Actively Recruiting
Adjuvant Abemaciclib for Locoregional Recurrence of HR-positive, HER2-negative Breast Cancer (JCOG2313, AURA)
Led by Japanese Foundation for Cancer Research · Updated on 2025-09-29
290
Participants Needed
1
Research Sites
521 weeks
Total Duration
On this page
Sponsors
J
Japanese Foundation for Cancer Research
Lead Sponsor
J
Japan Clinical Oncology Group
Collaborating Sponsor
AI-Summary
What this Trial Is About
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.
CONDITIONS
Official Title
Adjuvant Abemaciclib for Locoregional Recurrence of HR-positive, HER2-negative Breast Cancer (JCOG2313, AURA)
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Diagnosed with first locoregional recurrence (ipsilateral breast tumor, chest wall, or regional lymph node) after primary breast cancer treatment
- At least one recurrence lesion confirmed by biopsy, surgical specimen, or cytology cell block
- Lesion pathologically confirmed as invasive breast cancer or diagnosed in cytology cell block if primary cancer was invasive
- Hormone receptor positive and HER2 negative in all lesions evaluated
- No prior distant metastasis of breast cancer
- Imaging confirms no lymph nodes 10 mm or larger and no distant metastasis before registration
- Age 18 years or older at registration
- ECOG Performance Status of 0 or 1
- Chemotherapy for locoregional recurrence allowed before enrollment
- No bilateral breast cancer
- No prior treatment with CDK4/6 inhibitors
- Written informed consent obtained
You will not qualify if you...
- Active double cancer requiring treatment
- Infectious disease needing systemic therapy
- Fever of 38.0°C or higher at registration
- Women pregnant, possibly pregnant, within 28 days postpartum, or breastfeeding; men with partners intending pregnancy
- Psychiatric illness or symptoms interfering with daily living or trial participation
- Ongoing systemic steroids equivalent to 10 mg/day prednisolone or other immunosuppressants
- Unstable angina within past 3 weeks or myocardial infarction within past 6 months
- Uncontrolled hypertension
- Uncontrolled diabetes despite insulin or oral therapy
- Positive for hepatitis B antigen or hepatitis C antibodies (if HCV-RNA undetectable, allowed)
- Positive for HIV antibodies (testing not mandatory)
- Interstitial pneumonia, pulmonary fibrosis, or severe emphysema diagnosed by chest CT
AI-Screening
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Trial Site Locations
Total: 1 location
1
Cancer Institute Hospital of JFCR
Koto-ku, Tokyo, Japan, 135-8550
Actively Recruiting
Research Team
Y
Yukinori Ozaki, MD. PhD.
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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