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Safety/Efficacy of Letrozole Monotherapy or in Combination With Zoledronic Acid as Extended Adjuvant Treatment of Postmenopausal Patients With Primary Breast Cancer

Primary Purpose

Osteoporosis, Postmenopausal

Status
Completed
Phase
Phase 3
Locations
Germany
Study Type
Interventional
Intervention
Letrozole
Zoledronic acid
Sponsored by
Novartis
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoporosis focused on measuring Breast cancer, postmenopausal, bone mineral density, Zoledronic acid, Letrozole, extended adjuvant treatment., Postmenopausal women with primary hormone receptor positive breast cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Compliant postmenopausal women with primary operable breast cancer after 4 to 6 years of therapy with tamoxifen (end of tamoxifen therapy within last 6 months) Performance status 0-2 (Eastern Cooperative Oncology Group) Patients without severe osteoporosis at study entry No evidence of relapse at the time of randomization Adequate function of bone marrow, kidney, and liver Exclusion Criteria: Estrogen- and progesterone-receptor status negative or unknown Completion of adjuvant tamoxifen therapy more than 6 months prior to study start Inflammatory breast cancer Current/active dental problems including infection of the teeth or jawbone, dental or fixture trauma, or a current or prior diagnosis of osteonecrosis of the jaw, of exposed bone in the mouth, or of slow healing after dental procedures. Recent (within 6 weeks) or planned dental or jaw surgery History of diseases with influence on bone metabolism such as Paget's disease and primary overactive parathyroid Prior or concomitant therapies: chemotherapy within the last 12 months, intravenous or oral bisphosphonates, systemic corticosteroids, anabolic steroids or growth hormones, Tibolone, parathyroid hormone, systemic sodium fluoride or any drugs known to affect the skeleton (such as calcitonin, mithramycin, or gallium nitrate) Patients with previous or concomitant cancers (not breast cancer) within the past 5 years EXCEPT adequately treated basal or squamous cell skin cancers or in situ cancer of the cervix. Patients with previous other cancer(s) must have been disease-free for at least 5 years. Patients currently receiving oral bisphosphonates must discontinue these at least 3 weeks prior to study start. Additional protocol defined inclusion/exclusion criteria may apply.

Sites / Locations

  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novaertis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Letrozole

Letrozole + Zoledronic Acid

Arm Description

Letrozole orally 2.5 mg/day for 3 years

Letrozole orally 2.5mg/day for 3 years; Zoledronic acid 4mg every 6 months by infusion

Outcomes

Primary Outcome Measures

Change in Bone Mineral Density (BMD) From Baseline to Month 36
Change in bone mineral density (BMD) measured by dual X-ray absorptiometry (DXA) in lumbar spine (L1-L4). Change calculated by (Month 36 BMD-Baseline BMD)/Baseline BMD*100.
Percent Change in Bone Mineral Density (BMD) From Baseline to Month 36
Bone Mineral Density is measured by dual energy x-ray absorptiometry (DXA) scan. ANCOVA model was used in the analysis where: Variable = Baseline, Center, Treatment BMD = (Month 36 BMD-Baseline BMD)/Baseline BMD*100.
Change in T-score From Baseline to Month 36
BMD measured by DXA (dual energy x-ray absorptiometry) at lumbar spine, L1-L4. The T-Score is a comparison of a patient's BMD to that of a healthy 30 year of the same sex and ethnicity. The criteria of the World Health Organization are Normal is a T-Score of 1.0 or higher. Osteopenia is defined as between - 1.0 and -2.5. Osteoporosis is defined as -2.5 or lower, meaning a bone density that is two and half standard deviations below the mean of a 30 year old man/woman.
Change in Z Score From Baseline to Month 36
Bone Mineral Density is measured by dual energy x-ray absorptiometry (DXA). The Z-Score is the number of standard deviations a patient's BMD differs from the average BMD of their age, sex and ethnicity. A Z-score of less than minus -1.5 raises concern of factors other than aging as contributing to osteoporosis.

Secondary Outcome Measures

Change in Bone Mineral Density From Baseline to 12 Months
Change in bone mineral density (BMD) measured by dual X-ray absorptiometry (DXA) in lumbar spine (L1-L4). Change calculated by (Month 36 BMD-Baseline BMD)/Baseline BMD*100.
Number of Participants With Any Kind of Fractures, by Visit.
Number of participants with fractures of any type since the last visit
Median Disease Free Survival (DFS)
Disease Free Survival is measured in days and represents the number of days participants were progression free. Progression free survival is defined as the time from randomization to the date of the first documented progression or recurrence of disease or death from any cause. Median disease free survival is the time when 50% of the patients had a recurrence.
Change in T-Score From Baseline to Month 12
BMD measured by DXA (dual energy x-ray absorptiometry) at lumbar spine, L1-L4. The T-Score is a comparison of a patient's BMD to that of a healthy 30 year of the same sex and ethnicity. The criteria of the World Health Organization are Normal is a T-Score of 1.0 or higher. Osteopenia is defined as between - 1.0 and -2.5. Osteoporosis is defined as -2.5 or lower, meaning a bone density that is two and half standard deviations below the mean of a 30 year old man/woman.
Change in Z-Score From Baseline to Month 12
(DXA). The Z-Score is the number of standard deviations a patient's BMD differs from the average BMD of their age, sex and ethnicity. A Z-score of less than minus -1.5 raises concern of factors other than aging as contributing to osteoporosis

Full Information

First Posted
May 31, 2006
Last Updated
October 10, 2011
Sponsor
Novartis
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1. Study Identification

Unique Protocol Identification Number
NCT00332709
Brief Title
Safety/Efficacy of Letrozole Monotherapy or in Combination With Zoledronic Acid as Extended Adjuvant Treatment of Postmenopausal Patients With Primary Breast Cancer
Official Title
An Open Phase III Trial With Letrozole Alone or in Combination With Zoledronic Acid as Extended Adjuvant Treatment of Postmenopausal Patients With Primary Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
October 2011
Overall Recruitment Status
Completed
Study Start Date
January 2006 (undefined)
Primary Completion Date
August 2010 (Actual)
Study Completion Date
August 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis

4. Oversight

5. Study Description

Brief Summary
This was a prospective, randomized, open-label, two arm phase III trial designed to evaluate the efficacy and safety of zoledronic acid in preventing bone loss in postmenopausal women with operable breast cancer who had received 4 to 6 years of adjuvant tamoxifen therapy after resection of the tumor. Patients were treated with letrozole 2.5 mg orally per day or letrozole 2.5 mg orally per day in combination with zoledronic acid 4 mg/6 months as an infusion. This trial did not recruit patients in the United States.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoporosis, Postmenopausal
Keywords
Breast cancer, postmenopausal, bone mineral density, Zoledronic acid, Letrozole, extended adjuvant treatment., Postmenopausal women with primary hormone receptor positive breast cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
83 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Letrozole
Arm Type
Experimental
Arm Description
Letrozole orally 2.5 mg/day for 3 years
Arm Title
Letrozole + Zoledronic Acid
Arm Type
Experimental
Arm Description
Letrozole orally 2.5mg/day for 3 years; Zoledronic acid 4mg every 6 months by infusion
Intervention Type
Drug
Intervention Name(s)
Letrozole
Intervention Description
2.5 mg/day for 3 years
Intervention Type
Drug
Intervention Name(s)
Zoledronic acid
Intervention Description
4 mg every 6 months
Primary Outcome Measure Information:
Title
Change in Bone Mineral Density (BMD) From Baseline to Month 36
Description
Change in bone mineral density (BMD) measured by dual X-ray absorptiometry (DXA) in lumbar spine (L1-L4). Change calculated by (Month 36 BMD-Baseline BMD)/Baseline BMD*100.
Time Frame
at 36 months as compared to baseline
Title
Percent Change in Bone Mineral Density (BMD) From Baseline to Month 36
Description
Bone Mineral Density is measured by dual energy x-ray absorptiometry (DXA) scan. ANCOVA model was used in the analysis where: Variable = Baseline, Center, Treatment BMD = (Month 36 BMD-Baseline BMD)/Baseline BMD*100.
Time Frame
Baseline, Month 36
Title
Change in T-score From Baseline to Month 36
Description
BMD measured by DXA (dual energy x-ray absorptiometry) at lumbar spine, L1-L4. The T-Score is a comparison of a patient's BMD to that of a healthy 30 year of the same sex and ethnicity. The criteria of the World Health Organization are Normal is a T-Score of 1.0 or higher. Osteopenia is defined as between - 1.0 and -2.5. Osteoporosis is defined as -2.5 or lower, meaning a bone density that is two and half standard deviations below the mean of a 30 year old man/woman.
Time Frame
Baseline and Month 36
Title
Change in Z Score From Baseline to Month 36
Description
Bone Mineral Density is measured by dual energy x-ray absorptiometry (DXA). The Z-Score is the number of standard deviations a patient's BMD differs from the average BMD of their age, sex and ethnicity. A Z-score of less than minus -1.5 raises concern of factors other than aging as contributing to osteoporosis.
Time Frame
Baseline, month 36
Secondary Outcome Measure Information:
Title
Change in Bone Mineral Density From Baseline to 12 Months
Description
Change in bone mineral density (BMD) measured by dual X-ray absorptiometry (DXA) in lumbar spine (L1-L4). Change calculated by (Month 36 BMD-Baseline BMD)/Baseline BMD*100.
Time Frame
Baseline, 12 months
Title
Number of Participants With Any Kind of Fractures, by Visit.
Description
Number of participants with fractures of any type since the last visit
Time Frame
Baseline, Month 6, 12, 18, 24 , 30 and 36
Title
Median Disease Free Survival (DFS)
Description
Disease Free Survival is measured in days and represents the number of days participants were progression free. Progression free survival is defined as the time from randomization to the date of the first documented progression or recurrence of disease or death from any cause. Median disease free survival is the time when 50% of the patients had a recurrence.
Time Frame
36 months
Title
Change in T-Score From Baseline to Month 12
Description
BMD measured by DXA (dual energy x-ray absorptiometry) at lumbar spine, L1-L4. The T-Score is a comparison of a patient's BMD to that of a healthy 30 year of the same sex and ethnicity. The criteria of the World Health Organization are Normal is a T-Score of 1.0 or higher. Osteopenia is defined as between - 1.0 and -2.5. Osteoporosis is defined as -2.5 or lower, meaning a bone density that is two and half standard deviations below the mean of a 30 year old man/woman.
Time Frame
Baseline, Month 12
Title
Change in Z-Score From Baseline to Month 12
Description
(DXA). The Z-Score is the number of standard deviations a patient's BMD differs from the average BMD of their age, sex and ethnicity. A Z-score of less than minus -1.5 raises concern of factors other than aging as contributing to osteoporosis
Time Frame
Baseline, Month 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Compliant postmenopausal women with primary operable breast cancer after 4 to 6 years of therapy with tamoxifen (end of tamoxifen therapy within last 6 months) Performance status 0-2 (Eastern Cooperative Oncology Group) Patients without severe osteoporosis at study entry No evidence of relapse at the time of randomization Adequate function of bone marrow, kidney, and liver Exclusion Criteria: Estrogen- and progesterone-receptor status negative or unknown Completion of adjuvant tamoxifen therapy more than 6 months prior to study start Inflammatory breast cancer Current/active dental problems including infection of the teeth or jawbone, dental or fixture trauma, or a current or prior diagnosis of osteonecrosis of the jaw, of exposed bone in the mouth, or of slow healing after dental procedures. Recent (within 6 weeks) or planned dental or jaw surgery History of diseases with influence on bone metabolism such as Paget's disease and primary overactive parathyroid Prior or concomitant therapies: chemotherapy within the last 12 months, intravenous or oral bisphosphonates, systemic corticosteroids, anabolic steroids or growth hormones, Tibolone, parathyroid hormone, systemic sodium fluoride or any drugs known to affect the skeleton (such as calcitonin, mithramycin, or gallium nitrate) Patients with previous or concomitant cancers (not breast cancer) within the past 5 years EXCEPT adequately treated basal or squamous cell skin cancers or in situ cancer of the cervix. Patients with previous other cancer(s) must have been disease-free for at least 5 years. Patients currently receiving oral bisphosphonates must discontinue these at least 3 weeks prior to study start. Additional protocol defined inclusion/exclusion criteria may apply.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Novartis Pharmaceuticals
Organizational Affiliation
Novartis Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Novartis Investigative Site
City
Deggendorf
Country
Germany
Facility Name
Novartis Investigative Site
City
Frankfurt/Main
Country
Germany
Facility Name
Novartis Investigative Site
City
Freiburg
Country
Germany
Facility Name
Novartis Investigative Site
City
Georgsmarienhutte
Country
Germany
Facility Name
Novartis Investigative Site
City
Gottingen
Country
Germany
Facility Name
Novartis Investigative Site
City
Halle
Country
Germany
Facility Name
Novaertis Investigative Site
City
Hamein
Country
Germany
Facility Name
Novartis Investigative Site
City
Hannover
Country
Germany
Facility Name
Novartis Investigative Site
City
Hoxter
Country
Germany
Facility Name
Novartis Investigative Site
City
Ilsede
Country
Germany
Facility Name
Novartis Investigative Site
City
Jena
Country
Germany
Facility Name
Novartis Investigative Site
City
Karlsruhe
Country
Germany
Facility Name
Novartis Investigative Site
City
Koln
Country
Germany
Facility Name
Novartis Investigative Site
City
Leer
Country
Germany
Facility Name
Novartis Investigative Site
City
Lubeck
Country
Germany
Facility Name
Novartis Investigative Site
City
Mannheim
Country
Germany
Facility Name
Novartis Investigative Site
City
Munster
Country
Germany
Facility Name
Novartis Investigative Site
City
Rostock
Country
Germany
Facility Name
Novartis Investigative Site
City
Salzgitter
Country
Germany
Facility Name
Novartis Investigative Site
City
Schwenningen
Country
Germany
Facility Name
Novartis Investigative Site
City
Stendal
Country
Germany
Facility Name
Novartis Investigative Site
City
Volklingen
Country
Germany
Facility Name
Novartis Investigative Site
City
Witten
Country
Germany

12. IPD Sharing Statement

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Safety/Efficacy of Letrozole Monotherapy or in Combination With Zoledronic Acid as Extended Adjuvant Treatment of Postmenopausal Patients With Primary Breast Cancer

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