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Breast Cancer Chemoprevention by SOM230, an IGF-I Action Inhibitor: A Proof of Principle Trial

Primary Purpose

Atypical Ductal Breast Hyperplasia, Lobular Carcinoma in Situ (LCIS), Atypical Lobular Hyperplasia (ALH) of Breast

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
SOM 230 / Pasireotide
Sponsored by
NYU Langone Health
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Atypical Ductal Breast Hyperplasia

Eligibility Criteria

21 Years - undefined (Adult, Older Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria

  • Over 21 years of age
  • Must sign informed consent, witnessed, and dated prior to entry
  • The participant has an increased risk for developing breast cancer which may include; Atypical Ductal Hyperplasia (ADH), Lobular Carcinoma in situ (LCIS), and/or Atypical Lobular Hyperplasia (ALH)
  • Performance Status: ECOG 0-1 unless mobility is limited from chronic physical handicap
  • No clinical evidence of other malignancies (except Basal Cell carcinoma)
  • Complete blood count, differential and platelet count must be within normal limits (WNL) or verified by the study chair to be related to conditions not interfering with normal health status
  • Adequate hepatic and renal function (these must be WNL or verified by study chair to be related to conditions not interfering with normal health status)
  • Normal fasting glucose
  • No history of diabetes
  • Medically and Psychologically able to comply with all study requirements
  • Accessible to Follow up

Exclusion Criteria

  • Less than 21 years of age
  • Known invasive breast cancer of any type
  • Bilateral prophylactic mastectomy
  • Prior malignancy of any type that occurred less than 5 years previously, except for basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix
  • Existing non-malignant disease that would preclude the administration of SOM230
  • Pregnancy: All subjects will have a beta human chorionic gonadotropin (b-hCG) serum pregnancy test to rule out pregnancy, a history will also be taken to make certain that recent sexual exposure does not put them at risk for pregnancy. If so a second serum pregnancy test will be done. Volunteers will be asked to use barrier contraception during study.
  • Tamoxifen or other preventive measures within 6 months
  • Serious Psychiatric condition or addictive disorder
  • Diabetes or elevated fasting blood sugar
  • Inability to inject medication or test for finger stick glucose
  • Symptomatic gallstones or known gall bladder disease
  • History of cholecystitis without cholecystectomy
  • Electrolyte abnormalities (particularly hypokalemia or hypomagnesemia)

QT related exclusion criteria

  • QTcF at screening > 450 msec.
  • History of syncope or family history of idiopathic sudden death.
  • Sustained or clinically significant cardiac arrhythmias.
  • Risk factors for Torsades de Pointes such as hypokalemia, hypomagnesemia, cardiac failure, clinically significant/symptomatic bradycardia, or high-grade AV block.
  • Concomitant disease(s) that could prolong QT such as autonomic neuropathy (caused by diabetes, or Parkinson's disease), HIV, cirrhosis, uncontrolled hypothyroidism or cardiac failure
  • Concomitant medication(s) known to increase the QT interval.

Sites / Locations

  • NYU School of Medicine

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

ADH, ALH, LCIS, SOM 230

Arm Description

Women who meet eligibility criteria.

Outcomes

Primary Outcome Measures

Cell Proliferation and apoptosis
Tissue from initial diagnostic breast biopsies will be compared to the remaining tissue excised after treatment with SOM230. Tissue will be stained to measure cell proliferation and apoptosis (cell death).

Secondary Outcome Measures

Full Information

First Posted
June 9, 2011
Last Updated
December 2, 2016
Sponsor
NYU Langone Health
Collaborators
United States Department of Defense
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1. Study Identification

Unique Protocol Identification Number
NCT01372644
Brief Title
Breast Cancer Chemoprevention by SOM230, an IGF-I Action Inhibitor: A Proof of Principle Trial
Official Title
Breast Cancer Chemoprevention by SOM230, an IGF-I Action Inhibitor: A Proof of Principle Trial
Study Type
Interventional

2. Study Status

Record Verification Date
December 2016
Overall Recruitment Status
Completed
Study Start Date
November 2007 (undefined)
Primary Completion Date
December 2010 (Actual)
Study Completion Date
November 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NYU Langone Health
Collaborators
United States Department of Defense

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Atypical ductal hyperplasia (ADH) and atypical lobular hyperplasia (ALH) increases breast cancer risk. In post menopausal women, SERMS are standard chemopreventive agents. The investigators have previously shown insulin-like growth factor-I (IGF-I) is required to permit estrogen (E2) and progesterone action in the mammary gland, and that a novel somatostatin analog, SOM230, that inhibits IGF-I action can prevent E2 action on the mammary gland. It reduces cell proliferation and increases apoptosis (cell death) in the rat mammary gland. This study was designed to determine whether women at high risk for breast cancer respond to SOM230 in the same way that rats do. Methods: Women with atypical ductal hyperplasia or lobular carcinoma in-situ by core biopsy were treated for 9.5 days with SOM230 (600mcg BID). Surgical excision was performed on day 10. Sections were examined before and after SOM230 treatment for cell proliferation (Ki67) and apoptosis (TUNEL). Serum IGF-I, fasting glucose, insulin, and HbA1C were measured in anticipation of changes.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Atypical Ductal Breast Hyperplasia, Lobular Carcinoma in Situ (LCIS), Atypical Lobular Hyperplasia (ALH) of Breast

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
15 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ADH, ALH, LCIS, SOM 230
Arm Type
Experimental
Arm Description
Women who meet eligibility criteria.
Intervention Type
Drug
Intervention Name(s)
SOM 230 / Pasireotide
Primary Outcome Measure Information:
Title
Cell Proliferation and apoptosis
Description
Tissue from initial diagnostic breast biopsies will be compared to the remaining tissue excised after treatment with SOM230. Tissue will be stained to measure cell proliferation and apoptosis (cell death).
Time Frame
10 days

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria Over 21 years of age Must sign informed consent, witnessed, and dated prior to entry The participant has an increased risk for developing breast cancer which may include; Atypical Ductal Hyperplasia (ADH), Lobular Carcinoma in situ (LCIS), and/or Atypical Lobular Hyperplasia (ALH) Performance Status: ECOG 0-1 unless mobility is limited from chronic physical handicap No clinical evidence of other malignancies (except Basal Cell carcinoma) Complete blood count, differential and platelet count must be within normal limits (WNL) or verified by the study chair to be related to conditions not interfering with normal health status Adequate hepatic and renal function (these must be WNL or verified by study chair to be related to conditions not interfering with normal health status) Normal fasting glucose No history of diabetes Medically and Psychologically able to comply with all study requirements Accessible to Follow up Exclusion Criteria Less than 21 years of age Known invasive breast cancer of any type Bilateral prophylactic mastectomy Prior malignancy of any type that occurred less than 5 years previously, except for basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix Existing non-malignant disease that would preclude the administration of SOM230 Pregnancy: All subjects will have a beta human chorionic gonadotropin (b-hCG) serum pregnancy test to rule out pregnancy, a history will also be taken to make certain that recent sexual exposure does not put them at risk for pregnancy. If so a second serum pregnancy test will be done. Volunteers will be asked to use barrier contraception during study. Tamoxifen or other preventive measures within 6 months Serious Psychiatric condition or addictive disorder Diabetes or elevated fasting blood sugar Inability to inject medication or test for finger stick glucose Symptomatic gallstones or known gall bladder disease History of cholecystitis without cholecystectomy Electrolyte abnormalities (particularly hypokalemia or hypomagnesemia) QT related exclusion criteria QTcF at screening > 450 msec. History of syncope or family history of idiopathic sudden death. Sustained or clinically significant cardiac arrhythmias. Risk factors for Torsades de Pointes such as hypokalemia, hypomagnesemia, cardiac failure, clinically significant/symptomatic bradycardia, or high-grade AV block. Concomitant disease(s) that could prolong QT such as autonomic neuropathy (caused by diabetes, or Parkinson's disease), HIV, cirrhosis, uncontrolled hypothyroidism or cardiac failure Concomitant medication(s) known to increase the QT interval.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David L Kleinberg, MD
Organizational Affiliation
NYU School of Medicine
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Julia Smith, MD
Organizational Affiliation
NYU School of Medicine
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Deborah Axelrod, MD
Organizational Affiliation
NYU School of Medicine
Official's Role
Study Director
Facility Information:
Facility Name
NYU School of Medicine
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
25385439
Citation
Singh B, Smith JA, Axelrod DM, Ameri P, Levitt H, Danoff A, Lesser M, de Angelis C, Illa-Bochaca I, Lubitz S, Huberman D, Darvishian F, Kleinberg DL. Insulin-like growth factor-I inhibition with pasireotide decreases cell proliferation and increases apoptosis in pre-malignant lesions of the breast: a phase 1 proof of principle trial. Breast Cancer Res. 2014 Nov 11;16(6):463. doi: 10.1186/s13058-014-0463-1.
Results Reference
derived

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Breast Cancer Chemoprevention by SOM230, an IGF-I Action Inhibitor: A Proof of Principle Trial

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