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A Randomized, Open-label, Multi-center Phase IV Study Evaluating Palbociclib Plus Endocrine Treatment Versus a Chemotherapy-based Treatment Strategy in Patients With Hormone Receptor Positive / HER2 Negative Breast Cancer in a Real World Setting (GBG 93 - PADMA Study). (PADMA)

Primary Purpose

Metastatic Breast Cancer

Status
Recruiting
Phase
Phase 4
Locations
Germany
Study Type
Interventional
Intervention
Palbociclib / Chemotherapy (capecitabine, epirubicin, paclitaxel, vinorelbine) / Endocrine therapy (exemestane, fulvestrant, letrozole, tamoxifen)
Sponsored by
German Breast Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Breast Cancer focused on measuring Palbociclib, Endocrine Therapy, Chemotherapy, Real world setting, Electronic patient-reported outcome, Daily Monitoring Treatment Impact, Health care utilization (call tracking, geofencing)

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Written informed consent prior to beginning specific protocol procedures, including expected cooperation of the patients for the treatment and follow-up, willingness and ability to complete collection of data via wearable device and study mobile must be obtained and documented according to the local regulatory requirements.
  2. Female or male patients.
  3. Age ≥ 18 years old.
  4. Metastatic invasive hormone receptor positive and HER2 negative breast cancer (histologically confirmed).
  5. Patients who in the opinion of the treating physician are candidates suitable for randomization for mono-chemotherapy treatment, that has either an approved label in Europe and/or is supported by guidelines for the treatment of first-line advanced BC, which are based on evidence on safety and efficacy in this setting.
  6. Symptomatic or asymptomatic metastatic breast cancer.
  7. Resolution of all acute toxic effects of prior anti-cancer therapy or surgical procedures to NCI CTCAE version 4.0 grade ≤ 1 (except alopecia or other toxicities not considered a safety risk for the patient at investigator's discretion).
  8. Life-expectancy > 6 months.
  9. For female patients: The patients need to be either A) of non-childbearing potential (documented postmenopausal or post hysterectomy) B) childbearing potential with negative serum or urinary pregnancy test (in this case patients need to use highly effective non-hormonal contraceptive methods).

Exclusion Criteria:

  1. Indication for poly-chemotherapy or single-agent endocrine therapy only or bevacizumab.
  2. Asymptomatic oligometastases of the bone as the only site of metastatic disease.
  3. Uncontrolled/untreated central nervous system lesions.
  4. Patients who received treatment for metastatic/relapsed breast cancer.
  5. Inadequate organ function as per physician's assessment immediate prior to randomization.
  6. Treatment with preparations containing St. John´s Wort within the last 7 days prior to randomization and/or concurrent use.
  7. Known severe hypersensitivity reactions to compounds or excipients similar to palbociclib, planned chemotherapy or planned endocrine therapy.
  8. Existing contraindication against the use of palbociclib, planned chemotherapy or planned endocrine therapy.
  9. Patients with hereditary problems of galactose intolerance, the Lapp lactase deficiency, and glucose-galactose malabsorption.
  10. Female patients: pregnancy or lactation at the time of randomization or intention to become pregnant during the study and up to six months after treatment. Male patients: Intention to beget a child during the study and up to six months after treatment.

Sites / Locations

  • Agaplesion Markus Krankenhaus - Klinik für Gynäkologie und GeburtshilfeRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Palbociclib + endocrine therapy

Chemotherapy +/- endocrine maintenance therapy

Arm Description

Experimental arm for testing palbociclib + endocrine therapy.

Chemotherapy +/- endocrine maintenance as comparator arm.

Outcomes

Primary Outcome Measures

Time-to-treatment failure (TTF)
To compare the time-to-treatment failure (TTF) for patients randomized to receive pre-defined chemotherapy treatment strategy versus those randomized to receive palbociclib and endocrine therapy.

Secondary Outcome Measures

Full Information

First Posted
November 22, 2017
Last Updated
February 22, 2022
Sponsor
German Breast Group
Collaborators
Pfizer, AMS Advanced Medical Services GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT03355157
Brief Title
A Randomized, Open-label, Multi-center Phase IV Study Evaluating Palbociclib Plus Endocrine Treatment Versus a Chemotherapy-based Treatment Strategy in Patients With Hormone Receptor Positive / HER2 Negative Breast Cancer in a Real World Setting (GBG 93 - PADMA Study).
Acronym
PADMA
Official Title
A Randomized, Open-label, Multi-center Phase IV Study Evaluating Palbociclib Plus Endocrine Treatment Versus a Chemotherapy-based Treatment Strategy in Patients With Hormone Receptor Positive / HER2 Negative Breast Cancer in a Real World Setting (GBG 93 - PADMA Study).
Study Type
Interventional

2. Study Status

Record Verification Date
February 2022
Overall Recruitment Status
Recruiting
Study Start Date
March 1, 2018 (Actual)
Primary Completion Date
March 31, 2023 (Anticipated)
Study Completion Date
March 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
German Breast Group
Collaborators
Pfizer, AMS Advanced Medical Services GmbH

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The goal of the study for patients with metastatic breast cancer (MBC) is to show that palbociclib + endocrine therapy shows a significant improvement in time-to-treatment failure over chemotherapy regimen (mono-chemotherapy with or without endocrine therapy). This would provide level 1 evidence from real world that palbociclib plus endocrine therapy is the first choice in MBC patients needing first-line therapy not only compared to endocrine therapy but also compared to chemotherapy with or without endocrine maintenance therapy. In addition, we assume that patient-reported outcome as measured by FACT-B and a novel composite endpoint of well-being and healthcare utilization (DMTI) will be improved with palbociclib + endocrine treatment vs. chemotherapy regimen.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Breast Cancer
Keywords
Palbociclib, Endocrine Therapy, Chemotherapy, Real world setting, Electronic patient-reported outcome, Daily Monitoring Treatment Impact, Health care utilization (call tracking, geofencing)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
150 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Palbociclib + endocrine therapy
Arm Type
Experimental
Arm Description
Experimental arm for testing palbociclib + endocrine therapy.
Arm Title
Chemotherapy +/- endocrine maintenance therapy
Arm Type
Active Comparator
Arm Description
Chemotherapy +/- endocrine maintenance as comparator arm.
Intervention Type
Drug
Intervention Name(s)
Palbociclib / Chemotherapy (capecitabine, epirubicin, paclitaxel, vinorelbine) / Endocrine therapy (exemestane, fulvestrant, letrozole, tamoxifen)
Intervention Description
Drug intervention
Primary Outcome Measure Information:
Title
Time-to-treatment failure (TTF)
Description
To compare the time-to-treatment failure (TTF) for patients randomized to receive pre-defined chemotherapy treatment strategy versus those randomized to receive palbociclib and endocrine therapy.
Time Frame
31 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written informed consent prior to beginning specific protocol procedures, including expected cooperation of the patients for the treatment and follow-up, willingness and ability to complete collection of data via wearable device and study mobile must be obtained and documented according to the local regulatory requirements. Female or male patients. Age ≥ 18 years old. Metastatic invasive hormone receptor positive and HER2 negative breast cancer (histologically confirmed). Patients who in the opinion of the treating physician are candidates suitable for randomization for mono-chemotherapy treatment, that has either an approved label in Europe and/or is supported by guidelines for the treatment of first-line advanced BC, which are based on evidence on safety and efficacy in this setting. Symptomatic or asymptomatic metastatic breast cancer. Resolution of all acute toxic effects of prior anti-cancer therapy or surgical procedures to NCI CTCAE version 4.0 grade ≤ 1 (except alopecia or other toxicities not considered a safety risk for the patient at investigator's discretion). Life-expectancy > 6 months. For female patients: The patients need to be either A) of non-childbearing potential (documented postmenopausal or post hysterectomy) B) childbearing potential with negative serum or urinary pregnancy test (in this case patients need to use highly effective non-hormonal contraceptive methods). Exclusion Criteria: Indication for poly-chemotherapy or single-agent endocrine therapy only or bevacizumab. Asymptomatic oligometastases of the bone as the only site of metastatic disease. Uncontrolled/untreated central nervous system lesions. Patients who received treatment for metastatic/relapsed breast cancer. Inadequate organ function as per physician's assessment immediate prior to randomization. Treatment with preparations containing St. John´s Wort within the last 7 days prior to randomization and/or concurrent use. Known severe hypersensitivity reactions to compounds or excipients similar to palbociclib, planned chemotherapy or planned endocrine therapy. Existing contraindication against the use of palbociclib, planned chemotherapy or planned endocrine therapy. Patients with hereditary problems of galactose intolerance, the Lapp lactase deficiency, and glucose-galactose malabsorption. Female patients: pregnancy or lactation at the time of randomization or intention to become pregnant during the study and up to six months after treatment. Male patients: Intention to beget a child during the study and up to six months after treatment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Konstantin Reißmüller
Phone
49-6102-7480
Ext
438
Email
konstantin.reissmueller@gbg.de
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sibylle Loibl, MD, PhD
Organizational Affiliation
German Breast Group - GBG Forschungs GmbH
Official's Role
Study Chair
Facility Information:
Facility Name
Agaplesion Markus Krankenhaus - Klinik für Gynäkologie und Geburtshilfe
City
Frankfurt am Main
ZIP/Postal Code
60431
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marc Thill, MD, PhD
Email
marc.thill@fdk.info

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Randomized, Open-label, Multi-center Phase IV Study Evaluating Palbociclib Plus Endocrine Treatment Versus a Chemotherapy-based Treatment Strategy in Patients With Hormone Receptor Positive / HER2 Negative Breast Cancer in a Real World Setting (GBG 93 - PADMA Study).

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