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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT06065748
Registration number
NCT06065748
Ethics application status
Date submitted
26/09/2023
Date registered
4/10/2023
Titles & IDs
Public title
A Study to Evaluate Efficacy and Safety of Giredestrant Compared With Fulvestrant (Plus a CDK4/6 Inhibitor), in Participants With ER-Positive, HER2-Negative Advanced Breast Cancer Resistant to Adjuvant Endocrine Therapy (pionERA Breast Cancer)
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Scientific title
A Phase III Randomized, Open-Label Study Evaluating Efficacy and Safety of Giredestrant Compared With Fulvestrant, Both Combined With a CDK4/6 Inhibitor, in Patients With Estrogen Receptor-Positive, HER2-Negative Advanced Breast Cancer With Resistance to Prior Adjuvant Endocrine Therapy
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Secondary ID [1]
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2022-502980-39-00
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Secondary ID [2]
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CO44657
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Estrogen Receptor-Positive, HER2-Negative Advanced 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 - Giredestrant
Treatment: Drugs - Fulvestrant
Treatment: Drugs - Abemaciclib
Treatment: Drugs - Palbociclib
Treatment: Drugs - Ribociclib
Treatment: Drugs - LHRH Agonist
Diagnosis / Prognosis - FoundationOne Liquid CDx Assay (F1LCDx)
Experimental: Giredestrant + Investigator's Choice of CDK4/6i - Participants in the experimental arm will receive giredestrant plus the investigator's choice of CDK4/6 inhibitor (CDK4/6i): palbociclib, ribociclib, or abemaciclib.
Active comparator: Fulvestrant + Investigator's Choice of CDK4/6i - Participants in the control arm will receive fulvestrant plus the investigator's choice of CDK4/6 inhibitor (CDK4/6i): palbociclib, ribociclib, or abemaciclib.
Treatment: Drugs: Giredestrant
Giredestrant 30 milligrams (mg) orally (PO) once a day (QD) on Days 1-28 of each 28-day cycle until progressive disease (PD) or unacceptable toxicity.
Treatment: Drugs: Fulvestrant
Fulvestrant 500 mg intramuscularly (IM) on Days 1 and 15 of Cycle 1 and on Day 1 of each subsequent 28-day cycle until PD or unacceptable toxicity.
Treatment: Drugs: Abemaciclib
If chosen by the investigator as the CDK4/6i, participants will receive abemaciclib 150 mg PO twice per day (BID) on Days 1-28 of each 28-day cycle until PD or unacceptable toxicity.
Treatment: Drugs: Palbociclib
If chosen by the investigator as the CDK4/6i, participants will receive palbociclib 125 mg PO QD on Days 1-21 of each 28-day cycle until PD or unacceptable toxicity.
Treatment: Drugs: Ribociclib
If chosen by the investigator as the CDK4/6i, participants will receive ribociclib 600 mg PO QD on Days 1-21 of each 28-day cycle until PD or unacceptable toxicity.
Treatment: Drugs: LHRH Agonist
Only pre/perimenopausal female participants and male participants will receive a luteinizing hormone-releasing hormone (LHRH) agonist locally approved for use in breast cancer on Day 1 of each 28-day treatment cycle.
Diagnosis / Prognosis: FoundationOne Liquid CDx Assay (F1LCDx)
F1LCDx is a next-generation sequencing (NGS)-based in vitro diagnostic test that detects and analyses genomic alterations in circulating cell-free DNA (cfDNA) isolated from plasma derived from the anti-coagulated peripheral whole blood of cancer patients. It will be used to determine the eligibility of participants requiring confirmation of ESR1 mutation status (mutation detected \[ESR1m\] vs. no mutation detected \[ESR1nmd\]).
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Diagnosis / Prognosis
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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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Progression-Free Survival (PFS) in the ESR1 mutation (ESR1m) Subgroup
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Assessment method [1]
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PFS is defined as the time from randomization to the first occurrence of PD, as determined by the investigator according to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1), or death from any cause during the study.
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Timepoint [1]
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From randomization to first occurrence of progressive disease (PD) or death (up to 5 years)
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Primary outcome [2]
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PFS in the Full Analysis Set (FAS) Population
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Assessment method [2]
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Timepoint [2]
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From randomization to first occurrence of PD or death (up to 5 years)
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Secondary outcome [1]
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PFS in the ESR1 no-mutation-detected (ESR1nmd) Subgroup
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Assessment method [1]
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Timepoint [1]
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From randomization to first occurrence of PD or death (up to 5 years)
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Secondary outcome [2]
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Overall Survival (OS)
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Assessment method [2]
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OS is defined as the time from randomization to death from any cause. It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
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Timepoint [2]
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From randomization until death from any cause (up to 5 years)
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Secondary outcome [3]
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Confirmed Objective Response Rate (cORR)
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Assessment method [3]
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The cORR is defined as the percentage of participants with a complete response (CR) or partial response (PR) on two consecutive occasions at least 4 weeks apart, as determined by the investigator according to RECIST v1.1. It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
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Timepoint [3]
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From randomization until treatment discontinuation (up to 5 years)
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Secondary outcome [4]
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Duration of Response (DOR)
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Assessment method [4]
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DOR is defined as the time from the first occurrence of a documented objective response to PD, as determined by the investigator according to RECIST v1.1, or death from any cause (whichever occurs first). It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
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Timepoint [4]
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From the first occurrence of a documented objective response to PD or death (up to 5 years)
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Secondary outcome [5]
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Clinical Benefit Rate (CBR)
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Assessment method [5]
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The CBR is defined as the percentage of participants with stable disease for at least (=)24 weeks or a CR or PR, as determined by the investigator according to RECIST v1.1. It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
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Timepoint [5]
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From randomization until treatment discontinuation (up to 5 years)
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Secondary outcome [6]
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Time to Chemotherapy
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Assessment method [6]
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Time to chemotherapy is defined as the time from randomization until the start date of the first chemotherapy or death from any cause (whichever occurs first). It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
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Timepoint [6]
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From randomization until the start of chemotherapy or death (up to 5 years)
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Secondary outcome [7]
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Time to Confirmed Deterioration (TTCD) in Pain Severity
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Assessment method [7]
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TTCD in pain severity is defined as the time from randomization to the first documentation of =2-point increase from baseline on the "worst pain" item score of the Brief Pain Inventory-Short Form (BPI-SF). It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
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Timepoint [7]
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From randomization until end of follow-up (up to 5 years)
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Secondary outcome [8]
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TTCD in Pain Presence and Interference
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Assessment method [8]
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TTCD in pain presence and interference is defined as the time from randomization to the first documentation of =10-point increase in pain score, as determined using the European Organisation for Research and Treatment of Cancer Quality of Life-Core 30 (EORTC QLQ-C30) questionnaire. It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
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Timepoint [8]
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From randomization until end of follow-up (up to 5 years)
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Secondary outcome [9]
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TTCD in Physical Functioning
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Assessment method [9]
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TTCD in physical functioning (PF) is defined as the time from randomization to the first documentation of =10-point decrease in PF score, as determined using the EORTC QLQ-C30 questionnaire. It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
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Timepoint [9]
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From randomization until end of follow-up (up to 5 years)
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Secondary outcome [10]
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TTCD in Role Functioning
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Assessment method [10]
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TTCD in role functioning (RF) is defined as the time from randomization to the first documentation of =10-point decrease in RF score, as determined using the EORTC QLQ-C30 questionnaire. It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
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Timepoint [10]
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From randomization until end of follow-up (up to 5 years)
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Secondary outcome [11]
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TTCD in Global Health Status/Quality of Life
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Assessment method [11]
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TTCD in in Global Health Status/Quality of Life (GHS/QoL) is defined as the time from randomization to the first documentation of =10-point decrease in GHS/QoL score, as determined using the EORTC QLQ-C30 questionnaire. It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
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Timepoint [11]
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From randomization until end of follow-up (up to 5 years)
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Secondary outcome [12]
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Incidence and Severity of Adverse Events
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Assessment method [12]
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Incidence will be reported as the number of participants with at least one adverse event, with severity determined according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 5 (NCI CTCAE v5.0).
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Timepoint [12]
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From Baseline until 28 days after the final dose of study treatment (up to 5 years)
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Secondary outcome [13]
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Number of Participants with Vital Sign Abnormalities Over the Course of the Study
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Assessment method [13]
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Vital signs include respiratory rate, pulse rate, systolic and diastolic blood pressure, and temperature.
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Timepoint [13]
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From Baseline until 28 days after the final dose of study treatment (up to 5 years)
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Secondary outcome [14]
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Number of Participants with Clinical Laboratory Test Abnormalities for Hematology and Biochemistry Parameters Over the Course of the Study
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Assessment method [14]
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Timepoint [14]
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From Baseline until 28 days after the final dose of study treatment (up to 5 years)
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Eligibility
Key inclusion criteria
* Locally advanced or metastatic adenocarcinoma of the breast, not amenable to treatment with curative intent
* Documented estrogen receptor-positive (ER+), HER2-negative (HER2-) tumor assessed locally on the most recent tumor biopsy (or an archived tumor sample if a recent tumor sample is not available for testing)
* Confirmed ESR1 mutation status (ESR1m versus ESR1nmd) in baseline circulating tumor DNA (ctDNA) through central laboratory testing
* Resistance to prior adjuvant endocrine therapy (ET). Prior use of neo/adjuvant CDK4/6i is allowed.
* No prior systemic anti-cancer therapy for advanced disease
* Measurable disease as defined per RECIST v.1.1 or non-measurable (including bone-only) disease
* Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-1
* For pre/perimenopausal women and for men: willing to undergo and maintain treatment with approved LHRH agonist therapy (as per local guidelines) for the duration of study treatment
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Minimum age
18
Years
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Maximum age
No limit
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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
* Prior systemic therapy (e.g., prior chemotherapy, immunotherapy, or biologic therapy) for locally advanced unresectable or metastatic breast cancer
* Prior treatment with another SERD (e.g., fulvestrant, oral SERDs) or novel ER-targeting agents
* Advanced, symptomatic, visceral spread that is at risk of life-threatening complications in the short term
* Active cardiac disease or history of cardiac dysfunction
* Clinically significant history of liver disease
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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
11/12/2023
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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
30/12/2028
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Actual
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Sample size
Target
1050
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC
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Recruitment hospital [1]
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Northern Beaches Hospital - Frenchs Forest
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Recruitment hospital [2]
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Nepean Hospital; Nepean Cancer Care Centre - Kingswood
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Recruitment hospital [3]
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Mater Hospital; Patricia Ritchie Centre for Cancer Care and Research - North Sydney
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University of the Sunshine Coast - Sippy Downs
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Mater Misericordiae Limited - South Brisbane
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Recruitment hospital [6]
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Cancer Research SA - Adelaide
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Recruitment hospital [7]
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Barwon Health - Geelong
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Recruitment hospital [8]
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Sunshine Hospital - St Albans
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Recruitment hospital [9]
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South West Healthcare - Warrnambool
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Recruitment postcode(s) [1]
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2086 - Frenchs Forest
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Recruitment postcode(s) [2]
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2747 - Kingswood
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Recruitment postcode(s) [3]
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2060 - North Sydney
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Recruitment postcode(s) [4]
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4556 - Sippy Downs
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Recruitment postcode(s) [5]
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4101 - South Brisbane
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Recruitment postcode(s) [6]
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5000 - Adelaide
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Recruitment postcode(s) [7]
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3220 - Geelong
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Recruitment postcode(s) [8]
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3021 - St Albans
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Recruitment postcode(s) [9]
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3280 - Warrnambool
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Recruitment outside Australia
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Alabama
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California
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Colorado
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Florida
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Maine
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Maryland
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Argentina
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Argentina
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Ciudad Autonoma Buenos Aires
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Recoleta
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Bruxelles
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Gent
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ES
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GO
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MA
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PE
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Ontario
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Santiago
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Beijing
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Chengdu
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Chongqing
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Fuzhou City
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Guangzhou City
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China
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Hangzhou
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China
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Harbin
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China
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Jinan City
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China
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Jinan
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China
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Kunming City
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China
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China
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Nanning City
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China
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Shanghai City
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China
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Shanghai
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China
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Taiyuan City
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China
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Taizhou
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China
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Tianjin
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China
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Urumqi
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China
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Wuhan City
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China
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Wuhan
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China
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Xi'an City
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China
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Xian
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China
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Xuzhou
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China
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Zhejiang
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China
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Zhengzhou
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Rennes
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Germany
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Guatemala
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Marche
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?ód?
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Muang Chiang MAI Delivery Branch 3
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Thailand
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Songkhla
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Hoffmann-La Roche
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Ethics approval
Ethics application status
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Summary
Brief summary
This is a Phase III, randomized, open-label multicenter study that will evaluate the efficacy and safety of giredestrant compared with fulvestrant, both in combination with the investigator's choice of a CDK4/6 inhibitor (palbociclib, ribociclib or abemaciclib), in participants with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer who have developed resistance to adjuvant endocrine therapy.
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Trial website
https://clinicaltrials.gov/study/NCT06065748
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
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Clinical Trials
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Address
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Hoffmann-La Roche
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Contact person for public queries
Name
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0
Reference Study ID Number: CO44657 https://forpatients.roche.com/
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Address
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Phone
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888-662-6728 (U.S. Only)
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Email
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[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
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What data in particular will be shared?
For eligible studies, qualified researchers may request access to individual patient level clinical data. See Roche's commitment to transparency of clinical study information here: https://go.roche.com/data_sharing
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
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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/NCT06065748