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RecruitingInterventionalPhase 2

A Phase 2 Study of Alisertib in Combination With Endocrine Therapy in Patients With HR+, HER2-negative Recurrent or Metastatic Breast Cancer

NCT ID: NCT06369285Sponsor: Puma Biotechnology, Inc.Last updated: 2025-12-10

Summary

PUMA-ALI-1201 is a randomized, dose optimization, multicenter, Phase 2 study of alisertib administered in combination with endocrine therapy in participants with pathology-confirmed HR-positive/HER2-negative metastatic breast cancer (MBC) following progression on or after at least two prior lines of endocrine therapy in the recurrent or metastatic setting. This study is intended to evaluate the optimal alisertib dose administered in combination with the selected endocrine therapy. The study is also planned to evaluate the efficacy, safety, and pharmacokinetics of alisertib in combination with endocrine and to identify the biomarker-defined subgroup(s) that may benefit most from combined alisertib and endocrine therapy.

Arms & interventions

  • DrugAlisertib

    Alisertib enteric-coated tablets will be taken by mouth twice daily on days 1-3, 8-10, and 15-17 of each 28-day cycle.

  • DrugEndocrine therapy

    Investigator selected endocrine therapy will be taken in 28-day dosing cycles according to the approved prescribing information. 1 mg of anastrozole tablet by mouth once daily or 2.5 mg of letrozole tablet by mouth once daily or 25 mg of exemestane tablet by mouth once daily or 20 mg of tamoxifen tablet by mouth once daily or 500 mg of fulvestrant intramuscular injection on Study Day 1, 15, 29, and once every 28 days thereafter

Outcome measures

Primary

  • Objective Response Rate (ORR) Within Dose Subgroup

    Objective response rate is defined as the percentage of participants demonstrating a confirmed objective response during the study.

    Time frame: From date of randomization to first confirmed Complete or Partial Response, whichever came earlier, assessed up to 48 months

  • Duration of Response (DOR) Within Dose Subgroup

    Duration of response is measured from the time at which measurement criteria are first met for Complete Response (CR) or Partial Response (PR) (whichever status is recorded first) until the first date of recurrence or progressive disease (PD) or death is objectively documented.

    Time frame: From start date of response (after date of randomization) to first PD, assessed up to 48 months

  • Disease Control Rate (DCR) Within Dose Subgroup

    Disease control rate is the proportion of participants who achieve overall tumor response (confirmed CR or PR) or Stable Disease (SD) lasting for at least 24 weeks from randomization.

    Time frame: From date of randomization to first confirmed Complete or Partial Response, whichever came earlier, assessed up to 48 months

  • Progression Free Survival (PFS) Within Dose Subgroup

    Progression Free Survival (PFS) is measured in months and based on the local tumor assessment. The time interval from the date of randomization until the first date on which recurrence, progression, or death due to any cause, is documented.

    Time frame: From date of randomization to date of recurrence, progression or death, assessed up to 48 months

  • Overall Survival (OS) Within Dose Subgroup

    Overall survival (OS) is defined as the time from randomization to death due to any cause, censored at the last date known alive on or prior to the data cutoff employed for the analysis, whichever was earlier.

    Time frame: From date of randomization to death, assessed up to 48 months

  • Percentage of Participants With Treatment-Emergent Adverse Events (Adverse Events and Serious Adverse Events) in the Enrolled Population

    Treatment emergent adverse events are those events reported on or after the first dose of investigational product and up to 28 days after last dose.

    Time frame: From date of first dose through last dose plus 28 days, assessed up to 48 months

Secondary

  • Objective Response Rate (ORR) Within Biomarker-Defined Subgroup

    Time frame: From date of randomization to first confirmed Complete or Partial Response, whichever came earlier, assessed up to 48 months

  • Duration of Response (DOR) Within Biomarker-Defined Subgroup

    Time frame: From start date of response (after date of randomization) to first PD, assessed up to 48 months

  • Disease Control Rate (DCR) Within Biomarker-Defined Subgroup

    Time frame: From date of randomization to first confirmed Complete or Partial Response, whichever came earlier, assessed up to 48 months

  • Progression Free Survival (PFS) Within Biomarker-Defined Subgroup

    Time frame: From date of randomization to date of recurrence, progression or death, assessed up to 48 months

  • Overall Survival (OS) Within Biomarker-Defined Subgroup

    Time frame: From date of randomization to death, assessed up to 48 months

Eligibility criteria

Sex: AllAge: 18 Years and olderHealthy volunteers: No
Inclusion Criteria: * Aged ≥18 years at signing of informed consent. * Pathology-confirmed diagnosis of adenocarcinoma of the breast with evidence of recurrent or metastatic disease not amenable to curative therapy. * Progression on or after treatment with at least two prior lines of endocrine therapy in the recurrent or metastatic setting. a. If metastatic disease recurrence occurs during or within six months of discontinuing adjuvant endocrine therapy, then that endocrine therapy will count as one line of prior therapy. * Participants must have received a CDK4/6i in combination with endocrine therapy in the recurrent or metastatic setting. * HR-positive and HER2-negative tumor status reported per local laboratory testing. HR and HER2 testing must be performed consistent with current American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) or European Society of Medical Oncology (ESMO) guidelines: Exclusion Criteria: * Treatment with chemotherapy in the recurrent or metastatic setting. * Prior treatment with an Aurora Kinase A (AURKA) specific-targeted or pan-Aurora-targeted agent, including alisertib, in any setting. Note: There are additional inclusion and exclusion criteria. The study center will determine if you meet all of the criteria.

Study locations (35)

Alabama Oncology

Birmingham, Alabama, 34235

Recruiting

Mayo Clinic Hospital

Phoenix, Arizona, 85054

Recruiting

Beverly Hills Cancer Center

Beverly Hills, California, 90211

Recruiting

MemorialCare Orange Coast Medical Center

Fountain Valley, California, 92708

Recruiting

City of Hope at Orange County Lennar Foundation Cancer Center

Irvine, California, 92618

Recruiting

LA Cancer Network

Los Angeles, California, 90017

Recruiting

UCLA Department of Medicine - Hematology/Oncology

Los Angeles, California, 90095

Recruiting

University of California San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center

San Francisco, California, 94158

Recruiting

University of Colorado School of Medicine

Aurora, Colorado, 80045

Recruiting

Yale University, Yale Cancer Center

New Haven, Connecticut, 06520

Withdrawn

Mayo Clinic Florida

Jacksonville, Florida, 32224

Recruiting

Cancer Specialists of North Florida

Jacksonville, Florida, 32256

Recruiting

Moffitt Cancer Center

Tampa, Florida, 33612

Recruiting

Winship Cancer Institute, Emory University

Atlanta, Georgia, 30322

Recruiting

University of Illinois Cancer Center

Chicago, Illinois, 60612

Recruiting

The University of Chicago

Chicago, Illinois, 60637

Recruiting

Massachusetts General Hospital

Boston, Massachusetts, 02114

Recruiting

Dana-Farber Cancer Institute

Boston, Massachusetts, 02215

Recruiting

University of Minnesota, Masonic Cancer Center

Minneapolis, Minnesota, 55455

Recruiting

Mayo Clinic

Rochester, Minnesota, 55905

Recruiting

Missouri Cancer Associates

Columbia, Missouri, 65201

Recruiting

Saint Luke's Cancer Institute

Kansas City, Missouri, 64111

Recruiting

Oncology Hematology Associates

Springfield, Missouri, 65807

Recruiting

Washington University School of Medicine

St Louis, Missouri, 63110

Recruiting

Cancer Care Specialists

Reno, Nevada, 89511

Recruiting

University of Rochester Medical Center

Rochester, New York, 14642

Recruiting

UNC Hospitals, University of North Carolina at Chapel Hill

Chapel Hill, North Carolina, 27514

Recruiting

The Ohio State University, Stefanie Spielman Comprehensive Breast Center

Columbus, Ohio, 43212

Recruiting

Taylor Cancer Research Center

Maumee, Ohio, 43537

Recruiting

Alliance Cancer Specialists

Horsham, Pennsylvania, 19044

Recruiting

University of Pennsylvania, Abramson Cancer Center, Perelman Center for Advanced Medicine

Philadelphia, Pennsylvania, 19104

Recruiting

University of Pittsburgh (UPMC)

Pittsburgh, Pennsylvania, 15213

Recruiting

Tennessee Oncology, Greco-Hainsworth Center for Research

Nashville, Tennessee, 37203

Recruiting

Texas Oncology

Dallas, Texas, 75246

Recruiting

Virginia Cancer Institute

Richmond, Virginia, 23229

Recruiting