Afimoxifene in Reducing the Risk of Breast Cancer in Women With Mammographically Dense Breast

NCT03063619 | Completed Phase 2 Results DMC FDA Drug

• 5 other identifiers: 2017-0328NCI-2017-00244N01-CN-2012-00034MDA2016-07-02N01CN00034
• Study Type: interventional
• Target: 194
• Locations: 1 country
• Sites: 5

Brief Summary

This randomized phase II trial studies how well afimoxifene works in reducing the risk of breast cancer in women with mammographically dense breast. Estrogen can cause the growth of breast cancer cells. Hormone therapy using afimoxifene may fight breast cancer by blocking the use of estrogen by the tumor cells.

Conditions

Mammographically Dense Breast

Outcome Measures

Primary Outcomes (1)

• Mammographic Breast Density Using Cumulus Software

  To determine change of mammographic breast density using Cumulus software. Cumulus is a semi-automated computerized measure of dense area that uses reader-based thresholds to define the breast edge and regions of density on a digital or digitized mammogram. Each pixel within the breast area between the skin line and pectoral muscle is segmented into either fat or fibro glandular tissue; this defines the cut-off point.

  Baseline to Month 12

Secondary Outcomes (3)

• Mammographic Breast Density Using Volpara Software

  Baseline to Month 12

• 4-OHT Plasma Levels

  Baseline to Month 12

• 4-OHT Tissue Levels

  Baseline to Month 12

Study Arms (2)

Arm A (placebo)

PLACEBO COMPARATOR

Patients apply placebo gel topically to each breast QD for up to 52 weeks.

Other: Laboratory Biomarker Analysis; Other: Placebo; Other: Questionnaire Administration

Arm B (afimoxifene)

EXPERIMENTAL

Patients apply afimoxifene gel topically to each breast QD for up to 52 weeks.

Drug: Afimoxifene; Other: Laboratory Biomarker Analysis; Other: Questionnaire Administration

Interventions

Afimoxifene DRUG

Applied topically

Also known as: 4-Hydroxy-Tamoxifen, 4-Hydroxytamoxifen, 4-OHT

Arm B (afimoxifene)

Laboratory Biomarker Analysis OTHER

Correlative studies

Arm A (placebo); Arm B (afimoxifene)

Placebo OTHER

Applied topically

Also known as: placebo therapy, PLCB, sham therapy

Arm A (placebo)

Questionnaire Administration OTHER

Ancillary studies

Arm A (placebo); Arm B (afimoxifene)

Eligibility Criteria

• Age: 40 Years - 69 Years
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Women age 40-69 years, or less than 40 years if 5-year breast cancer Gail risk is ≥ 1.66%.
• Mammographically dense breast (heterogeneously dense \[C\] or extremely dense \[D\], based on American College of Radiology \[ACR\] BIRADS fifth edition classification or heterogeneously dense \[3\] or extremely dense \[4\], based on ACR BIRADS fourth edition classification) in either breast
• Eastern Cooperative Oncology Group (ECOG) performance status =\< 1 (Karnofsky \>= 70%)
• White blood cells \>= 3,000/microliter
• Absolute neutrophil count \>= 1,500/microliter
• Platelets \>= 100,000/microliter
• Total bilirubin within normal institutional limits
• Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase \[SGOT\])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 1.5 × institutional upper limit of normal (ULN)
• Creatinine within normal institutional limits
• Participant must have a gynecology examination within the last 3 years, with no atypical hyperplasia and no cancer
• Premenopausal women taking non hormonal intra-uterine device (IUD) birth control method will be eligible, if they have been on the same IUD for at least 3 months prior to enrollment and plan to continue using the same method throughout the study
• Women of child-bearing potential must agree to use a reliable nonhormonal contraceptive method during the study and for 2 months after completing study medications; reliable nonhormonal methods of contraception include barrier contraception and an intra-uterine device (IUD); Note: women who had tubal ligation or had a partner who had undergone a vasectomy (and are monogamous) are eligible for the study and are not required to use barrier contraception
• If the participant is of childbearing potential, she must have a documented negative urine pregnancy test within 7 days prior to randomization
• Willingness to avoid exposing breast skin to natural or artificial sunlight (i.e. tanning beds) for the duration of the study
• Ability to understand and the willingness to sign a written informed consent document

You may not qualify if:

• History of allergic reactions attributed to compounds of similar chemical or biologic composition to 4-OHT gel
• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, thromboembolic disease, or psychiatric illness/social situations that would limit compliance with study requirements
• Pregnant, or had given birth, or nursed at any time during the last 12 months
• Women with a previous history of invasive breast cancer or bilateral ductal carcinoma in situ (DCIS) or current untreated DCIS; women with a history of cancer within the last 3 years, except for non-melanoma skin cancer; women with unilateral DCIS (with or without radiation therapy) are eligible as long as they have an unaffected breast
• Prior bilateral breast surgery (mastectomy, segmental mastectomy, or breast augmentation surgery including breast implants or breast reductions)
• Women with "mosaic mammographic screening views", i.e., whose larger breast size precludes being imaged within a single mammographic screening view
• Women with active liver disease, abnormal uterine bleeding, or prior diagnosis of endometrial hyperplasia
• Prior use of selective estrogen receptor modulators (SERMS) and aromatase inhibitors (AIs) for prevention or therapy
• Skin lesions on the breast that disrupt the stratum corneum (e.g., eczema, ulceration)
• Treatment with any investigational drug or investigational biologic within 30 days of initiating study treatment or during the study

Sponsors & Collaborators

• M.D. Anderson Cancer Center: lead
• National Cancer Institute (NCI): collaborator

Study Sites (5)

Moffitt Cancer Center

Tampa, Florida, 33612, United States

Location

Northwestern University

Chicago, Illinois, 60611, United States

Location

Dana-Farber Cancer Institute

Boston, Massachusetts, 02215, United States

Location

Columbia University/Herbert Irving Cancer Center

New York, New York, 10032, United States

Location

M D Anderson Cancer Center

Houston, Texas, 77030, United States

Location

Related Links

• M D Anderson Cancer Center

MeSH Terms

Interventions

afimoxifene; 4,17 beta-dihydroxy-4-androstene-3-one

Results Point of Contact

• Title: Dr. Banu Arun
• Organization: M D Anderson Cancer Center

barun@mdanderson.org

(713) 792-2817

Study Officials

• Banu Arun, MD

  M.D. Anderson Cancer Center

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 22, 2017
• First Posted: February 24, 2017
• Study Start: January 30, 2018
• Primary Completion: October 26, 2021
• Study Completion: October 26, 2021
• Last Updated: February 22, 2024
• Results First Posted: February 22, 2024

Record last verified: 2024-02

Locations

US (5)