RESOLVE: letRozole abEmaciclib combinationS in endOmetriaL and oVarian cancEr: A Multi-Cohort Phase 2 Study of Letrozole/Abemaciclib Alone and in Combination With Metformin, Zotatifin and Gedatolisib

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Investigational drug late phase More information Active drug More information Moderate burden on patient More information Started >3 years ago More information

Trial Details

Sponsor: Dana-Farber Cancer Institute (other)

Phase: 2

Start date: Dec. 24, 2018

Planned enrollment: 180

Trial ID: NCT03675893
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More trial details at ClinicalTrials.gov More info

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Investigational Drug AI Analysis

chevron Show for: Gedatolisib (PKI-587, PF-05212384)

chevron Show for: Zotatifin (eFT226)

chevron Show for: LY3023414 (Samotolisib)

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Goal: To evaluate the antitumor activity and safety of endocrine therapy with letrozole plus the CDK4/6 inhibitor abemaciclib, alone or combined with agents targeting translational control (zotatifin) or the PI3K/AKT/mTOR pathway (gedatolisib or LY3023414), and with metformin, in ER-positive endometrial cancer and in low-grade serous ovarian cancer.

Patients: Adults (≥18 years) with measurable, recurrent or metastatic endometrial cancer or endometrial carcinosarcoma with an endometrioid epithelial component (ER≥1% by IHC), or with low-grade serous carcinoma of the ovary, fallopian tube, or peritoneum (ER status not required). ECOG 0–1, adequate organ function, and available archival tissue are required. Prior therapies are allowed without limit; prior CDK4/6 inhibitor exposure is excluded for most cohorts but required for Cohort 7. Cohorts 6–7 require TP53 wild type and glycemic control (HbA1c ≤6.4%, fasting glucose ≤140 mg/dL). Key exclusions include active brain metastases, recent chemo/radiation or strong CYP3A4 modifiers, significant cardiovascular risk, uncontrolled hypertension, and prior PI3K-pathway inhibitors for Cohorts 6–7.

Design: Multi-cohort, open-label, non-randomized phase 2 study. Parallel cohorts test doublet and triplet combinations with expansion permitted. Planned enrollment is 180.

Treatments: Cohort 1A: abemaciclib plus letrozole. Cohort 3: abemaciclib, letrozole, and metformin; metformin is an antihyperglycemic agent explored for antiproliferative and pro-apoptotic effects in cancer. Cohorts 4–5: abemaciclib, letrozole, and zotatifin; zotatifin (eFT226) is a first-in-class selective eIF4A inhibitor that clamps eIF4A onto polypurine motifs in 5′ UTRs, selectively suppressing translation of oncogenic mRNAs (e.g., RTKs, cyclin D1). Early-phase studies in ER+/HER2– metastatic breast cancer have shown manageable safety and signals of activity when combined with endocrine therapy and abemaciclib, with partial responses and median PFS around 7 months in small cohorts. Cohorts 6–7: abemaciclib, letrozole, and gedatolisib; gedatolisib is a potent pan-class I PI3K and mTORC1/2 inhibitor that provides comprehensive PAM pathway blockade. In phase 1b breast cancer studies, gedatolisib combined with CDK4/6 inhibition and endocrine therapy produced high response rates in treatment-naïve HR+ disease and meaningful activity after prior CDK4/6 inhibitors, with a manageable toxicity profile dominated by expected class effects. Cohorts 1–2 include LY3023414 (samotolisib) with or without letrozole; LY3023414 is an oral dual PI3K/mTOR and DNA-PK inhibitor with a short half-life and transient pathway inhibition. Single-agent activity has been observed in biomarker-selected endometrial cancer and in combination with enzalutamide in mCRPC, improving progression-free endpoints; common adverse events include GI symptoms, fatigue, anemia, hyperglycemia, and hypophosphatemia. All cohorts include continuous oral abemaciclib BID; letrozole is given daily; zotatifin is IV on days 1 and 8 of 21-day cycles; gedatolisib is IV on days 1, 8, and 15 of 28-day cycles; LY3023414 is oral BID.

Outcomes: Co-primary endpoints: 6-month progression-free survival rate and objective response rate by RECIST 1.1. Secondary endpoints: overall survival and treatment-related toxicities per CTCAE v5.0.

Burden on patient: Moderate. Patients will take continuous oral therapy (abemaciclib with or without letrozole and metformin/LY3023414) and, in select cohorts, receive IV infusions of zotatifin on days 1 and 8 of 21-day cycles or gedatolisib on days 1, 8, and 15 of 28-day cycles, necessitating frequent clinic visits. Safety monitoring will require regular laboratory assessments (hematology, chemistry, liver function, glucose/HbA1c for PAM inhibitors) and periodic imaging for RECIST response, comparable to typical phase 2 oncology studies. No intensive pharmacokinetic sampling is described; archival tissue is required but no mandatory fresh biopsies are specified, which limits procedural burden. Travel and time commitments increase during infusion weeks, particularly for the 3-dose-per-28-day gedatolisib schedule.

Last updated: Oct 2025

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Sites (3)

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Beth Israel Deaconess Medical Center (BIDMC)

Boston, Massachusetts, 02215, United States

No email / (617) 667-5661

Status: Recruiting

Dana Farber Cancer Institute

Boston, Massachusetts, 02215, United States

[email protected] / 877-338-7425

Status: Recruiting

Massachusetts General Hospital Cancer Center

Boston, Massachusetts, 02214, United States

No email / 617-724-4000

Status: Recruiting