Letrozole in Treating Breast Cancer in Postmenopausal Women With Stage I, II, or III Breast Cancer Previously Treated With Tamoxifen (GIM4) (GIM4)
Breast Cancer
About this trial
This is an interventional treatment trial for Breast Cancer focused on measuring stage IA breast cancer, stage IB breast cancer, stage II breast cancer, stage IIIA breast cancer, stage IIIB breast cancer, stage IIIC breast cancer
Eligibility Criteria
INCLUSION CRITERIA
- Signed informed consent prior to beginning protocol specific procedures.
- Histologically proven breast cancer at the first diagnosis with tumor stage I-II-III. Patients with histologically documented (microscopic) infiltration of the skin (pT4) will also be eligible.
- Axillary Nodal status allowed: Nx, pNo, pN1, pN2, pN3.
Postmenopausal status defined by one of the following:
- Age > 55 years with cessation of menses
- Age < 55 years but not spontaneous menses for at least 1 year
- Age < 55 years and spontaneous menses within the past 1 year, but currently amenorrheic (e.g. spontaneous, or secondary to hysterectomy), AND with postmenopausal gonadotrophin levels (luteinizing hormone and follicle stimulating hormone levels >40 IU/L) or postmenopausal estradiol levels (<5 ng/dL) or according to the definition of "postmenopausal range" for the laboratory involved.
- Bilateral oophorectomy
- Adjuvant TAM received for at least 2 years and not more than 3 years and 3 months. Patients treated with adjuvant chemotherapy, are required to have begun receiving TAM within 3 months after the completion of chemotherapy.
- Definitive surgical treatment must be either mastectomy or breast conserving surgery, with axillary lymph node dissection or sentinel node biopsy for operable breast cancer.
- ECOG/WHO performance Status 0-1. Patients must be accessible for treatment and follow-up.
- Concomitant treatment with biphosphonates are allowed and should be recorded during the trial.
EXCLUSION CRITERIA
- Male patients.
- Any locally advanced (T4) or inflammatory breast cancer. However, patients with microscopic infiltration of the skin (pT4) will be eligible.
- Patients with distant metastases. Any suspicious manifestation requires appropriate investigation to exclude metastases.
- Histology other than adenocarcinoma.
- Patients with previous or concomitant (not breast cancer) malignancy within the past 5 years EXCEPT adequately treated basal or squamous cell carcinoma of the skin or in situ carcinoma of the cervix. Patients who have had a previous other malignancy must have been disease free for 5 years.
- Patients with other non-malignant systemic diseases (cardiovascular, renal, hepatic, lung embolism, etc.) which would prevent prolonged follow-up.
- Use of hormone Replacement Therapy within four weeks before randomization.
- Concurrent treatment with other experimental drugs. Participation in another clinical trial with any investigational regimen within 30 days prior to study entry.
- Concurrent treatment with any other anti-cancer therapy.
Sites / Locations
- Istituto Nazionale per la Ricerca sul Cancro
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Letrozole for 3-2 years
Letrozole for 5 year
Patients pre-treated with TAM for 2-3 years will receive letrozole 2,5 mg/die for 3-2 years. Total duration of early adjuvant endocrine therapy: 5 years
Patients pre-treated with TAM for 2-3 years will receive letrozole 2,5 mg/die for additional 5 years. Total duration of early adjuvant endocrine therapy: 7 years for patients pretreated with 2 years of TAM and 8 years for patients pre-treated with 3 years of TAM