Abemaciclib for Molecular Residual Disease Detected by Circulating Tumor DNA in HR+/HER2- Early Breast Cancer

NCT ID: NCT07292207

Last Updated: 2025-12-18

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: PHASE2
• Total Enrollment: 30 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2026-01-10
• Study Completion Date: 2031-08-31

Brief Summary

The goal of this clinical study is to determine whether monitoring ctDNA and treating patients who become ctDNA-positive with abemaciclib can help prevent the recurrence of hormone receptor-positive, HER2-negative breast cancer after curative surgery and standard therapy. The study will also assess the safety of abemaciclib and the medical problems that may occur during treatment. Participants will receive routine follow-up after surgery, undergo regular blood tests to measure ctDNA, and, if ctDNA becomes positive, receive abemaciclib for a defined treatment period with scheduled clinic visits for examinations and safety assessments. Researchers will evaluate recurrence-free survival, distant recurrence-free survival, adverse events, the time between ctDNA positivity and clinical recurrence, and the rate of ctDNA clearance at the end of abemaciclib therapy.

Detailed Description

The purpose of this clinical study is to investigate whether identifying molecular relapse through ctDNA monitoring and initiating abemaciclib treatment at the time of ctDNA positivity can reduce the risk of recurrence in patients with hormone receptor-positive, HER2-negative early breast cancer who have completed curative surgery and standard adjuvant therapy. The study also aims to evaluate the safety profile of abemaciclib in this early-stage setting and to clarify how patients tolerate the treatment over time. Participants will undergo routine postoperative surveillance, including scheduled imaging and laboratory testing, as well as regular blood sampling for ctDNA analysis. When ctDNA becomes detectable, indicating minimal residual disease, participants will begin a predefined course of abemaciclib and attend clinic visits at regular intervals for physical examinations, toxicity assessments, and laboratory monitoring.

In addition to determining whether early intervention with abemaciclib can delay or prevent clinical recurrence, researchers will examine several key outcomes. These include invasive disease-free survival, distant recurrence-free survival, and the incidence of adverse events throughout the treatment period. The study will also measure the "lead time" between ctDNA positivity and radiologic or clinical recurrence, which may provide insight into the biological dynamics of disease relapse. Furthermore, researchers will evaluate ctDNA clearance at the completion of abemaciclib therapy, as ctDNA clearance may serve as an early indicator of treatment efficacy. Collectively, these results are expected to clarify the clinical utility of ctDNA-guided therapy escalation and to inform future strategies for preventing recurrence in early breast cancer.

Conditions

ctDNA Monitoring; Breast Cancer

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Treatment for MRD positive

ctDNA-posotive during adjuvant treatment

Group Type: EXPERIMENTAL

Abemaciclib 150 MG Oral Tablet

Intervention Type: DRUG

Adding abemaciclib for 2-year with endcrine treatment

Interventions

Abemaciclib 150 MG Oral Tablet

Adding abemaciclib for 2-year with endcrine treatment

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Histologically confirmed invasive breast cancer.
• ctDNA-positive after completion of definitive local/systemic therapy.
• Definitive breast surgery performed; axillary node status confirmed.
• HR-positive, HER2-negative disease.
• Tumor and nodal status meet predefined pathological risk criteria.
• ECOG PS 0 - 1.
• No bilateral breast cancer.
• Adequate recovery from prior therapy and acceptable organ function.
• No distant metastasis before registration.
• Appropriate contraception; informed consent obtained.

Exclusion Criteria

• Active second malignancy.
• Prior CDK4/6 inhibitor use.
• Recent major surgery or active infection.
• Uncontrolled hypertension or significant cardiac disease.
• Recent thromboembolic events.
• Interstitial lung disease or active pneumonitis.
• Unrecovered toxicities from prior treatment.
• Active HIV, HBV, or HCV infection.
• Pregnancy or breastfeeding.

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

Sponsors

Tohoku University

OTHER

Sponsor Role: collaborator

Japanese Foundation for Cancer Research

OTHER

Sponsor Role: collaborator

National Cancer Center, Japan

OTHER_GOV

Sponsor Role: collaborator

University of Tsukuba

OTHER

Sponsor Role: collaborator

Gifu University Graduate School of Medicine

OTHER

Sponsor Role: collaborator

Aichi Cancer Center

OTHER

Sponsor Role: collaborator

Nagoya City University

OTHER

Sponsor Role: lead

Responsible Party

Kazuki Nozawa

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Ryuta Asada, PhD

Role: STUDY_DIRECTOR

Nagoya City University

Locations

Nagoya City University

Nagoya, , Japan

Countries

Japan

Central Contacts

Kazuki Nozawa, MD

Role: CONTACT

Phone: +81-52-851-5511

Email: kazuki.nozawa7@gmail.com

Facility Contacts

Kazuki Nozawa, MD

Role: primary

Other Identifiers

NCU-003-Abema

Identifier Type: -

Identifier Source: org_study_id

NCU

Identifier Type: OTHER

Identifier Source: secondary_id