ClinicalTrials.gg
RecruitingNCT06805812PALMARES-2Updated Feb 3, 2025

Predicting clinicAL outcoMes During First-line CDK4/6 Inhibitors Plus Endocrine Therapy in Patients With Advanced Hormone REceptor-poSitive HER2-negative Breast Cancer: the Retrospective-prospective Multicenter Italian PALMARES-2 Study

An observational study in Breast Adenocarcinoma, Breast Cancer Stage IV and Breast Cancer, Metastatic, sponsored by Fondazione IRCCS Istituto Nazionale dei Tumori, Milano. Recruiting at 24 sites in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-02-03.

Primary conditionBreast Neoplasms, MaleRegistry: Breast NeoplasmsReclassifiedWhy we changed it
Registry
Breast Neoplasms — the first condition term the registry derived for this study.
ClinicalTrials.gg
Breast Neoplasms, Male
Why
  1. The study's listed conditions name Breast Neoplasms, Male, a narrower term within Breast Neoplasms.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Fondazione IRCCS Istituto Nazionale dei Tumori, Milano · Observational

From the registry’s dates

  • Started May 2023; still recruiting 3 years 6 months later.
Study type
Observational
Model
Cohort
Time perspective
Other
Enrollment
3,500
Ages
18 Years and older
Sex
All
01

Study summary

PALMARES-2 is a retrospective/prospective, observational, multicenter, population-based study, aiming at providing real-world evidences on HR+/HER2- aBC patients treated with first-line CDK4/6i plus ET. The present study has the objective to collect data coming from different sources, i.e. RWD, medical images and biological samples, from patients treated with CDK4/6i as first-line of therapy for HR+/HER2- aBC. In consideration of the complexity of data collected and different objectives of the study, this master protocol foresees different sub-studies, which encompasses different methodologies for data collection, data extraction and analyses.

Read the detailed description

The PALMARES-2 study aims to collect data from different sources, i.e. real-world clinical data, medical images and biological data and samples, from patients treated with CDK4/6i as first-line therapy for patients with HR+/HER2- advanced breast cancer. Due to the complexity of the data collected and the different objectives of the study, this protocol includes several sub-studies, which include different methodologies for data collection, extraction and analysis:

  • The first sub-study (RWD sub-study) will aim to collect real-world clinical data of patients who received ET+CDK4/6i in the first-line setting; the primary objective of this sub-study is to assess whether there is a difference in OS between the three CDK4/6i in the real-world population, while secondary objectives include comparisons in specific sub-groups;
  • The second sub-study (Safety sub-study) includes the collection of comorbidities, concomitant medications and toxicities of patients enrolled in the study; the primary objective of this sub-study is to evaluate the difference in severe toxicity between the three CDK4/6i in the real-world population
  • The third sub-study (medical imaging sub-study) consists of the collection of computed tomography (CT) and fluorodeoxyglucose positron emission tomography (FdG-PET) images at baseline and digitised haematoxylin-eosin (HE) slides to build a multi-omics predictive model;
  • The fourth sub-study (translational sub-study) aims to collect tumour samples from a proportion of patients enrolled in the study to perform genomics and transcriptomics analyses; information from this data source will be integrated into the model built with the previous data to further improve the performance of the previous model
  • The fifth sub-study (subsequent lines sub-study) focuses on the lines of treatment administered to patients enrolled in the study at the time of progression after first-line treatment with ET+CDK4/6i, with the aim of building predictive models of response to subsequent lines of treatment, capable of supporting oncologists' and patients' decisions in this context.
02

Conditions studied

  • Breast Adenocarcinoma
  • Breast Cancer Stage IV
  • Breast Cancer, Metastatic
  • Breast Carcinoma
  • Breast Diseases
  • Breast Neoplasms
  • Breast Neoplasms, Male
  • Breast Cancer
  • Breast Cancer With Metastatic Bone Disease
  • Breast Cancers
  • Breast Neoplasm
  • Breast Tumors
  • HR+ HER2- Men, Pre/Postmenopausal Advanced Breast Cancer
  • HR+ Advanced or Metastatic Breast Cancer
  • HR+/HER2- Breast Cancer
  • HRpos Breast Neoplasms
  • HR-positive, HER2-negative Advanced Breast Cancer
  • HR-positive, HER2-negative and PIK3CA Mutation Advanced Breast Cancer
  • HR-positive Breast Cancer
  • Hormone Receptor-Positive Breast Cancer
  • Hormone Receptor Positive Breast Adenocarcinoma
  • Hormone Receptor Positive Breast Carcinoma
  • Hormone Receptor Positive Breast Neoplasms
  • Hormone Receptor Positive HER-2 Negative Breast Cancer
  • Hormone Receptor Positive Malignant Neoplasm of Breast
  • Hormone Receptor Positive Metastatic Breast Cancer
  • Hormone Receptor Positive, HER2 Negative Breast Cancer
  • Hormone Receptor Negative Breast Cancer
  • Hormone Receptor Positive, HER2-negative, Advanced Breast Cancer
  • Hormone Receptor Positive Breast Cancer
  • Hormone Receptor Positive (ER+/PR+, and Her2-) Metastatic Breast Cancer
  • Hormone Receptor Positive, HER2-negative Neoplasms
  • Hormone Receptor Positive, HER2-low Neoplasms
  • Hormone Receptor Positive (HR+), HER2-negative Breast Cancer
  • Hormone Receptor (HR)-Positive Breast Cancer
  • Hormone Receptor-Positive, HER2-Negative Metastatic Breast Cancer
  • Palbociclib
  • Ribociclib
  • Abemaciclib
  • CDK4/6 Inhibitor
  • CDK4/6 Inhibitors

Keywords

  • HR+/HER2- Advanced Breast Cancer
  • HR+/HER2- Metastatic Breast Cancer
  • Palbociclib
  • Ribociclib
  • Abemaciclib
  • CDK4/6i
  • Cyclin-Dependent Kinase 4/6 inhibitors
  • Metastatic Breast Cancer
03

In context

Breast Neoplasms, Male Reclassified

286 studies on the registry are indexed under Breast Neoplasms, Male; 5 are open to participants now.

This study's planned enrollment of 3,500 is above the median of 165 across 28 observational studies indexed under Breast Neoplasms, Male.

Browse Breast Neoplasms, Male studies →

Lead sponsor

Fondazione IRCCS Istituto Nazionale dei Tumori, Milano is the lead sponsor of 172 studies on the registry; 50 are open to participants now.

Compared within Breast Neoplasms, Male, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Breast Neoplasms. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

The study involves the retrospective and prospective collection of consecutive HR+/HER2- advanced Breast Cancer patients (defined as metastatic or locally advanced not candidate for definitive curative intervention) treated with CDK4/6i in combination with endocrine therapy as first-line treatment for advanced disease in different Italian cancer centers.

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

  • Diagnosis of HR+/- advanced Breast Cancer (aBC), as defined as at least 1% estrogen receptor (ER) and/or progesterone receptor (PgR) positivity at IHC. HER2 negativity is defined on the basis of an IHC score of 0, 1+, or 2+ with absence of gene amplification at in situ hybridization (ISH) analyses.
  • Have received or are candidate to receive treatment with palbociclib, ribociclib or abemaciclib in combination with endocrine therapy as treatment for HR+/HER2- aBC.

Exclusion criteria

Exclusion Criteria:

  • Less than 3 months of follow up from the CDK4/6i start to the date of data cut-off;
  • Have received CDK4/6i as monotherapy;
  • Have received CDK4/6i as treatment for localized disease.
Terms in these criteria, in plain language(3)

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.

HER2

HER2 is a protein, made from the ERBB2 gene, that drives the growth of some cancers. A study may look for a level of the protein, extra copies of the gene, or a particular change in it.

In breast cancer, protein tests are read as HER2-positive, HER2-low or HER2-negative; other cancers use their own rules. Check which test result the study requires.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

05

Study design

Observational model
Cohort
Time perspective
Other
Enrollment
3,500 participants (estimated)
Patient registry
No
Biospecimen retention
Samples with dna

Interventions

  • Administered in combination with endocrine therapy

  • Administered in combination with endocrine therapy

  • Administered in combination with endocrine therapy

06

What researchers measure

Primary outcomes

  1. Overall Survival (OS)

    Time frame: From the first-line treatment start to date of any-cause death or last follow up, up to 120 months

Secondary outcomes

  1. Real-world Progression-Free Survival (rwPFS)

    Time frame: From the start of first-line treatment to date of disease progression documented in patient medical charts or death or last follow up, whichever occurs first, up to 120 months

  2. Time To Next Treatment or Death (TTNT-D)

    Time frame: From the start of first-line treatment to date of subsequent therapy start or death or last follow up, whichever occurs first, up to 120 months

  3. Time To Chemotherapy or Death (TTC-D)

    Time frame: From the start of first-line treatment to date of first chemotherapy for advanced disease start or death or last follow up, whichever occurs first, up to 120 months

07

Study locations

24 of 24 sites recruiting
08

References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: Undecided — IPD will be evaluated for submission

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started May 2023 (actual). Primary completion is estimated for Dec 2030, 91 months after the start.

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

Registered
Jan 7, 2025
First posted
Feb 3, 2025
StartActual
May 1, 2023
Primary completionEst.
Dec 31, 2030
CompletionEst.
Dec 31, 2040
Last update
Feb 3, 2025
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 Feb 3, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06805812
Collaborators
European Institute of Oncology, Italy, Humanitas Research Hospital IRCCS, Rozzano-Milan, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, OSPEDALE ASST CREMONA, IOV Oncologico Veneto Padova, ASST Fatebenefratelli Sacco, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy, IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori Meldola, Azienda Ospedaliero-Universitaria di Modena, Azienda Ospedaliero-Universitaria Maggiore della Carità di Novara, A.O.U. Federico II, Napoli, San Raffaele University Hospital, Italy, Centro di Riferimento Oncologico - Aviano, Azienda Socio-Sanitaria Territoriale Lariana, Azienda ULSS 3 Serenissima, Ospedale di Mirano, Azienda Ospedaliero Universitaria Policlinico Umberto I, Roma, Fondazione IRCCS Policlinico San Matteo di Pavia, IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Azienda Ospedaliero-Universitaria Careggi, Humanitas, Istituto Clinico Catanese, Istituto Nazionale Tumori IRCCS - Fondazione G. Pascale, Fondazione Policlinico Universitario Campus Bio-Medico, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
Responsible party
Sponsor
First posted
Feb 3, 2025
Start date
May 1, 2023
Primary completion
Dec 31, 2030 (estimated)
Completion
Dec 31, 2040 (estimated)
Last update
Feb 3, 2025

Study contacts

Claudio Vernieri, M.D., Ph.D.
Contact
claudio.vernieri@istitutotumori.mi.it
+390223903066

Oversight

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

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