Pilot Study of Effects of Duavee® on Imaging and Blood Biomarkers In Women With Menopausal Symptoms

NCT ID: NCT04379024

Last Updated: 2021-10-29

Basic Information

• Recruitment Status: TERMINATED
• Clinical Phase: EARLY_PHASE1
• Total Enrollment: 11 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2020-06-01
• Study Completion Date: 2021-07-31

Brief Summary

Pilot study to test feasibility of 6 months of Duavee® vs wait-list control in post-menopausal women symptomatic for hot flashes.

Detailed Description

Duavee® which is the combination of the selective estrogen receptor modulator bazedoxifene and conjugated estrogen 0.45 mg) is an FDA approved drug for treatment of hot-flashes and prevention of osteoporosis in postmenopausal women. The investigators recently reported the results of a single arm pilot study suggesting that 6 months of Duavee® was associated with improvement in several risk biomarkers including benign breast tissue proliferation, mammographic fibroglandular volume, IGF-1, SHBG and progesterone in high risk women in late menopause transition. Prior to opening a randomized Phase IIB trial of 6 months of Duavee® vs placebo in high risk women with hot-flashes followed by open label Duavee®, the intent of this study is to assess probable uptake of such a trial design with a pilot of 6 months of Duavee® vs wait-list control in symptomatic women. Additional imaging biomarker information from MRI will be obtained. A finding on MRI of greater background parenchymal enhancement (BPE) in high risk women is positively associated with higher probability of developing breast cancer and is independent of fibroglandular volume. BPE is reduced by selective estrogen receptor modulators including tamoxifen. The investigators will investigate change in MRI BPE over time for women randomly assigned to either receive Duavee® or not (wait-list control). The investigators will also explore development of fully automated breast MRI volumetric density measures.

Conditions

Focus of Study is Healthy Women at Risk for Breast Cancer

Keywords

Imaging; Biomarkers

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: NONE

Study Groups

Immediate active agent

Duavee. One capsule daily for 6 months (+/- 1 month) of Duavee (Bazedoxifene 20 mg plus conjugated estrogens 0.45 mg)

Group Type: EXPERIMENTAL

DUAVEE 0.45Mg-20Mg Tablet

Intervention Type: DRUG

One capsule daily for 6 months (+/- 1 month)

Delayed active agent

No intervention for first 6 months. Then option to receive daily Duavee for 6 months.

Group Type: OTHER

DUAVEE 0.45Mg-20Mg Tablet

Intervention Type: DRUG

One capsule daily for 6 months (+/- 1 month)

Interventions

DUAVEE 0.45Mg-20Mg Tablet

One capsule daily for 6 months (+/- 1 month)

Intervention Type: DRUG

Other Intervention Names

Bazedoxifene 20 mg plus conjugated estrogens 0.45 mg

Eligibility Criteria

Inclusion Criteria

• Women who report vasomotor symptoms (hot flashes or night sweats)
• No menstrual periods for at least 3 months
• Must have at least one ovary (hysterectomy is permitted; bilateral salpingo- oophorectomy is excluded).
• BMI <36 kg/m2
• Moderate risk of developing breast cancer based on having any one or more of the following:

• First or 2nd degree relative with breast cancer
• Known carrier of moderate to high penetrance germline mutation
• Prior breast biopsy showing proliferative breast disease or multiple biopsies
• High mammographic density (Volpara® categories c or d or BIRADs density assessment as heterogeneously or extremely dense (c or d).
• IBIS Breast Cancer Risk Evaluation Version 8 10-year relative risk of >2X that for the population for age group.

Exclusion Criteria

• Risk: A prior biopsy showing LCIS, DCIS, or invasive breast cancer.
• Medical Conditions:

• Have a predisposition to or prior history of thromboembolism, deep venous thrombosis, pulmonary embolism, or stroke
• History of renal or liver disease
• Prior invasive ovarian or endometrial cancer
• Medications

• Current anticoagulant use other than low dose aspirin
• Taking systemic hormones within two months (eight weeks) prior to baseline MRI and mammogram.
• Taking tamoxifen, raloxifene, Duavee, or any selective estrogen receptor modulator, or an aromatase inhibitor within 12 months prior to baseline MRI and mammogram.

• Minimum Eligible Age: 45 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: Yes

Sponsors

Breast Cancer Research Foundation

OTHER

Sponsor Role: collaborator

Carol Fabian, MD

OTHER

Sponsor Role: lead

Responsible Party

Carol Fabian, MD

Professor

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

Carol J Fabian, MD

Role: PRINCIPAL_INVESTIGATOR

University of Kansas Medical Center

Locations

University of Kansas Medical Center

Kansas City, Kansas, United States

Countries

United States

References

Fabian CJ, Nye L, Powers KR, Nydegger JL, Kreutzjans AL, Phillips TA, Metheny T, Winblad O, Zalles CM, Hagan CR, Goodman ML, Gajewski BJ, Koestler DC, Chalise P, Kimler BF. Effect of Bazedoxifene and Conjugated Estrogen (Duavee) on Breast Cancer Risk Biomarkers in High-Risk Women: A Pilot Study. Cancer Prev Res (Phila). 2019 Oct;12(10):711-720. doi: 10.1158/1940-6207.CAPR-19-0315. Epub 2019 Aug 16.

Reference Type: BACKGROUND

PMID: 31420361 (View on PubMed)

Other Identifiers

Study00145121

Identifier Type: -

Identifier Source: org_study_id