About this trial
This is a prospective, multicenter, open-label, single-arm phase II investigator-initiated study designed to evaluate the efficacy and safety of inavolisib in combination with ribociclib and fulvestrant as first-line treatment in Chinese patients with PIK3CA-mutant, hormone receptor-positive (HR+), HER2-negative (HER2-), endocrine-resistant metastatic breast cancer (mBC). Approximately 160 patients will be enrolled at around 16 centers in China.
The study consists of a screening period of up to 28 days, a treatment period, and a post-treatment follow-up period.
PIK3CA mutation status must be determined in blood or tumor tissue using polymerase chain reaction (PCR)-based assays or next-generation sequencing (NGS) performed in a local clinical laboratory. Patients with locally confirmed PIK3CA mutations who meet all eligibility criteria will be enrolled and receive study treatment with inavolisib, ribociclib, and fulvestrant. Details of the treatment regimen are provided in the Study Treatment section. Study treatment will continue until radiologically confirmed disease progression as determined by the investigator, unacceptable toxicity, withdrawal of informed consent, or study termination, whichever occurs first.
Patients must have measurable disease according to RECIST v1.1. Patients with bone-only metastases are not eligible, even if the lesions are considered measurable. Locally advanced disease must be unsuitable for surgical resection or other local treatment with curative intent.
Eligibility criteria
Qualifiers
Signed informed consent form (ICF).
Female, aged ≥18 years at the time of signing the ICF.
Age ≥60 years; OR
Age <60 years with amenorrhea for ≥12 consecutive months in the absence of oral contraceptives, hormone replacement therapy, or gonadotropin-releasing hormone (GnRH) agonists/antagonists, and with follicle-stimulating hormone (FSH) and plasma estradiol levels in the postmenopausal range per local laboratory assessment; OR
Disqualifiers
Metaplastic breast carcinoma.
Any history of leptomeningeal disease or carcinomatous meningitis.
Prior systemic therapy for metastatic breast cancer (mBC).
Prior treatment with fulvestrant or other selective estrogen receptor degraders (SERDs), except neoadjuvant use ≤6 months.
Trial design
Treatments tested in this trial
- Inavolisib + Ribociclib + Fulvestrant
Treatment groups
Locations
Sponsors and collaborators
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Lead sponsor
Hoffmann-La Roche
Collaborator
Novartis
Collaborator