Omega-3 Fatty Acids in Preventing Joint Symptoms in Patients With Stage I-III Breast Cancer Receiving Anastrozole, Exemestane, or Letrozole

NCT ID: NCT01478477

Last Updated: 2023-02-27

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

NA

Total Enrollment

44 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-10-04

Study Completion Date

2014-01-09

Brief Summary

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This randomized pilot trial studies omega-3 fatty acid in preventing joint symptoms in patients with stage I-III breast cancer receiving anastrozole, exemestane, or letrozole. Omega-3 fatty acid supplement may lessen or prevent joint stiffness or pain in patients receiving hormone therapy for breast cancer.

Detailed Description

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OBJECTIVES:

I. To assess the feasibility of evaluating joint symptoms in postmenopausal women with breast cancer randomized to n-3 PUFA (omega-3 fatty acid) vs. placebo supplementation using the Functional Assessment of Cancer Therapy-Breast (FACT-B) and endocrine subscale (FACT-ES), Brief Pain Inventory (BPI) and Stanford's Health Assessment -Disability Index (HAS) during the first 6 months of adjuvant aromatase inhibitor (AI) therapy.

II. To preliminarily evaluate the efficacy of n-3 PUFA vs. placebo supplementation on AI induced joint symptoms.

III. To explore blood and imaging based biomarkers (plasma and red blood cell \[RBC\] levels of n-3 PUFAs, inflammatory cytokines and receptors, and intra-articular tenosynovial inflammation by musculoskeletal magnetic resonance imaging \[MRI\] imaging) of AI-induced joint symptoms in women on AI therapy randomized to n-3 PUFAs vs. placebo supplementation.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive omega-3 fatty acid orally (PO) once daily (QD) for 6 months in the absence of disease progression or unacceptable toxicity.

ARM II: Patients receive placebo PO QD for 6 months in the absence of disease progression or unacceptable toxicity.

Conditions

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Recurrent Breast Cancer Stage IA Breast Cancer Stage IB Breast Cancer Stage II Breast Cancer Stage IIIA Breast Cancer Stage IIIB Breast Cancer Stage IIIC Breast Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Arm I (omega-3 fatty acid supplement)

Omega 3 Polyunsaturated Fatty Acids(n-3 PUFA)

Group Type EXPERIMENTAL

omega-3 fatty acid supplement

Intervention Type DIETARY_SUPPLEMENT

6 capsules per day (4.3 g)x 6 months

Clinical assessments

Intervention Type OTHER

All three instruments will be administered at baseline, at 3 months, 6 months and at additional time intervals when there is a significant change in therapy (discontinuation/switch, pain medication administration) during routine medical oncology visits.

Assessment of therapy complications

Intervention Type OTHER

Severity/grade of reaction according to the NCI Common Terminology Criteria for Adverse Events v4.0 (CTCAE).

Magnetic Resonance Imaging

Intervention Type PROCEDURE

Optional bilateral hand and wrist MRI imaging will be obtained at baseline and at 6 months to eligible patients who have no contraindications to MRI imaging.

Correlative/special studies

Intervention Type PROCEDURE

Plasma, RBC, and serum samples from the baseline blood draw will also be stored at -70C for fatty acid and biomarker analyses and repeated at 3 month and 6 month intervals. Samples will be analyzed in batches every 6 months.

Arm II (placebo)

Typical American Diet oils (TAD)

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

6 capsules per day (4.3 g)x 6 months. Supplement should be taken with food once per day. No specific food requirements are needed.

Clinical assessments

Intervention Type OTHER

All three instruments will be administered at baseline, at 3 months, 6 months and at additional time intervals when there is a significant change in therapy (discontinuation/switch, pain medication administration) during routine medical oncology visits.

Assessment of therapy complications

Intervention Type OTHER

Severity/grade of reaction according to the NCI Common Terminology Criteria for Adverse Events v4.0 (CTCAE).

Magnetic Resonance Imaging

Intervention Type PROCEDURE

Optional bilateral hand and wrist MRI imaging will be obtained at baseline and at 6 months to eligible patients who have no contraindications to MRI imaging.

Correlative/special studies

Intervention Type PROCEDURE

Plasma, RBC, and serum samples from the baseline blood draw will also be stored at -70C for fatty acid and biomarker analyses and repeated at 3 month and 6 month intervals. Samples will be analyzed in batches every 6 months.

Clinical Assessments

Brief Pain Inventory (BPI), Stanford's Health Assessment-Disability Index (HAS), FACT-B and endocrine subscale (FACT-ES)

Group Type EXPERIMENTAL

omega-3 fatty acid supplement

Intervention Type DIETARY_SUPPLEMENT

6 capsules per day (4.3 g)x 6 months

Placebo

Intervention Type OTHER

6 capsules per day (4.3 g)x 6 months. Supplement should be taken with food once per day. No specific food requirements are needed.

Assessment of therapy complications

Adverse events will be monitored by self-reporting of signs and symptoms. Patients will maintain a daily diary of time of supplement intake and any possible ill effects, with instructions to contact the PI or Research Nurse to discuss and manage any possible side effects.

Group Type EXPERIMENTAL

omega-3 fatty acid supplement

Intervention Type DIETARY_SUPPLEMENT

6 capsules per day (4.3 g)x 6 months

Placebo

Intervention Type OTHER

6 capsules per day (4.3 g)x 6 months. Supplement should be taken with food once per day. No specific food requirements are needed.

Magnetic Resonance Imaging

Optional bilateral hand and wrist MRI imaging will be obtained

Group Type EXPERIMENTAL

omega-3 fatty acid supplement

Intervention Type DIETARY_SUPPLEMENT

6 capsules per day (4.3 g)x 6 months

Placebo

Intervention Type OTHER

6 capsules per day (4.3 g)x 6 months. Supplement should be taken with food once per day. No specific food requirements are needed.

Correlative/special studies

Enrolled participants will have peripheral blood samples drawn for plasma and RBC n-3 PUFA levels within 4 weeks of starting AI therapy.

Group Type EXPERIMENTAL

omega-3 fatty acid supplement

Intervention Type DIETARY_SUPPLEMENT

6 capsules per day (4.3 g)x 6 months

Placebo

Intervention Type OTHER

6 capsules per day (4.3 g)x 6 months. Supplement should be taken with food once per day. No specific food requirements are needed.

Interventions

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omega-3 fatty acid supplement

6 capsules per day (4.3 g)x 6 months

Intervention Type DIETARY_SUPPLEMENT

Placebo

6 capsules per day (4.3 g)x 6 months. Supplement should be taken with food once per day. No specific food requirements are needed.

Intervention Type OTHER

Clinical assessments

All three instruments will be administered at baseline, at 3 months, 6 months and at additional time intervals when there is a significant change in therapy (discontinuation/switch, pain medication administration) during routine medical oncology visits.

Intervention Type OTHER

Assessment of therapy complications

Severity/grade of reaction according to the NCI Common Terminology Criteria for Adverse Events v4.0 (CTCAE).

Intervention Type OTHER

Magnetic Resonance Imaging

Optional bilateral hand and wrist MRI imaging will be obtained at baseline and at 6 months to eligible patients who have no contraindications to MRI imaging.

Intervention Type PROCEDURE

Correlative/special studies

Plasma, RBC, and serum samples from the baseline blood draw will also be stored at -70C for fatty acid and biomarker analyses and repeated at 3 month and 6 month intervals. Samples will be analyzed in batches every 6 months.

Intervention Type PROCEDURE

Other Intervention Names

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fish oil omega fatty acid O3FA MNSG-194® n-3 PUFA supplementation PLCB Typical American Diet oils TAD Brief Pain Inventory BPI Stanford's Health Assessment-Disability Index HAS FACT-B and endocrine subscale FACT-ES adverse events toxicities Expected Toxicities Potential Toxicities MRI NMR imaging NMRI nuclear magnetic resonance imaging laboratory studies

Eligibility Criteria

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Inclusion Criteria

* Women diagnosed with breast cancer stages I-III initiating first adjuvant AI therapy with any of the Food and Drug Administration- (FDA) approved AIs (anastrozole, exemestane, letrozole)
* Concurrent gonadotropin-releasing hormone (GnRH) agonist therapy is allowed
* Concurrent breast related radiation therapy is allowed
* Prior tamoxifen use is allowed
* Prior chemotherapy is allowed
* History of osteoarthritis and/or fibromyalgia is allowed
* Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria

* Metastatic malignancy of any kind
* Rheumatoid arthritis and other types of autoimmune and inflammatory joint disease, with the exception of osteoarthritis and fibromyalgia
* AI use \> 2 weeks prior to study enrollment
* Known bleeding disorders
* History of diabetes mellitus, heart disease or TIA/stroke
* Current use of warfarin or other anticoagulants
* Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia,or psychiatric illness/social situation that would limit compliance with study requirements
* Daily use of n-3 PUFA concentrates or capsules or regular or any other supplements that might interact with n-3 PUFA supplements within six months of study initiation; sporadic use of n-3 PUFA supplement may be eligible if there has been a 3-month washout period prior to randomization
* Pregnant or nursing women
* Known sensitivity or allergy to fish or fish oil
* Concurrent use of daily full dose aspirin (≥ 325 mg/day), nonsteroidal anti-inflammatory drugs (NSAIDs) or NSAID-containing products or steroids; one month washout period is required prior to randomization
* Unable to give informed consent
* In patients consenting for optional MRIs, any contraindication to MRI examination including but not limited to ferromagnetic metal in the body, pacemaker, or severe claustrophobia
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Cancer and Leukemia Group B

NETWORK

Sponsor Role collaborator

Ohio State University Comprehensive Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Nicole Williams

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nicole Williams, MD

Role: PRINCIPAL_INVESTIGATOR

Ohio State University

Locations

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Ohio State University Medical Center

Columbus, Ohio, United States

Site Status

Countries

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United States

References

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Orchard TS, Andridge RR, Yee LD, Lustberg MB. Diet Quality, Inflammation, and Quality of Life in Breast Cancer Survivors: A Cross-Sectional Analysis of Pilot Study Data. J Acad Nutr Diet. 2018 Apr;118(4):578-588.e1. doi: 10.1016/j.jand.2017.09.024. Epub 2017 Dec 9.

Reference Type DERIVED
PMID: 29233615 (View on PubMed)

Related Links

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Other Identifiers

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NCI-2011-03262

Identifier Type: REGISTRY

Identifier Source: secondary_id

OSU-11022

Identifier Type: -

Identifier Source: org_study_id

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