En studie för att se om östrogen kan bromsa tillväxten av vissa akuta bröstcancer (PRESTO)
Preoperativ ESTradiOl Window of Opportunity-studie i postmenopausala kvinnor med nyligen diagnostiserad ER-positiv bröstcancer
Some breast cancers have estrogen receptors (ER+). The investigators know that some ER+ tumours can be cured by hormone therapy alone while other ER+ breast cancers cannot. Currently, there is no perfect way to tell these groups apart nor do the investigators know why some respond when others do not.
Research findings suggest that the two types of ER+ breast cancers differ in their response to estrogen with estrogen being toxic to one type and not the other. For those tumours that find estrogen toxic, this may explain why tumours only start to grow when estrogen levels decrease after menopause.
The purpose of this study is to see whether a two-week treatment of estrogen equal to pre-menopausal estrogen levels will decrease the rate at which patients' ER+ tumours grow. This will be done by comparing the growth rate in the tissue removed during standard of care surgery after patients have been treated with 7-14 days of estrogen prior to that surgery.
Studieöversikt
Status
Betingelser
Intervention / Behandling
Detaljerad beskrivning
Breast cancer is a heterogeneous disease that includes two ER+ genetic subtypes (luminal A and luminal B) that differ in their response to treatment.
Results from the Women's Health Initiative Trial showed that estrogen treated hysterectomized women with no prior history of breast cancer had a significant and persistent decrease in breast cancer incidence when compared to placebo treated participants. This implies that some ER+ breast cancers are in fact growth inhibited by estrogens and are not growth promoted.
The hypothesis of this study is that some ER+ breast cancers (luminal A) are actually sensitive (growth inhibited) by estrogen.
Objectives:
- To assess changes in breast cancer proliferation after a 7-14 day trial of estradiol in newly diagnosed estrogen receptor positive post-menopausal breast cancer patients prior to surgery.
- Exploratory analysis of biologic correlates with comparison to available genotyping tests.
This is an open-label single group assignment pilot study for safety/efficacy and exploratory biologic correlates
Studietyp
Inskrivning (Faktisk)
Fas
- Fas 2
Kontakter och platser
Studieorter
-
-
Alberta
-
Edmonton, Alberta, Kanada, T6G 1Z2
- Cross Cancer Institute
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:
- Female gender
- Estrogen receptor positive (ER+) breast cancer
- HER2 negative breast cancer
- Post-menopausal by greater than 5 years
- No previous hormonal replacement therapy
- Low to intermediate histologic grade
- ECOG Performance status of 0 of 1
- Adequate hematological, renal and hepatic function is required
- Ability to take oral medication
- Patient must have adequate tissue for diagnosis, biomarkers and Ki67 assays
Exclusion Criteria:
- Pre-menopausal women
- Locally advanced or metastatic breast cancer
- Current, previous or planning for pre-operative treatment with chemotherapy, hormone therapy including corticosteroids, radiation therapy for malignancy or other condition
- Known hypersensitivity or intolerance to estradiol
- Ischemic changes on baseline electrocardiogram
- Symptomatic but untreated cholelithiasis
- History of deep vein thrombosis, pulmonary embolism, stroke, acute myocardial infarction, congestive cardiac failure, untreated hypertension or known inherited hypercoagulable disorder
- Undiagnosed abnormal vaginal bleeding or prior history of endometrial cancer
- Untreated metabolic disturbances (glucose > 15.0 mmol/L and triglycerides > 400 mg/dL)
- Current treatment with drugs known to be moderate or strong inhibitors of inducers of isoenzyme CYP3A4
- The time between study enrolment and definitive breast surgery is not sufficient for administration of at least 7 days of estradiol
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: N/A
- Interventionsmodell: Enskild gruppuppgift
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: Estradiol treatment
Estradiol 6 mg daily for 7-14 days |
Eligible participants will take 2 mg Estradiol 3 times daily for 7-14 days pre-surgery.
Andra namn:
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Tidsram |
|---|---|
|
Att bedöma förändringar i bröstcancerproliferation efter en 7-14 dagars försök med östradiol hos nyligen diagnostiserade östrogenreceptorpositiva postmenopausala bröstcancerpatienter före operation.
Tidsram: slutet av 7-14 dagars behandling med östradiol
|
slutet av 7-14 dagars behandling med östradiol
|
Sekundära resultatmått
Resultatmått |
Tidsram |
|---|---|
|
Explorativ analys av biologiska korrelationer med jämförelse med tillgängliga genotypningstester
Tidsram: slutet av 7-14 dagars behandling med östradiol
|
slutet av 7-14 dagars behandling med östradiol
|
|
Analys av data om återfall/överlevnad baserat på initialt Ki67-svar på 7-14 dagars försök med östradiol.
Tidsram: 10 år
|
10 år
|
Samarbetspartners och utredare
Sponsor
Utredare
- Huvudutredare: Judith Hugh, MD, University of Alberta
Studieavstämningsdatum
Studera stora datum
Studiestart
Primärt slutförande (Faktisk)
Avslutad studie (Beräknad)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Beräknad)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- EER001
Plan för individuella deltagardata (IPD)
Planerar du att dela individuella deltagardata (IPD)?
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