Study of Abemaciclib and Elacestrant in Participants With Brain Metastasis Due to ER+/HER-2- Breast Cancer

NCT ID: NCT05386108

Last Updated: 2026-01-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE1/PHASE2

Total Enrollment

73 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-08-31

Study Completion Date

2026-12-31

Brief Summary

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This is a multi-site, global, open-label study that includes a phase 1b evaluation of elacestrant in combination with abemaciclib in women and men with brain metastases from estrogen receptor (ER)-positive, human epidermal growth factor receptor-2 (HER-2) negative breast cancer. Phase 1b was designed to select the recommended phase 2 dose (RP2D) and is followed by an ongoing phase 2 evaluation of elacestrant in combination with abemaciclib in participants with active brain metastases from ER-positive, HER-2 negative breast cancer.

Detailed Description

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Conditions

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Breast Neoplasms Brain Neoplasms Neoplasms by Site Neoplasms Breast Diseases Central Nervous System Neoplasms Brain Diseases Central Nervous System Diseases

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Phase 1b Cohort 1

Elacestrant 300 milligrams (mg) once daily (QD) + abemaciclib 100 mg twice daily (BID)

Group Type EXPERIMENTAL

Elacestrant

Intervention Type DRUG

300 mg, 400 mg

Abemaciclib

Intervention Type DRUG

100 mg, 150 mg

Phase 1b Cohort 2

Elacestrant 400 mg QD + abemaciclib 100 mg BID

Group Type EXPERIMENTAL

Elacestrant

Intervention Type DRUG

300 mg, 400 mg

Abemaciclib

Intervention Type DRUG

100 mg, 150 mg

Phase 1b Cohort 3

Elacestrant 400 mg QD + abemaciclib 150 mg BID

Group Type EXPERIMENTAL

Elacestrant

Intervention Type DRUG

300 mg, 400 mg

Abemaciclib

Intervention Type DRUG

100 mg, 150 mg

Phase 2

Elacestrant in combination with abemaciclib at the RP2D determined in Phase 1b

Group Type EXPERIMENTAL

Elacestrant

Intervention Type DRUG

300 mg, 400 mg

Abemaciclib

Intervention Type DRUG

100 mg, 150 mg

Interventions

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Elacestrant

300 mg, 400 mg

Intervention Type DRUG

Abemaciclib

100 mg, 150 mg

Intervention Type DRUG

Other Intervention Names

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Elacestrant dihydrochloride RAD-1901 ER-306323 Orserdu Verzenio

Eligibility Criteria

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Inclusion Criteria

1. Participant has the signed informed consent form before any study-related activities according to local guidelines.
2. Women or men aged ≥18 years, at the time of informed consent signature.

* Female participants may be either postmenopausal or pre/perimenopausal. Postmenopausal status is defined by:

1. Age ≥60 years
2. Age \<60 years and amenorrhea for 12 or more months without an alternative cause) and follicle stimulating hormone and estradiol in postmenopausal ranges per local reference ranges
3. Documentation of prior bilateral oophorectomy, at least 1 month before first dose of trial therapy).
* Pre-menopausal / peri-menopausal women and men must be concurrently receiving a luteinizing hormone-releasing hormone (LHRH) agonist starting at least 3-4 weeks before the start of trial therapy and is planning to continue LHRH during the study.
3. Participant must have ER-positive, HER-2 negative tumor status as confirmed by local laboratory testing in the following manner:

* Documentation of ER positive tumor with ≥ 1% staining by immunohistochemistry (IHC) as defined in the 2010 or 2020 American Society for Clinical Oncology (ASCO) recommendations for ER testing, with or without progesterone receptor (PGR) positivity
* HER-2 negative tumor with an IHC result of 0 or 1+ for cellular membrane protein expression or an in situ hybridization negative result as defined in the 2013 or 2018 ASCO recommendations for HER-2 testing
4. In Phase 2, participants must have at least one active and measurable brain metastasis per RECIST version 1.1.

* Any of the following qualifies brain metastases as active:

1. Newly diagnosed brain metastasis in participants who never received prior central nervous system (CNS)-directed therapy.
2. Newly diagnosed brain metastasis outside any area that was previously subjected to CNS-directed therapy.
3. Brain metastases demonstrating unequivocal progression in the opinion of the treating investigator in an area that has previously been subjected to CNS-directed therapy.
* For lesions, including brain metastases, to qualify as measurable, and possibly be selected as target lesions, per RECIST version 1.1, the longest diameter must be ≥10 millimeters \[mm\] by computed tomography \[CT\] or magnetic resonance imaging \[MRI\]).
* In Phase 1b, the presence of brain metastases is allowed but not required for eligibility, in this case, at least 1 measurable lesion outside the brain is required.
5. Participants receiving concomitant corticosteroids must be on a stable or decreasing dose for at least 7 days prior to baseline and not receiving doses higher than 4 mg of dexamethasone per day or equivalent.
6. Participants have experienced no more than one seizure within 4 weeks prior to starting trial therapy.
7. Participants' prior therapy received in the metastatic setting includes:

* At least one endocrine therapy
* Up to two chemotherapy regimens
* Up to two lines of prior cyclin-dependent kinase (CDK) 4/6 inhibitor, not including abemaciclib

Note 1: Toxicity from prior therapy must be resolved to NCI CTCAE version 5.0 Grade ≤1, with the exception of alopecia and peripheral sensory neuropathy (Grade ≤2).

Note 2: Chemotherapy refers to not targeted cytotoxic agents (for example, alkylating agents, taxanes, nucleotide analogs, platinum-based drugs, vinca alkaloids, etc) and antibody drug conjugates (ADCs). Targeted therapies (for example, kinase inhibitors) are not considered chemotherapy for eligibility purposes. Not targeted cytotoxic agents administered for less than 1 cycle will not be counted as a prior chemotherapy regimen.
8. Participant has documented intracranial and/or extracranial radiological progression or recurrence while on or after the most recent therapy.
9. Participant has an Eastern Cooperative Oncology Group (ECOG) performance status of ≤2
10. Participant has a life expectancy ≥ 12 weeks.
11. Participant has adequate bone marrow and organ function, as defined by the following laboratory values:

1. Absolute neutrophil count (ANC) ≥1.5 × 10\^9/liter (L)
2. Platelets ≥100 × 10\^9/L
3. Hemoglobin ≥9.0 grams (g)/deciliter (dL)
4. Potassium, sodium, calcium (corrected for serum albumin) and magnesium CTCAE Grade ≤1 (if screening assessments are abnormal, these assessments may be repeated up to 2 times; participants may receive appropriate supplementation or treatment prior to reassessment)
5. Creatinine clearance (per Cockcroft-Gault formula) ≥50 mL/minute
6. Serum albumin ≥3.0 g/dL (≥30 g/L)
7. Liver function tests:

In absence of liver metastases, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤3.0 × upper limit of normal (ULN). If the participant has liver metastases, ALT and AST ≤5.0 × ULN.
8. Total serum bilirubin \<1.5 × ULN except for participants with Gilbert's syndrome who may be included if the total serum bilirubin is ≤3.0 × ULN or direct bilirubin ≤ 1.5 × ULN
12. The participant is willing and able to adhere to the study visit schedule and other protocol requirements.

Exclusion Criteria

1. Immediate CNS-specific treatment is likely to be required, per the treating physician's assessment.
2. Participant has imminent organ failure and/or visceral crisis.
3. Participant has leptomeningeal metastases, defined as having positive cerebrospinal fluid (CSF) cytology or unequivocal radiologic and clinical evidence of leptomeningeal involvement. Note: Discrete dural metastases are permitted.
4. Breast cancer treatment-naïve participants (that is, not having received any systemic therapy) in the advanced/metastatic setting.
5. History of pulmonary embolism (PE), cardiovascular accident (CVA), myocardial infarction (MI) in the past 6 months from screening visit.
6. Prior therapy with abemaciclib in the metastatic setting. Note: Use of abemaciclib in the adjuvant setting is allowed if the last treatment administration was more than 12 months prior to first recurrence.
7. Prior therapy with elacestrant or other investigational selective estrogen receptor degraders (SERDs), or investigational alike agents such as selective estrogen receptor modulators (SERMs), selective estrogen receptor covalent antagonists (SERCANs), complete estrogen receptor antagonists (CERANs), and proteolysistargeting chimeras (PROTACs) in the metastatic setting.
8. Participant has a concurrent malignancy or malignancy within 3 years of enrollment, with the exception of adequately treated basal or squamous cell skin cancer, superficial bladder cancer, carcinoma in situ of the cervix, or second primary breast cancer; and any other malignancy that is considered in complete remission by the Investigator(s) that is approved by the Medical Monitor.
9. Currently participating in another breast cancer intervention clinical study. Participants who are being followed for overall survival for another clinical trial with no therapy and study intervention are allowed after the washout period for any prior therapy.
10. Prior anti-cancer or investigational drug treatment within the following windows:

* Fulvestrant treatment (last injection) \<42 days before first dose of study drug
* Any other endocrine therapy \<14 days before first dose of study drug. Note: LHRH agonists should not be counted as endocrine therapy.
* Chemotherapy or other anti-cancer therapy \<14 days before first dose of study drug
* Any investigational anti-cancer drug therapy within \<28 days or \<5 half lives, whichever is shorter
* Bisphosphonates or receptor activator of nuclear factor-κB ligand (RANKL) inhibitors initiated, or dose changed \<1 month prior to first dose of study drug according to institutional guidelines.
11. Radiation therapy (including CNS directed) within 7 days before the first dose of study drug or without a full recovery from radiotherapy acute effects.
12. Uncontrolled significant active infections

* Participants with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection must have undetectable viral load (or detected below the lower limit of quantification) during screening
* Participants known to be human immunodeficiency virus positive (HIV+) are allowed as long as they have undetectable viral load (viral suppression) at baseline.
13. Major surgery within 4 weeks of starting trial therapy.
14. Inability to take oral medication, or history of malabsorption syndrome or any other uncontrolled gastrointestinal condition that may significantly alter the absorption of study drugs.
15. Females of childbearing potential who do not agree to use a highly effective non-hormonal method of contraception and to abstain from donating ova within 28 days of the first dose of study treatment through 120 days after the last dose of study treatment. Highly effective non-hormonal method of contraception includes any of the following:

1. Intrauterine device (non-hormonal)
2. Sexual abstinence
3. Bilateral tubal occlusion/ligation
4. Have a vasectomized partner with confirmed azoospermia.
16. Male participants (including males after a vasectomy) with a pregnant or non-pregnant female of childbearing potential partner who do not agree to use a highly effective barrier contraception method (condoms) within 28 days of the first dose of study treatment until 120 days of the last dose of study treatment. And male participants who do not agree to abstain from freezing or donating sperm within the same period. In addition, female partners of childbearing potential, of male participants (who has not undergone vasectomy) must use highly effective methods of contraception.
17. Females who are pregnant or breastfeeding. Females should not get pregnant during study treatment and for 120 days after last dose of study treatment. Females should not breastfeed during administration of elacestrant and for 1 week after receiving the last dose.
18. Known intolerance to either study drug or any of their excipients.
19. Participants currently receiving or received any of the following medications prior to first dose of trial therapy:

1. Known strong or moderate inducers or inhibitors of cytochrome P450 (CYP) 3A4 (including foods and herbal preparations) within 14 days or \<5 half-lives, whichever is shorter)
2. Herbal preparations/medications (which are not strong or moderate inducers or inhibitors of CYP3A4). These include, but are not limited to, kava, ephedra (ma huang), gingko biloba, dehydroepiandrosterone (DHEA), yohimbe, saw palmetto, and ginseng within 7 days prior to initiating trial therapy
3. Vaccination, including but not limited to vaccination against coronavirus disease-19 (COVID-19), during the 7 days prior to randomization.
20. Any severe medical or psychiatric condition that in the opinion of the investigator(s) would preclude the participant's participation in a clinical study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Stemline Therapeutics, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Providence Medical Foundation

Fullerton, California, United States

Site Status RECRUITING

California Research Institute

Los Angeles, California, United States

Site Status RECRUITING

Carle Cancer Center

Urbana, Illinois, United States

Site Status RECRUITING

Dana-Farber Cancer Institute

Boston, Massachusetts, United States

Site Status RECRUITING

Henry Ford Hospital

Detroit, Michigan, United States

Site Status RECRUITING

Miami Valley Hospital South

Centerville, Ohio, United States

Site Status RECRUITING

Oregon Health & Science University

Portland, Oregon, United States

Site Status COMPLETED

SCRI Oncology Partners

Nashville, Tennessee, United States

Site Status RECRUITING

University of Texas MD Anderson Cancer Center

Houston, Texas, United States

Site Status RECRUITING

UT Health San Antonio University of Texas

San Antonio, Texas, United States

Site Status RECRUITING

Virginia Cancer Institute

Norfolk, Virginia, United States

Site Status RECRUITING

Antwerp University Hospital

Edegem, , Belgium

Site Status RECRUITING

Universitaire Ziekenhuizen Leuven - Campus Gasthuisberg

Leuven, , Belgium

Site Status RECRUITING

Universite Catholique de Louvain (UCL) - Cliniques Universitaires Saint-Luc

Woluwe-Saint-Lambert, , Belgium

Site Status RECRUITING

Institut de Cancerologie de l'Ouest site Paul Papin

Angers, , France

Site Status RECRUITING

Hôpital Morvan - CHRU de Brest - cancérologie et d'hématologie

Brest, , France

Site Status RECRUITING

Centre Francois Baclesse - Oncologie Medicale - Cancerolo

Caen, , France

Site Status RECRUITING

Centre Jean Perrin

Clermont-Ferrand, , France

Site Status RECRUITING

Centre Léon Bérard - Département Oncologie Médicale

Lyon, , France

Site Status RECRUITING

Centre de Cancerologie du Grand Montpellier

Montpellier, , France

Site Status RECRUITING

Hôpital de la Pitiê Salpêtriêre

Paris, , France

Site Status RECRUITING

Centre Hospitalier Universitaire de Poitiers

Poitiers, , France

Site Status RECRUITING

Institut Claudius Regaud

Toulouse, , France

Site Status RECRUITING

Klinikum Bayreuth GmbH

Bayreuth, , Germany

Site Status RECRUITING

Uniklinik Koeln - Klinik und Poliklinik fuer Frauenheilkunde

Cologne, , Germany

Site Status COMPLETED

Universitatsklinikum Carl Gustav Carus

Dresden, , Germany

Site Status RECRUITING

Universitaetsklinikum Duesseldorf

Düsseldorf, , Germany

Site Status RECRUITING

Universitätsklinikum Erlangen

Erlangen, , Germany

Site Status RECRUITING

Medizinische Hochschule Hannover

Hanover, , Germany

Site Status RECRUITING

Universitätsklinikum Leipzig

Leipzig, , Germany

Site Status RECRUITING

Klinikum Worms gGmbH

Worms, , Germany

Site Status RECRUITING

Helios Klinikum Wuppertal

Wuppertal, , Germany

Site Status RECRUITING

National and Capodistrian University of Athens - University General Hospital Attikon

Athens, , Greece

Site Status RECRUITING

Metropolitan Hospital [Oncology]

Piraeus, , Greece

Site Status RECRUITING

EUROMEDICA General Clinic of Thessaloniki

Thessaloniki, , Greece

Site Status COMPLETED

Interbalkan European Medical Center

Thessaloniki, , Greece

Site Status RECRUITING

AOU Ospedali Riuniti Umberto I-G.M.Lancisi -G.Salesi

Ancona, , Italy

Site Status RECRUITING

Istituto di Candiolo, IRCCS

Candiolo, , Italy

Site Status RECRUITING

Istituto Romagnolo per lo Studio dei Tumori Dino Amadori - IRST IRCCS

Meldola, , Italy

Site Status RECRUITING

A. O. Ospedali Riuniti Parpardo, Piemonte, Messina

Messina, , Italy

Site Status RECRUITING

IEO - Istituto Europeo di Oncologia, IRCCS

Milan, , Italy

Site Status RECRUITING

Azienda Ospedaliero-Universitaria di Modena, Policlinico di Modena

Modena, , Italy

Site Status RECRUITING

Ospedale San Gerardo, ASST di Monza, IRCCS

Monza, , Italy

Site Status RECRUITING

Azienda Ospedaliera Universitaria Federico II

Napoli, , Italy

Site Status RECRUITING

Istituto Nazionale dei Tumori - Fondazione Pascale, IRCCS

Napoli, , Italy

Site Status RECRUITING

Istituto Oncologico Veneto IOV - IRCCS

Padua, , Italy

Site Status RECRUITING

IRCCS Policlinico San Matteo, Università degli studi di Pavia, Pavia Fondazione IRCCS Policlinico San Matteo

Pavia, , Italy

Site Status RECRUITING

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Roma, , Italy

Site Status RECRUITING

Azienda Ospedaliera Santa Maria di Terni

Terni, , Italy

Site Status RECRUITING

AOU Città della Salute e della Scienza di Torino, Ospedale Molinette

Torino, , Italy

Site Status RECRUITING

Asan Medical Center

Seoul, , South Korea

Site Status RECRUITING

Gangnam Severance Hospital

Seoul, , South Korea

Site Status RECRUITING

Samsung Medical Center

Seoul, , South Korea

Site Status RECRUITING

Ewha Womans University MokDong Hospital

Seoul, , South Korea

Site Status RECRUITING

Seoul National University Bundang Hospital

Seoul, , South Korea

Site Status RECRUITING

Seoul National University Hospital

Seoul, , South Korea

Site Status RECRUITING

University Hospital Reina Sofía

Córdoba, Andalusia, Spain

Site Status RECRUITING

University Hospital Ramón y Cajal

Madrid, Madrid, Spain

Site Status RECRUITING

University Hospital 12 de Octubre

Madrid, Madrid, Spain

Site Status RECRUITING

Clara Campal Comprehensive Cancer Center (CIOCC)

Madrid, Madrid, Spain

Site Status RECRUITING

University Clinical Hospital Virgen de la Arrixaca

El Palmar, Murcia, Spain

Site Status RECRUITING

Hospital Clinic De Barcelona

Barcelona, , Spain

Site Status RECRUITING

Hospital Universitari Vall D Hebron

Barcelona, , Spain

Site Status RECRUITING

Clinica Universidad de Navarra

Madrid, , Spain

Site Status RECRUITING

Hospital Clínico San Carlos

Madrid, , Spain

Site Status RECRUITING

Hospital Universitario Quirónsalud Madrid

Madrid, , Spain

Site Status RECRUITING

Clinica Universidad de Navarra

Pamplona, , Spain

Site Status RECRUITING

Complexo Hospitalario Universitario De Santiago

Santiago de Compostela, , Spain

Site Status RECRUITING

Fundación Instituto Valenciano De Oncología

Valencia, , Spain

Site Status RECRUITING

Hospital Universitario Virgen del Rocío

Valencia, , Spain

Site Status RECRUITING

Adana Sehir Hastanesi

Adana, , Turkey (Türkiye)

Site Status RECRUITING

Ankara Bilkent Sehir Hastanesi Tibbi Onkoloji Klinigi

Ankara, , Turkey (Türkiye)

Site Status RECRUITING

Ankara University Medical Faculty

Ankara, , Turkey (Türkiye)

Site Status RECRUITING

Dr. Abdurrahman Yurtaslan Ankara Onkoloji Egitim ve Arastirma Hastanesi

Ankara, , Turkey (Türkiye)

Site Status RECRUITING

Gulhane Egitim ve Arastirma Hastanesi Tibbi Onkoloji Klinigi

Ankara, , Turkey (Türkiye)

Site Status RECRUITING

Hacettepe University Medical Faculty

Ankara, , Turkey (Türkiye)

Site Status RECRUITING

Memorial Ankara Hastanesi Tibbi Onkoloji

Ankara, , Turkey (Türkiye)

Site Status RECRUITING

Ege University Medical Faculty

Bornova, , Turkey (Türkiye)

Site Status RECRUITING

Acibadem Altunizade Hospital

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

Medipol Mega Hospital - Medical Oncology

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

Prof. Dr. Suleyman Yalcin Sehir Hastanesi

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

University Hospitals of Leicester NHS Trust -Glenfield Hospital

Leicester, , United Kingdom

Site Status WITHDRAWN

The Clatterbridge Cancer Centre NHS Foundation Trust

Liverpool, , United Kingdom

Site Status WITHDRAWN

Guy's and St Thomas' NHS Foundation Trust

London, , United Kingdom

Site Status RECRUITING

University College London Hospitals NHS Foundation Trust - University College Hospital (UCH) - Macmillan Cancer Centre

London, , United Kingdom

Site Status RECRUITING

The Christie NHS Foundation Trust - Medical Oncology

Manchester, , United Kingdom

Site Status RECRUITING

Countries

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United States Belgium France Germany Greece Italy South Korea Spain Turkey (Türkiye) United Kingdom

Central Contacts

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Stemline Trials

Role: CONTACT

1-877-332-7961

Facility Contacts

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Ellie McDowall

Role: primary

44 207 188 7188 ext. 51783

Ioannis Charalampidis

Role: primary

44 203 447 2929

Zoe Brammer

Role: primary

44 161 446 8347

Role: backup

44 161 918 2352

Other Identifiers

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2024-512878-98-00

Identifier Type: CTIS

Identifier Source: secondary_id

ELA-0121

Identifier Type: -

Identifier Source: org_study_id

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