OPERA-01: a phase III study of palazestrant for ER+, HER2- advanced breast cancer after CDK4/6 inhibitor therapy.
Barbara Pistilli, Meritxell Bellet Ezquerra, Lucia Del Mastro...
https://pubmed.ncbi.nlm.nih.gov/41461598/Actively Recruiting
Led by Olema Pharmaceuticals, Inc. · Updated on 2026-03-13
510
Participants Needed
233
Research Sites
65 weeks
Total Duration
Researchers are evaluating palazestrant OP-1250 compared to standard endocrine therapies for adults with ER-positive, HER2-negative advanced or metastatic breast cancer that has progressed after endocrine therapy combined with a CDK46 inhibitor. This international phase 3 trial aims to assess the safety and effectiveness of palazestrant versus fulvestrant or aromatase inhibitors such as anastrozole, letrozole, or exemestane. Participants are randomly assigned to receive either palazestrant daily on a 28-day cycle at doses of 90 mg or 120 mg during the dose-selection phase, or the standard-of-care endocrine therapy including fulvestrant administered on specific days or one of the aromatase inhibitors given daily on similar cycles. The trial includes an initial dose-selection period with about 120 participants, followed by a larger randomized phase with approximately 390 participants receiving the selected dose of palazestrant or standard treatment. Throughout the study, participants will be monitored for adverse events, dose adjustments, and drug discontinuations up to 16 weeks. Researchers will measure progression-free survival for up to two years and overall survival for up to four years after randomization. Regular assessments will include clinical evaluations and safety monitoring to observe the effects and tolerability of the treatments during the trial.
CONDITIONS
OP-1250 (Palazestrant) vs. Standard of Care for the Treatment of ER+/HER2- Advanced Breast Cancer
O
Olema Pharmaceuticals, Inc.
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Olema Pharmaceuticals, Inc.
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Palazestrant (OP-1250) | Standard Endocrine Therapy (Fulvestrant, Anastrozole, Letrozole, or Exemestane) |
|---|---|---|
| What it is | Palazestrant (OP-1250) is an orally administered selective estrogen receptor degrader (SERD) being evaluated as a novel treatment for ER+, HER2- advanced breast cancer. | Standard of care endocrine therapy includes Fulvestrant (injectable SERD), Anastrozole, Letrozole, and Exemestane (all oral aromatase inhibitors) for ER+, HER2- advanced breast cancer. |
| Role in trial | Tested as the investigational therapy compared head-to-head with current guideline-standard endocrine agents. | Serves as the active comparator arm reflecting current endocrine therapy choices in clinical care. |
| Primary use | Investigational treatment aiming to improve progression-free survival and overall survival in ER+, HER2- advanced breast cancer following prior CDK4/6 inhibitor and endocrine therapy. | Approved therapies used to control disease and prolong survival as standard care after CDK4/6 inhibitor failure in ER+, HER2- advanced breast cancer. |
| How it is given or performed | Palazestrant is taken orally once daily, typically in continuous 28-day cycles. | Fulvestrant is given as injections (on Days 1, 15, then every 28 days). Anastrozole, Letrozole, Exemestane are taken orally once daily in 28-day cycles. |
| Evidence status | No mature data yet for progression-free or overall survival; ongoing trial with results not yet established. | Extensive published evidence supports clinical benefit of these therapies in this setting, as documented in prior studies and guideline reviews. |
| Important limitations | As an investigational agent, long-term efficacy, safety, and comparative benefit versus standard therapy are not yet established. No direct real-world evidence is available until trial completion. | Disease progression remains common despite available standard therapies. Prior exposure to CDK4/6 inhibitors and endocrine therapy may affect response rates. Real-world limitations include resistance and drug-related adverse events. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Repeated 28-day cycles until disease progression or discontinuation.
Participants receive either palazestrant or standard endocrine therapy (fulvestrant, anastrozole, letrozole, or exemestane) as part of their treatment.
Visits every 4 weeks aligned with treatment cycles
Duration - Up to 4 years or until death
Participants are monitored for overall survival and long-term safety after treatment ends.
Periodic visits for survival status assessments
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Barbara Pistilli, Meritxell Bellet Ezquerra, Lucia Del Mastro...
https://pubmed.ncbi.nlm.nih.gov/41461598/Olema Pharmaceuticals, Inc.
Lead Sponsor