Study of Nivolumab Versus Placebo in Combination With Neoadjuvant Chemotherapy and Adjuvant Endocrine Therapy in Participants With High-risk, Estrogen Receptor-Positive (ER+), Human Epidermal Growth Factor Receptor 2-Negative (HER2-) Primary Breast Cancer (CheckMate 7FL)
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ClinicalTrials.gov Identifier: NCT04109066 |
Recruitment Status :
Active, not recruiting
First Posted : September 30, 2019
Last Update Posted : May 16, 2023
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Condition or disease | Intervention/treatment | Phase |
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Breast Cancer | Biological: nivolumab Drug: paclitaxel (PTX) Other: nivolumab placebo Drug: anthracycline Drug: cyclophosphamide Drug: Endocrine Therapy Procedure: Surgery | Phase 3 |
Expanded Access : An investigational treatment associated with this study is no longer available outside the clinical trial. More info ...
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 521 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Double (Participant, Investigator) |
Primary Purpose: | Treatment |
Official Title: | A Randomized, Multicenter, Double-blind, Placebo-controlled Phase 3 Study of Nivolumab Versus Placebo in Combination With Neoadjuvant Chemotherapy and Adjuvant Endocrine Therapy in Patients With High-risk, Estrogen Receptor-Positive (ER+), Human Epidermal Growth Factor Receptor 2-Negative (HER2-) Primary Breast Cancer |
Actual Study Start Date : | November 20, 2019 |
Actual Primary Completion Date : | January 16, 2023 |
Estimated Study Completion Date : | January 15, 2024 |

Arm | Intervention/treatment |
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Experimental: Arm A: Nivolumab combined with neoadjuvant CT and adjuvant ET
Nivolumab with paclitaxel followed by nivolumab with anthracycline + cyclophosphamide as neoadjuvant (pre-surgery) treatment, then nivolumab with adjuvant (post-surgery) endocrine therapy of investigator's choice
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Biological: nivolumab
Specified Dose on Specified days Drug: paclitaxel (PTX) Specified dose on Specified days Drug: anthracycline Specified dose on Specified days Drug: cyclophosphamide Specified dose on Specified days Drug: Endocrine Therapy Variable endocrine therapy of investigators choice Procedure: Surgery Surgery for breast cancer |
Placebo Comparator: Arm B: Placebo combined with neoadjuvant CT and then adjuvant ET
Nivolumab placebo with paclitaxel followed by nivolumab placebo with anthracycline + cyclophosphamide as neoadjuvant (pre-surgery) treatment, then adjuvant (post-surgery) endocrine therapy of investigator's choice
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Drug: paclitaxel (PTX)
Specified dose on Specified days Other: nivolumab placebo Specified dose on Specified days Drug: anthracycline Specified dose on Specified days Drug: cyclophosphamide Specified dose on Specified days Drug: Endocrine Therapy Variable endocrine therapy of investigators choice Procedure: Surgery Surgery for breast cancer |
- Pathological Complete response (pCR) using the definition of ypT0/is ypN0 [ Time Frame: approximately 7 months ]
- pCR rate using the definition of ypT0/is ypN0 in the PDL1+ population [ Time Frame: approximately 7 months ]
- Residual cancer burden (RCB) category status (0, I, II, III) [ Time Frame: approximately 7 months ]
- RCB category status (0, I, II, III) in the PD-L1+ population [ Time Frame: approximately 7 months ]
- Incidence of adverse events (AEs) [ Time Frame: approximately 17 months ]
- Severity of AEs [ Time Frame: approximately 17 months ]
- Incidence of deaths [ Time Frame: approximately 17 months ]

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Localized invasive breast ductal carcinoma, confirmed by the local pathologist, that includes the following combined primary tumor and clinical node (cN) categories: T1c (tumor size = 2 cm)-T2 (tumor size > 2 cm), cN1-N2 OR T3-T4, cN0-cN2. Note: Axillary lymph node status must be assessed by fine needle biopsy or core biopsy.
- Estrogen receptor-positive (ER+) breast cancer (BC) and with or without progesterone receptor (PgR) expression (determined on the most recently analyzed tissue sample, tested locally, and confirmed by the central laboratory), as defined in the relevant American Society of Clinical Oncology (ASCO)- College of American Pathologists (CAP) Guidelines.
- Human epidermal growth factor receptor 2 (HER2-) BC tested in the local laboratory, defined as a negative in situ hybridization test or an immunohistochemistry (IHC) status of 0, 1+, or 2+.
- Tumor Grade 3 of ductal histology, Or Tumor Grade 2 of ductal histology having an ER expression level percentage between 1-10%
- Must agree to provide primary breast tumor tissue at baseline and at surgery
- Must be deemed eligible for surgery
- Males and females must agree to follow specific methods of contraception, if applicable, while participating in the trial
- Must have an Eastern Cooperative Oncology Group (ECOG) scale performance status of 0 or 1
Exclusion Criteria:
- Breastfeeding, pregnant, or expecting to conceive or father children within the projected duration of the study, starting with the screening through 12 months for participants who receive cyclophosphamide, or 6 months for participants who do not receive cyclophosphamide, after the last dose of study treatment
- Prior treatment with chemotherapy, endocrine therapy (ET), targeted therapy, and/or radiation therapy for the currently diagnosed breast cancer prior to enrollment
- Prior treatment with an anti-PD-1, anti-PD-L1, anti-PD-L2, or anti-CTLA-4 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways
- Significant cardiovascular disease such as left ventricular ejection fraction (LVEF) < 50% at baseline as assessed by echocardiography (ECHO) or multigated acquisition (MUGA) scan performed at screening, or Class III or IV myocardial disease as described by the New York Heart Association
- History of ipsilateral invasive BC, regardless of treatment, ipsilateral ductal carcinoma in situ treated with radiation, or contralateral invasive BC, at any time
- Definitive clinical or radiologic evidence of metastatic disease
- Multicentric BC (the presence of > 1 tumor in different quadrants of the breast)
- Bilateral invasive BC
Other protocol-defined inclusion/exclusion criteria apply

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04109066

Study Director: | Bristol-Myers Squibb | Bristol-Myers Squibb |
Responsible Party: | Bristol-Myers Squibb |
ClinicalTrials.gov Identifier: | NCT04109066 |
Other Study ID Numbers: |
CA209-7FL |
First Posted: | September 30, 2019 Key Record Dates |
Last Update Posted: | May 16, 2023 |
Last Verified: | May 2023 |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Nivolumab Breast Cancer Cancer Estrogen Receptor-Positive (ER+) |
Human Epidermal Growth Factor 2 Negative (HER2-) Neoadjuvant Adjuvant Primary Breast Cancer |
Breast Neoplasms Neoplasms by Site Neoplasms Breast Diseases Skin Diseases Paclitaxel Cyclophosphamide Nivolumab Antineoplastic Agents, Phytogenic Antineoplastic Agents Tubulin Modulators Antimitotic Agents |
Mitosis Modulators Molecular Mechanisms of Pharmacological Action Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Antirheumatic Agents Antineoplastic Agents, Alkylating Alkylating Agents Myeloablative Agonists Antineoplastic Agents, Immunological Immune Checkpoint Inhibitors |