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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

  Show 150 Study Locations
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 09, 2009