Breast CancerPhase 3BOLERO-2NCT00863655
Everolimus in Combination With Exemestane in the Treatment of Postmenopausal Women With Estrogen Receptor Positive Locally Advanced or Metastatic Breast Cancer Who Are Refractory to Letrozole or Anastrozole
A Phase 3 study testing Everolimus and Exemestane in people with Breast Cancer, run by Novartis Pharmaceuticals at 200 sites in 24 countries.
Trial summary
There are no treatments specifically approved after recurrence or progression on a non steroidal aromatase inhibitors (NSAI). In light of the need for new treatment options for postmenopausal women after failure of prior NSAI therapy, the purpose of this Phase III study is to compare efficacy and safety of a treatment… Read more about this study
- Who is it for?
- Ages 18 years and older, women only
- Conditions the study is for
- Breast Cancer
- What is being tested?
- Everolimus and Exemestane
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 724 participants
- Where
- 200 sitesin 24 countries
- Study dates
- 3 Jun 2009to 4 Dec 2014
- 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
- Adult women (≥ 18 years of age) with metastatic or locally advanced breast cancer not amenable to curative treatment by surgery or radiotherapy.
- Histological or cytological confirmation of estrogen-receptor positive (ER+) breast cancer
- Postmenopausal women.
- Disease refractory to non steroidal aromatase inhibitors (NSAI),
- Radiological or clinical evidence of recurrence or progression on or after the last systemic therapy prior to randomization.
- Patients must have at least one lesion that can be accurately measured or bone lesions in the absence of measurable disease as defined above.
Who cannot join
- HER2-overexpressing patients
- Patients with only non-measurable lesions other than bone metastasis (e.g. pleural effusion, ascites etc.).
- Patients who received more than one chemotherapy line for Advanced Breast Cancer.
- Previous treatment with exemestane or mTOR inhibitors.
- Known hypersensitivity to mTOR inhibitors, e.g. sirolimus (rapamycin).
- Radiotherapy within four weeks prior to randomization
- Currently receiving hormone replacement therapy,
- Other protocol-defined inclusion/exclusion criteria may apply
Trial locations and contacts
200 sites in 24 countries.
200 sites in 24 countries
United States63 sites
University of New Mexico Cancer Research Center Dept of UNM Cancer & Research
Albuquerque, New Mexico, 87131
Kaiser Permanente Medical Group Kaiser Permanente-Moanalua M.C
Anaheim, California, 92807
Anne Arundel Health System Research Institute Wayson Pavilion
Annapolis, Maryland, 21401
Comprehensive Blood and Cancer Center Dept. of CBCC (3)
Bakersfield, California, 93309
Mercy Medical Center Medical Oncology & Hematology
Baltimore, Maryland, 21202
Weinberg Cancer Institute at Franklin Square Hospital
Baltimore, Maryland, 21237-3998
Maryland Hematology/Oncology Associates, P.A.
Baltimore, Maryland, 21237
Hematology Oncology Clinic Hematology Oncology Clinic (2)
Baton Rouge, Louisiana, 70808
Comprehensive Cancer Center - Boca Raton Deerfield Beach
Boca Raton, Florida, 33248
Lahey Clinic Dept of Lahey Clinic (2)
Burlington, Massachusetts, 01805
Ironwood Cancer and Research Centers
Chandler, Arizona, 85224
Medical University of South Carolina -Hollings Cancer Center Dept. MUSC/HollingsCancerCtr
Charleston, South Carolina, 29425
Regional Cancer Care Associates Dept. of the CCHD
Cherry Hill, New Jersey, 08003
Rush University Medical Center Study Coordinator
Chicago, Illinois, 60612
University of Texas Southwestern Medical Center SimmonsComprehensiveCancerCtr.
Dallas, Texas, 75390-8852
Florida Cancer Research Institute
Davie, Florida, 33328
Georgia Cancer Specialists. Drug Ship
Decatur, Georgia, 30033
Fairview Southdale Medical Oncology Clinic
Edina, Minnesota, 55435
Trinitas Comprehensive Cancer Center Dept. of Trinitas
Elizabeth, New Jersey, 07207
Highlands Oncology Group DeptofHighlandsOncologyGrp(2)
Fayetteville, Arkansas, 72703
Florida Cancer Specialists DeptofFloridaCancerSpecialists
Fort Myers, Florida, 33901
The Center for Cancer and Blood Disorders Dept. of The Ctr for C & BD(2)
Fort Worth, Texas, 76104
Frederick Memorial Hospital Dept. of FMH-IRB
Frederick, Maryland, 21701
Cancer Care Associates Dept.ofCancerCareAssoc. (2)
Fresno, California, 93720
Grass Valley Hematology Oncology Medical Group Dept. of Grass Valley Hem/Onc
Grass Valley, California, 95945
Penn State University / Milton S. Hershey Medical Center Division of Oncology (2)
Hershey, Pennsylvania, 17033-0850
Memorial Hospital Memorial Cancer Institute
Hollywood, Florida, 33021
University of Texas/MD Anderson Cancer Center Dept.ofMDAndersonCancerCtr(2)
Houston, Texas, 77030-4009
Hematology Oncology of Indiana
Indianapolis, Indiana, 46260
Scripps Clinic SC
La Jolla, California, 92121
Horizon Oncology Center
Lafayette, Indiana, 47905
Clinical Research Alliance Dept.ofArenaOncologyAssoc(2)
Lake Success, New York, 11042
ProHealth Care
Lake Success, New York, 11042
Cancer Centers of Southwest Oklahoma Cancer Research Dept.of Southwest Oklahoma
Lawton, Oklahoma, 73505
Southeast Nebraska Oncology Cancer Center
Lincoln, Nebraska, 68510
The Angeles Clinic and Research Institute
Los Angeles, California, 90025
USC/Kenneth Norris Comprehensive Cancer Center Regulatory Contact 3
Los Angeles, California, 90053
University of Louisville / James Graham Brown Cancer Center SC
Louisville, Kentucky, 40202
University of Wisconsin Hospital & Clinics UW ComprehensiveCancerCtr(2)
Madison, Wisconsin, 53792
Crescent City Research Consortium, LLC Dept of Hem&Onc Specialist - 2
Metairie, Louisiana, 70006
Sarah Cannon Research Institute Dept.ofSarahCannonCancerCtr(5)
Nashville, Tennessee, 37203
Beth Israel Medical Center Dept.ofBeth Israel Med. Ctr(2)
New York, New York, 10003
Weill Cornell Medical College Weill Cornell Med. Ctr.
New York, New York, 10021
Hematology Oncology Association of Rockland
Nyack, New York, 10960
Northern Utah Cancer Associates SC
Ogden, Utah, 84403-3105
MD Anderson Cancer Center - Orlando Dept.ofMDACC-Orlando(2)
Orlando, Florida, 32806
Oncology Specialists, SC Dept.of Oncology Specialists
Park Ridge, Illinois, 60068-0736
Central Utah Clinic CRAD001Y2301
Provo, Utah, 84604
Medical Oncology & Hematology Associates of Northern VA Med. Onc&Hem Assoc. of No.VA
Reston, Virginia, 20190
Hope Oncology HOPE Richardson
Richardson, Texas, 75080
Utah Cancer Specialists Dept.of Utah Cancer Spec. (2)
Salt Lake City, Utah, 84106
University of Utah / Huntsman Cancer Institute Dept.ofHuntsmanCancerInst.(2)
Salt Lake City, Utah, 84112
Sharp Memorial Hospital SharpClinicalOncologyResearch
San Diego, California, 92123
University of California San Francisco UCSF Medical Center
San Francisco, California, 94101
Premiere Oncology/Pinnacle Oncology Hematology Dept.ofPremiereOncologyAZ
Santa Monica, California, 90404
St Joseph Heritage Healthcare Dept. of RRMG (4)
Santa Rosa, California, 94503
Holy Cross Hospital Holy Cross
Silver Spring, Maryland, 20910
St. Louis Cancer & Breast Institute Dept.ofSt.LouisCancer&Breast
St Louis, Missouri, 63141
Cancer Care Associates SC
Tulsa, Oklahoma, 74136
Marion L. Shepard Cancer Center
Washington, North Carolina, 27889
Palm Beach Cancer Institute
West Palm Beach, Florida, 33401
Cancer Center of Kansas Dept.ofCancerCtr.ofKansas
Wichita, Kansas, 67214-3728
Florida Medical Clinic PA Dept.ofFloridaMedicalClinic
Zephyrhills, Florida, 33542
Japan20 sites
Novartis Investigative Site
Bunkyo-ku, Tokyo, 113-8677
Novartis Investigative Site
Chuo-ku, Tokyo, 104-0045
Novartis Investigative Site
Chuo-ku, Tokyo, 104-8560
Novartis Investigative Site
Fukuoka, Fukuoka, 811-1395
Novartis Investigative Site
Hidaka, Saitama, 350-1298
Novartis Investigative Site
Isehara, Kanagawa, 259-1193
Novartis Investigative Site
Kagoshima, Kagoshima-ken, 892-0833
Novartis Investigative Site
Kashiwa, Chiba, 277-8577
Novartis Investigative Site
Kitaadachi-gun, Saitama, 362-0806
Novartis Investigative Site
Kitakyushu, Fukuoka, 802-0077
Novartis Investigative Site
Koto, Tokyo, 135-8550
Novartis Investigative Site
Kumamoto, Kumamoto, 860-8556
Novartis Investigative Site
Kyoto, Kyoto, 606-8507
Novartis Investigative Site
Maebashi, Gunma, 371-8511
Novartis Investigative Site
Matsuyama, Ehime, 791-0280
Novartis Investigative Site
Nagoya, Aichi-ken, 464-8681
Novartis Investigative Site
Osaka, Osaka, 537-8511
Novartis Investigative Site
Osaka, Osaka, 540-0006
Novartis Investigative Site
Sapporo, Hokkaido, 060-8648
Novartis Investigative Site
Suita, Osaka, 565-0871
Canada16 sites
Novartis Investigative Site
Calgary, Alberta, T2N 4N2
Novartis Investigative Site
Cambridge, Ontario, N1R 3G2
Novartis Investigative Site
Greenfield Park, Quebec, J4V 2H1
Novartis Investigative Site
Halifax, Nova Scotia, B3H 2Y9
Novartis Investigative Site
London, Ontario, N6A 4L6
Novartis Investigative Site
Moncton, New Brunswick, E1C 6Z8
Novartis Investigative Site
Montreal, Quebec, H2W 1S6
Novartis Investigative Site
Montreal, Quebec, H2W 1T8
Novartis Investigative Site
Montreal, Quebec, H4J 1C5
Novartis Investigative Site
Newmarket, Ontario, J7Y 2P9
Novartis Investigative Site
Québec, Quebec, G1S 4L8
Novartis Investigative Site
Sherbrooke, Quebec, J1H 5N4
Novartis Investigative Site
St. Catharines, Ontario, L2S 0A9
Novartis Investigative Site
Toronto, Ontario, M4C 3E7
Novartis Investigative Site
Toronto, Ontario, M4N 3M5
Novartis Investigative Site
Weston, Ontario, M9N 1N8
Spain12 sites
Novartis Investigative Site
A Coruña, Galicia, 15006
Novartis Investigative Site
Barcelona, Catalonia, 08035
Novartis Investigative Site
Lleida, Catalonia, 25198
Novartis Investigative Site
Madrid, Madrid, 28033
Novartis Investigative Site
Madrid, Madrid, 28041
Novartis Investigative Site
Madrid, Madrid, 28046
Novartis Investigative Site
Málaga, Andalusia, 29010
Novartis Investigative Site
Mallorca, Balearic Islands, 07198
Novartis Investigative Site
Palma de Mallorca, Balearic Islands, 07120
Novartis Investigative Site
Santiago de Compostela, Galicia, 15706
Novartis Investigative Site
Seville, Andalusia, 41017
Novartis Investigative Site
Terrassa, Catalonia, 08221
Italy10 sites
Novartis Investigative Site
Antella - Bagno A Ripoli, FI, 50011
Novartis Investigative Site
Brindisi, BR, 72100
Novartis Investigative Site
Catania, CT, 95100
Novartis Investigative Site
Genova, GE, 16132
Novartis Investigative Site
Perugia, PG, 06129
Novartis Investigative Site
Province of Macerata, MC, 62100
Novartis Investigative Site
Saronno, Va, 21047
Novartis Investigative Site
Terni, TR, 05100
Novartis Investigative Site
Torino, TO, 10126
Novartis Investigative Site
Varese, VA, 21100
France9 sites
Novartis Investigative Site
La Roche-sur-Yon, 85925
Novartis Investigative Site
Le Mans, 72000
Novartis Investigative Site
Lyon, 69373
Novartis Investigative Site
Marseille, 13008
Novartis Investigative Site
Paris, 75010
Novartis Investigative Site
Rouen, 76000
Novartis Investigative Site
Rouen, 76038
Novartis Investigative Site
Saint-Herblain Cédex, 44805
Novartis Investigative Site
Saint-Nazaire, 44600
Germany8 sites
Novartis Investigative Site
Berlin, 10098
Novartis Investigative Site
Düsseldorf, 40225
Novartis Investigative Site
Frankfurt, 60389
Novartis Investigative Site
Mannheim, 68165
Novartis Investigative Site
München, 80637
Novartis Investigative Site
München, 81377
Novartis Investigative Site
Münster, 48149
Novartis Investigative Site
Trier, 54290
Australia6 sites
Novartis Investigative Site
Bedford Park, South Australia, 5042
Novartis Investigative Site
Nambour, Queensland, 4560
Novartis Investigative Site
Parkville, Victoria, 3002
Novartis Investigative Site
Parkville, Victoria, 3050
Novartis Investigative Site
Redcliffe, Queensland, 4020
Novartis Investigative Site
Subiaco, Western Australia, 6008
Belgium6 sites
Novartis Investigative Site
Brussels, 1000
Novartis Investigative Site
Brussels, 1090
Novartis Investigative Site
Leuven, 3000
Novartis Investigative Site
Liège, 4000
Novartis Investigative Site
Sint-Niklaas, 9100
Novartis Investigative Site
Wilrijk, 2610
Netherlands6 sites
Novartis Investigative Site
Alkmaar, 1815 JD
Novartis Investigative Site
Amsterdam, 1090 HM
Novartis Investigative Site
Dordrecht, 3318AT
Novartis Investigative Site
Eindhoven, Netherlands, 5631 BM
Novartis Investigative Site
Sittard-Geleen, 6162 BG
Novartis Investigative Site
The Hague, 2545 CH
United Kingdom6 sites
Novartis Investigative Site
Broomfield, Chelmsford, CM1 7ET
Novartis Investigative Site
Cardiff, CF14 2TL
Novartis Investigative Site
Nottingham, NG5 1PB
Novartis Investigative Site
Sheffield, S10 2SJ
Novartis Investigative Site
Southampton, SO16 6YD
Novartis Investigative Site
Truro, Cornwall, TR1 3LJ
Austria5 sites
Novartis Investigative Site
Innsbruck, Austria, A-6020
Novartis Investigative Site
Linz, A-4010
Novartis Investigative Site
Salzburg, 5020
Novartis Investigative Site
Vienna, A-1090
Novartis Investigative Site
Wels, Austria, A-4600
Brazil5 sites
Novartis Investigative Site
Porto Alegre, Rio Grande do Sul, 90560-030
Novartis Investigative Site
Rio de Janeiro, Rio de Janeiro, 20230-130
Novartis Investigative Site
Salvador, Estado de Bahia, 41825-010
Novartis Investigative Site
São Paulo, São Paulo, 01246-000
Novartis Investigative Site
Uberlândia, Minas Gerais, 38408-150
Thailand4 sites
Novartis Investigative Site
Bangkok, 10400
Novartis Investigative Site
Bangkok, 10700
Novartis Investigative Site
Chiang Mai, 50200
Novartis Investigative Site
Songkhla, 90110
Czechia3 sites
Novartis Investigative Site
Brno, Czech Republic, 656 53
Novartis Investigative Site
Olomouc, CZE, 775 20
Novartis Investigative Site
Prague, Czech Republic, 14044
Egypt3 sites
Novartis Investigative Site
Alexandria
Novartis Investigative Site
Cairo
Novartis Investigative Site
Menoufiya, Egypt
Hungary3 sites
Novartis Investigative Site
Budapest, H-1122
Novartis Investigative Site
Szeged, H-6720
Novartis Investigative Site
Szolnok, H-5000
Poland3 sites
Novartis Investigative Site
Krakow, 31-108
Novartis Investigative Site
Rzeszów, 35-021
Novartis Investigative Site
Warsaw, 04-125
South Korea3 sites
Novartis Investigative Site
Hwasun-gun, Jeollanam-do, 58128
Novartis Investigative Site
Seoul, Korea, 03722
Novartis Investigative Site
Seoul, 01812
Sweden3 sites
Novartis Investigative Site
Stockholm, SE-118 83
Novartis Investigative Site
Stockholm, SE-171 76
Novartis Investigative Site
Uppsala, SE-751 85
Turkey (Türkiye)3 sites
Novartis Investigative Site
Altunizade, 34662
Novartis Investigative Site
Ankara, 06100
Novartis Investigative Site
Izmir, Turkey, 35040
New Zealand1 site
Novartis Investigative Site
Christchurch, Christchurch, 8001
About this study
Official title: A Randomized Double-Blind, Placebo-Controlled Study of Everolimus in Combination With Exemestane in the Treatment of Postmenopausal Women With Estrogen Receptor Positive Locally Advanced or Metastatic Breast Cancer Who Are Refractory to Letrozole or Anastrozole
There are no treatments specifically approved after recurrence or progression on a non steroidal aromatase inhibitors (NSAI). In light of the need for new treatment options for postmenopausal women after failure of prior NSAI therapy, the purpose of this Phase III study is to compare efficacy and safety of a treatment with exemestane + everolimus to exemestane + placebo in postmenopausal women with estrogen receptor positive locally advanced or metastatic breast cancer refractory to NSAI.
- Conditions
- Breast Cancer
- Being tested
- Everolimus, Exemestane, Everolimus Placebo
- Keywords
- Breast Cancer, Estrogen Receptor positive, ER+, exemestane, mTOR, everolimus, refractory, NSAI
- Medical subject headings
- Breast Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
EverolimusDrug
Also called RAD001
Everolimus was formulated as tablets of 5-mg strength and was packaged into blister packs . Everolimus (two 5 mg tablets daily) were administered in a blinded manner on their respective treatment arms by continuous oral daily dosing.
ExemestaneDrug
Exemestane 25 mg orally daily.
Everolimus PlaceboDrug
Placebo was formulated to be indistinguishable from the everolimus tablets. Matching placebo (two tablets daily) were administered in a blinded manner on their respective treatment arms by continuous oral daily dosing.
| Study group | Role | What they receive |
|---|---|---|
| Everolimus + Exemestane | Experimental | Everolimus 10 mg daily in combination with exemestane 25 mg daily Receives: Drug: Everolimus; Drug: Exemestane |
| Placebo + Exemestane | Active comparator | Placebo of everolimus in combination with exemestane 25 mg daily Receives: Drug: Exemestane; Drug: Everolimus Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression-free Survival (PFS) Based on Local Radiology Review of Tumor Assessments.
Progression-free survival, the primary endpoint in this study, is defined as the time from the date of randomization to the date of first documented radiological progression or death due to any cause. Disease progression was based on the tumor assessment by the local radiologist or investigator using RECIST 1.0 criteria. If a patient did not progress or known to have died at the date of the analysis cut-off or start of another antineoplastic therapy, the PFS date was censored to the date of last adequate tumor assessment prior to cut-off date or start of antineoplastic therapy. For patients with lytic or mixed (lytic+sclerotic) bone lesions, the following is considered progression: appearance of ≥1 new lytic lesions in bone; the appearance of ≥ new lesions outside of bone and unequivocal progression of existing bone lesions.
Measured: date of randomization to the date of first documented tumor progression or death from any cause, whichever occurs first, reported between day of first patient randomized up to about 19 months
Secondary outcomes (11)
Overall Survival (OS) by Number of Deaths
Overall survival, the key secondary endpoint in this study, is defined as the time from date of randomization to the date of death due to any cause. If a patient is not known to have died, survival was censored at the date of last contact.
Measured: up to 53 months
Overall Survival (OS) by Median
Overall survival, the key secondary endpoint in this study, is defined as the time from date of randomization to the date of death due to any cause.
Measured: up to 53 months
Overall Response Rate (ORR)
Overall response rate (ORR) is the percentage of patients with a best overall response of complete response (CR) or partial response (PR) according to RECIST 1.0. Per RECIST criteria 1.0, CR: Disappearance of all target lesions; PR: At least a 30% decrease in the sum of the longest diameter of all target lesions, taking as reference the baseline sum of the longest diameters.
Measured: up to 21 months
Clinical Benefit Rate (CBR)
CBR is defined as the percentage of patients with best overall response of either complete response (CR), a partial response (PR) or stable disease (SD) >= 24 weeks, according to RECIST 1.0. Per RECIST criteria 1.0, CR: Disappearance of all target lesions; PR: At least a 30% decrease in the sum of the longest diameter of all target lesions, taking as reference the baseline sum of the longest diameters; SD = Neither sufficient shrinkage to qualify for PR or CR nor an increase in lesions which would qualify for PD; PD = At least a 20% increase in the sum of the longest diameter of all measured target lesions, taking as reference the smallest sum of longest diameter of all target lesions recorded at or after baseline.
Measured: up to 21 months
Proportion of Patients With no Deterioration of Eastern Cooperative Oncology Group Performance Status (ECOG PS) Using Kaplan-Meier
The ECOG PS (Eastern Cooperative Oncology Group Performance Scale) is a standard criteria for measuring how treatment of cancer impacts level of functioning in terms of the ability to care for oneself, daily activity, \& physical ability (walking, working, etc.). Scale score ranges:0 to 5, 5 being the worst. Scale index: 0: Fully active, able to carry on all pre-disease performance without restriction. 1: Restricted in physically strenuous activity but ambulatory \& able to carry out work of a light or sedentary nature. 2: Ambulatory \& capable of all self-care but unable to carry out any work activities. Up \& about more than 50% of waking hours. 3: Capable of only limited self-care, confined to bed or chair more than 50% of waking hours. 4 - Completely disabled. Cannot carry on any self-care. Totally confined to bed or chair. 5 - Dead. A deterioration of ECOG is an increase of 1 of the ECOG PS without improvement back to initial level at a subsequent time of measurement.
Measured: 2, 4, 6, 9 months
Patient-reported Outcomes (PROs): Time to Deterioration of PRO Scores Using Kaplan Meier - EORTC QLQ-C30
The QLQ-C30 is composed of both multi-item scales and single-item measures. These include 5 functional scales, 3 symptom scales, a global health status - QoL scale, and 6 single items. Each of the multi-item scales includes a different set of items - no item occurs in more than 1 scale. All of the scales measures range in score from 0 to 100. A high scale score = higher response level. Thus a high score for a functional scale represents a healthy level of function, a high score for the global health status / QoL represents a high quality of life but a high score for a symptom scale / item represents a high level of symptomatology / problems. The principle for scoring these scales: 1.) Estimate the average of the items that contribute to the scale = raw score. 2.) Linear transformation to standardize the raw score, so that scores range from 0 to 100; a higher score represents a higher ("better") level of functioning, or a higher ("worse") level of symptoms.
Measured: Up to 21 months
Proportion of Patients With Having no Overall Response Based on Investigator Assessment
overall response = complete response (CR) + partial response (PR) per RECIST 1.0 Time to overall response (CR or PR) based on investigator is the time between date of randomization/start of treatment until first documented response (CR or PR). This analysis included all patients/responders. Patients who did not achieve a confirmed PR or CR were censored at last adequate tumor assessment date when they did not progress. Per RECIST criteria 1.0, CR: Disappearance of all target lesions; PR: At least a 30% decrease in the sum of the longest diameter of all target lesions, taking as reference the baseline sum of the longest diameters.
Measured: 2, 4, 6, 9 months
Duration of Response (Among Participants With Best Overall Response of CR or PR) Estimated Per Kaplan-Meier
Duration of response of CR or PR based on investigator applies only to patients whose best overall response was CR or PR (RECIST 1.0). The start date was the date of first documented response (CR or PR) and the end date and censoring is defined the same as that for time to progression. Per RECIST criteria 1.0, CR: Disappearance of all target lesions; PR: At least a 30% decrease in the sum of the longest diameter of all target lesions, taking as reference the baseline sum of the longest diameters.
Measured: 21 months
Everolimus Concentrations at Week 4
Characterize the pharmacokinetics (PK) of everolimus in combination with exemestane using Cmin (pre-dose) and C2h (post-dose) at week 4 in a small group of patients.
Measured: pre-dose, 2 hours post-dose
Exemestane Concentrations at Week 4
Characterize the PK of exemestane in combination with or without everolimus using Cmin and C2h at week 4 in a small group of patients.
Measured: predose, 2 hours post-dose
Estradiol Plasma Concentrations
Compare estradiol concentrations from baseline to week 4 in both treatment arms.
Measured: Baseline, Week 4
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Mar 2009 (estimated)
- Study start3 Jun 2009
- Primary completion4 Dec 2014
- Study completion4 Dec 2014
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 (10)Papers the sponsor has linked to this study.
- Other trials for Breast CancerStudies 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
- 724 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
- NCT00863655
- Sponsor's protocol ID
- CRAD001Y2301
- Other IDs
- 2008-008698-69, 2008
- Acronym
- BOLERO-2
- Status last verified
- Mar 2017
- First submitted
- 16 Mar 2009
- Last updated
- 2 May 2017
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Luftner D, Schuetz F, Schneeweiss A, Hartkopf A, Bloch W, Decker T, Uleer C, Stotzer O, Foerster F, Schmidt M, Mundhenke C, Tesch H, Jackisch C, Fischer T, Kreuzeder J, Guderian G, Fasching PA. Efficacy and safety of everolimus plus exemestane in patients with hormone receptor-positive, HER-2-negative advanced breast cancer: Results from the open-label, multicentre, non-interventional BRAWO study. Int J Cancer. 2024 Jul 1;155(1):128-138. doi: 10.1002/ijc.34912. Epub 2024 Mar 6.
PubMed 38447007Wedam 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 29522361Chandarlapaty S, Chen D, He W, Sung P, Samoila A, You D, Bhatt T, Patel P, Voi M, Gnant M, Hortobagyi G, Baselga J, Moynahan ME. Prevalence of ESR1 Mutations in Cell-Free DNA and Outcomes in Metastatic Breast Cancer: A Secondary Analysis of the BOLERO-2 Clinical Trial. JAMA Oncol. 2016 Oct 1;2(10):1310-1315. doi: 10.1001/jamaoncol.2016.1279.
PubMed 27532364Hortobagyi GN, Chen D, Piccart M, Rugo HS, Burris HA 3rd, Pritchard KI, Campone M, Noguchi S, Perez AT, Deleu I, Shtivelband M, Masuda N, Dakhil S, Anderson I, Robinson DM, He W, Garg A, McDonald ER 3rd, Bitter H, Huang A, Taran T, Bachelot T, Lebrun F, Lebwohl D, Baselga J. Correlative Analysis of Genetic Alterations and Everolimus Benefit in Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer: Results From BOLERO-2. J Clin Oncol. 2016 Feb 10;34(5):419-26. doi: 10.1200/JCO.2014.60.1971. Epub 2015 Oct 26.
PubMed 26503204Piccart M, Hortobagyi GN, Campone M, Pritchard KI, Lebrun F, Ito Y, Noguchi S, Perez A, Rugo HS, Deleu I, Burris HA 3rd, Provencher L, Neven P, Gnant M, Shtivelband M, Wu C, Fan J, Feng W, Taran T, Baselga J. Everolimus plus exemestane for hormone-receptor-positive, human epidermal growth factor receptor-2-negative advanced breast cancer: overall survival results from BOLERO-2dagger. Ann Oncol. 2014 Dec;25(12):2357-2362. doi: 10.1093/annonc/mdu456. Epub 2014 Sep 17.
PubMed 25231953Rugo HS, Pritchard KI, Gnant M, Noguchi S, Piccart M, Hortobagyi G, Baselga J, Perez A, Geberth M, Csoszi T, Chouinard E, Srimuninnimit V, Puttawibul P, Eakle J, Feng W, Bauly H, El-Hashimy M, Taran T, Burris HA 3rd. Incidence and time course of everolimus-related adverse events in postmenopausal women with hormone receptor-positive advanced breast cancer: insights from BOLERO-2. Ann Oncol. 2014 Apr;25(4):808-815. doi: 10.1093/annonc/mdu009. Epub 2014 Mar 10.
PubMed 24615500Yardley DA, Noguchi S, Pritchard KI, Burris HA 3rd, Baselga J, Gnant M, Hortobagyi GN, Campone M, Pistilli B, Piccart M, Melichar B, Petrakova K, Arena FP, Erdkamp F, Harb WA, Feng W, Cahana A, Taran T, Lebwohl D, Rugo HS. Everolimus plus exemestane in postmenopausal patients with HR(+) breast cancer: BOLERO-2 final progression-free survival analysis. Adv Ther. 2013 Oct;30(10):870-84. doi: 10.1007/s12325-013-0060-1. Epub 2013 Oct 25.
PubMed 24158787Campone M, Beck JT, Gnant M, Neven P, Pritchard KI, Bachelot T, Provencher L, Rugo HS, Piccart M, Hortobagyi GN, Nunzi M, Heng DY, Baselga J, Komorowski A, Noguchi S, Horiguchi J, Bennett L, Ziemiecki R, Zhang J, Cahana A, Taran T, Sahmoud T, Burris HA 3rd. Health-related quality of life and disease symptoms in postmenopausal women with HR(+), HER2(-) advanced breast cancer treated with everolimus plus exemestane versus exemestane monotherapy. Curr Med Res Opin. 2013 Nov;29(11):1463-73. doi: 10.1185/03007995.2013.836078. Epub 2013 Sep 4.
PubMed 23962028Noguchi S, Masuda N, Iwata H, Mukai H, Horiguchi J, Puttawibul P, Srimuninnimit V, Tokuda Y, Kuroi K, Iwase H, Inaji H, Ohsumi S, Noh WC, Nakayama T, Ohno S, Rai Y, Park BW, Panneerselvam A, El-Hashimy M, Taran T, Sahmoud T, Ito Y. Efficacy of everolimus with exemestane versus exemestane alone in Asian patients with HER2-negative, hormone-receptor-positive breast cancer in BOLERO-2. Breast Cancer. 2014 Nov;21(6):703-14. doi: 10.1007/s12282-013-0444-8. Epub 2013 Feb 13.
PubMed 23404211Baselga J, Campone M, Piccart M, Burris HA 3rd, Rugo HS, Sahmoud T, Noguchi S, Gnant M, Pritchard KI, Lebrun F, Beck JT, Ito Y, Yardley D, Deleu I, Perez A, Bachelot T, Vittori L, Xu Z, Mukhopadhyay P, Lebwohl D, Hortobagyi GN. Everolimus in postmenopausal hormone-receptor-positive advanced breast cancer. N Engl J Med. 2012 Feb 9;366(6):520-9. doi: 10.1056/NEJMoa1109653. Epub 2011 Dec 7.
PubMed 22149876
Study at a glance
From the registry record, last updated by the sponsor on 2 May 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized Double-Blind, Placebo-Controlled Study of Everolimus in Combination With Exemestane in the Treatment of Postmenopausal Women With Estrogen Receptor Positive Locally Advanced or Metastatic Breast Cancer Who Are Refractory to Letrozole or Anastrozole
- ClinicalTrials.gov ID
- NCT00863655
- Acronym / sponsor ID
- BOLERO-2 / CRAD001Y2301
- Conditions
- Breast Cancer
- Keywords
- Breast Cancer, Estrogen Receptor positive, ER+, exemestane, mTOR, everolimus, refractory, NSAI
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 724 participants (actual)
- Lead sponsor
- Novartis PharmaceuticalsIndustry (pharma, biotech, devices)
- Study start
- 3 Jun 2009 (actual)
- Primary completion
- 4 Dec 2014 (actual)
- Study completion
- 4 Dec 2014 (actual)
- First posted
- 18 Mar 2009 (estimated)
- Results
- Posted 31 Aug 2012
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
There are no treatments specifically approved after recurrence or progression on a non steroidal aromatase inhibitors (NSAI). In light of the need for new treatment options for postmenopausal women after failure of prior NSAI therapy, the purpose of this Phase III study is to compare efficacy and safety of a treatment with exemestane + everolimus to exemestane + placebo in postmenopausal women with estrogen receptor positive locally advanced or metastatic breast cancer refractory to NSAI.
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 |
|---|---|---|
| Everolimus + Exemestane | Experimental | Drug: Everolimus, Drug: ExemestaneEverolimus 10 mg daily in combination with exemestane 25 mg daily |
| Placebo + Exemestane | Active comparator | Drug: Exemestane, Drug: Everolimus PlaceboPlacebo of everolimus in combination with exemestane 25 mg daily |
Who may qualify
- Ages
- 18 years and older
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Adult women (≥ 18 years of age) with metastatic or locally advanced breast cancer not amenable to curative treatment by surgery or radiotherapy.
- Histological or cytological confirmation of estrogen-receptor positive (ER+) breast cancer
- Postmenopausal women.
- Disease refractory to non steroidal aromatase inhibitors (NSAI),
- Radiological or clinical evidence of recurrence or progression on or after the last systemic therapy prior to randomization.
Key exclusion criteria (8 listed)
- HER2-overexpressing patients
- Patients with only non-measurable lesions other than bone metastasis (e.g. pleural effusion, ascites etc.).
- Patients who received more than one chemotherapy line for Advanced Breast Cancer.
- Previous treatment with exemestane or mTOR inhibitors.
- Known hypersensitivity to mTOR inhibitors, e.g. sirolimus (rapamycin).
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 |
|---|---|---|
| EverolimusAlso: RAD001Everolimus was formulated as tablets of 5-mg strength and was packaged into blister packs . Everolimus (two 5 mg tablets daily) were administered in a blinded manner on their respective treatment arms by continuous oral daily dosing. | Drug | Everolimus + Exemestane |
| ExemestaneExemestane 25 mg orally daily. | Drug | Everolimus + Exemestane, Placebo + Exemestane |
| Everolimus PlaceboPlacebo was formulated to be indistinguishable from the everolimus tablets. Matching placebo (two tablets daily) were administered in a blinded manner on their respective treatment arms by continuous oral daily dosing. | Drug | Placebo + Exemestane |
Primary outcome
Progression-free Survival (PFS) Based on Local Radiology Review of Tumor Assessments.
Time frame: date of randomization to the date of first documented tumor progression or death from any cause, whichever occurs first, reported between day of first patient randomized up to about 19 months
Progression-free survival, the primary endpoint in this study, is defined as the time from the date of randomization to the date of first documented radiological progression or death due to any cause. Disease progression was based on the tumor assessment by the local radiologist or investigator using RECIST 1.0 criteria. If a patient did not progress or known to have died at the date of the analysis cut-off or start of another antineoplastic therapy, the PFS date was censored to the date of last adequate tumor assessment prior to cut-off date or start of antineoplastic therapy. For patients with lytic or mixed (lytic+sclerotic) bone lesions, the following is considered progression: appearance of ≥1 new lytic lesions in bone; the appearance of ≥ new lesions outside of bone and unequivocal progression of existing bone lesions.
11 secondary outcomes
Overall Survival (OS) by Number of Deaths
Time frame: up to 53 months
Overall Survival (OS) by Median
Time frame: up to 53 months
Overall Response Rate (ORR)
Time frame: up to 21 months
Clinical Benefit Rate (CBR)
Time frame: up to 21 months
Proportion of Patients With no Deterioration of Eastern Cooperative Oncology Group Performance Status (ECOG PS) Using Kaplan-Meier
Time frame: 2, 4, 6, 9 months
Patient-reported Outcomes (PROs): Time to Deterioration of PRO Scores Using Kaplan Meier - EORTC QLQ-C30
Time frame: Up to 21 months
Proportion of Patients With Having no Overall Response Based on Investigator Assessment
Time frame: 2, 4, 6, 9 months
Duration of Response (Among Participants With Best Overall Response of CR or PR) Estimated Per Kaplan-Meier
Time frame: 21 months
Everolimus Concentrations at Week 4
Time frame: pre-dose, 2 hours post-dose
Exemestane Concentrations at Week 4
Time frame: predose, 2 hours post-dose
Estradiol Plasma Concentrations
Time frame: Baseline, Week 4
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 May 2017.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 38447007Luftner D, Schuetz F, Schneeweiss A, Hartkopf A, Bloch W, Decker T, Uleer C, Stotzer O, Foerster F, Schmidt M, Mundhenke C, Tesch H, Jackisch C, Fischer T, Kreuzeder J, Guderian G, Fasching PA. Efficacy and safety of everolimus plus exemestane in patients with hormone receptor-positive, HER-2-negative advanced breast cancer: Results from the open-label, multicentre, non-interventional BRAWO study. Int J Cancer. 2024 Jul 1;155(1):128-138. doi: 10.1002/ijc.34912. Epub 2024 Mar 6.
- 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.
- Derived from this study: PubMed 27532364Chandarlapaty S, Chen D, He W, Sung P, Samoila A, You D, Bhatt T, Patel P, Voi M, Gnant M, Hortobagyi G, Baselga J, Moynahan ME. Prevalence of ESR1 Mutations in Cell-Free DNA and Outcomes in Metastatic Breast Cancer: A Secondary Analysis of the BOLERO-2 Clinical Trial. JAMA Oncol. 2016 Oct 1;2(10):1310-1315. doi: 10.1001/jamaoncol.2016.1279.
- Derived from this study: PubMed 26503204Hortobagyi GN, Chen D, Piccart M, Rugo HS, Burris HA 3rd, Pritchard KI, Campone M, Noguchi S, Perez AT, Deleu I, Shtivelband M, Masuda N, Dakhil S, Anderson I, Robinson DM, He W, Garg A, McDonald ER 3rd, Bitter H, Huang A, Taran T, Bachelot T, Lebrun F, Lebwohl D, Baselga J. Correlative Analysis of Genetic Alterations and Everolimus Benefit in Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer: Results From BOLERO-2. J Clin Oncol. 2016 Feb 10;34(5):419-26. doi: 10.1200/JCO.2014.60.1971. Epub 2015 Oct 26.
- Derived from this study: PubMed 25231953Piccart M, Hortobagyi GN, Campone M, Pritchard KI, Lebrun F, Ito Y, Noguchi S, Perez A, Rugo HS, Deleu I, Burris HA 3rd, Provencher L, Neven P, Gnant M, Shtivelband M, Wu C, Fan J, Feng W, Taran T, Baselga J. Everolimus plus exemestane for hormone-receptor-positive, human epidermal growth factor receptor-2-negative advanced breast cancer: overall survival results from BOLERO-2dagger. Ann Oncol. 2014 Dec;25(12):2357-2362. doi: 10.1093/annonc/mdu456. Epub 2014 Sep 17.
- Derived from this study: PubMed 24615500Rugo HS, Pritchard KI, Gnant M, Noguchi S, Piccart M, Hortobagyi G, Baselga J, Perez A, Geberth M, Csoszi T, Chouinard E, Srimuninnimit V, Puttawibul P, Eakle J, Feng W, Bauly H, El-Hashimy M, Taran T, Burris HA 3rd. Incidence and time course of everolimus-related adverse events in postmenopausal women with hormone receptor-positive advanced breast cancer: insights from BOLERO-2. Ann Oncol. 2014 Apr;25(4):808-815. doi: 10.1093/annonc/mdu009. Epub 2014 Mar 10.
- Derived from this study: PubMed 24158787Yardley DA, Noguchi S, Pritchard KI, Burris HA 3rd, Baselga J, Gnant M, Hortobagyi GN, Campone M, Pistilli B, Piccart M, Melichar B, Petrakova K, Arena FP, Erdkamp F, Harb WA, Feng W, Cahana A, Taran T, Lebwohl D, Rugo HS. Everolimus plus exemestane in postmenopausal patients with HR(+) breast cancer: BOLERO-2 final progression-free survival analysis. Adv Ther. 2013 Oct;30(10):870-84. doi: 10.1007/s12325-013-0060-1. Epub 2013 Oct 25.
- Derived from this study: PubMed 23962028Campone M, Beck JT, Gnant M, Neven P, Pritchard KI, Bachelot T, Provencher L, Rugo HS, Piccart M, Hortobagyi GN, Nunzi M, Heng DY, Baselga J, Komorowski A, Noguchi S, Horiguchi J, Bennett L, Ziemiecki R, Zhang J, Cahana A, Taran T, Sahmoud T, Burris HA 3rd. Health-related quality of life and disease symptoms in postmenopausal women with HR(+), HER2(-) advanced breast cancer treated with everolimus plus exemestane versus exemestane monotherapy. Curr Med Res Opin. 2013 Nov;29(11):1463-73. doi: 10.1185/03007995.2013.836078. Epub 2013 Sep 4.
- Derived from this study: PubMed 23404211Noguchi S, Masuda N, Iwata H, Mukai H, Horiguchi J, Puttawibul P, Srimuninnimit V, Tokuda Y, Kuroi K, Iwase H, Inaji H, Ohsumi S, Noh WC, Nakayama T, Ohno S, Rai Y, Park BW, Panneerselvam A, El-Hashimy M, Taran T, Sahmoud T, Ito Y. Efficacy of everolimus with exemestane versus exemestane alone in Asian patients with HER2-negative, hormone-receptor-positive breast cancer in BOLERO-2. Breast Cancer. 2014 Nov;21(6):703-14. doi: 10.1007/s12282-013-0444-8. Epub 2013 Feb 13.
- Derived from this study: PubMed 22149876Baselga J, Campone M, Piccart M, Burris HA 3rd, Rugo HS, Sahmoud T, Noguchi S, Gnant M, Pritchard KI, Lebrun F, Beck JT, Ito Y, Yardley D, Deleu I, Perez A, Bachelot T, Vittori L, Xu Z, Mukhopadhyay P, Lebwohl D, Hortobagyi GN. Everolimus in postmenopausal hormone-receptor-positive advanced breast cancer. N Engl J Med. 2012 Feb 9;366(6):520-9. doi: 10.1056/NEJMoa1109653. Epub 2011 Dec 7.
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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
200 sites in 24 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Everolimus and Exemestane in people with Breast Cancer, run by Novartis Pharmaceuticals at 200 sites in 24 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 6 inclusion and 8 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 2 May 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 200 sites in United States, Japan, Canada, Spain, Italy and 19 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. 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 31 Aug 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?
Progression-free Survival (PFS) Based on Local Radiology Review of Tumor Assessments. (time frame: date of randomization to the date of first documented tumor progression or death from any cause, whichever occurs first, reported between day of first patient randomized up to about 19 months). 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 NCT00863655, which also lists 10 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 2 May 2017.