PYTHIA

  • Research type

    Research Study

  • Full title

    Palbociclib in molecularly characterized ER-positive/HER2-negative metastatic breast cancer: the PYTHIA study A Phase II Study of Palbociclib plus Fulvestrant for pretreated patients with ER+/HER2- Metastatic Breast Cancer

  • IRAS ID

    204319

  • Contact name

    Gianfilippo Bertelli

  • Contact email

    g.bertelli@bsuh.nhs.uk

  • Sponsor organisation

    International Breast Cancer Study Group (IBCSG)

  • Eudract number

    2014-005387-15

  • Clinicaltrials.gov Identifier

    NCT02536742

  • Clinicaltrials.gov Identifier

    Breast International Group, BIG_14-04; Pfizer Inc., WI198393

  • Duration of Study in the UK

    3 years, 7 months, 1 days

  • Research summary

    The PYTHIA trial is a Phase II trial aiming to discover potentially innovative biomarkers in postmenopausal women with metastatic or locally relapsed breast cancer receiving palbociclib/fulvestrant treatment.
    The trial will enroll 120 patients. Enrollment is expected to be completed within 12 months from the activation date. The final trial analysis is expected approximately 30-36 months after the inclusion of the first patient under the amendment.
    Three countries (Belgium, Italy and United Kingdom) and a total of 22 centers will participate in PYTHIA trial.

    Summary of Results
    This study was launched in 2015 with the initial aim to demonstrate the superiority of a therapy consisting of two drugs, namely palbociclib and fulvestrant compared to a therapy consisting of placebo plus fulvestrant in postmenopausal women with a certain type of metastatic or locally-relapsed breast cancer. In 2016, the drug palbociclib became commercially available for this indication. Therefore, the study was revised to a single-arm study with only the therapy palbociclib and fulvestrant further investigated. The goal of this revised study was to evaluate potential biomarkers that are associated with the duration of how long patients live without their cancer getting worse.

    A total of 124 patients were enrolled in the PYTHIA trial. The first results were addressed at a specific marker called serum thymidine kinase activity (sTKa). This marker was measured before and during the treatment and appeared to have a prognostic value on how well patients respond to the treatment. High levels of sTKa before the treatment and incompletely suppressed during the treatment, may help to identify patients with poorer prognosis and primary resistance. However, as the study is limited by the sample size, these data need further validation in larger patient populations.

  • REC name

    East Midlands - Derby Research Ethics Committee

  • REC reference

    17/EM/0360

  • Date of REC Opinion

    8 Dec 2017

  • REC opinion

    Further Information Favourable Opinion