Treatment of Canadian Men and Pre/Peri/Post-menopausal Women With ER+ Advanced Breast Cancer in the Real-World Setting With Hormone Therapy ± Targeted Therapy

NCT ID: NCT02753686

Last Updated: 2023-02-15

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 440 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2016-03-15
• Study Completion Date: 2022-12-01

Brief Summary

Although randomized controlled trials (RCTs) provide evidence of efficacy, generalization of these results to patients in the real-world setting is challenging, given RCTs are conducted in highly selected patient populations.

An understanding of the effectiveness of approved cancer therapies in routine clinical practice is essential in order to optimize the management of these patients and to identify treatment and monitoring gaps.

This is the first Canadian study to describe real-world treatment patterns/sequencing, effectiveness and monitoring for men and pre/postmenopausal HR+ HER2- advanced breast cancer patients. This registry incorporates an observational prospective cohort design and will enroll 500 men and pre/postmenopausal HR+ HER2- advanced breast cancer women that have been exposed to endocrine therapy (ET) or ET in combination with targeted therapy (TT) including patients receiving CDK4/6 inhibitor therapy combinations..

Conditions

HR+ HER2- Men, Pre/Postmenopausal Advanced Breast Cancer

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Cohort 1: Endocrine Therapy (ET)

HR+ HER2- male, female pre/postmenopausal advanced breast cancer patients being treated with endocrine therapy

Endocrine therapy may include one of the following therapies: letrozole, anastrozole, exemestane, tamoxifen or fulvestrant

Intervention Type: DRUG

Cohort 2: Endocrine Therapy (ET) plus Targeted Therapy (TT)

HR+ HER2- male, female pre/ postmenopausal advanced breast cancer patients being treated with endocrine therapy in combination with targeted therapy including CDK4/6 inhibitor therapy

Endocrine therapy in combination with targeted therapy may include: everolimus plus exemestane or CDK4/6 inhibitor plus endocrine therapy

Intervention Type: DRUG

Interventions

Endocrine therapy may include one of the following therapies: letrozole, anastrozole, exemestane, tamoxifen or fulvestrant

Intervention Type: DRUG

Endocrine therapy in combination with targeted therapy may include: everolimus plus exemestane or CDK4/6 inhibitor plus endocrine therapy

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

1. Patient is an adult, male or female ≥ 18 years old at the time of informed consent.

2. Patient has histologically and/or cytologically confirmed diagnosis of breast cancer.

3. Patient has inoperable locally advanced or metastatic breast cancer.

4. Patient has ER positive and/or PgR positive HER2-negative breast cancer by local laboratory testing (based on most recently analyzed biopsy).

5. In the case of women, both pre/perimenopausal and postmenopausal patients are allowed to be included in this study.

1. Postmenopausal status is defined as per investigator's judgment. Definition included as guidance only:

1. Prior bilateral oophorectomy 2. Or age ≥60 3. Or age < 60 and amenorrhea for 12 or more months (in the absence of chemotherapy, tamoxifen, toremifen, or ovarian suppression), and FSH and estradiol in the postmenopausal range per local normal range. If patient is taking tamoxifen or toremifene and age < 60, then FSH and plasma estradiol levels should be in postmenopausal range per local normal range.

b) Premenopausal status is defined as per investigator's judgment. Definition included as guidance only:

1. Patient had last menstrual period within the last 12 months 2. Or if on tamoxifen or toremifene within the past 14 days, plasma estradiol and FSH must be in the premenopausal range per local normal range 3. Or in case of therapy induced amenorrhea, plasma estradiol and/or FSH must be in the premenopausal range per local normal range.

c) Perimenopausal status is defined as neither premenopausal nor postmenopausal as per investigator's judgment.

6. Patient having received maximum one prior chemotherapy line for advanced/metastatic breast cancer is allowed.

Note: A chemotherapy line in advanced disease is an anticancer regimen(s) that contains at least 1 cytotoxic chemotherapy agent and given for 21 days or longer. If a cytotoxic chemotherapy regimen was discontinued for a reason other than disease progression and lasted less than 21 days, then this regimen does not count as a "prior line of chemotherapy".

7. Patient receiving targeted therapy plus endocrine therapy (ET+TT) in either the 1st, 2nd or 3rd line or endocrine therapy alone (ET) in either the 2nd or 3rd line advanced metastatic setting:

1. as per approved Health Canada indication OR

2. as per available expanded treatment protocol(s) only if efficacy assessments in these protocols are considered routine standard of care OR

3. as per available compassionate / expanded access program

Notes: 1. Date of initiation of treatment should be a maximum of 12 months prior to the date of enrollment in this study for patients receiving CDK4/6 inhibitor therapy based combinations. Date of initiation of treatment should be a maximum of 1 month prior to the date of enrollment in this study for patients receiving all other endocrine monotherapies or combination therapies. 2. 1st, 2nd and 3rd line therapy in the advanced setting is defined as the first, second and third treatment received respectively in the metastatic setting (which could include endocrine monotherapy, targeted therapy combination with endocrine therapy or chemotherapy). 3. 3. Patients enrolled in the ET cohort must have received a prior CDK4/6 inhibitor for advanced/metastatic breast cancer. Patients who have received two subsequent lines of CDK4/6 inhibitor therapy are allowed.

8. The decision to use ET or ET+TT has been reached prior to and independently of the current study.

9. Patient willing to be followed according to routine standard of care practice.

10. Signed informed consent to allow the collection of the data for the purposes of this study.

Exclusion Criteria

1. Patient currently receiving chemotherapy at baseline/study entry is excluded (however patient could have received up to one line of chemotherapy in the metastatic setting prior to study entry or as a subsequent therapy after completion of ET or ET+TT treatment).

2. Patient having received more than 3 lines of therapy in the metastatic setting.

3. Any contraindications to the study treatments as presented in the respective Canadian Product Monographs for each therapy.

4. Patient is participating in a clinical trial for an investigational treatment with the exception expanded treatment protocol or access program where efficacy assessments are considered routine standard of care.

5. Patient is undergoing any treatment that is not considered standard of care as per regional policies and guidelines with the exception of treatments accessed via expanded treatment protocols or access programs.

6. Patient does not understand or is not willing to sign the informed consent for participation in the study.

7. According to the judgment of the physician participation in the study may interfere with the treatment or compromise the well-being of the patient.

8. Patient is expected to travel for an extensive time period or be unavailable during the study period.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Novartis Pharmaceuticals

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Novartis Pharmaceuticals

Role: STUDY_DIRECTOR

Novartis Pharmaceuticals

Locations

Novartis Investigative Site

Calgary, Alberta, Canada

Novartis Investigative Site

Burnaby, British Columbia, Canada

Novartis Investigative Site

North Vancouver, British Columbia, Canada

Novartis Investigative Site

Richmond, British Columbia, Canada

Novartis Investigative Site

Vancouver, British Columbia, Canada

Novartis Investigative Site

Moncton, New Brunswick, Canada

Novartis Investigative Site

Moncton, New Brunswick, Canada

Novartis Investigative Site

Cambridge, Ontario, Canada

Novartis Investigative Site

Kingston, Ontario, Canada

Novartis Investigative Site

Kitchener, Ontario, Canada

Novartis Investigative Site

London, Ontario, Canada

Novartis Investigative Site

Newmarket, Ontario, Canada

Novartis Investigative Site

Ottawa, Ontario, Canada

Novartis Investigative Site

Sault Ste. Marie, Ontario, Canada

Novartis Investigative Site

Toronto, Ontario, Canada

Novartis Investigative Site

Toronto, Ontario, Canada

Novartis Investigative Site

Toronto, Ontario, Canada

Novartis Investigative Site

Windsor, Ontario, Canada

Novartis Investigative Site

Greenfield Park, Quebec, Canada

Novartis Investigative Site

Montreal, Quebec, Canada

Novartis Investigative Site

Montreal, Quebec, Canada

Novartis Investigative Site

Montreal, Quebec, Canada

Novartis Investigative Site

Québec, Quebec, Canada

Novartis Investigative Site

Regina, Saskatchewan, Canada

Novartis Investigative Site

Saskatoon, Saskatchewan, Canada

Countries

Canada

References

Doyle C, Lohmann AE, Iqbal N, Henning JW, Kulkarni S, Califaretti N, Hilton J, Ferrario C, Bouganim N, Mates M, Guillemette S, Leite R, Caron MA, Thireau F, Machado A, Chia S. A Canadian real-world, multi-center, prospective, observational study assessing the treatment duration, the treatment sequence, and the overall survival for patients treated with endocrine therapy +/- targeted therapy in HR + HER2-negative advanced breast cancer. Breast Cancer Res Treat. 2025 Apr;210(2):425-438. doi: 10.1007/s10549-024-07580-8. Epub 2025 Jan 23.

Reference Type: DERIVED

PMID: 39847203 (View on PubMed)

Other Identifiers

CRAD001YCA09

Identifier Type: -

Identifier Source: org_study_id