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CompletedNCT03447132SAFIAUpdated Mar 10, 2023

Fulvestrant Versus Fulvestrant Plus Palbociclib in Operable Breast Cancer Responding to Fulvestrant

A Phase 3 interventional study of Fulvestrant 500mg and Palbociclib 125mg in Breast Neoplasm Female, sponsored by International Cancer Research Group, United Arab Emirates. Completed at 14 sites in 8 countries. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-03-10.

Sponsored by International Cancer Research Group, United Arab Emirates · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Primary completion was Apr 2021, 5 years 6 months ago, and no results have been posted to the registry.
Phase
Phase 3
Study type
Interventional
Enrollment
354
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

This is a multicenter, international, double-blind randomized Phase III study to evaluate the pathological complete response (pCR) according to Chevalier classification between Fulvestrant® and the combination of Fulvestrant® plus Palbociclib as neoadjuvant therapy of hormone-sensitive patients with operable luminal breast cancer.

Eligible patients will be assessed upfront using the OncotypeDX® molecular test (Recurrence Score \<31).

Read the detailed description

This is a multicenter, international, double-blind, randomized study.

Eligible patients based on inclusion/exclusion criteria will be assessed using OncotypeDX molecular test. Patients with low/intermediate risk (Recurrence Score \<31) will be treated with the induction neoadjuvant Fulvestrant (500 mg (milligram) intra muscular(i.m) at Day 1, 14 and 28 and then every 4 weeks), plus Goserelin (3.6 mg subcutaneous (s.c) every 4 weeks, only for pre and peri-menopausal patients) for 4 months, followed by clinical and radiological assessment of the disease response.

Patients with objective response or stabilization will be randomized and treated for 4 additional months with:

  • Fulvestrant 500 mg i.m every 4 weeks (+ Goserelin 3.6 mg s.c every 4 weeks, only for pre and peri-menopausal patients) and Placebo

or

  • Combination Fulvestrant 500 mg i.m every 4 weeks (+ Goserelin 3.6 mg s.c every 4 weeks, only for pre and peri-menopausal patients) and Palbociclib 125 mg per os daily, 3 weeks on and 1 week off.

Patients with documented progressive disease will be considered at the discretion of the investigator for surgery or neoadjuvant chemotherapy. The preferred chemotherapy protocol will be FEC 100 -Taxotere (5fluorouracil 500mg/m2, Epirubicin 100 mg/m2, cyclophosphamide 500 mg/m2 (FEC) q3 weeks for 3 cycles followed by Docetaxel 100 mg/m2 (T) q 3 weeks for 3 cycles) for a total of 6 cycles with clinical and radiological assessment after each 3 cycles of chemotherapy (CT). Chemotherapy candidates will as well undergo surgery. The expected interval between the cycles will be 21 days, unless the patient has not recovered from toxicity. Specific dose adjustments will be set out in the protocol.

Breast and nodal surgery will be performed at completion of therapy (8 months of hormonal therapy for responding patients and 6 additional cycles of CT for non-responders). The type of surgery will be left at the discretion of the investigators.

Radiation therapy and adjuvant systemic treatment and endocrine therapy will be as well left at the discretion of the investigators.

Patients will be followed every 6 months during 5 years post surgery.

02

Conditions studied

  • Breast Neoplasm Female

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Keywords

  • Breast Cancer
  • Luminal
  • Neoadjuvant
  • pCR
  • Surgery
03

In context

Breast Neoplasms

14,825 studies on the registry are indexed under Breast Neoplasms; 3,319 are open to participants now.

This study's enrollment of 354 is above the median of 72 across 10,896 interventional studies indexed under Breast Neoplasms.

Browse Breast Neoplasms studies →

Lead sponsor

International Cancer Research Group, United Arab Emirates is the lead sponsor of 2 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Written prior to beginning specific protocol procedures including expected cooperation of the patients for the treatment and follow-up must be obtained and documented according to the local regulatory requirements.
  2. Age >18.
  3. women or pre-menopausal (with medical or surgical oophorectomy)
  4. Performance status \< 2 (according to WHO criteria).
  5. confirmed non- breast cancer (Luminal A or B)

    • HR (hormone receptor ) positive (Estrogen or Progesterone)> 1%.
    • Her-2 negative (score 0 or 1 by immunochemistry), FISH (fluorescence in situ hybridization) negative if IHC (immuno-histochemistry) score 2).
  6. Clinical stage II and IIIa.
  7. No previous breast cancer treatment by surgery, radiotherapy, hormone therapy or chemotherapy.
  8. Measurable or evaluable disease.
  9. Hematology:

    • ≥ 1.5 G/L.
    • count ≥ 100 G/L.
    • Leucocyte count > 3.0 G/L.
    • > 9g/dl.
  10. Hepatic function:

    • Total ≤ 1.5 time the Upper Normal Limit (UNL).
    • ASAT ( aspartate transaminase ) ≤ 2.5xUNL.
    • ALAT (alanine aminotransferase) ≤ 2.5xUNL.
    • Alkaline phosphatase ≤ 2.5 time the upper normal limit (UNL).
  11. Renal function:

    • Serum creatinine ≤1.5xUNL (and if Serum creatinine >1.5xUNL, ≥50 mL/min).
    • Creatinine clearance ≥40 mL/min in case of MRI.
  12. Metabolic function:

    • Serum magnesium ≥ lower limit of normal.
    • Serum calcium ≥ lower limit of normal.
  13. No progressive heart disease and no anthracycline (normal ( left ventricular ejection fraction) according to the institution guidelines).
  14. Negative pregnancy test (urine or serum) within 7 days prior to registration for all women of . Patients of childbearing potential must implement adequate non-hormonal measures during study treatment.

Exclusion criteria

Exclusion Criteria:

  1. Male patients.
  2. Her-2 positive tumors or unknown HR/Her-2 status.
  3. Pregnancy or breast-feeding, or plan to become pregnant within 6 months post treatment.
  4. No willingness to use highly effective methods of (per institutional standard) during treatment and for 6 months post treatment.
  5. Any form of breast cancer other than those described in the inclusion criteria, particularly inflammatory and/or overlooked forms (stages IIIb or IV).
  6. Non-measurable tumour.
  7. Bilateral breast cancer.
  8. Previous treatment for breast cancer including surgery for their disease or have had primary axillary dissection, radiotherapy and systemic therapy.
  9. Patient with history of other cancer, except in situ cervical cancer or baso-cellular skin cancer, considered cured.
  10. Patient has another disease, which is deemed incompatible with the inclusion in the protocol.
  11. Heart, kidney, medullary, respiratory or liver failure. cardiovascular disease (including myocardial infarction, unstable angina, symptomatic congestive heart failure, serious uncontrolled cardiac arrhythmia) ≤ 1 year before enrollment in the study.

    • History of interstitial lung disease e.g. pneumonitis or pulmonary fibrosis or evidence of interstitial lung disease at baseline
    • Acute urinary infection, ongoing hemorrhagic cystitis.
  12. Uncontrolled diabetes.
  13. Symptomatic or progressive disorder of the central nervous system (CNS) Peripheral neuropathy > grade 2
  14. Significant psychiatric abnormalities.
  15. History of to studied treatment or
  16. Known previous or ongoing abuse narcotic drug, other medication or alcohol
  17. Any agent within 30 days before initiation of study treatment.
  18. No major surgical procedure within 28 days of initiation of treatment.
  19. Subject unwilling or unable to comply with study requirement.
Terms in these criteria, in plain language(18)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
354 participants (actual)

Study arms

  • Active comparator
    Fulvestrant 500mg + Palbociclib 125mg

    + Goserelin 3.6 mg if pre or peri menopausal patient - duration 4 months

    Drug: Fulvestrant 500mg · Drug: Palbociclib 125mg · Drug: Goserelin 3.6 MG

  • Placebo comparator
    Fulvestrant 500mg + Placebos

    + Goserelin 3.6 mg if pre or peri menopausal patient - duration 4 months

    Drug: Fulvestrant 500mg · Drug: Goserelin 3.6 MG · Drug: Placebos

Interventions

06

What researchers measure

Primary outcomes

  1. pCR according to Le Chevalier's classification

    pathological complete response will be assessed according to Le Chevalier's classification between two arms

    Time frame: up to 5 years after the end of treatment period

Secondary outcomes

  1. pCR according to Sataloff's classification

    pathological complete response will be assessed according to Sataloff's classification between two arms

    Time frame: up to 5 years after the end of treatment period

  2. radiological response

    radiological response according to the WHO criteria (US/Mammography/MRI)

    Time frame: up to 5 years after the end of treatment period

  3. Rate of breast conservative surgery

    Rate of breast conservative surgery will be assessed and compared between two arms

    Time frame: up to 5 years after the end of treatment period

  4. Safety /Tolerability of the combination Fulvestrant + Palbociclib

    Safety and tolerability will be assessed in terms of adverse events (AEs), laboratory data and vital signs. Treatment-related adverse events will be assessed by using CTCAE v4.1 classification

    Time frame: up to 5 years after the end of treatment period

  5. DFS and OS

    Evaluation and comparison of Disease Free Survival (DFS) and Overall Survival (OS) between two arms

    Time frame: up to 5 years after the end of treatment period

07

Study locations

14 sites
  • Center Pierre et Marie Curie
    Algiers, Algeria
  • Cancer Center - Blida
    Blida, Algeria
  • CHU - Oran
    Oran, Algeria
  • University of Alexandria
    Alexandria, Egypt
  • National Cancer Institut (NCI)
    Cairo, Egypt
  • King Hussein Cancer Center (KHCC) - Amman
    Amán, Jordan
  • Hotel Dieu de France
    Beyrouth, Lebanon
  • Hopital Cheikh Khalifa Ibn Zaid
    Casablanca, Morocco
  • Department of Oncology - Institut National d'Oncologie
    Rabat, Morocco
  • King Abdul Aziz Medical City-National Guard Health Affairs (NGHA)
    Riyadh, Saudi Arabia
  • Oncology Center- King Fahad Medical City (KFMC)
    Riyadh, Saudi Arabia
  • Oncology Center- King Saud University Medical City (KSUMC)
    Riyadh, Saudi Arabia
  • Oncologie Medicale de l'Ariana (SOMA)
    Tunis, Tunisia
  • Tawam Hospital
    Al Ain, United Arab Emirates
08

References and documents

Publications

  • Alsaleh K, Al Zahwahry H, Bounedjar A, Oukkal M, Saadeddine A, Mahfouf H, Bouzid K, Bensalem A, Filali T, Abdel-Razeq H, Larbaoui B, Kandil A, Abulkhair O, Al Foheidi M, Ghosn M, Rasool H, Boussen H, Mezlini A, Haddaoui A, Ayari J, Al Ghamdi M, Errihani H, Abdel-Aziz N, Arafah M, Dabouz F, Bahadoor M, Kullab S, Nabholtz JM; King Saud University, Riyadh, Kingdom of Saudi Arabia, and the International Cancer Research Group (ICRG), Sharjah, Unites Arab Emirates. Neoadjuvant endocrine therapy with or without palbociclib in low-risk patients: a phase III randomized double-blind SAFIA trial. J Cancer Res Clin Oncol. 2023 Aug;149(9):6171-6179. doi: 10.1007/s00432-023-04588-3. Epub 2023 Jan 21. PubMed 36680581 ↗

Individual participant data

Plan to share: Yes

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Dec 2017 to primary completion in Apr 2021, 39 months.

Of 328 non-industry phase 3 interventional studies under Breast Neoplasms, half reached primary completion within 79 months of starting (the median), counting those still running; a quarter within 50 and three quarters within 127. This study's 39 months is below that.

Counting every sponsor, half of 600 studies reached it within 59 months; a quarter within 36 and three quarters within 96.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 11, 2018
First posted
Feb 27, 2018
StartActual
Dec 20, 2017
Primary completionActual
Apr 12, 2021
CompletionActual
Jul 20, 2021
Last update
Mar 10, 2023
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Mar 10, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03447132
Lead sponsor
International Cancer Research Group, United Arab Emirates
Responsible party
Sponsor
First posted
Feb 27, 2018
Start date
Dec 20, 2017
Primary completion
Apr 12, 2021
Completion
Jul 20, 2021
Last update
Mar 10, 2023

Study contacts

Jean-Marc Nabholtz, MD
study chair · International Cancer Research Group

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Nov 2018. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Palbociclib

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