NCT04964934

Phase III Study to Assess AZD9833+ CDK4/6 Inhibitor in HR+/HER2-MBC With Detectable ESR1m Before Progression (SERENA-6)

A Phase III, Double-blind, Randomised Study to Assess Switching to AZD9833 (a Next Generation, Oral SERD) + CDK4/6 Inhibitor vs Continuing Aromatase Inhibitor (Letrozole or Anastrozole)+ CDK4/6 Inhibitor in HR+/HER2-MBC Patients With Detectable ESR1Mutation Without Disease Progression During 1L Treatment With Aromatase Inhibitor+ CDK4/6 Inhibitor- A ctDNA Guided Early Switch Study

• Status: Active Not Recruiting
• Phase: Phase 3
• Study type: Interventional
• Enrollment: 315 (actual)
• Sponsor: AstraZeneca · Industry
• Sex: All
• Age: 18 Years – 130 Years
• Healthy volunteers: Not accepted

Summary

The study is intended to show superiority of AZD9833 in combination with CDK4/6 inhibitor (palbociclib, abemaciclib or ribociclib) versus aromatase inhibitors (anastrozole or letrozole) in combination with CDK4/6 inhibitor in patients with hormone receptor-positive (HR-positive), human epidermal growth factor receptor 2-negative (HER2-negative) metastatic breast cancer with detectable ESR1 mutation.

Detailed description

Breast cancer is the most common type of cancer among women. In people with breast cancer, the body is not able to control the growth of some cells. These extra cells can form tumors in the breast. When tumor cells move to different parts of the body this is called advanced cancer. Researchers are looking for better ways to treat advanced breast cancer. This trial will look at six drugs: palbociclib, abemaciclib, ribociclib, letrozole, anastrozole, and AZD9833. AZD9833 is the trial drug, and is the only drug not yet approved for use. Palbociclib, abemaciclib and ribociclib work in the same way and are a type of cancer drug called a CDK4/6 inhibitor. Letrozole and anastrozole work in the same way and are both a type of cancer drug called an aromatase inhibitor (AI). CDK4/6 inhibitors and AIs work together to block the tumor's ability to grow. These drugs have been approved for combined use in people with advanced breast cancer that is HR-positive and HER2-negative. But if people get mutations in the ESR1 gene, it can make the AI and CDK4/6 inhibitor treatment work less well. The trial drug, AZD9833, is designed to work with a CDK4/6 inhibitor in the same way that an AI does. Researchers think that AZD9833 might work better with a CDK4/6 inhibitor than an AI does in people who get mutations in their ESR1 gene. Participants in this trial will have already been receiving one of the following combinations of a CDK4/6 inhibitor and an AI: * palbociclib + anastrozole * palbociclib + letrozole * abemaciclib + anastrozole * abemaciclib + letrozole * ribociclib + anastrozole * ribociclib + letrozole During the trial, participants will remain on the same CDK4/6 inhibitor that they were taking before the trial. In this trial, the researchers want to find out how well switching a participant with an ESR1 gene mutation from an AI (letrozole or anastrozole) to AZD9833 works in the treatment of advanced breast cancer that is HR-positive and HER2-negative. The researchers will look at which trial treatment helps the participants live longer with the cancer before it gets worse. The researchers also want to know more about how safe AZD9833 is. The trial participants will be split into 2 groups: * Participants in Group A will receive AZD9833, a CDK4/6 inhibitor, and a placebo * Participants in Group B will receive an AI, a CDK4/6 inhibitor, and a placebo A placebo looks like a treatment but does not have any medicine in it. A computer program will be used to randomly choose the treatments each participant gets. This helps make sure the groups are chosen fairly. Researchers do this so that comparing the results of each treatment will be as accurate as possible. The participants will take their trial treatments over 28-day cycles, with a placebo and either AZD9833 or an AI taken once daily by mouth for all 28 days. If the participant is taking abemaciclib, they will take it twice daily by mouth for all 28 days. If the participant is taking palbociclib or ribociclib, they will take it once daily by mouth for 21 days and then stop taking it for the final 7 days of the cycle. The participant will then repeat the 28-day cycle receiving the trial treatment in the same way for as long as they are in the trial. Participants will visit their trial site regularly throughout the trial. At these visits, the trial doctors will check the health of the participants. They will also take blood samples and do scans of the participants' tumors. Participants will take their trial treatment until their cancer gets worse or they decide to leave the trial.

Conditions

• ER-Positive HER2-Negative Breast Cancer

Interventions

Type	Name	Description
DRUG	AZD9833	Dosage formulation: AZD9833 tablets will be administered orally
DRUG	AZD9833 Placebo	Dosage formulation: AZD9833 placebo tablets will be administrated orally.
DRUG	Anastrozole	Dosage formulation: anastrozole tablets will be administered orally.
DRUG	Anastrozole placebo	Dosage formulation: anastrozole placebo tablets will be administrated orally.
DRUG	Letrozole	Dosage formulation: letrozole tablets will be administered orally.
DRUG	Letrozole placebo	Dosage formulation: letrozole placebo tablets will be administered orally.
DRUG	Palbociclib	Dosage formulation: palbociclib tablets/capsules will be administered orally
DRUG	Abemaciclib	Dosage formulation: abemaciclib tablets will be administered orally
DRUG	Luteinizing hormone-releasing hormone (LHRH) agonist	Men (when medically applicable) and pre- or peri-menopausal women are required to receive a monthly LHRH agonist.
DRUG	Ribociclib	Dosage formulation: ribociclib tablets will be administered orally

Timeline

• Start date: 2021-06-30
• Primary completion: 2025-06-30
• Completion: 2027-11-26
• First posted: 2021-07-16
• Last updated: 2026-01-16

Locations

265 sites across 23 countries: United States, Australia, Austria, Belgium, Bulgaria, Canada, France, Germany, Hungary, Israel, Italy, Japan, Norway, Poland, Portugal, Russia, Slovakia, South Korea, Spain, Switzerland, Taiwan, Turkey (Türkiye), United Kingdom

Regulatory

• FDA-regulated drug study