NCT05207709

Brief Summary

HARMONIA is an international, multicenter, randomized, open-label and phase III study. The primary objective of this study is to demonstrate that the combination of ribociclib with endocrine therapy (letrozole or fulvestrant) is superior to palbociclib with endocrine therapy (letrozole or fulvestrant) in prolonging progression-free survival in patients with advanced HR+/HER2- and HER2-E breast cancer. The study will enroll approximately 456 patients with HER2-E disease from approximately 95 sites worldwide. In addition, the HARMONIA trial will include an exploratory cohort of patients with HR+/HER2- and Basal-like disease treated with paclitaxel +/- Tislelizumab. This cohort does not have a predefined sample size and the objective is only exploratory, given the suggested lack of efficacy of the combinations of hormone therapy and CDK4/6 inhibitors in this subgroup of patients. Enrolment into the basal-like cohort will stop once the HER2-E disease cohort is fully enrolled.

Trial Health

78
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
456

participants targeted

Target at P50-P75 for phase_3

Timeline
10mo left

Started Mar 2022

Longer than P75 for phase_3

Geographic Reach
3 countries

71 active sites

Status
active not recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress83%
Mar 2022Mar 2027

First Submitted

Initial submission to the registry

January 4, 2022

Completed
22 days until next milestone

First Posted

Study publicly available on registry

January 26, 2022

Completed
2 months until next milestone

Study Start

First participant enrolled

March 28, 2022

Completed
3.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2026

Completed
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2027

Expected
Last Updated

April 29, 2025

Status Verified

April 1, 2025

Enrollment Period

3.9 years

First QC Date

January 4, 2022

Last Update Submit

April 24, 2025

Conditions

Keywords

PAM50intrinsic subtypeHER2-Enriched

Outcome Measures

Primary Outcomes (1)

  • Progression-free survival

    using RECIST 1.1 criteria, as assessed by local radiologists/investigators

    From date of randomization until the date of first documented progression, death, lost of follow-up, withdraw consent or the study is terminated by SOLTI, whichever occurs first, assessed up to approximately 62 months after the first patient enrolled

Secondary Outcomes (5)

  • Progression-free survival 2

    From randomization until documented progression to second line of therapy, death, lost of follow-up, withdraw consent or the study is terminated by SOLTI, whichever occurs first, assessed up to approximately 62 months after the first patient enrolled

  • Overall Survival

    until patient death, assessed up to approximately 62 months after the first patient enrolled

  • Overall response and clinical benefit

    until disease progression or 24 weeks from treatment start.

  • Time to response and duration of response

    time from treatment start to response and time from response to disease progression, assessed up to approximately 62 months after the first patient enrolled

  • Adverse events (safety)

    from randomization/enrollment to end of study assessed up to approximately 62 months after the first patient enrolled

Study Arms (3)

Ribociclib + Endocrine Therapy

EXPERIMENTAL

Ribociclib + Fulvestrant or Letrozole

Drug: Ribociclib + Letrozole OR Fulvestrant

Palbociclib + Endocrine Therapy

EXPERIMENTAL

Palbociclib + Fulvestrant or Letrozole

Drug: Palbociclib + Letrozole OR Fulvestrant

Paclitaxel +/- Tislelizumab - Exploratory cohort

EXPERIMENTAL

Additional experimental Cohort that includes patients with Basal-Like intrinsic subtype.

Drug: Paclitaxel +/- Tislelizumab

Interventions

Endocrine Therapy will be selected by the investigator. For premenopausal women and men: LHRH agonist once every 4 weeks

Ribociclib + Endocrine Therapy

Endocrine Therapy will be selected by the investigator. For premenopausal women and men: LHRH agonist once every 4 weeks

Palbociclib + Endocrine Therapy

Patients in this arm could receive as the first line of therapy

Paclitaxel +/- Tislelizumab - Exploratory cohort

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Histologically documented HR-positive and HER2-negative breast cancer by local testing
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.
  • advanced (loco regionally recurrent not amenable to curative therapy or metastatic) breast cancer.
  • Availability of FFPE tumor block for biomarker analysis, obtained during metastatic period.
  • HER2-E or Basal-like subtype as per central PAM50 analysis.
  • Measurable disease or non-measurable disease, as defined by RECIST v1.1
  • Adequate hematologic and end-organ function
  • Patient must be willing and able to comply with scheduled visits, treatment plans, laboratory tests, and other trial procedures.
  • Women of childbearing potential must have confirmed negative serum pregnancy test within 7 days prior to randomization.
  • Women of CBP must be willing to use highly effective methods of contraception.
  • Patient must have a 6-lead or 12-lead ECG with ALL of the following parameters at screening:
  • QTcF interval (QT interval using Fridericia's correction) at screening \< 450 msec.
  • Resting heart rate 50-90 beats per minute (determined from the ECG).

You may not qualify if:

  • Prior therapy with any CDK4/6 inhibitors.
  • Patient has received prior treatment with chemotherapy for advanced/metastatic breast cancer

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (71)

Morton Plant Hospital

Clearwater, Florida, 33756, United States

Location

University of Miami

Coral Gables, Florida, 33124, United States

Location

Memorial Regional Hospital

Hollywood, Florida, 33021, United States

Location

Mount Sinai Florida

Miami, Florida, 33140, United States

Location

Northwestern

Chicago, Illinois, 60611, United States

Location

Carle Cancer Center

Urbana, Illinois, 61801, United States

Location

University of Kentucky, Markey Cancer Center

Lexington, Kentucky, 40536, United States

Location

Sinai of Baltimore

Baltimore, Maryland, 21215, United States

Location

Dana Faber Cancer Institute

Boston, Massachusetts, 02215, United States

Location

Baptist Memorial Health Care

Oxford, Mississippi, 38655, United States

Location

University of Nebraska Medical Center

Omaha, Nebraska, 68198, United States

Location

Nevada Cancer Research Foundation

Las Vegas, Nevada, 89121, United States

Location

NHOH

Londonderry, New Hampshire, 03053, United States

Location

Nothwell Health

New York, New York, 11042-1069, United States

Location

Montefiore

The Bronx, New York, 10467, United States

Location

University of North Carolina Lineberger

Chapel Hill, North Carolina, 27514, United States

Location

Novant Health Care

Winston-Salem, North Carolina, 27103, United States

Location

Ohio State University Comprehensive Cancer Center

Columbus, Ohio, 43210, United States

Location

Dayton Clinical Oncology

Kettering, Ohio, 45429, United States

Location

Legacy Good Samaritan Hospital and Medical Cente

Portland, Oregon, 97210, United States

Location

Providence Portland Medical Center

Portland, Oregon, 97225, United States

Location

The Medical University of South Carolina

Charleston, South Carolina, 29425, United States

Location

Upstate Carolina Medical Center

Spartanburg, South Carolina, 29302, United States

Location

Edwards Comprehensive Cancer Center

Huntington, Virginia, 25701, United States

Location

Bon Secours Memorial Regional Medical Center

Mechanicsville, Virginia, 231136, United States

Location

Unv. Wisconsin

Madison, Wisconsin, 53792, United States

Location

Hospital Senhora da Oliveira - Guimarães

Creixomil, Portugal

Location

IPO Lisboa

Lisbon, 1500-650, Portugal

Location

Hospital Beatriz Ângelo

Loures, 2674-514, Portugal

Location

Instituto Portugues de Oncologia de Porto Francisco Gentil, EPE

Porto, 4200-072, Portugal

Location

Centro Hospitalar Vila Nova de Gaia

Vila Nova de Gaia, 4434-502, Portugal

Location

Hospital Son Llàtzer

Palma de Mallorca, Balearic Islands, 07198, Spain

Location

Institut Català d' Oncologia (ICO Badalona)

Badalona, Barcelona, 08916, Spain

Location

Hospital del Mar

Barcelona, Barcelona, 08003, Spain

Location

IOB-Institute of Oncology. Hospital Quironsalud Barcelona

Barcelona, Barcelona, 8023, Spain

Location

Institut Català d'Oncologia (ICO Hospitalet)

L'Hospitalet de Llobregat, Barcelona, 08908, Spain

Location

Hospital General de Catalunya

Sant Cugat del Vallès, Barcelona, 08195, Spain

Location

Hospital Universitario de Canarias

Santa Cruz de Tenerife, Canary Islands, 38320, Spain

Location

Institut Català d' Oncologia de Girona (ICO Girona)

Girona, Girona, 17007, Spain

Location

Hospital Clínico Universitario de A Coruña

A Coruña, La Coruña, 15006, Spain

Location

Hospital Clínico Universitario de Santiago CHUS

Santiago de Compostela, La Coruña, 15706, Spain

Location

Complejo Asistencial Universitario de León

León, León, 24001, Spain

Location

Hospital Universitario de Fuenlabrada

Fuenlabrada, Madrid, 28942, Spain

Location

Hospital Universitario Ramón y Cajal

Madrid, Madrid, 28034, Spain

Location

Fundación Jiménez Díaz

Madrid, Madrid, 28040, Spain

Location

Hospital La Paz

Madrid, Madrid, 28046, Spain

Location

Hospital Universitario Virgen de la Arrixaca

El Palmar, Murcia, 30120, Spain

Location

Hospital Universitario Morales Meseguer

Murcia, Murcia, 30008, Spain

Location

Hospital Quiron Salud Sagrado Corazon Sevilla

Seville, Sevilla, 41013, Spain

Location

Hospital Universitario Virgen del Rocio

Seville, Sevilla, 41013, Spain

Location

Hospital Clínico Universitario Lozano Blesa

Zaragoza, Zaragoza, 50009, Spain

Location

Hospital General Universitario de Alicante

Alicante, 03010, Spain

Location

Vall d´Hebron University Hospital

Barcelona, 08035, Spain

Location

Hospital Clinic de Barcelona

Barcelona, 08036, Spain

Location

Hospital de Basurto

Bilbao, 48013, Spain

Location

Complejo Hospitalario San Pedro de Alcántara

Cáceres, 10003, Spain

Location

Hospital Universitario Virgen de las Nieves

Granada, 18014, Spain

Location

H. Clínico San Cecilio de Granada

Granada, 18016, Spain

Location

Hospital Universitario de Gran Canaria Doctor Negrin

Las Palmas, 35010, Spain

Location

Hospital Universitari Arnau de Vilanova de Lleida

Lleida, 25198, Spain

Location

Hospital Universitario La Princesa

Madrid, 28006, Spain

Location

Hospital Universitario 12 de Octubre

Madrid, 28041, Spain

Location

Centro Integral Oncológico Clara Campal (CIOCC)

Madrid, 28050, Spain

Location

Hospital Universitario Puerta de Hierro de Majadahonda

Madrid, 28222, Spain

Location

Hospital Virgen de la Victoria

Málaga, 29010, Spain

Location

Hospital Sant Joan de Reus

Reus, 43204, Spain

Location

Hospital Universitario de Salamanca

Salamanca, 37007, Spain

Location

Hospital Universitario Marqués de Valdecilla

Santander, 39008, Spain

Location

Hospital Virgen de la Macarena

Seville, 41007, Spain

Location

Instituto Valenciano de Oncología (IVO)

Valencia, 46009, Spain

Location

Hospital Clinico Universitario de Valencia

Valencia, 46010, Spain

Location

Related Publications (1)

  • Kalinsky K, Accordino MK, Chiuzan C, Mundi PS, Sakach E, Sathe C, Ahn H, Trivedi MS, Novik Y, Tiersten A, Raptis G, Baer LN, Oh SY, Zelnak AB, Wisinski KB, Andreopoulou E, Gradishar WJ, Stringer-Reasor E, Reid SA, O'Dea A, O'Regan R, Crew KD, Hershman DL. Randomized Phase II Trial of Endocrine Therapy With or Without Ribociclib After Progression on Cyclin-Dependent Kinase 4/6 Inhibition in Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer: MAINTAIN Trial. J Clin Oncol. 2023 Aug 20;41(24):4004-4013. doi: 10.1200/JCO.22.02392. Epub 2023 May 19.

Related Links

MeSH Terms

Conditions

Breast Neoplasms

Interventions

ribociclibLetrozoleFulvestrantpalbociclib

Condition Hierarchy (Ancestors)

Neoplasms by SiteNeoplasmsBreast DiseasesSkin DiseasesSkin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

NitrilesOrganic ChemicalsTriazolesAzolesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsEstradiolEstrenesEstranesSteroidsFused-Ring CompoundsPolycyclic CompoundsEstradiol CongenersGonadal Steroid HormonesGonadal HormonesHormonesHormones, Hormone Substitutes, and Hormone Antagonists

Study Officials

  • Aleix Prat, MD

    Hospital Clínic of Barcelona / SOLTI

    PRINCIPAL INVESTIGATOR
  • Lisa A Carey, MD

    UNC Lineberger Comprehensive Cancer Center

    PRINCIPAL INVESTIGATOR
  • Dan G Stover, MD

    Stefanie Spielman Comprehensive Breast Center

    PRINCIPAL INVESTIGATOR
  • Tomás Pascual, MD

    Hospital Clínic of Barcelona / SOLTI cancer research group

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 4, 2022

First Posted

January 26, 2022

Study Start

March 28, 2022

Primary Completion

March 1, 2026

Study Completion (Estimated)

March 1, 2027

Last Updated

April 29, 2025

Record last verified: 2025-04

Data Sharing

IPD Sharing
Will not share

Locations