Ibandronate or Zoledronate in Treating Patients With Newly Diagnosed Bone Metastases From Breast Cancer

NCT ID: NCT00326820

Last Updated: 2013-03-13

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

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

1404 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-01-31

Study Completion Date

2015-10-31

Brief Summary

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RATIONALE: Ibandronate and zoledronate may help relieve some of the symptoms caused by bone metastases. It is not yet know whether ibandronate is more effective than zoledronate in treating bone metastases from breast cancer.

PURPOSE: This randomized phase III trial is studying ibandronate to see how well it works compared with zoledronate in treating patients with newly diagnosed bone metastases from breast cancer.

Detailed Description

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OBJECTIVES:

Primary

* Compare the efficacy, in terms of reducing frequency and timing of skeletal-related events (SREs), of ibandronate vs zoledronate in patients with newly diagnosed bone metastases secondary to breast cancer.

Secondary

* Compare the median time to first SRE in patients treated with these regimens.
* Compare the percentage of patients experiencing a SRE after treatment with these regimens.
* Compare the number of occult vertebral fractures present in patients at the end of treatment with these regimens.
* Compare the pain and analgesic scores and quality of life of patients treated with these regimens.
* Compare the number of patients developing renal dysfunction or hypocalcemia during the study period.
* Compare the number of patients developing osteonecrosis of the jaw during study treatment and follow-up.
* Compare the overall survival of these patients at 96 weeks and at 5 years.
* Compare the health-resource usage of patients treated with these regimens.

OUTLINE: This is a randomized, open-label, parallel-group, controlled, multicenter study. Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients receive zoledronate IV over 15 minutes on day 1. Treatment repeats every 21\* or 28 days for at least 96 weeks (24 or 32 courses) in the absence of disease progression or unacceptable toxicity.

NOTE: \*Patients who receive concurrent chemotherapy every 3 weeks receive study treatment every 21 days

* Arm II: Patients receive oral ibandronate once daily on days 1-28. Treatment repeats every 28 days for at least 96 weeks (24 courses) in the absence of disease progression or unacceptable toxicity. Patients with bone pain or hypercalcemia at study entry or those who require IV therapy due to hypercalcemia while on study may receive 1 treatment with ibandronate IV at the discretion of the supervising clinician.

Quality of life and pain are assessed at baseline, after every 3 courses, and at completion of study treatment.

After completion of study treatment, patients are followed annually for up to 3 years.

PROJECTED ACCRUAL: A total of 1,400 patients will be accrued for this study.

Conditions

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Breast Cancer Hypercalcemia of Malignancy Metastatic Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Ibandronic Acid

50mg tablet once daily over 96 weeks

Group Type EXPERIMENTAL

ibandronate sodium

Intervention Type DRUG

Zoledronic Acid

4 mg via intravenous infusion (iv) over a minimum of 15 minutes in at least 100mls of saline every 4 weeks over 96 weeks

Group Type ACTIVE_COMPARATOR

zoledronic acid

Intervention Type DRUG

Zolendronic Acid

Intervention Type DRUG

Zoledronic acid 4 mg by intravenous infusion every 4 weeks.

Interventions

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ibandronate sodium

Intervention Type DRUG

zoledronic acid

Intervention Type DRUG

Zolendronic Acid

Zoledronic acid 4 mg by intravenous infusion every 4 weeks.

Intervention Type DRUG

Other Intervention Names

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Zoledronate

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically proven breast cancer

* Metastatic disease
* Previous relapsed disease in sites other than bone allowed
* Newly diagnosed multiple bone metastases within the past 3 months, meeting all of the following criteria:

* Painful or asymptomatic
* Lytic, mixed, or purely sclerotic type
* Radiological diagnosis
* IV bisphosphonate therapy indicated
* No CNS metastases
* Hormone receptor status not specified

PATIENT CHARACTERISTICS:

* ECOG performance status 0-2
* Male or female
* Menopausal status not specified
* No known active peptic ulcer
* Not pregnant or nursing
* Fertile patients must use effective contraception
* No active dental problems, including infection of the teeth or jawbone (maxilla or mandible) or dental or fixture trauma
* No prior or current diagnosis of osteonecrosis of the jaw, exposed bone in the mouth, or slow healing after dental procedures
* Creatinine clearance ≥ 30 mL/min
* Bilirubin ≤ 1.5 x upper limit of normal (ULN)
* AST and ALT ≤ 1.5 times ULN
* No history of bisphosphonate hypersensitivity
* Able to comply with instructions relating to oral study medications
* Able to take oral study medications
* No psychiatric illness or other condition that would preclude giving informed consent

PRIOR CONCURRENT THERAPY:

* At least 6 months since prior bisphosphonate therapy
* At least 6 weeks since prior and no concurrent dental or jaw surgery (e.g., extractions or implants)

* Concurrent unplanned dental extractions allowed provided study medication is discontinued for 8 weeks before and after the surgery
* Concurrent chemotherapy and/or hormone therapy for metastatic disease allowed
* No concurrent medications that affect bone metabolism (e.g., calcitonin or other nontrial bisphosphonates)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Velindre NHS Trust

OTHER_GOV

Sponsor Role collaborator

Wales Cancer Trials Unit

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Peter J. Barrett Lee, MD

Role: STUDY_CHAIR

Velindre NHS Trust

Locations

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William Harvey Hospital

Ashford, England, United Kingdom

Site Status

North Devon District Hospital

Barnstaple, England, United Kingdom

Site Status

Royal Bournemouth Hospital

Bournemouth, England, United Kingdom

Site Status

Burnley General Hospital

Burnley, England, United Kingdom

Site Status

Queen's Hospital

Burton-on-Trent, England, United Kingdom

Site Status

Kent and Canterbury Hospital

Canterbury, England, United Kingdom

Site Status

Broomfield Hospital

Chelmsford, Essex, England, United Kingdom

Site Status

Gloucestershire Oncology Centre at Cheltenham General Hospital

Cheltenham, England, United Kingdom

Site Status

Countess of Chester Hospital

Chester, England, United Kingdom

Site Status

Essex County Hospital

Colchester, England, United Kingdom

Site Status

Walsgrave Hospital

Coventry, England, United Kingdom

Site Status

Darent Valley Hospital

Dartford Kent, England, United Kingdom

Site Status

Derbyshire Royal Infirmary

Derby, England, United Kingdom

Site Status

Dorset County Hospital

Dorchester, England, United Kingdom

Site Status

University Hospital of North Durham

Durham, England, United Kingdom

Site Status

Royal Devon and Exeter Hospital

Exeter, England, United Kingdom

Site Status

Queen Elizabeth Hospital

Gateshead, England, United Kingdom

Site Status

Diana Princess of Wales Hospital

Grimsby, England, United Kingdom

Site Status

Calderdale Royal Hospital

Halifax, England, United Kingdom

Site Status

University Hospital of Hartlepool

Hartlepool, Cleveland, England, United Kingdom

Site Status

Wycombe General Hospital

High Wycombe, England, United Kingdom

Site Status

Huddersfield Royal Infirmary

Huddersfield, West Yorks, England, United Kingdom

Site Status

Princess Royal Hospital at Hull and East Yorkshire NHS Trust

Hull, England, United Kingdom

Site Status

Ipswich Hospital

Ipswich, England, United Kingdom

Site Status

Royal Liverpool University Hospital

Liverpool, England, United Kingdom

Site Status

Whipps Cross Hospital

London, England, United Kingdom

Site Status

Saint Bartholomew's Hospital

London, England, United Kingdom

Site Status

St. George's Hospital

London, England, United Kingdom

Site Status

Royal Marsden - London

London, England, United Kingdom

Site Status

Charing Cross Hospital

London, England, United Kingdom

Site Status

Macclesfield District General Hospital

Macclesfield, England, United Kingdom

Site Status

Maidstone Hospital

Maidstone, England, United Kingdom

Site Status

Queen Elizabeth The Queen Mother Hospital

Margate, England, United Kingdom

Site Status

Clatterbridge Centre for Oncology

Metropolitan Borough of Wirral, England, United Kingdom

Site Status

St. Mary's Hospital

Newport, England, United Kingdom

Site Status

Nottingham City Hospital

Nottingham, England, United Kingdom

Site Status

King's Mills Hospital

Nottinghamshire, England, United Kingdom

Site Status

George Eliot Hospital

Nuneaton, England, United Kingdom

Site Status

Peterborough Hospitals Trust

Peterborough, England, United Kingdom

Site Status

Dorset Cancer Centre

Poole Dorset, England, United Kingdom

Site Status

Portsmouth Oncology Centre at Saint Mary's Hospital

Portsmouth, England, United Kingdom

Site Status

Rosemere Cancer Centre at Royal Preston Hospital

Preston, England, United Kingdom

Site Status

Alexandra Healthcare NHS

Redditch, Worcestershire, England, United Kingdom

Site Status

Conquest Hospital

Saint Leonards-on-Sea, England, United Kingdom

Site Status

Scarborough General Hospital

Scarborough, England, United Kingdom

Site Status

Scunthorpe General Hospital

Scunthorpe, England, United Kingdom

Site Status

Wexham Park Hospital

Slough, Berkshire, England, United Kingdom

Site Status

Solihull Hospital

Solihull, England, United Kingdom

Site Status

Southampton General Hospital

Southampton, England, United Kingdom

Site Status

University Hospital of North Tees

Stockton-on-Tees, England, United Kingdom

Site Status

Royal Marsden - Surrey

Sutton, England, United Kingdom

Site Status

Torbay Hospital

Torquay Devon, England, United Kingdom

Site Status

Royal Cornwall Hospital

Truro, Cornwall, England, United Kingdom

Site Status

South Tyneside District Hospital

Tyne & Wear, England, United Kingdom

Site Status

Warrington Hospital NHS Trust

Warrington, England, United Kingdom

Site Status

South Warwickshire Hospital

Warwick, Warwickshire, England, United Kingdom

Site Status

Southend University Hospital NHS Foundation Trust

Westcliff-on-Sea, England, United Kingdom

Site Status

Royal Albert Edward Infirmary

Wigan, England, United Kingdom

Site Status

Royal Hampshire County Hospital

Winchester, England, United Kingdom

Site Status

Worcester Royal Hospital

Worcester, England, United Kingdom

Site Status

Yeovil District Hospital

Yeovil - Somerset, England, United Kingdom

Site Status

Hairmyres Hospital

East Kilbride, Scotland, United Kingdom

Site Status

Falkirk and District Royal Infirmary

Falkirk, Scotland, United Kingdom

Site Status

Western Infirmary

Glasgow, Scotland, United Kingdom

Site Status

Crosshouse Hospital

Kilmarnock, Scotland, United Kingdom

Site Status

Wishaw General Hospital

Wishaw, Scotland, United Kingdom

Site Status

Nevill Hall Hospital

Abergavenny, Wales, United Kingdom

Site Status

Bronglais District General Hospital

Aberystwyth, Wales, United Kingdom

Site Status

Ysbyty Gwynedd

Bangor, Wales, United Kingdom

Site Status

Princess of Wales Hospital

Bridgend, Wales, United Kingdom

Site Status

Velindre Cancer Center at Velindre Hospital

Cardiff, Wales, United Kingdom

Site Status

West Wales General Hospital

Carmarthen, Wales, United Kingdom

Site Status

Withybush General Hospital

Haverfordwest, Wales, United Kingdom

Site Status

Prince Charles Hospital

Mid Glamorgan, Wales, United Kingdom

Site Status

Royal Gwent Hospital

Newport Gwent, Wales, United Kingdom

Site Status

Glan Clwyd Hospital

Rhyl, Denbighshire, Wales, United Kingdom

Site Status

South West Wales Cancer Institute

Swansea, Wales, United Kingdom

Site Status

Wrexham Maelor Hospital

Wrexham, Wales, United Kingdom

Site Status

Royal Glamorgan Hospital

Llantrisant, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Gillespie D, Farewell D, Barrett-Lee P, Casbard A, Hawthorne AB, Hurt C, Murray N, Probert C, Stenson R, Hood K. The use of randomisation-based efficacy estimators in non-inferiority trials. Trials. 2017 Mar 9;18(1):117. doi: 10.1186/s13063-017-1837-3.

Reference Type DERIVED
PMID: 28274254 (View on PubMed)

Barrett-Lee P, Casbard A, Abraham J, Hood K, Coleman R, Simmonds P, Timmins H, Wheatley D, Grieve R, Griffiths G, Murray N. Oral ibandronic acid versus intravenous zoledronic acid in treatment of bone metastases from breast cancer: a randomised, open label, non-inferiority phase 3 trial. Lancet Oncol. 2014 Jan;15(1):114-22. doi: 10.1016/S1470-2045(13)70539-4. Epub 2013 Dec 11.

Reference Type DERIVED
PMID: 24332514 (View on PubMed)

Other Identifiers

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WCTU-ZICE

Identifier Type: -

Identifier Source: secondary_id

NCRI-ZICE

Identifier Type: -

Identifier Source: secondary_id

ROCHE-ZICE

Identifier Type: -

Identifier Source: secondary_id

ISRCTN13914201

Identifier Type: -

Identifier Source: secondary_id

EU-20613

Identifier Type: -

Identifier Source: secondary_id

EUDRACT-2005-001710-40

Identifier Type: -

Identifier Source: secondary_id

CDR0000478864

Identifier Type: -

Identifier Source: org_study_id

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