Bone Density and Bone Loss in Postmenopausal Women With Breast Cancer Receiving Treatment in Clinical Trial IBCSG-1-98

NCT ID: NCT00369850

Last Updated: 2012-07-27

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

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

458 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-05-31

Study Completion Date

2012-01-31

Brief Summary

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RATIONALE: Diagnostic procedures, such as bone mineral density testing and x-ray, help measure bone loss in women receiving treatment for breast cancer. The test results may help doctors plan better treatment.

PURPOSE: This phase III trial is studying bone density and bone loss in postmenopausal women with breast cancer receiving treatment in clinical trial IBCSG-1-98.

Detailed Description

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OBJECTIVES:

* Compare the effects on bone mineral density (BMD) in the L2-L4 (posterio-anterior) region of the spine and hip by assessing bone density in postmenopausal women with breast cancer receiving treatment on protocol IBCSG-1-98.
* Compare the incidence of radiological gross changes and fractures identified from spine x-rays (T4-L4) in these patients (in groups 1 and 2).
* Use longitudinal BMD measurements to estimate a linear rate of bone loss based on mixed effect models.
* Identify serum markers for bone loss to determine how they correlate with osteoporosis, microfractures, clinical fractures, and breast cancer-related bone events.

OUTLINE: This is a multicenter study and a substudy of protocol IBCSG-1-98. Patients are assigned to 1 of 3 groups according to the length of treatment they have undergone on protocol IBCSG-1-98.

* Group 1 (prior to or at the end of the second year of treatment on protocol IBCSG-1-98): Patients undergo bone mineral density (BMD) testing of the L2-L4 spine and hip at baseline and years 1, 2, 3, and 4 from baseline. They also undergo x-rays of the T4-L4 spine at baseline and years 1, 3, and 4 from baseline.
* Group 2 (after 2 years but before the end of the third year of treatment on protocol IBCSG-1-98): Patients undergo BMD testing of the L2-L4 spine and hip at baseline and years 1, 2, and 3 from baseline. They also undergo x-rays of the T4-L4 spine at baseline and years 2 and 3 from baseline.
* Group 3 (after 3 years but before the end of the fifth year of treatment on protocol IBCSG-1-98): Patients undergo BMD testing of the L2-L4 spine and hip at baseline and years 1 and 2 from baseline (for patients in 4th year of treatment) or year 1 from baseline (for patients in 5th year of treatment).

Patients undergo blood collection at baseline and periodically during study for biomarker correlative study.

PROJECTED ACCRUAL: A total of 660 patients will be accrued for this study.

Conditions

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Breast Cancer Osteoporosis

Keywords

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osteoporosis stage I breast cancer stage II breast cancer stage IIIA breast cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Tamoxifen for 5 years

Patients treated with tamoxifen for 5 years after randomisation.

Group Type EXPERIMENTAL

laboratory biomarker analysis

Intervention Type OTHER

Biomarkers (C-telopeptide, osteocalcin and skeletal alkaline phosphatase) will be assessed in serum.

Dual energy X-ray absorptiometry (DEXA)

Intervention Type PROCEDURE

Mone mineral density measurements of L2-L4 and hip will be performed using DEXA.

Spine X-ray

Intervention Type PROCEDURE

Thoracic and lumbar X-ray (T4-L4, lateral projection) will be performed.

Letrozole for 5 years

Patients treated with letrozole for 5 years after randomisation.

Group Type EXPERIMENTAL

laboratory biomarker analysis

Intervention Type OTHER

Biomarkers (C-telopeptide, osteocalcin and skeletal alkaline phosphatase) will be assessed in serum.

Dual energy X-ray absorptiometry (DEXA)

Intervention Type PROCEDURE

Mone mineral density measurements of L2-L4 and hip will be performed using DEXA.

Spine X-ray

Intervention Type PROCEDURE

Thoracic and lumbar X-ray (T4-L4, lateral projection) will be performed.

Tamoxifen 2 years plus letrozole 3 years

Patients treated with tamoxifen for 2 years and afterwards with letrozole for 3 years.

Group Type EXPERIMENTAL

laboratory biomarker analysis

Intervention Type OTHER

Biomarkers (C-telopeptide, osteocalcin and skeletal alkaline phosphatase) will be assessed in serum.

Dual energy X-ray absorptiometry (DEXA)

Intervention Type PROCEDURE

Mone mineral density measurements of L2-L4 and hip will be performed using DEXA.

Spine X-ray

Intervention Type PROCEDURE

Thoracic and lumbar X-ray (T4-L4, lateral projection) will be performed.

Letrozole 2 years plus tamoxifen 3 years

Patients treated with letrozole for 2 years and afterwards with tamoxifen for 3 years.

Group Type EXPERIMENTAL

laboratory biomarker analysis

Intervention Type OTHER

Biomarkers (C-telopeptide, osteocalcin and skeletal alkaline phosphatase) will be assessed in serum.

Dual energy X-ray absorptiometry (DEXA)

Intervention Type PROCEDURE

Mone mineral density measurements of L2-L4 and hip will be performed using DEXA.

Spine X-ray

Intervention Type PROCEDURE

Thoracic and lumbar X-ray (T4-L4, lateral projection) will be performed.

Interventions

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laboratory biomarker analysis

Biomarkers (C-telopeptide, osteocalcin and skeletal alkaline phosphatase) will be assessed in serum.

Intervention Type OTHER

Dual energy X-ray absorptiometry (DEXA)

Mone mineral density measurements of L2-L4 and hip will be performed using DEXA.

Intervention Type PROCEDURE

Spine X-ray

Thoracic and lumbar X-ray (T4-L4, lateral projection) will be performed.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Diagnosis of breast cancer

* Resected disease
* Enrolled on protocol IBCSG-1-98

* Receiving adjuvant endocrine therapy comprising 1 of the following regimens:

* Letrozole
* Tamoxifen
* Letrozole after 2 years of tamoxifen
* Tamoxifen after 2 years of letrozole
* Not yet completed 5 years of treatment
* No breast cancer recurrence or second primary cancer
* No known, symptomatic bone disease, including osteomalacia or osteogenesis imperfecta
* No prior registration to protocol IBCSG-1-98 Bone Mineral Density substudy
* Hormone receptor status:

* Estrogen receptor-positive and/or progesterone receptor-positive tumor

PATIENT CHARACTERISTICS:

* Female
* Postmenopausal
* No uncontrolled thyroid or parathyroid disease, Cushing's disease, or other pituitary diseases
* No malabsorption syndrome or clinically relevant vitamin D deficiency
* No patients for whom the bone density determination is impossible

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* More than 1 year since prior and no concurrent anticonvulsants
* More than 6 weeks since prior and no concurrent corticosteroids (at doses \> the equivalent of 5 mg/day prednisone) for \> 2 weeks total
* No prior or concurrent sodium fluoride (at daily doses ≥ 5 mg/day) for \> 1 month
* More than 12 months since prior and no concurrent anabolic steroids
* More than 6 months since prior treatment, either investigational or not, for the prevention of osteoporosis (excluding calcium or cholecalciferol \[vitamin D\])
* No concurrent raloxifene
* Concurrent therapeutic intervention for osteoporosis comprising bisphosphonates allowed
* Concurrent warfarin allowed provided it is given for ≤ 4 weeks
Minimum Eligible Age

30 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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ETOP IBCSG Partners Foundation

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Stefan Aebi, MD

Role: STUDY_CHAIR

Insel Gruppe AG, University Hospital Bern

Andrea Decensi, MD

Role: STUDY_CHAIR

European Institute of Oncology

Locations

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Institute of Oncology at Prince of Wales Hospital

Randwick, New South Wales, Australia

Site Status

Royal Brisbane and Women's Hospital

Brisbane, Queensland, Australia

Site Status

Institut Bergonie

Bordeaux, , France

Site Status

Centro di Riferimento Oncologico - Aviano

Aviano, , Italy

Site Status

Ospedali Riuniti di Bergamo

Bergamo, , Italy

Site Status

European Institute of Oncology

Milan, , Italy

Site Status

Dunedin Hospital

Dunedin, , New Zealand

Site Status

Instituto Nacional de Enfermedades Neoplasicas

Lima, , Peru

Site Status

Groote Schuur Hospital

Cape Town, , South Africa

Site Status

Hospital Ruber Internacional

Madrid, , Spain

Site Status

Kantonspital Aarau

Aarau, , Switzerland

Site Status

Inselspital Bern

Bern, , Switzerland

Site Status

Centre Hospitalier Universitaire Vaudois

Lausanne, , Switzerland

Site Status

Ospedale Beata Vergine

Mendrisio, , Switzerland

Site Status

Kantonsspital - St. Gallen

Sankt Gallen, , Switzerland

Site Status

Regionalspital

Thun, , Switzerland

Site Status

Countries

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Australia France Italy New Zealand Peru South Africa Spain Switzerland

References

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Decensi A, Sun Z, Guerrieri-Gonzaga A, Thurlimann B, McIntosh C, Tondini C, Monnier A, Campone M, Debled M, Schonenberger A, Zaman K, Johansson H, Price KN, Gelber RD, Goldhirsch A, Coates AS, Aebi S. Bone mineral density and circulating biomarkers in the BIG 1-98 trial comparing adjuvant letrozole, tamoxifen and their sequences. Breast Cancer Res Treat. 2014 Apr;144(2):321-9. doi: 10.1007/s10549-014-2849-2. Epub 2014 Feb 1.

Reference Type DERIVED
PMID: 24487691 (View on PubMed)

Other Identifiers

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IBCSG-18-98-BS

Identifier Type: OTHER

Identifier Source: secondary_id

EU-20623

Identifier Type: OTHER

Identifier Source: secondary_id

IBCSG-1-98-BS

Identifier Type: OTHER

Identifier Source: secondary_id

NOVARTIS-2026703019

Identifier Type: OTHER

Identifier Source: secondary_id

CDR0000482381

Identifier Type: -

Identifier Source: org_study_id