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Comparative Study for the Degree of Biological Changes After Short-term 2 Weeks and 4 Weeks Preoperative Endocrine Therapy in Luminal Breast Cancer

Primary Purpose

Breast Neoplasms

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Endocrine therapy
Endocrine therapy
Sponsored by
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Neoplasms focused on measuring Hormone receptors-positive breast neoplasms, preoperative endocrine therapy, Ki-67

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Signed the informed consent.
  2. Female aged between 18 and 70 years.
  3. Pathologically diagnosed operable invasive breast cancer meeting the following criterias:

    • Hormone receptor (HR)-positive: pathologically diagnosed estrogen receptor (ER)-positive and/or progesterone receptor (PR)-positive;
    • Human epidermal growth factor receptor 2 (HER2)-negative: FISH or immunohistochemistry (IHC).
  4. WHO Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
  5. Newly diagnosed breast cancer.
  6. The important organ functions meet the following criterias:

    • WBC >=3.0 x 10^9/L; Neutrophilic granulocytes >=1.5×10^9/L; Platelet >=100 x 10^9/L; Hb >=9 g/dL;
    • Total bilirubin no more than 1.5 times the normal upper limit (ULN); AST and ALT no more than 1.5 times ULN; AKP no more than 2.5 times ULN;
    • Serum creatinine no more than 1.5 times ULN or Clearance rate of creatinine >= 60ml/min;
    • Thyroid stimulating hormone (TSH) <= ULN (T3, T4 levels need to be detected simultaneously if abnormalities, the patient can be included if T3, T4 levels is normal);
    • LVEF basement >= 50%.
  7. Able to swallow tablets.
  8. Pregnancy test (serum or urine HCG test within 72h before enrollment) must be negative in non-surgical sterilization or women of childbearing age, must be not for the nursing and be willing to take non-pharmacological contraception during treatment (such as intrauterine device, condom, etc).

Exclusion Criteria:

  1. Evidence of distant metastasis.
  2. Bilateral or multiple unilateral breast tumors with different histological characteristics (such as ER/PR/HER2 status, tumor grade or type, etc).
  3. Any invasive malignancy diagnosed within previous 5 years (other than successfully treated cervical carcinoma in situ, skin basal cell carcinoma or cutaneous squamous cell carcinoma).
  4. Prior radiotherapy, chemotherapy, endocrine therapy, targeted therapy etc.
  5. Concurrent use of HRT or any other estrogen-containing medication (including vaginal estrogens) within 4 weeks.
  6. Prior use of estrogen implants.
  7. Prior use of high-dose systemic corticosteroids (except as antiemetic treatment), immunotherapy, or biological response modifiers (e.g., interferon, etc).
  8. Use of an unlicensed or other investigational drug within 4 weeks.
  9. Any severe comorbidities, inability to give informed consent or unavailability for follow-up, including but not limited to any of the following:

    • Heart failure above NYHA class 2 level; high-risk uncontrollable arrhythmia; unstable angina pectoris; myocardial infarction within 1 year; valvular heart disease with clinically significance or requiring intervention.
    • Chronic obstructive pulmonary disease requires treatment.
    • Chronic liver disease (cirrhosis, chronic active hepatitis, etc).
    • Cerebrovascular accident occurred within 6 months.
    • Severe epilepsy or central nervous system diseases.
    • Hypertension which cannot be well controlled by antihypertensive drugs.
    • Abnormal coagulation, bleeding tendency, or receiving thrombolysis or anticoagulant therapy.
    • Chronic renal insufficiency.
    • Active infection.
    • Psychiatric disability, etc.
  10. Pregnant or nursing females.

Sites / Locations

  • Sun Yat-sen Memorial HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Arm I (2 weeks preoperative endocrine therapy))

Arm II (4 weeks preoperative endocrine therapy)

Arm Description

Patients receive endocrine therapy before surgery for 2 weeks. Choice of endocrine therapy is according to guidelines and centre policy.

Patients receive endocrine therapy before surgery for 4 weeks. Choice of endocrine therapy is according to guidelines and centre policy.

Outcomes

Primary Outcome Measures

Percentage Change From Pre-treatment to Post-treatment in Ki-67 Labelling Index
Ki-67 labelling index is calculated as the percentage of cells with Ki-67-positive nuclear immunostaining as measured by immunohistochemistry (IHC). Range 0-100. Percentage change from pre-treatment to post-treatment=[(Ki-67post - Ki-67pre)/Ki-67pre]x100%

Secondary Outcome Measures

Disease Free Survival (DFS)
Overall Survival (OS)

Full Information

First Posted
July 15, 2019
Last Updated
July 16, 2019
Sponsor
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
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1. Study Identification

Unique Protocol Identification Number
NCT04023292
Brief Title
Comparative Study for the Degree of Biological Changes After Short-term 2 Weeks and 4 Weeks Preoperative Endocrine Therapy in Luminal Breast Cancer
Official Title
Comparative Study for the Degree of Biological Changes After Short-term 2 Weeks and 4 Weeks Preoperative Endocrine Therapy in Luminal Breast Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
July 2019
Overall Recruitment Status
Recruiting
Study Start Date
July 2019 (Anticipated)
Primary Completion Date
July 2023 (Anticipated)
Study Completion Date
July 2025 (Anticipated)

3. Sponsor/Collaborators

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

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
RATIONALE: Estrogen can promote proliferation of tumor cells in hormone receptors (HR)-positive breast cancer. The standard therapy of Luminal subtypes is endocrine therapy, which can influence proliferation of tumor cells by blocking the use of estrogen by cancer cells or lowering the amount of estrogen the body makes. Thus, markers of proliferation are candidate markers of efficacy after short-term (e.g., 2 weeks or 4 weeks) preoperative hormone therapy. Ki-67 is most commonly used among these markers. In contrast to the absolute value, the degree of Ki-67 changes which consider the baseline values would be better to reflect the sensitivity of therapy. It is not yet known whether the degree of Ki-67 changes after 2 weeks or 4 weeks presurgery endocrine therapy is different and which interval is more suitable to assess therapy sensitivity. PURPOSE: This randomized phase II trial is studying to compare the degree of Ki-67 changes after 2 weeks or 4 weeks preoperative endocrine therapy and to determine a more appropriate interval to assess hormone therapy sensitivity in women who are undergoing surgery for HR-positive, Human epidermal growth factor receptor 2 (HER2)-negative breast cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Neoplasms
Keywords
Hormone receptors-positive breast neoplasms, preoperative endocrine therapy, Ki-67

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
185 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm I (2 weeks preoperative endocrine therapy))
Arm Type
Experimental
Arm Description
Patients receive endocrine therapy before surgery for 2 weeks. Choice of endocrine therapy is according to guidelines and centre policy.
Arm Title
Arm II (4 weeks preoperative endocrine therapy)
Arm Type
Active Comparator
Arm Description
Patients receive endocrine therapy before surgery for 4 weeks. Choice of endocrine therapy is according to guidelines and centre policy.
Intervention Type
Drug
Intervention Name(s)
Endocrine therapy
Other Intervention Name(s)
tamoxifen, Letrozole, Anastrazole, Exemestane, etc.
Intervention Description
Use before surgery for 2 weeks. Choice of endocrine therapy is according to guidelines and centre policy.
Intervention Type
Drug
Intervention Name(s)
Endocrine therapy
Other Intervention Name(s)
tamoxifen, Letrozole, Anastrazole, Exemestane, etc.
Intervention Description
Use before surgery for 4 weeks. Choice of endocrine therapy is according to guidelines and centre policy.
Primary Outcome Measure Information:
Title
Percentage Change From Pre-treatment to Post-treatment in Ki-67 Labelling Index
Description
Ki-67 labelling index is calculated as the percentage of cells with Ki-67-positive nuclear immunostaining as measured by immunohistochemistry (IHC). Range 0-100. Percentage change from pre-treatment to post-treatment=[(Ki-67post - Ki-67pre)/Ki-67pre]x100%
Time Frame
2 weeks or 4 weeks endocrine treatment before surgery
Secondary Outcome Measure Information:
Title
Disease Free Survival (DFS)
Time Frame
5 years post-randomisation
Title
Overall Survival (OS)
Time Frame
5 years post-randomisation

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed the informed consent. Female aged between 18 and 70 years. Pathologically diagnosed operable invasive breast cancer meeting the following criterias: Hormone receptor (HR)-positive: pathologically diagnosed estrogen receptor (ER)-positive and/or progesterone receptor (PR)-positive; Human epidermal growth factor receptor 2 (HER2)-negative: FISH or immunohistochemistry (IHC). WHO Eastern Cooperative Oncology Group (ECOG) performance status of 0-1. Newly diagnosed breast cancer. The important organ functions meet the following criterias: WBC >=3.0 x 10^9/L; Neutrophilic granulocytes >=1.5×10^9/L; Platelet >=100 x 10^9/L; Hb >=9 g/dL; Total bilirubin no more than 1.5 times the normal upper limit (ULN); AST and ALT no more than 1.5 times ULN; AKP no more than 2.5 times ULN; Serum creatinine no more than 1.5 times ULN or Clearance rate of creatinine >= 60ml/min; Thyroid stimulating hormone (TSH) <= ULN (T3, T4 levels need to be detected simultaneously if abnormalities, the patient can be included if T3, T4 levels is normal); LVEF basement >= 50%. Able to swallow tablets. Pregnancy test (serum or urine HCG test within 72h before enrollment) must be negative in non-surgical sterilization or women of childbearing age, must be not for the nursing and be willing to take non-pharmacological contraception during treatment (such as intrauterine device, condom, etc). Exclusion Criteria: Evidence of distant metastasis. Bilateral or multiple unilateral breast tumors with different histological characteristics (such as ER/PR/HER2 status, tumor grade or type, etc). Any invasive malignancy diagnosed within previous 5 years (other than successfully treated cervical carcinoma in situ, skin basal cell carcinoma or cutaneous squamous cell carcinoma). Prior radiotherapy, chemotherapy, endocrine therapy, targeted therapy etc. Concurrent use of HRT or any other estrogen-containing medication (including vaginal estrogens) within 4 weeks. Prior use of estrogen implants. Prior use of high-dose systemic corticosteroids (except as antiemetic treatment), immunotherapy, or biological response modifiers (e.g., interferon, etc). Use of an unlicensed or other investigational drug within 4 weeks. Any severe comorbidities, inability to give informed consent or unavailability for follow-up, including but not limited to any of the following: Heart failure above NYHA class 2 level; high-risk uncontrollable arrhythmia; unstable angina pectoris; myocardial infarction within 1 year; valvular heart disease with clinically significance or requiring intervention. Chronic obstructive pulmonary disease requires treatment. Chronic liver disease (cirrhosis, chronic active hepatitis, etc). Cerebrovascular accident occurred within 6 months. Severe epilepsy or central nervous system diseases. Hypertension which cannot be well controlled by antihypertensive drugs. Abnormal coagulation, bleeding tendency, or receiving thrombolysis or anticoagulant therapy. Chronic renal insufficiency. Active infection. Psychiatric disability, etc. Pregnant or nursing females.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Shicheng Su, M.D., Ph.D.
Phone
+86 13631304227
Email
sushch@mail.sysu.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Erwei Song, M.D., Ph.D.
Phone
+86 13926477694
Email
songew@mail.sysu.edu.cn
Facility Information:
Facility Name
Sun Yat-sen Memorial Hospital
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510120
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shicheng Su, M.D.,Ph.D.
Phone
+86 13631304227
Email
sushch@mail.sysu.edu.cn
First Name & Middle Initial & Last Name & Degree
Erwei Song, M.D.,Ph.D.
Phone
+86 13926477694
Email
songew@mail.sysu.edu.cn

12. IPD Sharing Statement

Learn more about this trial

Comparative Study for the Degree of Biological Changes After Short-term 2 Weeks and 4 Weeks Preoperative Endocrine Therapy in Luminal Breast Cancer

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