Evaluation of Predictive Factors Regarding the Effectivity of Aromatase Inhibitor Therapy (PreFace) (PreFace)

• ClinicalTrials.gov Identifier: NCT01908556
• Recruitment Status: Unknown
• First Posted: July 25, 2013
• Last Update Posted: July 25, 2013
• Sponsor: Institut fuer Frauengesundheit
• Collaborators: Novartis; ClinSol
• Information provided by (Responsible Party): Institut fuer Frauengesundheit

Study Description

Brief Summary:

Aromatase inhibitors have shown a superior efficacy compared to tamoxifen in the treatment of hormonal receptor positive breast cancer in postmenopausal patients.

Side effects like osteoporosis, bone fractures and muscle/bone pain are however more frequent using of aromatase inhibitors compared with tamoxifen. These side effects compromise the patients' well being in a significant way and may favour the use of Tamoxifen in clinical practice.

Furthermore there is evidence that polymorphisms in the CYP2D6 Gene might be associated with an improved efficacy of Tamoxifen that is equieffective to aromatase inhibitors.

Concerning the pharmacogenetics of aromatase inhibition there are known polymorphisms of the CYP19A1 gene that are associated with altered peripheral sex hormone levels and altered prognosis in breast cancer patients. One study could even associate a polymorphism in the CYP19A1 gene with a prolonged time to progression in patients with metastatic breast cancer who have been treated with letrozol.

Therefore the aim of this study is to identify biomarkers that could predict the efficacy of an adjuvant Letrozol treatment in postmenopausal breast cancer patients.

Condition or disease	Intervention/treatment	Phase
is to Identify Biomarkers That Could Predict the Efficacy of an Adjuvant Letrozol Treatment in Postmenopausal Breast Cancer Patients.	Drug: Letrozole	Phase 4

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 3545 participants
• Allocation: N/A
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: Open Labeled, Propective, Multicentric Phase IV Study to Examine the Influence of Pharmacogenetic Markers on the Efficacy and Side Effects in Postmenopausal, Steroid Hormone Positive Breast Cancer Patients, Who Are Treated With Letrozol.
• Study Start Date: February 2009
• Estimated Primary Completion Date: December 2015

Arms and Interventions

Arm

Intervention/treatment

Experimental: Letrozol; All patients are treated with letrozole 2.5 mg for 5 years for the adjuvant treatment of postmenopausal patients with a hormone receptor positive primary breast cancer. Patients are treated according to the authorities' approval of the drug. Of all patients a germline DNA sample will be obtained before the treatment starts and serum samples will be taken at months 0, 6 and 12. Furthermore the paraffin embedded tissue block will be sent to a central pathology laboratory for central assessment of tumor biomarkers.

Drug: Letrozole

Outcome Measures

Primary Outcome Measures :

1. Disease free survival in association with tested genotypes (whole genome scan) [ Time Frame: 5 years ]

Secondary Outcome Measures :

1. Overall survival in association with tested genotypes Quality of life in association with tested genotypes Health economy in the use of aromatase inhibitors Identification of genetic susceptibility markers for hormonal receptor positive breast cancer [ Time Frame: 5 years ]

Eligibility Criteria

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

Criteria

Inclusion Criteria:

• Indication for adjvuant antihormonal treatment of breast cancer
• Age ≥ 18 years
• Histological proven hormonal receptor positive breast cancer
• No evidence of distant breast cancer disease
• Patient must be postmenopausal
• Postmenopausal is defined as one of the following criteria
• Age above 55 years
• Age ≤55 years, but no spontaneous menstruation since 12 months
• Age ≤55 years and postmenopausal gonadotropin levels (luteinizing Hormone and follicle-stimulating hormone >40 IU/L)
• Bilateral Oophorectomy
• Life expectancy greater than 12 months
• ECOG performance Status of at least 0, 1 or 2.
• Patients should be able to be compliant to the study procedures
• Signed informed consent

Exclusion Criteria:

• Patients who have no indication for an aromatase inhibitor or have a known hypersensitivity to letrozole
• Prior treatment with letrozole other aromatase inhibitors
• Evidence of distant metastastatic breast cancer disease
• Unstable or serious co-existing medical condition, including potentially serious infection that would make the patient inappropriate for study participation, or any serious medical or psychiatric disorder that would interfere with the patient's safety or informed consent. (No specific tests are required for confirmation of egilibility)
• Other concurrent malignant disease with the exception of cone-biopsied in situ carcinoma of the cervix uteri, or adequately treated basal or squamous cell carcinoma of the skin, or other curable cancers e.g. Hodgkin's disease or non-Hodgkin-lymphoma, provided 5 years have elapsed from completion of therapy, and there has been no recurrence
• Patients with unstable angina, or uncontrolled cardiac disease (e.g. Class III and IV New York Heart Association's Functional Classification, see Appendix 9) or uncontrolled endocrine disorders.
• Instabiler Diabetes mellitus; insulinpflichtiger Typ II Diabetes
• Other antihormonal investigational or non-investigational drugs within the past 30 days and the concomitant use of investigational or non-investigational drugs except trastuzumab in the adjuvant treatment of HER2 positive breast cancer
• Male patients
• Psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol.

Contacts and Locations

Locations

Germany

Frauenklinik University Hospital

Erlangen, Bavaria, Germany, 91054

Sponsors and Collaborators

Institut fuer Frauengesundheit

Novartis

ClinSol

More Information

• Responsible Party: Institut fuer Frauengesundheit
• ClinicalTrials.gov Identifier: NCT01908556
• Other Study ID Numbers: TRAFO-001
• First Posted: July 25, 2013
• Last Update Posted: July 25, 2013
• Last Verified: February 2009

Additional relevant MeSH terms:

Breast Neoplasms; Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Letrozole; Antineoplastic Agents; Aromatase Inhibitors; Steroid Synthesis Inhibitors; Enzyme Inhibitors; Molecular Mechanisms of Pharmacological Action; Estrogen Antagonists; Hormone Antagonists; Hormones, Hormone Substitutes, and Hormone Antagonists; Physiological Effects of Drugs