search
Back to results

Effect of HSD3B1 (1245C) Gene Mutation on Treatment of Stage I-III Breast Cancer

Primary Purpose

Anatomic Stage I Breast Cancer AJCC v8, Anatomic Stage II Breast Cancer AJCC v8, Anatomic Stage III Breast Cancer AJCC v8

Status
Suspended
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Biospecimen Collection
Letrozole
Questionnaire Administration
Sponsored by
University of Washington
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Anatomic Stage I Breast Cancer AJCC v8

Eligibility Criteria

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

Inclusion Criteria:

  • Subject must be female age >= 18 years.
  • Postmenopausal as defined by at least one of the following:

    • Age >= 60 years;
    • Age < 60 years and cessation of regular menses for at least 12 consecutive months with no alternative pathological or physiological cause; or serum estradiol and follicle stimulating hormone levels within the local laboratory's normal reference range for postmenopausal females;
    • Documented bilateral oophorectomy.
  • Histologically confirmed diagnosis of carcinoma of the breast, clinical stage I-III.
  • Minimum tumor diameter of 1.0 cm as assessed by palpation or imaging (e.g., ultrasound) and with enough tumor left after the initial diagnostic biopsy to provide tumor tissue during the planned tumor resection.
  • Candidate for surgical resection.
  • ER+ breast cancer (> 1% positive stained cells) based on the most recent tumor biopsy documented by a local laboratory or medical record.
  • HER2-negative breast cancer based on the most recent tumor biopsy and documented by a local laboratory or medical record. HER2-negative tumor is defined per American Society of Clinical Oncology and the College of American Pathologists guidelines, 2018.
  • Stated willingness to comply with all study procedures and availability for the duration of the study.
  • Prior use of hormone contraceptives and replacement therapy is allowed (e.g., estrogen and/or progestin). Vaginal preparations are allowed.
  • Ability to take oral medication and be willing to adhere to the study intervention.

Exclusion Criteria:

  • Pre-treatment tumor biopsy sample not likely to provide adequate tissue sections for biomarker assays.
  • Inoperable or metastatic disease.
  • Subjects who have received any prior therapy for breast cancer, including radiotherapy, surgery, and cytotoxic and endocrine treatments for the current breast cancer, or received any therapy within the last 1 year for a prior primary breast cancer.
  • The subject must not have had hormonal therapy for breast cancer treatment or for breast cancer prevention within 1 year prior to study enrollment. (Note: Synchronous breast, cancer (including bilateral breast cancer) at separate sites is permissible, provided the patient does not receive medical treatments for breast cancer or radiation therapy to the ipsilateral breast during the study intervention period.
  • Subjects with plans to undergo neoadjuvant chemotherapy.
  • Treatment with another investigational drug or other intervention within 28 days before the first administration of letrozole.
  • History of allergic reactions/hypersensitivity attributed to compounds of similar chemical or biologic composition to letrozole or any ingredients.
  • Uncontrolled current illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.

Sites / Locations

  • Fred Hutch/University of Washington Cancer Consortium

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (letrozole)

Arm Description

Patients receive letrozole PO QD for 21 days in the absence of disease progression or unacceptable toxicity. Patients also undergo collection of saliva samples. If tumor resection occurs before or after day 22, letrozole administration must occur for a minimum of 14 days and a maximum of 70 days of total treatment.

Outcomes

Primary Outcome Measures

Changes in Ki67
Will be assessed according to germline status.
Changes in Ki67
Will be assessed according to somatic HSD3B1 (1245C) variant status.
Changes in estrogen receptor (ER)alpha
Will be assessed according to germline status.
Changes in estrogen receptor (ER)alpha
Will be assessed according to somatic HSD3B1 (1245C) variant status.
Changes in ER beta
Will be assessed according to germline status.
Changes in ER beta
Will be assessed according to somatic HSD3B1 (1245C) variant status.
Effect of HSD3B1 (1245C) variant on changes in Ki67
Will evaluate whether androgen receptor (AR)+ modifies the effect of HSD3B1 (1245C) variant on changes in Ki67 before and after preoperative letrozole treatment, and whether this effects ER- and AR- gene expression signatures.
Expression of 3betaHSD1
Will compare expression of 3betaHSD1 according to HSD3B1 allele status.
Expression of intracellular androgen
Will compare expression of intracellular androgen according to HSD3B1 allele status.
Expression of estrogen levels
Will compare expression of estrogen levels according to HSD3B1 allele status.

Secondary Outcome Measures

Full Information

First Posted
December 9, 2021
Last Updated
October 19, 2023
Sponsor
University of Washington
Collaborators
National Cancer Institute (NCI)
search

1. Study Identification

Unique Protocol Identification Number
NCT05183828
Brief Title
Effect of HSD3B1 (1245C) Gene Mutation on Treatment of Stage I-III Breast Cancer
Official Title
Association of HSD3B1 Genotype With Response to Preoperative Letrozole Therapy Among Postmenopausal Women With Estrogen-Receptor Positive (ER+) HER2/Neu-Negative (HER2-) Invasive Carcinomas of the Breast
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Suspended
Why Stopped
Enrollment temporarily on hold for data analysis
Study Start Date
January 23, 2022 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Washington
Collaborators
National Cancer Institute (NCI)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This stage IV trial examines how a mutation in HSD3B1 (1245C) gene affects treatment of stage I-III breast cancer. This trial may help researchers determine if mutations in HSD3B1 decreases the efficacy of aromatase inhibitor therapy such as letrozole. Letrozole may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.
Detailed Description
OUTLINE: Patients receive letrozole orally (PO) once daily (QD) for 21 days in the absence of disease progression or unacceptable toxicity. If tumor resection occurs before or after day 22, letrozole administration must occur for a minimum of 14 days and a maximum of 70 days of total treatment. Patients also undergo collection of saliva samples.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Anatomic Stage I Breast Cancer AJCC v8, Anatomic Stage II Breast Cancer AJCC v8, Anatomic Stage III Breast Cancer AJCC v8, Breast Adenocarcinoma, Invasive Breast Carcinoma of No Special Type

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment (letrozole)
Arm Type
Experimental
Arm Description
Patients receive letrozole PO QD for 21 days in the absence of disease progression or unacceptable toxicity. Patients also undergo collection of saliva samples. If tumor resection occurs before or after day 22, letrozole administration must occur for a minimum of 14 days and a maximum of 70 days of total treatment.
Intervention Type
Procedure
Intervention Name(s)
Biospecimen Collection
Other Intervention Name(s)
Biological Sample Collection, Biospecimen Collected, Specimen Collection
Intervention Description
Undergo collection of saliva samples
Intervention Type
Drug
Intervention Name(s)
Letrozole
Other Intervention Name(s)
CGS 20267, Femara
Intervention Description
Given PO
Intervention Type
Other
Intervention Name(s)
Questionnaire Administration
Intervention Description
Ancillary studies
Primary Outcome Measure Information:
Title
Changes in Ki67
Description
Will be assessed according to germline status.
Time Frame
Before (baseline) and up to 9 months after surgery
Title
Changes in Ki67
Description
Will be assessed according to somatic HSD3B1 (1245C) variant status.
Time Frame
Before (baseline) and up to 9 months after surgery
Title
Changes in estrogen receptor (ER)alpha
Description
Will be assessed according to germline status.
Time Frame
Before (baseline) and up to 9 months after surgery
Title
Changes in estrogen receptor (ER)alpha
Description
Will be assessed according to somatic HSD3B1 (1245C) variant status.
Time Frame
Before (baseline) and up to 9 months after surgery
Title
Changes in ER beta
Description
Will be assessed according to germline status.
Time Frame
Before (baseline) and up to 9 months after surgery
Title
Changes in ER beta
Description
Will be assessed according to somatic HSD3B1 (1245C) variant status.
Time Frame
Before (baseline) and up to 9 months after surgery
Title
Effect of HSD3B1 (1245C) variant on changes in Ki67
Description
Will evaluate whether androgen receptor (AR)+ modifies the effect of HSD3B1 (1245C) variant on changes in Ki67 before and after preoperative letrozole treatment, and whether this effects ER- and AR- gene expression signatures.
Time Frame
Before (baseline) and up to 9 months after surgery
Title
Expression of 3betaHSD1
Description
Will compare expression of 3betaHSD1 according to HSD3B1 allele status.
Time Frame
Up to 9 months after surgery
Title
Expression of intracellular androgen
Description
Will compare expression of intracellular androgen according to HSD3B1 allele status.
Time Frame
Up to 9 months after surgery
Title
Expression of estrogen levels
Description
Will compare expression of estrogen levels according to HSD3B1 allele status.
Time Frame
Up to 9 months after surgery

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject must be female age >= 18 years. Postmenopausal as defined by at least one of the following: Age >= 60 years; Age < 60 years and cessation of regular menses for at least 12 consecutive months with no alternative pathological or physiological cause; or serum estradiol and follicle stimulating hormone levels within the local laboratory's normal reference range for postmenopausal females; Documented bilateral oophorectomy. Histologically confirmed diagnosis of carcinoma of the breast, clinical stage I-III. Minimum tumor diameter of 1.0 cm as assessed by palpation or imaging (e.g., ultrasound) and with enough tumor left after the initial diagnostic biopsy to provide tumor tissue during the planned tumor resection. Candidate for surgical resection. ER+ breast cancer (> 1% positive stained cells) based on the most recent tumor biopsy documented by a local laboratory or medical record. HER2-negative breast cancer based on the most recent tumor biopsy and documented by a local laboratory or medical record. HER2-negative tumor is defined per American Society of Clinical Oncology and the College of American Pathologists guidelines, 2018. Stated willingness to comply with all study procedures and availability for the duration of the study. Prior use of hormone contraceptives and replacement therapy is allowed (e.g., estrogen and/or progestin). Vaginal preparations are allowed. Ability to take oral medication and be willing to adhere to the study intervention. Exclusion Criteria: Pre-treatment tumor biopsy sample not likely to provide adequate tissue sections for biomarker assays. Inoperable or metastatic disease. Subjects who have received any prior therapy for breast cancer, including radiotherapy, surgery, and cytotoxic and endocrine treatments for the current breast cancer, or received any therapy within the last 1 year for a prior primary breast cancer. The subject must not have had hormonal therapy for breast cancer treatment or for breast cancer prevention within 1 year prior to study enrollment. (Note: Synchronous breast, cancer (including bilateral breast cancer) at separate sites is permissible, provided the patient does not receive medical treatments for breast cancer or radiation therapy to the ipsilateral breast during the study intervention period. Subjects with plans to undergo neoadjuvant chemotherapy. Treatment with another investigational drug or other intervention within 28 days before the first administration of letrozole. History of allergic reactions/hypersensitivity attributed to compounds of similar chemical or biologic composition to letrozole or any ingredients. Uncontrolled current illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Meghan R. Flanagan
Organizational Affiliation
Fred Hutch/University of Washington Cancer Consortium
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fred Hutch/University of Washington Cancer Consortium
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Effect of HSD3B1 (1245C) Gene Mutation on Treatment of Stage I-III Breast Cancer

We'll reach out to this number within 24 hrs