Docosahexaenoic Acid in Preventing Recurrence in Breast Cancer Survivors

This study is ongoing, but not recruiting participants.
Information provided by (Responsible Party):
National Cancer Institute (NCI) Identifier:
First received: May 6, 2013
Last updated: October 28, 2015
Last verified: September 2015
This randomized phase II trial studies how well docosahexaenoic acid works in preventing recurrence in breast cancer survivors. Docosahexaenoic acid supplement may prevent recurrence in breast cancer survivors.

Condition Intervention Phase
Benign Breast Neoplasm
Ductal Breast Carcinoma In Situ
Invasive Breast Carcinoma
Lobular Breast Carcinoma In Situ
Paget Disease of the Breast
Stage IA Breast Cancer
Stage IB Breast Cancer
Stage IIA Breast Cancer
Stage IIB Breast Cancer
Stage IIIA Breast Cancer
Stage IIIB Breast Cancer
Stage IIIC Breast Cancer
Drug: Docosahexaenoic Acid
Other: Laboratory Biomarker Analysis
Other: Placebo
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Prevention
Official Title: A Multicenter Phase II Study of Docosahexaenoic Acid (DHA) in Patients With a History of Breast Cancer, Premalignant Lesions, or Benign Breast Disease

Resource links provided by NLM:

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

Primary Outcome Measures:
  • Percent change in normal breast tissue TNF-alpha levels [ Time Frame: Baseline to 12 weeks ] [ Designated as safety issue: No ]
    Differences between active treatment and placebo arm will be compared using analysis of covariance where the post-treatment measurements will be used as a dependent variable and the pretreatment measurements will be included as a covariate in the analysis. Two-sided student t-test or the nonparametric Wilcoxon rank-sum test will be used where appropriate.

Secondary Outcome Measures:
  • Absolute change in CLS-B index defined as follows (number of slides with at least one CLS-B)/(total number of slides examined) measured by immunohistochemical techniques for CD68 [ Time Frame: Baseline to 12 weeks ] [ Designated as safety issue: No ]
    Fisher's exact test will be used.

  • Absolute change in CLS-B/cm^2 adjusted for the pre-treatment measurements [ Time Frame: Baseline to 12 weeks ] [ Designated as safety issue: No ]
  • Absolute change in the presence of CLS-B measured by immunohistochemical techniques for CD68 [ Time Frame: Baseline to 12 weeks ] [ Designated as safety issue: No ]
    Fisher's exact test will be used.

  • Percent change in the breast tissue mRNA levels of tissue biomarkers [ Time Frame: Baseline to 12 weeks ] [ Designated as safety issue: No ]
    Biomarkers (COX-2/IL-1beta/aromatase) are measured by quantitative real-time PCR. Paired t-test or one-sample Wilcoxon rank-sum test will be used.

  • RBC fatty acid level as a surrogate of compliance [ Time Frame: Up to 12 weeks ] [ Designated as safety issue: No ]

Estimated Enrollment: 64
Study Start Date: May 2013
Estimated Primary Completion Date: March 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm I (docosahexaenoic acid)
Patients receive docosahexaenoic acid PO BID for 12 weeks.
Drug: Docosahexaenoic Acid
Given PO
Other Name: Fatty Acid 22:6
Other: Laboratory Biomarker Analysis
Correlative studies
Placebo Comparator: Arm II (placebo)
Patients receive placebo PO BID for 12 weeks.
Other: Laboratory Biomarker Analysis
Correlative studies
Other: Placebo
Given PO
Other Names:
  • placebo therapy
  • PLCB
  • sham therapy

Detailed Description:


I. To determine whether treatment with docosahexaenoic acid (DHA) for 12 weeks at 1000 mg twice daily as compared to placebo reduces normal breast tissue levels of tumor necrosis factor-alpha (TNF-alpha) in overweight and obese patients with a history of stage I-III invasive breast cancer, ductal carcinoma in situ (DCIS), Paget's disease, lobular carcinoma in situ (LCIS), or proliferative benign breast disease.


I. To investigate the effect of DHA at 1000 mg twice daily on tissue biomarkers

  • Change from the baseline in cyclooxygenase-2 (COX-2)/interleukin-1-beta (IL-1beta)/aromatase measured by quantitative real-time polymerase chain reaction (PCR).
  • Change from the baseline in crown-like structures of the breast (CLS-B) measured by immunohistochemical techniques for cluster of differentiation (CD)68.
  • Change from baseline in CLS-B index determined as follows: ([number of slides with evidence of at least one CLS-B]/[total number of slides examined]).
  • Change from baseline in CLS-B/cm^2 defined as the number of CLS-B/cm^2. II. Evaluate age as a predictor of CLS-B and inflammatory biomarkers (TNF-alpha/COX-2/IL-1beta) at baseline and over the time of treatment.

III. Evaluate red blood cell (RBC) fatty acid level as a surrogate of compliance.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients receive docosahexaenoic acid orally (PO) twice daily (BID) for 12 weeks.

ARM II: Patients receive placebo PO BID for 12 weeks.


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

Inclusion Criteria:

  • Participants must have a history of histologically-confirmed stage I-III invasive breast cancer or ductal carcinoma in situ (DCIS), Paget's disease, lobular carcinoma in situ (LCIS), or proliferative benign breast disease
  • No evidence of disease (in situ or invasive cancer that would normally be treated by resection) at trial entry as determined by the investigator
  • >= 6 months from all previous breast cancer treatment (including surgery for invasive cancer, chest wall radiotherapy, chemotherapy, trastuzumab and endocrine therapy)
  • Participants must have a body mass index (BMI) >= 25, defined as (weight in kilograms/[height in meters]^2)
  • Participants must have adequate accessible breast tissue as determined by the treating physician, consisting of one breast unaffected by invasive cancer, which has not been radiated; a history of prior pre-invasive breast cancer or benign biopsy of this breast will be permitted
  • Daily DHA consumption =< 200 mg/day in the month prior to screening estimated by an abbreviated DHA food frequency questionnaire
  • Mammogram within no more than 6 months prior to the date of informed consent (normal/benign Breast Imaging-Reporting and Data System [BI-RADS] 1 or 2) and no further routine breast imaging planned during the course of the study (12 weeks DHA/placebo)
  • Eastern Cooperative Oncology Group (ECOG) performance status must be =< 2 (Karnofsky >= 60%)
  • Absolute neutrophil count >= 1,500/uL
  • Platelets >= 75,000/uL
  • White blood cells >= 3,000/uL
  • Hemoglobin >= 10 g/dL
  • Total bilirubin within 1.5 times the institution's upper limit of normal (ULN)
  • Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) within 1.5 times the institution's ULN
  • Serum creatinine within 1.5 times the institution's ULN
  • Pregnant women will be excluded; for women of childbearing potential; negative pregnancy testing within 72 hours prior to or on study visit #1 (day 0) and willingness to use adequate contraception during the study intervention OR post-menopausal defined as any one of the following 1) prior hysterectomy, 2) absence of menstrual period for 1 year in the absence of prior chemotherapy or 3) absence of menstrual period for 2 years in women with a prior history of chemotherapy exposure who were pre-menopausal prior to chemotherapy
  • Willingness to comply with all study interventions and follow-up procedures including the ability to swallow the study drug
  • Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

  • Any type of active invasive cancer (excluding breast and non-melanoma skin cancer) within the preceding 18 months
  • A history of histologically-confirmed bilateral invasive breast cancer
  • Bilateral mastectomy
  • Prior history or evidence of metastatic breast cancer
  • Prior radiation therapy to the contralateral (unaffected) breast
  • Prior history of contralateral (unaffected) breast augmentation with breast implant placement
  • History of daily use of aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) in the week preceding study entry
  • History of DHA supplementation > 200 mg/day in the month preceding study entry
  • History of autoimmune disorder or any illness that requires therapy with chronic steroids or immunomodulators
  • History of therapeutic doses of anticoagulants including warfarin and low molecular weight heparin (e.g. for prior deep venous thrombosis and pulmonary embolism) in the preceding year
  • Participants may not be receiving any other investigational agents during the study
  • Women who have received cancer surgery, chemotherapy, biological therapy (e.g., trastuzumab), or radiotherapy for the treatment of any cancer within 6 months of study participation
  • Women who are receiving endocrine therapy for breast cancer treatment or chemoprevention including tamoxifen, letrozole, anastrozole, fulvestrant, or exemestane at the time of screening
  • Individuals with severe underlying chronic illness, such as uncontrolled diabetes; ongoing or active infection, psychiatric illness or social situations which in the opinion of the investigator would interfere with study participation
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to DHA or corn/soy oil in placebo agent
  • Pregnant, breastfeeding, or women of childbearing potential unwilling to use a reliable contraceptive method
  Contacts and Locations
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Please refer to this study by its identifier: NCT01849250

United States, Massachusetts
Dana-Farber Cancer Institute
Boston, Massachusetts, United States, 02115
United States, New York
Columbia University Medical Center
New York, New York, United States, 10032
Memorial Sloan-Kettering Cancer Center
New York, New York, United States, 10065
United States, Texas
M D Anderson Cancer Center CCOP Research Base
Houston, Texas, United States, 77030
Sponsors and Collaborators
National Cancer Institute (NCI)
Principal Investigator: Ayca Gucalp M.D. Anderson Cancer Center
  More Information

No publications provided

Responsible Party: National Cancer Institute (NCI) Identifier: NCT01849250     History of Changes
Other Study ID Numbers: NCI-2013-00859, NCI-2013-00859, 12-474, MDACC: 2011-0766, MSKCC:12-267, 12-267, N01-CN-2012-00034, DFCI:12- 474, AAAK6752, MDACC- 2011-0766, MSKCC-12-267, H-33017, CUMC: AAAK6752, 2011-0766, MDA10-16-01, N01CN00034, N01CN35159, P30CA016672
Study First Received: May 6, 2013
Last Updated: October 28, 2015
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Breast Diseases
Breast Neoplasms
Carcinoma in Situ
Carcinoma, Ductal, Breast
Carcinoma, Intraductal, Noninfiltrating
Carcinoma, Lobular
Paget's Disease, Mammary
Carcinoma, Ductal
Neoplasms by Histologic Type
Neoplasms by Site
Neoplasms, Ductal, Lobular, and Medullary
Neoplasms, Glandular and Epithelial
Skin Diseases processed this record on November 25, 2015