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Metastatic Breast CancerPhase 2PYTHIANCT02536742

Palbociclib in Molecularly Characterized ER-positive/HER2-negative Metastatic Breast Cancer

A Phase 2 study testing Palbociclib and Fulvestrant in people with Metastatic Breast Cancer, run by ETOP IBCSG Partners Foundation at 19 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This international, multicenter, prospective single arm Phase II biomarker discovery clinical trial with the primary objective of assessing the association of PFS with gene mutations, gene copy number aberrations and gene signatures in post-menopausal women with hormone receptor positive, HER2-negative metastatic or… Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Metastatic Breast Cancer
What is being tested?
Palbociclib and Fulvestrant
Could I receive a placebo?
No, everyone receives an active treatment
How many people
124 participants
Where
19 sitesin 3 countries
Study dates
30 Aug 2016to 22 Dec 2022
Phase
Phase 2
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

  • Female gender
  • Age ≥ 18 years
  • Postmenopausal, defined as women with:
  • Prior bilateral surgical oophorectomy; or
  • Amenorrhea and age ≥ 60 years; or
  • Age < 60 years and amenorrhea for 12 or more consecutive months in the absence of alternative pathological or physiological cause and FSH and serum estradiol levels within the laboratory's reference ranges for postmenopausal women.
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  • Endocrine resistant disease, defined as one of:
  • Relapse while on adjuvant endocrine therapy;
  • Relapse within 12 months after completion of adjuvant endocrine therapy;
  • Progression of disease under first line endocrine therapy for metastatic and/or loco-regionally advanced breast cancer.
  • Note: Patient may have received one prior chemotherapy for advanced or metastatic breast cancer.
  • ER positive tumor and HER2-negative tumor, as assessed locally
  • ECOG Performance Status 0-1.
  • Measurable or non-measurable but evaluable disease according to RECIST 1.1.
  • Written Informed Consent (IC) for screening procedures.
  • Written informed consent to participate in the AURORA program of BIG.
  • The patient has been informed of and agrees to data transfer and handling, in accordance with national data protection guidelines.
  • Life expectancy >3 months.
  • Hematological status:
  • Absolute neutrophil count ≥ 1.5 × 109/L
  • Platelet count ≥ 100 × 109/L
  • Hemoglobin ≥ 9 g/dL
  • Hepatic status:
  • Serum total bilirubin ≤ 1.5 × upper limit of normal (ULN).
  • AST and ALT ≤ 2.5 × ULN; if the patient has liver metastases, ALT and AST must be ≤ 5 × ULN.
  • Glucose in normal range, or well-controlled diabetes defined as an HbA1c level ≤ 7.5%.
  • Renal status:
  • Creatinine ≤ 1.5 ×ULN or creatinine clearance > 60 ml/min.
  • International Normalized Ratio (INR) or Prothrombin Time (PT) ≤1.5 × ULN unless patient is receiving anticoagulant therapy as long as PT or PTT is within therapeutic range of intended use of anticoagulant.
  • Ability to swallow oral medication.

Who cannot join

  • Prior use of fulvestrant or any CDK inhibitor.
  • More than one prior line of chemotherapy for metastatic or locally relapsed disease.
  • Previous or current non-breast malignancies within the last 5 years, with the exception of in situ carcinoma of the cervix, and adequately treated basal cell or squamous cell carcinoma of the skin.
  • Known active uncontrolled or symptomatic CNS metastases, carcinomatous meningitis or leptomeningeal disease as indicated by clinical symptoms, cerebral edema, and/or progressive growth.
  • Any of the following in the previous 6 months: myocardial infarction, severe/unstable angina pectoris, ongoing cardiac dysrhythmias of NCI CTCAE grade ≥2, atrial fibrillation of any grade, coronary/peripheral artery bypass graft, symptomatic congestive heart failure (NYHA functional classification ≥3), cerebrovascular accident including transient ischemic attack, or symptomatic pulmonary embolism.
  • QTc exceeding 480msec, family or personal history of long or short QT syndrome, Brugada syndrome or known history of QTc prolongation, or Torsade de Pointes (TdP).
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  • Uncontrolled electrolyte disorders that can reinforce the QT-prolonging effect of the drug (e.g., hypocalcemia, hypokalemia, hypomag¬nesemia).
  • Known history of HIV seropositivity. HIV screening is not required at baseline.
  • Uncontrolled diabetes defined as HbA1c level > 7.5%.
  • Concurrent disease or familial, sociological or geographical condition that would make the patient inappropriate for trial participation or any serious medical disorder that would interfere with the patient's safety.
  • Dementia, altered mental status, or any psychiatric condition that would prevent the understanding or rendering of Informed Consent.
  • Known abnormalities in coagulation such as bleeding diathesis, or treatment with anticoagulants precluding intramuscular injections of fulvestrant.
  • Treatment with an investigational agent in the 4 weeks before enrollment.
  • Concurrent treatment with any of the drugs not permitted
  • Adverse events (except alopecia) from previous systemic cancer therapy, radiotherapy or surgery have not recovered to CTCAE v4.0 grade 1 or resolved prior to enrollment.

Trial locations and contacts

19 sites in 3 countries.

19 sites in 3 countries

Belgium7 sites
  • Sint-Augustinus

    Antwerp, 2610

  • Institut Jules Bodet

    Brussels, 1000

  • Cliniques Universitaires Saint-Luc

    Brussels, 1200

  • Antwerp University Hospital

    Edegem, 2650

  • UZ Leuven

    Leuven

  • CHU Liege

    Liège

  • Clinique St. Elizabeth

    Namur, 5000

Other trials in Belgium

Italy7 sites
  • Ospedali degli Infermi, S.O.C. Oncologia

    Biella, 13879

  • Ospedale Centrale Bolzano, Medical Oncology

    Bolzano

  • IRCCS San Martino University Hospital

    Genova

  • Mater Salutis Hospital AULSS 21 della Regione Veneto

    Legnago

  • Istituto Europeo di Oncologia

    Milan

  • Istituti Clinici Scientifici Maugeri, Medical Oncology Unit

    Pavia, 27100

  • Azienda USL4 Prato

    Prato

Other trials in Italy

United Kingdom5 sites
  • Velindre NHS Trust

    Cardiff

  • Western General Hospital

    Edinburgh

  • Beatson West of Scotland Cancer Centre

    Glasgow

  • Singleton Hospital

    Swansea

  • Royal Cornwall

    Truro

Other trials in United Kingdom

About this study

Official title: A Phase II Study of Palbociclib Plus Fulvestrant for Pretreated Patients With ER+/HER2- Metastatic Breast Cancer

This international, multicenter, prospective single arm Phase II biomarker discovery clinical trial with the primary objective of assessing the association of PFS with gene mutations, gene copy number aberrations and gene signatures in post-menopausal women with hormone receptor positive, HER2-negative metastatic or locally relapsed breast cancer whose disease has progressed after prior adjuvant endocrine therapy or one line systemic treatment, i.e., endocrine treatment or chemotherapy, administered for metastatic disease.

Read the detailed description

Patients will be treated with the combination of palbociclib and fulvestrant. The primary objective is to assess the association of the primary endpoint progression-free survival (PFS) with potential markers.

The trial is included in the AURORA program conducted by the Breast International Group (BIG), an international study aiming to collect and characterize biological samples, including metastatic tissue, from patients with advanced breast cancer.

The primary aim of the PYTHIA study is to discover potentially innovative biomarkers for the selection of patients to Palbociclib/Fulvestrant treatment. The strength of the trial lies in its conduct in conjunction with the AURORA study, which systematically evaluates a panel of biomarkers in tissue and blood, in a certified central lab. Stemming from this association, an abundance of molecular profiling information will become available for different biological samples. Additional molecular and functional imaging assessments performed within the context of the PYTHIA study increase its scientific merit, since it will represent a prospective, systematic effort to identify biomarkers for patient stratification, integrating several molecular profiling assessments.

Keywords
Breast Cancer, Metastatic, HER2 negative, Palbociclib
Medical subject headings
Breast Neoplasms, Neoplasm Metastasis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PalbociclibDrug

    Also called PD-0332991, Ibrance

    125 mg, orally, daily for 3 weeks followed by 1 week off; repeated at every 28 days cycle until progression, lack of tolerability, or patient declines further protocol treatment.

  • FulvestrantDrug

    Also called Faslodex

    500mg, intramuscularly on days 1 and 15 of cycle 1, then on day 1 (+/- 3 days) of every 28 days cycle until progression, lack of tolerability, or patient declines further protocol treatment.

Study groups in NCT02536742
Study groupRoleWhat they receive
ExperimentalExperimentalPalbociclib plus Fulvestrant
Receives: Drug: Palbociclib; Drug: Fulvestrant

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With and Without Progression Free Survival (PFS) Events

    Time from treatment initiation until documented disease progression according to RECIST 1.1 or death, whichever occurs first

    Measured: Maximum 36 months

Secondary outcomes (2)
  1. Best Overall Response

    Best overall response is based on RECIST (Response evaluation criteria in solid tumors) 1.1 criteria and is defined as best response recorded from enrollment across all time points until disease progression. Confirmation of partial response (PR) or complete response (CR) by an additional scan was not requested in this trial (rationale: initially because of randomized placebo-controlled design; subsequently because no hypothesis testing of progression-free survival, PFS, distribution relative to an historical control).

    Measured: From date of enrolment until patient's end of treatment visit (or a maximum of 12 months after EoT in the absence of tumor progression), assessed up to 48 months.

  2. Best Overall Response of Complete Response (CR) or Partial Response (PR) or Stable Disease (SD)

    Disease control is defined as best overall response of complete response (CR) or partial response (PR), or stable disease (SD) (or non-CR/non-PD, progressive disease, in the case of non-measurable disease only) lasting for at least 24 weeks, measured from enrollment until first documentation of progressive disease

    Measured: From date of enrolment until patient's end of treatment visit (or a maximum of 12 months after EoT in the absence of tumor progression), assessed up to 48 months.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Sep 2015 (estimated)
  2. Study start30 Aug 2016
  3. Primary completion28 Aug 2020
  4. Study completion22 Dec 2022

Resources

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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
124 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02536742
Sponsor's protocol ID
IBCSG 53-14 / BIG 14-04
Other IDs
2014-005387-15, WI198393, 2014
Acronym
PYTHIA
Status last verified
Jul 2023
First submitted
25 Aug 2015
Last updated
26 Aug 2026
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Mittendorf EA, Liu Y, Tucker SL, McKenzie T, Qiao N, Akli S, Biernacka A, Liu Y, Meijer L, Keyomarsi K, Hunt KK. A novel interaction between HER2/neu and cyclin E in breast cancer. Oncogene. 2010 Jul 8;29(27):3896-907. doi: 10.1038/onc.2010.151. Epub 2010 May 10.

    PubMed 20453888
  • Finn RS, Crown JP, Lang I, Boer K, Bondarenko IM, Kulyk SO, Ettl J, Patel R, Pinter T, Schmidt M, Shparyk Y, Thummala AR, Voytko NL, Fowst C, Huang X, Kim ST, Randolph S, Slamon DJ. The cyclin-dependent kinase 4/6 inhibitor palbociclib in combination with letrozole versus letrozole alone as first-line treatment of oestrogen receptor-positive, HER2-negative, advanced breast cancer (PALOMA-1/TRIO-18): a randomised phase 2 study. Lancet Oncol. 2015 Jan;16(1):25-35. doi: 10.1016/S1470-2045(14)71159-3. Epub 2014 Dec 16.

    PubMed 25524798
  • Turner NC, Ro J, Andre F, Loi S, Verma S, Iwata H, Harbeck N, Loibl S, Huang Bartlett C, Zhang K, Giorgetti C, Randolph S, Koehler M, Cristofanilli M; PALOMA3 Study Group. Palbociclib in Hormone-Receptor-Positive Advanced Breast Cancer. N Engl J Med. 2015 Jul 16;373(3):209-19. doi: 10.1056/NEJMoa1505270. Epub 2015 Jun 1.

    PubMed 26030518
  • Di Leo A, Malorni L. Polyendocrine treatment in estrogen receptor-positive breast cancer: a "FACT" yet to be proven. J Clin Oncol. 2012 Jun 1;30(16):1897-900. doi: 10.1200/JCO.2012.41.7394. Epub 2012 Apr 30. No abstract available.

    PubMed 22547606
  • Malorni L, Tyekucheva S, Hilbers FS, Ignatiadis M, Neven P, Colleoni M, Henry S, Ballestrero A, Bonetti A, Jerusalem G, Papadimitriou K, Bernardo A, Seles E, Duhoux FP, MacPherson IR, Thomson A, Davies DM, Bergqvist M, Migliaccio I, Gebhart G, Zoppoli G, Bliss JM, Benelli M, McCartney A, Kammler R, De Swert H, Ruepp B, Fumagalli D, Maibach R, Cameron D, Loi S, Piccart M, Regan MM; International Breast Cancer Study Group; Breast International Group and PYTHIA Collaborators. Serum thymidine kinase activity in patients with hormone receptor-positive and HER2-negative metastatic breast cancer treated with palbociclib and fulvestrant. Eur J Cancer. 2022 Mar;164:39-51. doi: 10.1016/j.ejca.2021.12.030. Epub 2022 Feb 13.

    PubMed 35172272

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Palbociclib and Fulvestrant in people with Metastatic Breast Cancer, run by ETOP IBCSG Partners Foundation at 19 sites in 3 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 30 inclusion and 15 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 26 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 19 sites in Belgium, Italy, United Kingdom. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 26 Feb 2024). 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 and Without Progression Free Survival (PFS) Events (time frame: Maximum 36 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 NCT02536742, which also lists 5 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 26 Aug 2026.

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