Palbociclib for HR Positive / HER2-negative Isolated Locoregional Recurrence of Breast Cancer

Last updated: April 8, 2026
Sponsor: ETOP IBCSG Partners Foundation
Overall Status: Active - Not Recruiting

Phase

3

Condition

N/A

Treatment

Standard endocrine therapy

Palbociclib 125mg

Clinical Study ID

NCT03820830
IBCSG 59-19
2018-003553-19
WI239003
BIG 18-02
  • Ages > 18
  • All Genders

Study Summary

POLAR is a phase III clinical trial, which will test the safety and efficacy of an investigational combination of drugs to learn whether the combination of drugs works for a specific cancer. Palbociclib (Ibrance®) is the name of the investigational agent, which is assessed together with standard anti-hormone therapy in this study. Palbociclib is used to treat patients with hormone receptor-positive / HER2-negative breast cancer which has spread beyond the original tumor and/or to other organs.

During this study, anti-hormone therapy will consist of either a selective estrogen receptor modulator (such as tamoxifen) or an aromatase inhibitor (anastrozole, letrozole, exemestane) or fulvestrant (Faslodex®). Premenopausal women and men may also receive a drug called an LHRH (luteinizing hormone-releasing hormone) agonist by injection.

It is standard of care for people with hormone receptor positive breast cancer to take anti-hormone therapy. The study doctor will determine the type of standard anti-hormone therapy that will be given during this trial.

The purpose of the POLAR study is to compare the effect of using 3 years of palbociclib in combination with standard anti-hormone therapy with standard anti-hormone therapy alone and to evaluate the time until the breast cancer returns, if it does return.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Histologically confirmed invasive breast cancer, defined as first proven ipsilaterallocal and/or regional recurrence of a primary invasive breast cancer in at least oneof these sites:
  • breast;

  • the chest wall including mastectomy scar and/or skin;

  • axillary or internal mammary lymph nodes.

  1. Completion of locoregional therapy:
  • completion of gross excision of recurrence within 6 months prior torandomization;

  • completion of radiotherapy (if given) more than 2 weeks prior to randomization

  1. Negative or microscopically involved margins

  2. Female or male aged 18 years or older

  3. ECOG performance status 0 or 1

  4. Recurrent tumor must be hormone receptor positive: ER+ and/or PgR+ ≥1% by IHC

  5. Recurrent tumor must be HER2-negative (0, 1+, 2+ by IHC and/or ISH/FISH notamplified).Tumor with HER2 status 2+ by IHC must also be negative (not amplified) byISH/FISH

8.-10. Normal hematological, renal, and liver function 11. The patient agrees to make tumor (diagnostic core biopsy or surgical specimen of ipsilateral isolated locoregional recurrence) available for submission for central pathology review 12. Patients must either be planned to initiate, or have already started, endocrine therapy for ipsilateral isolated locoregional recurrence 13.) Written Informed Consent prior to randomization

Exclusion

Exclusion Criteria:

  1. Recurrence of any size with direct extension to the chest wall and/or to the skin (ulceration or skin nodules) not surgically removable

  2. Evidence of distant metastasis as based on conventional staging examinations (physical, chest X-ray or CT, abdominal ultrasound or CT, bone scintigraphy orFDG-PET-CT).

  3. Bilateral synchronous or metachronous invasive breast cancer (in situ carcinoma ofthe contralateral breast is allowed)

  4. Inflammatory breast cancer

  5. Patients with a history of malignancy, other than invasive breast cancer, with thefollowing exceptions:

  • Patients diagnosed, treated and disease-free for at least 5 years and deemed bythe investigator to be at low risk for recurrence of that malignancy areeligible.

  • Patients with the following malignancies are eligible, even if diagnosed andtreated within the past 5 years: ductal carcinoma in situ of the breast;cervical cancer in situ; thyroid cancer in situ; non-metastatic,non-melanomatous skin cancers.

  1. Previous treatment with palbociclib or any other CDK 4/6 inhibitors

  2. Previous or planned chemotherapy or planned radiotherapy for the ipsilateralisolated locoregional recurrence (radiotherapy is allowed, but must be completedmore than 2 weeks prior to randomization)

  3. Concurrent disease or condition that would make the patient inappropriate for studyparticipation or any serious medical disorder that would interfere with thepatient's safety

  4. Pregnant or lactating women; lactation has to stop before randomization

  5. Patients with psychiatric illness/social situations that would limit compliance withstudy requirements

  6. Contraindications or known hypersensitivity to the palbociclib or excipients

  7. History of extensive disseminated/bilateral or known presence of interstitialfibrosis or interstitial lung disease, including a history of pneumonitis,hypersensitivity pneumonitis, interstitial pneumonia, obliterative bronchiolitis,and pulmonary fibrosis. A history of prior radiation pneumonitis is not consideredan exclusion criterion.

Study Design

Total Participants: 405
Treatment Group(s): 2
Primary Treatment: Standard endocrine therapy
Phase: 3
Study Start date:
August 27, 2019
Estimated Completion Date:
January 01, 2029

Study Description

Local or regional recurrence of breast cancer after mastectomy or lumpectomy indicates a poor prognosis, and accompanies or precedes distant metastasis in a high proportion of patients. Patients with isolated locoregional recurrences (ILRR), without evidence of distant metastasis hold a substantial risk of developing subsequent distant metastasis, with 5-year survival probabilities ranging between 45% and 80% after locoregional recurrence. These outcomes show the powerful negative prognostic importance of ILRR events and the need for treatments beyond surgical removal of the ILRR.

Adjuvant chemotherapy and endocrine therapies reduce the risk of relapse and death in patients with primary breast cancer. However, few data are available to inform the recommendation of systemic treatment for locoregional recurrence.

The International Breast Cancer Studies Group carried out the CALOR trial, Chemotherapy as Adjuvant for Locally Recurrent breast cancer (IBCSG 27-02 / BIG 1-02 / NSABP B-37), in collaboration with the Breast International Group (BIG) and the National Surgical Adjuvant Breast and Bowel Project (NSABP), to establish whether chemotherapy improves the outcome of patients with ILRR. An updated, final analysis of CALOR after median follow-up of about 9 years was published in the Journal of Clinical Oncology in April 2018, which confirmed chemotherapy benefitted patients with resected ER-negative ILRR and did not support the use of chemotherapy for ER-positive ILRR.

CALOR results strongly suggest that tailoring treatment according to the disease characteristics of the recurrent lesion, in this case ILRR, provides a better indication of the possible responsiveness to treatment than relying on the characteristics of the primary tumor.

Palbociclib has been granted FDA approval in the U.S. for the treatment of HR-positive/HER2-negative advanced breast cancer in combination with the hormonal treatments letrozole and fulvestrant given the unprecedented results in terms of efficacy of two pivotal clinical trials (PALOMA-2 and PALOMA-3). Palbociclib and other CDK4/6 inhibitors have also shown a good toxicity profile and therefore are ideal candidates for combination with hormonal therapy. CDK4/6 pathway activation is a well-known mechanism of resistance to endocrine therapy, indeed CDK4/6 inhibitors have shown activity in cellular models of acquired resistance to endocrine therapies.

The reason for prolonged duration of palbociclib in the adjuvant setting (2 years) comes from the evidence of preclinical studies where cell senescence was investigated as an appealing mechanism of cell death and was indeed observed in vitro after exposure of breast cancer cells and tumors to a combination of endocrine therapy and palbociclib. It is therefore hypothesized that the longer patients receive combined treatment with palbociclib and an antiestrogen, the more likely they may derive prolonged clinical benefit.

Based on the results of the CALOR trial and on strong evidence of activity of the combination of CDK4/6 inhibitors and endocrine therapy, the hypothesis of the POLAR trial is that the CDK4/6 inhibitor palbociclib in combination with endocrine therapy may be active as adjuvant therapy in patients with HR-positive/HER2-negative resected isolated locoregional recurrence of breast cancer.

Connect with a study center

  • Medizinische Universität Graz (MUG)

    Graz,
    Austria

    Site Not Available

  • Medizinische Universität Innsbruck - Univ.-Klinik f. Frauenheilkunde

    Innsbruck,
    Austria

    Site Not Available

  • Uniklinikum Salzburg

    Salzburg,
    Austria

    Site Not Available

  • MUW - Universitätsklinik für Innere Medizin

    Vienna,
    Austria

    Site Not Available

  • Institut Sainte Catherine

    Avignon, 84918
    France

    Site Not Available

  • Institut Bergonie

    Bordeaux, 33076
    France

    Site Not Available

  • Polyclinique Bordeaux Nord

    Bordeaux, 333000
    France

    Site Not Available

  • Centre Francois Baclesse

    Caen, 14000
    France

    Site Not Available

  • Cêntre Hospitaler de Cholet

    Cholet, 49300
    France

    Site Not Available

  • Centre Georges François Leclerc

    Dijon, 21079
    France

    Site Not Available

  • Centre Hospitalier Universitaire de Limoges

    Limoges, 87000
    France

    Site Not Available

  • Groupe hospitalier de Bretagne Sud, Hôpital du Scorff

    Lorient,
    France

    Site Not Available

  • Centre Leon Berard

    Lyon, 69008
    France

    Site Not Available

  • ICM Val d'Aurelle

    Montpellier, 34298
    France

    Site Not Available

  • Centre Antoine Lacassagne

    Nice, 06189
    France

    Site Not Available

  • Centre Paul Strauss

    Strasbourg,
    France

    Site Not Available

  • Institut Claudius Regaud

    Toulouse, 31100
    France

    Site Not Available

  • Gustave Roussy

    Villejuif, 94800
    France

    Site Not Available

  • National Institute of Oncology

    Budapest,
    Hungary

    Site Not Available

  • Medical University

    Debrecen,
    Hungary

    Site Not Available

  • Cro Irccs

    Aviano,
    Italy

    Site Not Available

  • ASST Papa Giovanni XXIII

    Bergamo,
    Italy

    Site Not Available

  • PO Antonio Perrino Brindisi

    Brindisi,
    Italy

    Site Not Available

  • Istituto scientifico Romagnolo per lo studio e la cura

    Meldola,
    Italy

    Site Not Available

  • Istituto Europeo di Oncologia

    Milan,
    Italy

    Site Not Available

  • AOU Maggiore Della Carita, University of Eastern Piedmont

    Novara,
    Italy

    Site Not Available

  • Azienda Ospedaliero-Universitaria di Parma

    Parma,
    Italy

    Site Not Available

  • Istituti Clinici Scientifici Maugeri

    Pavia,
    Italy

    Site Not Available

  • Ospedale S. Stefano

    Prato,
    Italy

    Site Not Available

  • U.O. Oncologia, Ospedale Infermi

    Rimini,
    Italy

    Site Not Available

  • Hospital Universitario de Canarias

    San Cristóbal de La Laguna, Tenerife
    Spain

    Site Not Available

  • Hospital Universitario de La Coruña

    A Coruña,
    Spain

    Site Not Available

  • Hospital General Universitario de Alicante

    Alicante,
    Spain

    Site Not Available

  • Hospital Universitario Vall d´Hebrón

    Barcelona,
    Spain

    Site Not Available

  • Instituto Catalan de Oncologia L´Hospitalet

    Barcelona,
    Spain

    Site Not Available

  • Hospital de Basurto

    Bilbao,
    Spain

    Site Not Available

  • Institut Català d´Oncología (ICO)

    Girona,
    Spain

    Site Not Available

  • Hospital Universitario de La Coruña

    La Coruna,
    Spain

    Site Not Available

  • HU Ramón y Cajal

    Madrid,
    Spain

    Site Not Available

  • Hospital Universitario 12 de Octubre

    Madrid,
    Spain

    Site Not Available

  • Hospital Virgen de la Victoria

    Málaga,
    Spain

    Site Not Available

  • Hospital Virgen de la Macarena

    Sevilla,
    Spain

    Site Not Available

  • Hospital Virgen de la Macarena

    Seville,
    Spain

    Site Not Available

  • Instituto Valenciano de Oncología (IVO)

    Valencia,
    Spain

    Site Not Available

  • Hospital Universitario Río Hortega

    Valladolid,
    Spain

    Site Not Available

  • Hospital Universitario Miguel Servet

    Zaragoza,
    Spain

    Site Not Available

  • Kantonsspital Baden

    Baden,
    Switzerland

    Site Not Available

  • Brustzentrum Basel Bethesda Spital

    Basel,
    Switzerland

    Site Not Available

  • Inselspital Bern

    Bern,
    Switzerland

    Site Not Available

  • Centre du Sein Fribourg

    Fribourg,
    Switzerland

    Site Not Available

  • Fondazione Oncologia Lago Maggiore

    Locarno,
    Switzerland

    Site Not Available

  • Kouros Moccia Oncologia

    Locarno,
    Switzerland

    Site Not Available

  • Luzerner Kantonsspital

    Lucerne,
    Switzerland

    Site Not Available

  • Luzerner Kantonsspital

    Luzern,
    Switzerland

    Site Not Available

  • Kantonsspital Winterthur

    Winterthur,
    Switzerland

    Site Not Available

  • BZ Bethanien

    Zurich, 8001
    Switzerland

    Site Not Available

  • Brust-Zentrum AG Zürich

    Zurich,
    Switzerland

    Site Not Available

  • BZ Bethanien

    Zürich, 8001
    Switzerland

    Site Not Available

  • Brust-Zentrum AG Zürich

    Zürich,
    Switzerland

    Site Not Available

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