Exemestane in Treating Postmenopausal Women With Resected Stage I, Stage II, or Stage IIIA Breast Cancer Who Have Completed 5 Years of Tamoxifen

NCT ID: NCT00016432

Last Updated: 2011-04-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

1598 participants

Study Classification

INTERVENTIONAL

Study Start Date

2001-05-31

Study Completion Date

2011-02-28

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

RATIONALE: Estrogen can stimulate the growth of breast cancer cells. Hormone therapy using exemestane may fight breast cancer by reducing the production of estrogen by the tumor cells. It is not yet known whether exemestane is effective in preventing the recurrence of breast cancer.

PURPOSE: Randomized phase III trial to study the effectiveness of exemestane in preventing cancer recurrence in postmenopausal women who have resected stage I, stage II, or stage IIIA breast cancer and have completed 5 years of tamoxifen.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

OBJECTIVES:

* Determine whether the administration of 5 years of exemestane after 5 years of tamoxifen therapy is more effective than 5 years of prior tamoxifen therapy alone in prolonging disease-free survival, overall survival, and time to treatment failure in postmenopausal women with resected stage I, II, or IIIA breast cancer.
* Determine the effect of tamoxifen withdrawal on bone, in terms of height, fractures, and total alkaline phosphatase in these patients and on bone mineral density and bone biochemical markers in a subset of patients.
* Determine the effect of exemestane on bone loss after tamoxifen withdrawal in these patients.
* Evaluate the quality of life of a subset of these patients.

OUTLINE: This is a randomized study. Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients receive oral exemestane daily for 5 years.
* Arm II (closed as of 10/15/03): Patients receive an oral placebo daily for 5 years.

Quality of life is assessed at baseline and then every 6 months for 5.5 years.

Patients are followed every 6 months for 6 years and then annually thereafter.

PROJECTED ACCRUAL: A total of 3,000 patients will be accrued for this study within 3 years and 4 months.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Breast Cancer

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Group 1

Exemestane

Group Type EXPERIMENTAL

exemestane

Intervention Type DRUG

25 mg for 5 years

Group 2

Placebo

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Placebo

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

exemestane

25 mg for 5 years

Intervention Type DRUG

Placebo

Placebo

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically confirmed invasive adenocarcinoma of the breast at time of original diagnosis

* Tumor confined to the breast and ipsilateral axilla on clinical exam (T1-3, N0-1, M0) (stage I-IIIA)
* No ipsilateral lymph nodes clinically fixed to one another or to other structures (N2 disease) at time of original diagnosis
* Prior surgical resection, including 1 of the following:

* Total mastectomy and axillary dissection (modified radical mastectomy) OR
* Lumpectomy and axillary dissection

* Prior post-lumpectomy breast radiotherapy required
* Prior sentinel node biopsy allowed with the exception of the following:

* If any sentinel node is histologically positive by hematoxylin and eosin (H \& E) OR histologically suspicious on H \& E and confirmed positive by immunohistochemistry then the patient must have a complete axillary dissection
* Previously resected margins must be clear of invasive tumor and ductal carcinoma in situ
* Currently disease free
* Previously treated with tamoxifen for 57-66 months

* Completed tamoxifen within the past 180 days
* No bilateral malignancy or mass in the opposite breast suspicious for malignancy unless biopsy proven negative
* No local, regional, or distant recurrence of disease or second primary breast malignancy (including contralateral breast cancer)
* No advanced disease at time of original diagnosis (e.g., ulceration, erythema, infiltration of the skin or underlying chest wall \[complete fixation\], peau d'orange, or skin edema of any magnitude)

* Tethering or dimpling of the skin or nipple inversion allowed
* Current skeletal pain allowed if a bone scan and/or radiologic exam is negative for metastatic disease
* Hormone receptor status:

* Primary tumor estrogen receptor (ER) positive AND/OR
* Progesterone receptor positive
* Borderline ER positive tumors allowed if previously treated with tamoxifen

PATIENT CHARACTERISTICS:

Age:

* Postmenopausal

Sex:

* Female

Menopausal status:

* Postmenopausal, defined as 1 of the following:

* Prior bilateral oophorectomy
* Absence of spontaneous menstrual cycle for more than 1 year
* Follicle-stimulating hormone within the postmenopausal range if under 55 and had a prior hysterectomy without a bilateral oophorectomy

Performance status:

* Not specified

Life expectancy:

* At least 10 years

Hematopoietic:

* Absolute granulocyte count at least 1,500/mm\^3
* Platelet count at least 100,000/mm\^3
* Hemoglobin normal

Hepatic:

* Bilirubin less than 2 times upper limit of normal (ULN)
* SGOT or SGPT no greater than 2.5 times ULN
* Alkaline phosphatase less than 2 times ULN
* No systemic hepatic disease that would preclude study participation

Renal:

* Creatinine no greater than 1.5 times ULN
* No systemic renal disease that would preclude study participation

Cardiovascular:

* No systemic cardiovascular disease that would preclude study participation

Other:

* No other malignancy within the past 5 years except effectively treated squamous cell or basal cell skin cancer, surgically treated carcinoma in situ of the cervix, or surgically treated lobular carcinoma in situ of the ipsilateral or contralateral breast
* No nonmalignant systemic disease that would preclude study participation
* No psychiatric or addictive disorder that would preclude informed consent
* Not pregnant

PRIOR CONCURRENT THERAPY:

Biologic therapy:

* Not specified

Chemotherapy:

* Prior adjuvant chemotherapy allowed if administered concurrently with or prior to tamoxifen

Endocrine therapy:

* See Disease Characteristics
* No concurrent estrogen, progesterone, clomiphene, testosterone, gonadotropin-releasing hormone, oral contraceptives, selective estrogen-receptor modulators, or dehydroepiandrosterone (DHEA)

* Estring or estrogen vaginal cream at 0.3 mg or 1/8 of an applicator applied vaginally 3 times a week allowed
* No other concurrent systemic hormonal therapy (e.g., tamoxifen or raloxifene)

Radiotherapy:

* See Disease Characteristics
* Prior post-mastectomy loco-regional radiotherapy or post-lumpectomy regional radiotherapy allowed

Surgery:

* See Disease Characteristics

Other:

* Prior participation in other adjuvant NSABP study allowed if study was reported in peer-review publication or tamoxifen was not a study drug
* Concurrent bisphosphonates or calcitonin for prevention or treatment of osteoporosis allowed
* Concurrent statins (simvastatin, pravastatin, fluvastatin, atorvastatin, or lovastatin) or other drugs to control lipid levels allowed
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

NSABP Foundation Inc

NETWORK

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

NSABP Foundation, Inc.

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Norman Wolmark, MD

Role: PRINCIPAL_INVESTIGATOR

NSABP Foundation Inc

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Comprehensive Cancer Institute of Huntsville

Huntsville, Alabama, United States

Site Status

CCOP - Greater Phoenix

Phoenix, Arizona, United States

Site Status

University of Arkansas for Medical Sciences

Little Rock, Arkansas, United States

Site Status

City of Hope Comprehensive Cancer Center

Duarte, California, United States

Site Status

California Cancer Center

Fresno, California, United States

Site Status

Sutter Health Western Division Cancer Research Group

Greenbrae, California, United States

Site Status

Scripps Cancer Center

La Jolla, California, United States

Site Status

Rebecca and John Moores UCSD Cancer Center

La Jolla, California, United States

Site Status

Loma Linda University Cancer Institute

Loma Linda, California, United States

Site Status

Pacific Shores Medical Group

Long Beach, California, United States

Site Status

Jonsson Comprehensive Cancer Center, UCLA

Los Angeles, California, United States

Site Status

Chao Family Comprehensive Cancer Center

Orange, California, United States

Site Status

Comprehensive Cancer Centers of the Desert

Palm Springs, California, United States

Site Status

Sutter Cancer Center

Sacramento, California, United States

Site Status

Kaiser Permanente Medical Center/Kaiser Foundation Hospital - San Diego

San Diego, California, United States

Site Status

CCOP - Santa Rosa Memorial Hospital

Santa Rosa, California, United States

Site Status

Stanford University Medical Center

Stanford, California, United States

Site Status

Kaiser Permanente Medical Center - Vallejo

Vallejo, California, United States

Site Status

University of Colorado Cancer Center

Denver, Colorado, United States

Site Status

CCOP - Colorado Cancer Research Program, Incorporated

Denver, Colorado, United States

Site Status

University of Connecticut

Farmington, Connecticut, United States

Site Status

Hartford Hospital

Hartford, Connecticut, United States

Site Status

CCOP - Christiana Care Health Services

Newark, Delaware, United States

Site Status

George Washington University Medical Center

Washington D.C., District of Columbia, United States

Site Status

Morton Plant Hospital

Clearwater, Florida, United States

Site Status

Halifax Medical Center

Daytona Beach, Florida, United States

Site Status

Baptist Regional Cancer Institute - Jacksonville

Jacksonville, Florida, United States

Site Status

Sylvester Cancer Center, University of Miami

Miami, Florida, United States

Site Status

CCOP - Mount Sinai Medical Center

Miami Beach, Florida, United States

Site Status

MD Anderson Cancer Center Orlando

Orlando, Florida, United States

Site Status

Cancer Research Network Inc.

Plantation, Florida, United States

Site Status

Oncology Hematology Consultants

Sarasota, Florida, United States

Site Status

Emory University School of Medicine

Atlanta, Georgia, United States

Site Status

Medical College of Georgia

Augusta, Georgia, United States

Site Status

Dwight David Eisenhower Army Medical Center

Fort Gordon, Georgia, United States

Site Status

Cancer Center of Hawaii

Honolulu, Hawaii, United States

Site Status

North Idaho Cancer Center

Coeur d'Alene, Idaho, United States

Site Status

Illinois Oncology, Ltd.

Belleville, Illinois, United States

Site Status

Rush-Presbyterian-St. Luke's Medical Center

Chicago, Illinois, United States

Site Status

Illinois Masonic Medical Center

Chicago, Illinois, United States

Site Status

CCOP - Central Illinois

Decatur, Illinois, United States

Site Status

Alexian Brothers Medical Center

Elk Grove Village, Illinois, United States

Site Status

CCOP - Evanston

Evanston, Illinois, United States

Site Status

West Suburban Hospital Medical Center

Oak Park, Illinois, United States

Site Status

CCOP - Illinois Oncology Research Association

Peoria, Illinois, United States

Site Status

CCOP - Carle Cancer Center

Urbana, Illinois, United States

Site Status

Clarian Health Partners Inc.

Indianapolis, Indiana, United States

Site Status

St. Vincent Hospital and Health Care Center

Indianapolis, Indiana, United States

Site Status

CCOP - Northern Indiana CR Consortium

South Bend, Indiana, United States

Site Status

Genesis Medical Center

Davenport, Iowa, United States

Site Status

CCOP - Iowa Oncology Research Association

Des Moines, Iowa, United States

Site Status

Holden Comprehensive Cancer Center

Iowa City, Iowa, United States

Site Status

CCOP - Wichita

Wichita, Kansas, United States

Site Status

Lucille Parker Markey Cancer Center, University of Kentucky

Lexington, Kentucky, United States

Site Status

Norton Healthcare System

Louisville, Kentucky, United States

Site Status

Consultants in Blood Disorders and Cancer

Louisville, Kentucky, United States

Site Status

Louisiana State University Medical Center - New Orleans

New Orleans, Louisiana, United States

Site Status

Tulane University Medical Center

New Orleans, Louisiana, United States

Site Status

CCOP - Ochsner

New Orleans, Louisiana, United States

Site Status

Eastern Maine Medical Center

Bangor, Maine, United States

Site Status

Franklin Square Hospital Center

Baltimore, Maryland, United States

Site Status

National Naval Medical Center

Bethesda, Maryland, United States

Site Status

Boston Medical Center

Boston, Massachusetts, United States

Site Status

Lahey Clinic - Burlington

Burlington, Massachusetts, United States

Site Status

Berkshire Medical Center

Pittsfield, Massachusetts, United States

Site Status

Baystate Medical Center

Springfield, Massachusetts, United States

Site Status

CCOP - Michigan Cancer Research Consortium

Ann Arbor, Michigan, United States

Site Status

Henry Ford Health System

Detroit, Michigan, United States

Site Status

Michigan State University

East Lansing, Michigan, United States

Site Status

CCOP - Grand Rapids

Grand Rapids, Michigan, United States

Site Status

CCOP - Kalamazoo

Kalamazoo, Michigan, United States

Site Status

William Beaumont Hospital

Royal Oak, Michigan, United States

Site Status

Providence Hospital - Southfield

Southfield, Michigan, United States

Site Status

CCOP - Duluth

Duluth, Minnesota, United States

Site Status

Abbott-Northwestern Hospital

Minneapolis, Minnesota, United States

Site Status

CCOP - Metro-Minnesota

Saint Louis Park, Minnesota, United States

Site Status

Ellis Fischel Cancer Center - Columbia

Columbia, Missouri, United States

Site Status

CCOP - Kansas City

Kansas City, Missouri, United States

Site Status

CCOP - Cancer Research for the Ozarks

Springfield, Missouri, United States

Site Status

St. Louis University Health Sciences Center

St Louis, Missouri, United States

Site Status

CCOP - St. Louis-Cape Girardeau

St Louis, Missouri, United States

Site Status

CCOP - Montana Cancer Consortium

Billings, Montana, United States

Site Status

CCOP - Missouri Valley Cancer Consortium

Omaha, Nebraska, United States

Site Status

Methodist Hospital Cancer Center - Omaha

Omaha, Nebraska, United States

Site Status

CCOP - Southern Nevada Cancer Research Foundation

Las Vegas, Nevada, United States

Site Status

CCOP - Northern New Jersey

Hackensack, New Jersey, United States

Site Status

Cancer Institute of New Jersey

New Brunswick, New Jersey, United States

Site Status

Newark Beth Israel Medical Center

Newark, New Jersey, United States

Site Status

MBCCOP - University of New Mexico HSC

Albuquerque, New Mexico, United States

Site Status

New York Oncology Hematology, P.C.

Albany, New York, United States

Site Status

Glens Falls Hospital

Glens Falls, New York, United States

Site Status

Staten Island University Hospital

Staten Island, New York, United States

Site Status

CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C.

Syracuse, New York, United States

Site Status

Lincoln Medical and Mental Health Center

The Bronx, New York, United States

Site Status

MBCCOP-Our Lady of Mercy Cancer Center

The Bronx, New York, United States

Site Status

Alamance Cancer Center

Burlington, North Carolina, United States

Site Status

Lineberger Comprehensive Cancer Center, UNC

Chapel Hill, North Carolina, United States

Site Status

East Carolina University School of Medicine

Greenville, North Carolina, United States

Site Status

CCOP - Southeast Cancer Control Consortium

Winston-Salem, North Carolina, United States

Site Status

Comprehensive Cancer Center at Wake Forest University

Winston-Salem, North Carolina, United States

Site Status

CCOP - Merit Care Hospital

Fargo, North Dakota, United States

Site Status

Akron City Hospital

Akron, Ohio, United States

Site Status

Aultman Cancer Center

Canton, Ohio, United States

Site Status

Jewish Hospital of Cincinnati, Inc.

Cincinnati, Ohio, United States

Site Status

Barrett Cancer Center

Cincinnati, Ohio, United States

Site Status

Ireland Cancer Center

Cleveland, Ohio, United States

Site Status

CCOP - Columbus

Columbus, Ohio, United States

Site Status

Arthur G. James Cancer Hospital - Ohio State University

Columbus, Ohio, United States

Site Status

CCOP - Dayton

Kettering, Ohio, United States

Site Status

CCOP - Toledo Community Hospital

Toledo, Ohio, United States

Site Status

South Pointe Hospital - Cancer Care Center

Warrensville Heights, Ohio, United States

Site Status

CCOP - Oklahoma

Tulsa, Oklahoma, United States

Site Status

CCOP - Columbia River Oncology Program

Portland, Oregon, United States

Site Status

Lehigh Valley Hospital

Allentown, Pennsylvania, United States

Site Status

Geisinger Medical Center

Danville, Pennsylvania, United States

Site Status

Kimmel Cancer Center of Thomas Jefferson University - Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

Albert Einstein Cancer Center

Philadelphia, Pennsylvania, United States

Site Status

Allegheny General Hospital

Pittsburgh, Pennsylvania, United States

Site Status

University of Pittsburgh Cancer Institute

Pittsburgh, Pennsylvania, United States

Site Status

Reading Hospital and Medical Center

Reading, Pennsylvania, United States

Site Status

Mercy Hospital Cancer Center - Scranton

Scranton, Pennsylvania, United States

Site Status

CCOP - MainLine Health

Wynnewood, Pennsylvania, United States

Site Status

York Cancer Center

York, Pennsylvania, United States

Site Status

CCOP - Greenville

Greenville, South Carolina, United States

Site Status

CCOP - Upstate Carolina

Spartanburg, South Carolina, United States

Site Status

CCOP - Sioux Community Cancer Consortium

Sioux Falls, South Dakota, United States

Site Status

Thompson Cancer Survival Center

Knoxville, Tennessee, United States

Site Status

Center for Oncology Research and Treatment, Medical City Hospital

Dallas, Texas, United States

Site Status

Simmons Cancer Center - Dallas

Dallas, Texas, United States

Site Status

Baylor College of Medicine

Houston, Texas, United States

Site Status

Joe Arrington Cancer Research and Treatment Center

Lubbock, Texas, United States

Site Status

University of Texas Health Science Center at San Antonio

San Antonio, Texas, United States

Site Status

CCOP - Scott and White Hospital

Temple, Texas, United States

Site Status

Utah Valley Regional Medical Center - Provo

Provo, Utah, United States

Site Status

Huntsman Cancer Institute

Salt Lake City, Utah, United States

Site Status

Green Mountain Oncology Group

Bennington, Vermont, United States

Site Status

Vermont Cancer Center

Burlington, Vermont, United States

Site Status

Virginia Oncology Associates - Newport News

Newport News, Virginia, United States

Site Status

Eastern Virginia Medical School

Norfolk, Virginia, United States

Site Status

Massey Cancer Center

Richmond, Virginia, United States

Site Status

Oncology and Hematology Associates of Southwest Virginia, Inc.

Roanoke, Virginia, United States

Site Status

CCOP - Virginia Mason Research Center

Seattle, Washington, United States

Site Status

Puget Sound Oncology Consortium

Seattle, Washington, United States

Site Status

CCOP - Northwest

Tacoma, Washington, United States

Site Status

Camcare Health

Charleston, West Virginia, United States

Site Status

Camden-Clark Memorial Hospital

Parkersburg, West Virginia, United States

Site Status

St. Vincent Hospital

Green Bay, Wisconsin, United States

Site Status

CCOP - Marshfield Medical Research and Education Foundation

Marshfield, Wisconsin, United States

Site Status

St. Luke's Medical Center

Milwaukee, Wisconsin, United States

Site Status

Medical College of Wisconsin Cancer Center

Milwaukee, Wisconsin, United States

Site Status

Tom Baker Cancer Center - Calgary

Calgary, Alberta, Canada

Site Status

Cross Cancer Institute

Edmonton, Alberta, Canada

Site Status

British Columbia Cancer Agency

Vancouver, British Columbia, Canada

Site Status

Credit Valley Hospital

Mississauga, Ontario, Canada

Site Status

Toronto Sunnybrook Regional Cancer Centre

Toronto, Ontario, Canada

Site Status

Centre Hospitalier de l'Universite de Montreal

Montreal, Quebec, Canada

Site Status

Royal Victoria Hospital - Montreal

Montreal, Quebec, Canada

Site Status

Montreal General Hospital

Montreal, Quebec, Canada

Site Status

Jewish General Hospital - Montreal

Montreal, Quebec, Canada

Site Status

St. Mary's Hospital Center

Montreal, Quebec, Canada

Site Status

Hopital du Saint-Sacrement, Quebec

Québec, Quebec, Canada

Site Status

MBCCOP - San Juan

San Juan, , Puerto Rico

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States Canada Puerto Rico

References

Explore related publications, articles, or registry entries linked to this study.

Mamounas EP, Jeong JH, Wickerham DL, Smith RE, Ganz PA, Land SR, Eisen A, Fehrenbacher L, Farrar WB, Atkins JN, Pajon ER, Vogel VG, Kroener JF, Hutchins LF, Robidoux A, Hoehn JL, Ingle JN, Geyer CE Jr, Costantino JP, Wolmark N. Benefit from exemestane as extended adjuvant therapy after 5 years of adjuvant tamoxifen: intention-to-treat analysis of the National Surgical Adjuvant Breast And Bowel Project B-33 trial. J Clin Oncol. 2008 Apr 20;26(12):1965-71. doi: 10.1200/JCO.2007.14.0228. Epub 2008 Mar 10.

Reference Type RESULT
PMID: 18332472 (View on PubMed)

Mamounas E, Jeong J-H, Wickerham L, et al.: Benefit from exemestane (EXE) as extended adjuvant therapy after 5 years of tamoxifen (TAM): intent-to-treat analysis of NSABP B-33. [Abstract] Breast Cancer Res Treat 100 (Suppl 1): A-49, S22, 2006.

Reference Type RESULT

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

CDR0000068640

Identifier Type: -

Identifier Source: secondary_id

NSABP B-33

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.