WISEA Pilot Study of Aromatase Inhibitors for Women at Increased Risk of Breast Cancer Based on Estradiol Levels
Letrozole
+ Placebo
Breast Carcinoma In Situ+11
+ Adenocarcinoma
+ Breast Diseases
Prevention Study
Summary
Study start date: February 1, 2002
Actual date on which the first participant was enrolled.OBJECTIVES: Primary * The primary outcome of the study is the change in bone mineral density following a year on letrozole vs. a year on placebo. Secondary * Compare the safety, acceptability, and adherence to letrozole vs placebo in postmenopausal women at increased risk for the development or recurrence of breast cancer based on elevated plasma estradiol levels through evaluation of menopausal symptoms (including hot flushes, weight changes, sexual functioning, and genitourinary effects), blood lipid levels, markers of bone turnover, and multidimensional quality of life. * Determine the effect of letrozole-induced reduction of plasma estradiol levels on mammographic percent breast density. * Obtain background information for a future large chemoprevention trial to address the question of whether a reduction in plasma estradiol levels can reduce the risk of breast cancer in postmenopausal women. OUTLINE: This is a pilot, randomized, double-blind, placebo-controlled, multicenter study. Patients are randomized to 2:1 (experimental treatment: placebo arms). PROJECTED ACCRUAL: A total of 110 patients (73 for arm I and 37 for arm II) will be accrued for this study.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.49 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Prevention Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Female
Biological sex of participants that are eligible to enroll.From 35 to 120 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
DISEASE CHARACTERISTICS: * At increased risk for the development or recurrence of breast cancer, defined as an estradiol level ≥ 9 pg/mL * No evidence of suspicious or malignant disease, based on the following examinations: * Clinical bilateral breast examination within the past 6 months * Bilateral\* mammogram within 3 months before randomization OR within 30 days after randomization * Pelvic exam normal within the past 5 years * General physical exam within the past 6 months NOTE: \*Unilateral mammogram of the uninvolved breast for patients with prior invasive breast cancer or ductal carcinoma in situ (DCIS) * Bone density scan within 2 standard deviations from normal within the past 30 days * Bone density scan ≥ 2 standard deviations below normal allowed if approved by the study physician * At least 1 breast that has not been previously treated with radiotherapy or surgery (for patients with prior invasive breast cancer or DCIS) * Hormone receptor status: * Not specified PATIENT CHARACTERISTICS: Age * 35 and over Sex * Female Menopausal status * Postmenopausal, defined by any of the following criteria: * At least 12 months without spontaneous menstrual bleeding * Prior hysterectomy and bilateral salpingo-oophorectomy * ≥ 55 years of age with a prior hysterectomy with or without oophorectomy * \< 55 years of age with a prior hysterectomy without oophorectomy OR the status of the ovaries is unknown AND follicle-stimulating hormone (FSH) level is in the postmenopausal range Performance status * Normal activity must not be restricted for a significant portion of the day Life expectancy * At least 10 years Hematopoietic * Complete blood count with differential normal * Prior benign neutropenia allowed provided the granulocyte count is ≥ 1,500/mm\^3 Hepatic * Bilirubin normal * Alkaline phosphatase normal * SGOT and SGPT normal Renal * Creatinine normal Cardiovascular * No uncontrolled cardiovascular disease Other * Not pregnant * No other malignancy within the past 5 years except basal cell or squamous cell skin cancer or carcinoma in situ of the cervix * No osteoporosis * No hyperlipidemia * No mental health status resulting in cognitive or emotional impairment that would preclude study participation PRIOR CONCURRENT THERAPY: Biologic therapy * Not specified Chemotherapy * Not specified Endocrine therapy * More than 30 days since prior AND no concurrent use of any of the following hormonal agents: * Estrogen or progesterone replacement therapy * Oral contraceptives * Raloxifene or other plasma estrogen receptor modulators (SERMs) * Androgens (e.g., danazol) * Luteinizing hormone-releasing hormone (LHRH) analogs (e.g., goserelin or leuprolide) * Prolactin inhibitors (e.g., bromocriptine) * Antiandrogens (e.g., cyproterone) * More than 60 days since prior AND no concurrent tamoxifen * No prior aromatase inhibitors (for patients with prior invasive breast cancer or DCIS) * No concurrent phytoestrogenic dietary supplements (e.g., soy, ginseng, or other natural products) * Dietary soy allowed Radiotherapy * See Disease Characteristics Surgery * See Disease Characteristics * No prior bilateral mastectomy Other * More than 60 days since prior treatment for invasive breast cancer or DCIS * More than 30 days since prior bisphosphonates or calcitonin * No prior or concurrent participation on a treatment study for invasive breast cancer or DCIS * No concurrent participation in any other cancer prevention study or osteoporosis prevention study involving pharmacologic agents * No concurrent calcitonin * No concurrent bisphosphonate therapy * Concurrent cholecalciferol (vitamin D) and calcium to augment bone mineral density allowed
Study Plan
Find out more about all the medication administered in this study, their detailed description and what they involve.2 intervention groups are designated in this study
50% chance of being blinded to the placebo group
Treatment Groups
Group I
ExperimentalGroup II
PlaceboStudy Objectives
Primary Objectives
Secondary Objectives
Study Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 5 locations
Massachusetts General Hospital
Boston, United StatesOpen Massachusetts General Hospital in Google MapsDana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
Boston, United StatesBeth Israel Deaconess Medical Center
Boston, United StatesAbramson Cancer Center of the University of Pennsylvania
Philadelphia, United States