The Role of Simvastatin in The Epithelial-Mesenchymal Transition Process of Breast Cancer
Vimentin Expression-based Therapeutic Response in Triple Negative Breast Cancer Receiving Combination of Simvastatin and NAC: A Randomized, Double-Blind, Placebo-Controlled Trial
Introduction: Most cases of Triple Negative Breast Cancer (TNBC) have a high proliferation rate. TNBC is associated with a poor prognosis, a high recurrence rate, and a high incidence of distant metastases. The Epithelial-Mesenchymal Transition process (EMT) plays an essential role in the metastatic process. EMT markers were also more abundant in TNBC and contributed to a poorer TNBC prognosis. As an important EMT marker, the increased expression of vimentin also contributed to the increase in TNBC aggressiveness and resistance to chemotherapeutic agents. Through the mechanism of action in inhibiting the mevalonate pathway, statins can help inhibit the EMT process in metastases. Notably, simvastatin promotes the down-regulation of vimentin in breast cancer cells. The combination of statins and neoadjuvant chemotherapy (NAC) improves the cancer patient's response. This study is expected to evaluate the role of a combination between NAC and simvastatin on therapeutic response in TNBC patients through vimentin expression.
Methods: This study is a double-blind, randomized, placebo-controlled trial conducted in Dr. Cipto Mangunkusumo National Central General Hospital. An expected total of 26 TNBC patients will be assessed for eligibility and asked for informed consent. Patients with the plan to have ACT (Doxorubicin hydrochloride, Cyclophosphamide, Paclitaxel) chemotherapy regimen will receive either a combination of ACT-Simvastatin (40 mg/day) or ACT-Placebo. The biopsy will be taken pre-NAC to make the histopathological diagnosis and examine the expression of vimentin. Patients will be evaluated for adverse effects reaction every cycle and the clinical response after 8 cycles. The post-intervention biopsy will be conducted after the cycle finish. The pathological response and vimentin expression will be reviewed from the obtained samples.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Erwin D Yulian, MD
- Telefonnummer: +6281315249627
- E-mail: erwin.yulian@ui.ac.id
Studiesteder
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DKI Jakarta
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Jakarta Pusat, DKI Jakarta, Indonesien, 10430
- Rekruttering
- Dr. Cipto Mangunkusumo National Central General Hospital
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Kontakt:
- Erwin D Yulian, MD
- Telefonnummer: +6281315249627
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Female patients with advanced breast cancer (locally advanced and distantly advanced) with triple-negative molecular type confirmed by biopsy and immunohistochemical examination.
- The patient planned to receive 8 cycles of AC-T chemotherapy.
- Patient age > 18 years.
- Willing to participate in research by signing informed consent.
Exclusion Criteria:
- The patient is pregnant or breastfeeding.
- Patients who have received chemotherapy or are on simvastatin therapy.
- Allergy to statins.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Firedobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: Simvastatin
The group received standard treatment with simvastatin 40mg in capsule by oral route, once a day, for 21 days (every cycle of the chemotherapy regiment) |
The administration of Simvastatin 40 mg in addition to ACT regiment of neoadjuvant chemotherapy
Andre navne:
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Placebo komparator: Placebo
The group received standard treatment with placebo 40mg in capsule by oral route, once a day, for 21 days (every cycle of the chemotherapy regiment) |
The administration of Placebo capsule 40 mg in addition to ACT regiment of neoadjuvant chemotherapy
Andre navne:
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Vimentin Expression
Tidsramme: 6 months
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Vimentin expression is measured based on Histoscore (H-Score) with immunohistochemistry examination:
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6 months
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Pathological Response
Tidsramme: 6 months
|
Pathological Response as Measured by Miller-Payne system Evaluation before and after chemotherapy, divided into:
|
6 months
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Clinical Response
Tidsramme: 6 months
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Clinical response based on WHO (World Health Organization) criteria:
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6 months
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Erwin D Yulian, MD, Surgical Oncology Division, Department of Surgery, Universitas Indonesia
- Studieleder: Tantri Hellyanti, MD, Department of Pathological Anatomy, Universitas Indonesia
- Studiestol: Shabrina Adzania, MD, Research Assistant, Department of Surgery, Universitas Indonesia
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Neoplasmer efter sted
- Neoplasmer
- Hudsygdomme
- Brystsygdomme
- Brystneoplasmer
- Hud- og bindevævssygdomme
- Tredobbelt negative brystneoplasmer
- Organiske kemikalier
- Kulbrinter
- Kulbrinter, cyklisk
- Naphthalenes
- Polycykliske aromatiske kulbrinter
- Kulbrinter, aromatisk
- Polycykliske forbindelser
- Lovastatin
- Simvastatin
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- IndonesiaU2022
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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