Assessment of Safety and Efficacy of Estetrol in Postmenopausal Women With Advanced Estrogen Receptor Positive (ER+) Breast Cancer
Primary Purpose
Breast Neoplasms
Status
Completed
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
Estetrol
Sponsored by

About this trial
This is an interventional other trial for Breast Neoplasms focused on measuring dose-escalation, safety, dose-limiting toxicity
Eligibility Criteria
Inclusion Criteria:
- Postmenopausal women with ER-positive and HER2-negative locally advanced and/or metastatic breast cancer, who progressed on standard therapies or for whom standard therapies are intolerant;
- Patients should have experienced a natural or surgical menopause at least 5 years ago;
- Failure of anti-estrogen treatment with tamoxifen and aromatase inhibitor(s) due to the development of resistance or unacceptable side effects with this treatment;
- No undiagnosed vaginal bleeding;
- No treatment with fulvestrant within 6 months of start of treatment;
- Life expectancy at least 6 months;
- Tumour assessment (CT scan) before the start of the E4 treatment;
- Body mass index (BMI) between (≥) 18 and (≤) 35 kg/m2;
- Able to swallow an oral medication;
- Acceptable values of hematological parameters, liver and kidney function and calcium levels;
- Acceptable values of hemostasis parameters (as of second cohort);
- Eastern Cooperative Oncology Group (ECOG) Performance Status: 0-2 (as of second cohort);
- Reasonable physical and mental health as judged by the investigator and determined by physical examination, clinical laboratory assessments and vital signs;
- Willing to give informed consent in writing.
Exclusion Criteria:
- Uncontrolled nausea, vomiting, or diarrhea;
- History of venous or arterial thromboembolic disease or a known defect in the blood coagulation system;
- History of severe cardiac events or life threatening cardiac dysrhythmia (as of second cohort);
- Patients who have unstable angina or clinical congestive heart failure (as of second cohort);
- Uncontrolled hypertension, i.e. systolic blood pressure 160 mmHg and/or diastolic blood pressure 100 mmHg in the last 6 months with or without medication;
- Diabetes mellitus with poor glycaemic control in the last 6 months (HbA1c above 7.5%);
- Any other serious disease including systemic lupus erythematosus and untreated cholelithiasis;
- Smoking >10 cigarettes/day;
- Use of any other cancer therapy including radiotherapy (except for palliative reasons), endocrine therapy, immunotherapy, chemotherapy, or use of other investigational agents at the start of treatment.
Sites / Locations
- Katholisches Klinikum Mainz
- Universitatsmedizin Mainz
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
estetrol
Arm Description
3 + 3 design with inter-patient dose escalation
Outcomes
Primary Outcome Measures
The number of patients with a dose limiting toxicity (DLT)
Secondary Outcome Measures
Questionnaire on estrogen deficiency symptoms
Quality of Life will be assessed by means of a questionnaire on estrogen deficiency symptoms.
Pharmacokinetics: estetrol trough levels
Preliminary anti-tumour response according to RECIST 1.1
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02718144
Brief Title
Assessment of Safety and Efficacy of Estetrol in Postmenopausal Women With Advanced Estrogen Receptor Positive (ER+) Breast Cancer
Official Title
A Phase I/II Clinical Trial Assessing Safety and Efficacy of Estetrol (E4) in Postmenopausal Women With Advanced Estrogen Receptor Positive (ER+) Breast Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
November 2019
Overall Recruitment Status
Completed
Study Start Date
June 1, 2017 (Actual)
Primary Completion Date
December 31, 2019 (Actual)
Study Completion Date
December 31, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pantarhei Oncology B.V.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a multi-center, open-label, phase I/IIa trial, dose-escalation study with a 3 + 3 cohort design to determine the recommended dose of estetrol for the treatment of patients with advanced breast cancer. After completing phase I part of the study (i.e. 4 weeks of treatment), patients will receive further treatment for 8 weeks at their individual phase I dose level (phase IIa part of the study).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Neoplasms
Keywords
dose-escalation, safety, dose-limiting toxicity
7. Study Design
Primary Purpose
Other
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Actual)
8. Arms, Groups, and Interventions
Arm Title
estetrol
Arm Type
Experimental
Arm Description
3 + 3 design with inter-patient dose escalation
Intervention Type
Drug
Intervention Name(s)
Estetrol
Intervention Description
Estetrol formulated in tablets, in escalating doses, will be investigated in patients with estrogen receptor positive (ER+) locally advanced or metastatic breast cancer.
Primary Outcome Measure Information:
Title
The number of patients with a dose limiting toxicity (DLT)
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
Questionnaire on estrogen deficiency symptoms
Description
Quality of Life will be assessed by means of a questionnaire on estrogen deficiency symptoms.
Time Frame
12 weeks
Title
Pharmacokinetics: estetrol trough levels
Time Frame
2 weeks, 4 weeks, 8 weeks
Title
Preliminary anti-tumour response according to RECIST 1.1
Time Frame
12 weeks
Other Pre-specified Outcome Measures:
Title
Number of patients with Adverse Events (AEs)
Time Frame
12 weeks
10. Eligibility
Sex
Female
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Postmenopausal women with ER-positive and HER2-negative locally advanced and/or metastatic breast cancer, who progressed on standard therapies or for whom standard therapies are intolerant;
Patients should have experienced a natural or surgical menopause at least 5 years ago;
Failure of anti-estrogen treatment with tamoxifen and aromatase inhibitor(s) due to the development of resistance or unacceptable side effects with this treatment;
No undiagnosed vaginal bleeding;
No treatment with fulvestrant within 6 months of start of treatment;
Life expectancy at least 6 months;
Tumour assessment (CT scan) before the start of the E4 treatment;
Body mass index (BMI) between (≥) 18 and (≤) 35 kg/m2;
Able to swallow an oral medication;
Acceptable values of hematological parameters, liver and kidney function and calcium levels;
Acceptable values of hemostasis parameters (as of second cohort);
Eastern Cooperative Oncology Group (ECOG) Performance Status: 0-2 (as of second cohort);
Reasonable physical and mental health as judged by the investigator and determined by physical examination, clinical laboratory assessments and vital signs;
Willing to give informed consent in writing.
Exclusion Criteria:
Uncontrolled nausea, vomiting, or diarrhea;
History of venous or arterial thromboembolic disease or a known defect in the blood coagulation system;
History of severe cardiac events or life threatening cardiac dysrhythmia (as of second cohort);
Patients who have unstable angina or clinical congestive heart failure (as of second cohort);
Uncontrolled hypertension, i.e. systolic blood pressure 160 mmHg and/or diastolic blood pressure 100 mmHg in the last 6 months with or without medication;
Diabetes mellitus with poor glycaemic control in the last 6 months (HbA1c above 7.5%);
Any other serious disease including systemic lupus erythematosus and untreated cholelithiasis;
Smoking >10 cigarettes/day;
Use of any other cancer therapy including radiotherapy (except for palliative reasons), endocrine therapy, immunotherapy, chemotherapy, or use of other investigational agents at the start of treatment.
Facility Information:
Facility Name
Katholisches Klinikum Mainz
City
Mainz
Country
Germany
Facility Name
Universitatsmedizin Mainz
City
Mainz
Country
Germany
12. IPD Sharing Statement
Citations:
PubMed Identifier
24997853
Citation
Singer CF, Bennink HJ, Natter C, Steurer S, Rudas M, Moinfar F, Appels N, Visser M, Kubista E. Antiestrogenic effects of the fetal estrogen estetrol in women with estrogen-receptor positive early breast cancer. Carcinogenesis. 2014 Nov;35(11):2447-51. doi: 10.1093/carcin/bgu144. Epub 2014 Jul 5.
Results Reference
result
PubMed Identifier
25961355
Citation
Visser M, Kloosterboer HJ, Bennink HJ. Estetrol prevents and suppresses mammary tumors induced by DMBA in a rat model. Horm Mol Biol Clin Investig. 2012 Apr 1;9(1):95-103. doi: 10.1515/hmbci-2012-0015.
Results Reference
result
Learn more about this trial
Assessment of Safety and Efficacy of Estetrol in Postmenopausal Women With Advanced Estrogen Receptor Positive (ER+) Breast Cancer
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