Chidamide in Combination With Abemaciclib and Fulvestrant in Breast Cancer Patients Previously Treated With Palbociclib (CINDERELLA)
Primary Purpose
Breast Cancer
Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Chidamide
Abemaciclib
Fulvestrant
Sponsored by
About this trial
This is an interventional treatment trial for Breast Cancer
Eligibility Criteria
Inclusion Criteria:
- Participants volunteered to participate in this study and signed an informed consent form.
- Female, aged ≥ 18 years.
- ECOG PS score:0-2.
- Expected survival time ≥ 3 months.
- Histologically or cytologically confirmed estrogen receptor positive and/or progesterone receptor positive, HER2-negative loco-regional recurrent or metastatic disease not amenable to resection or radiation therapy with curative intent.
- Prior anti-tumor setting: ① No prior chemotherapy for recurrent or metastatic breast cancer; ② Disease recurrence and/or metastasis during or after palbociclib-based regimen in the (neo)adjutant setting or disease progression during or after palbociclib-based regimen for at least 6 months in the metastatic setting; ③ No prior fulvestrant for recurrent or metastatic breast cancer or no evidence of fulvestrant resistance; ④ No more than 3 lines of prior endocrine therapy for recurrent or metastatic breast cancer and meet one of the following requirements: relapse while after the first 2 years of adjuvant endocrine therapy, or disease progression after the first 6 months of latest endocrine therapy for advance or metastatic breast cancer, while on endocrine therapy;
- At least one extracranial measurable lesion defined according to RECIST V1.1 criteria or only bone lesion;
- The functions of vital organs meet the requirements;
- Participants recovered from any AE associated with prior tumor therapy prior to initial administration of the study drug (grade ≤1);
Exclusion Criteria:
- Prior treatment with histone deacetylase inhibitors (HDACi);
- Previously treated with CDK4/6 inhibitors other than palbociclib;
- Leptomeningeal metastasis confirmed by MRI or lumbar puncture;
- Radiographically confirmed central nervous system metastasis; the following conditions were excluded: ① asymptomatic brain metastases not requiring immediate radiotherapy or surgery; ② previously received local therapy (radiotherapy or surgery) for brain metastasis, stable for at least 4 weeks with imaging confirmation without symptomatic treatment (including glucocorticoid, mannitol, bevacizumab, etc.) for more than 2 weeks and clinical symptoms;
- Participants with visceral crises (e.g., lymphangitis carcinoma, bone marrow replacement, leptomeningeal metastasis, diffuse liver metastasis with abnormal liver functions), rapid disease progression, and patients not suitable for endocrine therapy;
- Participants with ascites, pleural effusion and pericardial effusion with clinical symptoms at baseline, requiring drainage within 4 weeks before the first medication;
- Inability to swallow, intestinal obstruction or other factors affecting drug taking and absorption;
- Systematic treatment such as chemotherapy, targeted therapy or other investigational drugs within 4 weeks prior to the start of treatment; endocrine therapy within 2 weeks prior to the start of treatment;
- Participant was diagnosed with any other malignant tumor in the past 5 years prior to the study, except for radically-treated non-melanoma skin cancer, basal cell or squamous cell skin cancer or cervical carcinoma in situ and thyroid papillary carcinoma.
- The participant has undergone major surgical procedures or significant trauma within 4 weeks prior to the start of treatment, or is expected to undergo major surgical treatment;
- Known history of allergy to the drug components of this regimen;
- Infected with active HBV and HCV; participants with stabilized hepatitis B (HBV-DNA lower than 500 IU/mL or copy number <1000 copies/ mL) and cured hepatitis C (negative for HCV RNA) were excluded;
- Have a history of immunodeficiency disease, including HIV positive, or other acquired or congenital immunodeficiency disease, or have a history of organ transplantation;
- Positive baseline pregnancy test; Or participants of reproductive age who were unwilling to use effective contraception during study participation and for at least 3 months after the last dose;
- According to the judgment of the researcher, there are serious concomitant diseases (such as severe hypertension, diabetes, thyroid disease, active infection, etc.) that endanger the patient's safety or affect the patient's completion of the study;
- The researcher determines that the participant is not suitable for the study;
Sites / Locations
- Fudan University Shanghai Cancer CenterRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
SAF
Arm Description
Fulvestrant 500mg d1, 15, 29, and then q4w, abemaciclib 150mg or 100mg bid, Chidamide 10-30mg biw.
Outcomes
Primary Outcome Measures
DLT
DLT:dose-limiting toxicity
PFS
PFS:progression free survival
Safety
Safety:Incidence and severity of adverse events (AE) and serious adverse events ;(SAE) in each dose group
Secondary Outcome Measures
ORR
Objective response rate (ORR) : Proportion of subjects whose efficacy was evaluated as CR/PR;
DCR
Disease control rate (DCR) : Proportion of subjects whose efficacy was assessed as CR/PR/SD;
CBR
Clinical benefit rate (CBR) : Proportion of subjects with CR, PR and SD≥24 weeks during the study;
DOR
Duration of remission (DoR) : The time from the first assessment of CR or PR to the first assessment of PD or death from any cause;
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05464173
Brief Title
Chidamide in Combination With Abemaciclib and Fulvestrant in Breast Cancer Patients Previously Treated With Palbociclib
Acronym
CINDERELLA
Official Title
Phase Ib/II Study of Chidamide in Combination With Abemaciclib and Fulvestrant in Patients Previously Treated With Palbociclib in HR+/HER2-Relapsed/Metastatic Breast Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
July 2022
Overall Recruitment Status
Recruiting
Study Start Date
July 1, 2022 (Actual)
Primary Completion Date
February 1, 2023 (Anticipated)
Study Completion Date
May 1, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Biyun Wang, MD
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
To evaluate the efficacy and safety of chidamide in combination with abemaciclib and fulvestrant in locally advanced/metastatic HR+/HER2- breast cancer who had failed prior palbociclib therapy
Detailed Description
Phase I (Stage Ib). To evaluate the safety and tolerability of chidamide in combination with abemaciclib and fulvestrant in locally advanced/metastatic HR+/HER2- breast cancer and to determine the recommended phase II dose of this combination regimen.
Stage 2 (Phase II). To determine the efficacy and safety of chidamide in combination with abemaciclib and fulvestrant in locally advanced/metastatic HR+/HER2- breast cancer with the recommended phase II dose.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
44 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
SAF
Arm Type
Experimental
Arm Description
Fulvestrant 500mg d1, 15, 29, and then q4w, abemaciclib 150mg or 100mg bid, Chidamide 10-30mg biw.
Intervention Type
Drug
Intervention Name(s)
Chidamide
Intervention Description
10-30mg biw
Intervention Type
Drug
Intervention Name(s)
Abemaciclib
Intervention Description
150mg or 100mg bid
Intervention Type
Drug
Intervention Name(s)
Fulvestrant
Intervention Description
500mg, d1, 15, 29, and then q4w.
Primary Outcome Measure Information:
Title
DLT
Description
DLT:dose-limiting toxicity
Time Frame
6 weeks
Title
PFS
Description
PFS:progression free survival
Time Frame
6 weeks
Title
Safety
Description
Safety:Incidence and severity of adverse events (AE) and serious adverse events ;(SAE) in each dose group
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
ORR
Description
Objective response rate (ORR) : Proportion of subjects whose efficacy was evaluated as CR/PR;
Time Frame
6 weeks
Title
DCR
Description
Disease control rate (DCR) : Proportion of subjects whose efficacy was assessed as CR/PR/SD;
Time Frame
6 weeks
Title
CBR
Description
Clinical benefit rate (CBR) : Proportion of subjects with CR, PR and SD≥24 weeks during the study;
Time Frame
6 weeks
Title
DOR
Description
Duration of remission (DoR) : The time from the first assessment of CR or PR to the first assessment of PD or death from any cause;
Time Frame
6 weeks
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Participants volunteered to participate in this study and signed an informed consent form.
Female, aged ≥ 18 years.
ECOG PS score:0-2.
Expected survival time ≥ 3 months.
Histologically or cytologically confirmed estrogen receptor positive and/or progesterone receptor positive, HER2-negative loco-regional recurrent or metastatic disease not amenable to resection or radiation therapy with curative intent.
Prior anti-tumor setting: ① No prior chemotherapy for recurrent or metastatic breast cancer; ② Disease recurrence and/or metastasis during or after palbociclib-based regimen in the (neo)adjutant setting or disease progression during or after palbociclib-based regimen for at least 6 months in the metastatic setting; ③ No prior fulvestrant for recurrent or metastatic breast cancer or no evidence of fulvestrant resistance; ④ No more than 3 lines of prior endocrine therapy for recurrent or metastatic breast cancer and meet one of the following requirements: relapse while after the first 2 years of adjuvant endocrine therapy, or disease progression after the first 6 months of latest endocrine therapy for advance or metastatic breast cancer, while on endocrine therapy;
At least one extracranial measurable lesion defined according to RECIST V1.1 criteria or only bone lesion;
The functions of vital organs meet the requirements;
Participants recovered from any AE associated with prior tumor therapy prior to initial administration of the study drug (grade ≤1);
Exclusion Criteria:
Prior treatment with histone deacetylase inhibitors (HDACi);
Previously treated with CDK4/6 inhibitors other than palbociclib;
Leptomeningeal metastasis confirmed by MRI or lumbar puncture;
Radiographically confirmed central nervous system metastasis; the following conditions were excluded: ① asymptomatic brain metastases not requiring immediate radiotherapy or surgery; ② previously received local therapy (radiotherapy or surgery) for brain metastasis, stable for at least 4 weeks with imaging confirmation without symptomatic treatment (including glucocorticoid, mannitol, bevacizumab, etc.) for more than 2 weeks and clinical symptoms;
Participants with visceral crises (e.g., lymphangitis carcinoma, bone marrow replacement, leptomeningeal metastasis, diffuse liver metastasis with abnormal liver functions), rapid disease progression, and patients not suitable for endocrine therapy;
Participants with ascites, pleural effusion and pericardial effusion with clinical symptoms at baseline, requiring drainage within 4 weeks before the first medication;
Inability to swallow, intestinal obstruction or other factors affecting drug taking and absorption;
Systematic treatment such as chemotherapy, targeted therapy or other investigational drugs within 4 weeks prior to the start of treatment; endocrine therapy within 2 weeks prior to the start of treatment;
Participant was diagnosed with any other malignant tumor in the past 5 years prior to the study, except for radically-treated non-melanoma skin cancer, basal cell or squamous cell skin cancer or cervical carcinoma in situ and thyroid papillary carcinoma.
The participant has undergone major surgical procedures or significant trauma within 4 weeks prior to the start of treatment, or is expected to undergo major surgical treatment;
Known history of allergy to the drug components of this regimen;
Infected with active HBV and HCV; participants with stabilized hepatitis B (HBV-DNA lower than 500 IU/mL or copy number <1000 copies/ mL) and cured hepatitis C (negative for HCV RNA) were excluded;
Have a history of immunodeficiency disease, including HIV positive, or other acquired or congenital immunodeficiency disease, or have a history of organ transplantation;
Positive baseline pregnancy test; Or participants of reproductive age who were unwilling to use effective contraception during study participation and for at least 3 months after the last dose;
According to the judgment of the researcher, there are serious concomitant diseases (such as severe hypertension, diabetes, thyroid disease, active infection, etc.) that endanger the patient's safety or affect the patient's completion of the study;
The researcher determines that the participant is not suitable for the study;
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Biyun Wang
Phone
18017312387
Email
wangbiyun0107@hotmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Biyun Wang
Organizational Affiliation
Fudan University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fudan University Shanghai Cancer Center
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200032
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Biyun Wang
Phone
18017312387
Email
pro_wangbiyun@163.com
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Chidamide in Combination With Abemaciclib and Fulvestrant in Breast Cancer Patients Previously Treated With Palbociclib
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