PET/CT Guided Fulvestrant Therapy for Patients With Recurrent or Metastatic Breast Cancer

NCT ID: NCT00816582

Last Updated: 2021-11-16

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

TERMINATED

Clinical Phase

NA

Total Enrollment

17 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-11-30

Study Completion Date

2018-07-31

Brief Summary

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Purpose:

To determine whether \[18F\]FES can predict clinical benefit (defined as complete response, partial response and stable disease ≥ 6 months) to fulvestrant (250 mg IM q 28 days) in post-menopausal women with recurrent or metastatic ER+ breast cancer who are candidates for further hormonal therapy.

Detailed Description

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The majority of women diagnosed with breast cancer are post-menopausal, of which up to 75% are estrogen (ER) and/or progesterone receptor (PR) positive. Even in pre-menopausal breast cancer over half of all patients will have expression of these hormone receptors. Thus therapeutic strategies targeting the estrogen receptor or its ligand are the most common treatment offered in breast cancer. Despite substantial benefits now demonstrated with selective estrogen receptor modulators (e.g. tamoxifen) and aromatase inhibitors (e.g. anastrazole, letrozole and exemestane), a significant proportion of patients will still unfortunately have or develop resistance to these hormonal therapies.

Despite approximately two-thirds of patients who are prescribed fulvestrant following prior hormonal agents not benefiting from this therapy, clinicians are still offering this option to all suitable women because of the lack of a better means of identifying the individual responders.

To assess whether the recommended treatment is beneficial to a specific individual, the disease burden is assessed before and following treatment. Conventional imaging techniques such as the bone scan or computerized tomography (CT) can take several months to show a successful response to treatment. Positron emission tomography (PET) can improve the evaluation of women with breast cancer by providing an accurate assessment of the extent of disease and unique information about tumor biology such as metabolic activity.

Conditions

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Breast Cancer

Keywords

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Post-menopausal hormone receptor positive recurrent/metastatic breast cancer. PET/CT Recurrent or metastatic

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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PET/CT Guided FES Therapy

All subjects will be seen at baseline and then monthly until month 6 of fulvestrant therapy unless clinical or radiological progression or unacceptable toxicity earlier than month 6.

Group Type EXPERIMENTAL

Diagnostic Imaging: 18F-FDG PET/CT Scan - Baseline

Intervention Type PROCEDURE

A18F-FDG PET/CT scan performed at baseline, prior to starting the fulvestrant treatment, to identify the sites involved by the subject's cancer.

Diagnostic Imaging: 18F-FES PET/CT - Baseline

Intervention Type PROCEDURE

A 18F-FES PET/CT scan performed at baseline, prior to starting the fulvestrant treatment, to determine the hormone receptor content of the sites involved by the breast cancer.

Diagnostic Imaging: 18F-FES PET/CT - 3 month follow-up

Intervention Type PROCEDURE

A 18F-FES PET/CT scan performed after three (3) monthly injections of fulvestrant to determine whether estrogen uptake is blocked by fulvestrant.

Interventions

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Diagnostic Imaging: 18F-FDG PET/CT Scan - Baseline

A18F-FDG PET/CT scan performed at baseline, prior to starting the fulvestrant treatment, to identify the sites involved by the subject's cancer.

Intervention Type PROCEDURE

Diagnostic Imaging: 18F-FES PET/CT - Baseline

A 18F-FES PET/CT scan performed at baseline, prior to starting the fulvestrant treatment, to determine the hormone receptor content of the sites involved by the breast cancer.

Intervention Type PROCEDURE

Diagnostic Imaging: 18F-FES PET/CT - 3 month follow-up

A 18F-FES PET/CT scan performed after three (3) monthly injections of fulvestrant to determine whether estrogen uptake is blocked by fulvestrant.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* post-menopausal (≥ 60 years old, or age ≥ 45 years with amenorrhea for \> 12 months or follicle stimulating hormone and estrogen levels within post-menopausal range, or prior bilateral oophorectomy)
* hormone receptor positive (ER and/or PgR) disease as determined locally
* WHO performance status 0-2
* life expectancy of ≥ 3 months
* the presence of at least one measurable or evaluable (non-measurable) lesion
* informed consent prior to any study procedures

Exclusion Criteria

* life threatening metastatic visceral disease
* brain or leptomeningeal metastases
* prior exposure to fulvestrant
* history of bleeding diathesis or need for long term anti-coagulation
Minimum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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British Columbia Cancer Agency

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Stephen Chia, MD

Role: PRINCIPAL_INVESTIGATOR

BC Cancer Agency - Vancouver Centre

Locations

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BC Cancer Agency - Southern Interior

Kelowna, British Columbia, Canada

Site Status

BC Cancer Agency - Fraser Valley

Surrey, British Columbia, Canada

Site Status

BC Cancer Agency - Vancouver Centre

Vancouver, British Columbia, Canada

Site Status

BC Cancer Agency - Vancouver Island

Victoria, British Columbia, Canada

Site Status

Countries

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Canada

Other Identifiers

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PET/CT Breast

Identifier Type: -

Identifier Source: org_study_id