Letrozole in Post-Menopausal Patients With Operable Hormone-Sensitive Breast Cancer
Breast Cancer Female
About this trial
This is an interventional treatment trial for Breast Cancer Female focused on measuring ER-positive, HER2-negative, invasive mammary carcinoma
Eligibility Criteria
Inclusion Criteria:
- Eligibility waivers are not permitted. Subjects must meet all of the inclusion and exclusion criteria to be registered to the study. Study treatment may not begin until a subject is registered.
- Patients must provide informed written consent
- ECOG performance status 0-2.
Clinical stage operable I, II or III invasive mammary carcinoma, which is ER-positive by IHC and HER2-negative by Herceptest (0 or 1+) or not amplified by in situ hybridization as per routine clinical testing.
- Patients who have measurable residual tumor at the primary site
- Patients who will undergo surgical treatment with either segmental resection or total mastectomy
- Measurable tumor. Measurable disease: a mass that can be reproducibly measured by physical exam, mammogram or ultrasound and is at least 1 cm in size
Post-menopausal female subjects ≥18 years of age, as defined by any of the following:
- Subjects at least 55 years of age;
- Subjects under 55 years of age and amenorrhoeic for at least 12 months or follicle-stimulating hormone (FSH) values ≥40 IU/L and estradiol levels ≤40 pg/mL (140 pmol/L) or in postmenopausal ranges per local or institutional reference ranges;
- Prior bilateral oophorectomy or prior radiation castration with amenorrhea for at least 6 months.
- (There is no upper age limit for enrollment to this study)
- No prior chemotherapy for this primary breast cancer.
- Patients with a prior history of contralateral breast cancer are eligible if they have no evidence of recurrence of their initial primary breast cancer.
- Women may have been taking tamoxifen or raloxifene as a preventive agent prior to study entry but must have discontinued the drug for at least 14 days prior to study enrollment.
- Subjects must have ended hormone replacement therapy (HRT) (e.g., conjugated estrogens tablets, USP, [Premarin]), at least 7 days prior to receiving the first dose of randomized therapy.
Patients must have adequate hepatic and renal function. All tests must be obtained less than 4 weeks from study entry. This includes:
- Creatinine <2X upper limits of normal
- Bilirubin, SGOT, SGPT <1.5X upper limits of normal
- Able to swallow and retain oral medication
Exclusion Criteria:
Patients with locally advanced disease who are candidates for other preoperative chemotherapy at the time of initial evaluation. This may include patients with locally advanced disease such as:
- Inflammatory breast cancer (T4d)
- Fixed axillary lymph node metastases (N2)
- Metastasis to ipsilateral internal mammary node (N3)
- Locally recurrent breast cancer
- Evidence of distant metastatic disease (i.e. lung, liver, bone, brain, etc.)
- Serious medical illness that in the judgment of the treating physician places the patient at high risk of operative mortality.
- Severe uncontrolled malabsorption condition or disease (i.e. grade II/III diarrhea, severe malnutrition, short gut syndrome)
- Dementia, altered mental status, or any psychiatric condition that would prohibit the understanding or rendering of informed consent.
- Use of an investigational drug within 30 days or 5 half-lives, whichever is longer, preceding the first dose of letrozole.
Sites / Locations
- Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
Arms of the Study
Arm 1
Experimental
Treatment
Drug: letrozole Take by mouth at a dose of 2.5 mg on days 7-30 Other: Blood Collection Blood used for gene expression analysis and reverse transcriptase-polymerase chain reaction Procedure: biopsy/lumpectomy/mastectomy Tissue collection,Surgery to remove tumor, Tumor tissues used for laboratory biomarker analysis