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| ID | Type | Description | Link |
|---|---|---|---|
| HUM 12443 | Other Identifier | University of Michigan Medical IRB |
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The study was stopped after 69 subjects were enrolled because of poor accrual.
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Women with hormone-receptor positive breast cancer are typically treated with hormone therapy as part of their treatment after surgery. In the past few years it has been found that treatment with aromatase inhibitors is superior to tamoxifen in postmenopausal women. Tamoxifen is still used for premenopausal women, however, because aromatase inhibitors are not effective in women who have functioning ovaries. Some women are premenopausal at the time they are diagnosed with breast cancer, but then stop having menstrual periods when they are treated with chemotherapy. It is unclear if these women can also be treated safely with aromatase inhibitors.
In this clinical trial the researchers will try to answer this question. Women with hormone receptor positive breast cancer who become postmenopausal with chemotherapy will be invited to participate in this study. Each woman will be treated with one of the aromatase inhibitors, anastrozole (Arimidex), and then carefully monitored to ensure that her ovaries do not start making estrogen. If her estrogen level remains low, then she will continued to be followed for 18 months. If the level increases to the level typically seen in premenopausal women, however, then she will stop taking part in this study.
The study will also evaluate multiple factors that may help doctors predict who will tolerate the therapy without having their ovaries start making estrogen again. Some of the factors to be evaluated include other hormone levels (blood tests) as well as family history of early menopause (mother, sisters). In addition, changes in certain genes that affect how patients' bodies handle chemotherapy drugs will be tested to see if they affect whether or not patients recover ovarian function. Overall, the purpose of the study is to determine which patients who become postmenopausal from chemotherapy are likely to tolerate aromatase inhibitor treatment safely, and how often the patients' ovarian function needs to be tested during treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| anastrozole | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| anastrozole | Drug | 1 mg tablet by mouth once a day |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| The Number of Women Who Recover Ovarian Function Within 12 Months of Al Monotherapy | In part 1 ovarian function recurrence is defined as one estradiol value >20 pg/ml or two consecutive values >10 pg/ml. In part 2 ovarian function recurrence is defined as a >75% increase in estradiol levels over prior if prior value was 15-30 pg/ml, or one estradiol value >30 pg/ml, or three consecutive values >20 pg/ml. | 12 months |
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Inclusion Criteria:
To be eligible for this study:
Exclusion Criteria:
You are not eligible to participate in this study if:
1. Your ovaries have been surgically removed, treated with radiation therapy, or if you are taking medications (Zoladex™ or Lupron™) to block the function of your ovaries.
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| Name | Affiliation | Role |
|---|---|---|
| Norah L. Henry, M.D., Ph.D. | University of Michigan | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sidney Kimmel Comprehensive Center at Johns Hopkins | Baltimore | Maryland | 21231-2410 | United States | ||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23613476 | Result | Henry NL, Xia R, Banerjee M, Gersch C, McConnell D, Giacherio D, Schott AF, Pearlman M, Stearns V, Partridge AH, Hayes DF. Predictors of recovery of ovarian function during aromatase inhibitor therapy. Ann Oncol. 2013 Aug;24(8):2011-6. doi: 10.1093/annonc/mdt149. Epub 2013 Apr 23. |
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69 patients were enrolled however only 59 patients began treatment with anastrozole. Patients that were enrolled and found to have estradiol concentrations greater than 20 pg/ml were not treated.
Subjects were recruited at the University of Michigan, the Dana-Farber Cancer Institute, and Johns Hopkins University from 2008 until 2010.
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| ID | Title | Description |
|---|---|---|
| FG000 | Anastrozole Part 1 | In the initial version of the clinical trial (designated part 1), subjects were required to have serum estradiol and FSH (Follicle-stimulating hormone) concentrations within the postmenopausal range according to local institutional guidelines within 28 days of enrollment. Subjects taking tamoxifen at the time of screening were only required to have postmenopausal serum estradiol concentrations. Subjects were treated with anastrozole, 1 mg orally daily. |
| FG001 | Anastrozole Part 2 | During the conduct of the trial the study was amended to change the eligibility criteria because of difficulties with the estradiol assay. Subjects enrolled after the amendment were required to sign consent and then have an average baseline estradiol concentration of ≤20 pg/ml in order to be considered eligible. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
Initiated treatment with Anastrozole, 1 mg orally daily.
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| ID | Title | Description |
|---|---|---|
| BG000 | Anastrozole Part 1 | In the initial version of the clinical trial (designated part 1), subjects were required to have serum estradiol and FSH concentrations within the postmenopausal range according to local institutional guidelines within 28 days of enrollment. Subjects taking tamoxifen at the time of screening were only required to have postmenopausal serum estradiol concentrations. Subjects were treated with anastrozole, 1 mg orally daily. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | The Number of Women Who Recover Ovarian Function Within 12 Months of Al Monotherapy | In part 1 ovarian function recurrence is defined as one estradiol value >20 pg/ml or two consecutive values >10 pg/ml. In part 2 ovarian function recurrence is defined as a >75% increase in estradiol levels over prior if prior value was 15-30 pg/ml, or one estradiol value >30 pg/ml, or three consecutive values >20 pg/ml. | Posted | Number | participants | 12 months |
|
All Adverse Events (AEs) will be captured while each patient is taking study medication and for 30 days after the patient discontinues study medication and/or trial participation.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Anastrozole | anastrozole: 1 mg tablet by mouth once a day |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Infection Grade 3 or 4 neutrophils | Infections and infestations | CTCAE (3.0) |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Fatigue | General disorders | CTCAE (3.0) |
Because of poor accrual, the trial was closed after 69 of a planned 150 patients were enrolled.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Norah Lynn Henry | University of Michigan Comprehensive Cancer Center | 734-936-4991 | norahh@umich.edu |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
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| ID | Term |
|---|---|
| D000077384 | Anastrozole |
| ID | Term |
|---|---|
| D009570 | Nitriles |
| D009930 | Organic Chemicals |
| D014230 | Triazoles |
| D001393 | Azoles |
| D006573 |
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| Dana-Farber Cancer Center |
| Boston |
| Massachusetts |
| 02115 |
| United States |
| University of Michigan | Ann Arbor | Michigan | 48109 | United States |
| Physician Decision |
|
| BG001 | Anastrozole Part 2 | Analysis of the first 18 subjects enrolled revealed a greater than expected discontinuation of AI therapy because of elevated serum estradiol concentrations. Discontinuation was believed to be primarily due to greater than expected variability in the assay as opposed to true recovery of ovarian function. Therefore, the protocol was amended. Subjects with an average baseline estradiol concentration of ≤20 pg/ml were considered eligible for part 2 and initiated treatment with anastrozole 1 mg orally daily. |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| OG001 | Anastrozole Part 2 | Analysis of the first 18 subjects enrolled revealed a greater than expected discontinuation of AI therapy because of elevated serum estradiol concentrations. Discontinuation was believed to be primarily due to greater than expected variability in the assay as opposed to true recovery of ovarian function. Therefore, the protocol was amended. Subjects with an average baseline estradiol concentration of ≤20 pg/ml were considered eligible for part 2 and initiated treatment with anastrozole 1 mg orally daily. |
|
|
| 2 |
| 59 |
| 53 |
| 59 |
| Fracture | Musculoskeletal and connective tissue disorders | CTCAE (3.0) |
|
| Insomnia | Psychiatric disorders | CTCAE (3.0) |
|
| Dermatology/Skin - Other (Specify) | Skin and subcutaneous tissue disorders | CTCAE (3.0) |
|
| Hair loss/alopecia (scalp or body) | Skin and subcutaneous tissue disorders | CTCAE (3.0) |
|
| Rash/desquamation | Skin and subcutaneous tissue disorders | CTCAE (3.0) |
|
| Hot flashes/flushes | Vascular disorders | CTCAE (3.0) |
|
| Hemorrhage, Vagina | Reproductive system and breast disorders | CTCAE (3.0) |
|
| Edema: limb | General disorders | CTCAE (3.0) |
|
| Joint-function | Musculoskeletal and connective tissue disorders | CTCAE (3.0) |
|
| Musculoskeletal/Soft Tissue - Other (Specify) | Musculoskeletal and connective tissue disorders | CTCAE (3.0) |
|
| Dizziness | Nervous system disorders | CTCAE (3.0) |
|
| Mood alteration | Nervous system disorders | CTCAE (3.0) |
|
| Mood alteration | Nervous system disorders | CTCAE (3.0) |
|
| Neuropathy: sensory | Nervous system disorders | CTCAE (3.0) |
|
| Pain-Abdomen | General disorders | CTCAE (3.0) |
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| Pain-Breast | Reproductive system and breast disorders | CTCAE (3.0) |
|
| Pain-Limb | Musculoskeletal and connective tissue disorders | CTCAE (3.0) |
|
| Pain-Head | Nervous system disorders | CTCAE (3.0) |
|
| Pain-Joint | Musculoskeletal and connective tissue disorders | CTCAE (3.0) |
|
| Pain-Muscle | Musculoskeletal and connective tissue disorders | CTCAE (3.0) |
|
| Pain - Other (Specify) | General disorders | CTCAE (3.0) |
|
| Vaginal dryness | Reproductive system and breast disorders | CTCAE (3.0) |
|
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| D017437 |
| Skin and Connective Tissue Diseases |
| Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |