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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04862663
Registration number
NCT04862663
Ethics application status
Date submitted
17/03/2021
Date registered
28/04/2021
Titles & IDs
Public title
Capivasertib + CDK4/6i + Fulvestrant for Advanced/Metastatic HR+/HER2- Breast Cancer (CAPItello-292)
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Scientific title
A Phase Ib/III, Open-label, Randomised Study of Capivasertib Plus CDK4/6 Inhibitors and Fulvestrant Versus CDK4/6 Inhibitors and Fulvestrant in Hormone Receptor-Positive and Human Epidermal Growth Factor Receptor 2-Negative Locally Advanced, Unresectable or Metastatic Breast Cancer (CAPItello-292)
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Secondary ID [1]
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2020-004637-20
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Secondary ID [2]
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D361DC00001
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Universal Trial Number (UTN)
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Trial acronym
CAPItello-292
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Locally Advanced (Inoperable) or Metastatic Breast Cancer
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Condition category
Condition code
Cancer
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Breast
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Capivasertib
Treatment: Drugs - Fulvestrant
Treatment: Drugs - Palbociclib
Treatment: Drugs - Ribociclib
Treatment: Drugs - Abemaciclib
Experimental: Capivasertib Plus Palbociclib and Fulvestrant - Capivasertib Plus Palbociclib and Fulvestrant (Ph 1b)
Experimental: Capivasertib Plus Ribociclib and Fulvestrant - Capivasertib Plus Ribociclib and Fulvestrant (Ph 1b)
Experimental: Capivasertib Plus Abemaciclib and Fulvestrant - Capivasertib Plus Abemaciclib and Fulvestrant (Ph 1b)
Experimental: Capivasertib Plus Fulvestrant and Investigator's choice of CDK4/6i (palbociclib or ribociclib) - Capivasertib Plus Fulvestrant and Investigator's choice of CDK4/6i (palbociclib or ribociclib) (Ph III)
Active comparator: Fulvestrant and Investigator's choice of CDK4/6i (palbociclib or ribociclib) - Fulvestrant and investigator's choice of CDK4/6i (palbociclib or ribociclib) (Ph III)
Treatment: Drugs: Capivasertib
Phase Ib: Capivasertib 320 mg/ 400 mg administered PO BD 4 days on /3 days off per week for 4 weeks (28 days cycle) Phase III: : Capivasertib, administered PO BD 4 days on / 3 days off per week for 4 weeks (28 days cycle) at the dose confirmed in the phase Ib portion
Treatment: Drugs: Fulvestrant
Phase Ib and Phase III: 500 mg (2 injections of 250 mg) on Day 1 of Weeks 1 and 3 of Cycle 1, and then on Day 1, Week 1 of each cycle thereafter
Treatment: Drugs: Palbociclib
Phase Ib: 100 mg/ 125 mg. Once daily for 21 consecutive days followed by 7 days off treatment to comprise a complete 28-day cycle Phase III: Administered once daily for 21 days of 28-day cycle, at the dose of 125 mg.
Treatment: Drugs: Ribociclib
Phase Ib: 200 mg/ 400 mg/ 600 mg. Once daily for 21 consecutive days followed by 7 days off treatment to comprise a complete 28-day cycle Phase III: Administered once daily for 21 days of 28-day cycle, at the dose confirmed in the phase 1b portion.
Treatment: Drugs: Abemaciclib
Phase Ib: 50 mg/ 100 mg/ 150 mg. Twice daily for 28 consecutive days to comprise a complete 28-day cycle
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Phase Ib: 1. The number of participants with dose-limiting toxicity, as defined in the protocol.
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Assessment method [1]
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Dose-limiting toxicity as described in the protocol that is not related to disease progression, intercurrent illness or concomitant medications and that, despite optimal therapeutic intervention, meets protocol-defined criteria.
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Timepoint [1]
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Within the first 28 day cycle.
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Primary outcome [2]
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Phase Ib: 2. The number of participants with treatment-related adverse events.
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Assessment method [2]
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Data will include clinical observations, ECG parameters, clinical chemistry and haematology and vital signs assessed as the number of participants with treatment-related adverse events.
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Timepoint [2]
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From baseline up to approximately 36 months.
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Primary outcome [3]
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Phase Ib: 3. The number of participants with treatment-related serious adverse events.
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Assessment method [3]
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Data will include clinical observations, ECG parameters, clinical chemistry and haematology and vital signs assessed as the number of participants with treatment-related adverse events.
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Timepoint [3]
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From baseline up to approximately 36 months.
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Primary outcome [4]
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Phase III: 1. Progression Free Survival (PFS).
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Assessment method [4]
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Progression Free Survival (PFS) is defined as time from randomization until progression per RECIST v1.1. as assessed by BICR or death due to any cause in the overall population, the altered population, and the confirmed non-altered population. RECIST related endpoints such as PFS, ORR, DoR, CBR will be collected.
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Timepoint [4]
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Up to approximately 47 months.
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Secondary outcome [1]
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Phase Ib: 1. PK parameters for Palbociclib, Ribociclib, Abemaciclib: Cmax.
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Assessment method [1]
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Maximum observed plasma (peak) drug concentration.
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Timepoint [1]
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Cycle 0 (Cycle 0 is 3 days), Cycle 1 Day 11 and Cycle 1 Day 14 (Cycle 1 is 28 days).
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Secondary outcome [2]
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Phase Ib: 2. PK parameters for Palbociclib, Ribociclib, Abemaciclib: AUC0-72h.
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Assessment method [2]
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Partial area under the plasma concentration-time curve from zero to 72 hours post-dose.
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Timepoint [2]
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Cycle 0 (Cycle 0 is 3 days).
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Secondary outcome [3]
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Phase Ib: 3. PK parameters for Palbociclib, Ribociclib, Abemaciclib: AUC0-24h.
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Assessment method [3]
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Partial area under the plasma concentration-time curve from zero to 24 hours post-dose.
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Timepoint [3]
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Cycle 0 (Cycle 0 is 3 days), Cycle 1 Day 11 and Cycle 1 Day 14 (Cycle 1 is 28 days).
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Secondary outcome [4]
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Phase Ib: 4. PK parameters for Palbociclib, Ribociclib, Abemaciclib: Cmin.
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Assessment method [4]
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Minimum observed plasma drug concentration.
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Timepoint [4]
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Cycle 1 Day 11 and Cycle 1 Day 14 (Cycle 0 is 3 days and Cycle 1 is 28 days).
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Secondary outcome [5]
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Phase Ib: 5. PK parameters for capivasertib: Cmax.
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Assessment method [5]
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Maximum observed plasma (peak) drug concentration.
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Timepoint [5]
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Cycle 1 Day 11 (Cycle 0 is 3 days and Cycle 1 is 28 days).
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Secondary outcome [6]
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Phase Ib: 6. PK parameters for capivasertib: AUC0-12h.
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Assessment method [6]
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Partial area under the plasma concentration-time curve from zero to 12 hours post-dose.
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Timepoint [6]
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Cycle 1 Day 11 (Cycle 0 is 3 days and Cycle 1 is 28 days).
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Secondary outcome [7]
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Phase Ib: 7. PK parameters for capivasertib: Cmin.
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Assessment method [7]
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Minimum observed plasma drug concentration.
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Timepoint [7]
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Cycle 1 Day 11 (Cycle 0 is 3 days and Cycle 1 is 28 days).
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Secondary outcome [8]
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Phase Ib: 8. Objective Response Rate (ORR).
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Assessment method [8]
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Objective Response Rate (ORR) is defined as the proportion of patients with measurable disease at baseline who have a confirmed complete response (CR) or confirmed partial response (PR), as determined by the investigator at local site per Response Evaluation Criteria in Solid Tumors (RECIST v1.1).
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Timepoint [8]
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Up to approximately 36 months.
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Secondary outcome [9]
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Phase Ib: 9. Clinical Benefit Rate (CBR) at 24 weeks.
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Assessment method [9]
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Clinical Benefit Rate (CBR) 24 weeks is defined as the percentage of patients who have a CR or PR or who have SD per RECIST v1.1 as assessed by the investigator at local site for at least 23 weeks after date of first dose.
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Timepoint [9]
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Up to approximately 36 months.
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Secondary outcome [10]
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Phase Ib: 10. Duration of Response (DoR).
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Assessment method [10]
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Duration of Response (DoR) will be defined as the time from the date of first documented confirmed response until date of documented progression per RECIST v1.1 as assessed by the investigator at local site or death due to any cause.
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Timepoint [10]
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Up to approximately 36 months.
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Secondary outcome [11]
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Phase Ib: 11. Progression Free Survival (PFS).
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Assessment method [11]
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Progression Free Survival (PFS) is defined as time from date of first dose until progression per RECIST v1.1. as assessed by the investigator at local site or death due to any cause.
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Timepoint [11]
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Up to approximately 36 months.
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Secondary outcome [12]
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Phase III: 1. Overall Survival (OS).
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Assessment method [12]
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Overall survival (OS) - time from randomization until the date of death due to any cause, secondary outcome measure in participants with HR+/HER2- locally advanced or metastatic breast cancer with gene alteration in PIK3CA/AKT1/PTEN - altered population, confirmed non-altered population and overall population.
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Timepoint [12]
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Up to approximately 69 months.
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Secondary outcome [13]
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Phase III: 2. Objective Response Rate (ORR).
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Assessment method [13]
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Objective Response Rate (ORR) - the proportion of patients who have a complete or partial response, as determined by BICR per RECIST v1.1 in participants with HR+/HER2- locally advanced or metastatic breast cancer with gene alteration in PIK3CA/AKT1/PTEN - altered population, confirmed non-altered population and overall population.
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Timepoint [13]
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Up to approximately 47 months.
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Secondary outcome [14]
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Phase III: 3. Progression Free Survival 2 (PFS2)
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Assessment method [14]
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Progression Free Survival 2 (PFS2) - time from randomization to the earliest of the progression event, after first subsequent therapy or death.
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Timepoint [14]
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Up to approximately 69 months.
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Secondary outcome [15]
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Phase III: 4. Duration of Response (DoR).
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Assessment method [15]
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Duration of Response (DoR) - the time from the date of first documented response until the date of progression per RECIST v1.1 as assessed by BICR, or death due to any cause.
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Timepoint [15]
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Up to approximately 47 months.
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Secondary outcome [16]
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Phase III: 5. Clinical Benefit Rate (CBR) at 24 weeks.
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Assessment method [16]
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Clinical Benefit Rate (CBR) at 24 weeks-the % of patients who have a CR or PR or who have SD per RECIST v1.1 as assessed by BICR for at least 23 weeks after randomisation.
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Timepoint [16]
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0
Up to approximately 47 months.
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Secondary outcome [17]
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Phase III: 6. Participant-reported physical functioning
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Assessment method [17]
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TTD of physical functioning as measured by the physical functioning subscale of the EORTC QLQ-C30.
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Timepoint [17]
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Up to approximately 69 months.
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Secondary outcome [18]
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Phase III: 7. Participant-reported GHS/QoL in participants
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Assessment method [18]
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TTD of GHS/QoL as measured by the GHS/QoL subscale of the EORTC QLQ-C30.
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Timepoint [18]
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Up to approximately 69 months.
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Secondary outcome [19]
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Phase III: 8. Participant-reported overall side effect bother in participants in the capivasertib arm relative to control arm
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Assessment method [19]
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Proportion of participants experiencing different levels of overall treatment tolerability as measured by the Patient Global Impression-Treatment Tolerability (PGI-TT).
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Timepoint [19]
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Up to approximately 69 months.
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Secondary outcome [20]
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Phase III: 9. Plasma concentration of capivasertib pre- and post-dose.
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Assessment method [20]
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Plasma concentration of capivasertib pre-, and post-dose.
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Timepoint [20]
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Up to approximately 69 months.
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Secondary outcome [21]
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Phase III: 10. The number of participants with adverse events.
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Assessment method [21]
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Data will include clinical observations, ECG parameters, clinical chemistry / haematology / glucose metabolism parameters and vital signs assessed as the number of participants with adverse events.
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Timepoint [21]
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Up to approximately 69 months.
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Secondary outcome [22]
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Phase III: 11. The number of participants with serious adverse events.
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Assessment method [22]
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Data will include clinical observations, ECG parameters, clinical chemistry / haematology / glucose metabolism parameters and vital signs assessed as the number of participants with serious adverse events.
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Timepoint [22]
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Up to approximately 69 months.
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Eligibility
Key inclusion criteria
Key inclusion criteria for both phases:
1. Adult females (pre-/peri-/ and post-menopausal), and adult males.
2. Histologically confirmed HR+/ HER2- breast cancer determined from the most recent tumour sample (primary or metastatic) per the American Society of Clinical Oncology and College of American Pathologists guideline. To fulfil the requirement of HR+ disease, a breast cancer must express ER with or without co-expression of progesterone receptor.
3. Eligible for fulvestrant therapy and at least one of the following: palbociclib, ribociclib, or abemaciclib, as per local investigator assessment. Previous tolerance to specific CDK4/6 inhibitors and dose levels required.
4. Adequate organ and bone marrow functions.
5. Consent to provide a mandatory FFPE tumour sample.
Key inclusion criteria only for phase III:
1. Previous treatment with an ET (tamoxifen, AI, or oral SERD) as a single agent or in combination, with radiological evidence of breast cancer recurrence or progression while on, or within 12 months of, completing a (neo)adjuvant ET regimen.
2. Provision of mandatory blood samples at screening for central testing using an investigational ctDNA test to be stratified based on PIK3CA/AKT1/PTEN status.
3. Be eligible for fulvestrant and at least one out of palbociclib or ribociclib (depending on the available CDK4/6i options at time of enrolment), as per local investigator assessment.
4. Have measurable lesion(s) according to Response Evaluation Criteria in Solid Tumours version 1.1 (RECIST v1.1) or, in the absence of measurable disease, lytic or mixed bone lesions that can be assessed by computed tomography (CT) or magnetic resonance imaging (MRI).
Key exclusion criteria for both phases:
1. History of another primary malignancy except for malignancy treated with curative intent with no known active disease = 2 years before the first dose of study intervention and of low potential risk for recurrence.
2. Radiotherapy within 2 weeks prior to study treatment initiation.
3. Major surgery or significant traumatic injury within 4 weeks of the first dose of study treatment.
4. Persistent toxicities (CTCAE Grade >1) caused by previous anticancer therapy, excluding alopecia. Participants with irreversible toxicity that is not reasonably expected to be exacerbated by study intervention may be included (eg, hearing loss or peripheral sensory neuropathy) after consultation with the AstraZeneca study physician.
5. Spinal cord compression, brain metastases or leptomeningeal metastases unless these lesions are definitively treated (eg. radiotherapy, surgery) and clinically stable off steroids for management of symptoms for at least 4 weeks prior to study treatment initiation.
6. Any of the following cardiac criteria at screening:
(a). Mean resting corrected QT interval (QTcF): (i) Participants to be treated with palbociclib:: QTcF = 470 ms obtained from the average of 3 consecutive (triplicate) ECGs (ii) Participants to be treated with ribociclib: QTcF = 450 ms obtained from the average of 3 consecutive (triplicate) ECGs (iii) Participants to be treated with abemaciclib (Phase Ib only): QTcF = 470 ms obtained from the average of 3 consecutive (triplicate) ECGs (b). Any clinically important abnormalities in cardiac rhythm, conduction or morphology of resting ECG (eg, complete left bundle branch block, third-degree heart block) (c). Any factors that increase the risk of QTc prolongation or risk of arrhythmic events (d). Experience of any of the following procedures or conditions in the preceding 6 months: coronary artery bypass graft, angioplasty, vascular stent, myocardial infarction, unstable angina pectoris, congestive heart failure New York Heart Association (NYHA) grade = 2 (e). Uncontrolled hypotension (f) uncontrolled hypertension (g). Cardiac ejection fraction outside institutional range of normal or < 50% (whichever is higher)
7. uncontrolled or high grade or symptomatic arrhythmia and atrial fibrillation
8. Any of these clinically significant abnormalities of glucose metabolism at screening:
1. . diabetes mellitus type I or type II requiring insulin treatment
2. . Glycated haemoglobin (HbA1c) = 8.0% (63.9 mmol/mol)
9. Previous allogeneic bone marrow transplant or solid organ transplant.
Key exclusion criteria for the phase III only:
1. Any prior treatment with, AKT, PI3K or mTOR inhibitors.
2. Prior treatment with CDK4/6 inhibitors in the metastatic setting (prior CDK4/6 inhibitors permitted in the adjuvant setting provided there was a CDK4/6i treatment free interval of at least 12 months).
3. More than 1 line of chemotherapy for metastatic disease
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Minimum age
18
Years
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Maximum age
99
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
10/05/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
14/08/2029
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Actual
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Sample size
Target
895
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Research Site - Darlinghurst
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Recruitment hospital [2]
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Research Site - Miranda
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Recruitment hospital [3]
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Research Site - Nedlands
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Research Site - Perth
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Recruitment hospital [5]
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Research Site - Wahroonga
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Recruitment hospital [6]
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Research Site - Waratah
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Recruitment postcode(s) [1]
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2010 - Darlinghurst
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Recruitment postcode(s) [2]
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2228 - Miranda
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Recruitment postcode(s) [3]
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6009 - Nedlands
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Recruitment postcode(s) [4]
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6009 - Perth
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Recruitment postcode(s) [5]
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2076 - Wahroonga
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Recruitment postcode(s) [6]
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2298 - Waratah
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Recruitment outside Australia
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United States of America
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California
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Colorado
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Connecticut
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Buenos Aires
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Leuven
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Alfenas
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Samsun
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Derry
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United Kingdom
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York
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Hanoi
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Ho Chi Minh
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Vietnam
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Vinh
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
AstraZeneca
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
A Phase Ib/III Open-label, Randomised Study of Capivasertib plus CDK4/6 Inhibitors and Fulvestrant versus CDK4/6 Inhibitors and Fulvestrant in Hormone Receptor-Positive and Human Epidermal Growth Factor Receptor 2-Negative Locally Advanced, Unresectable or Metastatic Breast Cancer (CAPItello-292)
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Trial website
https://clinicaltrials.gov/study/NCT04862663
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
0
0
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Address
0
0
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Country
0
0
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Phone
0
0
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Fax
0
0
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Email
0
0
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Contact person for public queries
Name
0
0
AstraZeneca Clinical Study Information Center
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Address
0
0
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Country
0
0
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Phone
0
0
1-877-240-9479
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Fax
0
0
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Email
0
0
[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
Query!
What data in particular will be shared?
Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal.
All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared.
Supporting document/s available: Study protocol, Statistical analysis plan (SAP)
Query!
When will data be available (start and end dates)?
AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure
Query!
Available to whom?
When a request has been approved AstraZeneca will provide access to the deidentified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure
Query!
Available for what types of analyses?
Query!
How or where can data be obtained?
IPD available at link: https://astrazenecagroup-dt.pharmacm.com/DT/Home
Query!
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04862663