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Pre-Operative Endocrine Therapy for Individualised Care with Abemaciclib

Disease site: Breast cancer

Treatment modality: Systemic therapy

Status: Open to recruitment


Trial Details

POETIC-A is a phase III, multicentre trial that tests whether a new drug called abemaciclib, given in combination with standard endocrine therapy (ET), is more effective than giving ET alone. Patients must be post-menopausal, have operable invasive breast cancer which is ER positive and HER2 negative, with high 5-year risk of relapse (defined as ‘high’ baseline Ki67 [≥8%] following treatment with a short course of endocrine therapy (ET) prior to surgery). 

The trial has 2 parts: i) a screening-registration part, followed by; ii) a randomised intervention part.


POETIC-A Registration

1. Patients may consent to the registration part of the trial at diagnosis and will be given ET for 2 weeks prior to their surgery.


2. Patients who were given ET for between 2 weeks and 6 months prior to their surgery as part of their standard treatment may consent to the registration part of the trial at any point from starting their ET through to being post-surgery and receiving their standard adjuvant treatment.

All patients are asked to donate some tumour tissue collected during surgery. A biological marker called Ki67 will be measured in the tumour tissue from surgery. Measuring Ki67 tells us how quickly cancer cells are growing and dividing. If this marker is confirmed to still be ‘high’ after at least two weeks of treatment with ET, it could mean that the patient may be less sensitive to standard endocrine treatment and has a higher risk of relapse. These patients will be invited to join the treatment part of the trial, after any planned non-ET treatment has been completed. Up to 8,000 patients will be registered over 3 years, of who approximately 2,500 will be randomised.


POETIC-A Randomisation

Everyone who agrees to join this study will be randomly assigned to one of two treatment groups:

  • Group 1: Standard endocrine therapy alone
  • Group 2: Standard endocrine therapy and abemaciclib

All randomised patients will take ET for at least 5 years, and those patients randomised to also receive abemaciclib will take it for 2 years.  Patients will be followed up (including research blood tests) for 5 years.


Further Information

Chief Investigator: Professor Stephen Johnston, The Royal Marsden NHS Foundation Trust

Coordinating Investigator: Dr Alistair Ring, The Royal Marsden NHS Foundation Trust 

ICR-CTSU Scientific/Methodology Lead: Professor Judith Bliss, The Institute of Cancer Research

Surgical Lead: Professor Cliona Kirwan, University of Manchester and Manchester University NHS Foundation Trust

Translational Study Lead: Professor Mitchell Dowsett, The Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden NHS Foundation Trust

Bioinformatics and Genomics Analysis Lead: Dr Maggie Cheang, The Institute of Cancer Research

Trial management contact: [email protected] Identifier: NCT04584853

Sponsor: The Institute of Cancer Research (ICR)

Funding: Lilly and Cancer Research UK (via ICR-CTSU programme)

More information about the POETIC-A trial can be found on the NIHR Be Part of Research website here. A plain English summary from Cancer Research UK can be found here.


Publications and Presentations

Update from the POETIC-A Chief Investigator - November 2021

Update from the POETIC-A Chief Investigator - May 2022


POETIC-A Videos for Study Patients

Clinical trials

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The division carries out or coordinates high-quality trials and translational research at both an early phase – typically to test new targeted drugs – and a later stage.