Endocrine Therapy for Breast and Prostate Cancer

LV
LB
Overseen ByLauren Butterfield, MSc
Age: 18+
Sex: Any
Trial Phase: Phase 4
Sponsor: Ottawa Hospital Research Institute
Must be taking: Endocrine therapy, CDK4/6 inhibitors, Androgen inhibitors
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 examines whether the time of day influences the effectiveness of hormone treatments for individuals with metastatic breast or prostate cancer. It compares taking the treatment in the morning versus the evening to determine which timing improves quality of life, tolerance, and effectiveness. Individuals with hormone receptor-positive metastatic breast cancer or castrate-sensitive prostate cancer, who are beginning specific hormone treatments like ARPI (androgen receptor pathway inhibitor) or a CDK4/6 inhibitor, may qualify. Participants must commit to taking their medication at a specific time and completing questionnaires. As a Phase 4 trial, the treatment is already FDA-approved and proven effective, and this research aims to understand how it benefits more patients.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop your current medications. However, you must be planning to start specific cancer treatments as part of the study. It's best to discuss your current medications with the trial team.

What is the safety track record for these treatments?

In earlier studies, CDK4/6 inhibitors for breast cancer have proven safe. Research has found that combining these inhibitors with other treatments, like anti-HER2 therapies, helps control the disease and slows tumor growth in most patients. A review of studies also found that using CDK4/6 inhibitors with certain radiation therapies is safe for patients with metastatic cancer.

For prostate cancer, drugs that block the androgen receptor pathway (ARPI) have undergone extensive study. Research shows that ARPI, when combined with other treatments, significantly improves survival rates compared to standard hormone treatments alone. Studies have consistently shown that patients generally tolerate these treatments well.

Overall, both CDK4/6 inhibitors for breast cancer and ARPI for prostate cancer are generally well-tolerated, with manageable side effects, as reported in clinical trials. This suggests a positive outlook for their safety in ongoing and future studies.12345

Why are researchers enthusiastic about this study treatment?

Researchers are excited about these treatments because they take a novel approach to managing breast and prostate cancers. Unlike standard treatments, which often focus on hormone suppression or chemotherapy, the CDK4/6 inhibitors for breast cancer and ARPI for prostate cancer target specific proteins involved in cancer cell growth. CDK4/6 inhibitors interfere with cancer cell division, potentially slowing down tumor progression more effectively. Meanwhile, ARPI targets androgen receptors in prostate cancer, which could offer a more tailored attack on cancer cells. This targeted strategy might lead to better outcomes with potentially fewer side effects compared to traditional therapies.

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

Research shows that CDK4/6 inhibitors, which participants in the breast cancer cohort of this trial may receive, effectively treat advanced breast cancer. Studies have found that combining these drugs with hormone therapy can extend the period during which the cancer does not grow from 14.4 months to about 27 months. This allows patients longer periods without their cancer worsening.

For advanced prostate cancer, androgen receptor pathway inhibitors (ARPI), which participants in the prostate cancer cohort of this trial may receive, have demonstrated strong results. Initial treatments with ARPI have improved survival rates compared to other therapies. One study found that patients experienced significant drops in prostate-specific antigen levels, which correlated with longer survival and slower disease progression. This makes ARPI a promising option for those with advanced prostate cancer.23567

Who Is on the Research Team?

MS

Marie-France Savard, MD

Principal Investigator

The Ottawa Hospital

AB

Ana-Alicia Beltran-Bless, MD

Principal Investigator

The Ottawa Hospital

Are You a Good Fit for This Trial?

This trial is for individuals with metastatic breast or prostate cancer. Participants will be assigned to take their endocrine therapy either in the morning or evening. The study aims to set up for a larger future trial by testing if the timing of medication affects quality of life, tolerability, and effectiveness.

Inclusion Criteria

Willing and able to complete questionnaires as per study protocol
Able to provide oral consent
Willing and able to complete questionnaires as per study protocol
See 7 more

Exclusion Criteria

I can take endocrine therapy and CDK4/6 inhibitors without any issues.
I am planning to take darolutamide twice a day.
I am planning to take abemaciclib twice a day.
See 2 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive endocrine-based therapy either in the morning or evening based on random group assignment

4 weeks

Follow-up

Participants are monitored for safety, quality of life, and efficacy outcomes

5 years

Long-term follow-up

Participants' overall survival and time to second-line systemic treatment are monitored

6 years

What Are the Treatments Tested in This Trial?

Interventions

  • ARPI
  • CDK4/6 Inhibitor
Trial Overview The REaCT-CHRONO-MetBP Pilot study is testing whether taking CDK4/6 inhibitors (for breast cancer) and ARPIs (for prostate cancer) in the morning versus evening has different impacts on patients' outcomes. It's a randomized pilot study focusing on feasibility for future research.
How Is the Trial Designed?
4Treatment groups
Active Control
Group I: Cohort A, Arm A: Breast Cancer Cohort, Morning GroupActive Control1 Intervention
Group II: Cohort B, Arm B: Prostate Cancer Cohort, Evening GroupActive Control1 Intervention
Group III: Cohort A, Arm B: Breast Cancer Cohort, Evening GroupActive Control1 Intervention
Group IV: Cohort B, Arm A: Prostate Cancer Cohort, Morning GroupActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Ottawa Hospital Research Institute

Lead Sponsor

Trials
585
Recruited
3,283,000+

Citations

Overall survival in patients with metastatic castration ...The results of this study show that compared with abiraterone acetate, initial treatment with apalutamide resulted in better real-world survival ...
Survival benefit associated with first-line androgen receptor ...First-line TI with ARPI showed significantly better survival outcomes compared with ADT alone in patients with de novo mCSPC, validating Level 1 ...
Treatment Patterns and Survival Outcomes Among ...Median overall survival and radiographic progression-free survival from the initiation of index therapy were 15.1 and 7.0 months, respectively.
Saruparib Plus ARPI Shows Promising Efficacy in ...Data from the efficacy-evaluable population showed that objective response rates were 88.5% (23/26) in patients with metastatic castration- ...
Prostate-Specific Antigen Reduction After Androgen ...A deep, rapid PSA reduction within 6 months of initiating an ARPI was associated with longer survival time and delayed progression to castration ...
a systematic review and network meta-analysis - PMCADT combinations consistently demonstrated superior PFS compared to ADT alone (HR, 0.34; 95% CI: 0.27–0.43; I2 = 0%), followed by AAP triplet ( ...
Final overall survival and safety analyses of the phase III ...At the time of the final OS analysis, 299 deaths were reported in 142/234 participants (60.7%) in the 177Lu-PSMA-617 arm and 157/234 (67.1%) in ...
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