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TerminatedNCT03905343Updated Jun 16, 2021

Ribociclib-endocrine Combination Therapy Versus Chemotherapy as 1st Line in Visceral mBC

A Phase 3 interventional study of Ribociclib and Mono-chemotherapy in Breast Cancer, sponsored by Swiss Cancer Institute. Terminated at 35 sites in 3 countries. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-06-16.

Sponsored by Swiss Cancer Institute · Phase 3, Interventional, and Treatment

Why this study was terminated
Feasibility (low patient accrual and financial reasons)
Phase
Phase 3
Study type
Interventional
Enrollment
25
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

The aim of this trial is to assess if patients treated with the combination of ribociclib and endocrine therapy respond to treatment as fast as patients treated with chemotherapy only, without decreasing their quality of life (QoL).

Read the detailed description

Breast cancer is the most frequent malignancy in women and the leading cause of cancer mortality in most countries in Europe. Metastatic breast cancer remains an incurable disease with a median overall survival (OS) of 2-4 years and a 5-year survival of only 25%. Patients with hormone receptor (HR)-positive breast cancer involving visceral disease at diagnosis have an even worse outcome.

Many oncologists still prefer to treat visceral disease primarily with chemotherapy rather than with endocrine treatment, thinking to receive a faster response with chemotherapy than with endocrine therapy, especially in patients with clinical symptoms or potentially threatening lesions. However, results from cross-sectional clinical practice studies suggest that endocrine therapy is associated with better quality of life, fewer concerns about side effects, less activity impairment and higher treatment satisfaction compared to chemotherapy. In addition, with the new data of CDK4/6 inhibitors combined with endocrine treatment there is an even better efficacy data available compared to endocrine therapy alone.

The aim of this trial is to assess if patients treated with the combination of ribociclib and endocrine therapy respond to treatment as fast as patients treated with chemotherapy only, without decreasing their quality of life (QoL).

02

Conditions studied

  • Breast Cancer

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Keywords

  • breast cancer
  • Visceral metastatic breast cancer
  • Ribociclib
  • Ribociclib-endocrine
03

In context

Breast Neoplasms

12,815 studies on the registry are indexed under Breast Neoplasms; 2,920 are open to participants now.

This study's enrollment of 25 is below the median of 72 across 9,494 interventional studies indexed under Breast Neoplasms.

Browse Breast Neoplasms studies →

Lead sponsor

Swiss Cancer Institute is the lead sponsor of 27 studies on the registry; 12 are 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

  • Written informed consent according to national law and ICH/GCP regulations before registration and prior to any trial specific procedures
  • Histologically or cytologically confirmed diagnosis of HR-positive (ER+ ≥10%), HER2-negative advanced stage breast cancer
  • Measurable visceral disease according to RECIST v1.1. Visceral disease in liver and/or lung. Peritoneal and/or pleural metastases only are accepted, with the condition to be measurable
  • No previous systemic anticancer therapy for metastatic disease allowed
  • Mono-chemotherapy is a reasonable treatment option
  • Patients with a prior malignancy and treated with curative intention are eligible if all treatment of that malignancy was completed at least 2 years before randomization and the patient has no evidence of disease at randomization. Less than 2 years is acceptable for adequately treated cervical carcinoma in situ or localized non-melanoma skin cancer
  • Patients with asymptomatic and stable (treated or untreated) central nervous system (CNS) metastases are eligible, provided they meet the following criteria:

    • ≤ 5 CNS lesions with a maximum diameter of the largest lesion of 10 mm
    • No evidence of progression at registration compared to the latest brain imaging (if applicable)
    • No ongoing requirement for corticosteroids as therapy for CNS disease
  • Baseline QoL and pain questionnaires have been completed within 21 days prior to registration
  • Postmenopausal women (without ovarian function suppression)
  • Age ≥ 18 years
  • WHO performance status 0-2
  • Adequate bone marrow function: neutrophil count ≥ 1.5 x 109/L, platelet count ≥ 100 x 109/L, hemoglobin ≥ 90 g/L
  • Adequate hepatic function: bilirubin ≤ 1.5 x ULN (except for patients with Gilbert's disease ≤ 3.0 x ULN), AST ≤ 2.5 x ULN, AP ≤ 2.5 x ULN
  • Adequate renal function: estimated glomerular filtration rate (eGFR) > 40 mL/min/1.73m2 (according to CKD-EPI or MDRD formula)
  • Patient is able and willing to swallow trial drug as whole tablet

Exclusion criteria

Exclusion Criteria:

  • Visceral crisis (clinical judgment of treating investigator based on the ABC consensus: "visceral crisis is defined as severe organ dysfunction as assessed by signs and symptoms, laboratory studies, and rapid progression of disease. Visceral crisis is not the mere presence of visceral metastases, but implies important visceral compromise leading to a clinical indication for a more rapidly efficacious therapy, particularly since another treatment option at progression will probably not be possible")
  • Symptomatic brain metastases indicative of active disease (defined as new and/or progressive brain metastases at the time of study entry) or leptomeningeal disease
  • Any prior systemic anti-cancer treatment for advanced stage breast cancer
  • Prior treatment with adjuvant CDK4/6 inhibitor
  • Concurrent or recent (within 30 days of randomization) treatment with any other experimental drug. Exception: participation in SAKK 96/12 is allowed
  • Concomitant use of other anti-cancer drugs or radiotherapy, except for local pain control
  • Planned surgery of metastatic sites in the first 12 treatment weeks
  • Severe or uncontrolled cardiovascular disease (congestive heart failure NYHA III or IV), unstable angina pectoris, history of myocardial infarction within the last six months, serious arrhythmias requiring medication (with exception of atrial fibrillation or paroxysmal supraventricular tachycardia)
  • Electrocardiogram (ECG) abnormalities of Q-wave infarction (unless identified ≥ 6 months prior to randomization), or QTc interval >450 msec. The use of concomitant medications with a known significant risk of prolonging the QT interval or inducing Torsades de pointes is not allowed
  • Any concomitant drugs contraindicated for use with the trial drugs according to the approved national product information
  • Known hypersensitivity to trial drug(s) or to any component of the trial drug(s)
  • Any other serious underlying medical, psychiatric, psychological, familial or geographical condition, which in the judgment of the investigator may interfere with the planned staging, treatment and follow-up, affect patient compliance or place the patient at high risk from treatment-related complications
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
25 participants (actual)

Study arms

  • Experimental
    A: endocrine therapy + ribociclib

    Drug: Ribociclib · Other: Endocrine-Therapy

  • Active comparator
    B: mono-chemotherapy

    Other: Mono-chemotherapy

Interventions

  • Ribociclib 600mg p.o. d1-21, q4w in combination with endocrine treatment for 3 years.

  • OtherMono-chemotherapy

    mono-chemotherapy for at least 12 weeks (afterwards, maintenance endocrine therapy ± ribociclib inhibitor is allowed) and up to 3 years.

  • OtherEndocrine-Therapy

    The choice of endocrine therapy is up to the investigator, but the chosen endocrine therapy has to be registered to be used in combination with ribociclib in the investigated indication.

06

What researchers measure

Primary outcomes

  1. Quality of life-adjusted early disease control

    A patient will be counted as a success for this endpoint when during the first 12 weeks \- the response according to RECIST v1.1 is stable disease or better.

    Time frame: at 12 weeks.

  2. Quality of life-adjusted early disease control

    A patient will be counted as a success for this endpoint when during the first 12 weeks \- the QoL according Functional Assessment of Cancer Therapy-Breast Trial Outcome Index \[FACT-B TOI\] score does not worsen by 5 points or more.

    Time frame: at 12 weeks.

Secondary outcomes

  1. Disease Control (DC) at 12 weeks

    A patient will be counted as a success for this endpoint when during the first 12 weeks the response according to RECIST v1.1 is stable disease or better. Patients with missing response assessments within the first 12 weeks will be counted as failure unless there was no progressive disease (PD) documented within the first 12 weeks and the first subsequent assessment also shows no PD

    Time frame: week 6, 12.

  2. Objective response rate (ORR)

    ORR is defined as the proportion of patients having achieved complete response (CR) or partial response (PR) during trial treatment. Response will be evaluated according to RECIST v1.1 criteria.

    Time frame: week 6, 12, then every 12 weeks up to 3 years or end of trial treatment.

  3. Time to objective response (OR)

    Time to OR will be calculated from randomization until first documented CR or PR according to RECIST v1.1 criteria. Time to OR will be calculated for patients having achieved a CR or PR at any time during trial treatment.

    Time frame: week 6, 12, then every 12 weeks up to 3 years or end of trial treatment.

  4. Progression-free survival (PFS)

    PFS is defined as the time from randomization until progression according the RECIST v1.1 criteria or death from any cause, whichever occurs first. Patients not having an event at the time of analysis as well as patients starting a new anti-cancer therapy in the absence of an event will be censored at the date of their last tumor assessment before starting a new anti-cancer treatment, if any.

    Time frame: week 6, 12, then every 12 weeks up to 3 years.

  5. Time to treatment failure (TTF)

    TTF is defined as the time from randomization until stopping of trial treatment from any cause. Patients not having an event at the time of analysis will be censored at the date of their last known date of trial treatment.

    Time frame: week 6, 12, then every 12 weeks up to 3 years.

  6. Overall survival (OS) at 3 years

    OS at 3 years is determined by the Kaplan-Meier estimator for OS at 3 years. OS is defined as time from randomization to death due to any cause. Any patient not known to have died at the time of analysis will be censored based on the last recorded date on which the patient was known to be alive.

    Time frame: week 6, 12, then every 12 weeks up to 3 years.

  7. Changes in overall QoL (FACT-B) until 24 months

    Changes in Functional Assessment of Cancer Therapy-Breast (FACT-B) total score (score range 0-148, higher scores indicate better quality of life)

    Time frame: Changes from baseline to 24 months

  8. Time to QoL deterioration

    Time to QoL deterioration is defined as the duration between baseline and first occurrence of a decrease of ≥ 5 points in the FACT-TOI score.

    Time frame: From baseline to 24 months

  9. Time to QoL improvement

    Time to QoL improvement is defined as the duration between baseline and first occurrence of an increase of ≥ 5 points in the FACT-TOI score.

    Time frame: From baseline to 24 months

  10. Time to pain improvement

    Improvements in pain will be assessed up to 24 months by the item pain severity of the Brief Pain Inventory (BPI), scale range: 0= no pain to 10 = pain as bad as one can imagine.

    Time frame: From baseline to 24 months

  11. Adverse events (AEs)

    All AEs will be assessed according to NCI CTCAE v5.0.

    Time frame: every 4 weeks up to 3 years.

07

Study locations

35 sites
  • Med. Univ. Klinik Graz
    Graz, 8036, Austria
  • Tirol Kliniken - BrustGesundheitZentrum Tirol
    Innsbruck, 6020, Austria
  • Salzburger Landeskliniken - Universitätsklinikum Salzburg
    Salzburg, 5020, Austria
  • Universitätsklinik für Frauenheilkunde
    Vienna, 1090, Austria
  • Algemeen Ziekenhuis Klina
    Brasschaat, 2930, Belgium
  • Grand Hôpital de Charleroi
    Charleroi, 6000, Belgium
  • Jessa Ziekenhuis
    Hasselt, 3500, Belgium
  • CHC Mont Légia
    Liège, 4000, Belgium
  • CHU de Liege
    Liège, 4000, Belgium
  • CHR de la Citadelle
    Liége, 4000, Belgium
  • CHU UCL Namur - Site Sainte Elisabeth
    Namur, 5000, Belgium
  • Clinique-Saint-Pierre
    Ottignies, 1340, Belgium
  • Kantonsspital Baden
    Baden, 5404, Switzerland
  • Kantonsspital Baden
    Baden, CH-5404, Switzerland
  • Universitaetsspital-Basel
    Basel, 4031, Switzerland
  • Brustzentrum Basel - Praxis für ambulante Tumortherapie
    Basel, 4052, Switzerland
  • Istituto Oncologico della Svizzera Italiana - Ospedale Regionale Bellinzona e Valli
    Bellinzona, 6500, Switzerland
  • Inselspital Bern
    Bern, CH-3010, Switzerland
  • Clinique des Grangettes
    Chêne-Bougeries, 1224, Switzerland
  • Kantonsspital Graubuenden
    Chur, CH-7000, Switzerland
  • Hôpital neuchâtelois
    La Chaux-de-Fonds, 2300, Switzerland
  • Centre Hospitalier Universitaire Vaudois
    Lausanne, CH-1011, Switzerland
  • Kantonsspital Liestal
    Liestal, CH-4410, Switzerland
  • Kantonsspital Luzern
    Lucerne, 6000, Switzerland
  • Hirslanden Klinik St. Anna Luzern
    Lucerne, 6006, Switzerland
  • Onkologie Zentrum Spital Männedorf
    Männedorf, 8708, Switzerland
  • Kantonsspital Olten
    Olten, 4600, Switzerland
  • Brustzentrum Ostschweiz
    Sankt Gallen, 9016, Switzerland
  • Kantonsspital - St. Gallen
    Sankt Gallen, CH-9007, Switzerland
  • Hôpital de Sion
    Sion, Switzerland
  • Spital STS AG
    Thun, 3600, Switzerland
  • Kantonsspital Winterthur, Brustzentrum
    Winterthur, 8401, Switzerland
  • Onkologie Bellevue
    Zurich, 8001, Switzerland
  • OnkoZentrum Zürich AG - Klinik im Park
    Zurich, 8038, Switzerland
  • Universitäts Spital Zürich
    Zurich, 8091, Switzerland
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 16, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT03905343
Lead sponsor
Swiss Cancer Institute
Collaborators
The Belgian Society of Medical Oncology
Responsible party
Sponsor
First posted
Apr 5, 2019
Start date
Jun 25, 2019
Primary completion
Apr 15, 2021
Completion
Apr 15, 2021
Last update
Jun 16, 2021

Study contacts

Thomas Ruhstaller, Prof
study chair · Kantonsspital St. Gallen - Breast Center St. Gallen

Oversight

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

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