Bone Mineral Density in Postmenopausal Women With Primary Breast Cancer Who Are Receiving Treatment on Clinical Trial CAN-NCIC-MA27

This study has been completed.
National Cancer Institute (NCI)
North Central Cancer Treatment Group
Southwest Oncology Group
Information provided by (Responsible Party):
Canadian Cancer Trials Group ( NCIC Clinical Trials Group ) Identifier:
First received: July 19, 2006
Last updated: January 9, 2012
Last verified: January 2012

RATIONALE: Learning about the effect of exemestane and anastrozole on bone mineral density in postmenopausal women with primary breast cancer may help plan treatment, decrease the risk of broken bones, and help patients live more comfortably.

PURPOSE: This phase III trial is studying bone mineral density in postmenopausal women with primary breast cancer who are receiving treatment on clinical trial CAN-NCIC-MA27.

Condition Intervention Phase
Breast Cancer
Dietary Supplement: calcium carbonate
Dietary Supplement: calcium citrate
Dietary Supplement: cholecalciferol
Drug: alendronate sodium
Drug: calcium gluconate
Drug: risedronate sodium
Other: laboratory biomarker analysis
Procedure: dual x-ray absorptometry
Phase 3

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Diagnostic
Official Title: The Influence of Five Years of Adjuvant Anastrozole or Exemestane on Bone Mineral Density In Postmenopausal Women With Primary Breast Cancer

Resource links provided by NLM:

Further study details as provided by Canadian Cancer Trials Group:

Primary Outcome Measures:
  • Percentage change of bone mineral density (BMD) measured at 2 years (from baseline) in the L1-L4 region of the spine and the hip [ Time Frame: 5 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Percentage change in BMD at 5 years (from baseline) [ Time Frame: 5 years ] [ Designated as safety issue: No ]
  • Mean percentage change in BMD at 1, 3, and 5 years (from baseline) [ Time Frame: 5 years ] [ Designated as safety issue: No ]
  • Proportion of patients without osteopenia or osteoporosis (stratum I) who develop BMD below the absolute threshold for osteopenia (< -2.0 standard deviation below the mean), suffer any osteoporotic fracture, or have an asymptomatic fracture revealed ... [ Time Frame: 5 years ] [ Designated as safety issue: No ]
  • Percentage of patients with osteopenia or osteoporosis (stratum II) who have ≥ 5% improvement of BMD at 2 years post randomization on protocol CAN-NCIC-MA27 and who have clinically apparent osteoporosis-related fracture of the long bones [ Time Frame: 5 years ] [ Designated as safety issue: No ]
  • Pattern of change in bone biomarkers from baseline [ Time Frame: 5 years ] [ Designated as safety issue: No ]
  • Clinical safety and tolerability of study medications [ Time Frame: 5 years ] [ Designated as safety issue: Yes ]

Enrollment: 497
Study Start Date: April 2006
Study Completion Date: March 2011
Primary Completion Date: March 2011 (Final data collection date for primary outcome measure)
Detailed Description:


  • Determine whether there is a clinically relevant difference in bone mineral density (BMD) at 2 years in postmenopausal women with primary breast cancer (with or without osteopenia or osteoporosis) treated with exemestane vs anastrozole on protocol CAN-NCIC-MA27.

OUTLINE: This is a multicenter, companion study. Patients are stratified according to baseline bone mineral density (BMD) measurement (T-score* ≥ -2.0 standard deviation [SD] [no osteopenia or osteoporosis] vs T-score* < -2.0 SD).

NOTE: *The lowest of the two T-scores: L1-L4 or total hip

Blood samples for the identification of bone biomarkers (formation marker: serum amino-terminal procollagen 1 extension peptide [P1NP] and resorption marker: serum N-telopeptide) are obtained at baseline and at 6 and 12 months. BMD is determined by dual-energy x-ray absorptiometry (DEXA) at baseline and then annually for 5 years (or for as long as patient is receiving treatment on protocol CAN-NCIC-MA27).

Patients receive oral calcium and oral cholecalciferol (vitamin D) daily. Patients with osteopenia or osteoporosis (stratum II) also receive oral bisphosphonate therapy

PROJECTED ACCRUAL: A total of 408 patients will be accrued for this study.


Ages Eligible for Study:   45 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No


  • Enrolled in and meets eligibility requirements for protocol CAN-NCIC-MA27
  • Acceptable quality dual-energy x-ray absorptiometry (DEXA) of the L1-L4 postero-anterior spine and hip within 12 weeks prior to randomization on protocol CAN-NCIC-MA27
  • Hormone receptor status:

    • Estrogen receptor- and/or progesterone receptor-positive tumor


  • Female
  • Postmenopausal
  • No malabsorption syndrome
  • No known cholecalciferol (vitamin D) deficiency, active hyper- or hypoparathyroidism, or Paget's disease
  • No uncontrolled thyroid disease, Cushing's disease, or other pituitary disease
  • No other bone disease (including osteomalacia or osteogenesis imperfecta)


  • More than 6 months since prior drugs (investigational or not), including bisphosphonates, for the prevention of osteoporosis (stratum I)
  • More than 12 months since prior and no concurrent anticonvulsants
  • More than 6 months since prior and no concurrent corticosteroids at doses > 5 mg/day of prednisone (or equivalent) for > 2 weeks
  • More than 12 months since prior and no concurrent anabolic steroids
  • No prior bisphosphonates (stratum II)
  • No concurrent sodium fluoride at daily doses ≥ 5 mg/day
  • No long-term (i.e., > 6 months) use of coumarins
  • No concurrent drugs (investigational or not), including bisphosphonates, for the prevention of osteoporosis (for patients with no osteopenia or osteoporosis [stratum I])
  Contacts and Locations
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Please refer to this study by its identifier: NCT00354302

Canada, British Columbia
BCCA - Vancouver Cancer Centre
Vancouver, British Columbia, Canada, V5Z 4E6
Canada, Manitoba
CancerCare Manitoba
Winnipeg, Manitoba, Canada, R3E 0V9
Canada, New Brunswick
The Moncton Hospital
Moncton, New Brunswick, Canada, E1C 6Z8
Atlantic Health Sciences Corporation
Saint John, New Brunswick, Canada, E2L 4L2
Canada, Ontario
Cambridge Memorial Hospital
Cambridge, Ontario, Canada, N1R 3G2
Algoma District Cancer Program
Sault Ste. Marie, Ontario, Canada, P6B 0A8
Thunder Bay Regional Health Science Centre
Thunder Bay, Ontario, Canada, P7B 6V4
Univ. Health Network-Princess Margaret Hospital
Toronto, Ontario, Canada, M5G 2M9
Odette Cancer Centre
Toronto, Ontario, Canada, M4N 3M5
St. Michael's Hospital
Toronto, Ontario, Canada, M5B 1W8
Canada, Quebec
Hopital Charles LeMoyne
Greenfield Park, Quebec, Canada, J4V 2H1
CHA-Hopital Du St-Sacrement
Quebec City, Quebec, Canada, G1S 4L8
Canada, Saskatchewan
Allan Blair Cancer Centre
Regina, Saskatchewan, Canada, S4T 7T1
Sponsors and Collaborators
NCIC Clinical Trials Group
National Cancer Institute (NCI)
North Central Cancer Treatment Group
Southwest Oncology Group
Study Chair: Paul E. Goss, MD, PhD Massachusetts General Hospital
Study Chair: James N. Ingle, MD Mayo Clinic
Study Chair: Dawn Hershman, MD Herbert Irving Comprehensive Cancer Center
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Canadian Cancer Trials Group ( NCIC Clinical Trials Group ) Identifier: NCT00354302     History of Changes
Other Study ID Numbers: MA27B  CAN-NCIC-MA27B  SWOG-NCIC-MA27B  NCCTG-NCIC-MA27B  CAN-NCIC-BONE  CDR0000483099 
Study First Received: July 19, 2006
Last Updated: January 9, 2012
Health Authority: Canada: Health Canada

Keywords provided by Canadian Cancer Trials Group:
stage I breast cancer
stage II breast cancer
stage IIIA breast cancer

Additional relevant MeSH terms:
Breast Neoplasms
Bone Diseases
Bone Diseases, Metabolic
Breast Diseases
Musculoskeletal Diseases
Neoplasms by Site
Skin Diseases
Calcium Carbonate
Calcium, Dietary
Risedronate Sodium
Bone Density Conservation Agents
Calcium Channel Blockers
Gastrointestinal Agents
Growth Substances
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs
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