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Intermittent Letrozole Therapy in Postmenopausal Women With Metastatic Breast Cancer

This study has been completed.
Dana-Farber Cancer Institute
Information provided by (Responsible Party):
Paul Goss, MD, PhD, Massachusetts General Hospital Identifier:
First received: October 24, 2007
Last updated: October 6, 2015
Last verified: October 2015
The purpose of this research study is to study the effects of using aromatase inhibitor (AI) therapy intermittently on participants with breast cancer. AIs are a class of drugs used to treat breast cancer in postmenopausal women. They work by decreasing the level of estrogen, which is believed to stimulate the growth of tumor tissue. Breast cancer that progresses despite therapy with an AI is thought to have become resistant to AI therapy. There is scientific evidence to suggest that resistant breast cancer cells learn to grow at the very low levels of estrogen present on AI therapy, and that increasing estrogen levels even slightly by stopping AI therapy may inhibit the breast cancer cells.

Condition Intervention Phase
Breast Cancer
Drug: Letrozole
Phase 2

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Clinical Trial of Intermittent Letrozole Therapy in Postmenopausal Women With CA 15-3 Positive, Hormone Receptor Positive, Metastatic Breast Cancer

Resource links provided by NLM:

Further study details as provided by Massachusetts General Hospital:

Primary Outcome Measures:
  • To determine the proportion of patients who have a decline in serum CA 15-3 once letrozole therapy has been reintroduced after a drug free observation phase. [ Time Frame: 2 years ]

Secondary Outcome Measures:
  • To determine the time to disease progression with intermittent letrozole. [ Time Frame: 2 years ]
  • To measure serum HER-2/neu levels and serum/plasma angiogenic mediators. [ Time Frame: 2 years ]

Enrollment: 3
Study Start Date: October 2007
Study Completion Date: September 2013
Primary Completion Date: May 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
No Intervention: Intermittent letrozole therapy
Determine the proportion of patients who have a decline in serum CA 15-3 or CA 27.29 once letrozole therapy has been reintroduced after a drug free observation phase in patients with postmenopausal hormone-receptor positive, CA 15-3 or CA 27.29 elevated.
Drug: Letrozole
Other Name: Femara

Detailed Description:
  • This study involves treating participants with intermittent AI therapy. The AI will be stopped at the time they enter the study. We plan on monitoring a marker in the participants blood called CA 15-3 (or CA 27.29) every 4 weeks to help us make a decision of when to re-start treatment with letrozole (femara). This marker is known to rise when disease is progressing and drop when the disease is responding to treatment. We will be stopping and re-starting therapy based on the changes of CA 15-3 in the participants blood.
  • In addition to bloodwork, the following tests and procedures will be performed on a monthly basis: medical history; physical examination and performance status.
  • Every 8 weeks the following will be performed: Tumor assessment by physical exam (if possible); Chest x-ray or CT scan or chest; CT scans of abdomen and pelvis; and bone scan.

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Female
  • 18 years of age or older
  • Postmenopausal
  • Histologically or cytologically confirmed adenocarcinoma of the breast with locally advanced or metastatic disease this is not considered amenable to curative treatment with elevation of CA 15-3 documented at the time of diagnosis of metastatic disease and prior to initiation of letrozole or anastrozole therapy
  • Current letrozole or anastrozole monotherapy with a documented CA 15-3 level that has decreased by at least 50% of the patients baseline
  • Letrozole or anastrozole must be discontinued at the time of study enrollment
  • Evidence of hormone sensitivity of primary or secondary tissue.
  • Measurable or nonmeasurable (but evaluable-defined as nontarget lesions) disease according to modified RECIST
  • Prior antiestrogen therapies including tamoxifen, steroidal AIs, nonsteroidal AIs, or fulvestrant in the adjuvant setting is allowed provided the patient is currently on letrozole or anastrozole monotherapy as first-line therapy for metastatic disease
  • Life expectancy of greater than 3 months
  • ECOG Performance Status of 0,1, or 2
  • Normal organ and marrow function as outlined in protocol

Exclusion Criteria:

  • Premenopausal
  • Trastuzumab or biologic therapy within 2 weeks
  • Prior or planned radiation therapy to a site of evaluable disease in the event that the site is the only site of evaluable disease
  • Concomitant anticancer treatments including trastuzumab, chemotherapy, or other biologic agents other than letrozole or anastrozole therapy
  • Chronic bisphosphonates for hypercalcemia or prevention of bone metastases.
  • Treatment with non-approved or investigational agent within 2 weeks before study entry
  • Presence of life-threatening metastatic disease, defined as extensive hepatic involvement, or past or present brain or leptomeningeal involvement, or symptomatic pulmonary lymphangitic spread
  • Patients who are highly symptomatic from their breast cancer, or who require urgent palliative chemotherapy, as decided by their treating physician
  • Previous or current systemic malignancy within the past five years, except for contralateral breast carcinoma, in situ carcinoma of the cervix treated by cone biopsy, or adequately treated basal or squamous cell carcinoma of the skin.
  • Any severe concomitant condition believed to render subject undesirable for participation
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Please refer to this study by its identifier: NCT00549822

United States, Massachusetts
Dana-Farber Cancer Institute
Boston, Massachusetts, United States, 02115
Massachusetts General Hospital
Boston, Massachusetts, United States, 02215
Sponsors and Collaborators
Massachusetts General Hospital
Dana-Farber Cancer Institute
Principal Investigator: Paul Goss, MD, PhD Massachusetts General Hospital
  More Information

Responsible Party: Paul Goss, MD, PhD, Professor of Medicine, Harvard Medical School, Massachusetts General Hospital Identifier: NCT00549822     History of Changes
Other Study ID Numbers: 07-109 
Study First Received: October 24, 2007
Last Updated: October 6, 2015

Keywords provided by Massachusetts General Hospital:
aromatase inhibitor
CA 15-3
Hormone receptor positive

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Breast Diseases
Skin Diseases
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Antineoplastic Agents
Aromatase Inhibitors
Steroid Synthesis Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Estrogen Antagonists
Hormone Antagonists processed this record on February 27, 2017