Letrozole in Preventing Cancer in Postmenopausal Women Who Have Received 4-6 Years of Hormone Therapy for Hormone Receptor-Positive, Lymph Node-Positive, Early-Stage Breast Cancer (SOLE)
Breast Cancer

About this trial
This is an interventional prevention trial for Breast Cancer focused on measuring stage IA breast cancer, stage IB breast cancer, stage II breast cancer, stage IIIA breast cancer
Eligibility Criteria
DISEASE CHARACTERISTICS:
Confirmed diagnosis of prior operable, noninflammatory breast cancer meeting the following criteria:
- Steroid hormone receptor-positive tumors (estrogen receptor and/or progesterone receptor), determined by immunohistochemistry, after primary surgery and before commencement of prior endocrine therapy
- Prior local treatment including surgery with or without radiotherapy for primary breast cancer with no known clinical residual loco-regional disease
- Following primary surgery, eligible patients must have had evidence of lymph node involvement either in the axillary or internal mammary nodes, but not supraclavicular nodes
- Clinically disease-free
Must have completed 4-6 years of prior adjuvant selective estrogen receptor modulators (SERMs), aromatase inhibitors (AIs), or a sequential combination of both
- When calculating 4-6 years, neoadjuvant endocrine therapy should not be included
- No evidence of recurrent disease or distant metastatic disease
- No prior bilateral breast cancer
PATIENT CHARACTERISTICS:
- Female
Must be postmenopausal by any of the following criteria:
- Patients of any age who have had a bilateral oophorectomy (including radiation castration AND amenorrheic for > 3 months)
- Patients 56 years old or older with any evidence of ovarian function must have biochemical evidence of definite postmenopausal status (defined as estradiol, luteinizing hormone [LH], and follicle-stimulating hormone [FSH] in the postmenopausal range)
Patients 55 years old or younger must have biochemical evidence of definite postmenopausal status (defined as estradiol, LH, and FSH in the postmenopausal range)
- Patients who have received prior luteinizing-hormone releasing-hormone (LHRH) analogues within the last year are eligible if they have definite evidence of postmenopausal status as defined above
- Clinically adequate hepatic function
- No bone fracture due to osteoporosis at any time during the 4-6 years of prior therapy
- No prior or current malignancy except adequately treated basal cell or squamous cell carcinoma of the skin, in situ carcinoma of the cervix or bladder, or contra- or ipsilateral in situ breast carcinoma
- No other nonmalignant systemic diseases (cardiovascular, renal, lung, etc.) that would prevent prolonged follow-up
- No psychiatric, addictive, or any other disorder that compromises compliance with protocol requirements
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- More than 12 months since prior and no other concurrent endocrine SERM/AI therapy
Any type of prior adjuvant therapy allowed including, but not limited to, any of the following:
- Neoadjuvant chemotherapy
- Neoadjuvant endocrine therapy
- Adjuvant chemotherapy
- Trastuzumab (Herceptin®)
- Ovarian ablation
- Gonadotropin releasing hormone analogues
- Lapatinib ditosylate
- No concurrent hormone-replacement therapy, bisphosphonates (except for treatment of bone loss), or any other investigational agent
Sites / Locations
- Dana-Farber/Harvard Cancer Center at Dana-Farber Cancer Institute
- Faulkner Hospital
- Armidale Hospital
- Bankstown - Lidcombe Hospital
- Southern Highlands Cancer Center
- Concord Repatriation General Hospital
- Breast Center
- Port Mcquarie Base Hospital
- Prince of Wales Private Hospital
- Tamworth Base Hospital
- Tweed Heads Hospital
- Calvary Mater Newcastle
- North West Regional Hospital
- Royal Hobart Hospital
- Box Hill Hospital
- Peter MacCallum Cancer Centre
- Austin Health
- Maroondah Hospital
- Royal Perth Hospital
- Landeskrankenhaus Feldkirch
- Medizinische Universitaet Graz
- Innsbruck Universitaetsklinik
- Krankenhaus BHS Linz
- Allgemeines Krankenhaus Linz
- St. Johanns-Spital
- Medical University of Vienna
- Allgemeines Krankenhaus - Universitatskliniken
- Krankenhaus Lainz
- Hanusch-Krankenhaus
- LKH Villach
- Klinikum Kreuzschwestern Wels GmbH
- Ziekenhuis Netwerk Antwerpen Middelheim
- Cliniques du Sud Luxembourg
- Imelda vzw, Ziekenhuis
- AZ Klina
- Institut Jules Bordet
- Academisch Ziekenhuis der Vrije Universiteit Brussel
- Cliniques Universitaires Saint-Luc
- Centre Hospitalier Universitaire Brugmann
- Algemeen Ziekenhuis Sint-Maarten - Campus Rooiberg
- Universitair Ziekenhuis Gent
- Hopital de Jolimont
- Virga Jesse Hospital
- Centre Hospitalier Hutois
- AZ Groeninge - Oncologisch Centrum
- U.Z. Gasthuisberg
- Centre Hospitalier de l'Ardenne
- Centre Hospitalier Regional de la Citadelle
- Clinique Saint-Joseph
- CHU Liege - Domaine Universitaire du Sart Tilman
- Jan Palfijn Hospital
- AZ Damiaan
- Clinique Saint-Pierre
- Clinique Saint Vincent
- AZ Nikolaas - Sint-Niklaas
- Sint-Elisabethziekenhuis
- Centre Hospitalier Peltzer-La Tourelle
- Hospital Santiago Oriente Dr. Luis Tisne Brousse
- Fundacion Arturo Lopez Perez
- Hospital Clinico San Borja Arriaran
- Instituto Nacional Del Cancer
- IRAM - Chile
- Hospital Clinico Regional de Valdivia at University Austral de Chile
- Hospital Carlos Van Buren
- Aarhus Universitetshospital - Aarhus Sygehus
- Copenhagen County Herlev University Hospital
- Centralsygehus Esbjerg
- Herning Central Hospital
- Hillerod Hospital
- Naestved Hospital
- Odense University Hospital
- Bornholms Hospital
- Roskilde Amtssygehuset
- Sonderborg Sygehus
- Vejle Sygehus
- Viborg Sygehus
- Institut Bergonie
- Aalen Breast Center
- Onkologische Schwerpunktpraxis Bielefeld
- Allgemeinen Krankenhaus Celle Kinderklinik
- Klinikum Deggendorf
- Praxis Dr. Wilke - Onkologie am Klinikum Fuerth
- Vinzenzkrankenhaus Hannover gGmbH
- Henriettenstiftung Krankenhaus
- Gynaekologisch-onkologische Praxis Hannover
- Frauenheilkunde u. Geburtshilfe
- Asklepios Klinik Lich
- Gemeinschaftspraxis Gynaekologie & Geburtshilfe
- Klinikum Meiningen GmbH
- Klinikum Memmingen
- Klinikum Offenback GmbH
- Deaconess Hospital
- Johanniter Kankenhaus Stendal
- SRH Zentralklinikum Suhl GmbH
- Universitaetsklinikum Tuebingen
- National Institute of Oncology - Budapest
- Szeged University
- Tata Memorial Hospital
- Centro di Riferimento Oncologico - Aviano
- Ospedale degli Infermi - ASL 12
- Azienda Sanitaria di Bolzano
- Spedali Civili di Brescia
- A. Perrino Hospital
- Azienda Istituti Ospitalieri
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori
- European Institute of Oncology
- Fondazione Salvatore Maugeri
- Misericordia e Dolce Hospital
- Ospedale Civile Rimini
- Ospedale di Circolo e Fondazione Macchi
- Osaka Rosai Hospital
- Sagara Hospital
- Kumamoto University Faculty of Medical and Pharmaceutical Sciences
- Kyoto University Hospital
- Niigata Cancer Center Hospital
- Yao Municipal Hospital
- Tokyo Metropolitan - Komagome Hospital
- Christchurch Hospital
- Waikato Hospital
- Instituto Nacional de Enfermedades Neoplasicas
- Russian Academy of Medical Sciences Cancer Research Center
- Tygerberg Hospital
- Sandton Oncology Medical Research
- Vall d'Hebron University Hospital
- M. D. Anderson International Espana SA
- Hospital Ramon y Cajal
- Hospital Universitario 12 de Octubre
- Hospital Son Llatzer
- Hospital Sant Joan de Reus
- Hospital Universitario Virgen Macarena
- Hospital de Torrevieja
- Instituto Valenciano De Oncologia
- Hospital Clinico Universitario de Valencia
- Lasarettet i Boras
- Malarsjukhuset Hospital
- Sahlgrenska University Hospital
- Lidkoping Hospital
- Skaraborgs Hospital
- Karolinska University Hospital - Huddinge
- Kantonsspital Aarau
- Kantonsspital Baden
- Istituto Oncologico della Svizzera Italiana - Ospedale San Giovanni
- Inselspital Bern
- Oncocare Sonnenhof-Klinik Engeriedspital
- AndreasKlinik Cham Zug
- Kantonsspital Graubuenden
- Brustzentrum Thurgau at Kantonsspital Frauenfeld
- Kantonsspital Freiburg
- Centre Hospitalier Universitaire Vaudois
- Lago Maggiore Oncology Foundation
- Ospedale "la Carita", Locarno
- Ospedale Civico
- Ospedale Beata Vergine
- Kantonsspital Olten
- Hopital Regional de Sion-Herens-Conthey
- Tumor Zentrum ZeTup St. Gallen und Chur
- Kantonsspital - St. Gallen
- Regionalspital
- Kantonsspital Winterthur
- Breast Center
- City Hospital Triemli
- UniversitaetsSpital Zuerich
- Borders General Hospital
- Dumfries & Galloway Royal Infirmary
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Continuous letrozole
Intermittent letrozole
Continuous letrozole: 5 years continuously (2.5 mg Letrozole daily)
Intermittent letrozole: 48 months over 5 yrs: 4 x 9 months (9 mo followed by 3 mo treatment-free interval in yrs 1-4, -> 36 mo) plus 1 x 12 mo in yr 5 -> 48 months