Breast NeoplasmsPhase 3NCT00073528
Study Comparing Lapatinib (GW572016) And Letrozole Versus Letrozole In Subjects With Advanced Or Metastatic Breast Cancer
A Phase 3 study testing Lapatinib and Letrozole in people with Breast Neoplasms, run by Novartis Pharmaceuticals at 278 sites in 29 countries.
Trial summary
This study evaluated and compared the efficacy and tolerability of lapatinib and letrozole, with letrozole and placebo in post-menopausal women with hormone receptor positive (ER positive and/or PgR positive) advanced or metastatic breast cancer, who had not received prior therapy for advanced or metastatic disease. Read more about this study
- Who is it for?
- Ages 18 years and older, women only
- Conditions the study is for
- Breast Neoplasms
- What is being tested?
- Lapatinib and Letrozole
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 1,286 participants
- Where
- 278 sitesin 29 countries
- Study dates
- 9 Dec 2003to 22 Mar 2018
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Women only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Signed informed consent;
- Subjects with histologically confirmed invasive breast cancer with stage IV disease at primary diagnosis or at relapse after curative-intent surgery;
- Subjects with either measurable or non-measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST).
- If the disease was restricted to a solitary lesion, its neoplastic nature was confirmed by cytology or histology.
- Tumors that were ER+ and/or PgR+;
- Post-menopausal female subjects ≥ 18 years of age.
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- ECOG Performance Status of 0 or 1;
- Subjects who had archived tumor tissue available to compare tumor response with intra-tumoral expression of ErbB1 and ErbB2.
- Adjuvant therapy with an aromatase inhibitor and / or trastuzumab was allowed; however, treatment was to stop more than 1 year prior (>12 months) to the first dose of randomized therapy.
- Subjects must have ended hormonal replacement therapy (HRT) at least 1 month (30 days) prior to receiving the first dose of randomized therapy.
Who cannot join
- Pre-menopausal, pregnant, or lactating;
- Received prior chemotherapy, hormonal therapy, immunotherapy, biologic therapy, or anti-ErbB1/ErbB2 therapy for advanced or metastatic disease;
- Bisphosphonate therapy for bone metastases was allowed; however, treatment was to be initiated prior to the first dose of randomized therapy. Prophylactic use of bisphosphonates in subjects without bone disease, except for the treatment of osteoporosis, was not permitted;
- Used an investigational drug within 30 days or 5 half-lives, whichever is longer, preceding the first dose of randomized therapy (lapatinib or placebo);
- Subjects with known history of/clinical evidence of CNS metastases or leptomeningeal carcinomatosis; and / or subjects on concurrent anti-cancer therapies other than letrozole; and / or who have not recovered from toxicities related to prior adjuvant therapy (surgery, radiotherapy, chemotherapy etc.)
- Subjects with active or uncontrolled infection and/ or with history of uncontrolled or symptomatic angina, arrhythmias, or congestive heart failure.
Trial locations and contacts
278 sites in 29 countries.
278 sites in 29 countries
United States84 sites
Novartis Investigative Site
Alhambra, California, 91801
Novartis Investigative Site
Amarillo, Texas, 79106
Novartis Investigative Site
Atlanta, Georgia, 30341
Novartis Investigative Site
Aurora, Colorado, 80045
Novartis Investigative Site
Bakersfield, California, 93309
Novartis Investigative Site
Bettendorf, Iowa, 52722
Novartis Investigative Site
Boca Raton, Florida, 33428
Novartis Investigative Site
Boca Raton, Florida, 33486
Novartis Investigative Site
Burlington, Vermont, 05401
Novartis Investigative Site
Canton, Ohio, 44718
Novartis Investigative Site
Chapel Hill, North Carolina, 27599-7305
Novartis Investigative Site
Charleston, West Virginia, 25304
Novartis Investigative Site
Dallas, Texas, 75246
Novartis Investigative Site
Dallas, Texas, 75390-9113
Novartis Investigative Site
Danville, Virginia, 24541
Novartis Investigative Site
Denver, Colorado, 80220
Novartis Investigative Site
Duarte, California, 91010
Novartis Investigative Site
Duluth, Minnesota, 55805
Novartis Investigative Site
Fargo, North Dakota, 58103
Novartis Investigative Site
Fountain Valley, California, 92708
Novartis Investigative Site
Fresno, California, 93710
Novartis Investigative Site
Fullerton, California, 92835
Novartis Investigative Site
Gainesville, Florida, 32605
Novartis Investigative Site
Gainesville, Florida, 32610
Novartis Investigative Site
Germantown, Tennessee, 38138
Novartis Investigative Site
Greenville, North Carolina, 27834
Novartis Investigative Site
Hershey, Pennsylvania, 17033
Novartis Investigative Site
Hollywood, Florida, 33021
Novartis Investigative Site
Hot Springs, Arkansas, 71913
Novartis Investigative Site
Houston, Texas, 77025
Novartis Investigative Site
Indianapolis, Indiana, 46202
Novartis Investigative Site
Irving, Texas, 75061
Novartis Investigative Site
Jonesboro, Arkansas, 72401
Novartis Investigative Site
Knoxville, Tennessee, 37916
Novartis Investigative Site
La Jolla, California, 92093-0987
Novartis Investigative Site
Lakeland, Florida, 33805
Novartis Investigative Site
Las Vegas, Nevada, 89169
Novartis Investigative Site
Long Beach, California, 90813
Novartis Investigative Site
Longmont, Colorado, 80501
Novartis Investigative Site
Los Angeles, California, 90095
Novartis Investigative Site
Louisville, Kentucky, 40202
Novartis Investigative Site
Manhasset, New York, 11030
Novartis Investigative Site
Marietta, Georgia, 30060
Novartis Investigative Site
Metairie, Louisiana, 70006
Novartis Investigative Site
Miami, Florida, 33136
Novartis Investigative Site
Minneapolis, Minnesota, 55407-3799
Novartis Investigative Site
Montebello, California, 90640
Novartis Investigative Site
New Haven, Connecticut, 06520
Novartis Investigative Site
New Orleans, Louisiana, 70121
Novartis Investigative Site
Northridge, California, 91325
Novartis Investigative Site
Ogden, Utah, 84403
Novartis Investigative Site
Omaha, Nebraska, 68114
Novartis Investigative Site
Orlando, Florida, 32804
Novartis Investigative Site
Oxnard, California, 93030
Novartis Investigative Site
Peoria, Illinois, 61615
Novartis Investigative Site
Philadelphia, Pennsylvania, 19111
Novartis Investigative Site
Pittsburgh, Pennsylvania, 15212
Novartis Investigative Site
Pleasant Hill, California, 94523
Novartis Investigative Site
Port Saint Lucie, Florida, 34952
Novartis Investigative Site
Porterville, California, 93257
Novartis Investigative Site
Redondo Beach, California, 90277
Novartis Investigative Site
Richmond, Virginia, 23230
Novartis Investigative Site
Robbinsdale, Minnesota, 55422
Novartis Investigative Site
Rochester, New York, 14623
Novartis Investigative Site
Saint Charles, Missouri, 63304
Novartis Investigative Site
Saint Louis Park, Minnesota, 55426
Novartis Investigative Site
Salt Lake City, Utah, 84106
Novartis Investigative Site
San Diego, California, 92120
Novartis Investigative Site
Santa Barbara, California, 93105
Novartis Investigative Site
Santa Fe, New Mexico, 87505
Novartis Investigative Site
Santa Maria, California, 93454
Novartis Investigative Site
Savannah, Georgia, 31406
Novartis Investigative Site
Seattle, Washington, 98104
Novartis Investigative Site
Skokie, Illinois, 60076
Novartis Investigative Site
St Louis, Missouri, 63141
Novartis Investigative Site
Tacoma, Washington, 98405
Novartis Investigative Site
Tucson, Arizona, 85715
Novartis Investigative Site
Vallejo, California, 94589
Novartis Investigative Site
Vista, California, 92081
Novartis Investigative Site
Voorhees Township, New Jersey, 08043
Novartis Investigative Site
West Columbia, South Carolina, 29210
Novartis Investigative Site
West Palm Beach, Florida, 33401
Novartis Investigative Site
Wheat Ridge, Colorado, 80033
Novartis Investigative Site
Worcester, Massachusetts, 01608
Germany45 sites
Novartis Investigative Site
Aalen, Baden-Wurttemberg, 73428
Novartis Investigative Site
Altenkirchen, Rhineland-Palatinate, 57610
Novartis Investigative Site
Augsburg, Bavaria, 86150
Novartis Investigative Site
Bayreuth, Bavaria, 95445
Novartis Investigative Site
Berlin, 10117
Novartis Investigative Site
Berlin, 10317
Novartis Investigative Site
Berlin, 12200
Novartis Investigative Site
Berlin, 14195
Novartis Investigative Site
Bonn, North Rhine-Westphalia, 53127
Novartis Investigative Site
Chemnitz, Saxony, 09009
Novartis Investigative Site
Coesfeld, North Rhine-Westphalia, 48653
Novartis Investigative Site
Dresden, Saxony, 01219
Novartis Investigative Site
Düsseldorf, North Rhine-Westphalia, 40217
Novartis Investigative Site
Erlangen, Bavaria, 91054
Novartis Investigative Site
Frankfurt am Main, Hesse, 60590
Novartis Investigative Site
Frankfurt am Main, Hesse, 60596
Novartis Investigative Site
Freiburg im Breisgau, Baden-Wurttemberg, 79106
Novartis Investigative Site
Goslar, Lower Saxony, 38642
Novartis Investigative Site
Hamburg, 20095
Novartis Investigative Site
Hamburg, 20259
Novartis Investigative Site
Hamburg, 22081
Novartis Investigative Site
Hamburg, 22457
Novartis Investigative Site
Hamburg, 22767
Novartis Investigative Site
Heidelberg, Baden-Wurttemberg, 69115
Novartis Investigative Site
Heidenheim, Baden-Wurttemberg, 89518
Novartis Investigative Site
Ibbenbueren, North Rhine-Westphalia, 49477
Novartis Investigative Site
Jena, Thuringia, 07743
Novartis Investigative Site
Kiel, Schleswig-Holstein, 24103
Novartis Investigative Site
Kiel, Schleswig-Holstein, 24105
Novartis Investigative Site
Leer, Lower Saxony, 26789
Novartis Investigative Site
Munich, Bavaria, 80335
Novartis Investigative Site
Munich, Bavaria, 80637
Novartis Investigative Site
Munich, Bavaria, 81377
Novartis Investigative Site
Münster, North Rhine-Westphalia, 48149
Novartis Investigative Site
Pinneberg, Schleswig-Holstein, 25421
Novartis Investigative Site
Regensburg, Bavaria, 93049
Novartis Investigative Site
Rehling, Bavaria, 86508
Novartis Investigative Site
Rosenheim, Bavaria, 83002
Novartis Investigative Site
Schwetzingen, Baden-Wurttemberg, 68723
Novartis Investigative Site
Stuttgart, Baden-Wurttemberg, 70174
Novartis Investigative Site
Troisdorf, North Rhine-Westphalia, 53840
Novartis Investigative Site
Ulm, Baden-Wurttemberg, 89075
Novartis Investigative Site
Velbert, North Rhine-Westphalia, 42551
Novartis Investigative Site
Wiesbaden, Hesse, 65191
Novartis Investigative Site
Wiesbaden, Hesse, 65199
Spain19 sites
Novartis Investigative Site
Alcala de Henares (Madrid)
Novartis Investigative Site
Badalona, 08916
Novartis Investigative Site
Barcelona, 08036
Novartis Investigative Site
Donostia / San Sebastian, 20014
Novartis Investigative Site
Elche, 03203
Novartis Investigative Site
Girona, 17007
Novartis Investigative Site
Leganes, Madrid, 28911
Novartis Investigative Site
Madrid, 28007
Novartis Investigative Site
Madrid, 28034
Novartis Investigative Site
Madrid, 28035
Novartis Investigative Site
Madrid, 28040
Novartis Investigative Site
Madrid, 28041
Novartis Investigative Site
Málaga, 29010
Novartis Investigative Site
Móstoles, 28935
Novartis Investigative Site
Oviedo, 33006
Novartis Investigative Site
Palma de Mallorca, 07010
Novartis Investigative Site
Valencia, 46010
Novartis Investigative Site
Vigo ( Pontevedra), 36204
Novartis Investigative Site
Zaragoza, 50009
Netherlands13 sites
Novartis Investigative Site
Amersfoort, 3813 TZ
Novartis Investigative Site
Delft, 2625 AD
Novartis Investigative Site
Doetinchem, 7009 BL
Novartis Investigative Site
Eindhoven, 5623 EJ
Novartis Investigative Site
Heerlen, 6419 PC
Novartis Investigative Site
Leidschendam, 2262 BA
Novartis Investigative Site
Maastricht, 6229 HX
Novartis Investigative Site
Nieuwegein, 3435 CM
Novartis Investigative Site
Sittard-geleen, 6162 BG
Novartis Investigative Site
The Hague, 2512 VA
Novartis Investigative Site
The Hague, 2545 CH
Novartis Investigative Site
Utrecht, 3582 KE
Novartis Investigative Site
Utrecht, 3584 CX
Canada12 sites
Novartis Investigative Site
Greater Sudbury, Ontario, P3E 5J1
Novartis Investigative Site
London, Ontario, N6A 4L6
Novartis Investigative Site
Mississauga, Ontario, L5B 1B8
Novartis Investigative Site
Montreal, Quebec, H1T 2M4
Novartis Investigative Site
Montreal, Quebec, H2L 4M1
Novartis Investigative Site
Montreal, Quebec, H3T 1E2
Novartis Investigative Site
Montreal, Quebec, H4J 1C5
Novartis Investigative Site
Oshawa, Ontario, L1G 2B9
Novartis Investigative Site
Québec, Quebec, G1S 4L8
Novartis Investigative Site
Sherbrooke, Quebec, J1H 5N4
Novartis Investigative Site
Toronto, Ontario, M6R 1B5
Novartis Investigative Site
Winnipeg, Manitoba, R2H 2A6
United Kingdom10 sites
Novartis Investigative Site
Birmingham, West Midlands, B18 7QH
Novartis Investigative Site
Chelmsford, Essex, CM1 7ET
Novartis Investigative Site
Huddersfield, HD3 3EA
Novartis Investigative Site
London, NW3 2QG
Novartis Investigative Site
London, SW17 0QT
Novartis Investigative Site
London, SW3 6JJ
Novartis Investigative Site
Manchester, Lancashire, M20 4BX
Novartis Investigative Site
Northwood, Middlesex, HA6 2RN
Novartis Investigative Site
Sheffield, S10 2SJ
Novartis Investigative Site
Sutton, Surrey, SM2 5PT
France9 sites
Novartis Investigative Site
Angers, 49033
Novartis Investigative Site
Besançon, 25030
Novartis Investigative Site
Grenoble, 38043
Novartis Investigative Site
Lille, 59020
Novartis Investigative Site
Montpellier, 34298
Novartis Investigative Site
Paris, 75248
Novartis Investigative Site
Pierre-Bénite, 69495
Novartis Investigative Site
Toulouse Cedex9, 31059
Novartis Investigative Site
Villejuif, 94805
Ireland8 sites
Novartis Investigative Site
Cork
Novartis Investigative Site
Dooradoyle
Novartis Investigative Site
Dublin, 4
Novartis Investigative Site
Dublin, 8
Novartis Investigative Site
Dublin, 9
Novartis Investigative Site
Galway
Novartis Investigative Site
Tallaght, Dublin, 24
Novartis Investigative Site
Wilton, Cork
Italy8 sites
Novartis Investigative Site
Bologna, Emilia-Romagna, 40138
Novartis Investigative Site
Crema, Lombardy, 26013
Novartis Investigative Site
Genoa, Liguria, 16128
Novartis Investigative Site
Genoa, Liguria, 16132
Novartis Investigative Site
Milan, Lombardy, 20162
Novartis Investigative Site
Parma, Emilia-Romagna, 43100
Novartis Investigative Site
Rome, Lazio, 00133
Novartis Investigative Site
Rome, Lazio, 00152
Denmark7 sites
Novartis Investigative Site
Aalborg, 9000
Novartis Investigative Site
Hillerød, 3400
Novartis Investigative Site
Koebenhavn Oe, 2100
Novartis Investigative Site
Næstved, 4700
Novartis Investigative Site
Odense C, 5000
Novartis Investigative Site
Roskilde, 4000
Novartis Investigative Site
Vejle, 7100
Hungary7 sites
Novartis Investigative Site
Budapest, 1032
Novartis Investigative Site
Budapest, 1088
Novartis Investigative Site
Budapest, 1096
Novartis Investigative Site
Kecskemét, 6000
Novartis Investigative Site
Kistarcsa, 2143
Novartis Investigative Site
Szeged, 6720
Novartis Investigative Site
Tatabánya, 2800
Australia5 sites
Novartis Investigative Site
Adelaide, South Australia, 5000
Novartis Investigative Site
Douglas, Queensland, 4814
Novartis Investigative Site
Garran, Australian Capital Territory, 2606
Novartis Investigative Site
Herston, Queensland, 4029
Novartis Investigative Site
Redcliffe, Queensland, 4020
Mexico5 sites
Novartis Investigative Site
Acapulco de Juárez, Guerrero, 39670
Novartis Investigative Site
Colima, 28010
Novartis Investigative Site
Durango, 34000
Novartis Investigative Site
Durango, 34079
Novartis Investigative Site
Mexico City, 14050
Poland5 sites
Novartis Investigative Site
Bydogoszcz, 85-796
Novartis Investigative Site
Krakow, 31-115
Novartis Investigative Site
Poznan, 61-866
Novartis Investigative Site
Warsaw, 02-781
Novartis Investigative Site
Wroclaw, 53-413
Russia4 sites
Novartis Investigative Site
Moscow, 107005
Novartis Investigative Site
Moscow, 115 478
Novartis Investigative Site
Saint Petersburg, 197022
Novartis Investigative Site
Saint Petersburg, 197758
South Africa4 sites
Novartis Investigative Site
Capital Park, 0002
Novartis Investigative Site
Panorama, 7500
Novartis Investigative Site
Parktown, 2193
Novartis Investigative Site
Port Elizabeth, 6001
Tunisia4 sites
Novartis Investigative Site
Sfax, 3000
Novartis Investigative Site
Sousse, 4000
Novartis Investigative Site
Tunis, 1004
Novartis Investigative Site
Tunis, 1007
Argentina3 sites
Novartis Investigative Site
Buenos Aires, 1425
Novartis Investigative Site
Buenos Aires, C1405BWU
Novartis Investigative Site
Capital Federal, Buenos Aires, C1426ANZ
Bulgaria3 sites
Novartis Investigative Site
Plovdiv, 4000
Novartis Investigative Site
Sofia, 1527
Novartis Investigative Site
Sofia, 1756
Croatia3 sites
Novartis Investigative Site
Osijek, 31000
Novartis Investigative Site
Pula, 52100
Novartis Investigative Site
Split, 21000
Czechia3 sites
Novartis Investigative Site
Brno, 656 53
Novartis Investigative Site
České Budějovice, 370 87
Novartis Investigative Site
Prague, 180 00
Pakistan3 sites
Novartis Investigative Site
Lahore, 54000
Novartis Investigative Site
Lahore
Novartis Investigative Site
Rawalpindi, 46000
South Korea3 sites
Novartis Investigative Site
Gyeonggi-do, 411-769
Novartis Investigative Site
Seodaemun-gu, Seoul, 03722
Novartis Investigative Site
Seoul, 135-710
Turkey (Türkiye)3 sites
Novartis Investigative Site
Ankara, 06100
Novartis Investigative Site
Istanbul, 34865
Novartis Investigative Site
Istanbul
Brazil2 sites
Novartis Investigative Site
Rio de Janeiro, 20560-120
Novartis Investigative Site
Salvador, Estado de Bahia, 41825-010
Chile2 sites
Novartis Investigative Site
Santiago, Región Metro de Santiago, 7500921
Novartis Investigative Site
Santiago, Región Metro de Santiago, 7591046
Peru2 sites
Novartis Investigative Site
Callao, Callao 2
Novartis Investigative Site
Lima, Lima 34
About this study
Official title: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Phase III Study Comparing GW572016 and Letrozole Versus Letrozole in Subjects With Estrogen/Progesterone Receptor- Positive Advanced or Metastatic Breast Cancer
This study evaluated and compared the efficacy and tolerability of lapatinib and letrozole, with letrozole and placebo in post-menopausal women with hormone receptor positive (ER positive and/or PgR positive) advanced or metastatic breast cancer, who had not received prior therapy for advanced or metastatic disease.
Read the detailed description
Subjects were randomly assigned to receive either lapatinib (1500 mg once daily orally) with letrozole (2.5 mg once daily orally), or letrozole (2.5 mg once daily orally) with placebo (which matched with lapatinib tablet). Randomization was stratified by site of disease (i.e., soft tissue/visceral disease versus bone only disease) and time since prior adjuvant endocrine therapy (<6 months or ≥ 6 months from discontinuation of adjuvant anti-estrogen therapy (e.g. tamoxifen or raloxifene) or no prior adjuvant antiestrogen therapy). Study therapy was administered daily until disease progression (objective or symptomatic) or withdrawal from therapy (e.g., due to unacceptable toxicity, withdrawal of consent, or other reason). All subjects were to be followed for survival information until death.
On 13 Apr 2015, after the introduction of the Long Term Follow UP (LTFU) phase (per protocol amendment 07), subjects receiving study treatment with lapatinib plus letrozole, or letrozole plus placebo had continued access to this study treatment until the occurrence of one of the following criteria:
- Disease progression (as determined by the Investigator),
- Intercurrent illness that prevented further administration of study treatment
- Drug related AE which was considered by the investigator to warrant permanent discontinuation of study treatment
- The subject decided to withdraw from the study. Investigators collected AEs and/or SAEs related to study participation, until 30 days following study treatment discontinuation. Subjects who were being followed-up for OS but were not taking study medication, were withdrawn from the study.
The study was terminated on 22-Mar-2018 (last subject last visit).
- Conditions
- Breast Neoplasms
- Being tested
- Lapatinib, Letrozole, Placebo
- Keywords
- Lapatinib, Letrozole, breast carcinoma, breast cancer, breast lump, HER2 positive metastatic breast cancer, breast cancer positive for human epidermal growth factor receptor 2, HER2, breast cancer progression, estrogen-receptor positive breast cancer, ER
- Medical subject headings
- Breast Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
LapatinibDrug
Also called GW572016
1500 mg orally once a day
LetrozoleDrug
2.5 mg orally once a day
PlaceboDrug
Placebo (which matched with lapatinib tablet)
| Study group | Role | What they receive |
|---|---|---|
| Placebo + Letrozole 2.5 mg | Placebo comparator | Letrozole (2.5 mg once daily orally) with Placebo (which matched with Lapatinib tablet) Receives: Drug: Letrozole; Drug: Placebo |
| Lapatinib 1500 mg + Letrozole 2.5 mg | Experimental | Lapatinib (1500 mg once daily orally) with Letrozole (2.5 mg once daily orally) Receives: Drug: Lapatinib; Drug: Letrozole |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With Progression Free Survival (PFS) in the Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Advanced or Metastatic Breast Cancer as Assessed by the Investigator
PFS is defined as the time from randomization until the earliest date of disease progression (PD) or death due to any cause, if sooner. The date of documented PD is defined as the date of radiological PD as assessed by the investigator based on imaging data and also by the clinical assessment of symptomatic progression. Per Response Evaluation Criteria in Solid Tumors (RECIST 1.0), PD is defined as a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as a reference the smallest sum LD recorded since the treatment started, or the appearance of 1 or more new lesions.
Measured: From the date of randomization until the date of the first documented progression or date of death from any cause, whichever came first, assessed for up to 46 months
Progression Free Survival (PFS) of Participants in the HER2-Positive Population as Assessed by the Investigator
PFS is defined as the time from randomization until the earliest date of disease progression or death due to any cause, if sooner. The date of documented disease progression is defined as the date of radiological disease progression as assessed by the investigator based on imaging data and also by the clinical assessment of symptomatic progression. Per RECIST 1.0, disease progression is defined as a 20% increase in the sum of the LD of target lesions, taking as a reference the smallest sum LD recorded since the treatment started, or the appearance of 1 or more new lesions.
Measured: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 46 months
Secondary outcomes (31)
Number of Participants With PFS in the Intent-To-Treat (ITT) Population as Assessed by the Investigator
PFS is defined as the time from randomization until the earliest date of disease progression or death due to any cause, if sooner. The date of documented disease progression is defined as the date of radiological disease progression as assessed by the investigator based on imaging data and also by the clinical assessment of symptomatic progression. Per RECIST 1.0, disease progression is defined as a 20% increase in the sum of the LD of target lesions, taking as a reference the smallest sum LD recorded since the treatment started, or the appearance of 1 or more new lesions.
Measured: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 46 months
PFS in Participants in the ITT Population as Assessed by the Investigator
PFS is defined as the time from randomization until the earliest date of disease progression or death due to any cause, if sooner. The date of documented disease progression is defined as the date of radiological disease progression as assessed by the investigator based on imaging data and also by the clinical assessment of symptomatic progression. Per RECIST 1.0, disease progression is defined as a 20% increase in the sum of the LD of target lesions, taking as a reference the smallest sum LD recorded since the treatment started, or the appearance of 1 or more new lesions.
Measured: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 46 months
Overall Survival in the HER2-Positive Population
Overall survival was defined as the time from randomization until death due to any cause.
Measured: From date of randomization until date of death due to any cause, assessed up to 46 months
Overall Tumor Response (OR) for Participants With Measurable and Non-measurable Disease, Including Bone Scans, in the HER2-Positive Population as Assessed by the Investigator
OR is defined as the percentage of participants achieving either a confirmed complete response (CR) or partial response (PR). Response was assessed via Response Evaluation criteria in Solid Tumors (RECIST). The percentage of participants with response was calculated by using the formula: 100 * (number of participants with CR + number of participants with PR)/total number of participants. CR: disappearance of all target lesions. PR: at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as a reference the baseline sum LD.
Measured: Up to 46 months
Number of Participants With Overall Tumor Response (OR) by Stratification Factors With Measurable Disease, Including Bone Scans, in the HER2-Positive Population as Assessed by the Investigator
Participants were stratified based on site of disease at screening (SDS) (soft tissue or visceral or bone-only disease) and prior adjuvant endocrine therapy (PAET) (discontinuation interval [DI] =>6 months or DI <6 months). OR is defined as the number of participants achieving either a confirmed CR or PR. Response was assessed via RECIST. CR: disappearance of all target lesions. PR: at least a 30% decrease in the sum of the LD of target lesions, taking as a reference the baseline sum LD. DI is defined as the time period from stopping the PEAT to the randomization date.
Measured: Up to 46 months
Clinical Benefit (CB) in the HER2-Positive Population as Assessed by the Investigator
CB is defined as the percentage of participants with evidence of confirmed CR, PR, or stable disease (SD) for at least 6 months. CR: disappearance of all target lesions. PR: at least a 30% decrease in the sum of the LD of target lesions, taking as a reference the baseline sum LD. SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the baseline measurement.
Measured: Up to 46 months
Number of Participants With the Indicated Best Response From the Participants With Measurable and Non-measurable Disease, Including Bone Scans, in the HER2-Positive Population as Assessed by the Investigator.
CR: disappearance of all target lesions. PR: at least a 30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD. SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as a reference the smallest sum LD since the baseline measurement. The best overall response is defined as the best response recorded from the start of treatment until disease progression/recurrence. PD: presence of target lesions, non-target lesions, and/or new lesions.
Measured: Up to 46 months
Number of Participants With the Indicated Best Response From the Participants With Measurable and Non-measurable Disease, Including Bone Scans, in the ITT Population as Assessed by the Investigator.
CR: disappearance of all target lesions. PR: at least a 30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD. SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as a reference the smallest sum LD since the baseline measurement. The best overall response is defined as the best response recorded from the start of treatment until disease progression/recurrence. PD: presence of target lesions, non-target lesions, and/or new lesions.
Measured: Up to 46 months
Number of Participants With the Indicated Time to Response for CR or PR in the HER2-Positive Population as Assessed by the Investigator
Time to response is defined as the time from randomization until the first documented evidence of CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sume of the LD of target lesions, taking as reference the baseline sum LD) (whichever status was recorded first). The assessments of CR or PR required confirmation using bone scans.
Measured: Up to 46 months
Duration of Response for the Participants With CR or PR in the HER2-Positive Population as Assessed by the Investigator
Duration of response is defined as the time from the first documented evidence of CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of the LD of target lesions, taking as a reference the baseline sum LD) until the first documented sign of disease progression or death due to any cause. The assessments of CR or PR required confirmation using bone scans.
Measured: Up to 46 months
Number of Participants With Evidence of Brain Metastases in the HER2-Positive Population
The confirmation criteria for the evidence of brain metastases was the incidence of lesions occurring within any part of the central nervous system (CNS) as evidenced by radiological scans. Metastases are defined as the spread of cancer from one part of the body to another.
Measured: Up to 46 months
Time to Progression (TTP) for the HER2-Positive Population as Assessed by the Investigator
TTP is defined as the interval between the date of randomization and the earliest date of disease progression or death due to breast cancer. Disease progression was based on the assessments by the Investigator.
Measured: Up to 46 months
Overall Survival in the ITT Population
Overall survival was defined as the time from randomization until death due to any cause.
Measured: From date of randomization until date of death due to any cause, assessed up to 46 months
Overall Tumor Response (OR) for Participants With Measurable and Non-measurable Disease, Including Bone Scans, in the ITT Population as Assessed by the Investigator
OR is defined as the percentage of participants achieving either a confirmed complete response (CR) or partial response (PR). Response was assessed via Response Evaluation criteria in Solid Tumors (RECIST). The percentage of participants with response was calculated by using the formula: 100 * (number of participants with CR + number of participants with PR)/total number of participants. CR: disappearance of all target lesions. PR: at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as a reference the baseline sum LD.
Measured: Up to 46 months
Number of Participants With Overall Tumor Response (OR) by Stratification Factors With Measurable Disease, Including Bone Scans, in the ITT Population as Assessed by the Investigator
Participants were stratified based on site of disease at screening (SDS) (soft tissue or visceral or bone-only disease) and prior adjuvant endocrine therapy (PAET) (discontinuation interval [DI] =>6 months or DI <6 months). OR is defined as the number of participants achieving either a confirmed CR or PR. Response was assessed via RECIST. CR: disappearance of all target lesions. PR: at least a 30% decrease in the sum of the LD of target lesions, taking as a reference the baseline sum LD. DI is defined as the time period from stopping the PEAT and the randomization date.
Measured: Up to 46 months
Clinical Benefit (CB) in the ITT Population as Assessed by the Investigator
CB is defined as the percentage of participants with evidence of confirmed CR, PR, or stable disease (SD) for at least 6 months. CR: disappearance of all target lesions. PR: at least a 30% decrease in the sum of the LD of target lesions, taking as a reference the baseline sum LD. SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the baseline measurement.
Measured: Up to 46 months
Number of Participants With the Indicated Time to Response for CR or PR in the ITT Population as Assessed by the Investigator
Time to response is defined as the time from randomization until the first documented evidence of CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sume of the LD of target lesions, taking as reference the baseline sum LD) (whichever status was recorded first). The assessments of CR or PR required confirmation using bone scans.
Measured: Up to 46 months
Duration of Response for the Participants With CR or PR in the ITT Population as Assessed by the Investigator
Duration of response is defined as the time from the first documented evidence of CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of the LD of target lesions, taking as a reference the baseline sum LD) until the first documented sign of disease progression or death due to any cause. The assessments of CR or PR required confirmation using bone scans.
Measured: Up to 46 months
Number of Participants With Evidence of Brain Metastases From the ITT Population
The confirmation criteria for the evidence of brain metastases was the incidence of lesions occurring within any part of the central nervous system (CNS) as evidenced by radiological scans. Metastases are defined as the spread of cancer from one part of the body to another.
Measured: Up to 46 months
TTP for Participants From the ITT Population as Assessed by the Investigator
TTP is defined as the interval between the date of randomization and the earliest date of disease progression or death due to breast cancer. Disease progression was based on the assessments by the Investigator.
Measured: Up to 46 months
Number of Participants Completing the Functional Assessment of Cancer Therapy-breast (FACT-B) Questionnaire at the Scheduled Visits
Quality of Life (QOL) was assessed using the FACT-B questionnaire, which was a 37-item (27 general and 10 breast cancer-specific questions) self-reporting instrument consisting of 5 dimensions: physical-, social/family-, emotional-, functional-well being, and a breast cancer subscale. Higher scores on the FACT-B scales (each ranging from 0 [not at all] to 4 [very much]) indicate a higher QOL. The score is transformed for FACT-B and results in a total score ranging from 0 to 144. Complete: completing at least 1 question from FACT-B.
Measured: Day 1 (baseline) visit; Week 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, and 192 visits; conclusion/withdrawal visit
Adjusted Mean Change From Baseline for the FACT-B Total Score Using Observed Data
Quality of Life (QOL) was assessed using the FACT-B questionnaire, which is a 37-item (27 general and 10 breast cancer-specific questions) self-reporting instrument consisting of 5 dimensions: physical-, social/family-, emotional-, functional-well being, and a breast cancer subscale. Higher scores on the FACT-B scales indicate a higher QOL; each ranging from 0 (not at all) to 4 (very much). The score is transformed for FACT-B and results in a total score ranging from 0 to 144. The FACT-B is designed to measure multidimensional QOL in participants with breast cancer.
Measured: Week 12, 24, 36, and 48 visits; conclusion/withdrawal visit
Adjusted Mean Change From Baseline for the Functional Assessment of Cancer Therapy-General (FACT-G) Score Using Observed Data
FACT-G is a subscale of the FACT-B QOL questionnaire and consists of 27 questions grouped into 4 domains that measure a participant's physical, functional, social and family, and emotional well-being. FACT-G is assessed on a five-point Likert-type scale, with scores ranging from 0 to 4 (0=not at all, 1=a little bit, 2=somewhat, 3=quite a bit, 4=very much). The total score is calculated as the sum of the item scores on the subscale; the total ranges from 0 to 108, with higher score indicating a better quality of life.
Measured: Week 12, 24, 36, and 48 visits; conclusion/withdrawal visit
Adjusted Mean Change From Baseline for the Trial Outcome Index (TOI) Score Using Observed Data
The TOI score is the sum of the physical well-being, functional well-being, and breast cancer unweighted subscale scores. The total TOI score ranges from 0 to 92, with higher scores representing a better quality of life.
Measured: Week 12, 24, 36, and 48 visits; conclusion/withdrawal visit
Number of Participants Classified as QOL Responders Based on the FACT-B, FACT-G, and TOI Total Scores
A minimally important difference (MID) is the smallest difference in a score for a measure of QOL that corresponds to a difference in function or clinical course. Responders are defined as participants with an MID => 8 for the FACT-B score, and an MID =>6 for the FACT-G and TOI scores.
Measured: Up to 46 months
Number of Participants With Clinical Benefit Categorized by HER2 Fluorescence in Situ Hybridization (FISH) Status
Clinical benefit: participants with CR, PR, or SD for =>6-month period. FISH testing measures the amount of the HER2 gene in each cell. This gene is responsible for the overproduction of the HER2 protein. FISH-positive: excessive amounts of the gene are present; FISH-negative: normal levels of the gene are present.
Measured: Up to 46 months
Number of Participants With Clinical Benefit Categorized by HER2 ImmunoHistoChemistry (IHC) Intensity
IHC is a commonly used test to assess the amount of the HER2 receptor protein on the surface of the cancer cells. The IHC test results in a score of 0 to 3+, which indicates the amount of HER2 receptor protein on the cells in a sample of breast cancer tissue. Tissue scores of 0 to 1+ indicate HER2 negativity; scores of 2+ and 3+ indicate HER2 positivity. Clinical benefit is defined as participants with CR, PR, or SD for =>6-month period.
Measured: Up to 46 months
Number of Participants With Response in Participants With Baseline Serum HER2 Extracellular Domain (ECD) Baseline Values Greater Than 15 Nanograms Per Milliliter (ng/mL) and 15 ng/mL or Lower
The HER2 ECD is a glycoprotein that can be shed from the cell surface into the blood of normal individuals and can be elevated in different pathologic conditions. The serum HER2 ECD level generally reflects the tissue HER2 status. The HER2 ECD is quantified in serum with an enzyme-linked immunosorbent assay (ELISA). Non-Evaluable (NE): any participant who could not be classified as CR, PR, SD, or PD.
Measured: Up to 46 months
Number of HER2-Negative Participants at Baseline With and Without Seroconversion to a Status of HER2 Positive
Participants who had a HER2-negative tumor status based on baseline tissue with baseline serum HER2 ECD values =<15 ng/mL but later had at least two consecutive serum HER2 ECD values >15 ng/mL experienced seroconversion.
Measured: Up to 46 months
Time to Seroconversion for Participants Who Were HER2 Negative at Baseline But Became HER2 Positive
Time to seroconversion was defined as the time from the date of randomization until the first instance of serum HER2 (>15 ng/mL) on two consecutive occasions.
Measured: Up to 46 months
Number of Participants With the Indicated Expression of Tumor by Epidermal Growth Factor Receptor (ErbB1/HER1/EGFR) at Baseline
EGFR is a cell surface receptor tyrosine kinase expressed in certain types of tumors. Depending upon the staining intensity, EGFR was graded as follows: 0=absence of membrane staining above background in all tumor cells; EGFR-positive=staining is defined as any IHC staining of tumor cell membranes above background level, whether it is complete or incomplete circumferential staining (1+, 2+, 3+).
Measured: Baseline
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Nov 2003 (estimated)
- Study start9 Dec 2003
- Primary completion3 Jun 2008
- Study completion22 Mar 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (6)Papers the sponsor has linked to this study.
- Other trials for Breast NeoplasmsStudies of the same condition, open and under way.
- More trials run by Novartis PharmaceuticalsThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 1,286 participants (actual)
Sponsor and investigators
- Lead sponsor
- Novartis Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Novartis Pharmaceuticals, Study director, Novartis Pharmaceuticals
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00073528
- Sponsor's protocol ID
- EGF30008
- Other IDs
- CLAP016A2308, 2004-003928-35, 2004
- Status last verified
- Feb 2021
- First submitted
- 24 Nov 2003
- Last updated
- 24 Feb 2021
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
Publications
Johnston S, Pippen J Jr, Pivot X, Lichinitser M, Sadeghi S, Dieras V, Gomez HL, Romieu G, Manikhas A, Kennedy MJ, Press MF, Maltzman J, Florance A, O'Rourke L, Oliva C, Stein S, Pegram M. Lapatinib combined with letrozole versus letrozole and placebo as first-line therapy for postmenopausal hormone receptor-positive metastatic breast cancer. J Clin Oncol. 2009 Nov 20;27(33):5538-46. doi: 10.1200/JCO.2009.23.3734. Epub 2009 Sep 28.
PubMed 19786658Schwartzberg LS, Franco SX, Florance A, O'Rourke L, Maltzman J, Johnston S. Lapatinib plus letrozole as first-line therapy for HER-2+ hormone receptor-positive metastatic breast cancer. Oncologist. 2010;15(2):122-9. doi: 10.1634/theoncologist.2009-0240. Epub 2010 Feb 15.
PubMed 20156908Sherrill B, Amonkar MM, Sherif B, Maltzman J, O'Rourke L, Johnston S. Quality of life in hormone receptor-positive HER-2+ metastatic breast cancer patients during treatment with letrozole alone or in combination with lapatinib. Oncologist. 2010;15(9):944-53. doi: 10.1634/theoncologist.2010-0012. Epub 2010 Aug 26.
PubMed 20798196Finn RS, Press MF, Dering J, O'Rourke L, Florance A, Ellis C, Martin AM, Johnston S. Quantitative ER and PgR assessment as predictors of benefit from lapatinib in postmenopausal women with hormone receptor-positive, HER2-negative metastatic breast cancer. Clin Cancer Res. 2014 Feb 1;20(3):736-43. doi: 10.1158/1078-0432.CCR-13-1260. Epub 2013 Nov 6.
PubMed 24198242Prat A, Cheang MC, Galvan P, Nuciforo P, Pare L, Adamo B, Munoz M, Viladot M, Press MF, Gagnon R, Ellis C, Johnston S. Prognostic Value of Intrinsic Subtypes in Hormone Receptor-Positive Metastatic Breast Cancer Treated With Letrozole With or Without Lapatinib. JAMA Oncol. 2016 Oct 1;2(10):1287-1294. doi: 10.1001/jamaoncol.2016.0922.
PubMed 27281556Wedam SB, Beaver JA, Amiri-Kordestani L, Bloomquist E, Tang S, Goldberg KB, Sridhara R, Ibrahim A, Kim G, Kluetz P, McKee A, Pazdur R. US Food and Drug Administration Pooled Analysis to Assess the Impact of Bone-Only Metastatic Breast Cancer on Clinical Trial Outcomes and Radiographic Assessments. J Clin Oncol. 2018 Apr 20;36(12):1225-1231. doi: 10.1200/JCO.2017.74.6917. Epub 2018 Mar 9.
PubMed 29522361
Study at a glance
From the registry record, last updated by the sponsor on 24 Feb 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Double-Blind, Placebo-Controlled, Multicenter Phase III Study Comparing GW572016 and Letrozole Versus Letrozole in Subjects With Estrogen/Progesterone Receptor- Positive Advanced or Metastatic Breast Cancer
- ClinicalTrials.gov ID
- NCT00073528
- Acronym / sponsor ID
- EGF30008
- Conditions
- Breast Neoplasms
- Keywords
- Lapatinib, Letrozole, breast carcinoma, breast cancer, breast lump, HER2 positive metastatic breast cancer, breast cancer positive for human epidermal growth factor receptor 2, HER2
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,286 participants (actual)
- Lead sponsor
- Novartis PharmaceuticalsIndustry (pharma, biotech, devices)
- Study start
- 9 Dec 2003 (actual)
- Primary completion
- 3 Jun 2008 (actual)
- Study completion
- 22 Mar 2018 (actual)
- First posted
- 26 Nov 2003 (estimated)
- Results
- Posted 17 May 2012
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study evaluated and compared the efficacy and tolerability of lapatinib and letrozole, with letrozole and placebo in post-menopausal women with hormone receptor positive (ER positive and/or PgR positive) advanced or metastatic breast cancer, who had not received prior therapy for advanced or metastatic disease.
Detailed description
Subjects were randomly assigned to receive either lapatinib (1500 mg once daily orally) with letrozole (2.5 mg once daily orally), or letrozole (2.5 mg once daily orally) with placebo (which matched with lapatinib tablet). Randomization was stratified by site of disease (i.e., soft tissue/visceral disease versus bone only disease) and time since prior adjuvant endocrine therapy (<6 months or ≥ 6 months from discontinuation of adjuvant anti-estrogen therapy (e.g. tamoxifen or raloxifene) or no prior adjuvant antiestrogen therapy). Study therapy was administered daily until disease progression (objective or symptomatic) or withdrawal from therapy (e.g., due to unacceptable toxicity, withdrawal of consent, or other reason). All subjects were to be followed for survival information until death.
On 13 Apr 2015, after the introduction of the Long Term Follow UP (LTFU) phase (per protocol amendment 07), subjects receiving study treatment with lapatinib plus letrozole, or letrozole plus placebo had continued access to this study treatment until the occurrence of one of the following criteria:
- Disease progression (as determined by the Investigator),
- Intercurrent illness that prevented further administration of study treatment
- Drug related AE which was considered by the investigator to warrant permanent discontinuation of study treatment
- The subject decided to withdraw from the study. Investigators collected AEs and/or SAEs related to study participation, until 30 days following study treatment discontinuation. Subjects who were being followed-up for OS but were not taking study medication, were withdrawn from the study.
The study was terminated on 22-Mar-2018 (last subject last visit).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Placebo + Letrozole 2.5 mg | Placebo comparator | Drug: Letrozole, Drug: PlaceboLetrozole (2.5 mg once daily orally) with Placebo (which matched with Lapatinib tablet) |
| Lapatinib 1500 mg + Letrozole 2.5 mg | Experimental | Drug: Lapatinib, Drug: LetrozoleLapatinib (1500 mg once daily orally) with Letrozole (2.5 mg once daily orally) |
Who may qualify
- Ages
- 18 years and older
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- Signed informed consent;
- Subjects with histologically confirmed invasive breast cancer with stage IV disease at primary diagnosis or at relapse after curative-intent surgery;
- Tumors that were ER+ and/or PgR+;
- Post-menopausal female subjects ≥ 18 years of age.
- ECOG Performance Status of 0 or 1;
Key exclusion criteria (6 listed)
- Pre-menopausal, pregnant, or lactating;
- Received prior chemotherapy, hormonal therapy, immunotherapy, biologic therapy, or anti-ErbB1/ErbB2 therapy for advanced or metastatic disease;
- Bisphosphonate therapy for bone metastases was allowed; however, treatment was to be initiated prior to the first dose of randomized therapy. Prophylactic use of bisphosphonates in subjects without bone disease, except for the treatment of osteoporosis, was not permitted;
- Used an investigational drug within 30 days or 5 half-lives, whichever is longer, preceding the first dose of randomized therapy (lapatinib or placebo);
- Subjects with known history of/clinical evidence of CNS metastases or leptomeningeal carcinomatosis; and / or subjects on concurrent anti-cancer therapies other than letrozole; and / or who have not recovered from toxicities related to prior adjuvant therapy (surgery, radiotherapy, chemotherapy etc.)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| LapatinibAlso: GW5720161500 mg orally once a day | Drug | Lapatinib 1500 mg + Letrozole 2.5 mg |
| Letrozole2.5 mg orally once a day | Drug | Lapatinib 1500 mg + Letrozole 2.5 mg, Placebo + Letrozole 2.5 mg |
| PlaceboPlacebo (which matched with lapatinib tablet) | Drug | Placebo + Letrozole 2.5 mg |
Primary outcome
Number of Participants With Progression Free Survival (PFS) in the Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Advanced or Metastatic Breast Cancer as Assessed by the Investigator
Time frame: From the date of randomization until the date of the first documented progression or date of death from any cause, whichever came first, assessed for up to 46 months
PFS is defined as the time from randomization until the earliest date of disease progression (PD) or death due to any cause, if sooner. The date of documented PD is defined as the date of radiological PD as assessed by the investigator based on imaging data and also by the clinical assessment of symptomatic progression. Per Response Evaluation Criteria in Solid Tumors (RECIST 1.0), PD is defined as a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as a reference the smallest sum LD recorded since the treatment started, or the appearance of 1 or more new lesions.
Progression Free Survival (PFS) of Participants in the HER2-Positive Population as Assessed by the Investigator
Time frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 46 months
PFS is defined as the time from randomization until the earliest date of disease progression or death due to any cause, if sooner. The date of documented disease progression is defined as the date of radiological disease progression as assessed by the investigator based on imaging data and also by the clinical assessment of symptomatic progression. Per RECIST 1.0, disease progression is defined as a 20% increase in the sum of the LD of target lesions, taking as a reference the smallest sum LD recorded since the treatment started, or the appearance of 1 or more new lesions.
31 secondary outcomes
Number of Participants With PFS in the Intent-To-Treat (ITT) Population as Assessed by the Investigator
Time frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 46 months
PFS in Participants in the ITT Population as Assessed by the Investigator
Time frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 46 months
Overall Survival in the HER2-Positive Population
Time frame: From date of randomization until date of death due to any cause, assessed up to 46 months
Overall Tumor Response (OR) for Participants With Measurable and Non-measurable Disease, Including Bone Scans, in the HER2-Positive Population as Assessed by the Investigator
Time frame: Up to 46 months
Number of Participants With Overall Tumor Response (OR) by Stratification Factors With Measurable Disease, Including Bone Scans, in the HER2-Positive Population as Assessed by the Investigator
Time frame: Up to 46 months
Clinical Benefit (CB) in the HER2-Positive Population as Assessed by the Investigator
Time frame: Up to 46 months
Number of Participants With the Indicated Best Response From the Participants With Measurable and Non-measurable Disease, Including Bone Scans, in the HER2-Positive Population as Assessed by the Investigator.
Time frame: Up to 46 months
Number of Participants With the Indicated Best Response From the Participants With Measurable and Non-measurable Disease, Including Bone Scans, in the ITT Population as Assessed by the Investigator.
Time frame: Up to 46 months
Number of Participants With the Indicated Time to Response for CR or PR in the HER2-Positive Population as Assessed by the Investigator
Time frame: Up to 46 months
Duration of Response for the Participants With CR or PR in the HER2-Positive Population as Assessed by the Investigator
Time frame: Up to 46 months
Number of Participants With Evidence of Brain Metastases in the HER2-Positive Population
Time frame: Up to 46 months
Time to Progression (TTP) for the HER2-Positive Population as Assessed by the Investigator
Time frame: Up to 46 months
Overall Survival in the ITT Population
Time frame: From date of randomization until date of death due to any cause, assessed up to 46 months
Overall Tumor Response (OR) for Participants With Measurable and Non-measurable Disease, Including Bone Scans, in the ITT Population as Assessed by the Investigator
Time frame: Up to 46 months
Number of Participants With Overall Tumor Response (OR) by Stratification Factors With Measurable Disease, Including Bone Scans, in the ITT Population as Assessed by the Investigator
Time frame: Up to 46 months
Clinical Benefit (CB) in the ITT Population as Assessed by the Investigator
Time frame: Up to 46 months
Number of Participants With the Indicated Time to Response for CR or PR in the ITT Population as Assessed by the Investigator
Time frame: Up to 46 months
Duration of Response for the Participants With CR or PR in the ITT Population as Assessed by the Investigator
Time frame: Up to 46 months
Number of Participants With Evidence of Brain Metastases From the ITT Population
Time frame: Up to 46 months
TTP for Participants From the ITT Population as Assessed by the Investigator
Time frame: Up to 46 months
Number of Participants Completing the Functional Assessment of Cancer Therapy-breast (FACT-B) Questionnaire at the Scheduled Visits
Time frame: Day 1 (baseline) visit; Week 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, and 192 visits; conclusion/withdrawal visit
Adjusted Mean Change From Baseline for the FACT-B Total Score Using Observed Data
Time frame: Week 12, 24, 36, and 48 visits; conclusion/withdrawal visit
Adjusted Mean Change From Baseline for the Functional Assessment of Cancer Therapy-General (FACT-G) Score Using Observed Data
Time frame: Week 12, 24, 36, and 48 visits; conclusion/withdrawal visit
Adjusted Mean Change From Baseline for the Trial Outcome Index (TOI) Score Using Observed Data
Time frame: Week 12, 24, 36, and 48 visits; conclusion/withdrawal visit
Number of Participants Classified as QOL Responders Based on the FACT-B, FACT-G, and TOI Total Scores
Time frame: Up to 46 months
Number of Participants With Clinical Benefit Categorized by HER2 Fluorescence in Situ Hybridization (FISH) Status
Time frame: Up to 46 months
Number of Participants With Clinical Benefit Categorized by HER2 ImmunoHistoChemistry (IHC) Intensity
Time frame: Up to 46 months
Number of Participants With Response in Participants With Baseline Serum HER2 Extracellular Domain (ECD) Baseline Values Greater Than 15 Nanograms Per Milliliter (ng/mL) and 15 ng/mL or Lower
Time frame: Up to 46 months
Number of HER2-Negative Participants at Baseline With and Without Seroconversion to a Status of HER2 Positive
Time frame: Up to 46 months
Time to Seroconversion for Participants Who Were HER2 Negative at Baseline But Became HER2 Positive
Time frame: Up to 46 months
Number of Participants With the Indicated Expression of Tumor by Epidermal Growth Factor Receptor (ErbB1/HER1/EGFR) at Baseline
Time frame: Baseline
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Feb 2021.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 19786658Johnston S, Pippen J Jr, Pivot X, Lichinitser M, Sadeghi S, Dieras V, Gomez HL, Romieu G, Manikhas A, Kennedy MJ, Press MF, Maltzman J, Florance A, O'Rourke L, Oliva C, Stein S, Pegram M. Lapatinib combined with letrozole versus letrozole and placebo as first-line therapy for postmenopausal hormone receptor-positive metastatic breast cancer. J Clin Oncol. 2009 Nov 20;27(33):5538-46. doi: 10.1200/JCO.2009.23.3734. Epub 2009 Sep 28.
- Background: PubMed 20156908Schwartzberg LS, Franco SX, Florance A, O'Rourke L, Maltzman J, Johnston S. Lapatinib plus letrozole as first-line therapy for HER-2+ hormone receptor-positive metastatic breast cancer. Oncologist. 2010;15(2):122-9. doi: 10.1634/theoncologist.2009-0240. Epub 2010 Feb 15.
- Background: PubMed 20798196Sherrill B, Amonkar MM, Sherif B, Maltzman J, O'Rourke L, Johnston S. Quality of life in hormone receptor-positive HER-2+ metastatic breast cancer patients during treatment with letrozole alone or in combination with lapatinib. Oncologist. 2010;15(9):944-53. doi: 10.1634/theoncologist.2010-0012. Epub 2010 Aug 26.
- Background: PubMed 24198242Finn RS, Press MF, Dering J, O'Rourke L, Florance A, Ellis C, Martin AM, Johnston S. Quantitative ER and PgR assessment as predictors of benefit from lapatinib in postmenopausal women with hormone receptor-positive, HER2-negative metastatic breast cancer. Clin Cancer Res. 2014 Feb 1;20(3):736-43. doi: 10.1158/1078-0432.CCR-13-1260. Epub 2013 Nov 6.
- Background: PubMed 27281556Prat A, Cheang MC, Galvan P, Nuciforo P, Pare L, Adamo B, Munoz M, Viladot M, Press MF, Gagnon R, Ellis C, Johnston S. Prognostic Value of Intrinsic Subtypes in Hormone Receptor-Positive Metastatic Breast Cancer Treated With Letrozole With or Without Lapatinib. JAMA Oncol. 2016 Oct 1;2(10):1287-1294. doi: 10.1001/jamaoncol.2016.0922.
- Derived from this study: PubMed 29522361Wedam SB, Beaver JA, Amiri-Kordestani L, Bloomquist E, Tang S, Goldberg KB, Sridhara R, Ibrahim A, Kim G, Kluetz P, McKee A, Pazdur R. US Food and Drug Administration Pooled Analysis to Assess the Impact of Bone-Only Metastatic Breast Cancer on Clinical Trial Outcomes and Radiographic Assessments. J Clin Oncol. 2018 Apr 20;36(12):1225-1231. doi: 10.1200/JCO.2017.74.6917. Epub 2018 Mar 9.
- Individual participant dataSharing planned: Yes. Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Novartis Pharmaceuticals study director
Novartis Pharmaceuticals
278 sites in 29 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Lapatinib and Letrozole in people with Breast Neoplasms, run by Novartis Pharmaceuticals at 278 sites in 29 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 10 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 24 Feb 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 278 sites in United States, Germany, Spain, Netherlands, Canada and 24 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 17 May 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of Participants With Progression Free Survival (PFS) in the Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Advanced or Metastatic Breast Cancer as Assessed by the Investigator (time frame: From the date of randomization until the date of the first documented progression or date of death from any cause, whichever came first, assessed for up to 46 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00073528, which also lists 6 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Feb 2021.