CDK4/6 Inhibitor + Fulvestrant for Breast Cancer

(AIM-BRIGHT Trial)

Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: University of California, San Diego
Must be taking: CDK4/6 inhibitors, Fulvestrant
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if an artificial intelligence model can identify patients with advanced breast cancer who might benefit from a second CDK4/6 inhibitor treatment combined with fulvestrant, after the first treatment proved ineffective. Researchers seek to discover if this combination can slow cancer progression more effectively than other treatments. The trial targets individuals with hormone receptor-positive (HR+) and HER2-negative advanced breast cancer who have experienced cancer progression after at least six months on a prior CDK4/6 inhibitor. Participants will receive either the second CDK4/6 inhibitor (a type of cancer drug) with fulvestrant or a treatment chosen by their doctor, with monthly check-ups. Ideal participants have previously tried a CDK4/6 inhibitor and can access necessary treatments. As a Phase 2 trial, this research focuses on measuring the treatment's effectiveness in an initial, smaller group, offering a chance to contribute to advancing cancer treatment.

Do I have to stop taking my current medications for the trial?

The trial does not specify if you need to stop taking your current medications. However, if you are on any investigational drugs that interact with the trial drugs, you must stop them at least 3 weeks before enrolling. It's best to discuss your current medications with the trial team.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that combining CDK4/6 inhibitors with fulvestrant has been tested in breast cancer patients. One study found that using abemaciclib (a type of CDK4/6 inhibitor) with fulvestrant extended the time patients lived without their cancer worsening. This suggests the combination is effective and generally well-tolerated.

Regarding safety, studies have examined how patients cope with these treatments. No major differences in survival rates have been observed among different CDK4/6 inhibitors, indicating similar safety profiles. Many patients tolerate these drugs well, although some side effects may occur.

In summary, past studies suggest this treatment combination is generally safe, and many patients manage it without serious issues.12345

Why do researchers think this study treatment might be promising for breast cancer?

Researchers are excited about the combination of a new CDK4/6 inhibitor with fulvestrant for breast cancer because it offers a fresh approach after initial treatments. Most current therapies, like other CDK4/6 inhibitors paired with hormone therapies, aim to stop cancer cell growth by targeting specific proteins. This study treatment introduces a different CDK4/6 inhibitor than what patients might have first received, potentially overcoming resistance and offering renewed effectiveness. Additionally, the option to tailor treatment choices to exclude CDK4/6 inhibitors, based on physician discretion, allows for personalized care strategies. This approach could provide new hope and better outcomes for patients who have developed resistance to initial therapies.

What evidence suggests that this trial's treatments could be effective for advanced breast cancer?

In this trial, participants will receive either a second CDK4/6 inhibitor with fulvestrant or a treatment of the physician's choice, excluding CDK4/6 inhibitors. Studies have shown that using a second CDK4/6 inhibitor with fulvestrant, a type of hormonal therapy, can effectively manage advanced breast cancer when the first CDK4/6 treatment stops working. Research indicates that this combination can significantly delay cancer progression, especially in patients whose cancer has spread only to the bones. Patients receiving this combination treatment experienced longer periods before needing additional therapies compared to other treatment options. This suggests that the combination not only helps control cancer but may also be more effective than chemotherapy after the initial CDK4/6 treatment. Overall, this approach highlights the potential benefits of continuing CDK4/6 inhibitors with fulvestrant for patients whose cancer progresses after their initial treatment.678910

Who Is on the Research Team?

KY

Kay Yeung, MD, PhD

Principal Investigator

University of California, San Diego

Are You a Good Fit for This Trial?

This trial is for individuals with advanced breast cancer that's hormone receptor positive (HR+) and HER2-. They must have previously progressed on a CDK4/6 inhibitor. The study uses an AI model to predict who might benefit from a second CDK4/6 inhibitor plus fulvestrant, compared to treatment chosen by their physician.

Inclusion Criteria

Ability to understand and sign the informed consent document
Use of highly effective contraception for participants of reproductive potential
I am older than 18 years.
See 17 more

Exclusion Criteria

I do not have any uncontrolled illnesses.
Life expectancy less than 6 months
Receiving other investigational agents within 3 weeks of study enrollment unless known pharmacokinetic interaction
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a second CDK4/6 inhibitor plus fulvestrant or treatment of physician's choice

6 months
Monthly clinic visits for checkups, tests, and questionnaires

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • A CDK4/6 inhibitor different from the first that the participant had received
Trial Overview The study tests if an AI model can help select patients who will respond better to a rechallenge with a different CDK4/6 inhibitor combined with fulvestrant versus standard therapy. It measures how long it takes for the tumor to worsen and assesses safety of the treatments.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Second CDK4/6 inhibitor plus fulvestrantExperimental Treatment1 Intervention
Group II: Treatment of physician's choiceActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of California, San Diego

Lead Sponsor

Trials
1,215
Recruited
1,593,000+

Citations

First- vs second-line CDK 4/6 inhibitor use for patients with ...Use of CDK4/6i with first-, vs second-, line ET was associated with longer time to receipt of 3rd-line therapy and longer time to receipt of chemotherapy.
Comparative efficacy of first- versus second-line CDK4/6 ...Patients receiving endocrine therapy alone or CDK4/6i after first progression were likely to have had better 1 L outcomes and minimal disease ...
Real-world treatment patterns and effectiveness after ...In the comparative analysis, chemotherapy appeared slightly less effective in CDK4/6i-exposed patients than in CDK4/6i-naive patients, with a ...
Key decision factors in second-line therapy: Expert insights ...This review underscores the importance of a personalized, evidence-based approach to the selection of endocrine-based therapy post-CDK4/6i failure.
Recent progress of CDK4/6 inhibitors' current practice in ...They showed that CDK4/6i plus fulvestrant significantly improved PFS in patients with bone-only metastases (PALOMA-3: HR = 0.43, 95% CI: 0.28– ...
Comparative efficacy and safety of CDK4/6 inhibitors ...This study aims to evaluate the clinical efficacy and safety profiles of various cyclin-dependent kinase 4/6 inhibitors(CDK4/6i) when ...
Comparative long-term outcomes of first-line CDK4/6 ...First-line CDK4/6 inhibitors plus ET was more effective than ET in terms of PFS (median survival time: 27.0 months versus 14.4 months, HR: 0.55, 95%CI 0.51 to ...
Comparative overall survival of CDK4/6 inhibitors in ...There is no statistically significant difference in OS between CDK4/6i despite differing statistical significance levels of individual trials.
Efficacy and safety of first-line CDK4/6 inhibitors plus AI ...There was no statistically significant difference in PFS among the four CDK4/6 inhibitors. Dalpiciclib has the best therapeutic effect in PFS.
advanced breast cancer following progression on a prior ...Conclusions: Abemaciclib + fulvestrant demonstrated statistically significant PFS improvement in pts with ABC progression on prior CDK4/6i- ...
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