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This is a multicentre, prospective study willing to evaluate AMH levels changes in response to chemotherapy plus GnRHa.
In the present study we propose to determine AMH levels in breast cancer patients, aged <40yrs receiving adjuvant chemotherapy and ovarian suppression by means of GnRHa with the aim to assess the role of AMH as surrogate marker of the preservation of ovarian reserve exerted by GnRHa.
Patients will receive 4 to 8 cycles of chemotherapy according to Institutional guidelines. Triptorelin 3.75 will be administered as an intramuscular injection before chemotherapy and every 28 days thereafter for all the duration of chemotherapy in patients with ER negative tumors and for 2 to 5 years in patients with ER positive tumors according to Institutional guidelines. Patients with ER+ve tumour will receive tamoxifen for 5 years at the end of chemotherapy as standard care. A blood sample will be drawn after signed informed consent to determine baseline AMH levels. A blood sample for determination of AMH levels will be collected at the end of chemotherapy and at 12 months after the end of chemotherapy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Triptorelin | Experimental | Triptorelin 3.75 administered every 28 days, for 4 to 7 injections depending on the number of cycles of chemotherapy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Triptorelin | Drug | Triptorelin administered once every 28 days in addition to chemotherapy |
|
| Measure | Description | Time Frame |
|---|---|---|
| AMH in response to chemotherapy plus GnRHa | To evaluate AMH levels changes in response to chemotherapy plus GnRHa in order to assess the role of AMH as surrogate marker of the preservation of ovarian reserve exerted by GnRHa | 18 months |
| Measure | Description | Time Frame |
|---|---|---|
| AMH and menstrual cycle | To correlate AMH behaviour with recovery of menstrual cycle (in the ER negative cohort); | 18 months |
| AMH after chemotherapy | To compare AMH levels obtained at the end of chemotherapy and at 12 months after the end of chemotherapy in the two cohorts of ER positive and ER negative patients |
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Inclusion Criteria:
Female subjects, aged <40yr at the time of breast cancer diagnosis
Diagnosis of operable breast cancer any T and N, any ER
Patients candidate to adjuvant chemotherapy for 4-8 cycles.
Patients compliant to adhere to all protocol procedures.
Adequate bone marrow, liver and renal function as assessed by the following laboratory requirements to be conducted within 28 days prior to the start of the study treatment.
Negative pregnancy test at the study enrolment; fertile women must use effective contraception during chemotherapy
Patients must be able to understand and sign written informed consent.
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Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Armando Santoro, MD | Istituto Clinico Humanitas | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istituto Clinico Humanitas | Rozzano | Milan | 20089 | Italy |
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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 |
|---|---|
| D017329 | Triptorelin Pamoate |
| ID | Term |
|---|---|
| D007987 | Gonadotropin-Releasing Hormone |
| D010906 | Pituitary Hormone-Releasing Hormones |
| D007028 | Hypothalamic Hormones |
| D036361 | Peptide Hormones |
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| 18 months |
| AMH levels >0.2 ng/mL at the 12-month time point | Evaluate the proportion of patients with AMH levels >0.2 ng/mL at the 12-month time point. | 18 months |
| D017437 |
| Skin and Connective Tissue Diseases |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D009479 | Neuropeptides |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D009842 | Oligopeptides |
| D009419 | Nerve Tissue Proteins |
| D011506 | Proteins |