Study of Radium-223 Dichloride in Combination With Exemestane and Everolimus Versus Placebo in Combination With Exemestane and Everolimus in Subjects With Bone Predominant HER2 Negative Hormone Receptor Positive Metastatic Breast Cancer

NCT ID: NCT02258451

Last Updated: 2023-11-24

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

283 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-06-04

Study Completion Date

2022-10-28

Brief Summary

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The objective of this study is to assess efficacy and safety of radium 223 dichloride in subjects with human epidermal growth factor receptor 2 (HER2) negative hormone receptor positive breast cancer with bone metastases treated with exemestane and everolimus

After implementation of CSP Amendment 10, only a limited number of subjects will remain in this study, in order to reduce the burden to study subjects, collection of data will be reduced and will focus mainly on acute safety, SSE, and OS. Once subjects are rolled over, the long-term safety will be collected and assessed entirely in the separate extended safety follow-up study.

Detailed Description

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Conditions

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Breast Neoplasms

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Radium-223 dichloride + exemestane/everolimus

Up to 6 cycles of radium-223 dichloride 50kBq/kg body weight (55 kBq/kg after implementation of National Institute of Standards and Technology \[NIST\] update) (randomized). Participants will also receive exemestane, 25-mg tablet once daily (after a meal), and everolimus, 10 mg once daily (with or without food), and supportive care as per the local or institutional standard of practice.

Group Type EXPERIMENTAL

Radium-223 dichloride (Xofigo, BAY88-8223)

Intervention Type DRUG

Up to 6 cycles of radium-223 dichloride 50kBq/kg body (55 kBq/kg after implementation of NIST update)

Exemestane

Intervention Type DRUG

One 25 mg tablet once daily after a meal.

Everolimus

Intervention Type DRUG

The recommended dose of everolimus administered in the study is 10 mg once daily with or without food.

Starting dose, dose modifications, and administration of exemestane and everolimus must be in compliance with the local labels in each of the participating countries and/or in line with local standard of practice.

Placebo + exemestane/everolimus

Up to 6 cycles of saline injection (placebo) (randomized). Participants will also receive exemestane, 25-mg tablet once daily (after a meal), and everolimus, 10 mg once daily (with or without food), and supportive care as per the local or institutional standard of practice.

Group Type PLACEBO_COMPARATOR

Placebo (saline)

Intervention Type DRUG

Up to 6 cycles of saline injection

Exemestane

Intervention Type DRUG

One 25 mg tablet once daily after a meal.

Everolimus

Intervention Type DRUG

The recommended dose of everolimus administered in the study is 10 mg once daily with or without food.

Starting dose, dose modifications, and administration of exemestane and everolimus must be in compliance with the local labels in each of the participating countries and/or in line with local standard of practice.

Interventions

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Radium-223 dichloride (Xofigo, BAY88-8223)

Up to 6 cycles of radium-223 dichloride 50kBq/kg body (55 kBq/kg after implementation of NIST update)

Intervention Type DRUG

Placebo (saline)

Up to 6 cycles of saline injection

Intervention Type DRUG

Exemestane

One 25 mg tablet once daily after a meal.

Intervention Type DRUG

Everolimus

The recommended dose of everolimus administered in the study is 10 mg once daily with or without food.

Starting dose, dose modifications, and administration of exemestane and everolimus must be in compliance with the local labels in each of the participating countries and/or in line with local standard of practice.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Women (≥18 years of age) with metastatic breast cancer not amenable to curative treatment by surgery or radiotherapy.
* Documentation of histological or cytological confirmation of estrogen receptor positive (ER+) and HER2 negative adenocarcinoma of the breast must be available.
* Documentation of menopausal status: postmenopausal subjects or pre-menopausal subjects with ovarian radiation or concomitant therapy with a luteinizing hormone-releasing hormone (LH-RH) agonist/antagonist are eligible.
* Subjects with bone dominant disease with at least 2 skeletal metastases identified at baseline by bone scintigraphy and confirmed by computed tomography (CT)/magnetic resonance imaging (MRI).
* Subjects must have received at least one line of hormonal therapy in the metastatic setting.
* Subjects who are eligible as per the Investigator's assessment and according to the local label for treatment with exemestane and everolimus as a second line or greater of hormone therapy in a metastatic setting.
* Subjects must have experienced recurrent/progressive disease following treatment with a non-steroidal aromatase inhibitor (letrozole or anastrozole) in an adjuvant or metastatic setting
* Subjects must have experienced no more than two skeletal-related events (SREs) prior to study entry defined as: need for external beam radiotherapy (EBRT) to bone pain, pathological bone fracture (excluding major trauma), spinal cord compression and/or orthopedic surgical procedure. Subjects with no prior SREs are not permitted.
* Subjects must be on therapy with bisphosphonates or denosumab for at least 1 month before start of study treatment.
* Adequate hematological, liver and kidney function.

Exclusion Criteria

* Subjects with Inflammatory breast cancer.
* Patients with immediately life-threatening visceral disease for whom chemotherapy is preferred treatment option.
* Subjects who have either received chemotherapy for metastatic disease or are considered by the treating investigator to be appropriate candidates for chemotherapy as current treatment for metastatic breast cancer are excluded. Chemotherapy administered for adjuvant/neo adjuvant disease is acceptable provided it was administered at least 1 year prior to study entry.
* Subjects who received prior treatment or are already receiving everolimus treatment prior to study entry are not eligible.
* Subjects with known or history of brain metastases or leptomeningeal disease: subjects with neurological symptoms must undergo a contrast CT scan or MRI of the brain within 28 days prior to randomization to exclude active brain metastasis. Imaging of the central nervous system (CNS) is otherwise not required.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Bayer

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Bayer Study Director

Role: STUDY_DIRECTOR

Bayer

Locations

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La Jolla, California, United States

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Los Angeles, California, United States

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New Haven, Connecticut, United States

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Hollywood, Florida, United States

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Ashland, Kentucky, United States

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Rockville, Maryland, United States

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Ann Arbor, Michigan, United States

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Detroit, Michigan, United States

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Pontiac, Michigan, United States

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Rochester, Minnesota, United States

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St Louis, Missouri, United States

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Newark, New Jersey, United States

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Jamaica, New York, United States

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Watertown, South Dakota, United States

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Spokane, Washington, United States

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Innsbruck, , Austria

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Brussels, , Belgium

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Edegem, , Belgium

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Kortrijk, , Belgium

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Leuven, , Belgium

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Angers, , France

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Nantes, , France

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Nîmes, , France

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Saint-Cloud, , France

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Tours, , France

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Herne, North Rhine-Westphalia, Germany

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Chai Wan, , Hong Kong

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Hong Kong, , Hong Kong

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Kowloon, , Hong Kong

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Afula, , Israel

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Beersheba, , Israel

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Haifa, , Israel

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Holon, , Israel

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Jerusalem, , Israel

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Jerusalem, , Israel

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Ramat Gan, , Israel

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Tel Aviv, , Israel

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Zrifin, , Israel

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Bari, Apulia, Italy

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Bologna, Emilia-Romagna, Italy

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Forlì Cesena, Emilia-Romagna, Italy

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Modena, Emilia-Romagna, Italy

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Rome, Lazio, Italy

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Rome, Lazio, Italy

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Genoa, Liguria, Italy

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Cremona, Lombardy, Italy

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Milan, Lombardy, Italy

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Pisa, Tuscany, Italy

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Nagoya, Aichi-ken, Japan

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Sapporo, Hokkaido, Japan

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Sayama, Osaka, Japan

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Hidaka, Saitama, Japan

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Kita-Adachigun, Saitama, Japan

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Koto-ku, Tokyo, Japan

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Kagoshima, , Japan

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Osaka, , Japan

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Oslo, , Norway

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Bialystok, , Poland

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Gdansk, , Poland

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Gdynia, , Poland

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Poznan, , Poland

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Warsaw, , Poland

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Singapore, , Singapore

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Singapore, , Singapore

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Singapore, , Singapore

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Suwon, Gyeonggido, South Korea

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Seoul, Seoul Teugbyeolsi, South Korea

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Busan, , South Korea

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Daegu, , South Korea

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Incheon, , South Korea

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Seoul, , South Korea

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Palma de Mallorca, Illes Baleares, Spain

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Barcelona, , Spain

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Barcelona, , Spain

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Barcelona, , Spain

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Madrid, , Spain

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Madrid, , Spain

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Madrid, , Spain

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Madrid, , Spain

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Pamplona, , Spain

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Seville, , Spain

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Seville, , Spain

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Aarau, Canton of Aargau, Switzerland

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Kaohsiung City, , Taiwan

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Taichung, , Taiwan

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Taipei, , Taiwan

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Taipei, , Taiwan

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Truro, Cornwall, United Kingdom

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Plymouth, Devon, United Kingdom

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Nottingham, Nottinghamshire, United Kingdom

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Taunton, Somerset, United Kingdom

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Bristol, , United Kingdom

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Countries

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United States Austria Belgium France Germany Hong Kong Israel Italy Japan Norway Poland Singapore South Korea Spain Switzerland Taiwan United Kingdom

References

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Rugo HS, Van Poznak CH, Neven P, Danielewicz I, Lee SC, Campone M, Chik JYK, Vega Alonso E, Naume B, Brain E, Siegel JM, Li R, Uema D, Wagner VJ, Coleman RE. Radium-223 in women with hormone receptor-positive bone-metastatic breast cancer receiving endocrine therapy: pooled analysis of two international, phase 2, randomized, double-blind, placebo-controlled trials. Breast Cancer Res Treat. 2024 Apr;204(2):249-259. doi: 10.1007/s10549-023-07147-z. Epub 2023 Dec 20.

Reference Type DERIVED
PMID: 38123789 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Related Links

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http://www.clinicaltrialsregister.eu/

Click here to find information about studies related to Bayer Healthcare products conducted in Europe

https://clinicaltrials.bayer.com/study/17096

Click here to find further information and, after study completion, the study results according to Bayer's transparency standards

Other Identifiers

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2014-002114-23

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

17096

Identifier Type: -

Identifier Source: org_study_id