{
"info": {
"nct_id": "NCT03633331",
"official_title": "A Phase II Trial Assessing the Tolerability of Palbociclib in Combination With Letrozole or Fulvestrant in Patients Aged 70 and Older With Estrogen Receptor-Positive, HER2-Negative Metastatic Breast Cancer",
"inclusion_criteria": "* Documentation of disease: estrogen receptor positive and/or progesterone receptor (PR) positive, HER2 negative metastatic breast cancer; histologic confirmation is required\n* Measurable disease or non-measurable disease\n* Planning to begin palbociclib for metastatic disease; one prior line of endocrine therapy and/or chemotherapy for metastatic disease is allowed; patients may begin or have already begun endocrine therapy before they start palbociclib treatment, but no more than two weeks prior to registration\n* No prior therapy with a CDK inhibitor\n* Resolution of all acute toxic effects of prior therapy or surgical procedures to CTCAE grade =< 1 (except alopecia) or to baseline toxicities prior to previous therapy or surgical procedures, prior to registration\n* No untreated brain metastases; patients with treated brain metastases must have completed treatment with steroids to be eligible\n* No known interstitial lung disease\n* No second malignancies other than non-melanoma skin cancers or cervical carcinoma in situ; however, patients are not considered to have a \"currently active\" malignancy if they have completed therapy and are free of disease for >= 3 years\n* No active infection requiring treatment with antibiotics\n* Patients must be able to swallow and retain oral medication\n* Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2\n* Patients must be able to read and comprehend English or Spanish\n* Absolute neutrophil count (ANC) >= 1500/mm^3 (1.5 x 10^9/L)\n* Platelet count >= 100,000/mm^3 (100 x 10^9/L)\n* Creatinine clearance >= 30 ml/min calculated using the Cockcroft-Gault formula\n* Total serum bilirubin =< 1.5 upper limit of normal (ULN) (< 3 ULN if Gilbert's disease)\n* Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) =< 3 x ULN (=< 5.0 x ULN if liver metastases present)\n* Alkaline phosphatase =< 2.5 x ULN (=< 5 x ULN if bone or liver metastases present)\nHealthy volunteers allowed\nMust have minimum age of 70 Years",
"exclusion_criteria": "",
"miscellaneous_criteria": ""
},
"inclusion_lines": [
{
"identified_line": {
"line": "* Documentation of disease: estrogen receptor positive and/or progesterone receptor (PR) positive, HER2 negative metastatic breast cancer; histologic confirmation is required",
"criterions": [
{
"exact_snippets": "estrogen receptor positive",
"criterion": "estrogen receptor status",
"requirement": {
"requirement_type": "status",
"expected_value": "positive"
}
},
{
"exact_snippets": "progesterone receptor (PR) positive",
"criterion": "progesterone receptor status",
"requirement": {
"requirement_type": "status",
"expected_value": "positive"
}
},
{
"exact_snippets": "HER2 negative",
"criterion": "HER2 status",
"requirement": {
"requirement_type": "status",
"expected_value": "negative"
}
},
{
"exact_snippets": "metastatic breast cancer",
"criterion": "breast cancer stage",
"requirement": {
"requirement_type": "stage",
"expected_value": "metastatic"
}
},
{
"exact_snippets": "histologic confirmation is required",
"criterion": "histologic confirmation",
"requirement": {
"requirement_type": "requirement",
"expected_value": true
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"or_criteria": [
{
"exact_snippets": "estrogen receptor positive",
"criterion": "estrogen receptor status",
"requirement": {
"requirement_type": "status",
"expected_value": "positive"
}
},
{
"exact_snippets": "progesterone receptor (PR) positive",
"criterion": "progesterone receptor status",
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"requirement_type": "status",
"expected_value": "positive"
}
}
]
},
{
"exact_snippets": "HER2 negative",
"criterion": "HER2 status",
"requirement": {
"requirement_type": "status",
"expected_value": "negative"
}
},
{
"exact_snippets": "metastatic breast cancer",
"criterion": "breast cancer stage",
"requirement": {
"requirement_type": "stage",
"expected_value": "metastatic"
}
},
{
"exact_snippets": "histologic confirmation is required",
"criterion": "histologic confirmation",
"requirement": {
"requirement_type": "requirement",
"expected_value": true
}
}
]
}
},
{
"identified_line": {
"line": "* Measurable disease or non-measurable disease",
"criterions": [
{
"exact_snippets": "Measurable disease",
"criterion": "disease measurability",
"requirement": {
"requirement_type": "type",
"expected_value": "measurable"
}
},
{
"exact_snippets": "non-measurable disease",
"criterion": "disease measurability",
"requirement": {
"requirement_type": "type",
"expected_value": "non-measurable"
}
}
]
},
"logical_structure": {
"or_criteria": [
{
"exact_snippets": "Measurable disease",
"criterion": "disease measurability",
"requirement": {
"requirement_type": "type",
"expected_value": "measurable"
}
},
{
"exact_snippets": "non-measurable disease",
"criterion": "disease measurability",
"requirement": {
"requirement_type": "type",
"expected_value": "non-measurable"
}
}
]
}
},
{
"identified_line": {
"line": "* Planning to begin palbociclib for metastatic disease; one prior line of endocrine therapy and/or chemotherapy for metastatic disease is allowed; patients may begin or have already begun endocrine therapy before they start palbociclib treatment, but no more than two weeks prior to registration",
"criterions": [
{
"exact_snippets": "Planning to begin palbociclib for metastatic disease",
"criterion": "palbociclib treatment",
"requirement": {
"requirement_type": "planned",
"expected_value": true
}
},
{
"exact_snippets": "one prior line of endocrine therapy and/or chemotherapy for metastatic disease is allowed",
"criterion": "prior therapy for metastatic disease",
"requirement": {
"requirement_type": "quantity",
"expected_value": {
"operator": "<=",
"value": 1,
"unit": "lines"
}
}
},
{
"exact_snippets": "patients may begin or have already begun endocrine therapy before they start palbociclib treatment, but no more than two weeks prior to registration",
"criterion": "endocrine therapy start time",
"requirement": {
"requirement_type": "time before registration",
"expected_value": {
"operator": "<=",
"value": 2,
"unit": "weeks"
}
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Planning to begin palbociclib for metastatic disease",
"criterion": "palbociclib treatment",
"requirement": {
"requirement_type": "planned",
"expected_value": true
}
},
{
"or_criteria": [
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"exact_snippets": "one prior line of endocrine therapy and/or chemotherapy for metastatic disease is allowed",
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"unit": "lines"
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"exact_snippets": "patients may begin or have already begun endocrine therapy before they start palbociclib treatment, but no more than two weeks prior to registration",
"criterion": "endocrine therapy start time",
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"operator": "<=",
"value": 2,
"unit": "weeks"
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}
}
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]
}
]
}
},
{
"identified_line": {
"line": "* No prior therapy with a CDK inhibitor",
"criterions": [
{
"exact_snippets": "No prior therapy with a CDK inhibitor",
"criterion": "prior therapy with a CDK inhibitor",
"requirement": {
"requirement_type": "presence",
"expected_value": false
}
}
]
},
"logical_structure": {
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{
"exact_snippets": "No prior therapy with a CDK inhibitor",
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}
}
]
}
},
{
"identified_line": {
"line": "* Resolution of all acute toxic effects of prior therapy or surgical procedures to CTCAE grade =< 1 (except alopecia) or to baseline toxicities prior to previous therapy or surgical procedures, prior to registration",
"criterions": [
{
"exact_snippets": "Resolution of all acute toxic effects of prior therapy or surgical procedures to CTCAE grade =< 1",
"criterion": "acute toxic effects of prior therapy or surgical procedures",
"requirement": {
"requirement_type": "severity",
"expected_value": {
"operator": "<=",
"value": 1,
"unit": "CTCAE grade"
}
}
},
{
"exact_snippets": "Resolution of all acute toxic effects of prior therapy or surgical procedures ... to baseline toxicities prior to previous therapy or surgical procedures",
"criterion": "acute toxic effects of prior therapy or surgical procedures",
"requirement": {
"requirement_type": "severity",
"expected_value": "baseline toxicities prior to previous therapy or surgical procedures"
}
}
]
},
"logical_structure": {
"or_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Resolution of all acute toxic effects of prior therapy or surgical procedures to CTCAE grade =< 1",
"criterion": "acute toxic effects of prior therapy or surgical procedures",
"requirement": {
"requirement_type": "severity",
"expected_value": {
"operator": "<=",
"value": 1,
"unit": "CTCAE grade"
}
}
}
]
},
{
"and_criteria": [
{
"exact_snippets": "Resolution of all acute toxic effects of prior therapy or surgical procedures ... to baseline toxicities prior to previous therapy or surgical procedures",
"criterion": "acute toxic effects of prior therapy or surgical procedures",
"requirement": {
"requirement_type": "severity",
"expected_value": "baseline toxicities prior to previous therapy or surgical procedures"
}
}
]
}
]
}
},
{
"identified_line": {
"line": "* No untreated brain metastases; patients with treated brain metastases must have completed treatment with steroids to be eligible",
"criterions": [
{
"exact_snippets": "No untreated brain metastases",
"criterion": "untreated brain metastases",
"requirement": {
"requirement_type": "presence",
"expected_value": false
}
},
{
"exact_snippets": "patients with treated brain metastases must have completed treatment with steroids",
"criterion": "treated brain metastases",
"requirement": {
"requirement_type": "treatment completion",
"expected_value": true
}
},
{
"exact_snippets": "patients with treated brain metastases must have completed treatment with steroids",
"criterion": "treated brain metastases",
"requirement": {
"requirement_type": "steroid treatment",
"expected_value": true
}
}
]
},
"logical_structure": {
"condition": {
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"criterion": "untreated brain metastases",
"requirement": {
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"expected_value": false
}
},
"then_criteria": {
"and_criteria": [
{
"exact_snippets": "patients with treated brain metastases must have completed treatment with steroids",
"criterion": "treated brain metastases",
"requirement": {
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"expected_value": true
}
},
{
"exact_snippets": "patients with treated brain metastases must have completed treatment with steroids",
"criterion": "treated brain metastases",
"requirement": {
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"expected_value": true
}
}
]
},
"else_criteria": null
}
},
{
"identified_line": {
"line": "* No known interstitial lung disease",
"criterions": [
{
"exact_snippets": "No known interstitial lung disease",
"criterion": "interstitial lung disease",
"requirement": {
"requirement_type": "presence",
"expected_value": false
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"exact_snippets": "No known interstitial lung disease",
"criterion": "interstitial lung disease",
"requirement": {
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"expected_value": false
}
}
]
}
},
{
"identified_line": {
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"criterions": [
{
"exact_snippets": "No second malignancies other than non-melanoma skin cancers or cervical carcinoma in situ",
"criterion": "second malignancies",
"requirement": {
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"expected_value": false
}
},
{
"exact_snippets": "No second malignancies other than non-melanoma skin cancers or cervical carcinoma in situ",
"criterion": "second malignancies",
"requirement": {
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"cervical carcinoma in situ"
]
}
},
{
"exact_snippets": "patients are not considered to have a \"currently active\" malignancy if they have completed therapy and are free of disease for >= 3 years",
"criterion": "currently active malignancy",
"requirement": {
"requirement_type": "status",
"expected_value": false
}
},
{
"exact_snippets": "patients are not considered to have a \"currently active\" malignancy if they have completed therapy and are free of disease for >= 3 years",
"criterion": "currently active malignancy",
"requirement": {
"requirement_type": "time since therapy completion",
"expected_value": {
"operator": ">=",
"value": 3,
"unit": "years"
}
}
}
]
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"and_criteria": [
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"or_criteria": [
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"expected_value": false
}
},
{
"exact_snippets": "No second malignancies other than non-melanoma skin cancers or cervical carcinoma in situ",
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}
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"criterion": "currently active malignancy",
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"expected_value": false
}
},
{
"exact_snippets": "patients are not considered to have a \"currently active\" malignancy if they have completed therapy and are free of disease for >= 3 years",
"criterion": "currently active malignancy",
"requirement": {
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"expected_value": {
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"value": 3,
"unit": "years"
}
}
}
]
}
]
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{
"and_criteria": [
{
"exact_snippets": "patients are not considered to have a \"currently active\" malignancy if they have completed therapy and are free of disease for >= 3 years",
"criterion": "currently active malignancy",
"requirement": {
"requirement_type": "status",
"expected_value": false
}
},
{
"exact_snippets": "patients are not considered to have a \"currently active\" malignancy if they have completed therapy and are free of disease for >= 3 years",
"criterion": "currently active malignancy",
"requirement": {
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"expected_value": {
"operator": ">=",
"value": 3,
"unit": "years"
}
}
}
]
}
]
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},
{
"identified_line": {
"line": "* No active infection requiring treatment with antibiotics",
"criterions": [
{
"exact_snippets": "No active infection requiring treatment with antibiotics",
"criterion": "active infection",
"requirement": {
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"expected_value": false
}
},
{
"exact_snippets": "No active infection requiring treatment with antibiotics",
"criterion": "treatment with antibiotics",
"requirement": {
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}
}
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{
"exact_snippets": "No active infection requiring treatment with antibiotics",
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"expected_value": false
}
},
{
"exact_snippets": "No active infection requiring treatment with antibiotics",
"criterion": "treatment with antibiotics",
"requirement": {
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"expected_value": false
}
}
]
}
},
{
"identified_line": {
"line": "* Patients must be able to swallow and retain oral medication",
"criterions": [
{
"exact_snippets": "Patients must be able to swallow",
"criterion": "ability to swallow",
"requirement": {
"requirement_type": "ability",
"expected_value": true
}
},
{
"exact_snippets": "retain oral medication",
"criterion": "ability to retain oral medication",
"requirement": {
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"expected_value": true
}
}
]
},
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"and_criteria": [
{
"exact_snippets": "Patients must be able to swallow",
"criterion": "ability to swallow",
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"expected_value": true
}
},
{
"exact_snippets": "retain oral medication",
"criterion": "ability to retain oral medication",
"requirement": {
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"expected_value": true
}
}
]
}
},
{
"identified_line": {
"line": "* Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2",
"criterions": [
{
"exact_snippets": "Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2",
"criterion": "ECOG performance status",
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"0",
"1",
"2"
]
}
}
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"exact_snippets": "Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2",
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"requirement_type": "status",
"expected_value": [
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"1",
"2"
]
}
}
]
}
},
{
"identified_line": {
"line": "* Absolute neutrophil count (ANC) >= 1500/mm^3 (1.5 x 10^9/L)",
"criterions": [
{
"exact_snippets": "Absolute neutrophil count (ANC) >= 1500/mm^3 (1.5 x 10^9/L)",
"criterion": "absolute neutrophil count (ANC)",
"requirement": {
"requirement_type": "quantity",
"expected_value": {
"operator": ">=",
"value": 1500,
"unit": "mm^3"
}
}
}
]
},
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{
"exact_snippets": "Absolute neutrophil count (ANC) >= 1500/mm^3 (1.5 x 10^9/L)",
"criterion": "absolute neutrophil count (ANC)",
"requirement": {
"requirement_type": "quantity",
"expected_value": {
"operator": ">=",
"value": 1500,
"unit": "mm^3"
}
}
}
]
}
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{
"identified_line": {
"line": "* Platelet count >= 100,000/mm^3 (100 x 10^9/L)",
"criterions": [
{
"exact_snippets": "Platelet count >= 100,000/mm^3 (100 x 10^9/L)",
"criterion": "platelet count",
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"expected_value": {
"operator": ">=",
"value": 100000,
"unit": "mm^3"
}
}
}
]
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"exact_snippets": "Platelet count >= 100,000/mm^3 (100 x 10^9/L)",
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"operator": ">=",
"value": 100000,
"unit": "mm^3"
}
}
}
]
}
},
{
"identified_line": {
"line": "* Creatinine clearance >= 30 ml/min calculated using the Cockcroft-Gault formula",
"criterions": [
{
"exact_snippets": "Creatinine clearance >= 30 ml/min",
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"operator": ">=",
"value": 30,
"unit": "ml/min"
}
}
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{
"exact_snippets": "calculated using the Cockcroft-Gault formula",
"criterion": "calculation method for creatinine clearance",
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}
}
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"and_criteria": [
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"exact_snippets": "Creatinine clearance >= 30 ml/min",
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}
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"criterions": [
{
"exact_snippets": "Total serum bilirubin =< 1.5 upper limit of normal (ULN)",
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"value": 1.5,
"unit": "ULN"
}
]
}
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{
"exact_snippets": "Total serum bilirubin ... (< 3 ULN if Gilbert's disease)",
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"value": 3,
"unit": "ULN"
}
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}
}
}
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"unit": "ULN"
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},
{
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"line": "* Alkaline phosphatase =< 2.5 x ULN (=< 5 x ULN if bone or liver metastases present)",
"criterions": [
{
"exact_snippets": "Alkaline phosphatase =< 2.5 x ULN",
"criterion": "alkaline phosphatase",
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"operator": "<=",
"value": 2.5,
"unit": "x ULN"
}
}
},
{
"exact_snippets": "Alkaline phosphatase ... =< 5 x ULN if bone or liver metastases present",
"criterion": "alkaline phosphatase with bone or liver metastases",
"requirement": {
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"expected_value": {
"operator": "<=",
"value": 5,
"unit": "x ULN"
}
}
}
]
},
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"condition": {
"and_criteria": [
{
"exact_snippets": "bone metastases present",
"criterion": "bone metastases",
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"expected_value": true
}
},
{
"exact_snippets": "liver metastases present",
"criterion": "liver metastases",
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}
}
]
},
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"value": 5,
"unit": "x ULN"
}
}
},
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"operator": "<=",
"value": 2.5,
"unit": "x ULN"
}
}
}
}
},
{
"identified_line": {
"line": "Healthy volunteers allowed",
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{
"exact_snippets": "Healthy volunteers allowed",
"criterion": "volunteer health status",
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"expected_value": "healthy"
}
}
]
},
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"and_criteria": [
{
"exact_snippets": "Healthy volunteers allowed",
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{
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{
"or_criteria": [
{
"and_criteria": [
{
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{
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{
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"exclusion_lines": [],
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"failed_inclusion": [
{
"identified_line": {
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{
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}