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NCT03691493: ASPIRE

Radiation Therapy, Palbociclib, and Hormone Therapy in Treating Breast Cancer Patients With Bone Metastasis

Completed Phase 2 Results posted Last updated 17 February 2025
What this trial tests

Phase 2 trial testing Anastrozole in Anatomic Stage IV Breast Cancer AJCC v8 in 36 participants. Completed in 13 October 2022.

Timeline
8 February 2019
Primary endpoint
13 October 2022
13 October 2022

Quick facts

Lead sponsorEmory University
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment36
Start date8 February 2019
Primary completion13 October 2022
Estimated completion13 October 2022
Sites10 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Emory University

Who can join

18 and older, any sex, with Anatomic Stage IV Breast Cancer AJCC v8 or Estrogen Receptor Positive. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Response Rate Primary · Up to 3 months post radiation

Response rate will be estimated as the number of responders divided by the number of patients evaluated for response. Among patients who present with pain, responders will be considered those patients who have a 2 point decrease in the Brief Pain Inventory (BPI), and among those who do not present with pain (radiotherapy due to risk of unstable fracture or cord compression), responders will be considered those without development of a pathologic fracture or neurologic compromise (cord compression) due to cancer on imaging.

Responders
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy29
Non-responders
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy6
Response Rate Incorporating BPI and Analgesic Measures According to International Bone Consensus Guideline Criteria Secondary · Up to 3 months post radiation

Response rate will be estimated as the number of responders divided by the number of patients evaluated for response. Among patients who present with pain, responders will be considered those patients who fulfill the International Bone Consensus response criteria using the BPI item rating maximum pain over the last 3 days at the index site and analgesic usage for the treated site within the last 24 hours prior to assessment. Among patients who do not present with pain (radiotherapy due to risk of unstable fracture or cord compression), responders will be considered those without development of

GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy18
Radiation, Palbociclib, Hormone Therapy2
Radiation, Palbociclib, Hormone Therapy7
Number of Participants With Adverse Events Graded According to Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 Secondary · Up to 3 months post radiation

Adverse events, such as bone fracture following radiotherapy, any grade 3 toxicity (except neutropenia or leukopenia), grade 4 neutropenia, grade 4 leukopenia, grade 3 febrile neutropenia, or grade 3 brachial plexopathy or spinal cord injury, will be summarized descriptively.

GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy31
Progression-free Survival (PFS) Secondary · Up to 44 months post radiation

PFS will be estimated using the Kaplan-Meier method.

GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy30.417.7 – NA
Overall Survival (OS) Secondary · Up to 44 months post radiation

OS will be estimated using the Kaplan-Meier method.

GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy37.925.4 – NA
Fatigue as Measured by The Multidimensional Fatigue Inventory (MFI) Secondary · Pre-radiation on day 1, Last Day of radiation (5-10 days), 1 month post radiation, and 3 months post radiation, change last day of radiation, change 1 month post radiation, change 3 months post radiation

Fatigue will be assessed before and after radiotherapy. The Multidimensional Fatigue Inventory (MFI) is a comprehensive self-report instrument designed to measure fatigue. It consists of 20 items rated on a 7-point scale and covers dimensions such as General Fatigue, Physical Fatigue, Mental Fatigue, Reduced Motivation, and Reduced Activity. Each question is score on a 1 to 5 scale, with 1 being 'yes, that is true' and 5 being 'No, that is not true'. The minimum score is 20 and the maximum score is100. The higher the score indicates fatigue.

Pre-radiation
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy55± 16.4
Last Day of radiation
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy53.6± 13.8
1-month post radiation
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy54.0± 16.6
3-month post radiation
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy52.3± 15.9
Change (Last Day of Radiation - Pre-radiation)
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy0.1± 11.5
Change (1-month post radiation - Pre-radiation)
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy-0.4± 15.2
Change (3-month post radiation - Pre-radiation)
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy-1.4± 12.7
Quality of Life as Measured by Short Form Health Survey (SF-36) Secondary · Pre-radiation on day 1, Last Day of radiation (5-10 days), 1 month post radiation, and 3 months post radiation, change last day of radiation, change 1 month post radiation, change 3 months post radiation

Quality of life will be assessed before and after radiotherapy. The SF-36 measures eight scales: physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE), and mental health (MH) Each scale is the weighted sum of the questions in their section and are directly transformed into a 0-100 scale i.e., the minimum score is 0, maximum is 100 A higher score indicates less disability Total score on the SF-36 is the summation of all the eight scales

Pre-radiation
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy41.8± 8.8
Last Day of radiation
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy42.0± 8.2
1-month post radiation
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy44.0± 8.1
3-month post radiation
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy44.0± 8.2
Change (Last Day of radiation - Pre-radiation)
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy0.2± 4.7
Change (1-month post radiation - Pre-radiation)
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy2.1± 6.6
Change (3-month post radiation - Pre-radiation)
GroupValue95% CI
Radiation, Palbociclib, Hormone Therapy1.9± 7.3
Quality of Life as Measured by European Organization for Research and Treatment of Cancer Metastases Module (EORTC QLQ-BM22) Secondary · Pre-radiation on day 1, Last Day of radiation (5-10 days), 1 month post radiation, and 3 months post radiation, change last day of radiation, change 1 month post radiation, change 3 months post radiation

Quality of life will be assessed before and after radiotherapy. EORTC QLQ-BM22 measures four multi-item scales: painful sites, functional interference, painful characteristics, and psychosocial aspects Each item is scaled from 1 (not at all) to 4 (very much) and directly transformed into a 0-100 scale A higher score in symptom scales indicates greater distress. A higher score in functional scales indicates greater functional ability

Pre-radiation
GroupValue95% CI
Treated, Painful Site28.0± 21.0
Treated, Pain Characteristics31.2± 26.5
Treated, Functional Interference63.6± 30.9
Treated, Psychological Aspects61.0± 20.9
Last Day of radiation
GroupValue95% CI
Treated, Painful Site21.5± 20.0
Treated, Pain Characteristics25.0± 23.7
Treated, Functional Interference73.4± 25.8
Treated, Psychological Aspects68.4± 19.8
1-month post radiation
GroupValue95% CI
Treated, Painful Site18.5± 15.1
Treated, Pain Characteristics22.2± 24.6
Treated, Functional Interference74.1± 26.6
Treated, Psychological Aspects69.9± 21.7
3-month post radiation
GroupValue95% CI
Treated, Painful Site17.7± 14.4
Treated, Pain Characteristics18.1± 16.6
Treated, Functional Interference74.8± 21.0
Treated, Psychological Aspects68.1± 23.3
Change (Last Day of radiation - Pre-radiation)
GroupValue95% CI
Treated, Painful Site-6.5± 14.1
Treated, Pain Characteristics-6.2± 19.4
Treated, Functional Interference9.8± 18.7
Treated, Psychological Aspects7.4± 18.7
Change (1-month post radiation - Pre-radiation)
GroupValue95% CI
Treated, Painful Site-9.4± 15.7
Treated, Pain Characteristics-9.0± 25.9
Treated, Functional Interference10.5± 29.8
Treated, Psychological Aspects9.0± 17.1
Change (3-month post radiation - Pre-radiation)
GroupValue95% CI
Treated, Painful Site-10.7± 15.8
Treated, Pain Characteristics-13.7± 20.0
Treated, Functional Interference11.9± 23.1
Treated, Psychological Aspects6.7± 19.0
Quality of Life as Measured by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 for Palliative Care (EORTC QLQ-C15-PAL) Secondary · Pre-radiation on day 1, Last Day of radiation (5-10 days), 1 month post radiation, and 3 months post radiation, change last day of radiation, change 1 month post radiation, change 3 months post radiation

Quality of life will be assessed before and after radiotherapy. The EORTC QLQ-C15-PAL measures seven scales: physical functioning, global health status, emotional functioning, fatigue, nausea/vomiting, appetite loss, and constipation For questions 1-14, each item is scaled from 1 (not at all) to 4 (very much) . For question 15 (global QoL), patients respond to a seven-point numerical scale from 1 (very poor overall) to 7 (excellent overall). The scale is scored from 0 to 100. A higher score in symptom scales indicates greater distress. A higher score in functional scales indicates greater fun

Pre-radiation
GroupValue95% CI
Evaluable, Global Health72.7± 19.6
Evaluable, Pain42.6± 28.9
Last Day of radiation
GroupValue95% CI
Evaluable, Global Health68.1± 20.5
Evaluable, Pain32.4± 28.4
1-month post radiation
GroupValue95% CI
Evaluable, Global Health72.7± 20.4
Evaluable, Pain28.7± 23.8
3-month post radiation
GroupValue95% CI
Evaluable, Global Health71.9± 20.5
Evaluable, Pain28.6± 23.8
Change (Last Day of radiation - Pre-radiation)
GroupValue95% CI
Evaluable, Global Health-4.6± 21.3
Evaluable, Pain-10.2± 25.3
Change (1-month post radiation - Pre-radiation)
GroupValue95% CI
Evaluable, Global Health0.0± 22.9
Evaluable, Pain-13.9± 27.7
Change (3-month post radiation - Pre-radiation)
GroupValue95% CI
Evaluable, Global Health-0.5± 19.6
Evaluable, Pain-13.8± 26.0
Depression as Measured by Hospital Anxiety and Depression Scale (HADS) Secondary · Pre-radiation on day 1, Last Day of radiation (5-10 days), 1 month post radiation, and 3 months post radiation, change last day of radiation, change 1 month post radiation, change 3 months post radiation

Depression will be assessed before and after radiotherapy. The Hospital Anxiety and Depression Scale (HADS) is a 14-item tool used to screen for anxiety and depression, which commonly coexist. The HADS produces a subscale for anxiety (HADS-A) and a separate subscale for depression (HADS-D). The respondent rates each item on a 4-point scale ranging from 0 (absence) to 3 (extreme presence). The total score is out of 42, (21 per subscale) and the range is 0-42. Scores are derived by summing responses for each of the two subscales or for the scale as a whole. Higher scores indicate greater levels

Pre-radiation
GroupValue95% CI
Evaluable Depression4.9± 3.5
Evaluable Anxiety6.1± 3.6
Last day of radiation
GroupValue95% CI
Evaluable Depression4.6± 3.5
Evaluable Anxiety5.3± 3.8
1-month post radiation
GroupValue95% CI
Evaluable Depression4.3± 3.5
Evaluable Anxiety5.2± 3.6
3-month post radiation
GroupValue95% CI
Evaluable Depression4.1± 3.5
Evaluable Anxiety5.3± 4.0
Change (Last day of radiation - Pre-radiation)
GroupValue95% CI
Evaluable Depression-0.3± 2.0
Evaluable Anxiety-0.8± 1.9
Change (1-month post radiation - Pre-radiation)
GroupValue95% CI
Evaluable Depression-0.6± 2.6
Evaluable Anxiety-0.8± 2.3
Change (3-month post radiation - Pre-radiation)
GroupValue95% CI
Evaluable Depression-0.7± 3.5
Evaluable Anxiety-0.8± 3.0
Number of Participants With Adherence as Measured by Drug Diary Secondary · Pre-radiation on day 1, Last Day of radiation (5-10 days), 1 month post radiation, and 3 months post radiation, change last day of radiation, change 1 month post radiation, change 3 months post radiation

Adherence will be determined by number of days drug taken divided by number of days drug should have been taken over the time period of the study.

Pre-radiation
GroupValue95% CI
Evaluable Palbo36
Evaluable Hormone36
Last Day of radiation
GroupValue95% CI
Evaluable Palbo33
Evaluable Hormone35
1-month post radiation
GroupValue95% CI
Evaluable Palbo25
Evaluable Hormone29
3-month post radiation
GroupValue95% CI
Evaluable Palbo26
Evaluable Hormone30

Adverse events — posted to ClinicalTrials.gov

Time frame: All-Cause Mortality monitored/assessed up to 44 months. Adverse Events were monitored/assessed up to 3 months post Radiation Therapy.. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Grade 1 Adverse Event
Serious: 0/36 (0%)
Deaths: 0/36
Grade 2 Adverse Event
Serious: 0/36 (0%)
Deaths: 0/36
Grade 3 Adverse Event
Serious: 0/36 (0%)
Deaths: 0/36
Grade 4 Adverse Event
Serious: 0/36 (0%)
Deaths: 0/36
Grade 5 Adverse Event
Serious: 0/36 (0%)
Deaths: 7/36
Other adverse events (31 terms — click to expand)

ReactionSystemGrade 1 Adverse EventGrade 2 Adverse EventGrade 3 Adverse EventGrade 4 Adverse EventGrade 5 Adverse Event
White Blood Cell DecreaseInvestigations
Neutrophil Count DecreaseBlood and lymphatic system disorders
AnemiaBlood and lymphatic system disorders
FatigueGeneral disorders
Lymphocyte Count DecreaseBlood and lymphatic system disorders
Platelet Count DecreasedInvestigations
NauseaGastrointestinal disorders
DiarrheaGastrointestinal disorders
VomitingGastrointestinal disorders
AnorexiaGeneral disorders
Moderate erythema over sternumSkin and subcutaneous tissue disorders
Any Grade 4 AE - excluding neutropenia and leukpeniaInvestigations
Bilateral Arm PainMusculoskeletal and connective tissue disorders
Bilateral Shoulder PainMusculoskeletal and connective tissue disorders
ConstipationGastrointestinal disorders
DehydrationMetabolism and nutrition disorders
Dry Skin/Rash on BackSkin and subcutaneous tissue disorders
DyspneaGeneral disorders
EsophagitisGastrointestinal disorders
Gastroesophagealreflux diseaseGastrointestinal disorders
Mouth SoresGastrointestinal disorders
Neck painMusculoskeletal and connective tissue disorders
Pain in extremityMusculoskeletal and connective tissue disorders
PruitusSkin and subcutaneous tissue disorders
Skin DesquamationSkin and subcutaneous tissue disorders
Skin HyperpigmentationSkin and subcutaneous tissue disorders
Sore ThroatRespiratory, thoracic and mediastinal disorders
Weight LossMetabolism and nutrition disorders
Back PainMusculoskeletal and connective tissue disorders
Dermatitis RadiationSkin and subcutaneous tissue disorders
CoughRespiratory, thoracic and mediastinal disorders

Data from ClinicalTrials.gov NCT03691493 adverse events section.

Sponsor's own description

This phase II trial studies how well radiation therapy given with standard care palbociclib and hormone therapy work in treating patients with breast cancer that has spread from one part of the body to the bone. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. Palbociclib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Antihormone therapy, such as fulvestrant, letrozole, anastrozole, exemestane, or tamoxifen, may lessen the amount of estrogen made by the body. Giving radiation therapy, palbociclib, and hormone therapy may work better in treating breast cancer patients with bone metastasis.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. CDK4 and CDK6 kinases: From basic science to cancer therapy.
    Fassl A, Geng Y, Sicinski P. · · 2022 · cited 351× · PMID 35025636 · DOI 10.1126/science.abc1495
  2. Radiotherapy as a tool to elicit clinically actionable signalling pathways in cancer.
    Petroni G, Cantley LC, Santambrogio L, Formenti SC, et al · · 2022 · cited 154× · PMID 34819622 · DOI 10.1038/s41571-021-00579-w
  3. CDK4/6 inhibitors: a novel strategy for tumor radiosensitization.
    Yang Y, Luo J, Chen X, Yang Z, et al · · 2020 · cited 53× · PMID 32933570 · DOI 10.1186/s13046-020-01693-w
  4. CDK 4/6 inhibitors combined with radiotherapy: A review of literature.
    Bosacki C, Bouleftour W, Sotton S, Vallard A, et al · · 2021 · cited 34× · PMID 33319074 · DOI 10.1016/j.ctro.2020.11.010
  5. CDK4, CDK6/cyclin-D1 Complex Inhibition and Radiotherapy for Cancer Control: A Role for Autophagy.
    Nardone V, Barbarino M, Angrisani A, Correale P, et al · · 2021 · cited 29× · PMID 34445095 · DOI 10.3390/ijms22168391
  6. Safety of cyclin-dependent kinase4/6 inhibitor combined with palliative radiotherapy in patients with metastatic breast cancer.
    Kim KN, Shah P, Clark A, Freedman GM, et al · · 2021 · cited 22× · PMID 34653725 · DOI 10.1016/j.breast.2021.10.001
  7. The role of CDK4/6 inhibitors in early breast cancer.
    Gil-Gil M, Alba E, Gavilá J, de la Haba-Rodríguez J, et al · · 2021 · cited 20× · PMID 34087775 · DOI 10.1016/j.breast.2021.05.008
  8. Advances in molecular targeted therapies to increase efficacy of (chemo)radiation therapy.
    Viktorsson K, Rieckmann T, Fleischmann M, Diefenhardt M, et al · · 2023 · cited 19× · PMID 37041372 · DOI 10.1007/s00066-023-02064-y

Verify or expand the search:

Other trials of Anastrozole

Trials testing the same drug.

Other recruiting trials for Anatomic Stage IV Breast Cancer AJCC v8

Currently open trials in the same condition.

Other Emory University trials

Trials by the same sponsor.

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