Evaluating the Role of the Addition of Ovarian Function Suppression (OFS) to Tamoxifen in Young Women

NCT00912548 | Unknown Phase 3 DMC

• 1 other identifier: KBCSG005
• Study Type: interventional
• Target: 1,234
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to compare 5-year disease free survival rate (DFS rate) between the hormone receptor positive breast cancer patients who were added Goserelin to Tamoxifen for ovarian function suppression after neo-/adjuvant cytotoxic chemotherapy and the hormone receptor positive breast cancer patients who were treated with Tamoxifen.

Conditions

Breast Cancer

Keywords

premenopause; ovarian function suppression; tamoxifen

Outcome Measures

Primary Outcomes (1)

• all cause recurrence

  the first 5 years after surgery

Study Arms (5)

TAM+OFS(E) group

EXPERIMENTAL

Patients should be premenopausal women ,prior to the start of chemotherapy, less than or equal to 45 years of age with oestrogen receptor positive ± progesterone receptor positive who have undergone a primary mass excision, received an neo-/adjuvant chemotherapy ± radiotherapy for their stage I, II or III breast cancer. This arm is ovarian suppression group which have a various starting time of ovarian function suppression after neo-/adjuvant chemotherapy. Ovarian function suppression will be done by administration of LHRH agonist (ZOLADEXTM) for 2 years. After that, the patients will complete taking tamoxifen 20mg/day for 5 years.

Drug: goserelin; Drug: tamoxifen

TAM(D) group

ACTIVE COMPARATOR

Patients, less than or equal to 45 years of age with hormone receptor positive breast cancer will be enrolled. Included All the patients have already treated by surgery, neo- or adjuvant chemotherapy ±and/or radiotherapy before enrolment. At 0, 6, 12, 18 and 24 months since the baseline asTsessment(0), the ovarian function status will be evaluated by menstruation status or serum FSH level. If the patients are regarded as the premenopausal women, they will be randomized into the additional ovarian function suppression group or tamoxifen only group. The latter will complete taking tamoxifen 20mg/day for 5 years.

Drug: tamoxifen

Permanent postmenopausal(A) group

NO INTERVENTION

Patients, less than or equal to 45 years of age with hormone receptor positive breast cancer will be enrolled. Included All the patients have already treated by surgery, neo- or adjuvant chemotherapy ±and/or radiotherapy before enrolment. Eligible patients except for premenopausal status at the baseline will be followed up until 2 years after the baseline assessment for evaluating the menopausal status. This group still remains to postmenopausal status and will taking tamoxifen 20mg/day for 5 years if they remain in the study.

TAM(B)

ACTIVE COMPARATOR

Patients, less than or equal to 45 years of age with hormone receptor positive breast cancer will be enrolled. Included All the patients have already treated by surgery, neo- or adjuvant chemotherapy ±and/or radiotherapy before enrolment. At 6, 12, 18 and 24 months since the baseline assessment (0), the ovarian function status will be evaluated by menstruation status or serum FSH level. If the patients are regarded as the premenopausal women, they will be randomized into the additional ovarian function suppression group or tamoxifen only group. This group, patients are premenopausal women, they will be randomized into tamoxifen only group, complete taking tamoxifen 20mg/day for 5 years.

Drug: tamoxifen

TAM+OFS (C)

EXPERIMENTAL

Patients, less than or equal to 45 years of age with hormone receptor positive breast cancer will be enrolled. Included All the patients have already treated by surgery, neo- or adjuvant chemotherapy ±and/or radiotherapy before enrolment. At 6, 12, 18 and 24 months since the baseline assessment (0), the ovarian function status will be evaluated by menstruation status or serum FSH level. If the patients are regarded as the premenopausal women, they will be randomized. This group, patients are premenopausal women, they will be randomized into the additional ovarian function suppression group. Ovarian function suppression will be done by administration of LHRH agonist (ZOLADEXTM) for 2 years. Then, Patients will complete taking tamoxifen 20mg/day for 5 years.

Drug: goserelin; Drug: tamoxifen

Interventions

goserelin DRUG

1. Zoladex™ administration: Zoladex™ depot is available as a sterile disposable syringe. The depot is administered subcutaneously under the abdominal skin under sterile conditions. If necessary the injection site may be pre-treated with a local anaesthetic. 2. Sequence of administration Zoladex depot: The substance is administered for 24 months (2 years) at 28-day intervals (a period of 34 days between 2 administrations must not be exceeded). 3. Dosage: Each depot contains 3.6mg Zoladex. The substance Zoladex is contained in a while cylindrical rodlet . 4. Storage instructions for Zoladex™ Zoladex™ is kept a room temperature.

Also known as: Zoladex®

TAM+OFS (C); TAM+OFS(E) group

tamoxifen DRUG

1. Dose and period of Tamoxifen therapy: Tamoxifen is administered in tablet form. Each day 2 X 10 mg or 1 X 20 mg Tamoxifen are taken in the form of the respective tablet. 2. Storage instructions for Tamoxifen Tamoxifen is stored at room temperature away from light.

Also known as: Nolvadex

TAM(B); TAM(D) group; TAM+OFS (C); TAM+OFS(E) group

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients must have undergone excision of the primary breast mass, proven histologically to be invasive breast adenocarcinoma.
• Patients must be within 3 months after the last cycle of chemotherapy.
• Patients must have the history of normal menstruation prior to the start of chemotherapy.
• Stage I, II or III
• Woman, less than or equal to 45 years of age
• Hormone receptor status : ER+ve and/or PgR+ve
• WHO performance status 0, 1 or 2.
• Patients who were treated with cytotoxic chemotherapy in pre- or post- surgery.
• Adequate haematological function defined by haemoglobin 10g/dL, neutrophil count 1.5x109/L and platelets 100x109/L.
• Adequate hepatic function defined by AST and ALT 2.5xupper limit of normal. Alkaline phosphatase 5xupper limit of normal, unless bone metastases in the absence of liver disease. Renal function adequate defined by creatinine\<175mmol/L.

You may not qualify if:

• Patients whose primary breast cancer was classified as:
• ER(-),ER unknown
• Patients with the history of hysterectomy or oophorectomy
• Sarcomas or squamous cell carcinomas of the breast are not eligible.
• Patients with malignancies (other than breast cancer) within the last 5 years, except for adequately treated in situ carcinoma of the cervix or basal cell / squamous cell carcinoma of the skin.
• Investigational drugs given within the previous 4 weeks.
• Patients known to be on any unlicensed non-cancer investigational agent.
• Patients with thrombocytopaenia (platelets \<100 x 109/l or on anti- coagulant therapy (contra-indicated due to risk of bleeding with i.m. injection of Zoladex).
• Patients treated with CMF(cyclophosphamide/methotrexate/5-fluorouracil) as prior chemotherapy
• Patients who are pregnant or lactating are ineligible.

Sponsors & Collaborators

• Korean Breast Cancer Study Group: lead

Study Sites (1)

Department of Surgery, Korea Cancer Center Hospital

Seoul, South Korea

Location

Related Publications (3)

• Kim HJ, Noh WC, Nam SJ, Park BW, Lee ES, Im SA, Jung YS, Yoon JH, Kang SS, Park KH, Lee SJ, Jeong J, Lee MH, Cho SH, Kim SY, Kim HA, Han SH, Han W, Hur MH, Kim S, Ahn SH. Five-year changes in ovarian function restoration in premenopausal patients with breast cancer taking tamoxifen after chemotherapy: An ASTRRA study report. Eur J Cancer. 2021 Jul;151:190-200. doi: 10.1016/j.ejca.2021.03.017. Epub 2021 May 16.

  PMID: 34010788 DERIVED

• Kim HA, Lee JW, Nam SJ, Park BW, Im SA, Lee ES, Jung YS, Yoon JH, Kang SS, Lee SJ, Park KH, Jeong J, Cho SH, Kim SY, Kim LS, Moon BI, Lee MH, Kim TH, Park C, Jung SH, Gwak G, Kim J, Kang SH, Jin YW, Kim HJ, Han SH, Han W, Hur MH, Noh WC; Korean Breast Cancer Study Group. Adding Ovarian Suppression to Tamoxifen for Premenopausal Breast Cancer: A Randomized Phase III Trial. J Clin Oncol. 2020 Feb 10;38(5):434-443. doi: 10.1200/JCO.19.00126. Epub 2019 Sep 16.

  PMID: 31518174 DERIVED

• Kim HA, Ahn SH, Nam SJ, Park S, Ro J, Im SA, Jung YS, Yoon JH, Hur MH, Choi YJ, Lee SJ, Jeong J, Cho SH, Kim SY, Lee MH, Kim LS, Moon BI, Kim TH, Park C, Kim SJ, Jung SH, Park H, Gwak GH, Kang SH, Kim JG, Kim J, Choi SY, Lim CW, Kim D, Yoo Y, Song YJ, Kang YJ, Jung SS, Shin HJ, Lee KJ, Han SH, Lee ES, Han W, Kim HJ, Noh WC. The role of the addition of ovarian suppression to tamoxifen in young women with hormone-sensitive breast cancer who remain premenopausal or regain menstruation after chemotherapy (ASTRRA): study protocol for a randomized controlled trial and progress. BMC Cancer. 2016 May 19;16:319. doi: 10.1186/s12885-016-2354-6.

  PMID: 27197523 DERIVED

MeSH Terms

Conditions

Breast Neoplasms

Interventions

Goserelin; Tamoxifen

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

Gonadotropin-Releasing Hormone; Pituitary Hormone-Releasing Hormones; Hypothalamic Hormones; Peptide Hormones; Hormones; Hormones, Hormone Substitutes, and Hormone Antagonists; Neuropeptides; Peptides; Amino Acids, Peptides, and Proteins; Oligopeptides; Nerve Tissue Proteins; Proteins; Stilbenes; Benzylidene Compounds; Benzene Derivatives; Hydrocarbons, Aromatic; Hydrocarbons, Cyclic; Hydrocarbons; Organic Chemicals

Study Officials

• Woo-Chul Noh, MD.PhD

  Department of Surgery, Korea Cancer Center Hospital, 215-4 Gongneung-dong, Nowon-gu, Seoul, Korea

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: May 31, 2009
• First Posted: June 3, 2009
• Study Start: May 1, 2009
• Primary Completion: December 1, 2015
• Study Completion: December 1, 2015
• Last Updated: June 16, 2009

Record last verified: 2009-06

Locations

KR (1)