The primary objective of this study is to evaluate 12 weeks progression-free survival (PFS) rate of Palbociclib plus Letrozole in ER/PR positive endometrioid or high-grade serous ovarian cancer who have disease progression on second-line chemotherapy.
Letrozole (Femara®) is an oral non-steroidal aromatase inhibitor that is approved worldwide for the treatment of postmenopausal women with breast cancer. It is administered orally on a continuous 2.5 mg daily dosing regimen and has a good toxicity profile. Palbociclib (Ibrance®) is an active potent and highly selective reversible inhibitor of cyclin- dependent kinases 4 and 6 (CDK4/6). Palbociclib was approved by the United States Food and Drug Administration (U.S. FDA) and the European Medicines Agency (EMA) for the treatment of postmenopausal women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer in combination with an aromatase inhibitor based on a randomized, double-blind, placebo-controlled, international clinical trial PALOMA-2. It is administered orally on a dose of 125 mg per day in 4-week cycles (3 weeks of treatment followed by 1 week off). This trial was based on preclinical studies that showed a synergistic effect between targeting the ER and cyclin-D-CDK4/6-Rb pathway. The principal toxicity was myelotoxicity but it was managed with appropriate supportive care and dose reductions13. Based on the results of phase 1 and 2 clinical trials of CDK4/6 inhibitors used as monotherapy to treat patients with recurrent ovarian cancer, we hypothesized that, as Palbociclibe is active in this population and many ovarian cancer show ER/PR expression, its combination with Letrozole can improve outcomes in ER/PR positive endometrioid or high-grade serous Ovarian Cancer who have disease progression on second-line chemotherapy, similar to what is seen in breast cancer studies.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
43
The Palbociclib capsules supplied for this study contains 75 mg, 100 mg or 125 mg of Palbociclib. It must be taken orally 125 mg once daily for 21 consecutive days followed by 7 days off treatment (Schedule 3/1) to comprise a complete cycle of 28 days.
Letrozole will be supplied as a 2.5 mg film-coated tablet. It must be taken at the recommended dose of 2.5 mg once daily.
UFMG - Universidade Federal de Minas Gerais
Belo Horizonte, Minas Gerais, Brazil
CPO - Centro de Pesquisa em Oncologia do Hospital São Lucas da PUCRS
Porto Alegre, Rio Grande do Sul, Brazil
INCA - Instituto Nacional de Câncer
Rio de Janeiro, Brazil
ICESP - Instituto do Câncer do Estado de São Paulo
São Paulo, Brazil
Twelve weeks of Progression Free Survival
The primary objective of this study is to evaluate 12 weeks progression-free survival (PFS) rate of Palbociclib plus Letrozole in ER/PR positive endometrioid or high-grade serous ovarian cancer who have disease progression on second-line chemotherapy.
Time frame: 12 weeks
Overall response
defined as the proportion of patients who have a partial or complete response to therapy according to RECIST 1.1
Time frame: 2 years
Overall Survival
Overall Survival at year 1 and 2
Time frame: 2 years
Clinical Benefit Rate
defined as the proportion of patients who have achieved complete response, partial response and stable disease for at least 24 weeks.
Time frame: 2 years
Duration of response
defined as the time from response to progression by RECIST v11.1 or death
Time frame: 2 years
CA-125 response (GCIG criteria)
defined as the proportion of patients who have achieved at least a 50% reduction in CA 125 levels from a pretreatment sample (must be confirmed and maintained for at least 28 days)
Time frame: 2 years
Time to progression by CA-125 (GCIG criteria) or RECIST
defined as the time from response to progression by CA 125 (GCIG criteria) or RECIST
Time frame: 2 years
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BP - A Beneficência Portuguesa de São Paulo
São Paulo, Brazil
Quality of Life (FACT-O questionnaire)
assessed using the FACT-O questionnaire
Time frame: 2 years
Safety (adverse events)
defined as the proportion of patients who present adverse events
Time frame: 2 years