Evaluating elacestrant for advanced breast cancer in patients without prior CDK4/6 inhibitors
ELACESTRANT in Women and Men With CDK4/6 Inhibitor-Naive Estrogen Receptor Positive, HER-2 Negative Metastatic Breast Cancer: An Open-Label Multicenter Phase 2 Study (ELCIN)
This study is testing a new drug called elacestrant to see if it helps people with advanced breast cancer who haven't used certain previous treatments.
Quick facts
| Phase | Phase 2 |
|---|---|
| Study type | Interventional |
| Enrollment | 60 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Stemline Therapeutics, Inc. Industry-sponsored |
| Drugs / interventions | chemotherapy |
| Locations | 34 sites (Springdale, Arkansas and 33 other locations) |
| Trial ID | NCT05596409 on ClinicalTrials.gov |
What this trial studies
This Phase 2 trial aims to assess the efficacy and safety of elacestrant in patients with estrogen receptor positive (ER+)/HER2- metastatic breast cancer who have not previously received CDK4/6 inhibitors. Participants will undergo a screening phase followed by a treatment phase lasting until disease progression or treatment discontinuation. The study will also include a survival follow-up phase for up to 24 months after the last patient is enrolled, with monitoring for adverse events for 28 days post-treatment.
Who should consider this trial
Good fit: Ideal candidates include men and women aged 18 and older with ER+/HER2- metastatic breast cancer who have received one or two prior hormonal therapies.
Not a fit: Patients who have previously been treated with CDK4/6 inhibitors or those with HER2 positive breast cancer may not benefit from this study.
Why it matters
Potential benefit: If successful, this treatment could provide a new therapeutic option for patients with advanced breast cancer who have not been treated with CDK4/6 inhibitors.
How similar studies have performed: Other studies have shown promise in targeting ER+/HER2- breast cancer, but the specific use of elacestrant in this context is relatively novel.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria:
1. Patient has signed the informed consent before all study specific activities are conducted.
2. Women or men aged ≥18 years (or the minimum age of consent as per local law), at the time of informed consent signature. Female patients may be either postmenopausal or premenopausal/perimenopausal.
1. Premenopausal or perimenopausal women and men must be concurrently given a luteinizing hormone-releasing hormone (LHRH) agonist starting at least 4 weeks before the start of trial therapy and is planning to continue LHRH during the study.
2. For perimenopausal women to be considered of non-childbearing potential, follicle-stimulating hormone (FSH) levels must be \>40 milli-international units per milliliter (mIU/mL).
3. Documentation of histopathologically or cytologically confirmed ER+, HER2-breast cancer, per local laboratory, as per the American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines. Note: In the context of this trial, ER status will be considered positive if ≥10% of tumor cells demonstrate positive nuclear staining by immunohistochemistry.
4. Radiological disease progression during or after the most recent therapy in the advanced/metastatic setting
5. Patient has received at least one (and up to two) prior hormonal therapy in the advanced/metastatic setting.
6. Patients with disease relapse while on adjuvant endocrine therapy after the 2 first years, or with disease relapse within 12 months of completing adjuvant endocrine therapy are allowed (i.e., patients with secondary-resistant breast cancer according to the 5th European School of Oncology (ESO)-European Society for Medical Oncology (ESMO) international consensus guidelines for advanced breast cancer, Cardoso et al 2020). This therapy will be considered as first line treatment for eligibility purposes.
7. At least one measurable lesion as per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 or a mainly lytic bone lesion for bone only disease.
8. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
9. Patient has adequate bone marrow and organ function, as defined by the following laboratory values:
1. Absolute neutrophil count (ANC) ≥1.5 × 10\^9/liter(L)
2. Platelets ≥100 × 10\^9/L
3. Hemoglobin ≥9.0 grams(g)/deciliter(dL)
4. Potassium, sodium, calcium (corrected for serum albumin) and magnesium, Common Terminology Criteria for Adverse Events (CTCAE) v5.0 grade ≤1. Note: Corrected calcium for serum albumin must be calculated manually by the site using the Payne formula: Corrected calcium (milligrams \[mg\]/dL) = measured total calcium (mg/dL) + 0.8 (Normal albumin \[g/dL\] - serum albumin \[g/dL\]), where normal albumin is usually defaulted to 4.0 g/dL.
5. Cockcroft-Gault based creatinine clearance ≥50 milliliters per minute (mL/min). Note: Creatinine clearance (male) = (\[140-age in years\] × weight in kilograms \[kg\])/ (\[serum creatinine in mg/dL\] × 72) Creatinine clearance (female) = (0.85 × \[140-age in years\] × weight in kg)/ (\[serum creatinine in mg/dL\] × 72)
6. Serum albumin ≥3.0 g/dL (≥30 g/L)
7. In absence of liver metastases, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤3.0 × upper limit of normal (ULN). If the patient has liver metastases, ALT and AST ≤5 × ULN
8. If the patient has liver metastases, ALT, and AST ≤5.0 × ULN
9. Total serum bilirubin \<1.5 × ULN except for patients with Gilbert's syndrome who may be included if the total serum bilirubin is ≤3.0 × ULN or direct bilirubin ≤ 1.5 × ULN. Note: Laboratory assessments may be repeated during the Screening Phase after supplementation or transfusions (a single red blood cells transfusion is allowed once during the screening period).
Exclusion Criteria:
1. Active or newly diagnosed central nervous system (CNS) metastases, including meningeal carcinomatosis.
2. Patients with advanced, symptomatic visceral crisis who are at risk of life-threatening complications in the short term, including massive uncontrolled effusions (peritoneal, pleural, pericardial) and liver involvement of \>50%.
3. Prior chemotherapy, elacestrant, or CDK4/6i in the advanced/metastatic setting.
4. Patients with only disease relapse while on the first 2 years of adjuvant endocrine therapy i.e., patients with primary endocrine resistance, are not eligible.
5. Patient has a concurrent malignancy or history of invasive malignancy within 3 years of enrollment, with the exception of basal or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the cervix that has completed curative treatment.
6. Uncontrolled significant active infections.
1. Patients with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection must have undetectable viral load during screening.
2. Patients known to be human immunodeficiency virus (HIV)+ are allowed as long as they have undetectable viral load at baseline.
7. Major surgery within 28 days before starting trial therapy.
8. Systemic radiotherapy within 14 days before starting trial therapy, or central nervous system (CNS) radiotherapy within 28 days before starting trial therapy. Inability to take oral medication, refractory or chronic nausea, gastrointestinal condition (including significant gastric or bowel resection), history of malabsorption syndrome, or any other uncontrolled gastrointestinal condition that may impact the absorption of study drug.
9. Known intolerance to elacestrant or any of its excipients.
10. Females of childbearing potential who do not agree to use a highly effective method of contraception and to abstain from donating/freezing ova within 28 days of the first dose of study treatment through 120 days after the last dose of study treatment. Highly effective non-hormonal methods of contraception should be used.
11. Men who do not agree to abstain from donating/freezing sperm, or to use a highly effective method of contraception within 28 days of the first dose of study treatment through 120 days after the last dose of study treatment. For subjects (who have not undergone vasectomy) with female partners of childbearing potential, the subject and his partner must use highly effective methods of contraception.
12. Females who are pregnant or breastfeeding. Females should not get pregnant during study treatment and for 120 days after last dose of study treatment. Females should not breastfeed during administration of elacestrant and for 1 week after receiving the last dose.
13. Patient is currently receiving or received any of the following medications prior to first dose of trial therapy:
1. Investigational anti-cancer therapy within 14 days (28 days in case of anticancer antibody-based treatments) or 5 half-lives, whichever is shorter.
2. Fulvestrant treatment (last injection) \<42 days before first dose of study drug.
3. Any other endocrine therapy \<14 days before first dose of study drug.
4. Known strong or moderate inducers or inhibitors of cytochrome P450 (CYP) 3A4 within 14 days or 5 half-lives, whichever is shorter.
5. Herbal preparations/medications within 7 days. These include, but are not limited to, St. John's wort, kava, ephedra (ma huang), gingko biloba, dehydroepiandrosterone (DHEA), yohimbe, saw palmetto, and ginseng.
14. Any severe medical or psychiatric condition that in the opinion of the investigator(s) would preclude the patient's participation in a clinical study
Where this trial is running
Springdale, Arkansas and 33 other locations
- Highlands Oncology Group, PA — Springdale, Arkansas, United States (Recruiting)
- OPN Healthcare — Arcadia, California, United States (Recruiting)
- University of Colorado Cancer Center — Aurora, Colorado, United States (Recruiting)
- Morton Plant Hospital - Baycare Health System — Clearwater, Florida, United States (Recruiting)
- Northwestern University, Northwestern Feinberg School of Medicine Prentice Women's Hospital — Chicago, Illinois, United States (Recruiting)
- Inventa Center for Cancer Research at Fort Wayne Medical Oncology and Hematology — Fort Wayne, Indiana, United States (Recruiting)
- Alliance for Multispecialty Research — Merriam, Kansas, United States (Completed)
- Comprehensive Cancer Centers of Nevada — Las Vegas, Nevada, United States (Recruiting)
- The Toledo Clinic — Toledo, Ohio, United States (Completed)
- UT Health San Antonio Mays Cancer Center — San Antonio, Texas, United States (Recruiting)
- Quality Cancer Care Alliance (QCCA) Northwest Medical Specialties — Tacoma, Washington, United States (Recruiting)
- Centro de Pesquisas Clinicas em Oncologia (Center for Clinical Research in Oncology (CPCO)) - Hospital Evangélico de Cachoeiro de Itapemirim — Cachoeiro De Itapemirim, Espirito Santo, Brazil (Recruiting)
- Hospital São Lucas PUCRS - Centro de Pesquisa em Oncologia (CPO) — Porto Alegre, Rio Granda Do Sul, Brazil (Recruiting)
- Hospital de Clinicas de Porto Alegre — Porto Alegre, Rio Granda Do Sul, Brazil (Recruiting)
- Centro de Pesquisas Oncologicas — Florianópolis, Santa Catarina, Brazil (Recruiting)
- Hospital de Amor de Barretos — Barretos, São Paulo, Brazil (Recruiting)
- Centro de Estudos e Pesquisas de Hematologia e Oncologia- CEPHO — Santo Andre, São Paulo, Brazil (Recruiting)
- Centro De Pesquisa Clinica DO Hospital Sirio-Libanes - UNIDADE Brasilia — Brasília, Brazil (Recruiting)
- Clinica de Pesquisas e Centro de Estudos Em Oncologia Ginecologica e Mamaria Ltda — São Paulo, Brazil (Recruiting)
- Complex Oncology Center — Plovdiv, Bulgaria (Recruiting)
- COMPLEX ONCOLOGICAL CENTER - Shumen — Shumen, Bulgaria (Recruiting)
- COC Veliko Tarnovo — Veliko Tarnovo, Bulgaria (Recruiting)
- Cancer Research Centre — Tbilisi, Georgia (Recruiting)
- Innova Medical Center — Tbilisi, Georgia (Recruiting)
- LTD Simon Khechinashvili University Clinic — Tbilisi, Georgia (Recruiting)
- Multiprofile Clinic Consilium Medulla — Tbilisi, Georgia (Recruiting)
- Institute of Clinical Oncology — Tbilisi, Georgia (Recruiting)
- Todua Clinic — Tbilisi, Georgia (Recruiting)
- I CAN Oncology Center, Centro Medico AVE — Monterrey, Nuevo Leon, Mexico (Recruiting)
- Torre Medica Hospital Dalinde — Ciudad de Mexico, Mexico (Recruiting)
- Fucam, Ac. — Ciudad de Mexico, Mexico (Recruiting)
- Unidad Médica Onco-Hematológica — Puebla, Mexico (Recruiting)
- Institutul Oncologic "Prof. Dr. Ion Chiricuta" Cluj Napoca — Cluj Napoca, Cluj, Romania (Recruiting)
- Centrul de Oncologie "Sf. Nectarie" — Craiova, Dolj, Romania (Recruiting)
Study contacts
- Study coordinator: Stemline Trials
- Email: clinicaltrials@menarinistemline.com
- Phone: 1-877-332-7961
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.