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Breast CancerPhase 2NCT05101564

Umbrella Trial of Subtype-Targeted Therapies in ER+/HER2- Breast Cancer

A Phase 2 study testing Alpelisib, Tamoxifen and Zotatifin in people with Breast Cancer and HER2-negative Breast Cancer, run by Jennifer Lee Caswell-Jin at 1 site in United States.

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

The purpose of this study is to learn if adding a new drug that is targeted at a specific genetic change found in some breast tumors pre-operatively will slow the growth of the tumor more than standard anti-hormone therapy used to treat this type of breast cancer. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Alpelisib, Tamoxifen and Zotatifin
Could I receive a placebo?
No, everyone receives an active treatment
How many people
19 participants
Where
1 siteUnited States
Study dates
20 Mar 2023to 3 Jun 2024
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
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Pre-Screening Phase
  • Biopsy-proven ER-positive, HER2-negative breast cancer. ER-positivity and PR-positivity are defined as ≥1% cells staining positive by immunohistochemistry. HER2-negativity is defined by IHC or FISH, per ASCO-CAP 2018 guidelines. Breast tumor must be intact and tumor size must be ≥ 1 cm as measured by ultrasound, mammogram, MRI, or clinical exam. If tumor is locally recurrent, it must be in the breast (not skin, node, or chest wall recurrence). Ki67 may or may not have been done locally but if done locally, must be ≥ 5%. Any nodal status is allowed, as M0 or M1 disease.
  • Women or men, age ≥ 18 years old.
  • Performance status 0 to 1 (by Eastern Cooperative Oncology Group [ECOG] scale).
  • Ability to understand and the willingness to sign a written informed consent document.
  • Treatment Phase
Show all 9Show fewer
  • Breast tumor classifies as relevant integrative subtype per tumor sequencing performed and analyzed by central laboratory.
  • Breast tumor Ki67 score ≥ 10% as assessed by central laboratory.
  • Each investigational agent specific inclusion criteria can be found in the agent-specific appendix

Who cannot join

  • Pregnant woman, as confirmed by positive serum hCG test prior to initiating study treatment. Nursing (lactating) woman also not allowed.
  • Prior breast cancer-directed therapy (surgery, radiation, chemotherapy, or endocrine therapy) is not allowed, with the exception of people with in-breast recurrences. People with in-breast recurrences cannot have had breast cancer-directed therapy (radiation, chemotherapy, or endocrine therapy; surgery is acceptable) within the 6 months prior to signing the pre-screening consent. Pre-endocrine therapy for breast cancer risk reduction is allowed.
  • Known hypersensitivity to study agent (IP) or standard endocrine therapy drug, or to any of the excipients of study agent (IP) or standard endocrine therapy drug.
  • Each study agent specific exclusion criteria can be found in the agent-specific appendix

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Stanford University

    Stanford, California, 94304

Other trials in United States

About this study

Official title: An Umbrella, Randomized, Controlled, Pre Operative Trial Testing Integrative Subtype Targeted Therapeutics in Estrogen Receptor Positive, HER2-Negative Breast Cancer

The purpose of this study is to learn if adding a new drug that is targeted at a specific genetic change found in some breast tumors pre-operatively will slow the growth of the tumor more than standard anti-hormone therapy used to treat this type of breast cancer. Different therapies are being tested based on the specific gene changes in the tumor. Not every tumor will have a gene change that is being studied.

Read the detailed description

Primary Objective: To evaluate the efficacy of investigational agent compared with standard endocrine therapy in in reducing Ki67 values based on digital pathology (QuPath) from baseline to on-treatment biopsy after an specific treatment duration (i.e. 14 days) in ER-positive, HER2-negative tumors (tumor size ≥1 cm) with Ki67 ≥ 10%, for different integrative subtype categories identified at integrative subtype screening.

Secondary Objective: To evaluate the efficacy of investigational agent compared with standard endocrine therapy on the proportion of subjects with Ki67 < 10% after a specific treatment duration (i.e. 14 days)

Being tested
Alpelisib, Tamoxifen, Zotatifin, Fulvestrant
Medical subject headings
Breast Neoplasms

What participants receive

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

  • AlpelisibDrug

    Also called Piqray, BYL719

    Alpelisib 300 mg

  • TamoxifenDrug

    Also called Soltamox, TAM

    Tamoxifen 20 mg

  • ZotatifinDrug

    Also called eFT226

    Zotatifin 0.10mg/kg (by weight)

  • FulvestrantDrug

    Also called Faslodex

    Fulvestrant 500 mg

Study groups in NCT05101564
Study groupRoleWhat they receive
IC1:Alpelisib in combination with Tamoxifen (closed to enrollment)ExperimentalIntegrative subtype IC1, Treatment (14 days, - 2 or + 7 days): Take assigned alpelisib pills, 300 mg (two 150 mg tablets) with food, once daily by mouth. Tamoxifen pills, 20 mg once daily by mouth
Receives: Drug: Alpelisib; Drug: Tamoxifen
IC1:Tamoxifen (closed to enrollment)Active comparatorIntegrative subtype 1, Treatment (14 days, -2 to +7 days): Take assigned tamoxifen pills, 20 mg once daily by mouth
Receives: Drug: Tamoxifen
IC2:Zotatifin in combination with FulvestrantExperimentalIntegrative subtype 2, Treatment (14 days, - 2 to +7 days). Zotatifin (calculated by weight, 0.10 mg/kg) should be administered as a 60-minute IV infusion on Days 1. A total of 500 mg Fulvestrant should be administered intramuscularly as two 5mL injection on Day 1.
Receives: Drug: Zotatifin; Drug: Fulvestrant
IC2:FulvestrantActive comparatorIntegrative subtype 2, Treatment (14 days, - 2 to +7 days) A total of 500 mg Fulvestrant should be administered intramuscularly as two 5mL injection on Day 1.
Receives: Drug: Fulvestrant
IC3:Zotatifin in combination with FulvestrantExperimentalIntegrative subtype 3, Treatment (14 days, - 2 to +7 days). Zotatifin (calculated by weight, 0.10 mg/kg) should be administered as a 60-minute IV infusion on Days 1. A total of 500 mg Fulvestrant should be administered intramuscularly as two 5mL injection on Day 1.
Receives: Drug: Zotatifin; Drug: Fulvestrant
IC3:FulvestrantActive comparatorIntegrative subtype 3, Treatment (14 days, - 2 to +7 days) A total of 500 mg Fulvestrant should be administered intramuscularly as two 5mL injection on Day 1. on Day 1.
Receives: Drug: Fulvestrant
IC4:Zotatifin in combination with FulvestrantExperimentalIntegrative subtype 4, Treatment (14 days, - 2 to +7 days). Zotatifin (calculated by weight, 0.10 mg/kg) should be administered as a 60-minute IV infusion on Days 1. A total of 500 mg Fulvestrant should be administered intramuscularly as two 5mL injection on Day 1.
Receives: Drug: Zotatifin; Drug: Fulvestrant
IC4:FulvestrantActive comparatorIntegrative subtype 4, Treatment (14 days, - 2 to +7 days) A total of 500 mg Fulvestrant should be administered intramuscularly as two 5mL injection on Day 1..
Receives: Drug: Fulvestrant
IC6:Zotatifin in combination with FulvestrantExperimentalIntegrative subtype 6, Treatment (14 days, - 2 to +7 days). Zotatifin (calculated by weight, 0.10 mg/kg) should be administered as a 60-minute IV infusion on Days 1. A total of 500 mg Fulvestrant should be administered intramuscularly as two 5mL injection on Day 1.
Receives: Drug: Zotatifin; Drug: Fulvestrant
IC6:FulvestrantActive comparatorIntegrative subtype 6, Treatment (14 days, - 2 to +7 days) A total of 500 mg Fulvestrant should be administered intramuscularly as two 5mL injection on Day 1.
Receives: Drug: Fulvestrant
IC7:Zotatifin in combination with FulvestrantExperimentalIntegrative subtype 7, Treatment (14 days, - 2 to +7 days). Zotatifin (calculated by weight, 0.10 mg/kg) should be administered as a 60-minute IV infusion on Days 1. A total of 500 mg Fulvestrant should be administered intramuscularly as two 5mL injection on Day 1.
Receives: Drug: Zotatifin; Drug: Fulvestrant
IC7:FulvestrantActive comparatorIntegrative subtype 7, Treatment (14 days, - 2 to +7 days) A total of 500 mg Fulvestrant should be administered intramuscularly as two 5mL injection on Day 1.
Receives: Drug: Fulvestrant
IC8:Zotatifin in combination with FulvestrantExperimentalIntegrative subtype 8, Treatment (14 days, - 2 to +7 days). Zotatifin (calculated by weight, 0.10 mg/kg) should be administered as a 60-minute IV infusion on Days 1. A total of 500 mg Fulvestrant should be administered intramuscularly as two 5mL injection on Day 1.
Receives: Drug: Zotatifin; Drug: Fulvestrant
IC8:FulvestrantActive comparatorIntegrative subtype 8, Treatment (14 days, - 2 to +7 days) A total of 500 mg Fulvestrant should be administered intramuscularly as two 5mL injection on Day 1.
Receives: Drug: Fulvestrant

What is being measured

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

  1. Percentage Change in Ki67

    The primary outcome is the percentage change in Ki67 expression comparing pre-treatment to on-treatment specimens. Ki67 values were log-transformed for analysis, and results are summarized as the mean percentage change with 95% confidence intervals.

    Measured: Measured pre-treatment and after treatment 15 or 19 days, based on the duration specified for the assigned therapy

Secondary outcomes (1)
  1. Ki67 <10% On-treatment Measurement

    The proportions of subjects with Ki67 less than 10% after treatment. The outcome will be reported as a number without dispersion.

    Measured: 15 or 19 days, based on the duration specified for the assigned therapy

Timeline

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

  1. First posted1 Nov 2021
  2. Study start20 Mar 2023
  3. Primary completion3 Jun 2024
  4. Study completion3 Jun 2024

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
19 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05101564
Sponsor's protocol ID
IRB-52869
Other IDs
NCI-2023-02578
Status last verified
Jan 2026
First submitted
28 Oct 2021
Last updated
12 Feb 2026
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Alpelisib, Tamoxifen and Zotatifin in people with Breast Cancer and HER2-negative Breast Cancer, run by Jennifer Lee Caswell-Jin at 1 site in United States.

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 9 inclusion and 4 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 12 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in 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. 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 22 Jan 2026). 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?

Percentage Change in Ki67 (time frame: Measured pre-treatment and after treatment 15 or 19 days, based on the duration specified for the assigned therapy). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 12 Feb 2026.

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