- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02936206
Examination of Breast Cancer Cells of Pre-menopausal and Post-menopausal Women Before and After Exposure to Tamoxifen or Fulvestrant.
April 27, 2021 updated by: Amy Tiersten, Icahn School of Medicine at Mount Sinai
Comparison in the Change of Proliferation Index Between Fulvestrant and Tamoxifen in Cyclin D1 +, Estrogen Receptor + Breast Cancer
The purpose of this study is to microscopically examine breast cancer cells of pre-menopausal and post-menopausal women before and after exposure to one of the two commonly used breast cancer drugs, tamoxifen or fulvestrant.
Study Overview
Status
Terminated
Conditions
Intervention / Treatment
Detailed Description
The researchers hypothesize that the cyclinD1-interactome can be used to orient the use of fulvestrant in premenopausal and postmenopausal women.
To test this hypothesis, the researchers propose a pre-surgical randomized clinical trial of tamoxifen vs fulvestrant in the window between breast cancer diagnosis on core biopsy and definitive surgery.
Women with ER/cyclinD1 positive tumors will be eligible.
Response to tamoxifen or fulvestrant will be evaluated using standard proliferation index as well as gene expression signatures obtained in pre-clinical models of tamoxifen resistance and sensitivity to fulvestrant.
In addition, the researchers propose to use cutting edge new technology allowing ex-vivo expansion of primary culture from only a few cancer cells obtained by fine needle biopsy.
The researchers propose to compare the response of these primary cells to patient response.
If successful, the impact of this work can support the expansion of use of fulvestrant to not only postmenopausal women but premenopausal women as well.
In addition, it may serve as a proof of principle to maximize the use of biopsy material to predict treatment response
Study Type
Interventional
Enrollment (Actual)
2
Phase
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
New York
-
New York, New York, United States, 10029
- Icahn School of Medicine at Mount Sinai
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New York, New York, United States, 10019
- Mount Sinai West
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New York, New York, United States, 10025
- Mount Sinai St. Luke's
-
-
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
Inclusion Criteria:
- Written informed consent prior to beginning specific protocol procedures, including expected cooperation of the patients for the study treatment regimen and follow-up, must be obtained and documented according to the local regulatory requirements
- Adult women greater than 18 years old
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2
New diagnosis of invasive cyclin D1 +, ER+, PR +/-, Her2- breast cancer
- Cyclin D1 positive as defined as a total immunohistochemical score of 5 or greater
- Hormone receptor positive as defined as ≥ 10% positive stained cells
- HER2-normal (IHC score 0-1 or FISH negative [in-situ hybridization (ISH) ratio <= 2.0 status])
- Tumor size at least 5 mm with planned primary surgery at Mount Sinai
- A negative urine dipstick pregnancy test
Exclusion Criteria:
- Estrogen receptor negative invasive breast carcinoma as defined as less than 10% stained cells
- Prior antiestrogen therapy
- Tumor size less than 5 mm
- Prior diagnosis of thrombosis or known hypercoagulable state
- Known history of bleeding diathesis
- Known liver disease
- Prior treatment with neoadjuvant therapy
- Inflammatory breast cancer defined as clinically significant erythema of the breast and/or documented dermal lymphatic invasion (not direct skin invasion by tumor or peau d'orange without erythema).
- Current severe or uncontrolled systemic disease
- Pregnancy or lactation period. Patients of childbearing potential must implement adequate non-hormonal contraceptive measures (barrier methods, intrauterine contraceptive devices) during study treatment.
- Prior malignancy (including invasive or ductal in-situ breast cancer) within 5 years prior to randomization, except curatively treated basal cell carcinoma of the skin and carcinoma in situ of the cervix.
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: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Fulvestrant
750 mg injection in 3 divided doses
|
fulvestrant 750 mg (three 5 ml injections slowly over 1-2 mn per injection in the buttocks) on day 1 only
Other Names:
|
Active Comparator: Tamoxifen
20mg orally
|
14 days of treatment with tamoxifen 20mg orally each day
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Ki67 Cell Percentage
Time Frame: baseline and 2 weeks
|
The change in proliferation index as measured by the percentage of cells staining for Ki67 at 2 weeks as compared on baseline.
|
baseline and 2 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Estrogen Receptor Level
Time Frame: baseline and 2 weeks
|
The change in estrogen receptor level at 2 weeks as compared to baseline.
|
baseline and 2 weeks
|
Change in Progesterone Receptor Level
Time Frame: baseline and 2 weeks
|
The change in progesterone receptor level at 2 weeks as compared to baseline.
|
baseline and 2 weeks
|
Incidence of Tamoxifen-resistance Gene Expression
Time Frame: 2 weeks
|
Number of tamoxifen-resistance gene expression signature observed in patients with cyclinD1 overexpressing breast cancers.
|
2 weeks
|
Incidence of Fulvestrant-sensitivity Gene Expression
Time Frame: 2 weeks
|
Number of fulvestrant-sensitivity gene expression signature observed in patients with cyclinD1 overexpressing breast cancers.
|
2 weeks
|
Drug Dose Level
Time Frame: 2 weeks
|
For samples that are available for culture in vivo, proliferation assay to test whether the cells derived from individual patients respond the same as the tumor in vivo in the same patient.
|
2 weeks
|
Percentage of Cells Staining Positive Within the Breast Tumor
Time Frame: 2 weeks
|
Differential treatment effect for pre and post menopausal subjects assessed by the mean change in levels (expressed as a percentage of cells staining positive within the breast tumor) of ER (and PR) between pre-treatment and post-treatment stratified by menopausal status.
|
2 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
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
October 1, 2016
Primary Completion (Actual)
May 1, 2020
Study Completion (Actual)
May 1, 2020
Study Registration Dates
First Submitted
October 14, 2016
First Submitted That Met QC Criteria
October 14, 2016
First Posted (Estimate)
October 18, 2016
Study Record Updates
Last Update Posted (Actual)
May 19, 2021
Last Update Submitted That Met QC Criteria
April 27, 2021
Last Verified
April 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Skin Diseases
- Neoplasms
- Neoplasms by Site
- Breast Diseases
- Breast Neoplasms
- Physiological Effects of Drugs
- Antineoplastic Agents
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Hormone Antagonists
- Bone Density Conservation Agents
- Estrogen Antagonists
- Estrogen Receptor Antagonists
- Selective Estrogen Receptor Modulators
- Estrogen Receptor Modulators
- Fulvestrant
- Tamoxifen
Other Study ID Numbers
- GCO 16-1470
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
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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