Simultaneous Versus Sequential Use of Adjuvant Chemotherapy and GnRHa in Treating ER+,Premenopausal Breast Cancer - Full Text View

Purpose

The present study is a randomized open-label -phase III study that aims to compare the efficacy and safety of the adjuvant chemotherapy with simultaneous or sequential application of Zoladex up to 2-3 years for ≤ 45 year old premenopausal hormone receptor-positive breast cancer.

Condition	Intervention	Phase
Breast Cancer	Drug: Zoladex Drug: chemotherapy (Anthrocyclin combined with or followed by Taxanes)	Phase 3


Study Type:	Interventional
Study Design:	Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	A Phase III,Randomized,Open Label Study Comparing Simultaneous Versus Sequential Use of Adjuvant Chemotherapy and GnRHa up to 2-3 Years for ≤ 45 Year Old Pre-menopausal Hormone Receptor-positive Breast Cancer

Resource links provided by NLM:

Genetics Home Reference related topics: breast cancer

MedlinePlus related topics: Breast Cancer

Drug Information available for: Goserelin Goserelin acetate

U.S. FDA Resources

Further study details as provided by Zhimin Shao, Fudan University:

Primary Outcome Measures:

Resumption of menstruation [ Time Frame: 1 year ]
the Resumption that patients recover the natural menstrual or serum E2, FSH, LH return to the premenopausal range within 1 year after stopping Zoladex

Secondary Outcome Measures:

RFS [ Time Frame: 5years ]
Relapse free survival (RFS): RFS related events ware defined as local-regional recurrence, distant metastasis or death, whichever occurred first.during follow up
OS [ Time Frame: 5 years ]
Overall survival
Other adverse events [ Time Frame: 5years ]
Other adverse events (Gynecological events, blood lipids, thrombosis, cardiovascular diseases, and etc.)


Estimated Enrollment:	220
Study Start Date:	June 2009
Estimated Study Completion Date:	September 2018
Estimated Primary Completion Date:	September 2015 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Zoladex combined with chemotherapy After signing informed consent, patients will be screened, eligible patients were randomly divided into 2 groups, the test group should use Zoladex 3.6mg once a month up to 2-3 years combined with chemotherapy,all patients will receive Tamoxifen after chemotherapy	Drug: Zoladex Eligible patients were randomly divided into 2 groups, the intervention group should use Zoladex 3.6mg once a month up to 2-3 years combined with chemotherapy,and the control group should use chemotherapy alone followed by Zoladex Other Name: Zoladex = GnRHa,Goserelin Drug: chemotherapy (Anthrocyclin combined with or followed by Taxanes) After signing informed consent, patients will be screened, eligible patients were randomly divided into 2 groups, the control group should Switch to use Zoladex 3.6mg once a month after chemotherapy up to 2-3 years,all patients will receive Tamoxifen after chemotherapy Other Name: Anthrocyclin combined with or followed by Taxanes
Active Comparator: Zoladex after chemotherapy After signing informed consent, patients will be screened, eligible patients were randomly divided into 2 groups, the control group should use Zoladex 3.6mg once a month up to 2-3 years after chemotherapy,all patients will receive Tamoxifen after chemotherapy	Drug: Zoladex Eligible patients were randomly divided into 2 groups, the intervention group should use Zoladex 3.6mg once a month up to 2-3 years combined with chemotherapy,and the control group should use chemotherapy alone followed by Zoladex Other Name: Zoladex = GnRHa,Goserelin Drug: chemotherapy (Anthrocyclin combined with or followed by Taxanes) After signing informed consent, patients will be screened, eligible patients were randomly divided into 2 groups, the control group should Switch to use Zoladex 3.6mg once a month after chemotherapy up to 2-3 years,all patients will receive Tamoxifen after chemotherapy Other Name: Anthrocyclin combined with or followed by Taxanes

Arms

Assigned Interventions

Experimental: Zoladex combined with chemotherapy

After signing informed consent, patients will be screened, eligible patients were randomly divided into 2 groups, the test group should use Zoladex 3.6mg once a month up to 2-3 years combined with chemotherapy,all patients will receive Tamoxifen after chemotherapy

Drug: Zoladex

Eligible patients were randomly divided into 2 groups, the intervention group should use Zoladex 3.6mg once a month up to 2-3 years combined with chemotherapy,and the control group should use chemotherapy alone followed by Zoladex

Other Name: Zoladex = GnRHa,Goserelin

Drug: chemotherapy (Anthrocyclin combined with or followed by Taxanes)

After signing informed consent, patients will be screened, eligible patients were randomly divided into 2 groups, the control group should Switch to use Zoladex 3.6mg once a month after chemotherapy up to 2-3 years,all patients will receive Tamoxifen after chemotherapy

Other Name: Anthrocyclin combined with or followed by Taxanes

Active Comparator: Zoladex after chemotherapy

After signing informed consent, patients will be screened, eligible patients were randomly divided into 2 groups, the control group should use Zoladex 3.6mg once a month up to 2-3 years after chemotherapy,all patients will receive Tamoxifen after chemotherapy

Drug: Zoladex

Eligible patients were randomly divided into 2 groups, the intervention group should use Zoladex 3.6mg once a month up to 2-3 years combined with chemotherapy,and the control group should use chemotherapy alone followed by Zoladex

Other Name: Zoladex = GnRHa,Goserelin

Drug: chemotherapy (Anthrocyclin combined with or followed by Taxanes)

After signing informed consent, patients will be screened, eligible patients were randomly divided into 2 groups, the control group should Switch to use Zoladex 3.6mg once a month after chemotherapy up to 2-3 years,all patients will receive Tamoxifen after chemotherapy

Other Name: Anthrocyclin combined with or followed by Taxanes

Detailed Description:

Data showed that ovarian suppression therapy may protect the ovarian function in premenopausal patients received chemotherapy for breast cancer. However this is still a controversial issue. Sequential use of GnRHa (Zoladex) as ovarian suppression treatment after chemotherapy has been established as an effective endocrine therapy for ER positive premenopausal breast cancer. The present study is a randomized open-label phase III study that aims to observe the efficacy and safety of the adjuvant chemotherapy with simultaneous combination of Zoladex up to 2-3years and chemotherapy compared with the sequential schedule in ≤ 45 year old premenopausal hormone receptor-positive breast cancer patients.

Eligibility


Ages Eligible for Study:	up to 45 Years (Child, Adult)
Sexes Eligible for Study:	Female
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

female
Primary invasive breast cancer pathologically approved by core needle or open biopsy
Patients must have undergone standard surgery for primary breast cancer as shown in the following:
- mastectomy
- breast conservation surgery followed by whole breast radiation
- axillary dissection or sentinel node biopsy
Need adjuvant chemotherapy after surgery
Patients taking neo-chemotherapy are eligible
Patients with synchronous bilateral cancers are eligible on the condition that If one side is IDC and the other side is DCIS, the IDC side should be of the ER and/or PR positive phenotype and IF two sides are both IDC, they must be ER and/or PR positive phenotype at the same time
Hormone receptor positive (≥＋) is defined as detecting ER or PR expression at any time is eligible. The situation of only PR positive and ER negative is eligible, too
Based on the study objective, all patients are required to be premenopausal as defined by
- menstruating actively
- less than 6 months since last menstrual period (LMP), or patients younger than 40 years of age who became amenorrheic not more than 1 year if the serum free E2、FSH and LH level was premenopausal (according to the reference value of local center).
- had previous hysterectomy with one or both ovaries left intact are eligible if the serum free E2、FSH and LH level are premenopausal (according to the reference value of local center).
patients must have an ECOG performance status of 0 or 1 (0-fully active, able to carry on all pre-disease performance without restriction, 1-restricted in physical strenuous actively but ambulatory)
leucocyte count must be ≥ 3.0*10^9/L and platelet count must be ≥ 100*10^9/L
AST/SGOT or ALT/AGPT must be < 3 times the ULN
serum creatinine must be < 2 times the ULN
pregnancy testing is negative and are willing to do contraception during the treatment period

Exclusion Criteria:

patients with metastatic malignant tumor
previous history of asynchronous bilateral breast cancer
any previous malignancy in the past 5 years, except for those treated with curative intent, such as carcinoma in situ of the cervix, squamous carcinoma of the skin or basal cell carcinoma of the skin
any non-malignant systemic disease which interfere long time follow up
history of medical ovarian ablation therapy
severe live dysfunction, Child－Pugh is grade C
Severe renal dysfunction
Occult breast cancer
severe heart dysfunction, heart functional classification is above Class III

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01712893

Contacts


Contact: Zhi-Min Shao, MD	86-021-64175590 ext 8808 ext 8808	zhimingshao@yahoo.com
Contact: Guang-Yu Liu, MD	86-021-64175590 ext 8808	liugy123@yahoo.com

Locations


China, Shanghai
FUSCC	Recruiting
Shanghai, Shanghai, China, 200032
Contact: guang-yu Liu, MD 86-021-64175590 ext 8808 liugy123@yahoo.com

Sponsors and Collaborators

Fudan University

Investigators


Principal Investigator:	Zhi-Min Shao, MD	Fudan University

More Information


Responsible Party:	Zhimin Shao, Director of Department of Surgical Oncology,Cancer Hospital & Institute, Fudan University
ClinicalTrials.gov Identifier:	NCT01712893 History of Changes
Other Study ID Numbers:	CD trial
Study First Received:	October 21, 2012
Last Updated:	October 23, 2012

Keywords provided by Zhimin Shao, Fudan University:


breast cancer adjuvant therapy Ovarian suppression

Additional relevant MeSH terms:


Breast Neoplasms Neoplasms by Site Neoplasms Breast Diseases Skin Diseases Tamoxifen Goserelin Taxane Estrogen Antagonists	Hormone Antagonists Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Antineoplastic Agents, Hormonal Antineoplastic Agents Selective Estrogen Receptor Modulators Estrogen Receptor Modulators Bone Density Conservation Agents

ClinicalTrials.gov processed this record on July 21, 2017