Platelets (PLT) >= 100,000/mm^3 (obtained after completion of NAC but =< 14 days prior to registration).
- REGISTRATION: COHORT A GROUP 2 AND COHORT B GROUP 4 ONLY: Hemoglobin (HgB) >= 8.0 g/dL (obtained after completion of NAC but =< 14 days prior to registration).
- REGISTRATION: COHORT A GROUP 2 AND COHORT B GROUP 4 ONLY: Total bilirubin =< 1.5 x upper limit of normal (ULN) (obtained after completion of NAC but =< 14 days prior to registration).
- REGISTRATION: COHORT A GROUP 2 AND COHORT B GROUP 4 ONLY: Aspartate transaminase (AST) serum glutamic oxaloacetic transaminase (SGOT) =< 3 x ULN (obtained after completion of NAC but =< 14 days prior to registration).
- REGISTRATION: COHORT A GROUP 2 AND COHORT B GROUP 4 ONLY: Alanine transaminase (ALT) serum glutamate pyruvate transaminase (SGPT) =< 3 x ULN (obtained after completion of NAC but =< 14 days prior to registration).
- REGISTRATION: COHORT A GROUP 2 AND COHORT B GROUP 4 ONLY: Serum creatinine =< 1.5 x ULN (obtained after completion of NAC but =< 14 days prior to registration).
- REGISTRATION: GROUP 2 ONLY: Negative pregnancy test done =< 7 days prior to registration, for persons of childbearing potential only.
Exclusion Criteria:
-
PRE-REGISTRATION: History of deep venous thrombosis (DVT) or pulmonary embolisms (PE) =< 12 months prior to preregistration; OR Active DVT and/or PE requiring anti-coagulant therapy.
- NOTE: Patients who are on anti-coagulant therapy for maintenance are eligible as long as the DVT and/or PE was > 12 months prior to enrollment and there is no evidence for active thrombosis (either DVT or PE).
- NOTE: Patients on anticoagulation are eligible; however peri-biopsy and peri-surgical management of anticoagulation is per the institutional standard of care.
- PRE-REGISTRATION: Prior treatment with CDK 4/6 inhibitors (e.g. palbociclib, ribociclib, abemaciclib, etc.)
- PRE-REGISTRATION: Prior treatment with immunotherapy or radiation for this breast cancer.
- PRE-REGISTRATION: Prior incisional or excisional breast biopsy for this cancer.
- PRE-REGISTRATION: Any contraindications to pre-registration biopsy (such as bleeding diatheses, etc.).
- PRE-REGISTRATION: Receiving any investigational agent which would be considered as a treatment for the primary neoplasm.
-
PRE-REGISTRATION: Other active malignancy =< 3 years prior to registration.
- EXCEPTIONS: Non-melanotic skin cancer or carcinoma-in-situ of the cervix.
- NOTE: If there is a history of prior malignancy, they must not be receiving another specific treatment for prior malignancy.
- PRE-REGISTRATION: Biopsy proven stage IV breast cancer.
- PRE-REGISTRATION: Serious pre-existing medical conditions that would preclude participation in this study (for example, interstitial lung disease, severe dyspnea at rest or requiring oxygen therapy, severe renal impairment [e.g., estimated creatinine clearance < 30 ml/min], history of major surgical resection involving the stomach or small bowel, or preexisting Crohn's disease or ulcerative colitis or a preexisting chronic condition resulting in baseline grade 2 or higher diarrhea).
-
PRE-REGISTRATION: History of any of the following conditions:
- Syncope of cardiovascular etiology.
- Ventricular arrhythmia of pathological origin (including, but not limited to, ventricular tachycardia and ventricular fibrillation).
- Sudden cardiac arrest.
- NOTE: Patients on anticoagulation are eligible; however peri-biopsy and peri-surgical management of anticoagulation is per the institutional standard of care.
-
REGISTRATION: COHORT A GROUP 2 AND COHORT B GROUP 4: Any of the following because this study involves an investigational agent whose genotoxic, mutagenic and teratogenic effects on the developing fetus and newborn are unknown:
- Pregnant persons.
- Nursing persons.
- Persons of childbearing potential who are unwilling to employ adequate contraception.
-
REGISTRATION: COHORT A GROUP 2 AND COHORT B GROUP 4: Failure to recover to grade 1 or lower from effects of neoadjuvant chemotherapy.
- Exceptions: Residual alopecia and grade 2 peripheral neuropathy are allowed.
- REGISTRATION: COHORT A GROUP 2 AND COHORT B GROUP 4: Concurrent use of strong and moderate inducers and/or strong inhibitors of cytochrome P450 3A =< 7 days prior to registration.
-
REGISTRATION: COHORT A GROUP 2 AND COHORT B GROUP 4: Known infections as follows (NOTE: Screening is not required for enrollment):
- Active systemic bacterial infection requiring intravenous antibiotics.
- Active fungal infection (requiring intravenous or oral antifungal treatment).
- Detectable viral infections (e.g. known human immunodeficiency virus [HIV], known active hepatitis B or C).

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03979508
United States, Arizona | |
Mayo Clinic in Arizona | Recruiting |
Scottsdale, Arizona, United States, 85259 | |
Contact: Clinical Trials Referral Office 855-776-0015 mayocliniccancerstudies@mayo.edu | |
Principal Investigator: Donald W. Northfelt, M.D. | |
United States, Florida | |
Mayo Clinic in Florida | Recruiting |
Jacksonville, Florida, United States, 32224-9980 | |
Contact: Clinical Trials Referral Office 855-776-0015 maycliniccancerstudies@mayo.edu | |
Principal Investigator: Sarah McLaughlin, M.D. | |
United States, Minnesota | |
Mayo Clinic in Rochester | Recruiting |
Rochester, Minnesota, United States, 55905 | |
Contact: Clinical Trials Referral Office 855-776-0015 mayocliniccancerstudies@mayo.edu | |
Principal Investigator: Matthew P. Goetz, M.D. |
Principal Investigator: | Matthew P Goetz | Mayo Clinic in Rochester |
Responsible Party: | Mayo Clinic |
ClinicalTrials.gov Identifier: | NCT03979508 |
Other Study ID Numbers: |
MC1734 NCI-2019-03567 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) ) MC1734 ( Other Identifier: Mayo Clinic in Rochester ) |
First Posted: | June 7, 2019 Key Record Dates |
Last Update Posted: | February 27, 2023 |
Last Verified: | January 2023 |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Carcinoma Breast Neoplasms Triple Negative Breast Neoplasms Carcinoma in Situ Carcinoma, Ductal Carcinoma, Intraductal, Noninfiltrating Carcinoma, Lobular Breast Carcinoma In Situ Carcinoma, Ductal, Breast |
Fibrocystic Breast Disease Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Neoplasms by Site Breast Diseases Skin Diseases Adenocarcinoma Neoplasms, Ductal, Lobular, and Medullary |