Breast CancerPhase 4REALNCT00688909
Rheumatological Evaluation of Anastrozole and Letrozole as Adjuvant Treatment in Post-menopausal Women With Breast Cancer
A Phase 4 study testing letrozole in people with Breast Cancer, run by Novartis Pharmaceuticals at 48 sites in United States.
Trial summary
This study will evaluate whether patients who are intolerant and discontinue anastrozole due to grade 2-3 arthralgia-myalgia have a decrease in rheumatological symptoms while taking letrozole Read more about this study
- Who is it for?
- Ages 50 years and older, women only
- Conditions the study is for
- Breast Cancer
- What is being tested?
- letrozole
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 261 participants
- Where
- 48 sitesUnited States
- Study dates
- Mar 2008to Jun 2009
- Phase
- Phase 4
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 50 years and older
- Women only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Postmenopausal women with HR+ early stage breast cancer at the time of initial diagnosis. For study purposes, postmenopausal is defined as:
- Age ≥ 50 y and amenorrheic for 12 or more months.
- Age ≥ 50 y and amenorrheic for 3 or more months after receiving adjuvant chemotherapy.
- Age < 50 y and amenorrheic for 12 or more months.
- Prior bilateral oophorectomy.
- Prior hysterectomy and has postmenopausal levels of FSH, LH, and estradiol as per local institutional standards.
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- Age > 55 y and prior hysterectomy.
- Patients who are intolerant and discontinue anastrozole 2-3 weeks prior to study entry when given as adjuvant treatment for HR+ early stage breast cancer due to grade 2-3 (NCI-CTCAE V3) arthralgia-myalgia.
- Hormone receptor-positive tumors as defined by institutional standards.
- ECOG performance status of 0, 1, or 2
- Consent to participate in the trial. -
Who cannot join
- Postmenopausal women with HR+ metastatic or locally relapsed breast cancer excluding chest wall recurrence with no evidence of systemic disease.
- Recent history of pain associated with non-traumatic bone fracture.
- Pain requiring chronic use of analgesics (due to any reason).
- History of rheumatological disease except osteoarthritis.
- Prior hormonal therapy with AIs other than anastrozole.
- Systemic hormone replacement therapy (HRT) less than 4 weeks before study entry other than Estring®, Vagifem® or low dose estrogen vaginal cream.
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- Concomitant disease which significantly affects quality of life.
- Patient unable to complete self administered questionnaire.
- Patients unable to sign consent form.
- Other protocol-defined inclusion/exclusion criteria may apply
Trial locations and contacts
48 sites in 1 country.
48 sites in 1 country
United States48 sites
Summa Health System
Akron, Ohio, 44304
Central Utah Clinic
American Fork, Utah, 84003
Cancer Care of W. NC
Asheville, North Carolina, 28801
Northeast Georgia Cancer Care, LLC
Athens, Georgia, 30607
Augusta Oncology
Augusta, Georgia, 30901
Mercey Hospital
Baltimore, Maryland, 21202
Maryland Hematology Oncology Associates, PA
Baltimore, Maryland, 21237
Suburban Hospital Cancer Program
Bethesda, Maryland, 20817
Broom Oncology
Binghamton, New York, 13905
Lynn Cancer Center
Boca Raton, Florida, 33428
South Carolina Oncology Associates
Columbia, South Carolina, 29210
Coastal Bend Cancer Center
Corpus Christi, Texas, 78404
Center for Oncology Research and Treatment
Dallas, Texas, 75230
Trinitas Comprehensive Cancer Center
Elizabeth, New Jersey, 07207
The Cancer Instiute at Alexian Brothers
Elk Grove Village, Illinois, 60007
Evanston Northwestern Hospital
Evanston, Illinois, 60201
Medical Oncology & Hematology Associates of Northern Virginia
Fairfax, Virginia, 22031
Front Range Specialist
Fort Collins, Colorado, 80528
Florida Cancer Specialists
Fort Myers, Florida, 33916
Oncology Specialist of North Georgia
Gainesville, Georgia, 30501
Grass Valley Hematology Oncology
Grass Valley, California, 95945
Green Bay Oncologist, St Vincent Hospital
Green Bay, Wisconsin, 54301
Rockingham Memorial Hospital Regional Cancer Center
Harrisonburg, Virginia, 22801
Memorial Cancer Center
Hollywood, Florida, 33021
Clearview Cancer Center
Huntsville, Alabama, 35805
Hematology Oncology Asssociates of Ohio & Michigan
Lambertville, Michigan, 48144
Southeast Nebraska Hematology & Oncology Consultants
Lincoln, Nebraska, 68516
Hematology Oncology Services of Arkansas
Little Rock, Arkansas, 72205
Kentuckiana Cancer Institute
Louisville, Kentucky, 40202
Mukesh Bhatt, MD, INC.
Medina, Ohio, 44256
The West Clinic
Memphis, Tennessee, 38138
Hematology-Oncology Assoc of Northern New Jersey
Morristown, New Jersey, 07962
Tenessee Oncology
Nashville, Tennessee, 37203
Peninsula Cancer Center
Newport News, Virginia, 23601
Northern Utah Associates
Ogden, Utah, 84403
Aptium Oncology - Comprehensive Cancer Care of the Desert
Palm Springs, California, 92262
Bay Area Cancer Research Group
Pleasant Hill, California, 94523
Mercy Hospital
Portland, Maine, 04101
Edward H. Kaplan MD & Associates - North Shore Cancer Research Associates
Skokie, Illinois, 60076
Somerset Hematology & Oncology
Somerville, New Jersey, 08876
Center for Cancer Care and Research
St Louis, Missouri, 63141
Ballas Cancer Center, LLC DBA - St Louis
St Louis, Missouri, 63414
Cooper University Hospital
Voorhees Township, New Jersey, 08043
Marion L. Shepard Cancer Center
Washington, North Carolina, 27889
Oncology Alliance
Wauwatosa, Wisconsin, 53226
Palm Beach Cancer Specialists
West Palm Beach, Florida, 33401
Berks Hematology Oncology
West Reading, Pennsylvania, 19611
Cancer Care of Kansas
Wichita, Kansas, 67214
About this study
Official title: Open-label, Single-arm, Multicenter Study to Evaluate the Rheumatological Tolerability of Letrozole as an Adjuvant Breast Cancer Treatment in Postmenopausal Women Who Are Intolerant and Discontinue Anastrozole Due to Grade 2-3 Arthralgia-myalgia
This study will evaluate whether patients who are intolerant and discontinue anastrozole due to grade 2-3 arthralgia-myalgia have a decrease in rheumatological symptoms while taking letrozole
Read the detailed description
This is a multi-center prospective non-randomized single arm, open label trial in postmenopausal HR positive early breast cancer patients who experience grade 2-3 arthralgia-myalgia while on anastrozole, resulting in the discontinuation of anastrozole. After a 2-3 week period without any aromatase inhibitor treatment, eligible patients will initiate letrozole treatment at a dose of 2.5mg per day for a duration of 24 weeks. If a patient has breast cancer recurrence or is intolerant to letrozole during the 24 week period, the drug will be discontinued.
- Conditions
- Breast Cancer
- Being tested
- letrozole
- Keywords
- breast cancer, adjuvant treatment in post menopausal women, letrozole, arthralgia-myalgia
- Medical subject headings
- Breast Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
letrozoleDrug
Also called Femara
2.5 mg daily by mouth for 6 months
| Study group | Role | What they receive |
|---|---|---|
| Letrozole | Experimental | Participants received 2.5 milligram (mg) of Letrozole tablets orally once daily (QD) for a period of 24 weeks. Receives: Drug: letrozole |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants Discontinuing Due to Grade 2 or Higher Arthralgia-myalgia.
The arthralgia status and the myalgia status were separately graded at Baseline (V1), Week 12 (V3) , and Week 24/EOS (V4). The grades of 0 for no pain, 1 for mild pain, 2 for moderate pain, 3 for severe pain, and 4 for disabling pain were used.
Measured: End of Study (24 weeks)
Secondary outcomes (5)
Time to Discontinuation Due to Grade 2 or Higher Arthralgia- Myalgia.
For patients who discontinued from the study due to either grade 2 or higher arthralgia-myalgia, the time to discontinuation was calculated as the duration between the Visit 1 date and the last dose date. If the last dose date was missing, the EOS date was used.
Measured: End of Study (24 weeks)
Percentage of Participants Discontinuing, Irrespective of Cause
The percentage of patients who discontinued from the study irrespective of the reasons.
Measured: End of Study (24 weeks)
Change in Brief Pain Inventory (BPI) Composite Score
The BPI is a pain assessment tool for use with cancer patients. The BPI measures both the intensity of pain (sensory dimension) and interference of pain in the patient's life (reactive dimension). It also queries the patient about pain relief, pain quality, and patient perception of the cause of pain. The BPI composite score was calculated based on questions 3 to 6 of the BPI Questionnaire (short form). First each question was scored from 0 (no pain) to 10 (pain as bad as you can imagine) and circled on the CRF. Then a composite score was calculated as the mean of the scores. If any answer was missing, the composite score was set to missing. Change in BPI composite score indicates the change from baseline at week 24.
Measured: Baseline, 24 weeks (End of Study)
Change in Disability Index as Assessed by Health Assessment Questionnaire (HAQ)
The HAQ is a validated, patient-oriented outcome assessment instrument. The short version '2 page HAQ' was used. It contains the HAQ Disability Index (HAQ-DI), the HAQ visual analog scale (VAS) for pain and the VAS patient global health scale. The Stanford HAQ 20-item disability scale was utilized for scoring of the Disability Index. The items were first scored within each category with values 0 to 3 (0 = Without any difficulty, 1 = With some difficulty, 2 = With much difficulty, 3 = Unable to do). The score for the disability index was the mean of the eight category scores. If more than 2 of the 8 categories, or >25%, were missing, the scale was not scored. If ≤2 of the categories were missing, the sum of the categories was divided by the number of answered categories. Change in Disability Index indicates the change from baseline at week 24.
Measured: Baseline, Visit 1(24 weeks = End of Study)
Change in Pain as Assessed by Visual Analog Scale (VAS) Scale of the Health Assessment Questionnaire (HAQ)
The HAQ is a validated, patient-oriented outcome assessment instrument. The short version '2 page HAQ' was used. It contains the HAQ Disability Index (HAQ-DI), the HAQ visual analog scale (VAS) for pain and the VAS patient global health scale. The VAS is a tool used to help a person rate the intensity of certain sensations and feelings, such as pain. The visual analog scale for pain is a straight line with one end meaning no pain and the other end meaning the worst pain imaginable. For pain intensity, the scale is most commonly anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 100 [100-mm scale]). A higher score indicates greater pain intensity. Change in pain as assessed by VAS indicates the change from baseline at week 24.
Measured: Baseline, Visit 1 (24 weeks = End of Study)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Jun 2008 (estimated)
- Study startMar 2008
- Primary completionJun 2009
- Study completionJun 2009
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- More trials run by Novartis PharmaceuticalsThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Other
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 261 participants (actual)
Sponsor and investigators
- Lead sponsor
- Novartis Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Novartis Pharmaceuticals, Study director, Novartis Pharmaceuticals
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00688909
- Sponsor's protocol ID
- CFEM345DUS59
- Acronym
- REAL
- Status last verified
- May 2021
- First submitted
- 29 May 2008
- Last updated
- 9 Jun 2021
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 9 Jun 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Open-label, Single-arm, Multicenter Study to Evaluate the Rheumatological Tolerability of Letrozole as an Adjuvant Breast Cancer Treatment in Postmenopausal Women Who Are Intolerant and Discontinue Anastrozole Due to Grade 2-3 Arthralgia-myalgia
- ClinicalTrials.gov ID
- NCT00688909
- Acronym / sponsor ID
- REAL / CFEM345DUS59
- Conditions
- Breast Cancer
- Keywords
- breast cancer, adjuvant treatment in post menopausal women, letrozole, arthralgia-myalgia
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 261 participants (actual)
- Lead sponsor
- Novartis PharmaceuticalsIndustry (pharma, biotech, devices)
- Study start
- Mar 2008
- Primary completion
- Jun 2009 (actual)
- Study completion
- Jun 2009 (actual)
- First posted
- 3 Jun 2008 (estimated)
- Results
- Posted 24 May 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will evaluate whether patients who are intolerant and discontinue anastrozole due to grade 2-3 arthralgia-myalgia have a decrease in rheumatological symptoms while taking letrozole
Detailed description
This is a multi-center prospective non-randomized single arm, open label trial in postmenopausal HR positive early breast cancer patients who experience grade 2-3 arthralgia-myalgia while on anastrozole, resulting in the discontinuation of anastrozole. After a 2-3 week period without any aromatase inhibitor treatment, eligible patients will initiate letrozole treatment at a dose of 2.5mg per day for a duration of 24 weeks. If a patient has breast cancer recurrence or is intolerant to letrozole during the 24 week period, the drug will be discontinued.
Study design
- Primary purpose
- Other
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Letrozole | Experimental | Drug: letrozoleParticipants received 2.5 milligram (mg) of Letrozole tablets orally once daily (QD) for a period of 24 weeks. |
Who may qualify
- Ages
- 50 years and older
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (11 listed)
- Postmenopausal women with HR+ early stage breast cancer at the time of initial diagnosis. For study purposes, postmenopausal is defined as:
- Patients who are intolerant and discontinue anastrozole 2-3 weeks prior to study entry when given as adjuvant treatment for HR+ early stage breast cancer due to grade 2-3 (NCI-CTCAE V3) arthralgia-myalgia.
- Hormone receptor-positive tumors as defined by institutional standards.
- ECOG performance status of 0, 1, or 2
- Consent to participate in the trial. -
Key exclusion criteria (10 listed)
- Postmenopausal women with HR+ metastatic or locally relapsed breast cancer excluding chest wall recurrence with no evidence of systemic disease.
- Recent history of pain associated with non-traumatic bone fracture.
- Pain requiring chronic use of analgesics (due to any reason).
- History of rheumatological disease except osteoarthritis.
- Prior hormonal therapy with AIs other than anastrozole.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| letrozoleAlso: Femara2.5 mg daily by mouth for 6 months | Drug | Letrozole |
Primary outcome
Number of Participants Discontinuing Due to Grade 2 or Higher Arthralgia-myalgia.
Time frame: End of Study (24 weeks)
The arthralgia status and the myalgia status were separately graded at Baseline (V1), Week 12 (V3) , and Week 24/EOS (V4). The grades of 0 for no pain, 1 for mild pain, 2 for moderate pain, 3 for severe pain, and 4 for disabling pain were used.
5 secondary outcomes
Time to Discontinuation Due to Grade 2 or Higher Arthralgia- Myalgia.
Time frame: End of Study (24 weeks)
Percentage of Participants Discontinuing, Irrespective of Cause
Time frame: End of Study (24 weeks)
Change in Brief Pain Inventory (BPI) Composite Score
Time frame: Baseline, 24 weeks (End of Study)
Change in Disability Index as Assessed by Health Assessment Questionnaire (HAQ)
Time frame: Baseline, Visit 1(24 weeks = End of Study)
Change in Pain as Assessed by Visual Analog Scale (VAS) Scale of the Health Assessment Questionnaire (HAQ)
Time frame: Baseline, Visit 1 (24 weeks = End of Study)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Jun 2021.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results for CFEM345DUS59 from the Novartis Clinical Trials Results DatabaseLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Novartis Pharmaceuticals study director
Novartis Pharmaceuticals
48 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing letrozole in people with Breast Cancer, run by Novartis Pharmaceuticals at 48 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 11 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 9 Jun 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 48 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 24 May 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of Participants Discontinuing Due to Grade 2 or Higher Arthralgia-myalgia. (time frame: End of Study (24 weeks)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Jun 2021.