S0308 Zoledronate or Ibandronate in Preventing Bone Problems in Women With Stage IV Breast Cancer That Has Spread to the Bone

November 11, 2013 updated by: Southwest Oncology Group

A Phase III Randomized, Multicenter Non-Inferiority Trial Evaluating the Efficacy of Oral Ibandronate Versus Intravenous Zoledronate in the Reduction of Skeletal-Related Events in Patients With Metastatic Breast Cancer

RATIONALE: Zoledronate and ibandronate may prevent or help relieve bone pain and other symptoms caused by bone metastases. It is not yet known whether zoledronate is more effective than ibandronate in preventing bone problems caused by bone metastases due to breast cancer.

PURPOSE: This randomized phase III trial is studying zoledronate to see how well it works compared to ibandronate in preventing bone problems in women with stage IV breast cancer that has spread to the bone.

Study Overview

Detailed Description

OBJECTIVES:

Primary

  • Compare the efficacy of zoledronate vs ibandronate, in terms of preventing the occurrence of skeletal-related events (SRE) (e.g., fracture, spinal cord compression, radiotherapy or surgery for bone symptoms or events, or hypercalcemia ≥ grade 3), in women with stage IV breast cancer and bone metastases.

Secondary

  • Compare the change in patient-reported measures of pain and use of analgesics in patients treated with these drugs.
  • Compare the time to first clinically apparent SRE in patients treated with these drugs.
  • Compare the toxicity of these drugs.
  • Compare the changes in performance status and overall survival of patients treated with these drugs.

OUTLINE: This is a multicenter, randomized study. Patients are stratified according to hormone receptor status (estrogen receptor [ER] and progesterone receptor [PR] negative vs ER and/or PR positive) and current evidence of fracture (vertebral or nonvertebral) or spinal compression (yes vs no). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive oral ibandronate once daily on days 1-28.
  • Arm II: Patients receive zoledronate IV over 15 minutes on day 1. In both arms, treatment repeats every 28 days for up to 18 courses in the absence of unacceptable toxicity.

Quality of life and pain are assessed at baseline, every 3 courses during study treatment, and at the end of study treatment.

After completion of study treatment, patients are followed periodically for up to 3 years.

PROJECTED ACCRUAL: A total of 488 patients will be accrued for this study.

Study Type

Interventional

Phase

  • Phase 3

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

DISEASE CHARACTERISTICS:

  • Histologically confirmed stage IV breast cancer at primary diagnosis or at recurrence

    • Any T, any N, M1
  • At least 1 dominant osteolytic or osteoblastic or mixed metastatic lesion outside any prior radiation field

    • Lesion measures ≥ 1.0 cm by x-ray, CT scan, and/or MRI
  • Controlled asymptomatic brain metastases allowed
  • Controlled bone pain, defined as a physician/health care provider rating of ≤ grade 2 pain-SELECT (Bone) on the NCI CTC for Adverse Events Version 3.0 rating scale, required
  • Current evidence of vertebral or nonvertebral fractures or spinal compression due to cancer, as determined by the treating physician, allowed
  • No Paget's disease of the bone
  • Estrogen receptor (ER) or progesterone receptor (PR) status known

PATIENT CHARACTERISTICS:

  • Female patient
  • Menopausal status not specified
  • Zubrod performance status 0-2
  • Creatinine normal
  • Creatinine clearance ≥ 60 mL/min
  • Serum calcium < 12 mg/dL
  • Not pregnant or nursing
  • Fertile patients must use effective contraception
  • Must be able to receive IV medication and oral medication (i.e., must have physical integrity of the upper gastrointestinal tract)
  • No malabsorption syndrome
  • No primary hyperparathyroidism
  • No known history of aspirin-sensitive asthma
  • No other prior malignancy except for the following:

    • Adequately treated basal cell or squamous cell skin cancer
    • In situ cervical cancer
    • Adequately treated stage I or II cancer currently in complete remission
    • Any other cancer for which the patient has been disease-free for at least 5 years
  • No uncontrolled medical illness or infection, including, but not limited to, the following:

    • Unstable angina
    • Recent myocardial infarction
    • Life-threatening cardiac arrhythmia

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No prior bisphosphonates for metastatic bone disease
  • More than 28 days since prior aminoglycoside antibiotics
  • At least 28 days since prior oral bisphosphonates for osteoporosis
  • More than 6 months since prior bisphosphonates used for adjuvant therapy
  • Concurrent treatment, including chemotherapy, hormonal therapy, and/or biologic therapy for metastatic breast cancer allowed
  • No concurrent participation in another clinical treatment trial for this cancer unless the patient is no longer receiving the intervention and is in the follow-up phase of the other clinical trial

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: SUPPORTIVE_CARE
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: zoledronate
Other Names:
  • zoledronic acid
EXPERIMENTAL: ibandronate
Other Names:
  • ibandronate sodium

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Skeletal-related events (SRE)

Secondary Outcome Measures

Outcome Measure
Change in patient's rating of worst pain as measured by the Brief Pain Inventory
Survival and time to first clinically apparent SRE
Tolerability and toxicity as measured by NCI CTCAE v3.0
Changes in performance status

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Study Chair: Saul E. Rivkin, MD, Swedish Cancer Institute at Swedish Medical Center - First Hill Campus

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

May 1, 2006

Primary Completion (ACTUAL)

May 1, 2006

Study Completion (ACTUAL)

May 1, 2006

Study Registration Dates

First Submitted

March 9, 2006

First Submitted That Met QC Criteria

March 9, 2006

First Posted (ESTIMATE)

March 13, 2006

Study Record Updates

Last Update Posted (ESTIMATE)

November 13, 2013

Last Update Submitted That Met QC Criteria

November 11, 2013

Last Verified

November 1, 2013

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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