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Metastatic Breast CancerPhase 3IMPORTANTNCT06044623

Implementing Geriatric Assessment for Dose Optimization of Cyclin-dependent Kinase (CDK) 4/6-inhibitors in Older Breast Cancer Patients

A Phase 3 study testing CDK 4/6 inhibitors and Endocrine therapy in people with Metastatic Breast Cancer and Advanced Breast Cancer, run by Region Örebro County at 12 sites in 6 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

IMPORTANT study is a multicenter, open-label, prospective, randomized-controlled, non-inferiority trial with a pragmatic approach involving older patients (≥ 70 years old) with advanced hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer, not amenable for curative… Read more about this study

Who is it for?
Ages 70 years and older
What is being tested?
CDK 4/6 inhibitors and Endocrine therapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
495 participants
Where
12 sitesin 6 countries
Study dates
1 Apr 2024to 31 May 2029
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 70 years and older
  • All sexes
  • No healthy volunteers
  • Older adult

Who may be able to join

  • The following inclusion criteria will be applied:
  • Patients male or female aged at least 70 years old at the time of informed consent.
  • Histologically or cytologically confirmed diagnosis of HR-positive (defined as estrogen-receptor ≥ 1%), HER2-negative breast cancer according to analysis of the most recent tumor specimen by local laboratory.
  • Advanced (locoregionally recurrent or metastatic) breast cancer not amenable to curative treatment.
  • No prior systemic treatment for advanced disease (recurrence during neo-/adjuvant endocrine therapy is allowed). A prior period of treatment with aromatase inhibitors or fulvestrant for up to 28 days from the CDK 4/6-inhibitor initiation is allowed.
  • Adjuvant treatment with CDK 4/6-inhibitors is allowed provided a disease-free interval from treatment end >12 months.
Show all 11Show fewer
  • Either measurable disease or non-measurable bone only disease, but evaluable according to RECIST criteria 1.1.
  • Written informed consent prior to any study-specific procedures.
  • Adequate organ function as defined in the summary of product characteristics (SmPC) for the CDK 4/6-inhibitors that is planned to be used.
  • Able to swallow capsules.
  • Able to understand and consent in English language or in native language for each participating country.

Who cannot join

  • Eligible patients will be excluded if they have one of the following criteria:
  • Patients considered from treating physician as non-suitable for treatment with CDK 4/6-inhibitors.
  • Contraindications according to SmPC for the CDK 4/6-inhibitors that is planned to be used.
  • Presence of visceral crisis, lymphangitis carcinomatosis, or leptomeningeal carcinomatosis.
  • History of any other cancer (except of non-melanoma skin cancer or carcinoma in-situ of the cervix), unless in complete remission with no therapy for a minimum of 3 years.
  • Participating in other interventional trial.

Trial locations and contacts

12 sites in 6 countries. Contact the study team or a site near you to ask about taking part.

Antonios Valachis, Assoc Prof contact

+46196021792

important@oru.se

12 sites in 6 countries

Greece5 sites, 5 recruiting
  • Fourth Oncology Department & Comprehensive Clinical Trials Center, Metropolitan Hospital

    Athens

    Helena Linardou, Dr, elinardou@otenet.gr

    Not yet recruiting
  • Second Department of Medical Oncology, Hygeia Hospital

    Athens

    Paris Kosmidis, Dr, parkosmi@otenet.gr

    Not yet recruiting
  • Division of Oncology, Department of Medicine, University Hospital, University of Patras Medical School

    Pátrai

    Angelos Koutras, Prof, angkoutr@otenet.gr

    Not yet recruiting
  • Medical Oncology Unit, S. Andrew Hospital

    Pátrai

    Athina Christopoulou, Dr, athinachristo@hotmail.com

    Not yet recruiting
  • Second Department of Medical Oncology, Euromedica General Clinic

    Thessaloniki

    Elena Fountzila, Assoc Prof, elenafou@gmail.com

    Not yet recruiting

Other trials in Greece

Italy2 sites, 2 recruiting
  • Radiation Oncology Unit - Oncology Department, Azienda Ospedaliero Universitaria Careggi

    Florence

    Icro Meattini, Assoc Prof, icro.meattini@unifi.it

    Luca Visani, Dr, l.visani88@gmail.com

    Not yet recruiting
  • "Sandro Pitigliani" Department of Medical Oncology, Hospital of Prato

    Prato

    Laura Biganzoli, Prof, laura.biganzoli@uslcentro.toscana.it

    Emanuela Risi, Dr, emanuela.risi@uslcentro.toscana.it

    Not yet recruiting

Other trials in Italy

Sweden2 sites, 2 recruiting
  • Department of Oncology, Örebro University Hospital

    Örebro

    Antonios Valachis, Assoc Prof, antonios.valachis@oru.se

    Recruiting
  • Department of Oncology, Uppsala University Hospital

    Uppsala, 75185

    Hendrik Lindman, Assoc Prof, Henrik.lindman@igp.uu.se

    Aglaia Schiza, Dr, Aglaia.schiza@igp.uu.se

    Not yet recruiting

Other trials in Sweden

Finland1 site, 1 recruiting
  • Department of Oncology, Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki

    Helsinki

    Peeter Karihtala, Prof, peeter.karihtala@hus.fi

    Recruiting

Other trials in Finland

Norway1 site, 1 recruiting
  • Department of Oncology, Akershus University Hospital (AHUS)

    Oslo

    Jürgen Geisler, Prof, jurgen.geisler@medisin.uio.no

    Kamilla Fjermeros, Dr, Kamilla.Fjermeros@ahus.no

    Not yet recruiting

Other trials in Norway

Spain1 site, 1 recruiting
  • Department of Medical Oncology, Hospital Clinic of Barcelona

    Barcelona

    Raquel Gomez, Dr, ragomez@recerca.clinic.cat

    Montserrat Munoz, Dr, mmunoz@clinic.cat

    Not yet recruiting

Other trials in Spain

About this study

Official title: Implementing Geriatric Assessment for Dose Optimization of CDK 4/6-inhibitors in Older Breast Cancer Patients - a Pragmatic Randomized-controlled Trial (IMPORTANT Trial)

IMPORTANT study is a multicenter, open-label, prospective, randomized-controlled, non-inferiority trial with a pragmatic approach involving older patients (≥ 70 years old) with advanced hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer, not amenable for curative treatment and without prior therapy for advanced disease, who are suitable to receive CDK 4/6-inhibitors plus endocrine therapy as first line therapy. The study implements two approaches with high level of evidence, namely the use of comprehensive geriatric assessment (CGA) approach in treatment decision making and the use of CDK 4/6-inhibitors as the initial treatment of choice, to investigate whether a common clinical practice (starting dose reduction of CDK 4/6-inhibitors in older patients) with evidence of low certainty can be standardized using a more individualized-based approach.

On the basis of baseline CGA assessment, patients will either receive full dose of CDK 4/6-inhibitors plus endocrine therapy (if patients are fit according to CGA) or be randomized to full dose vs. reduced initial dose of CDK 4/6-inhibitors (if vulnerable or frail according to CGA). The study hypothesis is that adjusting the dose according to vulnerability will allow patients to tolerate treatment better without jeopardizing the treatment efficacy.

This project has received funding from the European Union's HORIZON 2022 research and innovation actions supporting the implementation of the Mission on Cancer under grant agreement No 101104589.

Being tested
CDK 4/6 inhibitors, Endocrine therapy
Medical subject headings
Breast Neoplasms

What participants receive

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

  • CDK 4/6 inhibitorsDrug

    Either Palbociclib, Ribociclib or Abemaciclib

  • Endocrine therapyDrug

    Either Letrozole, Anastrozole, Exemestane or Fulvestrant in combination with CDK 4/6-inhibitor

Study groups in NCT06044623
Study groupRoleWhat they receive
Lower initial dose of CDK 4/6-inhibitor (vulnerable/frail patient cohort)Experimental-1 level dose reduction as initial dose of either one of the CDK 4/6-inhibitors: Palbociclib 100 mg x 1 for 21 days with 7 days off; or Ribociclib 400 mg x 1 for 21 days with 7 days off; or Abemaciclib 100 mg x 2 daily added to endocrine therapy.
Receives: Drug: CDK 4/6 inhibitors; Drug: Endocrine therapy
Full initial dose of CDK 4/6-inhibitor (vulnerable/frail patient cohort)Active comparatorFull initial dose of either one of the CDK 4/6-inhibitors: Palbociclib 125 mg x 1 for 21 days with 7 days off; or Ribociclib 600 mg x 1 for 21 days with 7 days off; or Abemaciclib 150 mg x 2 daily) added to physician's choice endocrine therapy.
Receives: Drug: CDK 4/6 inhibitors; Drug: Endocrine therapy
Full initial dose of CDK 4/6-inhibitor (fit patient cohort)OtherFull initial dose of either one of the CDK 4/6-inhibitors: Palbociclib 125 mg x 1 for 21 days with 7 days off; or Ribociclib 600 mg x 1 for 21 days with 7 days off; or Abemaciclib 150 mg x 2 daily) added to physician's choice endocrine therapy.
Receives: Drug: CDK 4/6 inhibitors; Drug: Endocrine therapy

What is being measured

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

  1. Time to treatment failure

    The time from randomization to treatment discontinuation because of any reason including disease progression, treatment toxicity, or death due to any cause.

    Measured: Up to 5 years from treatment initiation

Secondary outcomes (8)
  1. Overall treatment utility (OTU)

    A composite endpoint that will be assessed at the first efficacy evaluation. OTU incorporates objective and participant-reported outcome measures of anticancer efficacy, tolerability and acceptability of treatment providing a simple "good, intermediate or poor" categorization of outcome.

    Measured: Three months after treatment initiation

  2. Overall survival

    The time from randomization to death from any cause.

    Measured: Up to 5 years from treatment initiation

  3. Progression free survival

    The time from randomization to first documented evidence of disease progression or death from any cause.

    Measured: Up to 5 years from treatment initiation

  4. Time to chemotherapy initiation

    The time from randomization until the initiation of chemotherapy at any treatment line after CDK 4/6-inhibitors.

    Measured: Up to 5 years from treatment initiation

  5. Frequency of adverse events

    Adverse events will be assessed based on adverse events, as graded by CTCAE v 5.0 before each cycle and up to 28 days after the end of CDK 4/6-inhibitors.

    Measured: Up to 5 years from treatment initiation

  6. Assessment of Quality of life

    Quality of life will be assessed using three validated questionnaires, EORTC Quality of Life Questionnaire (QLQ)-C30, Elderly (ELD)-14, and European Quality of Life-5 Dimensions-5 Levels (EQ-5D-5L).

    Measured: Until disease progression, participant / physician decision to stop, death, or up to 24 months from treatment initiation whichever occurs first

  7. Time until Quality of life deterioration

    QoL deterioration, defined as the time from randomization until any clinically meaningful worsening (using minimal important differences as cut-off) of any QoL aspect measured by the questionnaires.

    Measured: Until disease progression, participant / physician decision to stop, death, or up to 24 months from treatment initiation whichever occurs first

  8. Cost effectiveness

    Resource use, length of life and quality of life data will be collected during the trial for the purpose of conducting an economic evaluation.

    Measured: Up to 24 months from treatment initiation

Timeline

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

  1. First posted21 Sep 2023
  2. Study start1 Apr 2024
  3. Primary completion31 Oct 2028 (estimated)
  4. Study completion31 May 2029 (estimated)

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
495 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06044623
Sponsor's protocol ID
280232
Acronym
IMPORTANT
Status last verified
Nov 2024
First submitted
13 Sep 2023
Last updated
19 Nov 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Valachis A, Biganzoli L, Christopoulou A, Fjermeros K, Fountzila E, Geisler J, Gomez-Bravo R, Karihtala P, Kosmidis P, Koutras A, Linardou H, Lindman H, Martinez-Ballestero I, Rodriguez AB, Meattini I, Munoz-Mateu M, Othman M, Psyrri A, Risi E, Schiza A, Spathas N, Utriainen M, Visani L, Ballesteros S, Basdekis I, Hay SD, Fotis T, Fricker S, de Graaf G, Jenset M, Kanters T, Lampropoulos K, Markou C, Mastoraki K, Nanou C, Reales Aviles JM, Santaholma M, Kosmidis T. Implementing geriatric assessment for dose optimization of CDK4/6 inhibitors in older breast cancer patients. Future Oncol. 2024;20(37):2937-2948. doi: 10.1080/14796694.2024.2413841. Epub 2024 Oct 21.

    PubMed 39431459

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing CDK 4/6 inhibitors and Endocrine therapy in people with Metastatic Breast Cancer and Advanced Breast Cancer, run by Region Örebro County at 12 sites in 6 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 11 inclusion and 6 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: looking for participants now, as of the sponsor's last update on 19 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in Greece, Italy, Sweden, Finland, Norway and 1 more country. 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?

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?

Contact Antonios Valachis, Assoc Prof (+46196021792, important@oru.se), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Time to treatment failure (time frame: Up to 5 years from treatment initiation). 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 NCT06044623, 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 19 Nov 2024.

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