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Closed (no longer recruiting)Last updated: 8 February 2024

NATALEE: This phase III trial is evaluating the safety and effectiveness of a targeted (biological) therapy (Ribociclib) with an endocrine therapy as an adjuvant treatment for people with hormone receptor positive (HR+) and HER2- breast cancerA Phase III Multi-center, Randomized, Open-label Trial to Evaluate Efficacy and Safety of Ribociclib With Endocrine Therapy as an Adjuvant Treatment in Patients With Hormone Receptor-positive, HER2-negartive Early Breast Cancer (New Adjuvant TriAl With Ribociclib

Clinical summary

Summary

Eligible patients enrolled in the Experimental Arm of this trial, will receive 400mg Ribociclib, once daily on days 1-21 of a 28 day cycle, followed by 7-days off and endocrine therapy continuously, once a day. Participants in the Comparator Arm of the trial will receive endocrine therapy only.

Conditions

This trial is treating patients with breast cancer (HR+ / HER2-).

Cancer

Breast Cancers Breast

Age

People18+

Phase

III

Trial Acronym

NATALEE

More information

Trial Identifiers

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Trial sponsor

Novartis Pharmaceuticals

Scientific Title

A Phase III Multi-center, Randomized, Open-label Trial to Evaluate Efficacy and Safety of Ribociclib With Endocrine Therapy as an Adjuvant Treatment in Patients With Hormone Receptor-positive, HER2-negartive Early Breast Cancer (New Adjuvant TriAl With Ribociclib

Eligibility

Inclusion

  • Patient is ≥ 18 years-old at the time of PICF signature
  • Patient is female with known menopausal status at the time of randomization or initiation of adjuvant ET (whichever occurs earlier), or male.
  • Patient with histologically confirmed unilateral primary invasive adenocarcinoma of the breast with a date of initial cytologic or histologic diagnosis within 18 months prior to randomization.
  • Patient has breast cancer that is positive for ER and/or PgR
  • Patient has HER2-negative breast cancer
  • Patient has available archival tumor tissue from the surgical specimen
  • Patient after surgical resection where tumor was removed completely, with the final surgical specimen microscopic margins free from tumor, and belongs to one of the following categories: anatomic stage group II or III
  • If indicated, patient has completed adjuvant and/or neoadjuvant chemotherapy according to the institutional guidelines
  • If indicated, patient has completed adjuvant radiotherapy according to the institutional guidelines
  • Patient has an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1.
  • Patient has no contraindication for the adjuvant ET in the trial and is planned to be treated with ET for 5 years

Exclusion

  • Patient has received any CDK4/6 inhibitor
  • Patient has received prior treatment with tamoxifen, raloxifene or AIs for reduction in risk ("chemoprevention") of breast cancer and/or treatment for osteoporosis within the last 2 years prior to randomization. Patient is concurrently using hormone replacement therapy.
  • Patient has received prior treatment with anthracyclines at cumulative doses of 450 mg/m² or more for doxorubicin, or 900 mg/m² or more for epirubicin.
  • Patient with a known hypersensitivity to any of the excipients of ribociclib and/or ET
  • Patient with distant metastases of breast cancer beyond regional lymph nodes (stage IV according to AJCC 8th edition) and/or evidence of recurrence after curative surgery.
  • Patient is concurrently using other anti-neoplastic therapy with the exception of adjuvant ET
  • Patient has had major surgery, chemotherapy or radiotherapy within 14 days prior to randomization
  • Patient has not recovered from clinical and laboratory acute toxicities related to prior anti-cancer therapies
  • Patient has a concurrent invasive malignancy or a prior invasive malignancy whose treatment was completed within 2 years before randomization
  • Patient has known HIV infection, Hepatitis B or C infection
  • Clinically significant, uncontrolled heart disease and/or cardiac repolarization abnormality
  • Patient is currently receiving any of the following substances within 7 days before randomization - Concomitant medications, herbal supplements, and/or fruits that are known as strong inhibitors or inducers of CYP3A4/5 or Medications that have a narrow therapeutic window and are predominantly metabolized through CYP3A4/5
  • is currently receiving or has received systemic corticosteroids ≤ 2 weeks prior to starting trial treatment
  • Patient has impairment of GI function or GI disease that may significantly alter the absorption of the oral trial treatments
  • Patient has any other concurrent severe and/or uncontrolled medical condition that would, in the Investigator's judgment, cause unacceptable safety risks, contraindicate patient participation in the clinical trial or compromise compliance with the protocol
  • Participation in other studies involving investigational drug(s) within 30 days prior to randomization or within 5 half-lives of the investigational drug(s) (whichever is longer), or participation in any other type of medical research judged not to be scientifically or medically compatible with this trial.
  • Pregnant or breast-feeding (lactating) women or women who plan to become pregnant or breast-feed during the trial

Exclusion

  • You have been diagnosed with a prior or secondary type of cancer.
  • You have certain types of non-cancer medical conditions.
  • You have had certain treatments, surgical procedures or drugs.
  • You have previously been treated (or are currently being treated) on a clinical trial.
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Clinical trials have complex eligibility criteria.

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