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letrozole and Response Evaluation Criteria in Solid Tumors

letrozole has been researched along with Response Evaluation Criteria in Solid Tumors in 4 studies

Response Evaluation Criteria in Solid Tumors: An internationally recognized set of published rules used for evaluation of cancer treatment that define when tumors found in cancer patients improve, worsen, or remain stable during treatment. These criteria are based specifically on the response of the tumor(s) to treatment, and not on the overall health status of the patient resulting from treatment.

Research Excerpts

ExcerptRelevanceReference
"Determine the efficacy and safety of first-line ribociclib plus letrozole in patients with de novo advanced breast cancer."9.27Ribociclib plus letrozole versus letrozole alone in patients with de novo HR+, HER2- advanced breast cancer in the randomized MONALEESA-2 trial. ( Arteaga, CL; Beck, JT; Cameron, DA; Conte, P; Germa, C; Hart, LL; Hortobagyi, GN; Jakobsen, E; Lindquist, D; Mondal, S; O'Shaughnessy, J; Petrakova, K; Sonke, GS; Souami, F; Villanueva, C, 2018)
" The present study compared clinical outcomes in women with metastatic breast cancer who received letrozole as first-line monotherapy in oncology practices across the United States versus patients in the letrozole-alone cohort of the PALOMA-2 phase 3 trial."5.34Concordance of real-world versus conventional progression-free survival from a phase 3 trial of endocrine therapy as first-line treatment for metastatic breast cancer. ( Bourla, AB; Cotter, MJ; Huang Bartlett, C; Huang, X; Mardekian, J; Parrinello, CM; Zhang, Z, 2020)
"Determine the efficacy and safety of first-line ribociclib plus letrozole in patients with de novo advanced breast cancer."5.27Ribociclib plus letrozole versus letrozole alone in patients with de novo HR+, HER2- advanced breast cancer in the randomized MONALEESA-2 trial. ( Arteaga, CL; Beck, JT; Cameron, DA; Conte, P; Germa, C; Hart, LL; Hortobagyi, GN; Jakobsen, E; Lindquist, D; Mondal, S; O'Shaughnessy, J; Petrakova, K; Sonke, GS; Souami, F; Villanueva, C, 2018)
"Although approximately 60 % of breast cancers in premenopausal women are HR positive, the role of neoadjuvant ET in this population is not well defined."1.42Management of Premenopausal Women with Neoadjuvant Endocrine Therapy: A Single-Institution Experience. ( Barbie, TU; Ma, C; Margenthaler, JA, 2015)

Research

Studies (4)

TimeframeStudies, this research(%)All Research%
pre-19900 (0.00)18.7374
1990's0 (0.00)18.2507
2000's0 (0.00)29.6817
2010's3 (75.00)24.3611
2020's1 (25.00)2.80

Authors

AuthorsStudies
Huang Bartlett, C1
Mardekian, J1
Cotter, MJ1
Huang, X1
Zhang, Z1
Parrinello, CM1
Bourla, AB1
Safra, T1
Kaufman, B1
Kadouri, L1
Efrat Ben-Baruch, N1
Ryvo, L1
Nisenbaum, B1
Evron, E1
Yerushalmi, R1
O'Shaughnessy, J1
Petrakova, K1
Sonke, GS1
Conte, P1
Arteaga, CL1
Cameron, DA1
Hart, LL1
Villanueva, C1
Jakobsen, E1
Beck, JT1
Lindquist, D1
Souami, F1
Mondal, S1
Germa, C1
Hortobagyi, GN1
Barbie, TU1
Ma, C1
Margenthaler, JA1

Clinical Trials (1)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
A RANDOMIZED, MULTICENTER, DOUBLE-BLIND PHASE 3 STUDY OF PD-0332991 (ORAL CDK 4/6 INHIBITOR) PLUS LETROZOLE VERSUS PLACEBO PLUS LETROZOLE FOR THE TREATMENT OF POSTMENOPAUSAL WOMEN WITH ER (+), HER2 (-) BREAST CANCER WHO HAVE NOT RECEIVED ANY PRIOR SYSTEMI[NCT01740427]Phase 3666 participants (Actual)Interventional2013-02-22Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

Change From Baseline Between Treatment Comparison in Euro Quality of Life (EQ-5D) Index

The EuroQol EQ-5D is a 6-item instrument designed to assess health status in terms of a single index value or utility score. It contains 5 descriptors of current health state (mobility, self-care, usual activities, pain or discomfort, and anxiety or depression) with each dimension having 3 levels of function (1=no problem, 2=some problem, and 3=extreme problem). The scores on the 5 descriptors are summarized to create a single summary score. An overall utility score is calculated based on these domains, with a range score from 0 (worse health scenario) to a maximum of 1.0 (best health scenario). (NCT01740427)
Timeframe: From Baseline up to 2.5 years

InterventionUnits on a scale (Mean)
Palbociclib Plus Letrozole0.014
Placebo Plus Letrozole-0.010

Change From Baseline Between Treatment Comparison in Functional Assessment of Cancer Therapy -Breast (FACT-B)

FACT is a modular approach to assess participant health-related quality of life using a 'core' set of questions (FACT-G) as well as a cancer site-specific module. The FACT-G is a 27-item compilation of general questions divided into 4 domains: Physical Well-Being, Social/Family Well-Being, Emotional Well-Being, and Functional Well-Being. The FACT-B consisted of the FACT-G (27-item) and a breast-specific module: a 10-item instrument designed to assess participant concerns relating to breast cancer. For all questions, participants were asked to respond to a five-level scale where 0=not at all, 1=a little bit, 2=somewhat, 3=quite a bit, and 4=very much. FACT-B total score = Physical Well-Being + Social/Family Well-Being + Emotional Well-Being + Functional Well-Being + Breast Cancer Subscale. As each of the items ranges from 0-4, the range of possible scores is 0-144, with 0 being the worst possible score and 144 the best. (NCT01740427)
Timeframe: From Baseline up to 2.5 years

InterventionUnits on a scale (Mean)
Palbociclib Plus Letrozole-0.106
Placebo Plus Letrozole0.219

Disease Control (DC)/Clinical Benefit Response (CBR)

DC is defined as the overall CR, PR, or stable disease (SD) ≥24 weeks according to the RECIST version 1.1. Disease Control Rate (DCR) is defined as the patients with CR, PR, or SD ≥24 weeks relative to all randomized participants. Participants who do not have on-study radiographic tumor reevaluation, who received anti-tumor treatment, a best response of SD≥24 weeks, or who died, progressed,or dropped out for any reason prior to achieving reaching a CR or PR and a best response of SD≥24 weeks was counted as non-responders in DCR. Per RECIST v1.1, CR: Complete disappearance of target lesions with exception of nodal disease. All target nodes must decrease to normal size (short axis <10mm). PR: ≥30% decrease under baseline of the sum of diameters of all target measurable lesions. The short diameter is used in the sum for target nodes, while the longest diameter is used in the sum for all other target lesions. SD: neither sufficient shrinkage nor increase to qualify for disease progression (NCT01740427)
Timeframe: From randomization until end of treatment (up to approximately 2.5 years)

InterventionPercentage of participants (Number)
Palbociclib Plus Letrozole85.8
Placebo Plus Letrozole71.2

Duration of Response (DR)

DR is defined as the time from the first documentation of objective tumor response (CR or PR) to the first documentation of disease progression or to death due to any cause, whichever occurs first. If tumor progression data included more than 1 date, the first date will be used. DR was calculated as [the date response ended (i.e. date of PD or death) - first CR or PR date + 1)]/30.4. DR would only be calculated for the subgroup of patients with an objective tumor response. Per RECIST v1.1, CR: Complete disappearance of target lesions with exception of nodal disease. All target nodes must decrease to normal size (short axis <10mm). PR: ≥30% decrease under baseline of the sum of diameters of all target measurable lesions.The short diameter is used in the sum for target nodes, while the longest diameter is used in the sum for all other target lesions. Stable Disease: neither sufficient shrinkage nor increase to qualify for disease progression. (NCT01740427)
Timeframe: From randomization until end of treatment (up to approximately 2.5 years)

InterventionMonths (Median)
Palbociclib Plus Letrozole20.1
Placebo Plus Letrozole16.7

Objective Response as Assessed by the Investigator

Objective Response (OR) defined as the overall complete response (CR) or partial response (PR) according to the RECIST v1.1. Objective Response Rate (ORR) is defined as proportion of patients with CR or PR relative to all randomized patients with measurable disease at baseline. Patients who do not have on-study radiographic tumor re-evaluation, who received anti-tumor treatment, or who died, progressed/ dropped out for any reason prior to reaching a CR or PR were counted as non-responders in the assessment of ORR. Per RECIST v1.1, CR: Complete disappearance of target lesions with exception of nodal disease. All target nodes must decrease to normal size (short axis <10mm). PR: ≥30% decrease under baseline of the sum of diameters of all target measurable lesions. The short diameter is used in the sum for target nodes, while the longest diameter is used in the sum for all other target lesions. Stable Disease: neither sufficient shrinkage nor increase to qualify for disease progression. (NCT01740427)
Timeframe: From randomization until end of treatment (up to approximately 2.5 years)

InterventionPercentage of participants (Number)
Palbociclib Plus Letrozole46.4
Placebo Plus Letrozole38.3

Objective Response: Patients With Measurable Disease at Baseline as Assessed by the Investigator

The OR is defined as the overall CR or PR according to the RECIST v1.1. ORR is defined as proportion of patients with CR or PR relative to all randomized patients with measurable disease at baseline. Patients who do not have on-study radiographic tumor re-evaluation, who received anti-tumor treatment, or who died, progressed/ dropped out for any reason prior to reaching a CR or PR were counted as non-responders in the assessment of ORR. Per RECIST v1.1, CR: Complete disappearance of target lesions with exception of nodal disease. All target nodes must decrease to normal size (short axis <10mm). PR: ≥30% decrease under baseline of the sum of diameters of all target measurable lesions. The short diameter is used in the sum for target nodes, while the longest diameter is used in the sum for all other target lesions. Stable Disease: neither sufficient shrinkage nor increase to qualify for disease progression. (NCT01740427)
Timeframe: From randomization until end of treatment (up to approximately 2.5 years)

InterventionPercentage of participants (Number)
Palbociclib Plus Letrozole60.7
Placebo Plus Letrozole49.1

Overall Survival (OS)

OS was defined as the time from date of randomization to date of death due to any cause. Participants without survival data beyond the date of their last follow-up were censored on the last date they were known to be alive. (NCT01740427)
Timeframe: From date of randomization until death due to any cause or censored, (assessed up to data cut-off date of 15-Nov-2021, approximately 8.7 years)

InterventionMonths (Median)
Palbociclib Plus Letrozole53.9
Placebo Plus Letrozole51.2

Progression-Free Survival (PFS) as Assessed by the Investigator.

PFS is defined as the time from the date of randomization to the date of the first documentation of objective tumor progression as per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) or death due to any cause in the absence of documented PD, whichever occurs first. If tumor progression data include more than 1 date, the first date will be used. PFS (in months) will be calculated as (first event date - randomization date +1)/30.4. Progression is defined using RECIST v1.1, as a 20% increase in the sum of diameters of target measurable lesions above the smallest sum observed (over baseline if no decrease in the sum is observed during therapy), with a minimum absolute increase of 5 mm, or unequivocal progression of pre-existing non-target lesions, or the appearance of new lesions. (NCT01740427)
Timeframe: From randomization date to date of first documentation of progression OR death (up to approximately 2.5 years)

InterventionMonths (Median)
Palbociclib Plus Letrozole24.8
Placebo Plus Letrozole14.5

Corrected QT Interval (QTc) Time-matched Change From Baseline on Cycle 1 Day 14

Triplicate 12-lead ECG measurements (each recording separated by approximately 2 minutes) were performed and sent to a central laboratory for blinded manual adjudication. The average was calculated. The time corresponding to beginning of depolarization to repolarization of the ventricles (QT interval) was adjusted for RR interval using QT and RR from each ECG by Fridericia's formula (QTcF = QT divided by cube root of RR), by Bazette's formula (QTcB = QT divided by square root of RR) and corrected QT interval according to study-specific criteria (QTcS). Time-matched change from baseline values were reported for QTc analysis population. (NCT01740427)
Timeframe: Time-matched triplicate ECGs were collected at 0 (predose), 2, 4, 6 and 8 hours on Day 0 and on Cycle1 Day14

,
Interventionmsec (Least Squares Mean)
QTcS at 0 hourQTcS at 2 hourQTcS at 4 hourQTcS at 6 hourQTcS at 8 hourQTcF at 0 hourQTcF at 2 hourQTcF at 4 hourQTcF at 6 hourQTcF at 8 hourQTcB at 0 hourQTcB at 2 hourQTcB at 4 hourQTcB at 6 hourQTcB at 8 hour
Palbociclib Plus Letrozole0.803.322.764.490.941.103.682.864.571.21-0.111.462.584.03-0.17
Placebo Plus Letrozole2.951.651.740.723.143.061.731.540.712.842.780.832.470.534.14

Number of Participants With Laboratory Abnormalities by Maximum Common Terminology Criteria for Adverse Events (CTCAE) Grade

Laboratory abnormalities included anemia, hemoglobin increased, neutrophils (absolute), platelets, white blood cells, alanine aminotransferase (ALT), alkaline phosphatase, aspartate aminotransferase (AST), bilirubin (total), creatinine, hypercalcemia, hyperkalemia, hypermagnesemia, hypernatremia, hypoalbuminemia, hypocalcemia, hypokalemia, hypomagnesemia and hyponatremia. Laboratory abnormalities were graded by CTCAE version (v) 4.0 as Grade 1 = mild, Grade 2 = moderate, Grade 3 = severe and Grade 4 = life-threatening. Categories with at least 1 non-zero data values are reported. (NCT01740427)
Timeframe: From randomization up to 28 days after last dose of study drug (assessed up to data cut-off date of 15-Nov-2021, approximately 8.7 years)

,
InterventionParticipants (Count of Participants)
Anemia: Grade 1-2Anemia: Grade 3Hemoglobin Increased: Grade 1-2Hemoglobin Increased: Grade 3Neutrophils (Absolute): Grade 1-2Neutrophils (Absolute): Grade 3Neutrophils (Absolute): Grade 4Platelets: Grade 1-2Platelets: Grade 3Platelets: Grade 4White Blood Cells: Grade 1-2White Blood Cells: Grade 3White Blood Cells: Grade 4ALT: Grade 1-2ALT: Grade 3ALT: Grade 4Alkaline Phosphatase: Grade 1-2Alkaline Phosphatase: Grade 3AST: Grade 1-2AST: Grade 3Bilirubin (Total): Grade 1-2Bilirubin (Total): Grade 3Creatinine: Grade 1-2Creatinine: Grade 3Creatinine: Grade 4Hypercalcemia: Grade 1-2Hypercalcemia: Grade 3Hyperkalemia: Grade 1-2Hyperkalemia: Grade 3Hyperkalemia: Grade 4Hypermagnesemia: Grade 1-2Hypermagnesemia: Grade 3Hypermagnesemia: Grade 4Hypernatremia: Grade 1-2Hypernatremia: Grade 3Hypoalbuminemia: Grade 1-2Hypoalbuminemia: Grade 3Hypocalcemia: Grade 1-2Hypocalcemia: Grade 3Hypocalcemia: Grade 4Hypokalemia: Grade 1-2Hypokalemia: Grade 3Hypomagnesemia: Grade 1-2Hypomagnesemia: Grade 3Hypomagnesemia: Grade 4Hyponatremia: Grade 1-2Hyponatremia: Grade 3
Palbociclib Plus Letrozole3283014110925460289612481776222161174726023333418821111118627192948118215843105111271210711
Placebo Plus Letrozole9062504221320057007600950822110201005425110266035142048103224100444

Observed Plasma Trough Concentration (Ctrough) at Steady-State

Summary of Plasma Palbociclib Within-Patient Mean Steady-State Trough Concentrations. (NCT01740427)
Timeframe: 0 hour (predose) on Day 14 of cycles 1 and 2

Interventionng/mL (Geometric Mean)
Cycle 1 Day 14Cycle 2 Day 14
Palbociclib Plus Letrozole70.164.2

Percentage of Participants With Corrected QT Interval (QTc)

Triplicate 12-lead ECG measurements (each recording separated by approximately 2 minutes) were performed and sent to a central laboratory for blinded manual adjudication. The average was calculated. The time corresponding to beginning of depolarization to repolarization of the ventricles (QT interval) was adjusted for RR interval using QT and RR from each ECG by Fridericia's formula (QTcF = QT divided by cube root of RR), by Bazette's formula (QTcB = QT divided by square root of RR) and corrected QT interval according to study-specific criteria (QTcS). Percentage of participants with post-baseline maximum absolute values and maximum increase from baseline were summarized for the safety analysis population. (NCT01740427)
Timeframe: For safety monitoring triplicate ECGs were obtained at 0 hour (pre-dose) on Day 1 of Cycle 1, Day 14 of Cycles 1 and Cycle 2, then on Day 1 of Cycles 4, 7, and 10. ECGs beyond Cycle 10 were performed as clinically indicated

,
InterventionPercentage of participants (Number)
Maximum QTcS <450 msecMaximum QTcS 450-<480 msecMaximum QTcS 480-<500 msecMaximum QTcS ≥500 msecMaximum QTcF <450 msecMaximum QTcF 450-<480 msecMaximum QTcF 480-<500 msecMaximum QTcF ≥500 msecMaximum QTcB <450 msecMaximum QTcB 450-<480 msecMaximum QTcB 480-<500 msecMaximum QTcB ≥500 msecMaximum QTcS Change <30 msecMaximum QTcS 30≤Change <60 msecMaximum QTcS Change≥60 msecMaximum QTcF Change <30 msecMaximum QTcF 30≤Change <60 msecMaximum QTcF Change≥60 msecMaximum QTcB Change <30 msecMaximum QTcB 30≤Change <60 msecMaximum QTcB Change≥60 msec
Palbociclib Plus Letrozole80.517.91.10.585.912.21.60.264.932.22.30.792.76.60.791.67.90.588.910.20.9
Placebo Plus Letrozole85.911.82.3089.59.50.9069.127.33.20.594.55.5093.66.4091.48.20.5

Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs; All Causalities)

An AE was any untoward medical occurrence in a clinical investigation participant administered a product or medical device; the event need not necessarily have a causal relationship with the treatment or usage. SAE was any untoward medical occurrence at any dose that resulted in death; was life-threatening; required hospitalization; resulted in persistent or significant disability or in congenital anomaly/birth defect. TEAE were events that occurred between first dose of study drug and up to 28 days after last dose that were absent before treatment or that worsened relative to pretreatment state. Severity was graded by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), Version 4.0 as Grade 1 = mild, Grade 2 = moderate, Grade 3 = severe, Grade 4 = life-threatening and Grade 5 = death related to AE. (NCT01740427)
Timeframe: From date of randomization up to 28 days after last dose of study drug, (assessed up to data cut-off date of 15-Nov-2021, approximately 8.7 years)

,
InterventionPercentage of Participants (Number)
Participants with AEsParticipants with SAEsParticipants with Grade 3 or 4 AEsParticipants with Grade 5 AEsPermanently discontinued study due to AEsPermanently disc. palbociclib/placebo due to AEsPermanently discontinued letrozole due to AEsTemporarily disc. palbociclib/placebo due to AEsTemporarily discontinued letrozole due to AEsWith palbociclib/placebo dose reduction due to AEs
Palbociclib Plus Letrozole99.127.582.73.64.114.29.079.522.740.8
Placebo Plus Letrozole96.417.130.22.32.35.95.417.111.32.3

PFS by Tumor Tissue Biomarkers Status, Including Genes (eg, Copy Numbers of CCND1, CDKN2A), Proteins (eg, Ki67, pRb), and RNA Expression (eg, cdk4, cdk6)

"PFS by biomarker status by Investigator assessment. Progression is defined using RECIST v1.1, as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.~Positive is defined as H-Score ≥1 and negative as H-Score <1. H-Score is calculated as the sum of the % of cells at each level of staining intensity (0, 1+, 2+, and 3+) multiplied by the staining intensity value: H-Score = (% at 0)*0 + (% at 1+)*1 + (% at 2+)*2 + (% at 3+)*3. H-Score values range from 0 to 300.~ER stands for estrogen receptor and Rb stands for retinoblastoma susceptibility gene product." (NCT01740427)
Timeframe: From randomization until end of treatment (up to approximately 24 Months)

,
InterventionMonths (Median)
ER PositiveER NegativeRb PositiveRb NegativeCyclin D1 PositiveCyclin D1 Negativep16 Positivep16 Negativep16 H-Score<175p16 H-Score≥175Ki67 ≤20%Ki67 >20%
Palbociclib Plus Letrozole24.915.624.2NA24.811.124.816.823.724.227.617.5
Placebo Plus Letrozole16.35.413.718.513.88.113.813.813.85.616.88.4

Survival Probability at 1 Year, 2 Year and 3 Year

One, two or three-year survival probability was defined as the probability of survival 1 year, 2 or 3 years after the date of randomization. The survival probability was estimated using the Kaplan-Meier method and 2-sided 95% confidence interval (CI) was calculated using the product limit method. (NCT01740427)
Timeframe: 1, 2 and 3 years after randomization

,
InterventionPercent probability (Number)
1 year survival probability2 year survival probability3 year survival probability
Palbociclib Plus Letrozole92.778.469.8
Placebo Plus Letrozole94.982.565.0

Trials

3 trials available for letrozole and Response Evaluation Criteria in Solid Tumors

ArticleYear
Concordance of real-world versus conventional progression-free survival from a phase 3 trial of endocrine therapy as first-line treatment for metastatic breast cancer.
    PloS one, 2020, Volume: 15, Issue:4

    Topics: Adult; Antineoplastic Agents, Hormonal; Aromatase Inhibitors; Breast Neoplasms; Electronic Health Re

2020
Everolimus Plus Letrozole for Treatment of Patients With HR
    Clinical breast cancer, 2018, Volume: 18, Issue:2

    Topics: Adult; Aged; Aged, 80 and over; Anemia; Antineoplastic Agents, Hormonal; Antineoplastic Combined Che

2018
Ribociclib plus letrozole versus letrozole alone in patients with de novo HR+, HER2- advanced breast cancer in the randomized MONALEESA-2 trial.
    Breast cancer research and treatment, 2018, Volume: 168, Issue:1

    Topics: Adult; Aged; Aged, 80 and over; Aminopyridines; Antineoplastic Combined Chemotherapy Protocols; Brea

2018

Other Studies

1 other study available for letrozole and Response Evaluation Criteria in Solid Tumors

ArticleYear
Management of Premenopausal Women with Neoadjuvant Endocrine Therapy: A Single-Institution Experience.
    Annals of surgical oncology, 2015, Volume: 22, Issue:12

    Topics: Adult; Anastrozole; Antineoplastic Agents, Hormonal; Antineoplastic Combined Chemotherapy Protocols;

2015