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Zoledronate or Ibandronate in Preventing Bone Problems in Women With Stage IV Breast Cancer That Has Spread to the Bone
This study has been completed.
First Received: March 9, 2006   Last Updated: January 9, 2010   History of Changes
Sponsor: Southwest Oncology Group
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00301886
  Purpose

RATIONALE: Zoledronate and ibandronate may prevent or help relieve bone pain and other symptoms caused by bone metastases. It is not yet known whether zoledronate is more effective than ibandronate in preventing bone problems caused by bone metastases due to breast cancer.

PURPOSE: This randomized phase III trial is studying zoledronate to see how well it works compared to ibandronate in preventing bone problems in women with stage IV breast cancer that has spread to the bone.


Condition Intervention Phase
Breast Cancer
Hypercalcemia of Malignancy
Metastatic Cancer
Pain
Drug: ibandronate sodium
Drug: zoledronic acid
Procedure: quality-of-life assessment
Phase III

Study Type: Interventional
Study Design: Supportive Care, Randomized
Official Title: A Phase III Randomized, Multicenter Non-Inferiority Trial Evaluating the Efficacy of Oral Ibandronate Versus Intravenous Zoledronate in the Reduction of Skeletal-Related Events in Patients With Metastatic Breast Cancer

Resource links provided by NLM:


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

Primary Outcome Measures:
  • Skeletal-related events (SRE)

Secondary Outcome Measures:
  • Change in patient's rating of worst pain as measured by the Brief Pain Inventory
  • Survival and time to first clinically apparent SRE
  • Tolerability and toxicity as measured by NCI CTCAE v3.0
  • Changes in performance status

Estimated Enrollment: 488
Study Start Date: May 2006
Detailed Description:

OBJECTIVES:

Primary

  • Compare the efficacy of zoledronate vs ibandronate, in terms of preventing the occurrence of skeletal-related events (SRE) (e.g., fracture, spinal cord compression, radiotherapy or surgery for bone symptoms or events, or hypercalcemia ≥ grade 3), in women with stage IV breast cancer and bone metastases.

Secondary

  • Compare the change in patient-reported measures of pain and use of analgesics in patients treated with these drugs.
  • Compare the time to first clinically apparent SRE in patients treated with these drugs.
  • Compare the toxicity of these drugs.
  • Compare the changes in performance status and overall survival of patients treated with these drugs.

OUTLINE: This is a multicenter, randomized study. Patients are stratified according to hormone receptor status (estrogen receptor [ER] and progesterone receptor [PR] negative vs ER and/or PR positive) and current evidence of fracture (vertebral or nonvertebral) or spinal compression (yes vs no). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive oral ibandronate once daily on days 1-28.
  • Arm II: Patients receive zoledronate IV over 15 minutes on day 1. In both arms, treatment repeats every 28 days for up to 18 courses in the absence of unacceptable toxicity.

Quality of life and pain are assessed at baseline, every 3 courses during study treatment, and at the end of study treatment.

After completion of study treatment, patients are followed periodically for up to 3 years.

PROJECTED ACCRUAL: A total of 488 patients will be accrued for this study.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed stage IV breast cancer at primary diagnosis or at recurrence

    • Any T, any N, M1
  • At least 1 dominant osteolytic or osteoblastic or mixed metastatic lesion outside any prior radiation field

    • Lesion measures ≥ 1.0 cm by x-ray, CT scan, and/or MRI
  • Controlled asymptomatic brain metastases allowed
  • Controlled bone pain, defined as a physician/health care provider rating of ≤ grade 2 pain-SELECT (Bone) on the NCI CTC for Adverse Events Version 3.0 rating scale, required
  • Current evidence of vertebral or nonvertebral fractures or spinal compression due to cancer, as determined by the treating physician, allowed
  • No Paget's disease of the bone
  • Estrogen receptor (ER) or progesterone receptor (PR) status known

PATIENT CHARACTERISTICS:

  • Female patient
  • Menopausal status not specified
  • Zubrod performance status 0-2
  • Creatinine normal
  • Creatinine clearance ≥ 60 mL/min
  • Serum calcium < 12 mg/dL
  • Not pregnant or nursing
  • Fertile patients must use effective contraception
  • Must be able to receive IV medication and oral medication (i.e., must have physical integrity of the upper gastrointestinal tract)
  • No malabsorption syndrome
  • No primary hyperparathyroidism
  • No known history of aspirin-sensitive asthma
  • No other prior malignancy except for the following:

    • Adequately treated basal cell or squamous cell skin cancer
    • In situ cervical cancer
    • Adequately treated stage I or II cancer currently in complete remission
    • Any other cancer for which the patient has been disease-free for at least 5 years
  • No uncontrolled medical illness or infection, including, but not limited to, the following:

    • Unstable angina
    • Recent myocardial infarction
    • Life-threatening cardiac arrhythmia

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No prior bisphosphonates for metastatic bone disease
  • More than 28 days since prior aminoglycoside antibiotics
  • At least 28 days since prior oral bisphosphonates for osteoporosis
  • More than 6 months since prior bisphosphonates used for adjuvant therapy
  • Concurrent treatment, including chemotherapy, hormonal therapy, and/or biologic therapy for metastatic breast cancer allowed
  • No concurrent participation in another clinical treatment trial for this cancer unless the patient is no longer receiving the intervention and is in the follow-up phase of the other clinical trial
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00301886

Sponsors and Collaborators
Southwest Oncology Group
Investigators
Study Chair: Saul E. Rivkin, MD Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
Investigator: Kathy S. Albain, MD Loyola University
Investigator: Dawn Hershman, MD Herbert Irving Comprehensive Cancer Center
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000463758, SWOG-S0308
Study First Received: March 9, 2006
Last Updated: January 9, 2010
ClinicalTrials.gov Identifier: NCT00301886     History of Changes
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
pain
hypercalcemia of malignancy
stage IV breast cancer
bone metastases
recurrent breast cancer

Additional relevant MeSH terms:
Metabolic Diseases
Zoledronic acid
Skin Diseases
Physiological Effects of Drugs
Hypercalcemia
Breast Neoplasms
Bone Density Conservation Agents
Pharmacologic Actions
Calcium Metabolism Disorders
Neoplasms
Neoplastic Processes
Neoplasms by Site
Pathologic Processes
Ibandronic acid
Neoplasm Metastasis
Water-Electrolyte Imbalance
Breast Diseases

ClinicalTrials.gov processed this record on February 08, 2010