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The Efficacy and Safety of Anlotinib Combined With Fulvestrant in Patients With Advanced Breast Cancer

Primary Purpose

Breast Neoplasm Female

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
anlotinib, fulvestrant
Sponsored by
Zhejiang Cancer Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Neoplasm Female

Eligibility Criteria

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

Inclusion Criteria:

  • Aged 18 years or older female;
  • ECOG score 0-1;
  • Life expectancy is not less than 12 weeks;
  • Histology confirmed HR-positive and HER2-negative locally advanced or metastatic breast cancer;
  • Premenopausal women have taken effective ovarian function suppression methods, such as drug suppression or ovariectomy;
  • At least one objectively measurable breast cancer lesions according to RECIST 1.1 ;
  • No more than one systemic chemotherapy for metastatic disease;
  • Disease relapse within 12 months after at least 24 months endocrine adjuvant therapy, or disease progress after at least 6 months endocrine salvage therapy;
  • Normal function of main organs and bone marrow: Hemoglobin≥90g/L; Neutrophil count (ANC)≥1.5×109/L; Platelet count (PLT)≥80×109/L; Total bilirubin≤1.5×ULN (upper limit of normal); Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5×ULN (≤5×ULN if has liver metastasis); Serum creatinine (Cr) ≤1.5×ULN or creatinine clearance ≥60mL/min (Cockcroft-Gault formula);
  • Sign the informed consent;

Exclusion Criteria:

  • Have received prior fulvestrant or anti-angiogenic drug treatment, or known to be allergic to any excipients in the study;
  • Visceral crisis;
  • Uncontrolled or high-burden CNS metastases;
  • Unable to swallow;
  • Abnormal coagulation function;
  • Tumor has invaded important blood vessels and may cause fatal bleeding;
  • Pleural effusion or pericardial effusion that requiring repeated drainage;
  • Hypertension that cannot be well controlled by a single antihypertensive drug;
  • Unstable angina, myocardial infarction within 6 months, serious arrhythmias;
  • The history of immunodeficiency, including HIV or other obtained or congenital immunodeficiency diseases, or a history of organ transplantation;
  • Poorly controlled diabetes;
  • Abnormal urine protein, and the 24-hour quantification suggests urine protein ≥1.0g;
  • Bleeding constitution or medical history
  • Unhealed wounds, ulcers or fractures;
  • Have arterial/venous thrombotic events within 6 months, such as cerebrovascular accidents (including temporary ischemic attacks), deep vein thrombosis and pulmonary embolism;
  • In other clinical trials of anti-tumor drugs simultaneously;
  • Other concomitant disease or disability that endangers safety according to the judgment of investigator;

Sites / Locations

  • Zhejiang Cancer HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

experimental group

Arm Description

anlotinib combined with fulvestrant

Outcomes

Primary Outcome Measures

Progression-Free Survival
Time from randomisation to tumour progression (in any way) or death (from any cause)

Secondary Outcome Measures

Overall Response Rate
Confirmed complete response or partial response according to RECIST 1.1
Clinical Benefit Rate
Confirmed complete response or partial response or stable disease of 24 weeks' duration or longer
Overall Survival
Time from randomisation to death (from any cause)
Adverse events
Adverse events occurred from randomisation to 30 days after the last dose administrated

Full Information

First Posted
August 9, 2021
Last Updated
October 10, 2021
Sponsor
Zhejiang Cancer Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05075512
Brief Title
The Efficacy and Safety of Anlotinib Combined With Fulvestrant in Patients With Advanced Breast Cancer
Official Title
A Prospective Study on Efficacy and Safety of Anlotinib Combined With Fulvestrant in Patients With HR-positive and HER2-negative, Secondary Endocrine-resistant, Locally Advanced or Metastatic Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Recruiting
Study Start Date
September 1, 2021 (Actual)
Primary Completion Date
August 31, 2023 (Anticipated)
Study Completion Date
August 31, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Zhejiang Cancer Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The management of HR-positive, HER2-negative metastatic breast cancer includes endocrine monotherapy or combination regimens, both with benefit diminishing as resistance develops. Nowadays, various studies have demonstrated that estrogen interacts with many angiogenic pathways and is an important mechanism for resistance leading to the question of whether combination with antiangiogenesis and antiestrogen therapies could be an appropriate therapeutic modality. Anlotinib is a novel multi-target tyrosine kinase inhibitor that effectively inhibit VEGFR, FGFR, PDGFR, c-KIT, c-MET and RET. Previous studies have proven the efficacy of both anlotinib monotherapy and combination regimens in advanced breast cancer. This phase II study aims to preliminarily evaluate the efficacy and safety of anlotinib combined with endocrine therapy.
Detailed Description
This study is a prospective, single-arm, open-label, phase II clinical trial. The secondary endocrine-resistant is defined as disease relapse within 12 months after at least 24 months endocrine adjuvant therapy, or disease progress after at least 6 months endocrine salvage therapy. Eligible patients were treated with oral anlotinib plus intramuscular fulvestrant till disease progression or intolerant toxicity. In the part of statistical analysis, 40 patients are required to have a 80% power to detect significant improvement in median progression-free survival from 5.8 (fulvestrant alone) to 10 (fulvestrant combined with anlotinib) months, if tested at a two-sided significance level of α=0.05.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Neoplasm Female

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
experimental group
Arm Type
Experimental
Arm Description
anlotinib combined with fulvestrant
Intervention Type
Drug
Intervention Name(s)
anlotinib, fulvestrant
Other Intervention Name(s)
AL3818
Intervention Description
anlotinib: 12 mg once daily on days 1-14, repeated every 21 days; fulvestrant: 500 mg on days 1 and 15 of cycle one, and then on day one of each subsequent 28 days cycle
Primary Outcome Measure Information:
Title
Progression-Free Survival
Description
Time from randomisation to tumour progression (in any way) or death (from any cause)
Time Frame
From randomisation to progression or death, assessed up to 60 months
Secondary Outcome Measure Information:
Title
Overall Response Rate
Description
Confirmed complete response or partial response according to RECIST 1.1
Time Frame
From randomisation to the first occurrence of the confirmed complete response or partial response, assessed up to 24 months
Title
Clinical Benefit Rate
Description
Confirmed complete response or partial response or stable disease of 24 weeks' duration or longer
Time Frame
From randomisation to the first occurrence of the confirmed complete response or partial response or stable disease, assessed up to 24 months
Title
Overall Survival
Description
Time from randomisation to death (from any cause)
Time Frame
From randomisation to death, assessed up to 96 months
Title
Adverse events
Description
Adverse events occurred from randomisation to 30 days after the last dose administrated
Time Frame
From randomisation to 30 days after the last dose administrated

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged 18 years or older female; ECOG score 0-1; Life expectancy is not less than 12 weeks; Histology confirmed HR-positive and HER2-negative locally advanced or metastatic breast cancer; Premenopausal women have taken effective ovarian function suppression methods, such as drug suppression or ovariectomy; At least one objectively measurable breast cancer lesions according to RECIST 1.1 ; No more than one systemic chemotherapy for metastatic disease; Disease relapse within 12 months after at least 24 months endocrine adjuvant therapy, or disease progress after at least 6 months endocrine salvage therapy; Normal function of main organs and bone marrow: Hemoglobin≥90g/L; Neutrophil count (ANC)≥1.5×109/L; Platelet count (PLT)≥80×109/L; Total bilirubin≤1.5×ULN (upper limit of normal); Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5×ULN (≤5×ULN if has liver metastasis); Serum creatinine (Cr) ≤1.5×ULN or creatinine clearance ≥60mL/min (Cockcroft-Gault formula); Sign the informed consent; Exclusion Criteria: Have received prior fulvestrant or anti-angiogenic drug treatment, or known to be allergic to any excipients in the study; Visceral crisis; Uncontrolled or high-burden CNS metastases; Unable to swallow; Abnormal coagulation function; Tumor has invaded important blood vessels and may cause fatal bleeding; Pleural effusion or pericardial effusion that requiring repeated drainage; Hypertension that cannot be well controlled by a single antihypertensive drug; Unstable angina, myocardial infarction within 6 months, serious arrhythmias; The history of immunodeficiency, including HIV or other obtained or congenital immunodeficiency diseases, or a history of organ transplantation; Poorly controlled diabetes; Abnormal urine protein, and the 24-hour quantification suggests urine protein ≥1.0g; Bleeding constitution or medical history Unhealed wounds, ulcers or fractures; Have arterial/venous thrombotic events within 6 months, such as cerebrovascular accidents (including temporary ischemic attacks), deep vein thrombosis and pulmonary embolism; In other clinical trials of anti-tumor drugs simultaneously; Other concomitant disease or disability that endangers safety according to the judgment of investigator;
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xiaojia Wang
Phone
+86 13906500190
Email
wxiaojia0803@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Jian Huang
Phone
+86 13588048995
Email
huang_jian22@aliyun.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jian Huang
Organizational Affiliation
Zhejiang Cancer Hospital
Official's Role
Study Director
Facility Information:
Facility Name
Zhejiang Cancer Hospital
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xiaojia Wang
Phone
+86 13906500190
Email
wxiaojia0803@163.com

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
the data will be shared from the trial begin and for 10 years
IPD Sharing Time Frame
from the trial begin and for 10 years
IPD Sharing Access Criteria
every one

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The Efficacy and Safety of Anlotinib Combined With Fulvestrant in Patients With Advanced Breast Cancer

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