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Adjuvant Ovarian Suppression Plus Aromatase Inhibitor or Tamoxifen in Young Women (ASPAIT)

Primary Purpose

Breast Cancer

Status
Recruiting
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
Goserelin
Tamoxifen
Aromatase Inhibitors
Leuprolide
Sponsored by
First Affiliated Hospital, Sun Yat-Sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring breast cancer, ovarian function suppression (OFS), aromatase inhibitors(AIs), tamoxifen(TAM)

Eligibility Criteria

undefined - 35 Years (Child, Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Signed informed consent;
  2. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2;
  3. Patients pathologically diagnosed with hormone receptor positive invasive breast cancer: immunohistochemistry ER positive (≥1%);
  4. Premenopausal patients with age ≤35 years (at least menstruate once for prior 3 months, assess menstruation situation before chemotherapy if have);
  5. No distant metastasis;
  6. Clinical stage (TNM) meets at least one of the conditions as follow: T≥2cm or at least one region of regional lymph node metastasis (including micrometastases);
  7. Patients must have undergone a surgery and (neo)adjuvant chemotherapy, targeted therapy, radiotherapy (if necessary) according to Chinese Anti-Cancer Association guidelines and specifications version 2015 for diagnosis and treatment of breast cancer;
  8. Indexes of hematology and biochemistry conform to following standards: HGB≥10g/dl, WBC≥4,000/mm3, PLT≥100,000/mm3, GOT, GPT, ALP≤2xULN, TBIL, DBIL, CCr≤1.5xULN.

Exclusion Criteria:

  1. Pregnant or lactating women or women of childbearing potential reject contraceptive measures;
  2. History of organ transplantation (including autologous bone marrow transplantation and peripheral stem cell transplantation);
  3. Concurrent malignancies or history of non-breast malignancies within the 5 years prior to study entry, except for curatively treated basal cell and squamous cell carcinomas of the skin, carcinoma in situ of the cervix; peripheral nervous system disorders caused by diseases or history of obvious mental and central nervous system disorders;
  4. Prior use of neo-adjuvant chemotherapy after a definite diagnosis;
  5. Nervous system disorders caused by diseases or obvious mental disorder, which would affect patients right to consent and compliance, or make patients in critical condition;
  6. Serious hepatopathy (e.g., cirrhosis, etc.), nephropathy, respiratory illness, digestive illness or poorly controlled diabetes;
  7. Cardiac illness with obvious abnormal EKG or clinical symptoms, namely congestive heart failure, coronary atherosclerotic heart disease with obvious symptoms, arrhythmia difficult to control by drugs, or history of myocardial infarction within the 12 months prior to study entry or class III/IV of cardiac function;
  8. Concurrent treatment in another investigational trial;
  9. Sensitivity or contraindication to any of the study medications.

Sites / Locations

  • Cancer Hospital Chinese Academy of Medical Sciences
  • Peking University First Hospital
  • Dongguan People's HospitalRecruiting
  • GuangDong Hospital Of Traditional Chinese MedicineRecruiting
  • Guangdong People's Hospital
  • Guangdong Provincial Women and Children's HospitalRecruiting
  • Guangzhou First Municipal People's HospitalRecruiting
  • Guangzhou Women and Childrens Medical CenterRecruiting
  • Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityRecruiting
  • Sun Yat-sen University Cancer CenterRecruiting
  • The Second Affiliated Hospital of Guangzhou Medical UniversityRecruiting
  • Guilin TCMhospital of ChinaRecruiting
  • Zhejiang Provincial People's Hospital
  • Harbin Medical University Cancer HospitalRecruiting
  • Yunnan Cancer Hospital
  • Maoming People's HospitalRecruiting
  • The first Affiliated Hospital of Guangxi Medical UniversityRecruiting
  • The Affiliated Hospital of Qingdao University
  • The First Affiliated Hospital of Wenzhou Medical University
  • Affiliated hospital of Guangdong Medicine CollegeRecruiting
  • Affiliated hospital of Guangdong Medicine CollegeRecruiting
  • Lian Jiang People' s HospitalRecruiting
  • Henan Cancer Hospital
  • Zhongshan People's HospitalRecruiting
  • The Fifth Affiliated Hospital Sun Yat-Sen UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Ovarian Suppression and aromatase inhibitors

Ovarian Suppression and tamoxifen

Arm Description

Ovarian Suppression:Goserelin 3.6 mg or Leuprolide 3.75 mg administered intravenously every 28 days, for 5 years. AI: no restriction of specific drugs, oral by standard dose of post-menopause breast cancer, for 5 years.

Ovarian Suppression:Goserelin 3.6 mg or Leuprolide 3.75 mg administered intravenously every 28 days, for 5 years. Tamoxifen: 20mg oral for every day, for 5 years.

Outcomes

Primary Outcome Measures

Disease-Free Survival (DFS)
DFS is defined as the time between randomization and the date of the first occurrence of events as follow: local, regional recurrence or distant metastasis of invasive breast cancer, contralateral invasive breast cancer, or death due to any diseases. Patients who have not had disease progression or death at the end of follow-up (5 years) will be censored at the date last known to be alive and distant metastasis free. Subgroup analysis DFS of Luminal A and Luminal B breast cancer.

Secondary Outcome Measures

Overall Survival (OS)
The time from randomization to death due to any cause. Patients still alive at the end of follow-up (5 years) will be censored at the last known alive date.
Invasive Breast Cancer Recurrence-Free Interval(BCFI)
The time between randomization and the first occurrence of local, regional recurrence or distant metastasis of invasive breast cancer, or contralateral invasive breast cancer. Patients who have not had invasive breast cancer recurrence at the end of follow-up (5 years) will be censored at the date last known to be distant metastasis free.
Adverse Effects Rate

Full Information

First Posted
September 18, 2016
Last Updated
January 12, 2023
Sponsor
First Affiliated Hospital, Sun Yat-Sen University
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1. Study Identification

Unique Protocol Identification Number
NCT02914158
Brief Title
Adjuvant Ovarian Suppression Plus Aromatase Inhibitor or Tamoxifen in Young Women
Acronym
ASPAIT
Official Title
Adjuvant Ovarian Suppression Plus Aromatase Inhibitor or Tamoxifen for Hormone Receptor-Positive Breast Cancer in Women Younger Than 35: A Multicenter Randomized Clinical Trial
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 30, 2016 (Actual)
Primary Completion Date
December 30, 2023 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
First Affiliated Hospital, Sun Yat-Sen University

4. Oversight

5. Study Description

Brief Summary
The objective of this study is to compare the curative effects in patients under the age of 35 with hormone receptor positive breast cancer and high recurrent risk factors including large tumor or metastatic lymph nodes randomized to ovarian function suppression (OFS) plus aromatase inhibitors or OFS plus tamoxifen as adjuvant endocrine therapy, and explore the differences of curative effects between different subtypes to provide direct evidence for treatments of young breast cancer patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
breast cancer, ovarian function suppression (OFS), aromatase inhibitors(AIs), tamoxifen(TAM)

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Ovarian Suppression and aromatase inhibitors
Arm Type
Experimental
Arm Description
Ovarian Suppression:Goserelin 3.6 mg or Leuprolide 3.75 mg administered intravenously every 28 days, for 5 years. AI: no restriction of specific drugs, oral by standard dose of post-menopause breast cancer, for 5 years.
Arm Title
Ovarian Suppression and tamoxifen
Arm Type
Active Comparator
Arm Description
Ovarian Suppression:Goserelin 3.6 mg or Leuprolide 3.75 mg administered intravenously every 28 days, for 5 years. Tamoxifen: 20mg oral for every day, for 5 years.
Intervention Type
Drug
Intervention Name(s)
Goserelin
Intervention Type
Drug
Intervention Name(s)
Tamoxifen
Intervention Type
Drug
Intervention Name(s)
Aromatase Inhibitors
Intervention Type
Drug
Intervention Name(s)
Leuprolide
Other Intervention Name(s)
leuprolide acetate
Primary Outcome Measure Information:
Title
Disease-Free Survival (DFS)
Description
DFS is defined as the time between randomization and the date of the first occurrence of events as follow: local, regional recurrence or distant metastasis of invasive breast cancer, contralateral invasive breast cancer, or death due to any diseases. Patients who have not had disease progression or death at the end of follow-up (5 years) will be censored at the date last known to be alive and distant metastasis free. Subgroup analysis DFS of Luminal A and Luminal B breast cancer.
Time Frame
5 years
Secondary Outcome Measure Information:
Title
Overall Survival (OS)
Description
The time from randomization to death due to any cause. Patients still alive at the end of follow-up (5 years) will be censored at the last known alive date.
Time Frame
5 years
Title
Invasive Breast Cancer Recurrence-Free Interval(BCFI)
Description
The time between randomization and the first occurrence of local, regional recurrence or distant metastasis of invasive breast cancer, or contralateral invasive breast cancer. Patients who have not had invasive breast cancer recurrence at the end of follow-up (5 years) will be censored at the date last known to be distant metastasis free.
Time Frame
5 years
Title
Adverse Effects Rate
Time Frame
5 years

10. Eligibility

Sex
Female
Maximum Age & Unit of Time
35 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consent; Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2; Patients pathologically diagnosed with hormone receptor positive invasive breast cancer: immunohistochemistry ER positive (≥1%); Premenopausal patients with age ≤35 years (at least menstruate once for prior 3 months, assess menstruation situation before chemotherapy if have); No distant metastasis; Clinical stage (TNM) meets at least one of the conditions as follow: T≥2cm or at least one region of regional lymph node metastasis (including micrometastases); Patients must have undergone a surgery and (neo)adjuvant chemotherapy, targeted therapy, radiotherapy (if necessary) according to Chinese Anti-Cancer Association guidelines and specifications version 2015 for diagnosis and treatment of breast cancer; Indexes of hematology and biochemistry conform to following standards: HGB≥10g/dl, WBC≥4,000/mm3, PLT≥100,000/mm3, GOT, GPT, ALP≤2xULN, TBIL, DBIL, CCr≤1.5xULN. Exclusion Criteria: Pregnant or lactating women or women of childbearing potential reject contraceptive measures; History of organ transplantation (including autologous bone marrow transplantation and peripheral stem cell transplantation); Concurrent malignancies or history of non-breast malignancies within the 5 years prior to study entry, except for curatively treated basal cell and squamous cell carcinomas of the skin, carcinoma in situ of the cervix; peripheral nervous system disorders caused by diseases or history of obvious mental and central nervous system disorders; Prior use of neo-adjuvant chemotherapy after a definite diagnosis; Nervous system disorders caused by diseases or obvious mental disorder, which would affect patients right to consent and compliance, or make patients in critical condition; Serious hepatopathy (e.g., cirrhosis, etc.), nephropathy, respiratory illness, digestive illness or poorly controlled diabetes; Cardiac illness with obvious abnormal EKG or clinical symptoms, namely congestive heart failure, coronary atherosclerotic heart disease with obvious symptoms, arrhythmia difficult to control by drugs, or history of myocardial infarction within the 12 months prior to study entry or class III/IV of cardiac function; Concurrent treatment in another investigational trial; Sensitivity or contraindication to any of the study medications.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lin Ying, doctor
Phone
020-28823235
Email
linying3@mail.sysu.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Chen R Ping, bachelor
Phone
13533242895
Email
ruping089@163.com
Facility Information:
Facility Name
Cancer Hospital Chinese Academy of Medical Sciences
City
Beijing
Country
China
Individual Site Status
Active, not recruiting
Facility Name
Peking University First Hospital
City
Beijing
Country
China
Individual Site Status
Active, not recruiting
Facility Name
Dongguan People's Hospital
City
Dongguan
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ailing Zhang
Facility Name
GuangDong Hospital Of Traditional Chinese Medicine
City
Guangzhou
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Qianjun Chen
Facility Name
Guangdong People's Hospital
City
Guangzhou
Country
China
Individual Site Status
Active, not recruiting
Facility Name
Guangdong Provincial Women and Children's Hospital
City
Guangzhou
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhang A Qin
Facility Name
Guangzhou First Municipal People's Hospital
City
Guangzhou
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Li Zhao
Facility Name
Guangzhou Women and Childrens Medical Center
City
Guangzhou
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hongming Ma
Facility Name
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
City
Guangzhou
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yao H Rui
Facility Name
Sun Yat-sen University Cancer Center
City
Guangzhou
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yuan Z Yu
Facility Name
The Second Affiliated Hospital of Guangzhou Medical University
City
Guangzhou
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lehong Zhang
Facility Name
Guilin TCMhospital of China
City
Guilin
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Rui Zhuo
Facility Name
Zhejiang Provincial People's Hospital
City
Hangzhou
Country
China
Individual Site Status
Active, not recruiting
Facility Name
Harbin Medical University Cancer Hospital
City
Harbin
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Li Cai
Facility Name
Yunnan Cancer Hospital
City
Kunming
Country
China
Individual Site Status
Active, not recruiting
Facility Name
Maoming People's Hospital
City
Maoming
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Weixiong Yang
Facility Name
The first Affiliated Hospital of Guangxi Medical University
City
Nanning
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jingcai Zhong
Facility Name
The Affiliated Hospital of Qingdao University
City
Qingdao
Country
China
Individual Site Status
Active, not recruiting
Facility Name
The First Affiliated Hospital of Wenzhou Medical University
City
Wenzhou
Country
China
Individual Site Status
Active, not recruiting
Facility Name
Affiliated hospital of Guangdong Medicine College
City
Zhanjiang
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Li J Wen
Facility Name
Affiliated hospital of Guangdong Medicine College
City
Zhanjiang
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhang Y Qi
Facility Name
Lian Jiang People' s Hospital
City
Zhanjiang
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Huang Heng
Facility Name
Henan Cancer Hospital
City
Zhengzhou
Country
China
Individual Site Status
Active, not recruiting
Facility Name
Zhongshan People's Hospital
City
Zhongshan
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Feihai Ling
Facility Name
The Fifth Affiliated Hospital Sun Yat-Sen University
City
Zhuhai
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hongyu Zhang

12. IPD Sharing Statement

Citations:
PubMed Identifier
24872111
Citation
Fan L, Strasser-Weippl K, Li JJ, St Louis J, Finkelstein DM, Yu KD, Chen WQ, Shao ZM, Goss PE. Breast cancer in China. Lancet Oncol. 2014 Jun;15(7):e279-89. doi: 10.1016/S1470-2045(13)70567-9.
Results Reference
background
PubMed Identifier
26211827
Citation
Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials. Lancet. 2015 Oct 3;386(10001):1341-1352. doi: 10.1016/S0140-6736(15)61074-1. Epub 2015 Jul 23.
Results Reference
background
PubMed Identifier
17512856
Citation
LHRH-agonists in Early Breast Cancer Overview group; Cuzick J, Ambroisine L, Davidson N, Jakesz R, Kaufmann M, Regan M, Sainsbury R. Use of luteinising-hormone-releasing hormone agonists as adjuvant treatment in premenopausal patients with hormone-receptor-positive breast cancer: a meta-analysis of individual patient data from randomised adjuvant trials. Lancet. 2007 May 19;369(9574):1711-23. doi: 10.1016/S0140-6736(07)60778-8.
Results Reference
background
PubMed Identifier
24881463
Citation
Pagani O, Regan MM, Walley BA, Fleming GF, Colleoni M, Lang I, Gomez HL, Tondini C, Burstein HJ, Perez EA, Ciruelos E, Stearns V, Bonnefoi HR, Martino S, Geyer CE Jr, Pinotti G, Puglisi F, Crivellari D, Ruhstaller T, Winer EP, Rabaglio-Poretti M, Maibach R, Ruepp B, Giobbie-Hurder A, Price KN, Bernhard J, Luo W, Ribi K, Viale G, Coates AS, Gelber RD, Goldhirsch A, Francis PA; TEXT and SOFT Investigators; International Breast Cancer Study Group. Adjuvant exemestane with ovarian suppression in premenopausal breast cancer. N Engl J Med. 2014 Jul 10;371(2):107-18. doi: 10.1056/NEJMoa1404037. Epub 2014 Jun 1.
Results Reference
background
PubMed Identifier
25495490
Citation
Francis PA, Regan MM, Fleming GF, Lang I, Ciruelos E, Bellet M, Bonnefoi HR, Climent MA, Da Prada GA, Burstein HJ, Martino S, Davidson NE, Geyer CE Jr, Walley BA, Coleman R, Kerbrat P, Buchholz S, Ingle JN, Winer EP, Rabaglio-Poretti M, Maibach R, Ruepp B, Giobbie-Hurder A, Price KN, Colleoni M, Viale G, Coates AS, Goldhirsch A, Gelber RD; SOFT Investigators; International Breast Cancer Study Group. Adjuvant ovarian suppression in premenopausal breast cancer. N Engl J Med. 2015 Jan 29;372(5):436-46. doi: 10.1056/NEJMoa1412379. Epub 2014 Dec 11.
Results Reference
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Adjuvant Ovarian Suppression Plus Aromatase Inhibitor or Tamoxifen in Young Women

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