UMIN-CTR Clinical Trial

Unique ID issued by UMIN C000000345
Receipt number R000000443
Scientific Title Phase II study of neoadjuvant treatment with Exemestane for 24 weeks in postmenopausal women with hormone receptor positive Stage II or IIIA breast cancer.
Date of disclosure of the study information 2006/03/06
Last modified on 2019/03/18 09:06:46

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Basic information

Public title

Phase II study of neoadjuvant treatment with Exemestane for 24 weeks in postmenopausal women with hormone receptor positive Stage II or IIIA breast cancer.

Acronym

Neoadjuvant Exemestane for 24 weeks in postmenopausal Women with hormone receptor positive Stage II or IIIA breast cancer (JFMC34-0601)

Scientific Title

Phase II study of neoadjuvant treatment with Exemestane for 24 weeks in postmenopausal women with hormone receptor positive Stage II or IIIA breast cancer.

Scientific Title:Acronym

Neoadjuvant Exemestane for 24 weeks in postmenopausal Women with hormone receptor positive Stage II or IIIA breast cancer (JFMC34-0601)

Region

Japan


Condition

Condition

Breast Cancer

Classification by specialty

Hematology and clinical oncology Breast surgery

Classification by malignancy

Malignancy

Genomic information

NO


Objectives

Narrative objectives1

Examine the clinical response and safety of neoadjuvant therapy with Exemestane for 24 weeks in postmenopausal women with hormone receptor positive Stage II or IIIA breast cancer. As secondary object, develop a predictive model of response and long term outcomes based on gene expression and proteomics profiling.

Basic objectives2

Safety,Efficacy

Basic objectives -Others


Trial characteristics_1

Confirmatory

Trial characteristics_2

Pragmatic

Developmental phase

Phase II


Assessment

Primary outcomes

Determine the clinical response rate.
Determine the incidence of adverse events.

Key secondary outcomes

Determine the long-term outcomes (overall survival, relapse free survival).
Determine the rate of improvement in surgical outcomes (breast conserving rate, local recurrence rate).
Determine the rate of axillary lymph node involvement and pathologic response. Examine the change of biomarker (e.g., Ki-67, TUNEL, bcl-2, M-30) with this treatment.
Develop a predictive model of response and long term outcomes based on gene expression and proteomics profiling.


Base

Study type

Interventional


Study design

Basic design

Single arm

Randomization

Non-randomized

Randomization unit


Blinding

Open -no one is blinded

Control

Uncontrolled

Stratification


Dynamic allocation


Institution consideration


Blocking


Concealment



Intervention

No. of arms

1

Purpose of intervention

Treatment

Type of intervention

Medicine

Interventions/Control_1

Preoperative treatment with Exemestane 25mg/day for 24 weeks.

Interventions/Control_2


Interventions/Control_3


Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit

55 years-old <=

Age-upper limit

79 years-old >=

Gender

Female

Key inclusion criteria

1) Histologically confirmed invasive breast cancer excluding mucinous and lobular cancer by core needle biopsy or open biopsy.
2) Clinical stage T2-T3, N0-2, M0.
3) Estrogen- and/or Progesterone-receptor positive tumor based on 10% or more nuclear staining of the invasive ductal component by immunohistochemistry.
4) Her2 expression was examined by IHC and/or FISH.
5) Previously untreated disease.
6) WHO performance status 0-1.
7) Expecting benefits from neoadjuvant therapy that would improve surgical outcome and meets criteria for 1 of the following:
(a) Marginal candidate for lumpectomy (e.g., lumpectomy feasible but patient at risk for positive margins or poor cosmetic outcome).
(b) Ineligible for lumpectomy, but modified radical mastectomy feasible.
8) Sentinel lymph node biopsy allowed before treatment or after treatment.
9) Patients must be age between 55 y.o. to 79 y.o. and postmenopausal verified by one of the following.
(a) amenorrhea more than 1 year
(b) artificial menopause by radiation or bilateral ovariectomy
(c) FSH >= 30mIU/ml and E2 < 10pg/ml
10) Willing and able to provide biopsy materials and blood samples for research purpose.
11) No severe liver dysfunction.
12) Confirmed by attending doctor as a candidate for this trial after consideration of other treatment options.
13) Written informed consent

Key exclusion criteria

1) Concurrent user of HRT, raloxifen and other sex hormone related drugs.
2) Patients with bilateral breast cancer, past history of breast cancer and active other type of cancer.
3) Absolute candidate for primary chemotherapy or surgery.

Target sample size

110


Research contact person

Name of lead principal investigator

1st name
Middle name
Last name Masakazu Toi

Organization

Graduate School of Medicine, Kyoto University

Division name

Department of Surgery (Breast Surgery)

Zip code


Address

54 Shogoin-Kawaramachi, Sakyo-ku, Kyoto 606-8507, Japan

TEL

075-751-3660

Email

toi@kuhp.kyoto-u.ac.jp


Public contact

Name of contact person

1st name
Middle name
Last name Japanese Foundation for Multidisciplinary Treatment of Cancer

Organization

Japanese Foundation for Multidisciplinary Treatment of Cancer

Division name

Office

Zip code


Address

TaniBuilding3F, 1-28-6, kameido, koutou-ku, Tokyo, 136-0071, Japan

TEL

03-5627-7594

Homepage URL

http://www.jfmc.or.jp/

Email

jfmc-dc@jfmc.or.jp


Sponsor or person

Institute

Japanese Foundation for Multidisciplinary Treatment of Cancer

Institute

Department

Personal name



Funding Source

Organization

Japanese Foundation for Multidisciplinary Treatment of Cancer

Organization

Division

Category of Funding Organization

Non profit foundation

Nationality of Funding Organization

Japan


Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization


Address


Tel


Email



Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions

札幌医科大学 第一外科(北海道)、岩手医科大学 外科(岩手)、福島県立医科大学 第二外科(福島)、筑波大学 乳腺甲状腺内分泌外科(茨城)、群馬県立がんセンター 乳腺科(群馬)、埼玉医科大学国際医療センター 乳腺腫瘍科(埼玉)、埼玉県立がんセンター 乳腺外科(埼玉)、東京都立駒込病院 外科(東京)、順天堂大学医学部附属練馬病院 乳腺外科(東京)、昭和大学病院 一般・消化器外科(東京)、東邦大学医療センター大森病院 乳腺・内分泌外科(東京)、東京医科大学 乳腺科(東京)、国立国際医療センター 外科(東京)、東京女子医科大学 東医療センター 外科(東京)、癌研究会有明病院 化学療法科(東京)、日本大学医学部附属板橋病院 乳腺内分泌外科(東京)、東京都立府中病院 外科(東京)、三井記念病院 乳腺内分泌外科(東京)、聖路加国際病院 乳腺外科(東京)、国際医療福祉大学三田病院 乳腺センター (東京)、神奈川県立がんセンター 乳腺甲状腺外科(神奈川)、東海大学医学部 乳腺内分泌外科(神奈川)、信州大学医学部附属病院 乳腺内分泌外科(長野)、新潟県立がんセンター新潟病院 外科(新潟)、藤田保健衛生大学病院 乳腺外科(愛知)、愛知県がんセンター中央病院 乳腺科(愛知)、名古屋市立大学病院 乳腺内分泌外科(愛知)、京都大学 乳腺外科(京都)、国立病院機構大阪医療センター 外科(大阪)、関西労災病院 外科(大阪)、広島市立安佐市民病院 外科(広島)、国立病院機構四国がんセンター 乳腺科(愛媛)、北九州市立医療センター 外科(福岡)、国立病院機構九州がんセンター 乳腺科(福岡)、医療法人にゅうわ会及川病院 外科・乳腺腫瘍科(福岡)、熊本大学医学部附属病院 乳腺・内分泌外科(熊本)、熊本市立熊本市民病院 乳腺内分泌外科(熊本)


Other administrative information

Date of disclosure of the study information

2006 Year 03 Month 06 Day


Related information

URL releasing protocol

http://www.jfmc.or.jp/wp-content/uploads/2015/01/jfmc34-0601_070117.pdf

Publication of results

Partially published


Result

URL related to results and publications

https://doi.org/10.1111/j.1349-7006.2011.01867.x

Number of participants that the trial has enrolled

116

Results

Between March 2006 and December 2007, 116 patients were enrolled. Among those, 102 patients completed 24 weeks administration. The ORR was 47% (55/116) at week 16 and 51% (59/116) at week 24, respectively. No serious toxicity was seen. At diagnosis, 59 patients (51%) would have required mastectomy but 40 patients were converted to BCS, showing an increase in the rate of BCS (77%). The 24-week aromatase inhibition provided preferable clinical benefits with significant reduction in Ki67 index.

Results date posted

2019 Year 03 Month 18 Day

Results Delayed


Results Delay Reason


Date of the first journal publication of results


Baseline Characteristics

Between March 2006 and December 2007 a total of 116 patients were enrolled. T2 stage were 110 cases and N0 were 91 cases. All patients were defined as ER-positive, 80 (68.9%) were PgR-positive and 3(2.5%) were HER2-positive by investigator evaluation.

Participant flow

During the first 16 weeks, 10 patients discontinued neoadjuvant exemestane treatment because of PD (4 patients), investigator decision (1 patient), adverse events (2 patients, 1 of whom was not evaluable at Week 16), or patients decision (3 patients, 2 of whom were not evaluable at Week 16). 102 patients completed 24 weeks of exemestane neoadjuvant treatment.

Adverse events

The most frequently seen adverse events were an abnormal increase in liver enzyme levels (SGOT, SGPT and ALP), hot flush, joint pain, hypoalbuminuria and elevated creatinine and bilirubin levels. None of these adverse events were deemed to be severe in intensity. The only Grade 3 adverse events were elevated liver enzymes in four cases.

Outcome measures

The primary end points were objective response rates (ORR) and safety after 16 and 24 weeks of treatment in intent to treatment analysis.

Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

Completed

Date of protocol fixation

2006 Year 02 Month 06 Day

Date of IRB

2005 Year 11 Month 25 Day

Anticipated trial start date

2006 Year 03 Month 01 Day

Last follow-up date

2018 Year 08 Month 01 Day

Date of closure to data entry


Date trial data considered complete


Date analysis concluded



Other

Other related information



Management information

Registered date

2006 Year 03 Month 02 Day

Last modified on

2019 Year 03 Month 18 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000000443


Research Plan
Registered date File name

Research case data specifications
Registered date File name

Research case data
Registered date File name