Breast Cancer
Conditions
Brief summary
This study will evaluate the efficacy, safety, and pharmacokinetics of inavolisib in combination with palbociclib and fulvestrant compared with placebo plus palbociclib and fulvestrant in participants with PIK3CA-mutant, hormone receptor (HR)-positive, HER2-negative locally advanced or metastatic breast cancer whose disease progressed during treatment or within 12 months of completing adjuvant endocrine therapy and who have not received prior systemic therapy for metastatic disease.
Interventions
Participants will receive oral inavolisib on Days 1-28 of each 28-day cycle.
Participants will receive oral placebo on Days 1-28 of each 28-day cycle.
Participants will receive oral palbociclib on Days 1-21 of each 28-day cycle.
Participants will receive intramuscular (IM) fulvestrant approximately every 4 weeks.
Sponsors
Study design
Eligibility
Inclusion criteria
* Confirmed diagnosis of HR+/HER2- breast cancer * Metastatic or locally advanced disease not amenable to curative therapy * Progression of disease during adjuvant endocrine treatment or within 12 months of completing adjuvant endocrine therapy with an aromatase inhibitor or tamoxifen * Receiving LHRH agonist therapy for at least 2 weeks prior to Day 1 of Cycle 1 if pre/peri-menopausal * Confirmation of biomarker eligibility (detection of specified mutation(s) of PIK3CA via specified test) * Consent to provide fresh or archival tumor tissue specimen * Measurable disease per Response Evaluation Criteria in Solid Tumors, Version 1.1 (RECIST v1.1); evaluable "bone-only" disease is not eligible; "bone-only" disease with at least one measurable, soft-tissue component, even if considered disease that is limited to bone but has lytic or mixed lytic/blastic lesions and at least one measurable soft-tissue component per RECIST v1.1 may be eligible * Eastern Cooperative Oncology Group Performance Status of 0 or 1 * Life expectancy of \> 6 months * Adequate hematologic and organ function within 14 days prior to initiation of study treatment
Exclusion criteria
* Metaplastic breast cancer * Any history of leptomeningeal disease or carcinomatous meningitis * Any prior systemic therapy for metastatic breast cancer * Prior treatment with fulvestrant or any selective estrogen-receptor degrader, with the exception of participants that have received fulvestrant or any selective estrogen-receptor degrader as part of neoadjuvant therapy only and with treatment duration of no longer than 6 months * Prior treatment with any PI3K, AKT, or mTOR inhibitor, or any agent whose mechanism of action is to inhibit the PI3K-AKT-mTOR pathway * Type 2 diabetes requiring ongoing systemic treatment at the time of study entry; or any history of Type 1 diabetes * Known and untreated, or active CNS metastases. Patients with a history of treated CNS metastases may be eligible * Active inflammatory or infectious conditions in either eye, or any eye conditions expected to require surgery during the study treatment period * Symptomatic active lung disease, or requiring daily supplemental oxygen * History of inflammatory bowel disease or active bowel inflammation * Anti-cancer therapy within 2 weeks before study entry * Investigational drug(s) within 4 weeks before randomization * Prior radiotherapy to \>= 25% of bone marrow, or hematopoietic stem cell or bone marrow transplantation * Chronic corticosteroid therapy or immunosuppressants * Pregnant, lactating, or breastfeeding, or intending to become pregnant during the study or within 2 weeks after the final dose of study treatment * Major surgical procedure, or significant traumatic injury, within 28 days prior to Day 1 of Cycle 1
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Progression-Free Survival (PFS) | Up to 3.7 years | PFS was defined as the time from randomization to the first occurrence of disease progression, as determined by the investigator according to Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1 or death from any cause (whichever occurs first). Progressive disease (PD) was defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum in the study, including baseline, in addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 millimeter (mm). The appearance of one or more new lesions was also considered progression. Data for participants without the occurrence of PD or death as of the clinical cutoff date (CCOD) were censored at the time of the last tumor assessment prior to the CCOD. Median PFS was calculated using the Kaplan-Meier methodology. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Objective Response Rate (ORR) | Up to approximately 6 years | ORR is defined as the percentage of participants with a complete response (CR) and/or partial response (PR) on at least two consecutive occasions ≥ 4 weeks apart, as determined by the investigator according to RECIST v1.1. CR is defined as the disappearance of all target lesions or any pathological lymph nodes (whether target or non-target) having a reduction in short axis to \<10 mm. PR is defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the smallest sum in the study (nadir), including baseline. |
| Percentage of Participants With Best Overall Response Rate (BOR) | Up to approximately 6 years | BOR is defined as the percentage of participants with a CR or PR, as determined by the investigator according to RECIST v1.1. CR is defined as the disappearance of all target lesions or any pathological lymph nodes (whether target or non-target) having a reduction in short axis to \<10 mm. PR is defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the smallest sum in the study (nadir), including baseline. |
| Duration of Response (DOR) | Up to approximately 6 years | DOR is defined as the time from the first occurrence of a CR or PR to the first occurrence of disease progression as determined by the investigator according to RECIST v1.1, or death from any cause (whichever occurs first). CR is defined as the disappearance of all target lesions or any pathological lymph nodes (whether target or non-target) having a reduction in short axis to \<10 mm. PR is defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the smallest sum in the study (nadir), including baseline. PD is defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum in the study, including baseline, in addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered progression. |
| Percentage of Participants With Clinical Benefit Rate (CBR) | Up to approximately 6 years | CBR is defined as the percentage of participants with a CR, PR, and/or stable disease (SD) for at least 24 weeks, as determined by the investigator according to RECIST v1.1. CR= disappearance of all target lesions or any pathological lymph nodes (whether target or non-target) having a reduction in short axis to \<10 mm. PR=at least a 30% decrease in the sum of diameters of target lesions, taking as reference the smallest sum in the study (nadir), including baseline. PD=at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum in the study (nadir), including baseline. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered progression. SD=neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum in the study. |
| Overall Survival (OS) | Up to approximately 6 years | OS is defined as the time from randomization to death from any cause. |
| Time to Deterioration (TTD) in Pain | From randomization to first documentation of a ≥ 2-point increase (Up to approximately 6 years) | TTD in pain is defined as the time from randomization to the first documentation of a ≥ 2-point increase from baseline on the "worst pain" item from the Brief Pain Inventory-Short Form (BPI-SF). BPI-SF is a self-administered questionnaire in which the participant was asked to rate severity on a 10-point scale where 0 represents 'No pain/No interference' and 10 represents 'Pain/Interference as bad as you can imagine'. A ≥2-point change is defined as clinically meaningful difference. |
| TTD in Physical Function (PF) | Treatment: Day 1 of Cycles 1-3, then Day 1 of every other cycle until treatment discontinuation. Post-treatment: Every 8 weeks for 2 years, then every 12 weeks thereafter, to end of study (up to 6 years) (Cycle length = 28 days)] | TTD in physical function is defined as the time from randomization to the first documentation of a ≥ 10-point decrease from baseline held for two consecutive cycles or initial decrease followed by death or treatment discontinuation within three weeks of last assessment in the European Organisation for Research and Treatment of Cancer Quality of Life-Core 30 Questionnaire (EORTC QLQ-C30) PF scale (items 1-5). A ≥10-point change is defined as a clinically meaningful difference. EORTC QLQ-C30 is a cancer-specific health-related quality-of life (QoL) questionnaire with 30 questions. For the PF scale, participant responses to 5 questions about daily activities (strenuous activities, long walks, short walks, bed/chair rest \& needing help with eating, dressing, washing themselves, or using the toilet) is scored on a 4-point scale (1=Not at All to 4=Very Much). Scores are linearly transformed on a scale of 0 to 100, with a high score indicating worst functioning. |
| TTD in Role Function (RF) | Treatment: Day 1 of Cycles 1-3, then Day 1 of every other cycle until treatment discontinuation. Post-treatment: Every 8 weeks for 2 years, then every 12 weeks thereafter, to end of study (up to 6 years) (Cycle length = 28 days)] | TTD in Role Function is defined as the time from randomization to the first documentation of a ≥ 10-point decrease from baseline held for two consecutive cycles, or initial decrease followed by death or treatment discontinuation within three weeks of last assessment in the EORTC QLQ-C30 RF scale (items 6 and 7). A ≥10-point change is defined as clinically meaningful difference. EORTC QLQ-C30 is a cancer specific health-related QoL questionnaire. For the role functioning scale, participant responses to the 2 questions "Q6: Were you limited in doing either your work or daily activities" and "Q7: Were you limited in pursuing your hobbies or other leisure time activities" were scored on a 4-point scale (1=Not at All to 4=Very Much). The scores were linearly transformed on a scale of 0 to 100, with a low score indicating better functioning. |
| TTD in Global Health Status (GHS) | Treatment: Day 1 of Cycles 1-3, then Day 1 of every other cycle until treatment discontinuation. Post-treatment: Every 8 weeks for 2 years, then every 12 weeks thereafter, to end of study (up to 6 years) (Cycle length = 28 days)] | TTD in (GHS)/health-related quality of life (HRQoL) is defined as the time from randomization to the first documentation of a ≥ 10-point decrease from baseline held for two consecutive cycles, or initial decrease followed by death or treatment discontinuation within three weeks of last assessment in the EORTC QLQ-30 GHS/HRQoL scale. A ≥10-point change is defined as clinically meaningful difference. EORTC QLQ-C30 is a cancer specific health-related QoL questionnaire. Participant responses to the questions regarding Global Health Status (Q29: GHS; "How would you rate your overall health during the past week?") and Quality of Life (Q30: QoL; "How would you rate your overall quality of life during the past week?") are scored on a 7-point scale (1= Very poor to 7=Excellent). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher score indicates a better outcome. |
| Number of Participants With Adverse Events (AEs) | Up to approximately 6 years | An AE is an untoward medical occurrence in participant administered a pharmaceutical product \& regardless of causal relationship with this treatment. An AE can therefore be any unfavorable \& unintended sign (including an abnormal laboratory finding), symptom/disease temporally associated with use of investigational product, whether or not considered related to investigational product. |
| Plasma Concentration of Inavolisib | Predose on Cycle 1 Days 1, 8 and 15 and Cycle 2 Day 15; 3 hours post-dose on Cycle 1 Days 1 and 15 (Cycle length = 28 days) | — |
| Plasma Concentration of Palbociclib | Predose on Cycle 1 Days 1, 8 and 15 and Cycle 2 Day 15; 3 hours post-dose on Cycle 1 Days 1 and 15 (Cycle length = 28 days) | — |
| Plasma Concentration of Fulvestrant | Predose on Cycle 1 Days 1, 8 and 15 and Cycle 2 Day 15; 3 hours post-dose on Cycle 1 Days 1 and 15 (Cycle length = 28 days) | — |
Countries
Argentina, Australia, Belgium, Brazil, Canada, China, Denmark, France, Georgia, Germany, Greece, Hong Kong, Hungary, Italy, Malaysia, New Zealand, Poland, Portugal, Russia, Singapore, South Korea, Spain, Taiwan, Thailand, Turkey (Türkiye), Ukraine, United Kingdom, United States
Contacts
Hoffmann-La Roche
Participant flow
Recruitment details
Participants took part in the study across 123 investigative centers in 28 countries. This study is still ongoing.
Pre-assignment details
A total of 325 participants with phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit, alpha isoform (PIK3CA) mutation, hormone receptor-positive, human epidermal growth factor receptor 2 negative (HER2-) locally advanced or metastatic breast cancer were randomized in 1:1 ratio to Inavolisib+ Palbociclib + Fulvestrant (Inavo+Palbo+Fulv) arm or Placebo + Palbociclib + Fulvestrant (Pbo+Palbo+Fulv) arm in this study.
Participants by arm
| Arm | Count |
|---|---|
| Inavo+Palbo+Fulv Participants received inavolisib, 9 mg, orally, QD on Days 1-28 of each 28 day cycle along with palbociclib 125 mg, orally, QD on Days 1-21 and fulvestrant, 500 mg, IM injections on Days 1 and 15 of Cycle 1 and then on Day 1 of each subsequent 28 day cycle until unequivocal disease progression, unacceptable toxicity, participant withdrawal of consent, or study termination. | 161 |
| Pbo+Palbo+Fulv Participants received placebo, orally, QD on Days 1-28 of each 28 day cycle along with palbociclib 125 mg, orally, QD on Days 1-21 and fulvestrant, 500 mg, IM injections on Days 1 and 15 of Cycle 1 and then of Day 1 of each subsequent 28 day cycle until unequivocal disease progression, unacceptable toxicity, participant withdrawal of consent, or study termination. | 164 |
| Total | 325 |
Baseline characteristics
| Characteristic | Pbo+Palbo+Fulv | Total | Inavo+Palbo+Fulv |
|---|---|---|---|
| Age, Continuous | 54.1 years STANDARD_DEVIATION 11.2 | 54.0 years STANDARD_DEVIATION 11.1 | 53.8 years STANDARD_DEVIATION 10.9 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 10 Participants | 20 Participants | 10 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 149 Participants | 294 Participants | 145 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 5 Participants | 11 Participants | 6 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 63 Participants | 124 Participants | 61 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants | 2 Participants | 1 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 3 Participants | 8 Participants | 5 Participants |
| Race (NIH/OMB) White | 97 Participants | 191 Participants | 94 Participants |
| Sex: Female, Male Female | 163 Participants | 319 Participants | 156 Participants |
| Sex: Female, Male Male | 1 Participants | 6 Participants | 5 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 43 / 162 | 54 / 162 |
| other Total, other adverse events | 157 / 162 | 158 / 162 |
| serious Total, serious adverse events | 39 / 162 | 17 / 162 |
Outcome results
Progression-Free Survival (PFS)
PFS was defined as the time from randomization to the first occurrence of disease progression, as determined by the investigator according to Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1 or death from any cause (whichever occurs first). Progressive disease (PD) was defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum in the study, including baseline, in addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 millimeter (mm). The appearance of one or more new lesions was also considered progression. Data for participants without the occurrence of PD or death as of the clinical cutoff date (CCOD) were censored at the time of the last tumor assessment prior to the CCOD. Median PFS was calculated using the Kaplan-Meier methodology.
Time frame: Up to 3.7 years
Population: FAS included all participants who were randomized to receive the treatment they were assigned.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inavo+Palbo+Fulv | Progression-Free Survival (PFS) | 15 months |
| Pbo+Palbo+Fulv | Progression-Free Survival (PFS) | 7.3 months |
Duration of Response (DOR)
DOR is defined as the time from the first occurrence of a CR or PR to the first occurrence of disease progression as determined by the investigator according to RECIST v1.1, or death from any cause (whichever occurs first). CR is defined as the disappearance of all target lesions or any pathological lymph nodes (whether target or non-target) having a reduction in short axis to \<10 mm. PR is defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the smallest sum in the study (nadir), including baseline. PD is defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum in the study, including baseline, in addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered progression.
Time frame: Up to approximately 6 years
Number of Participants With Adverse Events (AEs)
An AE is an untoward medical occurrence in participant administered a pharmaceutical product & regardless of causal relationship with this treatment. An AE can therefore be any unfavorable & unintended sign (including an abnormal laboratory finding), symptom/disease temporally associated with use of investigational product, whether or not considered related to investigational product.
Time frame: Up to approximately 6 years
Overall Survival (OS)
OS is defined as the time from randomization to death from any cause.
Time frame: Up to approximately 6 years
Percentage of Participants With Best Overall Response Rate (BOR)
BOR is defined as the percentage of participants with a CR or PR, as determined by the investigator according to RECIST v1.1. CR is defined as the disappearance of all target lesions or any pathological lymph nodes (whether target or non-target) having a reduction in short axis to \<10 mm. PR is defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the smallest sum in the study (nadir), including baseline.
Time frame: Up to approximately 6 years
Percentage of Participants With Clinical Benefit Rate (CBR)
CBR is defined as the percentage of participants with a CR, PR, and/or stable disease (SD) for at least 24 weeks, as determined by the investigator according to RECIST v1.1. CR= disappearance of all target lesions or any pathological lymph nodes (whether target or non-target) having a reduction in short axis to \<10 mm. PR=at least a 30% decrease in the sum of diameters of target lesions, taking as reference the smallest sum in the study (nadir), including baseline. PD=at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum in the study (nadir), including baseline. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered progression. SD=neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum in the study.
Time frame: Up to approximately 6 years
Percentage of Participants With Objective Response Rate (ORR)
ORR is defined as the percentage of participants with a complete response (CR) and/or partial response (PR) on at least two consecutive occasions ≥ 4 weeks apart, as determined by the investigator according to RECIST v1.1. CR is defined as the disappearance of all target lesions or any pathological lymph nodes (whether target or non-target) having a reduction in short axis to \<10 mm. PR is defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the smallest sum in the study (nadir), including baseline.
Time frame: Up to approximately 6 years
Plasma Concentration of Fulvestrant
Time frame: Predose on Cycle 1 Days 1, 8 and 15 and Cycle 2 Day 15; 3 hours post-dose on Cycle 1 Days 1 and 15 (Cycle length = 28 days)
Population: PK evaluable population included all participants who received at least one dose of study drug, had at least one post-baseline sample, and was based on the treatment participants actually received. Overall number analyzed is the number of participants with data available for analysis. Number analyzed is the number of participants with data available for analysis at the specified timepoint.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Inavo+Palbo+Fulv | Plasma Concentration of Fulvestrant | Predose, Cycle 1 Day 15 | 11.9 ng/ml | Geometric Coefficient of Variation 37 |
| Inavo+Palbo+Fulv | Plasma Concentration of Fulvestrant | Predose, Cycle 1 Day 1 | NA ng/ml | — |
| Inavo+Palbo+Fulv | Plasma Concentration of Fulvestrant | 3 hours Post-dose, Cycle 1 Day 15 | 12.2 ng/ml | Geometric Coefficient of Variation 44 |
| Inavo+Palbo+Fulv | Plasma Concentration of Fulvestrant | Predose, Cycle 1 Day 8 | 17.5 ng/ml | Geometric Coefficient of Variation 46 |
| Inavo+Palbo+Fulv | Plasma Concentration of Fulvestrant | Predose, Cycle 2 Day 15 | 18.0 ng/ml | Geometric Coefficient of Variation 37 |
| Inavo+Palbo+Fulv | Plasma Concentration of Fulvestrant | 3 hours Post-dose, Cycle 1 Day 1 | 1.03 ng/ml | Geometric Coefficient of Variation 200 |
| Pbo+Palbo+Fulv | Plasma Concentration of Fulvestrant | Predose, Cycle 2 Day 15 | 17.3 ng/ml | Geometric Coefficient of Variation 37 |
| Pbo+Palbo+Fulv | Plasma Concentration of Fulvestrant | 3 hours Post-dose, Cycle 1 Day 1 | 0.815 ng/ml | Geometric Coefficient of Variation 200 |
| Pbo+Palbo+Fulv | Plasma Concentration of Fulvestrant | Predose, Cycle 1 Day 8 | 16.2 ng/ml | Geometric Coefficient of Variation 46 |
| Pbo+Palbo+Fulv | Plasma Concentration of Fulvestrant | Predose, Cycle 1 Day 15 | 10.9 ng/ml | Geometric Coefficient of Variation 42 |
| Pbo+Palbo+Fulv | Plasma Concentration of Fulvestrant | 3 hours Post-dose, Cycle 1 Day 15 | 11.1 ng/ml | Geometric Coefficient of Variation 43 |
| Pbo+Palbo+Fulv | Plasma Concentration of Fulvestrant | Predose, Cycle 1 Day 1 | NA ng/ml | — |
Plasma Concentration of Inavolisib
Time frame: Predose on Cycle 1 Days 1, 8 and 15 and Cycle 2 Day 15; 3 hours post-dose on Cycle 1 Days 1 and 15 (Cycle length = 28 days)
Population: Pharmacokinetic (PK) evaluable population included all participants who received at least one dose of study drug, had at least one post-baseline sample, and was based on the treatment participants actually received. Overall number analyzed is the number of participants with data available for analysis. Number analyzed is the number of participants with data available for analysis at the specified timepoint.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Inavo+Palbo+Fulv | Plasma Concentration of Inavolisib | Predose, Cycle 1 Day 1 | NA nanogram/milliliter (ng/ml) | — |
| Inavo+Palbo+Fulv | Plasma Concentration of Inavolisib | 3 hours Post-dose, Cycle 1 Day 1 | 36 nanogram/milliliter (ng/ml) | Geometric Coefficient of Variation 223 |
| Inavo+Palbo+Fulv | Plasma Concentration of Inavolisib | Predose, Cycle 1 Day 8 | 17.8 nanogram/milliliter (ng/ml) | Geometric Coefficient of Variation 134 |
| Inavo+Palbo+Fulv | Plasma Concentration of Inavolisib | Predose, Cycle 1 Day 15 | 13.6 nanogram/milliliter (ng/ml) | Geometric Coefficient of Variation 240 |
| Inavo+Palbo+Fulv | Plasma Concentration of Inavolisib | 3 hours Post-dose, Cycle 1 Day 15 | 59.2 nanogram/milliliter (ng/ml) | Geometric Coefficient of Variation 119 |
| Inavo+Palbo+Fulv | Plasma Concentration of Inavolisib | Predose, Cycle 2 Day 15 | 16.9 nanogram/milliliter (ng/ml) | Geometric Coefficient of Variation 124 |
Plasma Concentration of Palbociclib
Time frame: Predose on Cycle 1 Days 1, 8 and 15 and Cycle 2 Day 15; 3 hours post-dose on Cycle 1 Days 1 and 15 (Cycle length = 28 days)
Population: PK evaluable population included all participants who received at least one dose of study drug, had at least one post-baseline sample, and was based on the treatment participants actually received. Overall number analyzed is the number of participants with data available for analysis. Number analyzed is the number of participants with data available for analysis at the specified timepoint.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Inavo+Palbo+Fulv | Plasma Concentration of Palbociclib | Predose, Cycle 1 Day 1 | NA ng/ml | — |
| Inavo+Palbo+Fulv | Plasma Concentration of Palbociclib | 3 hours Post-dose, Cycle 1 Day 1 | 20.7 ng/ml | Geometric Coefficient of Variation 182 |
| Inavo+Palbo+Fulv | Plasma Concentration of Palbociclib | Predose, Cycle 1 Day 8 | 73.9 ng/ml | Geometric Coefficient of Variation 56 |
| Inavo+Palbo+Fulv | Plasma Concentration of Palbociclib | Predose, Cycle 1 Day 15 | 69.9 ng/ml | Geometric Coefficient of Variation 78 |
| Inavo+Palbo+Fulv | Plasma Concentration of Palbociclib | 3 hours Post-dose, Cycle 1 Day 15 | 96.7 ng/ml | Geometric Coefficient of Variation 55 |
| Inavo+Palbo+Fulv | Plasma Concentration of Palbociclib | Predose, Cycle 2 Day 15 | 58.5 ng/ml | Geometric Coefficient of Variation 111 |
| Pbo+Palbo+Fulv | Plasma Concentration of Palbociclib | 3 hours Post-dose, Cycle 1 Day 15 | 98.0 ng/ml | Geometric Coefficient of Variation 62 |
| Pbo+Palbo+Fulv | Plasma Concentration of Palbociclib | Predose, Cycle 1 Day 1 | NA ng/ml | — |
| Pbo+Palbo+Fulv | Plasma Concentration of Palbociclib | Predose, Cycle 1 Day 15 | 73.3 ng/ml | Geometric Coefficient of Variation 65 |
| Pbo+Palbo+Fulv | Plasma Concentration of Palbociclib | 3 hours Post-dose, Cycle 1 Day 1 | 22.9 ng/ml | Geometric Coefficient of Variation 251 |
| Pbo+Palbo+Fulv | Plasma Concentration of Palbociclib | Predose, Cycle 2 Day 15 | 66.9 ng/ml | Geometric Coefficient of Variation 90 |
| Pbo+Palbo+Fulv | Plasma Concentration of Palbociclib | Predose, Cycle 1 Day 8 | 74.5 ng/ml | Geometric Coefficient of Variation 50 |
Time to Deterioration (TTD) in Pain
TTD in pain is defined as the time from randomization to the first documentation of a ≥ 2-point increase from baseline on the worst pain item from the Brief Pain Inventory-Short Form (BPI-SF). BPI-SF is a self-administered questionnaire in which the participant was asked to rate severity on a 10-point scale where 0 represents 'No pain/No interference' and 10 represents 'Pain/Interference as bad as you can imagine'. A ≥2-point change is defined as clinically meaningful difference.
Time frame: From randomization to first documentation of a ≥ 2-point increase (Up to approximately 6 years)
TTD in Global Health Status (GHS)
TTD in (GHS)/health-related quality of life (HRQoL) is defined as the time from randomization to the first documentation of a ≥ 10-point decrease from baseline held for two consecutive cycles, or initial decrease followed by death or treatment discontinuation within three weeks of last assessment in the EORTC QLQ-30 GHS/HRQoL scale. A ≥10-point change is defined as clinically meaningful difference. EORTC QLQ-C30 is a cancer specific health-related QoL questionnaire. Participant responses to the questions regarding Global Health Status (Q29: GHS; How would you rate your overall health during the past week?) and Quality of Life (Q30: QoL; How would you rate your overall quality of life during the past week?) are scored on a 7-point scale (1= Very poor to 7=Excellent). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher score indicates a better outcome.
Time frame: Treatment: Day 1 of Cycles 1-3, then Day 1 of every other cycle until treatment discontinuation. Post-treatment: Every 8 weeks for 2 years, then every 12 weeks thereafter, to end of study (up to 6 years) (Cycle length = 28 days)]
TTD in Physical Function (PF)
TTD in physical function is defined as the time from randomization to the first documentation of a ≥ 10-point decrease from baseline held for two consecutive cycles or initial decrease followed by death or treatment discontinuation within three weeks of last assessment in the European Organisation for Research and Treatment of Cancer Quality of Life-Core 30 Questionnaire (EORTC QLQ-C30) PF scale (items 1-5). A ≥10-point change is defined as a clinically meaningful difference. EORTC QLQ-C30 is a cancer-specific health-related quality-of life (QoL) questionnaire with 30 questions. For the PF scale, participant responses to 5 questions about daily activities (strenuous activities, long walks, short walks, bed/chair rest & needing help with eating, dressing, washing themselves, or using the toilet) is scored on a 4-point scale (1=Not at All to 4=Very Much). Scores are linearly transformed on a scale of 0 to 100, with a high score indicating worst functioning.
Time frame: Treatment: Day 1 of Cycles 1-3, then Day 1 of every other cycle until treatment discontinuation. Post-treatment: Every 8 weeks for 2 years, then every 12 weeks thereafter, to end of study (up to 6 years) (Cycle length = 28 days)]
TTD in Role Function (RF)
TTD in Role Function is defined as the time from randomization to the first documentation of a ≥ 10-point decrease from baseline held for two consecutive cycles, or initial decrease followed by death or treatment discontinuation within three weeks of last assessment in the EORTC QLQ-C30 RF scale (items 6 and 7). A ≥10-point change is defined as clinically meaningful difference. EORTC QLQ-C30 is a cancer specific health-related QoL questionnaire. For the role functioning scale, participant responses to the 2 questions Q6: Were you limited in doing either your work or daily activities and Q7: Were you limited in pursuing your hobbies or other leisure time activities were scored on a 4-point scale (1=Not at All to 4=Very Much). The scores were linearly transformed on a scale of 0 to 100, with a low score indicating better functioning.
Time frame: Treatment: Day 1 of Cycles 1-3, then Day 1 of every other cycle until treatment discontinuation. Post-treatment: Every 8 weeks for 2 years, then every 12 weeks thereafter, to end of study (up to 6 years) (Cycle length = 28 days)]