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Related Studies
Anastrozole and Gefitinib Compared With Fulvestrant and Gefitinib in Treating Postmenopausal Women With Recurrent or Metastatic Breast Cancer
This study is ongoing, but not recruiting participants.
First Received: April 7, 2003   Last Updated: October 23, 2008   History of Changes
Sponsor: Eastern Cooperative Oncology Group
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00057941
  Purpose

RATIONALE: Estrogen can stimulate the growth of breast cancer cells. Hormone therapy using anastrozole and fulvestrant may fight breast cancer by blocking the use of estrogen. Gefitinib may stop the growth of cancer cells by blocking the enzymes necessary for their growth. It is not yet known whether gefitinib is more effective when combined with anastrozole or fulvestrant in treating breast cancer.

PURPOSE: This randomized phase II trial is studying how well giving gefitinib together with anastrozole works compared to giving gefitinib together with fulvestrant in treating postmenopausal women with recurrent or metastatic breast cancer.


Condition Intervention Phase
Breast Cancer
Drug: anastrozole
Drug: fulvestrant
Drug: gefitinib
Phase II

Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Active Control
Official Title: A Randomized Phase II Trial of Combination Anastrozole (NSC #719344) Plus ZD1839 (Iressa, NSC #715055, IND #61187) and of Combination Fulvestrant (NSC #719276) Plus ZD1839 in the Treatment of Postmenopausal Women With Hormone Receptor-Positive Metastatic Breast Cancer

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Clinical benefit (i.e., complete response, partial response, or stable disease) [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Toxicity [ Designated as safety issue: Yes ]

Estimated Enrollment: 148
Study Start Date: September 2003
Estimated Primary Completion Date: September 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Arm I: Experimental
Patients receive oral anastrozole and oral gefitinib once daily on days 1-28.
Drug: anastrozole
Given orally
Drug: gefitinib
Given orally
Arm II: Experimental
Patients receive fulvestrant intramuscularly on day 1 and oral gefitinib once daily on days 1-28.
Drug: fulvestrant
Given intramuscularly
Drug: gefitinib
Given orally

Detailed Description:

OBJECTIVES:

  • Compare the antitumor activity of anastrozole and gefitinib vs fulvestrant and gefitinib in postmenopausal women with recurrent or metastatic hormone receptor-positive breast cancer.
  • Compare the safety of these regimens in these patients.
  • Compare the interaction of biological predictors of response in patients treated with these regimens.

OUTLINE: This is a randomized, open-label study. Patients are stratified according to prior hormonal therapy (yes vs no) and dominant site of disease (soft tissue/lymph nodes vs bone vs visceral). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive oral anastrozole and oral gefitinib once daily on days 1-28.
  • Arm II: Patients receive fulvestrant intramuscularly on day 1 and oral gefitinib once daily on days 1-28.

Courses in both arms repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Patients are followed every 3 months for 2 years and then every 6 months for 1 year.

PROJECTED ACCRUAL: A total of 148 patients (74 per treatment arm) will be accrued for this study within 2 years.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed adenocarcinoma of the breast

    • Recurrent or metastatic disease
  • Measurable disease
  • Patients with available tissue blocks from either the primary or metastatic site must submit the tissue for epidermal growth factor receptor analysis
  • No history of CNS metastasis
  • Hormone receptor status:

    • Estrogen and/or progesterone receptor positive

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Sex

  • Female

Menopausal status

  • Postmenopausal* defined by 1 of the following:

    • Prior bilateral oophorectomy or bilateral ovarian irradiation
    • No menstrual period for at least 12 months NOTE: *If age 55 and under and on tamoxifen within the past 6 months, must have an estradiol level in the postmenopausal range

Performance status

  • ECOG 0-2

Life expectancy

  • Not specified

Hematopoietic

  • Neutrophil count at least 1,500/mm^3
  • Platelet count at least 100,000/mm^3

Hepatic

  • Bilirubin no greater than 1.25 times upper limit of normal (ULN)
  • ALT and AST no greater than 2.5 times ULN (5 times ULN if liver metastases are present)
  • INR, PT, and PTT normal

Renal

  • Creatinine clearance at least 30 mL/min

Other

  • Not pregnant or nursing
  • No untreated ocular inflammation or infection
  • No medical or psychiatric condition that would preclude study compliance, ability to give informed consent, or assessment of response or anticipated toxic effects
  • No other invasive malignancies within the past 5 years except curatively treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
  • No contraindication to intramuscular injections

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • More than 3 weeks since prior trastuzumab (Herceptin®)
  • No concurrent trastuzumab

Chemotherapy

  • More than 3 weeks since prior chemotherapy
  • No more than 2 prior chemotherapy regimens for metastatic disease
  • No concurrent chemotherapy

Endocrine therapy

  • More than 3 months since prior luteinizing hormone-releasing hormone agonists or antagonists (patients 55 years old and under)
  • No prior hormonal therapy for metastatic disease
  • No prior estrogen receptor down-regulators (e.g., fulvestrant) in the adjuvant setting
  • No prior aromatase inhibitors (e.g., anastrozole, letrozole, exemestane, or aminoglutethimide) in the adjuvant setting
  • No other concurrent hormonal therapy

Radiotherapy

  • Recovered from prior radiotherapy
  • Concurrent radiotherapy to painful sites of bony disease or areas of impending fracture is allowed provided the following conditions are met:

    • Therapy was initiated prior to study entry
    • Sites of measurable disease outside the radiotherapy port are available for disease evaluation

Surgery

  • Not specified

Other

  • No prior agents that target epidermal growth factor receptors
  • No concurrent CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, or verapamil)
  • No concurrent anticoagulants, except for thrombotic events in patients in arm I
  • No concurrent medications that would alter the pharmacokinetics of gefitinib (e.g., phenytoin, carbamazepine, phenobarbital, rifampin, Hypericum perforatum [St. John's wort], oxcarbazepine, rifapentine, modafinil, and griseofulvin)
  • Concurrent bisphosphonates for hypercalcemia or bone metastases are allowed
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00057941

  Hide Study Locations
Locations
United States, California
Stanford Comprehensive Cancer Center - Stanford
Stanford, California, United States, 94305
United States, Colorado
Aurora Presbyterian Hospital
Aurora, Colorado, United States, 80012
Boulder Community Hospital
Boulder, Colorado, United States, 80301-9019
CCOP - Colorado Cancer Research Program
Denver, Colorado, United States, 80224-2522
Exempla Lutheran Medical Center
Wheat Ridge, Colorado, United States, 80033
Hope Cancer Care Center at Longmont United Hospital
Longmont, Colorado, United States, 80502
McKee Medical Center
Loveland, Colorado, United States, 80539
North Colorado Medical Center
Greeley, Colorado, United States, 80631
North Suburban Medical Center
Thornton, Colorado, United States, 80229
St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center
Grand Junction, Colorado, United States, 81502
Porter Adventist Hospital
Denver, Colorado, United States, 80210
Presbyterian - St. Luke's Medical Center
Denver, Colorado, United States, 80218
Rose Medical Center
Denver, Colorado, United States, 80220
Sky Ridge Medical Center
Lone Tree, Colorado, United States, 80124
St. Anthony Central Hospital
Denver, Colorado, United States, 80204
St. Joseph Hospital
Denver, Colorado, United States, 80218
St. Mary - Corwin Regional Medical Center
Pueblo, Colorado, United States, 81004
Penrose Cancer Center at Penrose Hospital
Colorado Springs, Colorado, United States, 80933
Swedish Medical Center
Englewood, Colorado, United States, 80110
United States, Connecticut
Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical Center
Hartford, Connecticut, United States, 06105
United States, Delaware
CCOP - Christiana Care Health Services
Newark, Delaware, United States, 19713
Tunnell Cancer Center at Beebe Medical Center
Lewes, Delaware, United States, 19958
United States, Florida
Baptist Cancer Institute - Jacksonville
Jacksonville, Florida, United States, 32207
Fawcett Memorial Hospital
Port Charlotte, Florida, United States, 33952
United States, Georgia
Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/Candler
Savannah, Georgia, United States, 31405
United States, Illinois
Alexian Brothers Radiation Oncology
Elk Grove Village, Illinois, United States, 60007
Carle Cancer Center at Carle Foundation Hospital
Urbana, Illinois, United States, 61801
CCOP - Carle Cancer Center
Urbana, Illinois, United States, 61801
Trinity Cancer Center at Trinity Medical Center - 7th Street Campus
Moline, Illinois, United States, 61265
Moline, Illinois, United States, 61265
Decatur Memorial Hospital Cancer Care Institute
Decatur, Illinois, United States, 62526
Elmhurst Memorial Hospital
Elmhurst, Illinois, United States, 60126
Hinsdale Hematology Oncology Associates
Hinsdale, Illinois, United States, 60521
Joliet Oncology-Hematology Associates, Limited - West
Joliet, Illinois, United States, 60435
Regional Cancer Center at Memorial Medical Center
Springfield, Illinois, United States, 62781-0001
Rush-Copley Cancer Care Center
Aurora, Illinois, United States, 60507
Moline, Illinois, United States, 61265
United States, Indiana
Saint Anthony Memorial Health Centers
Michigan City, Indiana, United States, 46360
United States, Iowa
CCOP - Iowa Oncology Research Association
Des Moines, Iowa, United States, 50309
Cedar Rapids Oncology Associates
Cedar Rapids, Iowa, United States, 52403
John Stoddard Cancer Center at Iowa Lutheran Hospital
Des Moines, Iowa, United States, 50316
John Stoddard Cancer Center at Iowa Methodist Medical Center
Des Moines, Iowa, United States, 50309
Mercy Cancer Center at Mercy Medical Center - Des Moines
Des Moines, Iowa, United States, 50314
Medical Oncology and Hematology Associates - West Des Moines
West Des Moines, Iowa, United States, 50266
Medical Oncology and Hematology Associates at John Stoddard Cancer Center
Des Moines, Iowa, United States, 50309
Medical Oncology and Hematology Associates at Mercy Cancer Center
Des Moines, Iowa, United States, 50314
McCreery Cancer Center at Ottumwa Regional
Ottumwa, Iowa, United States, 52501
Mercy Capitol Hospital
Des Moines, Iowa, United States, 50307
Mercy Medical Center - Sioux City
Sioux City, Iowa, United States, 51104
Siouxland Hematology-Oncology Associates, LLP
Sioux City, Iowa, United States, 51101
St. Luke's Regional Medical Center
Sioux City, Iowa, United States, 51104
United States, Louisiana
CCOP - Ochsner
New Orleans, Louisiana, United States, 70121
Ochsner Cancer Institute at Ochsner Clinic Foundation
New Orleans, Louisiana, United States, 70121
Ochsner Health Center - Bluebonnet
Baton Rouge, Louisiana, United States, 708169990
Terrebonne General Medical Center
Houma, Louisiana, United States, 70360
United States, Maryland
Union Hospital Cancer Program at Union Hospital
Elkton MD, Maryland, United States, 21921
United States, Massachusetts
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States, 02215
Morton Hospital & Medical Center
Taunton, Massachusetts, United States, 02780
Saints Memorial Cancer Center at Saints Memorial Medical Center
Lowell, Massachusetts, United States, 01852
Tufts-NEMC Cancer Center
Boston, Massachusetts, United States, 02111
United States, Michigan
Borgess Medical Center
Kalamazooaa, Michigan, United States, 49001
Bronson Methodist Hospital
Kalamazoo, Michigan, United States, 49007
CCOP - Michigan Cancer Research Consortium
Ann Arbor, Michigan, United States, 48106
Dickinson County Healthcare System
Iron Mountain, Michigan, United States, 49801
Foote Hospital
Jackson, Michigan, United States, 49201
Genesys Hurley Cancer Institute
Flint, Michigan, United States, 48503
West Michigan Cancer Center
Kalamazoo, Michigan, United States, 49007-3731
Hurley Medical Center
Flint, Michigan, United States, 48503
Oakwood Cancer Center at Oakwood Hospital and Medical Center
Dearborn, Michigan, United States, 48123-2500
Saint Joseph Mercy Cancer Center
Ann Arbor, Michigan, United States, 48106-0995
Seton Cancer Institute - Saginaw
Saginaw, Michigan, United States, 48601
Sparrow Regional Cancer Center
Lansing, Michigan, United States, 48912-1811
St. John Macomb Hospital
Warren, Michigan, United States, 48093
Van Elslander Cancer Center at St. John Hospital and Medical Center
Grosse Pointe Woods, Michigan, United States, 48236
Green Bay Oncology, Limited - Escanaba
Escanaba, Michigan, United States, 49431
United States, Minnesota
CCOP - Duluth
Duluth, Minnesota, United States, 55805
CCOP - Metro-Minnesota
Saint Louis Park, Minnesota, United States, 55416
Duluth Clinic Cancer Center - Duluth
Duluth, Minnesota, United States, 55805-1983
Fairview Ridges Hospital
Burnsville, Minnesota, United States, 55337
Fairview Southdale Hospital
Edina, Minnesota, United States, 55435
HealthEast Cancer Care at St. John's Hospital
Maplewood, Minnesota, United States, 55109
HealthEast Cancer Care at St. Joseph's Hospital
St Paul, Minnesota, United States, 55102
HealthEast Cancer Care at Woodwinds Health Campus
Woodbury, Minnesota, United States, 55125
Hennepin County Medical Center - Minneapolis
Minneapolis, Minnesota, United States, 55415
Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center
Robbinsdale, Minnesota, United States, 55422-2900
Regions Hospital Cancer Care Center
St. Paul, Minnesota, United States, 55101
Meeker County Memorial Hospital
Lichfield, Minnesota, United States, 55355
Mercy and Unity Cancer Center at Mercy Hospital
Coon Rapids, Minnesota, United States, 55433
Mercy and Unity Cancer Center at Unity Hospital
Fridley, Minnesota, United States, 55432
Miller - Dwan Medical Center
Duluth, Minnesota, United States, 55805
Minnesota Oncology Hematology, PA - Maplewood
Maplewood, Minnesota, United States, 55109
Minnesota Oncology Hematology, PA - Woodbury
Woodbury, Minnesota, United States, 55125
Park Nicollet Cancer Center
St. Louis Park, Minnesota, United States, 55416
Hutchinson Area Health Care
Hutchinson, Minnesota, United States, 55350
Ridgeview Medical Center
Waconia, Minnesota, United States, 55387
St. Francis Cancer Center at St. Francis Medical Center
Shakopee, Minnesota, United States, 55379
United Hospital
St. Paul, Minnesota, United States, 55102
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
Minneapolis, Minnesota, United States, 55407
United States, Mississippi
Hattiesburg Clinic, PA at Forrest General
Hattiesburg, Mississippi, United States, 39401
Hematology & Oncology Clinic
Hattiesburg, Mississippi, United States, 39402
United States, New Jersey
Cancer Institute of New Jersey at Cooper - Voorhees
Voorhees, New Jersey, United States, 08043
Carol G. Simon Cancer Center at Morristown Memorial Hospital
Morristown, New Jersey, United States, 07962
Fox Chase Virtua Health Cancer Program at Virtua West Jersey
Voorhees, New Jersey, United States, 08043
Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton
Marlton, New Jersey, United States, 08053
Mountainside Hospital Cancer Center
Montclair, New Jersey, United States, 07042
Overlook Hospital
Summit, New Jersey, United States, 07902
Shore Memorial Hospital - Somers Point
Somers Point, New Jersey, United States, 08244
United States, New York
Bassett Healthcare Regional Cancer Program at Mary Imogene Bassett Hospital
Cooperstown, New York, United States, 13326
Our Lady of Mercy Medical Center Comprehensive Cancer Center
Bronx, New York, United States, 10466
United States, Ohio
Doctors Hospital at Ohio Health
Columbus, Ohio, United States, 43228
CCOP - Columbus
Columbus, Ohio, United States, 43215
Community Hospital of Springfield and Clark County
Springfield, Ohio, United States, 45505
Adena Regional Medical Center
Chillicothe, Ohio, United States, 45601
Fairfield Medical Center
Lancaster, Ohio, United States, 43130
Genesis - Good Samaritan Hospital
Zanesville, Ohio, United States, 43701
Grady Memorial Hospital
Delaware, Ohio, United States, 43015
Grant Medical Center Cancer Care
Columbus, Ohio, United States, 43215
Licking Memorial Cancer Care Program at Licking Memorial Hospital
Newark, Ohio, United States, 43055
Riverside Methodist Hospital Cancer Care
Columbus, Ohio, United States, 43214-3998
MetroHealth Cancer Care Center at MetroHealth Medical Center
Cleveland, Ohio, United States, 44109
Mount Carmel Health - West Hospital
Columbus, Ohio, United States, 43222
Mount Carmel St. Ann's Cancer Center
Westerville, Ohio, United States, 43081
Mercy Medical Center
Springfield, Ohio, United States, 45504
St. Rita's Medical Center
Lima, Ohio, United States, 45801
Strecker Cancer Center at Marietta Memorial Hospital
Marietta, Ohio, United States, 45750
United States, Oklahoma
Natalie Warren Bryant Cancer Center at St. Francis Hospital
Tulsa, Oklahoma, United States, 74136
United States, Pennsylvania
Chester County Hospital
West Chester, Pennsylvania, United States, 19380
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center
Wilkes-Barre, Pennsylvania, United States, 18711
Joan Karnell Cancer Center at Pennsylvania Hospital
Philadelphia, Pennsylvania, United States, 19107
Geisinger Medical Group - Scenery Park
State College, Pennsylvania, United States, 16801
Hematology and Oncology Associates of Northeastern Pennsylvania
Scranton, Pennsylvania, United States, 18510
Geisinger Medical Center
Danville, Pennsylvania, United States, 17822-0001
Lewistown Hospital
Lewistown, Pennsylvania, United States, 17044
McGlinn Family Regional Cancer Center at Reading Hospital and Medical Center
Reading, Pennsylvania, United States, 19612-6052
Mercy Hospital Cancer Center - Scranton
Scranton, Pennsylvania, United States, 18501
Mount Nittany Medical Center
State College, Pennsylvania, United States, 16803
Penn State Cancer Institute at Milton S. Hershey Medical Center
Hershey, Pennsylvania, United States, 17033-0850
Pottstown Memorial Regional Cancer Center
Pottstown, Pennsylvania, United States, 19464
United States, South Dakota
Avera Cancer Institute
Sioux Falls, South Dakota, United States, 57105
Medical X-Ray Center, PC
Sioux Falls, South Dakota, United States, 57105
Sanford Cancer Center at Sanford USD Medical Center
Sioux Falls, South Dakota, United States, 57117-5039
United States, Wisconsin
Bay Area Cancer Care Center at Bay Area Medical Center
Marinette, Wisconsin, United States, 54143
Dean Medical Center - Madison
Madison, Wisconsin, United States, 53717
Green Bay Oncology, Limited - Oconto Falls
Oconto Falls, Wisconsin, United States, 54154
Green Bay Oncology, Limited - Sturgeon Bay
Sturgeon Bay, Wisconsin, United States, 54235
Green Bay Oncology, Limited at St. Mary's Hospital
Green Bay, Wisconsin, United States, 54303
Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center
Green Bay, Wisconsin, United States, 54301-3526
St. Mary's Hospital Medical Center - Green Bay
Green Bay, Wisconsin, United States, 54303
St. Vincent Hospital Regional Cancer Center
Green Bay, Wisconsin, United States, 54307-3508
Peru
Instituto Nacional de Enfermedades Neoplasicas
Lima, Peru, Lima 34
Sponsors and Collaborators
Eastern Cooperative Oncology Group
Investigators
Study Chair: Robert W. Carlson, MD Stanford University
  More Information

Additional Information:
No publications provided

Responsible Party: Stanford Cancer Center ( Robert W. Carlson )
Study ID Numbers: CDR0000285631, ECOG-4101
Study First Received: April 7, 2003
Last Updated: October 23, 2008
ClinicalTrials.gov Identifier: NCT00057941     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
recurrent breast cancer
stage IV breast cancer

Additional relevant MeSH terms:
Anastrozole
Estrogen Antagonists
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents, Hormonal
Skin Diseases
Antineoplastic Agents
Hormone Antagonists
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Fulvestrant
Breast Neoplasms
Enzyme Inhibitors
Protein Kinase Inhibitors
Pharmacologic Actions
Estrogen Receptor Modulators
Neoplasms
Neoplasms by Site
Therapeutic Uses
Aromatase Inhibitors
Gefitinib
Breast Diseases

ClinicalTrials.gov processed this record on November 27, 2009