Aromatase Inhibitor Host Factors Study
12. mai 2021 oppdatert av: Samuel Lunenfeld Research Institute, Mount Sinai Hospital
Patient-related Predictors of Estrogen Suppression in Postmenopausal Women Using Adjuvant Letrozole
The purpose of this study is to examine how key patient factors, including body size affect how well letrozole suppresses circulating estrogen levels.
This study has two components: (1) Part A - an observational phase to evaluate the impact of vitamin D and obesity on estrogen suppression in post-menopausal women already receiving letrozole treatment, and (2) Part B - an interventional phase for women with body mass index (BMI) > 25 kg/m2 to assess the effect of double AI dose on estrogen levels.
If BMI or other patient factors reduce the effectiveness of letrozole, modifications to treatment recommendations and studies to test higher dosing of letrozole may be needed to maximize the benefit of this treatment and minimize the risk of the breast cancer coming back.
Studieoversikt
Detaljert beskrivelse
The available evidence suggests that circulating estradiol levels play a critical role in determining effectiveness of aromatase inhibitor therapy, and that maximal suppression of aromatase activity and estrogen production is essential for optimal disease control.
Host factors such as high 25-Hydroxy Vitamin D (25-OH D) levels and obesity, which might increase residual estrogen levels, could adversely impact outcome and lead to an increased risk of recurrence or death.
The primary objective of Part A (which includes women regardless of BMI) is to directly evaluate the relationship between (i) 25-OH D levels and serum estrogen levels and (ii) BMI and serum estrogen levels in a cohort of postmenopausal women on standard dose letrozole therapy (2.5 mg/day).
Part B (which includes only women with BMI > 25 kg/m2) will determine whether an increased dose of letrozole (5 mg/day), which had no dose limiting side effects in a Phase I study improves suppression of estrogen in overweight/obese women.
Studietype
Intervensjonell
Registrering (Faktiske)
121
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
-
-
Ontario
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Toronto, Ontario, Canada, M5G 1X5
- Mount Sinai Hospital
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Toronto, Ontario, Canada, M5G 1M9
- Princess Margaret Hospital
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Toronto, Ontario, Canada, M5S 1B1
- Women's College Hospital
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-
Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Barn
- Voksen
- Eldre voksen
Tar imot friske frivillige
Nei
Kjønn som er kvalifisert for studier
Hunn
Beskrivelse
Inclusion Criteria:
- Postmenopausal female patients
- histological confirmed diagnosis of estrogen receptor and/or progesterone receptor positive breast cancer (Stage I-III) who have completed local therapy
- Currently prescribed and taking letrozole 2.5 mg daily for a minimum of 3 months
- Willing to provide written informed consent to participate
- for the experimental arm: all of the above and body mass index (BMI) > 25 kg/m2
Exclusion Criteria:
Known abnormal liver or renal function defined by:
- Serum Creatinine > 1.25 times institutional upper limit of normal (ULN) or Calculated Creatinine Clearance < 40 mL/min
- Serum Bilirubin, Aspartate transaminase (AST) or alanine transaminase (ALT) > 1.5 times ULN
- Presence of persistent local or known metastatic cancer
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: N/A
- Intervensjonsmodell: Enkeltgruppeoppdrag
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Annen: Post-menopausal Women Using Adjuvant Letrozole
Part A Routine Care Letrozole; Part B Double Dose Letrozole in overweight/obese participants
|
Part A Monitor standard of care letrozole use for 28 days; measure blood levels of estrogens and vitamin D at start and end of period.
Part B In overweight/obese participants who completed Part A, provide a double dose of letrozole and monitor use for 28 days; measure blood levels of estrogens and vitamin D at start and end of period.
Andre navn:
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Part A Correlation of Day 29 Estradiol With BMI
Tidsramme: Day 29
|
Determine if estradiol levels vary with BMI levels after 28 days of monitored adherence to standard dose letrozole, by calculating the Pearson correlation between estradiol and log-transformed BMI
|
Day 29
|
|
Part A Correlation of Day 29 Estrone With BMI
Tidsramme: Day 29
|
Determine if estrone levels vary with BMI levels after 28 days of monitored adherence to standard dose letrozole, by calculating the Pearson correlation between estrone and log-transformed BMI
|
Day 29
|
|
Part A Correlation of Day 29 Estradiol With Vitamin D
Tidsramme: Day 29
|
Determine if estradiol levels vary with Vitamin D levels levels after 28 days of monitored adherence to standard dose letrozole, by calculating the Pearson correlation between estradiol and log-transformed Vitamin D level
|
Day 29
|
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Part A Correlation of Day 29 Estrone With Vitamin D
Tidsramme: Day 29
|
Determine if estrone levels vary with Vitamin D levels levels after 28 days of monitored adherence to standard dose letrozole, by calculating the Pearson correlation between estrone and log-transformed Vitamin D level
|
Day 29
|
|
Part B Change in Estradiol Level After Double Dose of Letrozole
Tidsramme: Day 29 to Day 58
|
In overweight/obese patients enrolled in part B, determine if blood levels of estradiol levels changed from before to after the double dose of letrozole
|
Day 29 to Day 58
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Plasma Letrozole
Tidsramme: Day 29 and day 58
|
Day 29 and day 58
|
|
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Endocrine Symptoms During Part A of Study
Tidsramme: baseline, day 29 (end of part A)
|
Functional Assessment of Cancer Therapy - Endocrine Sub-scale (FACT-ES) consists of 19 questions answered of a Likert scale.
The sub-scale score ranges from 0 to 76 and the higher the score the better the quality of life
|
baseline, day 29 (end of part A)
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Endocrine Symptoms During Part B of the Study
Tidsramme: day 29 (end of part A) and day 58 (end of part B)
|
Functional Assessment of Cancer Therapy - Endocrine Sub-scale (FACT-ES) consists of 19 questions answered of a Likert scale.
The sub-scale score ranges from 0 to 76 and the higher the score the better the quality of life
|
day 29 (end of part A) and day 58 (end of part B)
|
Andre resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Musculoskeletal Symptoms
Tidsramme: baseline (day 1), day 29 (end of part A) and day 58 (end of part B)
|
baseline (day 1), day 29 (end of part A) and day 58 (end of part B)
|
Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Etterforskere
- Hovedetterforsker: Srikala Sridhar, M.D., Princess Margaret Hospital, Canada
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart (Faktiske)
1. oktober 2012
Primær fullføring (Faktiske)
1. desember 2016
Studiet fullført (Faktiske)
1. desember 2016
Datoer for studieregistrering
Først innsendt
15. august 2012
Først innsendt som oppfylte QC-kriteriene
16. august 2012
Først lagt ut (Anslag)
21. august 2012
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
13. mai 2021
Siste oppdatering sendt inn som oppfylte QC-kriteriene
12. mai 2021
Sist bekreftet
1. mai 2017
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
- Hudsykdommer
- Neoplasmer
- Neoplasmer etter nettsted
- Bryst sykdommer
- Brystneoplasmer
- Fysiologiske effekter av legemidler
- Molekylære mekanismer for farmakologisk virkning
- Enzymhemmere
- Antineoplastiske midler
- Hormoner, hormonsubstitutter og hormonantagonister
- Hormonantagonister
- Aromatasehemmere
- Steroidesyntesehemmere
- Østrogenantagonister
- Letrozol
Andre studie-ID-numre
- AI Host Factors
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
JA
IPD-planbeskrivelse
The data supporting the related manuscript are kept in institutional file storage on an internal server at Lunenfeld-Tanenbaum Research Institute. There are de-identification concerns in small, regionally restricted, clinical datasets which prevent these data being openly available, but data will be made available at reasonable request from the corresponding author for up to and including 5 years from publication of the related manuscript.
For all data requests please contact:
Dr David Cescon, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada. Dave.Cescon@uhn.ca
IPD-delingstidsramme
Up to and including 5 years from publication of the related manuscript (Elliott, Mitchell J et al. "Association between BMI, vitamin D, and estrogen levels in postmenopausal women using adjuvant letrozole: a prospective study."
NPJ breast cancer vol.
6 22. 12 Jun.
2020)
Tilgangskriterier for IPD-deling
Reasonable request
IPD-deling Støtteinformasjonstype
- STUDY_PROTOCOL
- SEVJE
- ICF
- CSR
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