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Transdermal or Oral Telapristone Acetate in Treating Patients Undergoing Mastectomy

Primary Purpose

BRCA1 Mutation Carrier, BRCA2 Mutation Carrier, Ductal Breast Carcinoma In Situ

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Telapristone Acetate
Placebo
Telapristone Acetate
Placebo
Laboratory Biomarker Analysis
Questionnaire Administration
Sponsored by
Northwestern University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for BRCA1 Mutation Carrier

Eligibility Criteria

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

Inclusion Criteria:

  • Women scheduled for unilateral or bilateral mastectomy for breast cancer therapy, pathology confirmed stage 0-II (including ductal carcinoma in situ), or prophylaxis (breast cancer, early onset [BRCA] mutation carriers, women with strong family history or lobular carcinoma in situ or other conditions where prophylactic mastectomy has been elected)
  • Eastern Cooperative Oncology Group (ECOG) performance status =< 1 (Karnofsky >= 70%)
  • Total bilirubin < 1.5 x upper limit of normal (ULN)
  • Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) < 2.5 x ULN
  • Alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) < 2.5 x ULN
  • Creatinine < 2 x ULN
  • Alkaline phosphatase < 2.5 x ULN
  • Blood urea nitrogen < 2 x ULN
  • Willing to use non-hormonal contraception (adequate barrier-type contraception or intrauterine device [IUD]) from the time the pregnancy test is performed for the duration of study participation, and 30 days after study drug cessation (for women of childbearing potential only)
  • Ability to understand and the willingness to sign a written informed consent document
  • Willing and able to schedule mastectomy 4 weeks (+/- 7days) following start of study agent
  • Willing to avoid exposing breast skin to natural or artificial sunlight (i.e. tanning beds) for the duration of study agent dosing
  • Negative urine pregnancy test result, for participants of child bearing potential, within 5 days prior to first dose of study medication; female of child-bearing potential is any woman (regardless of sexual orientation, whether she has undergone a tubal ligation, or remains celibate by choice) who meets the following criteria: has not undergone a hysterectomy or bilateral oophorectomy; OR has had a menstrual period at any time in the preceding 12 consecutive months)
  • Willing to use alcohol in moderation while taking study agent
  • Willing to refrain from using soy supplements, over the counter estrogen supplements like estroven, Chinese herbs, or other over-the-counter (OTC) herbal products

Exclusion Criteria:

  • The presence of skin invasion by the breast cancer, or inflammatory changes with skin edema AND erythema
  • Women with skin diseases (psoriasis, eczema)
  • A history of thromboembolic disorder or cerebral vascular disease
  • Use of oral contraceptives or other hormonal treatments within eight weeks prior to the randomization or during the period of the study; women should not have used Depo-Provera in the preceding 6 months; use of hormone coated IUD like Mirena is allowed
  • Participants may not have received any other investigational agents in the previous 3 months
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to telapristone (i.e. other progesterone antagonists)
  • Taken tamoxifen or other selective estrogen/progesterone receptor modulators (SERMs/SPRMs) within two years prior to entering study or been required to discontinue SERM therapy due to thromboembolic or uterine toxicity
  • Uncontrolled intercurrent 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
  • History of prior breast cancer-specific therapy within the previous 2 years; previous unilateral radiation in women scheduled for mastectomy of the contralateral side is allowed
  • Pregnant or breastfeeding
  • Currently taking spironolactone
  • Recent history (within 6 months) of alcoholism or drug abuse
  • Known active infection with human immunodeficiency virus (HIV), hepatitis A, B, or C

Sites / Locations

  • Cedars-Sinai Medical Center
  • Northwestern University
  • Memorial Sloan-Kettering Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Arm I (transdermal telapristone acetate)

Arm II (oral telapristone acetate)

Arm Description

Patients receive telapristone acetate transdermally and placebo PO QD for 4 weeks.

Patients receive placebo transdermally and telapristone acetate PO QD for 4 weeks.

Outcomes

Primary Outcome Measures

Mean Levels of Telapristone Acetate in Breast Tissue
Post-therapy mean levels of telapristone acetate in breast tissue.

Secondary Outcome Measures

Plasma Concentrations of Telapristone Acetate
Post-therapy plasma concentrations of telapristone acetate.
Within-breast Variation of Breast Tissue Concentration of Telapristone Acetate
Post-therapy concentrations of telapristone acetate in 5 locations within breast tissue.
Changes in Cell Proliferation
Changes in cell proliferation (Ki67 labeling index) measured in percentage of positive cells from baseline to mastectomy by tumor status in ER positive tumors.
Changes in Serum Sex Hormone Concentrations: Estradiol
Change in estradiol in premenopausal women from baseline to post-intervention compared between treatment groups
Change in Symptoms as Captured in the Breast Cancer Prevention Trial (BCPT) Eight Symptom Scale (BESS) Questionnaire
Mean change in symptoms as captured using the Breast Cancer Prevention Trial (BCPT) Eight Symptom Scale (BESS) questionnaire. A patient reported outcome, scores range from 0 (Not at All) to 4 (Extremely) when asked about experiencing symptoms. A positive change in scores indicates an increase in symptoms experienced and a negative change in scores indicates a decrease in symptoms experienced
Changes in Serum Sex Hormone Concentrations: Progesterone
Change in progesterone in premenopausal women from baseline to post-intervention compared between treatment groups
Changes in Serum Sex Hormone Concentrations: FSH
Change in FSH in premenopausal women from baseline to post-intervention compared between treatment groups

Full Information

First Posted
December 9, 2014
Last Updated
January 26, 2023
Sponsor
Northwestern University
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT02314156
Brief Title
Transdermal or Oral Telapristone Acetate in Treating Patients Undergoing Mastectomy
Official Title
Intra-mammary Distribution of Transdermal Telapristone Versus Oral Telapristone: A Randomized Window Trial in Women Undergoing Mastectomy
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Completed
Study Start Date
October 2015 (Actual)
Primary Completion Date
January 2018 (Actual)
Study Completion Date
May 2021 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This randomized trial studies transdermal or oral telapristone acetate in treating patients undergoing surgery to remove the breast (mastectomy). Telapristone acetate may help prevent breast cancer from forming in premenopausal women. Giving telapristone acetate transdermally may be safer and have fewer side effects than oral administration.
Detailed Description
PRIMARY OBJECTIVES: I. To demonstrate that mean levels of telapristone (telapristone acetate) in breast tissue following gel application will result in levels that are not more than 50% lower than those following oral administration. SECONDARY OBJECTIVES: I. To assess whether plasma concentrations of telapristone are significantly lower with transdermal than oral therapy. II. To compare within-breast variation of breast tissue concentration in transdermal and oral groups. III. To measure changes in cell proliferation (marker of proliferation (Ki-67 labeling index). IV. Explore changes in gene expression in breast tissue related to telapristone therapy. V. Assess change in serum progesterone associated with telapristone therapy. VI. Assess the safety and tolerability of oral and transdermal administration. VII. Assess symptom measurements using BESS Questionnaire OUTLINE: Participants are randomized to 1 of 2 treatment arms. ARM I (TRANSDERMAL TELAPRISTONE ACETATE): Patients receive telapristone acetate transdermally and placebo orally (PO) once daily (QD) for 4 weeks. ARM II (ORAL TELAPRISTONE ACETATE): Patients receive placebo transdermally and telapristone acetate PO QD for 4 weeks. After completion of study treatment, patients are followed up at day 60.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
BRCA1 Mutation Carrier, BRCA2 Mutation Carrier, Ductal Breast Carcinoma In Situ, Lobular Breast Carcinoma In Situ, Stage 0 Breast Cancer, Stage IA Breast Cancer, Stage IB Breast Cancer, Stage IIA Breast Cancer, Stage IIB Breast Cancer

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
67 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm I (transdermal telapristone acetate)
Arm Type
Experimental
Arm Description
Patients receive telapristone acetate transdermally and placebo PO QD for 4 weeks.
Arm Title
Arm II (oral telapristone acetate)
Arm Type
Active Comparator
Arm Description
Patients receive placebo transdermally and telapristone acetate PO QD for 4 weeks.
Intervention Type
Drug
Intervention Name(s)
Telapristone Acetate
Other Intervention Name(s)
CDB-4124, Proellex, Progenta
Intervention Description
Given transdermally
Intervention Type
Other
Intervention Name(s)
Placebo
Other Intervention Name(s)
PLCB
Intervention Description
Given PO
Intervention Type
Drug
Intervention Name(s)
Telapristone Acetate
Other Intervention Name(s)
CDB-4124, Proellex, Progenta
Intervention Description
Given PO
Intervention Type
Other
Intervention Name(s)
Placebo
Other Intervention Name(s)
PLCB
Intervention Description
Given transdermally
Intervention Type
Other
Intervention Name(s)
Laboratory Biomarker Analysis
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
Questionnaire Administration
Intervention Description
Ancillary studies
Primary Outcome Measure Information:
Title
Mean Levels of Telapristone Acetate in Breast Tissue
Description
Post-therapy mean levels of telapristone acetate in breast tissue.
Time Frame
At the time of mastectomy, up to 5 weeks from baseline
Secondary Outcome Measure Information:
Title
Plasma Concentrations of Telapristone Acetate
Description
Post-therapy plasma concentrations of telapristone acetate.
Time Frame
At the time of mastectomy, up to 5 weeks from baseline
Title
Within-breast Variation of Breast Tissue Concentration of Telapristone Acetate
Description
Post-therapy concentrations of telapristone acetate in 5 locations within breast tissue.
Time Frame
At the time of mastectomy, up to 5 weeks from baseline
Title
Changes in Cell Proliferation
Description
Changes in cell proliferation (Ki67 labeling index) measured in percentage of positive cells from baseline to mastectomy by tumor status in ER positive tumors.
Time Frame
Baseline to mastectomy (up to 5 weeks)
Title
Changes in Serum Sex Hormone Concentrations: Estradiol
Description
Change in estradiol in premenopausal women from baseline to post-intervention compared between treatment groups
Time Frame
Baseline to mastectomy, up to 5 weeks post-intervention
Title
Change in Symptoms as Captured in the Breast Cancer Prevention Trial (BCPT) Eight Symptom Scale (BESS) Questionnaire
Description
Mean change in symptoms as captured using the Breast Cancer Prevention Trial (BCPT) Eight Symptom Scale (BESS) questionnaire. A patient reported outcome, scores range from 0 (Not at All) to 4 (Extremely) when asked about experiencing symptoms. A positive change in scores indicates an increase in symptoms experienced and a negative change in scores indicates a decrease in symptoms experienced
Time Frame
Baseline to mastectomy (up to 5 weeks)
Title
Changes in Serum Sex Hormone Concentrations: Progesterone
Description
Change in progesterone in premenopausal women from baseline to post-intervention compared between treatment groups
Time Frame
Baseline to mastectomy (up to 5 weeks)
Title
Changes in Serum Sex Hormone Concentrations: FSH
Description
Change in FSH in premenopausal women from baseline to post-intervention compared between treatment groups
Time Frame
Baseline to mastectomy (up to 5 weeks)

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Women scheduled for unilateral or bilateral mastectomy for breast cancer therapy, pathology confirmed stage 0-II (including ductal carcinoma in situ), or prophylaxis (breast cancer, early onset [BRCA] mutation carriers, women with strong family history or lobular carcinoma in situ or other conditions where prophylactic mastectomy has been elected) Eastern Cooperative Oncology Group (ECOG) performance status =< 1 (Karnofsky >= 70%) Total bilirubin < 1.5 x upper limit of normal (ULN) Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) < 2.5 x ULN Alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) < 2.5 x ULN Creatinine < 2 x ULN Alkaline phosphatase < 2.5 x ULN Blood urea nitrogen < 2 x ULN Willing to use non-hormonal contraception (adequate barrier-type contraception or intrauterine device [IUD]) from the time the pregnancy test is performed for the duration of study participation, and 30 days after study drug cessation (for women of childbearing potential only) Ability to understand and the willingness to sign a written informed consent document Willing and able to schedule mastectomy 4 weeks (+/- 7days) following start of study agent Willing to avoid exposing breast skin to natural or artificial sunlight (i.e. tanning beds) for the duration of study agent dosing Negative urine pregnancy test result, for participants of child bearing potential, within 5 days prior to first dose of study medication; female of child-bearing potential is any woman (regardless of sexual orientation, whether she has undergone a tubal ligation, or remains celibate by choice) who meets the following criteria: has not undergone a hysterectomy or bilateral oophorectomy; OR has had a menstrual period at any time in the preceding 12 consecutive months) Willing to use alcohol in moderation while taking study agent Exclusion Criteria: The presence of skin invasion by the breast cancer, or inflammatory changes with skin edema AND erythema. Note: Paget's disease is permitted. Women receiving a "nipple delay" procedure prior to mastectomy. Women with skin diseases (psoriasis, eczema) on breast. A history of thromboembolic disorder or cerebral vascular disease Use of oral contraceptives or other hormonal treatments within eight weeks prior to the randomization or during the period of the study; women should not have used Depo-Provera in the preceding 6 months; use of hormone coated IUD like Mirena is allowed Participants may not have received any other investigational agents in the previous 3 months History of allergic reactions attributed to compounds of similar chemical or biologic composition to telapristone (i.e. other progesterone antagonists) Taken tamoxifen or other selective estrogen/progesterone receptor modulators (SERMs/SPRMs) within two years prior to entering study or been required to discontinue SERM therapy due to thromboembolic or uterine toxicity Uncontrolled intercurrent 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 History of prior breast cancer-specific therapy within the previous 2 years; previous unilateral radiation in women scheduled for mastectomy of the contralateral side is allowed Pregnant or breastfeeding Currently taking spironolactone Recent history (within 6 months) of alcoholism or drug abuse Known active infection with human immunodeficiency virus (HIV), hepatitis A, B, or C
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Seema Khan
Organizational Affiliation
Northwestern University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cedars-Sinai Medical Center
City
West Hollywood
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Memorial Sloan-Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States

12. IPD Sharing Statement

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Transdermal or Oral Telapristone Acetate in Treating Patients Undergoing Mastectomy

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