Breast CancerPhase 3NCT04851613
Study to Evaluate Efficacy & Safety of Afuresertib Plus Fulvestrant in Patients With Locally Advanced or Metastatic HR+/HER2- Breast Cancer
A Phase 3 study testing Afuresertib in people with Breast Cancer, run by Laekna Limited at 55 sites in 2 countries.
Trial summary
Study LAE205INT3101 is a Phase Ib/III study to evaluate the efficacy and safety of the combination therapy with afuresertib plus fulvestrant (afuresertib/placebo plus fulvestrant in Phase III) in patients with HR+/HER2- breast cancer who have failed 1 to 2 prior lines of endocrine therapy, and/or CDK4/6 inhibitor (up… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Breast Cancer
- What is being tested?
- Afuresertib
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 256 participants
- Where
- 55 sitesin 2 countries
- Study dates
- 18 Feb 2022to 30 Dec 2026
- Phase
- Phase 3
- Are there results?
- Not yet: the study is under way
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
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Female or male patients must be ≥ 18 years of age on the day of signing the informed consent and be able to provide written informed consent for the study.
- Patients with histologically or cytologically confirmed HR+/HER2- Breast Cancer characterized by the absence of HER2 expression and the presence of ER with/without PR expression.
- Female patients may be post-menopausal, pre-menopausal or peri-menopausal. Male and Pre- and peri-menopausal females may be enrolled if continuously treated with ovarian suppression therapy (use LHRHa at least starting from C1D1) for the duration of study participation.
- Before enrollment, patients who have undergone anti-cancer treatment must have a washout period of 4 weeks or 5 half-lives, whichever comes earlier.
- HR+/HER2- BC patients must meet all the following criteria to join this study:
- Relapsed locally advanced (LABC) or metastatic (mBC) disease; AND
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- Have received 1 to 2 prior lines of systemic treatments for LABC or mBC(at least one line was ET). If disease relapse during adjuvant therapy or relapse within 12 months from completion of adjuvant endocrine therapy, the adjuvant therapy will be counted as 1 line), including:
- Endocrine therapies including AIs and/or SERMs (1 or 2 lines) with or without a CDK4/6 inhibitor (up to 1 therapy); OR ii. A chemotherapy (monotherapy or combination therapy, at most 1 line only), with 1 additional line of endocrine therapy .
- For phase Ib part, patients must have at least one lesion that meets the definition of measurable disease by RECIST 1.1 criteria; for phase III, have measurable disease and/or at least 1 lytic or mixed (lytic + sclerotic) bone lesion that can be assessed by RECIST 1.1 criteria; patients with sclerotic/osteoblastic bone lesions only in the absence of measurable disease are not eligible (Appendix 2).
- In the Phase Ib part, Patients must provide informed consent for the procedures and the tests for PIK3CA/AKT/PTEN alterations and ESR1 mutations. The biomarkers will be tested retrospectively by gene sequencing tests using archival tumor sample (preferably within 18 months/78 weeks) or from peripheral blood or from a tumor biopsy sample. Formalin-fixed, paraffin embedded (FFPE) tissue blocksare preferred. In phase III, blood sample is mandatory for this test.
- In Phase III, subjects need to provide blood sample during the screening period for PIK3CA/AKT1/PTEN test, which will be conducted in the central laboratory. Only patients with PIK3CA/AKT1/PTEN alterations could include.
- Patients with an Eastern Cooperative Oncology Group (ECOG) Performance Score of 0 or 1.
- Patients who have adequate organ function as defined.
- Patients without a pre-existing diagnosis of diabetes mellitus (DM) who have a fasting glucose ≤ 126 mg/dL (or ≤ 7.0 mmol/L); or patients with type 2 diabetes who have a fasting glucose ≤ 167 mg/dL (or ≤ 9.3 mmol/L) AND glycosylated hemoglobin (HbA1c) ≤ 8%. Patients with DM type 1 or patients with DM type 2 requiring insulin or ≥21 anti-abetic medications for glycemic control are excluded.
- Patients with a life expectancy of 24 weeks or more based on investigator's assessment.
- Patients who have recovered from adverse events associated with pre-study medical, radiation and surgical treatments to ≤ Grade 1, excluding stable symptoms (e.g., alopecia, peripheral sensory neuropathy, skin hyperpigmentation, dysgeusia, etc.).
- Female patients of childbearing potential must have a negative pretreatment serum pregnancy test.
- Female patients of childbearing potential must agree to use effective contraception from enrollment to 1 year after discontinuation from the last dose of this study treatment.
- Patients who are able to swallow and retain oral medication and without gastrointestinal diseases to interfere with drug absorption.
- Patients must have no contraindications to fulvestrant.
Who cannot join
- Patients who had a recent major surgery that required hospitalization for longer than 48 hours (< 8 weeks from scheduled treatment starting date) or have used IV antibiotics for the treatment of systemic infection (< 2 weeks from scheduled treatment starting date).
- Patients who have additional known malignancies that are progressing or have required active treatments within 3 years of scheduled treatment starting date. (Note: Patients with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, that have undergone potentially curative therapy are not excluded).
- Patients who have a history of seizure or conditions that may predispose them to seizure and require anti-epileptic medications, or patients who have brain arteriovenous malformation, or intracranial masses that are causing edema or clinical symptoms.
- Patients who have known active CNS metastases and/or carcinomatous meningitis. (Note: Patients with previously treated brain metastases may participate provided that they are radiologically stable (i.e., without evidence of progression for at least 4 weeks by repeated imaging performed during study screening), clinically stable and without requirement of steroid treatment for at least 14 days prior to schedule treatment starting date.
- Patients who had prior treatment with fulvestrant or other selective estrogen receptor degraders (SERDs), or any PI3K/AKT/mTOR inhibitors, or any CDK4/6 inhibitors in phase I, II study.
- Patients who had the following conditions within 6 months (26 weeks) of scheduled treatment starting date: New York Heart Association congestive heart failure classification III to IV, unstable angina, myocardial infarction, arterial or venous thromboembolic events (e.g., pulmonary embolism, cerebrovascular accident including transient ischemic attacks), or serious cardiac arrhythmia associated with significant cardiovascular impairment as determined by the investigator.
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- Patients with QT interval corrected by the Frederica's correction formula (QTcF) > 470 msec(average value), unless the prolonged QT interval is due to (right or left) bundle branch block and/or pacemaker rhythm. If wide QRS complex is present, cardiology consultation is required to assess the risk for Torsade de Pointes. Note: QTcF = QT/(RR^0.33) .
- Patients who have uncontrolled hypertension (systolic blood pressure > 160 mmHg or diastolic blood pressure > 100 mmHg under anti-hypertensive treatment). Note: Patients with a history of hypertension are allowed, provided that blood pressure is controlled to within these limits by anti-hypertensive treatment.
- Patients with active Hepatitis B infection [defined as HBsAg (+) and HBV-DNA ≥ 200 IU/ml (1000 copy/ml)] or active Hepatitis C virus [defined as HCV antibody positive and HCV RNA (qualitative) test positive].
- Patients with known HIV seropositivity who has 1 of the following:
- Not receiving highly active antiretroviral therapy
- Receiving antiretroviral therapy that may interfere with the study drug (consult the Sponsor/Medical Monitor for review of medication prior to enrollment)
- CD4 count < 350 based on a test within 3 months of the screening visit
- An acquired immunodeficiency syndrome-defining opportunistic infection within 6 months (26 weeks) of the start of study screening
- Patients who have a history or current evidence of any condition, therapy, or laboratory abnormality that in the opinion of the investigator, might confound the results of the study, interfere with the participant's participation for the full duration of the study, or is not in the best interest of the participant to participate.
- Patients who have a known psychiatric or substance abuse disorder that would interfere with the participant's ability to cooperate with the requirements of the study.
- Patients who are receiving medications that are sensitive substrates of CYP3A4, OATP1B1, or BCRP with low therapeutic index. Please see related section for a list of these prohibited medications.
- Patients who are currently pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 1 year after the last dose of study treatment.
- Patients who have known cirrhosis with a Child-Pugh status of B and C.
- Patients who are ineligible for endocrine therapy (e.g., visceral crisis, inflammatory breast cancer, uncontrolled pleural or abdominal fluid drainage ≥4 times within one month before planned administration).
Trial locations and contacts
55 sites in 2 countries.
55 sites in 2 countries
China49 sites
Anyang cancer hospital
Anyang, Henan, 455000
Affiliated Hospital of Hebei University
Baoding, Hebei, 071000
Cancer Hospital Chinese Academy of Medical Sciences
Beijing, Beijing Municipality, 100021
Beijing Cancer Hospital
Beijing, Beijing Municipality, 100142
Peking Union Medical College Hospital (PUMCH)
Beijing, Beijing Municipality, 100730
The First Affiliated Hospital of Bengbu Medical College
Bengbu, Anhui, 233004
The first hospital of Jilin University
Changchun, Jilin, 130000
Jilin Provincial Cancer Hospital
Changchun, Jilin, 130012
Hunan Cancer Hospital
Changsha, Hunan, 410013
Sichuan Cancer Hospital
Chengdu, Sichuan, 610041
West China Hospital, Sichuan University
Chengdu, Sichuan, 610041
Sichuan Provincial People's Hospital
Chengdu, Sichuan, 610072
The First Affiliated Hospital of Chongqing Medical University
Chongqing, Chongqing Municipality, 400016
Chongqing University Cancer Hospital
Chongqing, Chongqing Municipality, 400030
The First People's Hospital of Foshan
Foshan, Guangdong, 528000
Fujian Cancer Hospital
Fuzhou, Fujian, 350014
Sun Yat-sen Memorial Hospital,Sun Yat-sen University
Guangzhou, Guangdong, 510000
Sun Yat-sen University Cancer Center
Guangzhou, Guangdong, 510050
The First Affiliated Hospital of Zhejiang University School of Medicine
Hangzhou, Zhejiang, 310003
Sir-run shaw Hospital Zhejiang University of Medicine
Hangzhou, Zhejiang, 310016
Zhejiang Cancer Hospital
Hangzhou, Zhejiang, 310022
Harbin Medical University Cancer Hospital
Harbin, Heilongjiang, 150081
Anhui Provincial Cancer Hospital
Hefei, Anhui, 230031
Shandong Cancer Hospital
Jinan, Shandong, 250117
Jiangsu Cancer Hospital
Nanjing, Jiangsu, 210009
Jiangsu Provincial People's Hospital
Nanjing, Jiangsu, 210029
Guangxi Zhuang Autonomous Region People's Hospital
Nanning, Guangxi, 530021
The First Affiliated Hospital of Guangxi Medical University
Nanning, Guangxi, 530021
Affiliated Hospital of Nantong University
Nantong, Jiangsu
Ningbo Li Huili Hospital
Ningbo, Zhejiang, 315040
Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
Shanghai, Shanghai Municipality, 200020
Zhongshan Hospital, Fudan University
Shanghai, Shanghai Municipality, 200032
Liaoning Cancer Hospital
Shenyang, Liaoning, 110000
The First Hospital of China Medical University
Shenyang, Liaoning, 110001
Shengjing Hospital of China Medical University
Shenyang, Liaoning, 110004
The Fourth Hospital of Hebei Medical University
Shijiazhuang, Hebei, 050011
The First Affiliated Hospital of Soochow University
Suzhou, Jiangsu, 215006
Taizhou Hospital
Taizhou, Zhejiang, 317000
Tangshan People's Hospital
Tangshan, Hebei, 063000
Tianjin Medical University Cancer Institute & Hospital
Tianjin, Tianjin Municipality, 300060
Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
Wuhan, Hubei, 430022
Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology
Wuhan, Hubei, 430022
Wuhan Central Hospital
Wuhan, Hubei, 430022
Hubei Cancer Hospital
Wuhan, Hubei, 430079
The First Affiliated Hospital of Xi'an Jiaotong University
Xi’an, Shanxi, 710061
Northern Jiangsu People's Hospital
Yangzhou, Jiangsu, 225001
Henan Cancer Hospital
Zhengzhou, Henan, 450008
The First Affiliated Hospital of Zhengzhou University
Zhengzhou, Henan, 450052
Zhongshan People's Hospital
Zhongshan, Guangdong, 528403
United States6 sites
Piedmont Cancer Institute
Atlanta, Georgia, 30318
University of Vermont
Burlington, Vermont, 05401
Virginia Cancer Specialists
Fairfax, Virginia, 22031
University of Iowa
Iowa City, Iowa, 52242
University of Mississippi Medical Center
Jackson, Mississippi, 39216
Providence St. Johns Health Center
Santa Monica, California, 90404
About this study
Official title: A Phase Ib/III Study to Evaluate the Efficacy and Safety of Afuresertib Plus Fulvestrant in Patients With Locally Advanced or Metastatic HR+/HER2- Breast Cancer Who Failed Standard of Care Therapies
Study LAE205INT3101 is a Phase Ib/III study to evaluate the efficacy and safety of the combination therapy with afuresertib plus fulvestrant (afuresertib/placebo plus fulvestrant in Phase III) in patients with HR+/HER2- breast cancer who have failed 1 to 2 prior lines of endocrine therapy, and/or CDK4/6 inhibitor (up to 1 therapy), and/or chemotherapy (up to 1 chemotherapy) as described in the inclusion criteria.
Read the detailed description
Eligible patients for this study must have either (1) progressive disease whilst receiving an endocrine therapy (AI or a SERM), and/or a CDK4/6 inhibitor for locally advanced or metastatic disease; or (2) relapsed with metastatic disease whilst receiving an ET (AI or SERM), and/or a CDK4/6 inhibitor, and/or chemotherapy in adjuvant setting. No more than 2 prior lines of systemic treatments for locally advanced or metastatic disease are allowed for this study, including 1-2 prior lines of endocrine therapy, with/without CDK4/6 inhibitor (up to 1 therapy), and/or chemotherapy (up to 1 therapy).
- Conditions
- Breast Cancer
- Being tested
- Afuresertib, Afuresertib/placebo
- Medical subject headings
- Breast Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AfuresertibDrug
Also called Fulvestrant
The starting doses of the combination therapy are afuresertib 125 mg PO, QD plus fulvestrant 500 mg IM, D1, 15 in the first cycle and afuresertib 125 mg PO, QD plus fulvestrant 500 mg IM, D1 Q4W in the subsequent cycles
Afuresertib/placeboDrug
Also called Fulvestrant
afuresertib/placebo 125mg QD combined with fulvestrant 500mg Q4W (D1, 15 in cycle 1)
| Study group | Role | What they receive |
|---|---|---|
| Phase I: Afuresertib and Fulvestrant Safety Run In | Experimental | Phase I: Safety run-in Cycle 1 (a cycle is 28 days) will be performed in the first 6 patients of the phase Ib. Combination regimens during the safety run-in period are: afuresertib 125 mg QD (once daily) + fulvestrant 500 mg Intra Muscular (IM) on Day 1, 15 of Cycle 1, and on Day 1 of the subsequent 28-day cycles. Receives: Drug: Afuresertib |
| Phase I: Afuresertib and Fulvestrant | Experimental | Phase I: Combination regimens are: afuresertib 125 mg QD (once daily) + fulvestrant 500 mg Intra Muscular (IM) on Day 1, 15 of Cycle 1, and on Day 1 of the subsequent 28-day cycles. Receives: Drug: Afuresertib |
| Phase III: afuresertib combined with fulvestrant (experimental arm) | Experimental | Phase III: afuresertib 125mg QD combined with fulvestrant 500mg Q4W (D1, 15 in cycle 1) Receives: Drug: Afuresertib |
| Phase III: placebo combined with fulvestrant (control arm) | Placebo comparator | PhaseIII:placebo combined with fulvestrant 500mg Q4W (D1, 15 in cycle 1) Receives: Drug: Afuresertib/placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Phase I: Overall Response Rate (ORR) based on RECIST 1.1
Phase I: Anti-tumor activity of the combination therapy with afuresertib plus fulvestrant in patients with HR+/HER2- BC
Measured: Phase I: Change from Baseline beginning at Cycle 3 Day 1 and then every 8 weeks × 40 weeks then every 3 months through study completion, an average of 1 year (each cycle is 28 days)
Phase III: Progression Free Survival (PFS) based on RECIST 1.1, as assessed by investigators
Phase III:To assess the anti-tumor activity of the combination therapy with afuresertib plus fulvestrant versus placebo plus fulvestrant in patients with PIK3CA/AKT1/PTEN alterations HR+/HER2- BC who have failed 1 to 2 prior lines of ET with/without a Phase III: CDK4/6 inhibitor (up to 1 therapy), or chemotherapy (up to 1 chemotherapy)
Measured: Phase III:Change from Baseline beginning at Cycle 3 Day 1 and then every 8 weeks for the first 12 months, then every 3 months through study completion
Secondary outcomes (11)
Phase I: Duration of Response (DOR) based on RECIST 1.1
Phase I: Anti-tumor activity of the combination therapy with afuresertib plus fulvestrant in patients with HR+/HER2- BC
Measured: Phase I: Change from Baseline beginning at Cycle 3 Day 1 and then every 8 weeks x 40 weeks then every 3 months through study completion, an average of 1 year (each cycle is 28 days)
Phase I: Clinical rate of benefit (CBR) based on RECIST 1.1
Phase I: Anti-tumor activity of the combination therapy with afuresertib plus fulvestrant in patients with HR+/HER2- BC
Measured: Phase I: Change from Baseline beginning at Cycle 3 Day 1 and then every 8 weeks x 40 weeks then every 3 months through study completion, an average of 1 year (each cycle is 28 days)
Phase I: Best Overall Response (BOR) based on RECIST 1.1
Phase I: Anti-tumor activity of the combination therapy with afuresertib plus fulvestrant in patients with HR+/HER2- BC
Measured: Phase I: Change from Baseline beginning at Cycle 3 Day 1 and then every 8 weeks x 40 weeks then every 3 months through study completion, an average of 1 year (each cycle is 28 days)
Phase I: Progression Free Survival (PFS) based on RECIST 1.1
Phase I: Anti-tumor activity of the combination therapy with afuresertib plus fulvestrant in patients with HR+/HER2- BC
Measured: Phase I: After Cycle 3 Day 1 and then every 8 weeks x 40 weeks then every 3 months through study completion, an average of 1 year (each cycle is 28 days)
Phase I: Pharmacokinetics- Time to Maximum Concentration (T-Max)
Phase I: Time to peak level of afuresertib
Measured: Phase I: Assessed on Day 1 and Day 15 of Cycle 1 (each cycle is 28 days)
Phase I: Pharmacokinetics- Area Under the Curve (AUC)
Area under the curve of afuresertib
Measured: Assessed on Day 1 and Day 15 of Cycle 1 (each cycle is 28 days)
Phase I: Frequency and severity of Adverse Events (AEs)
Phase I: findings on physical examination, ECG, vital signs, and reports of the laboratory results based on the CTCAE v5.0
Measured: Phase I: Through study completion for an average of 12 months
Phase III: Progression Free Survival (PFS) based on RECIST 1.1, as assessed by BICR
Phase III: Anti-tumor activity of the combination therapy with afuresertib plus fulvestrant in patients with HR+/HER2- BC
Measured: Phase III:Change from Baseline beginning at Cycle 3 Day 1 and then every 8 weeks for the first 12 months then every 3 months through study completion
Phase III:Frequency and severity of Adverse Events (AEs)
Phase III:findings on physical examination, ECG, vital signs, and reports of the laboratory results based on the CTCAE v5.0
Measured: Phase III:Through study completion
Phase III:Pharmacokinetics- Time to Maximum Concentration (T-Max)
Time to peak level of afuresertib
Measured: Assessed on Day 1 and Day 15 of Cycle 1 (each cycle is 28 days)
Phase III:Pharmacokinetics- Area Under the Curve (AUC)
Area under the curve of afuresertib
Measured: Assessed on Day 1 and Day 15 of Cycle 1 (each cycle is 28 days)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Apr 2021
- Study start18 Feb 2022
- Primary completion30 Oct 2026 (estimated)
- Study completion30 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- 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
- Model description
- Phase I: Single-arm, open-label study to evaluate efficacy, safety, tolerability, PK of the therapy with afuresertib plus fulvestrant. Phase III: A multi-center, randomized, double-blind, placebo-controlled study to assess efficacy and safety of afuresertib/placebo plus fulvestrant in patients with HR+/HER2- locally advanced or metastatic BC who have failed 1 to 2 prior lines of ET with/without a CDK4/6 inhibitor (up to 1 therapy), or chemotherapy (up to 1 chemotherapy).
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 256 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Laekna Limited
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Wenyue Ma, Study director, Laekna Limited
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04851613
- Sponsor's protocol ID
- LAE205INT3101
- Status last verified
- Mar 2026
- First submitted
- 13 Apr 2021
- Last updated
- 2 Apr 2026
- Results posted
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Zhang P, Sun T, Wang Y, Li W, Tong Z, Phadke S, Feinstein T, Ma W, Guo P, Zhang M, Yue Y, Xu B. Afuresertib plus fulvestrant for pretreated HR-positive, HER2-negative, advanced breast cancer: a phase Ib trial. Nat Commun. 2026 Feb 6;17(1):2456. doi: 10.1038/s41467-026-69225-2.
PubMed 41651834
Study at a glance
From the registry record, last updated by the sponsor on 2 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase Ib/III Study to Evaluate the Efficacy and Safety of Afuresertib Plus Fulvestrant in Patients With Locally Advanced or Metastatic HR+/HER2- Breast Cancer Who Failed Standard of Care Therapies
- ClinicalTrials.gov ID
- NCT04851613
- Acronym / sponsor ID
- LAE205INT3101
- Conditions
- Breast Cancer
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 256 participants (estimated)
- Lead sponsor
- Laekna LimitedIndustry (pharma, biotech, devices)
- Study start
- 18 Feb 2022 (actual)
- Primary completion
- 30 Oct 2026 (estimated)
- Study completion
- 30 Dec 2026 (estimated)
- First posted
- 20 Apr 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Study LAE205INT3101 is a Phase Ib/III study to evaluate the efficacy and safety of the combination therapy with afuresertib plus fulvestrant (afuresertib/placebo plus fulvestrant in Phase III) in patients with HR+/HER2- breast cancer who have failed 1 to 2 prior lines of endocrine therapy, and/or CDK4/6 inhibitor (up to 1 therapy), and/or chemotherapy (up to 1 chemotherapy) as described in the inclusion criteria.
Detailed description
Eligible patients for this study must have either (1) progressive disease whilst receiving an endocrine therapy (AI or a SERM), and/or a CDK4/6 inhibitor for locally advanced or metastatic disease; or (2) relapsed with metastatic disease whilst receiving an ET (AI or SERM), and/or a CDK4/6 inhibitor, and/or chemotherapy in adjuvant setting. No more than 2 prior lines of systemic treatments for locally advanced or metastatic disease are allowed for this study, including 1-2 prior lines of endocrine therapy, with/without CDK4/6 inhibitor (up to 1 therapy), and/or chemotherapy (up to 1 therapy).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 4
- Model description
- Phase I: Single-arm, open-label study to evaluate efficacy, safety, tolerability, PK of the therapy with afuresertib plus fulvestrant. Phase III: A multi-center, randomized, double-blind, placebo-controlled study to assess efficacy and safety of afuresertib/placebo plus fulvestrant in patients with HR+/HER2- locally advanced or metastatic BC who have failed 1 to 2 prior lines of ET with/without a CDK4/6 inhibitor (up to 1 therapy), or chemotherapy (up to 1 chemotherapy).
| Arm | Type | Receives |
|---|---|---|
| Phase I: Afuresertib and Fulvestrant Safety Run In | Experimental | Drug: AfuresertibPhase I: Safety run-in Cycle 1 (a cycle is 28 days) will be performed in the first 6 patients of the phase Ib. Combination regimens during the safety run-in period are: afuresertib 125 mg QD (once daily) + fulvestrant 500 mg Intra Muscular (IM) on Day 1, 15 of Cycle 1, and on Day 1 of the subsequent 28-day cycles. |
| Phase I: Afuresertib and Fulvestrant | Experimental | Drug: AfuresertibPhase I: Combination regimens are: afuresertib 125 mg QD (once daily) + fulvestrant 500 mg Intra Muscular (IM) on Day 1, 15 of Cycle 1, and on Day 1 of the subsequent 28-day cycles. |
| Phase III: afuresertib combined with fulvestrant (experimental arm) | Experimental | Drug: AfuresertibPhase III: afuresertib 125mg QD combined with fulvestrant 500mg Q4W (D1, 15 in cycle 1) |
| Phase III: placebo combined with fulvestrant (control arm) | Placebo comparator | Drug: Afuresertib/placeboPhaseIII:placebo combined with fulvestrant 500mg Q4W (D1, 15 in cycle 1) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (20 listed)
- Female or male patients must be ≥ 18 years of age on the day of signing the informed consent and be able to provide written informed consent for the study.
- Patients with histologically or cytologically confirmed HR+/HER2- Breast Cancer characterized by the absence of HER2 expression and the presence of ER with/without PR expression.
- Female patients may be post-menopausal, pre-menopausal or peri-menopausal. Male and Pre- and peri-menopausal females may be enrolled if continuously treated with ovarian suppression therapy (use LHRHa at least starting from C1D1) for the duration of study participation.
- Before enrollment, patients who have undergone anti-cancer treatment must have a washout period of 4 weeks or 5 half-lives, whichever comes earlier.
- HR+/HER2- BC patients must meet all the following criteria to join this study:
Key exclusion criteria (20 listed)
- Patients who had a recent major surgery that required hospitalization for longer than 48 hours (< 8 weeks from scheduled treatment starting date) or have used IV antibiotics for the treatment of systemic infection (< 2 weeks from scheduled treatment starting date).
- Patients who have additional known malignancies that are progressing or have required active treatments within 3 years of scheduled treatment starting date. (Note: Patients with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, that have undergone potentially curative therapy are not excluded).
- Patients who have a history of seizure or conditions that may predispose them to seizure and require anti-epileptic medications, or patients who have brain arteriovenous malformation, or intracranial masses that are causing edema or clinical symptoms.
- Patients who have known active CNS metastases and/or carcinomatous meningitis. (Note: Patients with previously treated brain metastases may participate provided that they are radiologically stable (i.e., without evidence of progression for at least 4 weeks by repeated imaging performed during study screening), clinically stable and without requirement of steroid treatment for at least 14 days prior to schedule treatment starting date.
- Patients who had prior treatment with fulvestrant or other selective estrogen receptor degraders (SERDs), or any PI3K/AKT/mTOR inhibitors, or any CDK4/6 inhibitors in phase I, II study.
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 |
|---|---|---|
| AfuresertibAlso: FulvestrantThe starting doses of the combination therapy are afuresertib 125 mg PO, QD plus fulvestrant 500 mg IM, D1, 15 in the first cycle and afuresertib 125 mg PO, QD plus fulvestrant 500 mg IM, D1 Q4W in the subsequent cycles | Drug | Phase I: Afuresertib and Fulvestrant, Phase I: Afuresertib and Fulvestrant Safety Run In, Phase III: afuresertib combined with fulvestrant (experimental arm) |
| Afuresertib/placeboAlso: Fulvestrantafuresertib/placebo 125mg QD combined with fulvestrant 500mg Q4W (D1, 15 in cycle 1) | Drug | Phase III: placebo combined with fulvestrant (control arm) |
Primary outcome
Phase I: Overall Response Rate (ORR) based on RECIST 1.1
Time frame: Phase I: Change from Baseline beginning at Cycle 3 Day 1 and then every 8 weeks × 40 weeks then every 3 months through study completion, an average of 1 year (each cycle is 28 days)
Phase I: Anti-tumor activity of the combination therapy with afuresertib plus fulvestrant in patients with HR+/HER2- BC
Phase III: Progression Free Survival (PFS) based on RECIST 1.1, as assessed by investigators
Time frame: Phase III:Change from Baseline beginning at Cycle 3 Day 1 and then every 8 weeks for the first 12 months, then every 3 months through study completion
Phase III:To assess the anti-tumor activity of the combination therapy with afuresertib plus fulvestrant versus placebo plus fulvestrant in patients with PIK3CA/AKT1/PTEN alterations HR+/HER2- BC who have failed 1 to 2 prior lines of ET with/without a Phase III: CDK4/6 inhibitor (up to 1 therapy), or chemotherapy (up to 1 chemotherapy)
11 secondary outcomes
Phase I: Duration of Response (DOR) based on RECIST 1.1
Time frame: Phase I: Change from Baseline beginning at Cycle 3 Day 1 and then every 8 weeks x 40 weeks then every 3 months through study completion, an average of 1 year (each cycle is 28 days)
Phase I: Clinical rate of benefit (CBR) based on RECIST 1.1
Time frame: Phase I: Change from Baseline beginning at Cycle 3 Day 1 and then every 8 weeks x 40 weeks then every 3 months through study completion, an average of 1 year (each cycle is 28 days)
Phase I: Best Overall Response (BOR) based on RECIST 1.1
Time frame: Phase I: Change from Baseline beginning at Cycle 3 Day 1 and then every 8 weeks x 40 weeks then every 3 months through study completion, an average of 1 year (each cycle is 28 days)
Phase I: Progression Free Survival (PFS) based on RECIST 1.1
Time frame: Phase I: After Cycle 3 Day 1 and then every 8 weeks x 40 weeks then every 3 months through study completion, an average of 1 year (each cycle is 28 days)
Phase I: Pharmacokinetics- Time to Maximum Concentration (T-Max)
Time frame: Phase I: Assessed on Day 1 and Day 15 of Cycle 1 (each cycle is 28 days)
Phase I: Pharmacokinetics- Area Under the Curve (AUC)
Time frame: Assessed on Day 1 and Day 15 of Cycle 1 (each cycle is 28 days)
Phase I: Frequency and severity of Adverse Events (AEs)
Time frame: Phase I: Through study completion for an average of 12 months
Phase III: Progression Free Survival (PFS) based on RECIST 1.1, as assessed by BICR
Time frame: Phase III:Change from Baseline beginning at Cycle 3 Day 1 and then every 8 weeks for the first 12 months then every 3 months through study completion
Phase III:Frequency and severity of Adverse Events (AEs)
Time frame: Phase III:Through study completion
Phase III:Pharmacokinetics- Time to Maximum Concentration (T-Max)
Time frame: Assessed on Day 1 and Day 15 of Cycle 1 (each cycle is 28 days)
Phase III:Pharmacokinetics- Area Under the Curve (AUC)
Time frame: Assessed on Day 1 and Day 15 of Cycle 1 (each cycle is 28 days)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Apr 2026.
- Derived from this study: PubMed 41651834Zhang P, Sun T, Wang Y, Li W, Tong Z, Phadke S, Feinstein T, Ma W, Guo P, Zhang M, Yue Y, Xu B. Afuresertib plus fulvestrant for pretreated HR-positive, HER2-negative, advanced breast cancer: a phase Ib trial. Nat Commun. 2026 Feb 6;17(1):2456. doi: 10.1038/s41467-026-69225-2.
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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.
Wenyue Ma study director
Laekna Limited
55 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Afuresertib in people with Breast Cancer, run by Laekna Limited at 55 sites in 2 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 20 inclusion and 20 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: under way, not looking for participants, as of the sponsor's last update on 2 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 55 sites in China, United States. 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?
This study is still under way. Results are not available in the source record yet.
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?
Phase I: Overall Response Rate (ORR) based on RECIST 1.1 (time frame: Phase I: Change from Baseline beginning at Cycle 3 Day 1 and then every 8 weeks × 40 weeks then every 3 months through study completion, an average of 1 year (each cycle is 28 days)). 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 NCT04851613, which also lists 1 linked publication.
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 Apr 2026.