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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03969121
Registration number
NCT03969121
Ethics application status
Date submitted
13/05/2019
Date registered
31/05/2019
Titles & IDs
Public title
Neoadjuvant Hormonal Therapy Plus Palbociclib in Operable, Hormone Sensitive and HER2-Negative Primary Breast Cancer
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Scientific title
A Phase III Randomized, Double-Blind, Neoadjuvant Study of Hormonal Therapy Plus Palbociclib Versus Hormonal Therapy Plus Placebo in Women With Operable, Hormone Sensitive and HER2-Negative Primary Breast Cancer
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Secondary ID [1]
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OOTR-N016/KBCRN-B-003/HT-PAB
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Breast Cancer Female
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Hormone Receptor Positive Malignant Neoplasm of Breast
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Condition category
Condition code
Cancer
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Breast
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Palbociclib
Treatment: Drugs - Endocrine therapy
Active comparator: Placebo + Endocrine therapy - Endocrine therapy for 16 weeks plus placebo
Active comparator: Palbociclib + Endocrine therapy - Endocrine therapy for 16 weeks plus Palbociclib
Treatment: Drugs: Palbociclib
Palbociclib will be administered orally once a day for 21 days every 28-day cycle followed by 7 days off treatment
Treatment: Drugs: Endocrine therapy
Pre- and peri-menopausal women will be receiving Ovarian Function Suppression (OFS) by either leuprorelin subcutaneous 3.75 mg q28days or goserelin subcutaneous 3.6 mg q28days plus tamoxifen 20 mg QD in 28-day cycles. Post-menopausal women will receive letrozole 2.5 mg QD in 28-day cycles.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Pre-operative Endocrine Prognostic Index (PEPI Score)
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Assessment method [1]
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The PEPI score is derived from four factors assigned a numerical score following neoadjuvant endocrine therapy, ( including Ki67 expression in the surgical specimen, pathologic tumor size, lymph node status, and estrogen receptor (ER) level).
The PEPI score is the sum of each component score and shows the risk points for relapse-free survival. PEPI=0 means low risk. PEPI= 1 to 3 means intermediate risk .
PEPI more than 4 means high risk.
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Timepoint [1]
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4 months
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Primary outcome [2]
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EndoPredictâ„¢ EPclin Score
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Assessment method [2]
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EndoPredict is a multigene test used to predict the risk of distant recurrence of early stage, ER positive ,HER-2 Negative invasive breast cancer. EndoPredict Clinical Score (EP clin ) categorizes patinets into low and high risk groups.Combination of the 12-Gene Molecular Score, tumor stage and lymph node status, generating an EPclin Risk Score.The EPclin Risk Score is calculated, according to the model, as:
EPclin Risk Score = (0.35 \* tumor size) + (0.64 \* lymph node status) + (0.28 \* 12-Gene Molecular Score) EPclin Risk Scores from 1.0 through 3.3 shows low risk of recurrencein 10 years.EPclin Risk Scores from 3.4 through 6.0 shows high risk of recurrence in 10 years.
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Timepoint [2]
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4 months
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Secondary outcome [1]
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Clinical Response Rate
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Assessment method [1]
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Observing any reduction in largest tumor diameter on clinical breast examination and ultrasound imaging of breast and axilla after 4 months
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Timepoint [1]
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4 months
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Secondary outcome [2]
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Ki67 change
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Assessment method [2]
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Drop in Ki67 index to less than or equal to 2.7%
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Timepoint [2]
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4 months
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Secondary outcome [3]
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pathological response rate
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Assessment method [3]
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Evaluating the rate of pathological Complete Response based on assessment of surgical specimen
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Timepoint [3]
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4 months
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Secondary outcome [4]
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Breast conserving rate
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Assessment method [4]
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Calculating the rate of breast conserving surgery based on the number of each surgery type
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Timepoint [4]
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4 months
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Secondary outcome [5]
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Number of Participants With Abnormal Laboratory Values and/or Adverse Events That Are Related to Treatment as Assessed by CTCAE v4.03
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Assessment method [5]
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Type, incidence, severity (as graded by National Cancer Institute - Common Terminology Criteria for Adverse Events \[NCI CTCAE\] v4.03), seriousness and relationship to study medications of adverse events (AE) and any laboratory abnormalities
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Timepoint [5]
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4 months
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Eligibility
Key inclusion criteria
1. Pre/peri- or post-menopausal women 18 years and older (or local legal age, whichever is higher)
2. Primary tumor greater than 15 mm in diameter
3. Histologically proven invasive breast cancer
4. Positive hormone receptor (ER and/or PgR =1% in proportion of positive staining score)
5. Negative HER-2 receptor (based on 2018 ASCO/CAP Guideline)
6. Ki67 index equal to or greater than 14% (Ki67 = 14%) by central assessment using actual or virtual slides
7. Eastern Cooperative Oncology Group Performance Status (ECOG PS) = 1
8. No previous history of radiotherapy or systemic therapy including chemotherapy and hormone therapy for breast cancer
9. Laboratory values must be as follows:
Absolute neutrophil count: = 1,500/mm3
Platelets: = 100,000/mm3
Hemoglobin: = 9 g/dL
Bilirubin: = 1.5 × upper limits of normal (ULN)
Serum Creatinine: = 1.5 × ULN
Alkaline phosphatase: = 2 × ULN
AST and ALT: = 2 × ULN
Cardiac function: Normal finding of Electrocardiogram (ECG) QTc = 480 msec (based on the mean value of the triplicate ECGs).
10. Able to give written informed consent form
11. Willingness and ability to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Male
2. Locally advanced breast cancer ( Any T4 or Any N2, N3), or distant metastasis
3. Multicentric breast cancer (Note: Multifocal breast cancer,located in one quadrant/are is eligible)
4. Prior treatment with chemotherapy, radiotherapy and/or endocrine therapy
5. Previous use of SERMs such as raloxifene.
6. Prior therapy with any CDK4/6 inhibitor or with everolimus, or any agent whose mechanism of action is to inhibit the PI3K-mTOR pathway.
7. Prior history of other malignancy within 5 years of study entry, aside from basal cell carcinoma of the skin or carcinoma-in-situ of the uterine cervix
8. Major surgery within 3 weeks of first study treatment
9. Patients treated within the last 7 days prior to randomization with:
* Food or drugs that are known strong and moderate CYP3A4 inhibitors (e.g., amprenavir, aprepitant, atazanavir, boceprevir, casopitant, cimetidine, ciprof-loxacin, clarithromycin, conivaptan, cobicistat, crizotinib, cyclosporine, da-runavir, diltiazem, dronedarone, elvitegravir, erythromycin, fluconazole, fosamprenavir, imatinib, indinavir, isavuconazole, istradefylline, itraconazole,ketoconazole, letermovir, lopinavir, mibefradil, miconazole, nefazodone, nelfinavir, nilotinib, posaconazole, ritonavir, saquinavir, schisandra sphenan-thera extract, telaprevir, telithromycin, tofisopam, verapamil, voriconazole, and grapefruit, grapefruit juice or any product containing grapefruit);
* Drugs that are known strong and moderate CYP3A4 inducers (e.g., bosentan, carbamazepine, efavirenz, etravirine, modafinil, phenobarbital, phenytoin, ri-fampin, rifapentin, and St. John's wort);
10. Any of the following in the previous 6 months of randomization: myocardial in-farction, severe/unstable angina, ongoing cardiac dysrhythmias of NCI CTCAE version 4.03 grade = 2, atrial fibrillation of any grade, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident in-cluding transient ischemic attack, or symptomatic pulmonary embolism
11. Family or personal history of long or short QT syndrome, Brugada syndrome or known history of QTc prolongation, or Torsade de Pointes (TdP).
12. Uncontrolled electrolyte disorders (eg, hypocalcemia, hypokalemia, hypomag-nesemia) that can compound the effects of a QTc-prolonging drug.
13. Active inflammatory bowel disease or chronic diarrhea. Short bowel syndrome. Upper gastrointestinal surgery including gastric resection.
14. Prior hematopoietic stem cell or bone marrow transplantation.
15. Known abnormalities in coagulation such as bleeding diathesis, or treatment with anticoagulants precluding subcutaneous injections of leuprorelin or goserelin.
16. Hepatitis B and/or hepatitis C carriers (Patients with HBsAg+ or HBV-DNA+ who need antiviral treatment during any anti-cancer therapy based on guidelines are excluded even if the patient's hepatic function is normal. Patients with HCVAb+, whose HCV-RNA is positive (+) are excluded.)
17. Known human immunodeficiency virus (HIV) infection
18. Known hypersensitivity to anti-aromatase drugs, tamoxifen or any cell cycle in-hibitor.
19. Patients who are pregnant or lactating. Patients of childbearing potential and/or her partner who are unwilling or unable to use a method of highly effective non-hormonal contraception throughout the study and continue for at least 21 days in patients after the last dose of investigational drug.
20. Other severe acute or chronic medical or psychiatric condition, or laboratory ab-normality that would impart, in the judgment of the investigator, excess risk as-sociated with study participation or study drug administration, or which, in the judgment of the investigator, would make the patient inappropriate for entry into this study
21. Patients who are investigational site staff members or relatives of those site staff OOTR-N016/KBCRN-B-003/HT-PAB Protocol (version 1.2 dated Oct 11, 2018) 24 members or patients who are the sponsor employees directly involved in the con-duct of the trial.
22. Participation in other studies involving investigational drug (s) (Phases 1-4) within 2 weeks before randomization and/or until a visit at 4 weeks (+7 days) after operation.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
16/07/2019
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
23/12/2021
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Sample size
Target
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Accrual to date
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Final
141
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Monash Health - Clayton
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Recruitment hospital [2]
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Peter MacCallum Cancer Centre - Melbourne
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Recruitment postcode(s) [1]
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3168 - Clayton
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Recruitment postcode(s) [2]
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- Melbourne
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Recruitment outside Australia
Country [1]
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Hong Kong
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State/province [1]
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Hong Kong
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Japan
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State/province [2]
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Hyogo
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Country [3]
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Japan
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State/province [3]
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Ibaraki
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Japan
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State/province [4]
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Fukuoka
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Japan
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State/province [5]
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Kagoshima
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Japan
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State/province [6]
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Kobe
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Country [7]
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Japan
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State/province [7]
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Kyoto
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Country [8]
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Japan
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State/province [8]
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Nagoya
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Country [9]
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Japan
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State/province [9]
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Osaka
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Country [10]
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Japan
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State/province [10]
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Saitama
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Japan
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State/province [11]
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Tokyo
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Japan
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State/province [12]
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Yokohama
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Korea, Republic of
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State/province [13]
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Gyeonggi-do
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Korea, Republic of
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State/province [14]
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Seongnam
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Korea, Republic of
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State/province [15]
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Seoul
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Country [16]
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Taiwan
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State/province [16]
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Changhua
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Country [17]
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Taiwan
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State/province [17]
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Kaohsiung
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Country [18]
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Taiwan
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State/province [18]
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Taipei
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Funding & Sponsors
Primary sponsor type
Other
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Name
Kyoto Breast Cancer Research Network
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Address
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Country
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Other collaborator category [1]
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Commercial sector/industry
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Name [1]
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Pfizer
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Address [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
The study is a randomized, double blind, placebo controlled, Phase 3 clinical trial with the primary objective of demonstrating the efficacy of palbociclib in combination with Endocrine therapy over Endocrine therapy alone measured by PEPI and EndoPredictâ„¢ EPclin Score in women with operable HR+, HER2 negative breast cancer . The Clinical Response Rate, drop in Ki67 index = 2.7% and Breast conserving rate will be compared between two arms.
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Trial website
https://clinicaltrials.gov/study/NCT03969121
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Masakazu Toi, MD,PhD
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Address
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Kyoto University, Professor of Breast Surgery Department
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Undecided
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03969121