RecruitingNot ApplicableNCT07214532

Signatera-Guided CDK4/6 Inhibitor Therapy in Breast Cancer

SIgnatera-Guided Initiation of Adjuvant CDK4/6 Inhibitor in Intermediate Risk HR+ HER2- Breast Cancer


Sponsor

Natera, Inc.

Enrollment

725 participants

Start Date

Mar 24, 2026

Study Type

INTERVENTIONAL

Conditions

Summary

The purpose of this study is to evaluate the efficacy and safety of ctDNA-guided initiation of CDK4/6 inhibitor therapy using the Signatera™ Designed on Genome test (referred to as "Signatera Genome") in participants with intermediate-risk HR+/HER2- early-stage breast cancer. Based on ctDNA test results, participants will either start CDK4/6 inhibitor therapy in addition to hormone therapy or continue hormone therapy with ongoing ctDNA surveillance. This study will compare outcomes to historical controls from the NataLEE trial to determine whether ctDNA-guided timing maintains efficacy while reducing unnecessary treatment. Participants will be followed for up to 9 years with regular blood draws, hormone therapy, imaging as needed, and quality-of-life assessments.


Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study uses a blood test called Signatera Genome — which detects tiny fragments of tumor DNA circulating in the bloodstream — to guide whether women with early-stage, hormone receptor-positive, HER2-negative breast cancer should receive an additional targeted therapy called a CDK4/6 inhibitor alongside hormone therapy. The goal is to treat only those whose ctDNA test suggests elevated risk, potentially sparing others from unnecessary medication and its side effects. Women (and men) aged 18 and older with a confirmed diagnosis of intermediate-risk early-stage breast cancer who have undergone surgery with clear margins may be eligible. Participation involves regular blood draws every three months, ongoing hormone therapy, and CDK4/6 inhibitor therapy if the blood test detects cancer signals, with follow-up lasting up to 9 years. This summary was generated with AI assistance to help patients understand the study in plain language.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DEVICEctDNA-Guided Treatment Strategy

Circulating tumor DNA testing using Signatera Genome assay is performed every 3 months for up to 4 years to guide timing of CDK4/6 inhibitor initiation. Participants with positive ctDNA results initiate CDK4/6 inhibitor therapy (ribociclib or abemaciclib) plus standard endocrine therapy for a minimum of 2 years. Participants with negative ctDNA results continue endocrine therapy alone with ongoing surveillance. CDK4/6 inhibitor selection and endocrine therapy regimen per the physician's choice following standard-of-care guidelines.


Locations(39)

University of Alabama at Birmingham

Birmingham, Alabama, United States

Mayo Clinic Arizona

Phoenix, Arizona, United States

Honor Health Research Institute

Scottsdale, Arizona, United States

University of Arizona Cancer Center

Tucson, Arizona, United States

Adventist Health/AIS Cancer Center

Bakersfield, California, United States

Marin Cancer Care

Greenbrae, California, United States

Loma Linda University

Loma Linda, California, United States

UCLA David Geffen School of Medicine

Santa Monica, California, United States

Stockton Hematology Oncology Medical Group

Stockton, California, United States

Kaiser Permanente NorCal

Vallejo, California, United States

Hartford Healthcare Institute

Hartford, Connecticut, United States

Yale Cancer Center

New Haven, Connecticut, United States

Baptist MD Anderson

Jacksonville, Florida, United States

Mayo Clinic Florida

Jacksonville, Florida, United States

Jupiter Medical Cancer

Jupiter, Florida, United States

Miami Cancer Institute

Miami, Florida, United States

Ocala Oncology

Ocala, Florida, United States

Northwestern University

Chicago, Illinois, United States

Northwest Cancer Center

Dyer, Indiana, United States

New England Cancer Specialists

Westbrook, Maine, United States

Karmanos Cancer Center - Wayne State University

Detroit, Michigan, United States

Cancer & Hematology Centers

Grand Rapids, Michigan, United States

Munson Medical Center Cowell Family Cancer Center

Traverse City, Michigan, United States

Mayo Clinic

Rochester, Minnesota, United States

Mercy Health - Sindelar Cancer Center

St Louis, Missouri, United States

Mercy Health - Pratt Cancer Center

St Louis, Missouri, United States

Cooper Health

Camden, New Jersey, United States

Rutgers

New Brunswick, New Jersey, United States

New York Cancer and Blood Specialists

Babylon, New York, United States

Atrium Levine Cancer Institute

Charlotte, North Carolina, United States

Allegheny (AHN)

Pittsburgh, Pennsylvania, United States

Sanford Health

Sioux Falls, South Dakota, United States

West Cancer Center

Germantown, Tennessee, United States

Vanderbilt

Nashville, Tennessee, United States

Houston Methodist Hospital

Houston, Texas, United States

Northwest Medical Specialties, PLLC

Puyallup, Washington, United States

Fred Hutch Cancer Center

Seattle, Washington, United States

MultiCare Cancer Institute

Tacoma, Washington, United States

West Virginia University

Morgantown, West Virginia, United States

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NCT07214532


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