A Randomized, Double-Blind, Placebo-Controlled, Multi-Center Phase 3 Study of Denosumab as Adjuvant Treatment for Women With Early-Stage Breast Cancer at High Risk of Recurrence (D-CARE)
A Randomized, Double-Blind, Placebo-Controlled, Multi-Center Phase 3 Study of Denosumab as Adjuvant Treatment for Women With Early-Stage Breast Cancer at High Risk of Recurrence (D-CARE)
This randomized phase 3 trial is studying the effect of denosumab to see if it can prevent disease recurrence in the bone or in any other part of the body, when it is given as adjuvant therapy for women with early-stage breast cancer, who are at high risk of disease recurrence.
Eligible participants were randomized in a 1:1 ratio to receive denosumab 120 mg or placebo subcutaneously (SC) for up to 5 years. Randomization was stratified based on:
The primary analysis was conducted after all enrolled participants had the opportunity to complete 5 years of treatment from study day 1.
Inclusion Criteria:
Histologically confirmed, American Joint Committee on Cancer (AJCC) stage II or III breast cancer
High risk of breast cancer recurrence, defined as documented evidence of one or more of the following criteria:
i) Biopsy evidence of breast cancer in regional lymph node(s) (LN) (node-positive disease); Nodal micrometastases only are not considered node positive ii) Tumor size > 5 cm (T3) or locally advanced disease (T4)
Documented pathological evaluation of the breast cancer for hormone receptor (estrogen receptor [ER] and progesterone receptor [PR]) status and HER-2 status
Subjects must be receiving or be scheduled to receive standard of care systemic adjuvant or neoadjuvant chemotherapy and/or endocrine therapy and/or HER-2 targeted therapy
For subjects receiving adjuvant therapy only:
subjects must have undergone complete resection of the primary tumor with clean surgical margins, or subjects must have undergone resection of the primary tumor and be scheduled for further treatment of the primary tumor with curative intent. Definitive treatment must be planned to be completed within approximately 9 months of randomization
Time between definitive surgery and randomization must be ≤ 12 weeks. Definitive surgery may include secondary interventions (e.g. to clear inadequate surgical margins)
Subjects with node positive disease must have undergone treatment of axillary LN with curative intent, or subjects must be scheduled for further treatment of regional lymph nodes with curative intent. Definitive treatment must be planned to be completed within approximately 9 months of randomization
Subjects must not have received prior neoadjuvant treatment. Endocrine treatment for less than 30 days prior to surgery is not considered prior neoadjuvant treatment
For subjects receiving neoadjuvant therapy only:
Time between start of neoadjuvant treatment and randomization must be ≤ 8 weeks and subjects must be scheduled to undergo definitive treatment (including surgery and/or radiotherapy) with curative intent within approximately 9 months of starting neoadjuvant treatment
Female subjects with age ≥ 18 years
Subjects with reproductive potential must have a negative pregnancy test within 14 days before randomization
Serum calcium or albumin-adjusted serum calcium ≥ 2.0 mmol/L (8.0 mg/dL) and ≤ 2.9 mmol/L (11.5 mg/dL)
Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
Written informed consent before any study-specific procedure is performed
Exclusion Criteria:
Provincia de Santa Fe, Santa Fe Province S3000FFV, Argentina
Liège, 4000, Belgium
ItajaÃ-, Santa Catarina 88301-220, Brazil
São Paulo, São Paulo 01246-000, Brazil
São Paulo, São Paulo 01317-000, Brazil
Ã…rhus C, 8000, Denmark
Hyères, 83400, France
Monaco, 98012, France
München, 80335, Germany
München, 80638, Germany
München, 81675, Germany
Tübingen, 72076, Germany
Hyderabad, Andhra Pradesh 500 024, India
Poria Eylit, 15208, Israel
Meldola FC, 47014, Italy
San Giovanni Rotondo FG, 71013, Italy
Kitakyushu-shi, Fukuoka 802-0077, Japan
Kurume-shi, Fukuoka 830-0013, Japan
Kure-shi, Hiroshima 737-0023, Japan
Akashi-shi, Hyōgo 673-8558, Japan
Isehara-shi, Kanagawa 259-1193, Japan
Kurashiki-shi, Okayama-ken 701-0192, Japan
Suita-shi, Osaka 565-0871, Japan
Hidaka-Shi, Saitama 350-1298, Japan
Kitaadachi-gun, Saitama 362-0806, Japan
Suntou-gun, Shizuoka 411-8777, Japan
Shimotsuke-shi, Tochigi 329-0498, Japan
Chuo-ku, Tokyo 104-0045, Japan
Sittard-Geleen, 6162 BG, Netherlands
Metro Manila, 1100, Philippines
Ljublijana, 1525, Slovenia
Goyang-si, Gyeonggi-do, 410-769, South Korea
Córdoba, AndalucÃ-a 14004, Spain
Cádiz, AndalucÃ-a 11009, Spain
Jaén, AndalucÃ-a 23007, Spain
Málaga, AndalucÃ-a 29010, Spain
A Coruña, Galicia 15006, Spain
A Coruña, Galicia 15009, Spain
Alcorcón, Madrid 28922, Spain
Putzu City, Chiayi 61363, Taiwan
İzmir, 35340, Turkey (Türkiye)
Bornova-Izmir, 35100, Turkey (Türkiye)
Dorset, BH7 7DW, United Kingdom