Abemaciclib with Endocrine Therapy for Breast Cancer Recurrence
Adjuvant Abemaciclib for Locoregional Recurrence of HR-positive, HER2-negative Breast Cancer (JCOG2313, AURA)
Recruiting
Phase 3Interventional Study
Breast CancerLocoregional RecurrenceAbemaciclibEndocrine Therapy
No Placebo Group
Every participant receives an active treatment — no one gets a placebo.
Pivotal Trial
This treatment is in the last trial phase before FDA approval.
Prior Safety Data
This treatment has already been tested in at least one earlier human trial.
Ready to participate?
Review the details below, then apply to join this clinical trial.
At a Glance
Age
18 and older
Sex
Any
Trial phase
Phase 3
Study type
Interventional
Purpose
Treatment
Participants needed
290 (estimated)
Sponsor
Japanese Foundation for Cancer Research · Other
Who this trial is looking for
This trial is looking for women with HR-positive, HER2-negative breast cancer who have had a local recurrence after initial treatment. Participants will receive either standard hormone therapy or hormone therapy plus abemaciclib, a new medication, for two years to see if it improves outcomes.
Are You a Good Fit for This Trial?
You may be able to join if
I have been diagnosed with the first local recurrence of breast cancer.
I am at least 18 years old.
I have a confirmed invasive breast cancer that is hormone receptor positive and HER2 negative.
I have no signs of distant metastasis.
I have a good performance status (ECOG 0 or 1).
I have not had prior treatment with CDK4/6 inhibitors.
I have obtained written consent to participate.
You may not be able to join if
I have active double cancer that needs treatment.
I have an ongoing infection that requires systemic therapy.
I have a fever of 38.0°C or higher at the time of registration.
I am pregnant, possibly pregnant, or breastfeeding.
I have psychiatric issues that interfere with daily living.
I have unstable angina or a heart attack in the last 6 months.
I have uncontrolled high blood pressure.
I have uncontrolled diabetes despite treatment.
Summarized in plain language from this trial's official eligibility criteria.
The full criteria are further down this page — only the research team can
confirm whether you qualify.
Think this trial could be right for you?
Answer a few quick questions to see if you may meet the eligibility requirements.
The JCOG2313 trial is a multicenter, randomized, phase III study designed to evaluate the efficacy and safety of adjuvant abemaciclib in combination with endocrine therapy versus endocrine therapy alone in patients with hormone receptor (HR)-positive, HER2-negative breast cancer who have undergone curative treatment for their first locoregional recurrence (LRR).
Although HR-positive, HER2-negativ…
The JCOG2313 trial is a multicenter, randomized, phase III study designed to evaluate the efficacy and safety of adjuvant abemaciclib in combination with endocrine therapy versus endocrine therapy alone in patients with hormone receptor (HR)-positive, HER2-negative breast cancer who have undergone curative treatment for their first locoregional recurrence (LRR).
Although HR-positive, HER2-negative breast cancer generally has a favorable prognosis, LRR-such as ipsilateral breast tumor recurrence (IBTR), chest wall recurrence, or regional lymph node recurrence-remains a clinically significant event that increases the risk of distant metastasis. While endocrine therapy is standard in this setting, the benefit of adding chemotherapy or other agents remains unclear, and treatment strategies vary widely.
Abemaciclib, a CDK4/6 inhibitor, has shown survival benefit in the adjuvant setting for high-risk early breast cancer. However, its role in post-LRR adjuvant treatment has not been evaluated in a randomized setting. This study aims to determine whether the addition of abemaciclib to endocrine therapy can improve invasive disease-free survival (IDFS) in patients after LRR.
Eligible patients are randomized 1:1 to receive either endocrine therapy alone or endocrine therapy plus abemaciclib (150 mg twice daily for 2 years). The primary endpoint is IDFS. Secondary endpoints include distant recurrence-free survival, breast cancer-specific survival, overall survival, and safety. A total of 290 patients will be enrolled. Randomization is stratified by site of recurrence, endocrine resistance, perioperative chemotherapy, and institution.
Additionally, a prospective ancillary study will assess circulating tumor DNA (ctDNA) as a biomarker for molecular residual disease (MRD). Plasma samples will be collected at predefined time points to evaluate the prognostic and predictive value of ctDNA for relapse and treatment response.
The JCOG2313 trial addresses an unmet need in the management of HR-positive, HER2-negative LRR and may contribute to the establishment of a new standard systemic therapy and personalized monitoring strategies.
Trial Locations
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Eligibility Criteria
Inclusion criteria:
1. The patient has been diagnosed with the first locoregional recurrence (LRR) after receiving definitive treatment for primary breast cancer. LRR includes one or more of the following:
(i) Ipsilateral breast tumor recurrence (ii) Ipsilateral chest wall recurrence (iii) Regi…
Inclusion criteria:
1. The patient has been diagnosed with the first locoregional recurrence (LRR) after receiving definitive treatment for primary breast cancer. LRR includes one or more of the following:
(i) Ipsilateral breast tumor recurrence (ii) Ipsilateral chest wall recurrence (iii) Regional lymph node recurrence
2. At least one LRR lesion must be confirmed by a biopsy, surgical specimen, or cell block from cytology, and must meet all of the following:
(i) Pathologically confirmed as invasive breast cancer, or diagnosed as breast cancer in a cytology cell block (in cases where only a cell block is available, the initial primary breast cancer must have been invasive).
(ii) Hormone receptor (HR) expression is positive. (iii) HER2 expression is negative.
※ If multiple lesions are pathologically evaluated and any lesion is HR-negative or HER2-positive, the patient is ineligible.
3. No prior diagnosis of distant metastasis of breast cancer.
4. Imaging assessment before registration confirms:
No lymph nodes ≥10 mm in short axis No evidence of distant metastasis
5. Age ≥18 years at the time of registration.
6. ECOG Performance Status of 0 or 1.
7. Chemotherapy for LRR is allowed prior to enrollment.
8. The patient does not have bilateral breast cancer.
9. No prior history of treatment with CDK4/6 inhibitors.
10. Written informed consent has been obtained for participation in this clinical trial.
Exclusion Criteria:
1. Presence of active double cancer (synchronous malignancy requiring treatment).
2. Ongoing infectious disease requiring systemic therapy.
3. Fever ≥38.0°C at the time of registration.
4. Women who are pregnant, possibly pregnant, within 28 days postpartum, or breastfeeding; men whose partners intend to become pregnant.
5. Psychiatric illness or symptoms that interfere with daily living and may compromise trial participation.
6. Ongoing systemic administration (oral or IV) of steroids equivalent to ≥10 mg/day of prednisolone or other immunosuppressive agents.
7. Unstable angina (developed or worsened within the past 3 weeks) or myocardial infarction within the past 6 months.
8. Uncontrolled hypertension.
9. Uncontrolled diabetes mellitus despite continuous insulin or oral antidiabetic therapy.
10. Positive for HBs antigen or HCV antibodies (Patients positive for HCV antibodies are not excluded if HCV-RNA is undetectable.)
11. Positive for HIV antibodies (HIV testing is not mandatory.)
12. Presence of interstitial pneumonia, pulmonary fibrosis, or severe emphysema as diagnosed by chest CT.
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