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AzTrials

Breast NeoplasmsPhase 3MONARCH 2NCT02107703

A Study of Abemaciclib (LY2835219) Combined With Fulvestrant in Women With Hormone Receptor Positive HER2 Negative Breast Cancer

A Phase 3 study testing Abemaciclib and Fulvestrant in people with Breast Neoplasms, run by Eli Lilly and Company at 146 sites in 20 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record

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Trial summary

The main purpose of this study is to compare progression-free survival for women with hormone receptor positive (HR+), human epidermal growth factor receptor (HER2) negative advanced breast cancer receiving either abemaciclib + fulvestrant or fulvestrant alone. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Breast Neoplasms
What is being tested?
Abemaciclib and Fulvestrant
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
669 participants
Where
146 sitesin 20 countries
Study dates
22 Jul 2014to Dec 2027
Phase
Phase 3

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Have a diagnosis of HR+, HER2- breast cancer
  • Have locally advanced disease not amenable to curative treatment by surgery or metastatic disease. In addition, participants must fulfill 1 of the following criteria:
  • relapsed with radiologic evidence of progression while receiving neoadjuvant or adjuvant endocrine therapy, with no subsequent endocrine therapy received following progression
  • relapsed with radiologic evidence of progression within 1 year from completion of adjuvant endocrine therapy, with no subsequent endocrine therapy received following progression
  • relapsed with radiologic evidence of progression more than 1 year from completion of adjuvant endocrine therapy and then subsequently relapsed with radiologic evidence of progression after receiving treatment with either an antiestrogen or an aromatase inhibitor as first-line endocrine therapy for metastatic disease. Participants may not have received more than 1 line of endocrine therapy or any prior chemotherapy for metastatic disease
  • presented de novo with metastatic disease and then relapsed with radiologic evidence of progression after receiving treatment with either an antiestrogen or an aromatase inhibitor as first line endocrine therapy for metastatic disease. Participants may not have received more than 1 line of endocrine therapy or any prior chemotherapy for metastatic disease
Show all 12Show fewer
  • for the endocrine naïve cohort: Must not have received prior endocrine therapy in current or prior disease setting
  • Have postmenopausal status due to either surgical/natural menopause or ovarian suppression (initiated at least 28 days prior to Day 1 of Cycle 1) with a gonadotropin-releasing hormone (GnRH) agonist such as goserelin
  • Have a negative serum pregnancy test at baseline (within 14 days prior to randomization) and agree to use medically approved precautions to prevent pregnancy during the study and for 12 weeks following the last dose of abemaciclib if postmenopausal status is due to ovarian suppression with a GnRH agonist
  • Have either measurable disease or nonmeasurable bone only disease
  • Have a performance status ≤1 on the Eastern Cooperative Oncology Group (ECOG) scale
  • Have discontinued previous therapies for cancer (including specifically, aromatase inhibitors, anti-estrogens, chemotherapy, radiotherapy, and immunotherapy) for at least 21 days for myelosuppressive agents or 14 days for nonmyelosuppressive agents prior to receiving study drug, and recovered from the acute effects of therapy (until the toxicity resolves to either baseline or at least Grade 1) except for residual alopecia or peripheral neuropathy

Who cannot join

  • Are currently receiving an investigational drug in a clinical trial or participating in any other type of medical research judged not to be scientifically or medically compatible with this study
  • Have visceral crisis, lymphangitic spread, or leptomeningeal carcinomatosis visceral crisis is not the mere presence of visceral metastases but implies severe organ dysfunction as assessed by symptoms and signs, laboratory studies, and rapid progression of the disease
  • Have clinical evidence or history of central nervous system metastasis
  • Have received prior treatment with chemotherapy (except for neoadjuvant/ adjuvant chemotherapy), fulvestrant, everolimus, or any CDK4/6 inhibitor. For the endocrine naïve cohort: In addition, have received treatment with any prior endocrine therapy
  • Have received treatment with a drug that has not received regulatory approval for any indication within 14 or 21 days prior to randomization of study drug for a nonmyelosuppressive or myelosuppressive agent, respectively
  • Have received recent (within 28 days prior to randomization) yellow fever vaccination
Show all 12Show fewer
  • Have had major surgery within 14 days prior to randomization of study drug to allow for post-operative healing of the surgical wound and site(s)
  • Have a personal history within the last 12 months of any of the following conditions: syncope of cardiovascular etiology, ventricular tachycardia, ventricular fibrillation, or sudden cardiac arrest
  • Have inflammatory breast cancer or a history of any other cancer (except nonmelanoma skin cancer or carcinoma in-situ of the cervix), unless in complete remission with no therapy for a minimum of 3 years
  • Have received an autologous or allogeneic stem-cell transplant
  • Have active bacterial or fungal infection, or detectable viral infection
  • Have initiated bisphosphonates or approved Receptor activator of nuclear factor kappa-B (RANK) ligand targeted agents <7 days prior to randomization

Trial locations and contacts

146 sites in 20 countries.

146 sites in 20 countries

United States43 sites
  • University Cancer & Blood Center, LLC

    Athens, Georgia, 30607

  • Palm Beach Cancer Institue

    Atlantis, Florida, 33462

  • Pharmasite Research, Inc.

    Baltimore, Maryland, 21208

  • Billings Clinic

    Billings, Montana, 59101

  • Dana Farber Cancer Institute

    Boston, Massachusetts, 02215

  • Washington University Medical School

    City of Saint Peters, Missouri, 63376

  • Washington University Medical School

    Creve Coeur, Missouri, 63141

  • Holy Cross Hospital

    Fort Lauderdale, Florida, 33308

  • Florida Cancer Specialists - South

    Fort Myers, Florida, 33901

  • Baylor College of Medicine

    Houston, Texas, 77030

  • Oncology Consultants P.A.

    Houston, Texas, 77030

  • St. Bernards Medical Center

    Jonesboro, Arkansas, 72401

  • Freeman Cancer Institute

    Joplin, Missouri, 64804

  • St Lukes Hospital

    Kansas City, Missouri, 64111

  • Kadlec Clinic Hematology and Oncology

    Kennewick, Washington, 99336

  • University of California - San Diego

    La Jolla, California, 92037-0845

  • Breslin Cancer Center

    Lansing, Michigan, 48910

  • Dartmouth-Hitchcock Medical Center

    Lebanon, New Hampshire, 03756-0001

  • The Boston Baskin Cancer Group

    Memphis, Tennessee, 38120

  • Minnesota Oncology/Hematology PA

    Minneapolis, Minnesota, 55404

  • SMO Sarah Cannon Research Inst.

    Nashville, Tennessee, 37203

  • Icahn School of Medicine at Mount Sinai

    New York, New York, 10029

  • Columbia University Medical Center

    New York, New York, 10032

  • Palm Beach Cancer Institue

    Palm Beach Gardens, Florida, 33410

  • Quincy Medical Group

    Quincy, Illinois, 62301

  • Kaiser Permanente

    Riverside, California, 92505

  • Rochester General Hospital

    Rochester, New York, 14621

  • Rochester General Hospital

    Rochester, New York, 14625

  • Harbin Clinic

    Rome, Georgia, 30165

  • Utah Cancer Specialists

    Salt Lake City, Utah, 84106

  • Univ of California San Francisco

    San Francisco, California, 94115

  • Sanford Research/USD

    Sioux Falls, South Dakota, 57104

  • Highlands Oncology Group

    Springdale, Arkansas, 72762

  • Washington University Medical School

    St Louis, Missouri, 63110

  • Washington University Medical School

    St Louis, Missouri, 63129

  • Florida Cancer Specialists - North

    St. Petersburg, Florida, 33705

  • Stanford University Clinic

    Stanford, California, 94305

  • Moffitt Cancer Center, Richard M. Shulze Family Foundation Outpatient Center

    Tampa, Florida, 33612

  • Oklahoma Cancer Specialists & Research Institute, LLC

    Tulsa, Oklahoma, 74146

  • St Mary Regional Cancer Center

    Walla Walla, Washington, 99362

  • Palm Beach Cancer Institue

    Wellington, Florida, 33414

  • Palm Beach Cancer Institue

    West Palm Beach, Florida, 33401

  • Novant Health, Oncology Research Institute

    Winston-Salem, North Carolina, 27103

Other trials in United States

Japan19 sites
  • Tokyo Met Cancer & Infectious Diseases Center Komagome Hp

    Bunkyo-ku, Tokyo, 113-8677

  • Chiba cancer center

    Chiba, Chiba, 260-8717

  • National Cancer Center Hospital

    Chuo-ku, Tokyo, 104-0045

  • National Hospital Organization Kyushu Cancer Center

    Fukuoka, 811-1395

  • Saitama Prefectural Cancer Center

    Ina-machi, Saitama, 362-0806

  • Sagara Hospital

    Kagoshima, 892-0833

  • National Cancer Center Hospital East

    Kashiwa, Chiba, 277-8577

  • St. Marianna University School of Medicine Hospital

    Kawasaki, Kanagawa, 216-8511

  • Japanese Foundation for Cancer Research

    Koto, Tokyo, 135-8550

  • Kurume General Hospital

    Kurume, Fukuoka, 830-0013

  • Kyoto University Hospital

    Kyoto, 606-8507

  • National Hospital Organization Shikoku Cancer Center

    Matsuyama, Ehime, 791-0280

  • Aichi Cancer Center Hospital

    Nagoya, Aichi-ken, 464-8681

  • Niigata Cancer Center Hospital

    Niigata, Niigata, 951-8566

  • Hyogo College of Medicine

    Nishinomiya, Hyōgo, 663-8501

  • National Hospital Organization Osaka Medical Center

    Osaka, 540-0006

  • Osaka International Cancer Institute

    Osaka, 541-8567

  • National Hospital Organization Hokkaido Cancer Center

    Sapporo, Hokkaido, 003-0804

  • Jichi Medical University Hospital

    Shimotsuke, Tochigi, 329- 0498

Other trials in Japan

South Korea10 sites
  • Chungbuk National University Hospital

    Cheongju-si, Chungcheongbuk-do [Chungbuk], 28644

  • Inha University Hospital

    Incheon, Incheon-gwangyeoksi [Incheon], 22332

  • Gachon University Gil Medical Center

    Namdong-gu, Incheon-gwangyeoksi [Incheon], 21565

  • Seoul National University Bundang Hospital

    Seongnam, Kyǒnggi-do, 13620

  • Seoul National University Hospital

    Seoul, Seoul-teukbyeolsi [Seoul], 3080

  • Severance Hospital, Yonsei University Health System

    Seoul, Seoul-teukbyeolsi [Seoul], 3722

  • Asan Medical Center

    Seoul, Seoul-teukbyeolsi [Seoul], 5505

  • Samsung Medical Center

    Seoul, Seoul-teukbyeolsi [Seoul], 6351

  • The Catholic Univ. of Korea Seoul St. Mary's Hospital

    Seoul, Seoul-teukbyeolsi [Seoul], 6591

  • Ulsan University Hospital

    Ulsan, Ulsan-Kwangyǒkshi, 44033

Other trials in South Korea

Taiwan8 sites
  • Kaohsiung Medical University Hospital

    Kaohsiung City, 80756

  • Kaohsiung Veterans General Hospital

    Kaohsiung City, 81362

  • Chang Gung Memorial Hospital at Kaohsiung

    Kaohsiung Niao Sung Dist, Kaohsiung, 83301

  • China Medical University Hospital

    Taichung, 40447

  • Taichung Veterans General Hospital

    Taichung, 407

  • National Taiwan University Hospital

    Taipei, 10002

  • Taipei Veterans General Hospital

    Taipei, 11217

  • Chang Gung Medical Foundation-Linkou Branch

    Taoyuan, 333

Other trials in Taiwan

Mexico7 sites
  • Centro Oncológico Internacional (COI)

    Guadalajara, Jalisco, 45647

  • Preparaciones Oncológicas S.C.

    León, Guanajuato, 37178

  • Grupo Medico Camino Sc

    Mexico City, Mexico City, 03310

  • Instituto Nacional de Cancerologia

    Mexico City, Mexico City, 14070

  • OCA Hospital

    Monterrey, Nuevo León, 64000

  • Tecnologico de Monterrey

    Monterrey, Nuevo León, 64710

  • Hospital Angeles

    Tijuana, Estado de Baja California, 22010

Other trials in Mexico

Spain7 sites
  • Hospital Universitari Vall d'Hebron

    Barcelona, Barcelona [Barcelona], 08035

  • Hospital General Universitario de Elche

    Elche, Alicante, 03202

  • Hospital Universitario Arnau de Vilanova de Lleida

    Lleida, Lleida [Lérida], 25198

  • Hospital Universitario 12 de Octubre

    Madrid, Madrid, Comunidad de, 28041

  • Hospital Clinico San Carlos

    Madrid, 28040

  • Hospital General Universitario Morales Meseguer

    Murcia, Murcia, Región de, 30008

  • Hospital Quirónsalud Valencia

    Valencia, València, 46010

Other trials in Spain

Russia6 sites
  • Arkhangelsk Clinical Oncological Dispensary

    Arkhangelsk, Arkhangelskaya oblast, 163045

  • Regional Budgetary Healthcare Institution 'Ivanovo Regional Oncology Dispensary'

    Ivanovo, Ivanovo Oblast, 153040

  • Kursk Regional Oncology Dispensary

    Kursk, Russian Federation, 305035

  • Fed State Budgetary Inst "N.N. Blokhin Med Center of Oncology" MHRF

    Moscow, Moscow, 115478

  • N.N.Petrov Research Institute of Oncology

    Saint Petersburg, Sankt-Peterburg, 197758

  • Saint-Petersburg City Clinical Oncology Dispensary

    Saint Petersburg, Sankt-Peterburg, 198255

Other trials in Russia

Australia5 sites
  • Monash Cancer Centre

    East Bentleigh, Victoria, 3165

  • Ashford Cancer Centre Research

    Kurralta Park, South Australia, 5037

  • Icon Cancer Centre South Brisbane

    South Brisbane, Queensland, 4101

  • Gold Coast University Hospital

    Southport, Queensland, 4215

  • St. John of God Subiaco Hospital

    Subiaco, Western Australia, 6008

Other trials in Australia

Germany5 sites
  • Gemeinschaftspraxis hop-augsburg

    Augsburg, Bavaria, 86150

  • Facharztzentrum Eppendorf

    Hamburg, 20249

  • Klinikum Ludwigsburg

    Ludwigsburg, Baden-Wurttemberg, 71640

  • Klinikum der Ludwig-Maximilians-Universitaet Muenchen

    München, Bavaria, 80336

  • Universitaetsklinikum Tuebingen

    Tübingen, Baden-Wurttemberg, 72076

Other trials in Germany

Belgium4 sites
  • UZ Brussel

    Brussels, Bruxelles-Capitale, Région de, 1090

  • Antwerp University Hospital

    Edegem, Antwerpen, 2650

  • UZ Leuven

    Leuven, Vlaams-Brabant, 3000

  • Centre Hospitalier Universitaire de Liège - Domaine Universitaire du Sart Tilman

    Liège, 4000

Other trials in Belgium

Canada4 sites
  • Tom Baker Cancer Center

    Calgary, Alberta, T2N 4N2

  • London Regional Cancer Program

    London, Ontario, N6A 5W9

  • Humber River Hospital

    Toronto, Ontario, M3M 0B2

  • Unity Health Toronto, St. Michael's Hospital

    Toronto, Ontario, M5B 1W8

Other trials in Canada

France4 sites
  • CHU Besançon

    Besançon, Doubs, 25000

  • Centre Jean Perrin - Centre Régional de Lutte contre le Cancer d'Auvergne

    Clermont-Ferrand, Puy-de-Dôme, 63011

  • Polyclinique De Blois

    La Chaussée-Saint-Victor, 41260

  • Clinique Victor Hugo - Centre Jean Bernard

    Le Mans, 72000

Other trials in France

Greece4 sites
  • Agios Savvas Regional Cancer Hospital

    Athens, Attikí, 11522

  • Chania General Hospital 'Agios Georgios'

    Chania, 73300

  • University General Hospital of Heraklion

    Heraklion, Krítí, 71110

  • University Hospital of Patras

    Pátrai, Achaḯa, 26504

Other trials in Greece

Italy4 sites
  • Ospedale Bellaria - Azienda USL di Bologna

    Bologna, 40139

  • Azienda Ospedaliero Universitaria S.Anna

    Cona, Emilia-Romagna, 44124

  • Istituto Oncologico Veneto IRCCS

    Padova, 35128

  • Istituto Nazionale Tumori Regina Elena

    Rome, Roma, 00144

Other trials in Italy

Denmark3 sites
  • Aalborg Universitets hospital

    Aalborg, 9000

  • Herlev and Gentofte Hospital

    Copenhagen, Capital Region, 2730

  • Roskilde Sygehus

    Roskilde, 4000

Other trials in Denmark

Finland3 sites
  • Helsinki University Hospital - Comprehensive Cancer Center (HYKS - Syöpäkeskus)

    Helsinki, Uusimaa, 00029

  • Tampereen yliopistollinen sairaala

    Tampere, Pirkanmaa, 33520

  • Turun Yliopistollinen Keskussairaala

    Turku, 20520

Other trials in Finland

Poland3 sites
  • Bialostockie Centrum Onkologii, Oddzial Onkologii Klinicznej

    Bialystok, 15-027

  • Uniwersyteckie Centrum Kliniczne

    Gdansk, Pomeranian Voivodeship, 80-214

  • Centrum Terapii Wspolczesnej J. M. Jasnorzewska Spolka Komandytowo-Akcyjna

    Lodz, Łódź Voivodeship

Other trials in Poland

Romania3 sites
  • Ianuli Med Consult SRL

    Bucharest, 010976

  • S.C. MedisProf SRL

    Cluj-Napoca, Cluj, 400058

  • Centrul de Oncologie "Sfântul Nectarie"

    Craiova, Dolj, 200347

Other trials in Romania

Switzerland3 sites
  • Universitätsspital Basel

    Basel, Canton of Basel-City, 4031

  • HUG-Hôpitaux Universitaires de Genève

    Geneva, 1211

  • Spital Thun

    Thun, Canton of Bern, 3600

Other trials in Switzerland

Puerto Rico1 site
  • Puerto Rico Hematology/Oncology Group

    Bayamón, PR, 00959

Other trials in Puerto Rico

About this study

Official title: MONARCH 2: A Randomized, Double-Blind, Placebo-Controlled, Phase 3 Study of Fulvestrant With or Without Abemaciclib, a CDK4/6 Inhibitor, for Women With Hormone Receptor Positive, HER2 Negative Locally Advanced or Metastatic Breast Cancer

The main purpose of this study is to compare progression-free survival for women with hormone receptor positive (HR+), human epidermal growth factor receptor (HER2) negative advanced breast cancer receiving either abemaciclib + fulvestrant or fulvestrant alone. Participants will be randomized to abemaciclib or placebo in a 2:1 ratio. The study will last about 9 months for each participant.

For the endocrine naïve cohort, all participants will received abemaciclib + fulvestrant.

Being tested
Abemaciclib, Fulvestrant, Placebo
Keywords
MONARCH 2
Medical subject headings
Breast Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AbemaciclibDrug

    Also called LY2835219

    Administered Orally

  • FulvestrantDrug

    Administered IM

  • PlaceboDrug

    Administered Orally

Study groups in NCT02107703
Study groupRoleWhat they receive
Abemaciclib + FulvestrantExperimentalAbemaciclib 150 milligram (mg) administered orally every 12 hours on Days 1 to 28 of a 28-day cycle in combination with fulvestrant 500mg administered intramuscularly (IM) on Days 1 and 15 of Cycle 1, then on Day 1 of Cycle 2 and beyond. Participants received treatment until discontinuation were met.
Receives: Drug: Abemaciclib; Drug: Fulvestrant
Placebo + FulvestrantPlacebo comparatorPlacebo administered orally every 12 hours on Days 1 to 28 of a 28-day cycle in combination with fulvestrant 500mg administered IM on Days 1 and 15 of Cycle 1, then on Day 1 of Cycle 2 and beyond. Participants received treatment until discontinuation were met.
Receives: Drug: Fulvestrant; Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Progression-Free Survival (PFS)

    PFS defined as the time from the date of randomization to the first evidence of disease progression as defined by response evaluation criteria in solid tumors (RECIST) v1.1 or death from any cause. Progressive Disease (PD) was at least a 20% increase in the sum of the diameters of target lesions, with reference being the smallest sum on study and an absolute increase of at least 5 mm, or unequivocal progression of non-target lesions, or 1 or more new lesions. If a participant does not have a complete baseline disease assessment, then the PFS time was censored at the date of randomization, regardless of whether or not objectively determined disease progression or death has been observed for the participant. If a participant was not known to have died or have objective progression as of the data inclusion cutoff date for the analysis, the PFS time was censored at the last adequate tumor assessment date.

    Measured: From Date of Randomization until Disease Progression or Death Due to Any Cause (Up To 31 Months)

Secondary outcomes (10)
  1. Overall Survival (OS)

    OS defined as the time from the date of randomization to the date of death due to any cause. For each participant who is not known to have died as of the data-inclusion cutoff date for overall survival analysis, OS time was censored on the last date the participant is known to be alive. The final analysis of the OS outcome was conducted after 440 OS events had been observed.

    Measured: From Date of Randomization until Death Due to Any Cause (Up To 72 Months)

  2. Percentage of Participants Achieving Complete Response (CR) or Partial Response (PR) (Objective Response Rate [ORR])

    ORR was the percentage of participants achieving a best overall response (BOR) of complete response (CR) or partial response (PR) as per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. CR defined as the disappearance of all target and non-target lesions and no appearance of new lesions. PR defined as at least a 30% decrease in the sum of the longest diameters (LD) of target lesions (taking as reference the baseline sum LD), no progression of non-target lesions, and no appearance of new lesions. PD was at least a 20% increase in the sum of the diameters of target lesions, with reference being the smallest sum on study and an absolute increase of at least 5 mm, or unequivocal progression of non-target lesions, or 1 or more new lesions.

    Measured: From Date of First Dose until Disease Progression or Death Due to Any Cause (Up To 31 Months)

  3. Duration of Response (DOR)

    DOR was the time from the date of first evidence of complete response or partial response to the date of objective progression or the date of death due to any cause, whichever is earlier. CR and PR were defined using the RECIST v1.1. CR defined as the disappearance of all target and non-target lesions and no appearance of new lesions. PR defined as at least a 30% decrease in the sum of the LD of target lesions (taking as reference the baseline sum LD), no progression of non-target lesions, and no appearance of new lesions. If a responder was not known to have died or have objective progression as of the data inclusion cutoff date, duration of response was censored at the last adequate tumor assessment date. PD was at least a 20% increase in the sum of the diameters of target lesions, with reference being the smallest sum on study and an absolute increase of at least 5 mm, or unequivocal progression of non-target lesions, or 1 or more new lesions.

    Measured: From Date of CR, PR until Disease Progression or Death Due to Any Cause (Up To 31 Months)

  4. Percentage of Participants Achieving CR, PR or Stable Disease (SD) (Disease Control Rate [DCR])

    Disease Control Rate (DCR) was the percentage of participants with a best overall response of CR, PR, or Stable Disease (SD) as per Response using RECIST v1.1 criteria. CR defined as the disappearance of all target and non-target lesions and no appearance of new lesions. PR defined as at least a 30% decrease in the sum of the LD of target lesions (taking as reference the baseline sum LD), no progression of non-target lesions, and no appearance of new lesions. SD was neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD for target lesions, no progression of non-target lesions, and no appearance of new lesions. PD was at least a 20% increase in the sum of the diameters of target lesions, with reference being the smallest sum on study and an absolute increase of at least 5 mm, or unequivocal progression of non-target lesions, or 1 or more new lesions.

    Measured: From Date of First Dose until Disease Progression or Death Due to Any Cause (Up To 31 Months)

  5. Percentage of Participants With CR, PR or SD With a Duration of At Least 6 Months (Clinical Benefit Rate [CBR])

    Clinical benefit rate defined as percentage of participants with best overall response of CR, PR, or SD with a duration of at least 6 months.CR defined as the disappearance of all target and non-target lesions and no appearance of new lesions.PR defined as at least a 30% decrease in the sum of the LD of target lesions (taking as reference the baseline sum LD), no progression of non-target lesions, and no appearance of new lesions.SD was neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD for target lesions, no progression of non-target lesions, and no appearance of new lesions. Percentage of participants=(participants with CR+PR+SD with a duration of at least 6 months /number of participants enrolled) *100.PD was at least a 20% increase in sum of the diameters of target lesions,with reference being the smallest sum on study and an absolute increase of at least 5 mm or unequivocal progression of non-target lesions,or 1 or more new lesions.

    Measured: From Date of First Dose until Disease Progression or Death Due to Any Cause (Up To 31 Months)

  6. Change From Baseline in Pain and Symptom Burden Assessment Using the Modified Brief Pain Inventory-Short Form (mBPI-sf)

    A self-reported scale that measures the severity of pain based on the average pain experienced over the past 24 hours. The severity scores range from 0 (no pain) to 10 (pain as severe as you can imagine). The overall change is based on the estimated main treatment effect. Least square (LS) Mean value was controlled for Treatment, visit, Treatment*Visit and baseline.

    Measured: Baseline, End of Study (Up To 31 Months)

  7. Pharmacokinetics (PK): Area Under the Concentration Curve (AUC) of Abemaciclib, Its Metabolites M2 and M20

    Area Under the Plasma Concentration versus Time Curve from Time Zero to Infinity (AUC[0-∞]) was evaluated for Abemaciclib and Metabolites M2 and M20.

    Measured: Cycle 1 Day 1 2-4 hours (h) post dose, Cycle 1 Day 15 4 and 7h post dose, Cycle 2 Day 1 pre dose and 3h post dose, Cycle 3 Day1 pre dose

  8. Change From Baseline in Health Status Using the EuroQol 5-Dimension 5 Level (EQ-5D 5L)

    European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) is a standardized measure of health status of the participant. The EQ-5D-5L is assessed using a visual analog scale (VAS) that ranged from 0 to 100mm, where 0 is the worst health you can imagine and 100 is the best health you can imagine. A higher score indicates better health state. LS Mean value was controlled for Treatment, visit, Treatment*Visit and baseline.

    Measured: Baseline, End of Study (Up To 31 Months)

  9. Change From Baseline to Short Term Follow up in Quality of Life Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30)

    EORTC QLQ-C30 v3.0 was a self-administered questionnaire with multidimensional scales that measures 5 functional domains (physical, role, cognitive, emotional, and social), global health status, and symptom scales of fatigue, pain, nausea and vomiting, dyspnea, loss of appetite, insomnia, constipation and diarrhea, and financial difficulties. A linear transformation is applied to standardize the raw scores to range between 0 and 100 per developer guidelines. For functional domains and global health status, scores range from 0 to 110 with higher scores representing a better level of functioning. For symptoms scales, scores range from 0 to 100 with higher scores representing a greater degree of symptoms. LS Mean value of changing from baseline to short follow up was estimated from the mixed model that was controlled for Treatment, visit, Treatment*Visit and baseline.

    Measured: Baseline, Short Term Follow Up (Up To 31 Months)

  10. Change From Baseline to Short Term Follow up in Quality of Life Using the EORTC QLQ-BR23 (Breast) Questionnaire

    EORTC-QLQ-BR23 measured multi-item functional scales for body image, sexual functioning and future perspective and measured single item symptoms scales which assessed systemic therapy side effects, breast symptoms and arm symptoms. For functional scales, scores ranged from 0 to 100 where higher scores represented a better level of functioning. For symptoms scales, scores ranged from 0 to 100 where higher scores represented a greater degree of symptoms. LS Mean value of changing from baseline to short follow up was estimated from the mixed model that was controlled for Treatment, visit, Treatment*Visit and baseline.

    Measured: Baseline, Short Term Follow Up (Up To 31 Months)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Apr 2014 (estimated)
  2. Study start22 Jul 2014
  3. Primary completion14 Feb 2017
  4. Study completionDec 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
669 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02107703
Sponsor's protocol ID
15362
Other IDs
I3Y-MC-JPBL, 2013-004728-13
Acronym
MONARCH 2
Status last verified
Sep 2026
First submitted
4 Apr 2014
Last updated
14 Oct 2026
Data monitoring committee
Yes
Individual data sharing
Yes: Anonymized individual patient level data will be provided in a secure access environment upon approval of a research proposal and a signed data sharing agreement.
Expanded access
Available

Publications

  • Neven P, Rugo HS, Tolaney SM, Iwata H, Toi M, Goetz MP, Kaufman PA, Lu Y, Haddad N, Hurt KC, Sledge GW Jr. Abemaciclib plus fulvestrant in hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer in premenopausal women: subgroup analysis from the MONARCH 2 trial. Breast Cancer Res. 2021 Aug 23;23(1):87. doi: 10.1186/s13058-021-01463-2.

    PubMed 34425869
  • Inoue K, Masuda N, Iwata H, Takahashi M, Ito Y, Miyoshi Y, Nakayama T, Mukai H, van der Walt JS, Mori J, Sakaguchi S, Kawaguchi T, Tanizawa Y, Llombart-Cussac A, Sledge GW Jr, Toi M. Japanese subpopulation analysis of MONARCH 2: phase 3 study of abemaciclib plus fulvestrant for treatment of hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer that progressed on endocrine therapy. Breast Cancer. 2021 Sep;28(5):1038-1050. doi: 10.1007/s12282-021-01239-8. Epub 2021 Apr 1.

    PubMed 33797023
  • Goetz MP, Okera M, Wildiers H, Campone M, Grischke EM, Manso L, Andre VAM, Chouaki N, San Antonio B, Toi M, Sledge GW Jr. Safety and efficacy of abemaciclib plus endocrine therapy in older patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative advanced breast cancer: an age-specific subgroup analysis of MONARCH 2 and 3 trials. Breast Cancer Res Treat. 2021 Apr;186(2):417-428. doi: 10.1007/s10549-020-06029-y. Epub 2021 Jan 3.

    PubMed 33392835
  • Sledge GW Jr, Toi M, Neven P, Sohn J, Inoue K, Pivot X, Burdaeva O, Okera M, Masuda N, Kaufman PA, Koh H, Grischke EM, Conte P, Lu Y, Barriga S, Hurt K, Frenzel M, Johnston S, Llombart-Cussac A. The Effect of Abemaciclib Plus Fulvestrant on Overall Survival in Hormone Receptor-Positive, ERBB2-Negative Breast Cancer That Progressed on Endocrine Therapy-MONARCH 2: A Randomized Clinical Trial. JAMA Oncol. 2020 Jan 1;6(1):116-124. doi: 10.1001/jamaoncol.2019.4782.

    PubMed 31563959
  • Sledge GW Jr, Toi M, Neven P, Sohn J, Inoue K, Pivot X, Burdaeva O, Okera M, Masuda N, Kaufman PA, Koh H, Grischke EM, Frenzel M, Lin Y, Barriga S, Smith IC, Bourayou N, Llombart-Cussac A. MONARCH 2: Abemaciclib in Combination With Fulvestrant in Women With HR+/HER2- Advanced Breast Cancer Who Had Progressed While Receiving Endocrine Therapy. J Clin Oncol. 2017 Sep 1;35(25):2875-2884. doi: 10.1200/JCO.2017.73.7585. Epub 2017 Jun 3.

    PubMed 28580882

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