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A Study of ARV-471 (PF-07850327) Plus Palbociclib Versus Letrozole Plus Palbociclib in Participants With Estrogen Receptor Positive, Human Epidermal Growth Factor Negative Advanced Breast Cancer (VERITAC-3)

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ClinicalTrials.gov Identifier: NCT05909397
Recruitment Status : Recruiting
First Posted : June 18, 2023
Last Update Posted : April 15, 2024
Sponsor:
Collaborator:
Arvinas Estrogen Receptor, Inc.
Information provided by (Responsible Party):
Pfizer

Brief Summary:

The purpose of this study is to understand the safety and effects of the study medicine ARV-471 (PF-07850327) given together with palbociclib in advanced breast cancer. In particular, the study will compare the combination of ARV-471 plus palbociclib to standard of care therapy (letrozole plus palbociclib). Both letrozole and palbociclib are medicines already used for treatment of breast cancer. ARV-471 is a new medicine under study.

This study is seeking participants who have breast cancer that:

  • Have a locally advanced or metastatic disease and cannot be fully cured by surgery or radiation therapy. A metastatic disease is when disease has spread to other parts of the body.
  • Is sensitive to hormonal therapy such as tamoxifen. This is called estrogen receptor positive disease.
  • Have not received any prior medicine for advanced disease. Example medications include tamoxifen or letrozole or exemestane.

The study will have an open-label SLI (study lead-in) before initiation of Phase 3 trial. During SLI, two dose levels of palbociclib in combination with ARV-471 will be explored in parallel. Assignment to the palbociclib dose is by chance. Half of the participant will receive one dose and the other half another palbociclib dose. The purpose of SLI is to determine the recommended Phase 3 dose of palbociclib to be administered in combination with ARV-471.

In the Phase 3, half of the participants will take ARV-471 plus palbociclib while the other half will take letrozole plus palbociclib. In both SLI and Phase 3, participants will take the study medicines by mouth, with food, once a day. Participants will take the study medicines until breast cancer increase in size or side effects become too severe. Side effects refer to unwanted reactions to medications. Participants will visit the study clinic about once every 4 weeks.


Condition or disease Intervention/treatment Phase
Breast Cancer Drug: ARV-471 (PF-07850327) Combination Product: Palbociclib Drug: Letrozole Phase 3

Detailed Description:
The purpose of this study is to demonstrate that ARV-471 in combination with palbociclib provides superior clinical benefit compared to letrozole in combination with palbociclib in participants with ER(+)/HER2(-) aBC who have not received any prior systemic anti-cancer therapies for their locoregionally advanced or metastatic disease. The study will have a Study Lead-in (SLI) and a Phase 3. In the SLI, 50 participants (approximately 25 each arm) will be randomly assigned on a 1:1 basis to one of the two dose levels (DLs). In the randomized Phase 3, approximately 1130 eligible participants (approximately 565 each arm) will be randomized in a 1:1 ratio to the Experimental Arm (ie, ARV-471 plus palbociclib at RP3D determined in the SLI) or Control Arm (ie, letrozole plus palbociclib at the registered doses). Randomization will be stratified by menopausal status at study entry, visceral disease and de novo metastatic disease.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 1180 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A PHASE 3, RANDOMIZED, OPEN-LABEL, MULTICENTER STUDY OF ARV-471(PF-07850327) PLUS PALBOCICLIB VERSUS LETROZOLE PLUS PALBOCICLIB FOR THE TREATMENT OF PARTICIPANTS WITH ESTROGEN RECEPTOR-POSITIVE, HER2-NEGATIVE BREAST CANCER WHO HAVE NOT RECEIVED ANY PRIOR SYSTEMIC ANTI-CANCER TREATMENT FOR ADVANCED DISEASE (VERITAC-3)
Actual Study Start Date : August 9, 2023
Estimated Primary Completion Date : August 28, 2028
Estimated Study Completion Date : July 26, 2030

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Breast Cancer

Arm Intervention/treatment
Experimental: Arm A (Investigational Arm)

Participants will receive:

  • ARV-471, orally, once daily, continuously, in a 28-day cycle, plus
  • Palbociclib, orally, once daily for 21 consecutive days followed by 7 days off treatment in a 28 day cycle
Drug: ARV-471 (PF-07850327)
Pharmaceutical form: Tablets. Route of Administration: Oral
Other Name: Vepdegestrant

Combination Product: Palbociclib
Pharmaceutical form: Capsules. Route of Administration: Oral.
Other Name: IBRANCE®

Active Comparator: Arm B (Comparator Arm):

Participants will receive:

  • Letrozole, orally, once daily, continuously, in a 28-day cycle, plus
  • Palbociclib, orally, once daily for 21 consecutive days followed by 7 days off treatment, in a 28-day cycle.
Drug: Letrozole
Pharmaceutical form: Capsules. Route of Administration: Orally
Other Name: FEMARA®

Combination Product: Palbociclib
Pharmaceutical form: Capsules. Route of Administration: Oral.
Other Name: IBRANCE®




Primary Outcome Measures :
  1. Study Lead-in (SLI): Incidence of Grade 4 neutropenia [ Time Frame: From randomization date up to Cycle 4 (each cycle is 28 days). ]
    It is defined as the number of participants with Grade 4 neutropenia AE (graded by NCI CTCAE v.5.0) with onset within the first 4 cycles divided by the number of participants.

  2. SLI: Incidence of dose reduction [ Time Frame: From randomization date up to Cycle 4 (each cycle is 28 days). ]
    It is defined as the number of participants reducing the dose of palbociclib and/or ARV-471 due to any cause occurring within the first 4 cycles divided by the number of participants.

  3. SLI: Incidence of drug discontinuation. [ Time Frame: From randomization date up to Cycle 4 (each cycle is 28 days). ]
    It is defined as the number of participants discontinuing palbociclib and/or ARV-471 due to any cause occurring within the first 4 cycles divided by the number of participants.

  4. Phase 3: Progression-Free Survival [ Time Frame: From randomization date, every 12 weeks, to date of first documentation of progression or death, up to approximately 4 years. ]
    Progression-free survival is defined as the time interval from the date of randomization to the date of first documented tumor progression determined by Blinded Independent Central Review (BICR) as per Response Evaluation Criteria in Solid Tumors (RECIST version 1.1) or death due to any cause, whichever come first.


Secondary Outcome Measures :
  1. SLI and Phase 3. Objective Response Rate [ Time Frame: From randomization date, every 12 weeks, to the date of progression or death (up to approximately 4 years). ]
    Objective response rate is defined as the proportion of participants who have a confirmed CR or PR, as best overall response determined by Investigators (SLI) or by BICR (Phase 3) as per RECIST version 1.1, from the date of randomization to the date of disease progression or death due to any cause, whichever occurs first.

  2. SLI and Phase 3: Duration of Response [ Time Frame: From the date of the first objective response, every 12 weeks, to the date of disease progression or death (up to approximately 4 years). ]
    Duration of response is defined as the time from first documented evidence of CR or PR until progressive disease (PD) determined by Investigators (SLI) or by BICR (Phase 3) as per RECIST version 1.1 or death due to any cause, whichever occurs first.

  3. SLI and Phase 3: Clinical Benefit Rate [ Time Frame: Every 12 weeks From randomization date, every 12 week, to the date of progression or death (up to approximately 4 years). ]
    Clinical benefit rate is defined as the proportion of participants who have a confirmed CR, PR at any time or SD or non CR/non PD for at least 24 weeks determined by Investigators (SLI) or by BICR (Phase 3) as per RECIST version 1.1, from the date of randomization until disease progression or death due to any cause, whichever occurs first.

  4. Phase 3: Overall Survival [ Time Frame: From randomization date, every 3 months, to date of death (up to approximately 6 years) ]
    Overall survival is defined as the time interval from the date of randomization to the date of documented death, due to any cause.

  5. SLI and Phase 3: Incidence of Treatment Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) [ Time Frame: From baseline to date to end of treatment (up to approximately 4 years) ]
    It is defined as the number of participants with TEAEs and SAEs divided by the number of participants. AEs and SAEs will be graded according to NCI CTCAE V5.0.

  6. SLI and Phase 3: Incidence of laboratory abnormalities [ Time Frame: From baseline to end of treatment (up to approximately 4 years) ]
    It is defined as the number of participants with laboratory abnormalities divided by the number of participants. Laboratory abnormalities will be graded according to NCI CTCAE V5.0.

  7. SLI and Phase 3: Incidence of Electrocardiogram (ECG) Abnormalities [ Time Frame: From baseline up to the end of treatment (up to approximately 4 years) ]
    It is defined as the number of participants with ECG abnormalities divided by the number of participants. ECG abnormalities will be graded according to NCI CTCAE V5.0.

  8. SLI and Phase 3: Plasma concentrations of ARV-471 and palbociclib [ Time Frame: From randomization date up to Cycle 5 (each cycle is 28 days) ]
    Plasma concentrations of ARV-471 and palbociclib

  9. Phase 3: Health state utility and health status will be assessed using the European Quality of Life Group questionnaire with 5 dimensions and 5 levels per dimension (EQ-5D-5L) [ Time Frame: From baseline, each cycle up to cycle 3, then every odd cycle to end of treatment (up to approximately 4 years). Each cycle is 28 days ]
    Change from baseline between treatment comparison in Quality of Life using the EQ-5D 5L questionnaire.

  10. Phase 3: Disease-related Quality of Life will be assessed using the European Organization for Research and Treatment of Cancer (EORTC) core quality of life questionnaire (QLQ-C30) [ Time Frame: From baseline, each cycle up to Cycle 3, then every odd cycle to end of treatment (up to approximately 4 years). Each cycle is 28 days. ]
    Change from baseline between treatment comparison in Quality of Life using the EORTC QLQ-C30 questionnaire.

  11. Phase 3: Disease- and treatment-related Quality of Life will be assessed using the European Organization for Research and Treatment of Cancer (EORTC) breast cancer module (QLQ-BR23) questionnaire. [ Time Frame: From baseline, each cycle up to Cycle 3, then every odd cycle to end of treatment (up to approximately 4 years). Each cycle is 28 days. ]
    Change from baseline between treatment comparison in Quality of Life Using the EORTC QLQ-BR23 (Breast) questionnaire.

  12. Phase 3: Changes from baseline in plasma ctDNA (Circulating Deoxyribonucleic Acid) [ Time Frame: From baseline to end of treatment (up to approximately 4 years) ]
    Quantitative changes from baseline



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Adult participants with loco-regional recurrent or metastatic disease not amenable to curative treatment
  • Confirmed diagnosis of ER+/HER2- breast cancer
  • No prior systemic treatment for loco-regional recurrent or metastatic disease
  • Measurable disease evaluable per Response Evaluation Criterion in Solid Tumors (RECIST) v.1.1 or non-measurable bone-only disease
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2
  • Phase 3 only: Participants should be willing to provide blood and tumor tissue

Exclusion Criteria:

  • Disease recurrence while on, or within 12 months of completion of adjuvant endocrine therapy
  • Prior treatment with cyclin dependent kinase 4/6 inhibitors (CDK4/6i), fulvestrant, elacestrant and other investigational drugs including novel endocrine therapies, any selective estrogen receptor degraders (SERDs), covalent antagonists (SERCAs) and complete ER antagonists (CERANs).
  • Inadequate liver, kidney and bone marrow function
  • Impaired cardiovascular function or clinically significant cardiovascular diseases
  • Refractory nausea and vomiting, inability to swallow capsules and tablets whole, chronic gastrointestinal diseases, significant gastric (total or partial) or bowel resection that would preclude adequate absorption of study interventions.
  • Current use or anticipated need for food, herbal supplements or drugs that are known strong CYP3A4 inhibitors or inducers.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05909397


Contacts
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Contact: Pfizer CT.gov Call Center 1-800-718-1021 ClinicalTrials.gov_Inquiries@pfizer.com

Locations
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Sponsors and Collaborators
Pfizer
Arvinas Estrogen Receptor, Inc.
Investigators
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Study Director: Pfizer CT.gov Call Center Pfizer
Additional Information:
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Responsible Party: Pfizer
ClinicalTrials.gov Identifier: NCT05909397    
Other Study ID Numbers: C4891002
2022-500545-24-00 ( Registry Identifier: CTIS (EU) )
First Posted: June 18, 2023    Key Record Dates
Last Update Posted: April 15, 2024
Last Verified: April 2024
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests.
URL: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Pfizer:
Advanced tumor of the breast
Advanced cancer of the breast
Breast neoplasm
Breast tumor
Breast cancer
ER positive
Estrogen receptor positive
HER2-negative
Metastatic breast cancer
Palbociclib
Letrozole
ARV-471
Vepdegestrant
Additional relevant MeSH terms:
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Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Letrozole
Palbociclib
Antineoplastic Agents
Aromatase Inhibitors
Steroid Synthesis Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Estrogen Antagonists
Hormone Antagonists
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Protein Kinase Inhibitors