- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT04711109
Untersuchung der Wirkung von Denosumab auf die Vorbeugung von Brustkrebs bei Frauen mit einer BRCA1-Keimbahnmutation (BRCA-P)
BRCA-P: Eine randomisierte, doppelblinde, placebokontrollierte, multizentrische, internationale Phase-3-Studie zur Bestimmung der präventiven Wirkung von Denosumab auf Brustkrebs bei Frauen mit einer BRCA1-Keimbahnmutation
This phase III trial compares denosumab to placebo for the prevention of breast cancer in women with a BRCA1 germline mutation. A germline mutation is an inherited gene change which, in the BRCA1 gene, is associated with an increased risk of breast and other cancers. Denosumab is a monoclonal antibody that is used to treat bone loss in order to reduce the risk of bone fractures in healthy people, and to reduce new bone growths in cancer patients whose cancer has spread to their bones. Research has shown that denosumab may also reduce the risk of developing breast cancer in women carrying a BRCA1 germline mutation.
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Detaillierte Beschreibung
PRIMARY OBJECTIVE:
I. To evaluate the reduction in the risk of any breast cancer (invasive or ductal carcinoma in situ [DCIS]) in women with germline BRCA1 mutation who are treated with denosumab compared to placebo.
SECONDARY OBJECTIVES:
I. To determine the reduction in the risk of invasive breast cancer in women with germline BRCA1 mutation who are treated with denosumab compared to placebo.
II. To determine the reduction in the risk of invasive triple negative breast cancer (TNBC) in women with germline BRCA1 mutation who are treated with denosumab compared to placebo.
III. To determine the reduction in risk of ovarian, fallopian and peritoneal cancers (in women who have not undergone prophylactic bilateral salpingo-oophorectomy [PBSO]) in women with germline BRCA1 mutation who are treated with denosumab compared to placebo.
IV. To determine the reduction in risk of other (i.e. non-breast and nonovarian) malignancies, including those known to be associated with BRCA1 germline mutations in women with germline BRCA1 mutation who are treated with denosumab compared to placebo.
V. To determine the reduction in the risk of clinical fractures in pre- and postmenopausal women with germline BRCA1 mutation who are treated with denosumab compared to placebo.
VI. To compare rates of breast biopsies and rate of benign breast lesions in women with germline BRCA1 mutation who are treated with denosumab compared to placebo.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM A: Patients receive denosumab subcutaneously (SC) every 6 months (q6m) for up to 5 years in the absence of the development of breast cancer or unacceptable toxicity.
ARM B: Patients receive placebo SC q6m for up to 5 years in the absence of the development of breast cancer.
After completion of study treatment, patients are followed up every 12 months for 5 years.
Studientyp
Einschreibung (Geschätzt)
Phase
- Phase 3
Kontakte und Standorte
Studienorte
-
-
California
-
Los Angeles, California, Vereinigte Staaten, 90033
- USC / Norris Comprehensive Cancer Center
-
San Francisco, California, Vereinigte Staaten, 94115
- UCSF Medical Center-Mount Zion
-
-
Colorado
-
Aurora, Colorado, Vereinigte Staaten, 80012
- Rocky Mountain Cancer Centers-Aurora
-
Aurora, Colorado, Vereinigte Staaten, 80045
- UCHealth University of Colorado Hospital
-
Boulder, Colorado, Vereinigte Staaten, 80304
- Rocky Mountain Cancer Centers-Boulder
-
Centennial, Colorado, Vereinigte Staaten, 80112
- Rocky Mountain Cancer Centers - Centennial
-
Denver, Colorado, Vereinigte Staaten, 80218
- Rocky Mountain Cancer Centers-Midtown
-
Denver, Colorado, Vereinigte Staaten, 80220
- Rocky Mountain Cancer Centers-Rose
-
Englewood, Colorado, Vereinigte Staaten, 80113
- Mountain Blue Cancer Care Center - Swedish
-
Englewood, Colorado, Vereinigte Staaten, 80113
- Rocky Mountain Cancer Centers - Swedish
-
Littleton, Colorado, Vereinigte Staaten, 80120
- Rocky Mountain Cancer Centers-Littleton
-
Lone Tree, Colorado, Vereinigte Staaten, 80124
- Rocky Mountain Cancer Centers-Sky Ridge
-
-
District of Columbia
-
Washington D.C., District of Columbia, Vereinigte Staaten, 20007
- MedStar Georgetown University Hospital
-
-
Illinois
-
Chicago, Illinois, Vereinigte Staaten, 60611
- Northwestern University
-
Chicago, Illinois, Vereinigte Staaten, 60637
- University of Chicago Comprehensive Cancer Center
-
Evanston, Illinois, Vereinigte Staaten, 60201
- NorthShore University HealthSystem-Evanston Hospital
-
Highland Park, Illinois, Vereinigte Staaten, 60035
- NorthShore University HealthSystem-Highland Park Hospital
-
Urbana, Illinois, Vereinigte Staaten, 61801
- Carle Cancer Center
-
-
Kansas
-
Overland Park, Kansas, Vereinigte Staaten, 66211
- University of Kansas Hospital-Indian Creek Campus
-
Westwood, Kansas, Vereinigte Staaten, 66205
- University of Kansas Hospital-Westwood Cancer Center
-
-
Maine
-
Scarborough, Maine, Vereinigte Staaten, 04074
- Maine Medical Center- Scarborough Campus
-
South Portland, Maine, Vereinigte Staaten, 04106
- Maine Medical Partners - South Portland
-
-
Maryland
-
Baltimore, Maryland, Vereinigte Staaten, 21287
- Johns Hopkins University/Sidney Kimmel Cancer Center
-
-
Massachusetts
-
Boston, Massachusetts, Vereinigte Staaten, 02215
- Beth Israel Deaconess Medical Center
-
Boston, Massachusetts, Vereinigte Staaten, 02215
- Dana-Farber Cancer Institute
-
-
Michigan
-
Ann Arbor, Michigan, Vereinigte Staaten, 48109
- University of Michigan Comprehensive Cancer Center
-
Grand Rapids, Michigan, Vereinigte Staaten, 49503
- Corewell Health Grand Rapids Hospitals - Butterworth Hospital
-
-
Minnesota
-
Rochester, Minnesota, Vereinigte Staaten, 55905
- Mayo Clinic in Rochester
-
Saint Paul, Minnesota, Vereinigte Staaten, 55101
- Regions Hospital
-
-
Nevada
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Las Vegas, Nevada, Vereinigte Staaten, 89148
- OptumCare Cancer Care at Fort Apache
-
-
New York
-
New York, New York, Vereinigte Staaten, 10065
- Memorial Sloan Kettering Cancer Center
-
New York, New York, Vereinigte Staaten, 10032
- NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
-
-
North Carolina
-
Charlotte, North Carolina, Vereinigte Staaten, 28204
- Novant Health Presbyterian Medical Center
-
Greensboro, North Carolina, Vereinigte Staaten, 27403
- Novant Health Breast Surgery - Greensboro
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Kernersville, North Carolina, Vereinigte Staaten, 27284
- Novant Health Cancer Institute - Kernersville
-
Mount Airy, North Carolina, Vereinigte Staaten, 27030
- Novant Health Cancer Institute - Mount Airy
-
Thomasville, North Carolina, Vereinigte Staaten, 27360
- Novant Health Cancer Institute - Thomasville
-
Winston-Salem, North Carolina, Vereinigte Staaten, 27103
- Novant Health Forsyth Medical Center
-
-
North Dakota
-
Fargo, North Dakota, Vereinigte Staaten, 58122
- Sanford Roger Maris Cancer Center
-
-
Ohio
-
Columbus, Ohio, Vereinigte Staaten, 43210
- Ohio State University Comprehensive Cancer Center
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, Vereinigte Staaten, 19104
- University of Pennsylvania/Abramson Cancer Center
-
Pittsburgh, Pennsylvania, Vereinigte Staaten, 15232
- University of Pittsburgh Cancer Institute (UPCI)
-
-
Texas
-
Dallas, Texas, Vereinigte Staaten, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Houston, Texas, Vereinigte Staaten, 77030
- M D Anderson Cancer Center
-
-
Utah
-
Salt Lake City, Utah, Vereinigte Staaten, 84112
- Huntsman Cancer Institute/University of Utah
-
-
Vermont
-
Burlington, Vermont, Vereinigte Staaten, 05401
- University of Vermont Medical Center
-
-
Virginia
-
Richmond, Virginia, Vereinigte Staaten, 23298
- Virginia Commonwealth University/Massey Cancer Center
-
-
Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
- Women with a confirmed deleterious or likely deleterious BRCA 1 germline mutation (variant class 4 or 5)
- Age >= 25 years and =< 55 years at randomization
- No evidence of breast cancer by MRI or mammography (MG) and clinical breast examination within the last 6 months prior to randomization
- No clinical evidence of ovarian cancer at randomization
- Negative pregnancy test at randomization for women of childbearing potential
- No preventive breast surgery planned at time of randomization
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Written informed consent before any study-specific procedure is performed
Exclusion Criteria:
-
Prior bilateral mastectomy
-
History of ovarian cancer (including fallopian and peritoneal cancer)
-
History of breast cancer
-
History of invasive cancer except for basal cell or squamous cell skin cancer or carcinoma in situ of the cervix, stage 1 papillary or follicular thyroid cancer, atypical hyperplasia or LCIS (lobular carcinoma in situ)
-
Pregnant or lactating women (within the last 2 months prior to randomization)
-
Unwillingness to use highly effective contraception method during and within at least 5 months after cessation of denosumab/placebo therapy in women of childbearing potential. (Note: Women of childbearing potential should be monitored for pregnancy prior to each denosumab/placebo injection)
-
Clinically relevant hypocalcemia (history and current condition), or serum calcium < 2.0 mmol/L (< 8.0 mg/dL)
* Hypocalcemia defined by calcium below the normal range (a single value below the normal range does not necessarily constitute hypocalcemia, but should be 'corrected' before dosing the subject). Monitoring of calcium level in regular intervals (usually prior to investigational product [IP] administration) is highly recommended
-
Tamoxifen, raloxifene or aromatase inhibitor use during the last 3 months prior to randomization or for a duration of more than 3 years in total (current and prior hormone replacement therapy [HRT] is permitted)
-
Prior use of denosumab
-
Subject has a known prior history or current evidence of osteonecrosis or osteomyelitis of the jaw, or an active dental/jaw condition which requires oral surgery including tooth extraction within 3 months of enrollment
-
Concurrent treatment with a bisphosphonate or an anti-angiogenic agent
-
Any major medical or psychiatric condition that may prevent the subject from completing the study
-
Known active infection with hepatitis B virus or hepatitis C virus
-
Known infection with human immunodeficiency virus (HIV)
-
Use of any other investigational product (current or prior aspirin or non-steroidal anti-inflammatory drugs [NSAIDs] are permitted)
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Verhütung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Doppelt
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
|---|---|
|
Experimental: Arm A (denosumab)
Patients receive denosumab SC q6m for up to 5 years in the absence of disease progression or unacceptable toxicity. |
Ancillary studies Given SC |
|
Placebo-Komparator: Arm B (placebo)
Patients receive placebo SC q6m for up to 5 years in the absence of disease progression. |
Ancillary studies Given SC |
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Time to the occurrence of any breast cancer (invasive or ductal carcinoma in situ [DCIS])
Zeitfenster: From randomization to the occurrence of breast cancer (invasive or DCIS), assessed up to 5 years
|
Time to breast cancer (invasive or DCIS) will be compared between the two treatment arms using a stratified Cox proportional hazards regression model. |
From randomization to the occurrence of breast cancer (invasive or DCIS), assessed up to 5 years
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Time to invasive breast cancer
Zeitfenster: Up to 5 years post treatment
|
Will be compared between the two treatment arms using a stratified Cox proportional hazards regression model. |
Up to 5 years post treatment
|
|
Time to invasive triple negative breast cancer
Zeitfenster: Up to 5 years post treatment
|
Will be compared between the two treatment arms using a stratified Cox proportional hazards regression model. |
Up to 5 years post treatment
|
|
Time to ovarian, fallopian and peritoneal cancer (in women who have not undergone prophylactic bilateral salpingo-oophorectomy)
Zeitfenster: Up to 5 years post treatment
|
Will be compared between the two treatment arms using a stratified Cox proportional hazards regression model. Time to ovarian cancer will be analyzed in the overall group and in different strata (oral contraceptive use, hormone replacement therapy use, and menopausal status). |
Up to 5 years post treatment
|
|
Time to other (nonbreast or ovarian cancer) malignancies, including those known to be associated with BRCA1 mutations
Zeitfenster: Up to 5 years post treatment
|
Will be compared between the two treatment arms using a stratified Cox proportional hazards regression model. |
Up to 5 years post treatment
|
|
Time to clinical fractures in pre- and postmenopausal women
Zeitfenster: Up to 5 years post treatment
|
Will be compared between the two treatment arms using a stratified Cox proportional hazards regression model. |
Up to 5 years post treatment
|
|
Frequency of breast biopsies
Zeitfenster: Up to 5 years post treatment
|
May be recommended as part of care based on a finding on mammogram, MRI, ultrasound or physical exam performed as part of monitoring for breast cancer. Will be compared between the two treatment arms via chi-square analysis. |
Up to 5 years post treatment
|
|
Frequency of benign breast lesions
Zeitfenster: Up to 5 years post treatment
|
May be recommended as part of care based on a finding on mammogram, MRI, ultrasound or physical exam performed as part of monitoring for breast cancer. Will be compared between the two treatment arms via chi-square analysis. |
Up to 5 years post treatment
|
|
Assess incidence, nature and severity of adverse events (AEs) using the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0
Zeitfenster: Up to 5 years post treatment
|
Overall toxicity rates (percentages) for grade 3 or higher adverse events considered at least possibly related to treatment will be reported per treatment arm. |
Up to 5 years post treatment
|
Mitarbeiter und Ermittler
Ermittler
- Studienstuhl: Judy E. Garber, MD, MPH, Dana-Farber Cancer Institute
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Primärer Abschluss (Geschätzt)
Studienabschluss (Geschätzt)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Neubildungen nach Standort
- Hautkrankheiten
- Haut- und Bindegewebserkrankungen
- Neubildungen
- Neoplasien der Brust
- Brusterkrankungen
- Aminosäuren, Peptide und Proteine
- Proteine
- Antikörper, monoklonal, humanisiert
- Antikörper, monoklonal
- Antikörper
- Immunglobuline
- Immunoproteine
- Blutproteine
- Serumglobuline
- Globuline
- Denosumab
Andere Studien-ID-Nummern
- A211801
- UG1CA189823 (US NIH Stipendium/Vertrag)
- NCI-2020-11358 (Registrierungskennung: NCI Clinical Trial Reporting Program)
- 2017-002505-35 (EudraCT-Nummer)
- ABCSG 50 (Andere Kennung: Austrian Breast & Colorectal Cancer Study Group)
- 2017 (US NIH Stipendium/Vertrag)
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