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Breast CancerPhase 2CORALLEENNCT03248427

Neadjuvant Multi-agent Chemotherapy or Letrozole Plus Ribociclib in Luminal B/HER2-negative Breast Cancer.

A Phase 2 study testing Ribociclib, Letrozole 2.5mg and Doxorubicin in people with Breast Cancer, run by SOLTI Breast Cancer Research Group at 21 sites in Spain.

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

CORALLEEN is a two-arm, randomized, multicentric study in postmenopausal women with primary HR+/HER2 negative Luminal B breast cancer that will explore if the combination of ribociclib with letrozole offers clinical benefit at least comparable to that of standard chemotherapy. 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?
Ribociclib, Letrozole 2.5mg and Doxorubicin
Could I receive a placebo?
No, everyone receives an active treatment
How many people
106 participants
Where
21 sitesSpain
Study dates
13 Jul 2017to 20 Jul 2019
Phase
Phase 2
Are there results?
None posted in the registry

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 Form prior to any study-specific procedure.
  • Female patients.
  • Post-menopausal status and age ≥18 years.
  • Histologically confirmed invasive breast carcinoma, with all the following characteristics:
  • Primary tumor ≥ 2cm in largest diameter as measured by breast MRI
  • Stage I to stage IIIA breast cancer
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  • No evidence of distant metastasis (M0)
  • Breast cancer eligible for primary surgery.
  • Available pre-treatment FFPE core (Tru-cut) biopsy evaluable for PAM50 or possibility to obtain one. Minimal sample requirements are to have at least 2 tumor cylinders with a minimal tissue surface of 10 mm2 tissue, containing at least 10% tumor cells and having enough tissue to do at least 2 cuts of 10 micrometers each.
  • Luminal B subtype as per PAM50 analysis of pre-treatment sample.
  • ER-positive and/or PgR-positive and HER2-negative tumor by ASCO/CAP guidelines assessed locally.
  • In the case of a multifocal tumor (defined as the presence of two or more foci of cancer within the same breast quadrant), the largest lesion must be ≥ 2 cm and designated the "target" lesion for all subsequent tumor evaluations and HR+/HER2-negative status must be documented in all the tumor foci.
  • ECOG performance status of 0 or 1.
  • Adequate hematological, renal and hepatic function.
  • Ability and willingness to comply with study visits, treatment, testing and to comply with the protocol.

Who cannot join

  • Any prior treatment for primary invasive breast cancer.
  • Inoperable locally advanced or inflammatory (i.e., inoperable Stage III) breast cancer.
  • Metastatic (Stage IV) breast cancer.
  • Bilateral invasive breast cancer.
  • Multicentric breast cancer, defined as the presence of two or more foci of cancer in different quadrants of the same breast.
  • Patients who have undergone sentinel lymph node biopsy prior to study treatment.
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  • Inability or unwillingness to swallow pills.
  • Malabsorption syndrome or other condition that would interfere with enteric absorption of study drugs.
  • Participation in a prior investigational study within 30 days prior to enrollment or within 5 half-lives of the investigational product, whichever is longer.
  • Patient with a Child-Pugh score B or C.
  • Patient has active cardiac disease or a history of cardiac dysfunction including any of the following:
  • History of acute coronary syndromes (including myocardial infarction, unstable angina, coronary artery bypass grafting, coronary angioplasty or stenting) or symptomatic pericarditis within 12 months prior to screening.
  • History of documented congestive heart failure (New York Heart Association functional classification III-IV).
  • Documented cardiomyopathy.
  • Patient has a Left Ventricular Ejection Fraction (LVEF) < 50% as determined by Multiple Gated acquisition (MUGA) scan or echocardiogram (ECHO).
  • Clinical significant cardiac arrhythmias (e.g. ventricular tachycardia), complete left bundle branch block, high-grade AV block (e.g. bifascicular block, Mobitz type II and third-degree AV block)
  • Long QT Syndrome or family history of idiopathic sudden death or congenital long QT syndrome.
  • On screening 12-lead ECG, any of the following cardiac parameters (defined as the mean of triplicate ECGs: bradycardia (resting heart rate < 50), tachycardia (resting heart rate > 90), PR interval > 220 msec, QRS interval >109 msec, or QTcF interval ≥450 msec (using Fridericia's correction).
  • Uncontrolled hypertension (Systolic blood pressure >160 mmHg or <90 mmHg and/or diastolic >100 mmHg).
  • Active infection requiring intravenous (IV) antibiotics.
  • Symptomatic hypercalcemia despite adequate management.
  • Clinically significant history of liver disease, including viral or other hepatitis, current alcohol abuse, or cirrhosis.
  • Known human immunodeficiency virus (HIV) infection.
  • Any other diseases, active or uncontrolled pulmonary dysfunction, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug, that may compromise compliance with the protocol, that may affect the interpretation of the results, or renders the patients at high risk from treatment complications.
  • Significant traumatic injury within 3 weeks prior to initiation of study treatment.
  • Major surgical procedure (not including minor procedures such as lymph node biopsy, tumor core biopsy, fine needle aspiration) within 4 weeks prior to initiation of study treatment or not fully recovered from any side effects of previous procedures.
  • Any psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol and follow-up schedule.
  • History of other malignancy within 5 years prior to screening, except for appropriately treated basal or squamous cell carcinoma, carcinoma in situ of the cervix, non-melanoma skin carcinoma, or Stage I uterine cancer.
  • Hormone replacement therapy stopped less than 2 weeks before treatment start.
  • Currently receiving or has received systemic corticosteroids until 2 weeks before treatment start or who have not fully recovered from side effects of such treatment. Following corticosteroid uses are permitted: single doses, topical applications (e.g. for rash), inhaled sprays (e.g. for obstructive airways diseases), eye drops or local injections (e.g. intra-articular)
  • Known hypersensitivity to any of the excipients of ribociclib, letrozole, doxorubicin, cyclophosphamide or paclitaxel.
  • Patients currently on following medications, which cannot be interrupted 7 days prior treatment start:
  • Any prohibited medication as per letrozole, doxorubicin, cyclophosphamide, or paclitaxel label.
  • Herbal preparations/medications, dietary supplements.
  • Medications that have a known risk to prolong the QT interval or cause Torsades de Pointe.
  • Medications with a narrow therapeutic window and predominantly metabolized through CYP3A4/5.
  • Strong inducers or inhibitors of CYP3A4/5, including grapefruit, grapefruit hybrids, pummelos, star-fruit and Seville oranges.
  • Warfarin or other coumarin-derived anticoagulant for treatment, prophylaxis or otherwise. Therapy with heparin, low molecular weight heparin or fondaparinux is allowed.

Trial locations and contacts

21 sites in 1 country.

21 sites in 1 country

Spain21 sites
  • Hospital Clinic de Barcelona

    Barcelona

  • Hospital General de Catalunya

    Barcelona

  • Hospital Universitari Vall d' Hebron

    Barcelona

  • Institut Català d'Oncologia l'Hospitalet

    Barcelona

  • Hospital San Pedro de Alcántara

    Cáceres

  • Consorcio Hospitalario Provincial de Castellón

    Castelló

  • Fundació Privada Hospital Asil de Granollers

    Granollers

  • Centro Integral Oncologico Clara Campal

    Madrid

  • Centro Oncológico MD Anderson International España

    Madrid

  • Hospital Quirón Madrid

    Madrid

  • Hospital Rey Juan Carlos

    Madrid

  • Hospital Universitario 12 de octubre

    Madrid

  • Hospital Universitario Fundación de Alcorcón

    Madrid

  • Hospital Universitario Fundación Jiménez Díaz

    Madrid

  • Hospital Universitari Son Espases

    Palma

  • Complexo Hospitalario Universitario de Santiago

    Santiago de Compostela

  • Hospital Virgen del Rocío

    Seville

  • Hospital Virgen Macarena

    Seville

  • Fundación Instituto Valenciano de Oncología

    Valencia

  • Hospital Clínico Universitario de Valencia

    Valencia

  • Hospital Universitari Arnau de Vilanova de València

    Valencia

Other trials in Spain

About this study

Official title: CORALLEEN: A Phase 2 Clinical Trial of Multi-agent Chemotherapy or Letrozole Plus Ribociclib (LEE011) as Neoadjuvant Treatment for Postmenopausal Patients With Luminal B/HER2-negative Breast Cancer.

CORALLEEN is a two-arm, randomized, multicentric study in postmenopausal women with primary HR+/HER2 negative Luminal B breast cancer that will explore if the combination of ribociclib with letrozole offers clinical benefit at least comparable to that of standard chemotherapy.

Read the detailed description

This is a parallel, two-arm, randomized 1:1, stratified by tumor size and nodal involvement, open-label, multicenter, exploratory study in postmenopausal women with primary operable HR+/HER2-negative Luminal B breast cancer according to PAM50 intrinsic subtype to evaluate the clinical benefit and biological effects of ribociclib combined with letrozole.

The primary trial objective is to evaluate the ability of each treatment strategy to provide ROR-low score at surgery.

Luminal B patients will be randomized 1:1 to either letrozole plus ribociclib or chemotherapy.Two weeks after the first administration of the assigned treatment, patients will undergo a biopsy to assess early biological response to treatment, at Ki67 protein and gene expression level. After finalization of the assigned neoadjuvant treatment, patients will undergo surgery.

The primary endpoint, Rate of ROR-low (at surgery) after neoadjuvant treatment, according to the Prosigna test will be centrally assessed.

Baseline, Day 15 and post-treatment (surgical) primary breast tumor tissue samples should be available for each patient for molecular characterization A post-surgery visit will be performed within 28 days (7 days) from surgery, and will mark the end of the study for that patient

Conditions
Breast Cancer
Being tested
Ribociclib, Letrozole 2.5mg, Doxorubicin, Cyclophosphamide, Paclitaxel
Keywords
Breast Cancer, Neoadjuvant, Luminal B tumors, Ribociclib
Medical subject headings
Breast Neoplasms

What participants receive

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

  • RibociclibDrug

    Also called LEE011

    Ribociclib flat-fixed dose of 600 mg daily (three 200-mg capsules), days 1 to 21 of a 28-days cycle.

  • Letrozole 2.5mgDrug

    Daily continuous

  • DoxorubicinDrug

    60 mg/m2 as a continuous IV perfusion

  • CyclophosphamideDrug

    600 MG/M2 in a 30 minutes IV infusion

  • PaclitaxelDrug

    80 mg/m2, in one hour IV infusion

Study groups in NCT03248427
Study groupRoleWhat they receive
Ribociclib + LetrozolExperimentalRibociclib: 600mg, 3-weeks-on/-week-off treatment Letrozole: 2.5mg daily; Six 28 days cycles
Receives: Drug: Ribociclib; Drug: Letrozole 2.5mg
ChemotherapyOtherChemotherapy treatment will consist of four cycles of AC (doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2 every 21 days) followed by weekly paclitaxel during 12 weeks.
Receives: Drug: Doxorubicin; Drug: Cyclophosphamide; Drug: Paclitaxel

What is being measured

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

  1. Rate of ROR-low according to the Prosigna test.

    Rate of ROR-low after neoadjuvant treatment at surgery, according to the Prosigna test,as per central assessment

    Measured: 24 weeks

Secondary outcomes (7)
  1. Tumor Overall response rate (ORR)

    Tumor overall objective response rate (ORR), defined as the sum of Partial Responses (PR) and Complete Responses (CR) according to RECIST v1.1, as per Investigator's assessments by breast MRI.

    Measured: 24 weeks

  2. pCR in the breast and axillary lymph nodes

    pCR is defined as the complete absence of invasive carcinoma in the breast and axillary lymph nodes on histological examination.

    Measured: 24 weeks

  3. PEPI Score

    Preoperative endocrine prognostic index (PEPI) score in the ribociclib plus letrozole treatment arm compared to historical values

    Measured: 24 weeks

  4. Residual Cancer Burden (RCB)

    Rate of residual cancer burden (RCB) score 0 or 1 (RCB0/1) after neoadjuvant treatment, according to the MD Anderson Cancer Center procedures, as per central assessment.

    Measured: 24 weeks

  5. Rate of breast conserving surgery (BCS)

    Rate of breast conserving surgery

    Measured: 24 weeks

  6. Decrease in Ki67 in both treatment arms.

    Decrease in Ki67 in both treatment arms.

    Measured: At baseline, in week 2, and pre-surgery

  7. Incidence, duration and severity of Adverse Events (AEs)

    Incidence, duration and severity of Adverse Events (AEs) assessed by the NCI Common Terminology for Classification of Adverse Events (CTCAE) version 4.

    Measured: Up to 24 weeks

Timeline

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

  1. First posted14 Aug 2017
  2. Study start13 Jul 2017
  3. Primary completion10 Jun 2019
  4. Study completion20 Jul 2019

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
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
106 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03248427
Sponsor's protocol ID
SOLTI1402
Acronym
CORALLEEN
Status last verified
Mar 2021
First submitted
3 Jul 2017
Last updated
17 Mar 2021
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Villacampa G, Falato C, Pare L, Hernando C, Arumi M, Saura C, Gomez G, Munoz M, Gil-Gil M, Izarzugaza Y, Ferrer N, Najera-Zuloaga J, Montano A, Ciruelos E, Gonzalez-Santiago S, Villagrasa P, Gavila J, Prat A, Pascual T. Pre-operative ribociclib plus letrozole versus chemotherapy: Health-related quality of life outcomes from the SOLTI CORALLEEN trial. Eur J Cancer. 2022 Oct;174:232-242. doi: 10.1016/j.ejca.2022.07.028. Epub 2022 Sep 5.

    PubMed 36067616
  • Prat A, Saura C, Pascual T, Hernando C, Munoz M, Pare L, Gonzalez Farre B, Fernandez PL, Galvan P, Chic N, Gonzalez Farre X, Oliveira M, Gil-Gil M, Arumi M, Ferrer N, Montano A, Izarzugaza Y, Llombart-Cussac A, Bratos R, Gonzalez Santiago S, Martinez E, Hoyos S, Rojas B, Virizuela JA, Ortega V, Lopez R, Celiz P, Ciruelos E, Villagrasa P, Gavila J. Ribociclib plus letrozole versus chemotherapy for postmenopausal women with hormone receptor-positive, HER2-negative, luminal B breast cancer (CORALLEEN): an open-label, multicentre, randomised, phase 2 trial. Lancet Oncol. 2020 Jan;21(1):33-43. doi: 10.1016/S1470-2045(19)30786-7. Epub 2019 Dec 11.

    PubMed 31838010

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Ribociclib, Letrozole 2.5mg and Doxorubicin in people with Breast Cancer, run by SOLTI Breast Cancer Research Group at 21 sites in Spain.

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 15 inclusion and 38 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 17 Mar 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 21 sites in Spain. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Rate of ROR-low according to the Prosigna test. (time frame: 24 weeks). 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 NCT03248427, which also lists 2 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 17 Mar 2021.

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