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Trial · Interventional

TerminatedPhase 2Results postedRegistry data

Neoadjuvant Study of Palbociclib in Combination With Letrozole and Trastuzumab in Stage II-III ER+ HER2+ Breast Cancer

Short name PALTAN

Overview

Status
Terminated
Phase
Phase 2
Enrollment
26 participants (actual)
Sponsor
Washington University School of Medicine · Other
Design
Allocation not applicable · Open label (no masking)
Countries
1 country

United States

Start
30 Jun 2017
Primary completion
24 Aug 2020
Completion
23 Sept 2020
First posted
20 Sept 2016 (estimated)
Last update posted
29 Sept 2021
Conditions
Breast Cancer · Cancer of Breast · Breast Carcinoma

Timeline

1 trial · 1 stopped early · 1 with posted results

  • Completed
  • Ongoing
  • Not yet recruiting
  • Stopped
  • Estimated dates (est.)
  • Results posted
20172018201920202021
  1. Ph 2

    PALTAN

    NCT02907918

    30 Jun 2017 to 23 Sept 2020

    Terminated

Registry summary

Text and fields below are the sponsor's entries at ClinicalTrials.gov, shown as posted.

The investigators propose to influence estrogen receptor (ER) signaling by combining endocrine therapy with CDK4/6 inhibition along with trastuzumab in ER+/ human epidermal growth factor receptor 2 (HER2)+ early stage breast cancer.

Interventions

  • PalbociclibDrug
  • LetrozoleDrug
  • TrastuzumabBiological
  • GoserelinDrug
  • Breast surgeryProcedure
  • Research tumor biopsyProcedure
  • Research bone marrow (OPTIONAL)Procedure
  • Research blood sampleProcedure
  • Research blood for germline DNAGenetic
  • Blood for detection of circulating tumor cellsProcedure

Arms1

  • Experimental

    Palbociclib + letrozole + trastuzumab +/- goserelin

    * Neoadjuvant palbociclib + letrozole (plus goserelin if premenopausal) + trastuzumab for a total of 16 weeks, consisting of (4) 28-day cycles * Definitive surgery will be performed preferably within 6 weeks after the end of Cycle 4. Letrozole and trastuzumab will continue until the day of surgery. Letrozole will continue to be taken daily and trastuzumab will be given every 3 weeks per standard of care guidelines. Adjuvant therapy following definitive surgery will be at the discretion of the treating physician

Primary outcomes1

Outcomes the sponsor listed as primary.

  1. Number of Participants With Pathologic Complete Response (pCR)

    Time frame · Completion of 4 cycles of treatment (approximately 16 weeks)

    Registry description

    A pathologic complete response (pCR) is defined as no histology evidence of invasive tumor cells in the surgical breast specimen and sentinel or axillary lymph nodes.

Secondary outcomes(2)
  1. Safety and Tolerability of Palbociclib in Combination With Neoadjuvant Letrozole and Trastuzumab (or FDA Approved Biosimilar) as Measured by Number of Participants With Grade 3 & 4 Adverse Events

    Time frame · 30 days after completion of neoadjuvant therapy (approximately 21 weeks)

    Registry description

    -The descriptions and grading scales found in the revised NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 will be utilized for all toxicity reporting.

  2. Change in Patient Reported Outcomes as Measured by NCI PRO-CTCAE

    Time frame · Baseline, cycle 2 day 1 (approximately 29 days), and end of cycle 4 (approximately 16 weeks)

    Registry description

    * Answers ranging from None to Very Severe (none=0 to very severe=4); Not at All to Very Much (not at all=0 to very much=4), Never to Almost Constantly (0=never to almost constantly=4) * PRO-CTCAE responses are scored from 0 to 4, and there are no standardized scoring rules yet established for how to combine attributes into a single score or how best to analyze PRO-CTCAE data longitudinally. * PRO-CTCAE scores for each attribute (frequency, severity and/or interference) will be presented descriptively

Posted results

Values are shown as posted at ClinicalTrials.gov, with their units. PepBank has not converted, pooled or compared them.

Primary outcome results

Primary outcomeCount of participants· Completion of 4 cycles of treatment (approximately 16 weeks)

Number of Participants With Pathologic Complete Response (pCR)

GroupValue (Participants)
Palbociclib + Letrozole + Trastuzumab +/- Goserelin2
Secondary and other outcome results(2)
Secondary outcomeCount of participants· 30 days after completion of neoadjuvant therapy (approximately 21 weeks)

Safety and Tolerability of Palbociclib in Combination With Neoadjuvant Letrozole and Trastuzumab (or FDA Approved Biosimilar) as Measured by Number of Participants With Grade 3 & 4 Adverse Events

GroupValue (Participants)
Palbociclib + Letrozole + Trastuzumab +/- Goserelin13
Secondary outcomeMean· Baseline, cycle 2 day 1 (approximately 29 days), and end of cycle 4 (approximately 16 weeks)

Change in Patient Reported Outcomes as Measured by NCI PRO-CTCAE

GroupValue (score on a scale)Spread
Baseline: Palbociclib + Letrozole + Trastuzumab +/- Goserelin1.34615380.8918434
Cycle 2 Day 1: Palbociclib + Letrozole + Trastuzumab +/- Goserelin1.34615380.6894814
End of Cycle 4: Palbociclib + Letrozole + Trastuzumab +/- Goserelin1.30434780.8756703

Adverse events, as posted

Adverse events as posted: participants affected out of participants at risk, by group
GroupDeathsSerious eventsOther events
Palbociclib + Letrozole + Trastuzumab +/- Goserelin* Neoadjuvant palbociclib + letrozole (plus goserelin if premenopausal) + trastuzumab for a total of 16 weeks, consisting of (4) 28-day cycles * Definitive surgery will be performed preferably within 6 weeks after the end of Cycle 4. Letrozole and trastuzumab will continue until the day of surgery. Letrozole will continue to be taken daily and trastuzumab will be given every 3 weeks per standard of care guidelines. Adjuvant therapy following definitive surgery will be at the discretion of the treating physician0 / 262 / 2626 / 26

Each cell reads participants affected / participants at risk, as the registry posted them.

Registry data comes from ClinicalTrials.gov. Study results come from studies, not from the registry. How PepBank works

Studies0

Studies that cite this trial.

No study cites this trial.

Other registry references

References listed at the registry that are not in PepBank. They link to PubMed.

  • DerivedAdemuyiwa FO, Northfelt DW, O'Connor T, Levine E, Luo J, Tao Y, Hoog J, Laury ML, Summa T, Hammerschmidt T, Guo Z, Frith A, Weilbaecher K, Opyrchal M, Aft R, Clifton K, Suresh R, Bagegni N, Hagemann IS, Iglesia MD, Ma CX. A phase II study of palbociclib plus letrozole plus trastuzumab as neoadjuvant treatment for clinical stages II and III ER+ HER2+ breast cancer (PALTAN). NPJ Breast Cancer. 2023 Jan 6;9(1):1. doi: 10.1038/s41523-022-00504-z. PMID 36609389

Eligibility

Who could join, as posted.

Sex
All
Age
from 18 Years
Healthy volunteers
Not accepted
Inclusion and exclusion criteria, as posted
Inclusion Criteria: * Newly diagnosed clinical stage II or III ER+/HER2+ breast cancer with complete surgical excision of the breast cancer after neoadjuvant therapy as the treatment goal, staging criteria is to be based on AJCC 7. * Tumor size at least 2 cm in one dimension by clinical or radiographic exam (World Health Organization (WHO) criteria). Patients with histologically confirmed palpable lymph nodes may be enrolled regardless of breast tumor size. A palpable mass is not required as long as the mass is at least 2 cm in one dimension by radiographic exam. * At least 18 years of age. * Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1 * Normal bone marrow and organ function as defined below: * Leukocytes ≥ 3,000/mcL * Absolute neutrophil count ≥ 1,500/mcl * Platelets ≥ 100,000/mcl * Total bilirubin ≤ institutional upper limit of normal (IULN) * AST(SGOT)/ALT(SGPT) ≤ 2.5 x IULN * Creatinine ≤ IULN OR creatinine clearance ≥ 60 mL/min/1.73 m\^2 for patients with creatinine levels above institutional normal * Left ventricular ejection fraction (LVEF) ≥ 50% by transthoracic echocardiogram or multigated acquisition scan (MUGA) * Baseline corrected QT interval (QTcF) \< 480 ms * Women of childbearing potential must agree to undergo pregnancy testing within 14 days of study entry and agree to use adequate contraception (barrier method of birth control, abstinence, not hormonal) prior to study entry and for the duration of study participation as well as chemical LHRH Agonist with goserelin. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately. * Ability to understand and willingness to sign an IRB approved written informed consent document (or that of legally authorized representative, if applicable). Exclusion Criteria: * Prior systemic therapy for indexed breast cancer. * Indeterminate or negative HER2 status. * Inflammatory breast cancer. * A history of other malignancy ≤ 5 years from diagnosis of indexed BC with the exception of basal cell or squamous cell carcinoma of the skin treated with local resection only or carcinoma in situ of the cervix. * Currently receiving any other investigational agents or received any within the past 28 days. * Know to be HIV positive. * Known hepatitis B or C infection. * A history of allergic reactions attributed to compounds of similar chemical or biologic composition to palbociclib, letrozole, trastuzumab, any other aromatase inhibitor, any other monoclonal antibody, or other agents used in the study. * Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, or cardiac arrhythmia. * Current use or anticipated need for food or drugs that are known strong CYP3A4 inhibitors (i.e., grapefruit juice, verapamil, ketoconazole, miconazole, itraconazole, posaconazole, erythromycin, clarithromycin, telithromycin, indinavir, saquinavir, ritonavir, nelfinavir, lopinavir, atazanavir, amprenavir, fosamprenavir, nefazodone, diltiazem, and delavirdine) or inducers (i.e. dexamethasone, glucocorticoids, progesterone, rifampin, phenobarbital, St. John's wort). * Any condition that impairs the ability to swallow or absorb oral medication (e.g., gastrointestinal tract disease resulting in an inability to take oral medication or a requirement for IV alimentation, prior surgical procedures affective absorption). * Pregnant and/or breastfeeding. Women of childbearing potential must have a negative pregnancy test within 14 days of study entry.

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