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Breast CancerPhase 2NCT02206984

Endocrine Response in Women With Invasive Lobular Breast Cancer

A Phase 2 study testing Tamoxifen, Anastrozole and Fulvestrant in people with Breast Cancer, run by Priscilla McAuliffe at 12 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

RATIONALE: Currently, adjuvant endocrine therapy often follows a "one-size-fits- all" approach, with most premenopausal women receiving tamoxifen, and most postmenopausal receiving aromatase inhibitor therapy. Read more about this study

Who is it for?
Any age, women only
Conditions the study is for
Breast Cancer
What is being tested?
Tamoxifen, Anastrozole and Fulvestrant
Could I receive a placebo?
No, everyone receives an active treatment
How many people
201 participants
Where
12 sitesUnited States
Study dates
30 Sep 2015to 19 Jul 2024
Phase
Phase 2
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 Any age
  • Women only
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Histologically confirmed invasive lobular breast cancer, that is hormone receptor-positive and HER2-negative, measuring at least 1 centimeter (cm) radiographically or clinically, clinical stages I-III. Invasive lobular histology will be diagnosed at the enrolling institution for purposes of study participation. Subsequently, invasive lobular histology will be confirmed by central pathology review, but this central review will not be required prior to patient enrollment.
  • Prior to initiation of study agents, study participants will be highly encouraged to undergo a baseline research core biopsy of their breast tumor. If this is not possible or the patient refuses, the pre-treatment tumor sample must be obtained from their archival diagnostic core biopsy. If definitive surgery is not performed at day 21-27 after study treatment, a second post-treatment research core biopsy will need to be obtained from their breast tumor. For patients undergoing surgery, the second biopsy will be removed from the breast tumor tissue excised during their operation. Note: In the event that the baseline breast tumor biopsy performed for research purposes does not yield adequate tumor tissue for analysis of the primary and secondary endpoints, tissue will be requested from the patient's archival clinical diagnostic core biopsy if it is available.The patient will still remain on study and complete protocol therapy as planned in this unlikely event.
  • Hormone receptor (HR) status of the invasive component must be documented before trial enrollment. The tumor must be HR-positive. HR will be considered positive if staining is 1% or greater for ER and/or PR. This will be determined at the enrolling institution for purposes of study participation and enrollment onto the trial. Subsequently, HR status will be confirmed by central pathology review, but this central review will not be required prior to enrolling the patient. HER2 status will be determined locally only, based upon current ASCO/CAP guidelines.
  • Patients must be female.
  • Participants must be fully postmenopausal.
  • ECOG performance status of 0, 1 or 2.
Show all 9Show fewer
  • Adequate organ and marrow function as defined by a history and physical exam that rules out comorbidities that would be exclusions to participation in the study (see exclusion criteria) and clinical laboratory parameters as deemed clinically appropriate by the treating physician.
  • Prior use of hormone contraceptives and replacement therapy is allowed (e.g., estrogen and/or progestin), but must have been discontinued at least 30 days prior to the study enrollment. Vaginal preparations (e.g., Vagifem® or Estring®)
  • Participant must be aware of the nature of her malignancy, understand the study requirements and risks and be able and willing to sign a written informed consent document.

Who cannot join

  • Prior or concurrent use of hormonal therapy, chemotherapy, radiation therapy, or novel therapy to treat the current breast cancer, including any history of prior irradiation to the ipsilateral breast. Additionally, the patient must not have had hormonal therapy for breast cancer treatment or for breast cancer prevention within 2 years prior to study enrollment. (Note: Synchronous breast, cancer (including bilateral breast cancer) at separate sites is permissible, provided the patient does not receive medical treatments for breast cancer or radiation therapy to the ipsilateral breast during the 21 day study intervention period.
  • Concurrent use of any other investigational agents.
  • History of allergic reactions/hypersensitivity attributed to compounds of similar chemical or biologic composition to tamoxifen, anastrozole, or fulvestrant or any of their ingredients.
  • History of thromboembolic disease or uterine cancer that is considered a contraindication to tamoxifen.
  • Active hepatitis viral infections or a known history of liver disease, especially moderate (Child-Pugh Class B) to severe (Child-Pugh Class C) hepatic impairment.
  • Uncontrolled current illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • HER-2 positivity.
  • Increased Risk of bleeding: including a history of a bleeding diathesis and/or known history of severe thrombocytopenia. NOTE: Anticoagulant use is not a contraindication to fulvestrant, but caution is advised in administration in patients on anticoagulation. Patients on anticoagulation who will receive fulvestrant will have PT and aPTT/INR assessed at baseline.

Trial locations and contacts

12 sites in 1 country.

12 sites in 1 country

United States12 sites
  • UAB Comprehensive Cancer Center

    Birmingham, Alabama, 35294

  • University of North Carolina at Chapel Hill

    Chapel Hill, North Carolina, 27514

  • University of Chicago Medical Center

    Chicago, Illinois, 60637

  • Lester and Sue Smith Breast Center, Baylor College of Medicine

    Houston, Texas, 77030

  • University of Texas MD Anderson Cancer Center

    Houston, Texas, 77064

  • Abramson Cancer Center of the University of Pennsylvania

    Philadelphia, Pennsylvania, 19104

  • Josh Plassmeyer

    Pittsburgh, Pennsylvania, 15213

  • Mayo Clinic

    Rochester, Minnesota, 55905

  • UCSF Helen Diller Family Comprehensive Cancer Center

    San Francisco, California, 94143

  • Univ. of Washington, Seattle Cancer Care Alliance, Fred Hutchinson Cancer Research Center

    Seattle, Washington, 98109

  • ALBERT EINSTEIN COLLEGE OF MEDICINE Montefiore Medical Center

    The Bronx, New York, 10467

  • Georgetown University Medical Center

    Washington D.C., District of Columbia, 20007

Other trials in United States

About this study

Official title: A Trial of Endocrine Response in Women With Invasive Lobular Breast Cancer

RATIONALE: Currently, adjuvant endocrine therapy often follows a "one-size-fits- all" approach, with most premenopausal women receiving tamoxifen, and most postmenopausal receiving aromatase inhibitor therapy. In current clinical practice, patients with invasive lobular carcinoma are treated no differently than patients with invasive ductal carcinoma based on the void of information specific to patients with this tumor type. Identification of a biological signal of tamoxifen and/or AI-resistance and/or fulvestrant-sensitivity in ILC patients would have dramatic implications for the future management of this breast cancer subtype.

PURPOSE: To study whether fulvestrant is more effective than anastrozole or tamoxifen in reducing Ki67 in ILC and whether that Ki67 reduction will correlate with alterations in expression of ER and ER-regulated genes. Differential Ki67 effect in this study will serve as a surrogate for outcome of ILC patients on endocrine therapy.

Read more

Primary Objective:

To determine the change from baseline to post-treatment Ki67 values in ER-positive, HER2-negative ILC tissue derived from postmenopausal women awaiting definitive surgery or further neoadjuvant treatment who are randomized to 21-24 days of neoadjuvant endocrine treatments with fulvestrant (two 250 mg IM injections given on day 1), anastrozole (1mg given orally daily), or tamoxifen (20mg given orally daily).

Read the detailed description

OBJECTIVES

Primary

To determine the change from baseline to post-treatment Ki67 values in ER-positive, HER2-negative ILC tissue derived from postmenopausal women awaiting definitive surgery or further neoadjuvant treatment who are randomized to 21-24 days of neoadjuvant endocrine treatments with fulvestrant (two 250 mg IM injections given on day 1), anastrozole (1mg given orally daily), or tamoxifen (20mg given orally daily).

Secondary

  • To evaluate ER protein expression in ILC tissues at baseline and following neoadjuvant endocrine therapy.
  • To evaluate PR protein expression in ILC tissues at baseline and following neo-adjuvant endocrine therapy.
  • To evaluate ER-related and ILC-specific candidate gene mRNA expression in ILC tissues at baseline and following neoadjuvant endocrine therapy in an effort to identify biomarkers of endocrine response and putative drivers of endocrine resistance in ILC.
  • To evaluate associations between changes in Ki67 in ILC tissues following neoadjuvant endocrine therapy with ER and PR protein expression, or ER and candidate gene mRNA expression at baseline and post-treatment.

Exploratory

  • To evaluate DNA methylation in ILC tissues at baseline and following neo-adjuvant endocrine therapy.
  • To evaluate associations between germline and somatic DNA sequence variants with changes in Ki67 in ILC tissues following neo-adjuvant endocrine therapy.
  • To evaluate the activity of signaling pathways in ILC tissues by immunohistochemical or other protein analyses, such as histone modifications, at baseline and following neo-adjuvant endocrine therapy.
Conditions
Breast Cancer
Medical subject headings
Breast Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT02206984
Study groupRoleWhat they receive
tamoxifenActive comparatorTamoxifen is administered orally, at a dose of 20 mg,daily, for 21 days
Receives: Drug: Tamoxifen
AnastrozoleActive comparator1mg given orally daily for 21 days
Receives: Drug: Anastrozole
fulvestrantActive comparator500 mg, administered as two 250 mg IM injections, given on days 1 and 14
Receives: Drug: Fulvestrant

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Log-transformed Ki67 Proliferative Index

    Ki67 expression is a routine pathologic marker that is strongly associated with cell proliferation. It is extensively used as a prognostic and predictive marker in cancer. Ki67 was calculated as a percentage of 1000 tumor cells counted in both the pre- and post-treatment specimens.

    The primary endpoint was change in log-transformed Ki67 at post-treatment compared to baseline. We used fixed paired differences with mean (SD) log (post/pre).

    Measured: Baseline, Day 21-27

Secondary outcomes (6)
  1. Pre-treatment Ki67 Proliferative Index

    Ki67 expression is a routine pathologic marker that is strongly associated with cell proliferation. It is extensively used as a prognostic and predictive marker in cancer. Ki67 was calculated as a percentage of 1000 tumor cells counted in both the pre- and post-treatment specimens.

    Measured: Baseline

  2. Post-treatment Ki67 Proliferative Index

    Ki67 expression is a routine pathologic marker that is strongly associated with cell proliferation. It is extensively used as a prognostic and predictive marker in cancer. Ki67 was calculated as a percentage of 1000 tumor cells counted in both the pre- and post-treatment specimens.

    Measured: Day 21-27

  3. Pre-treatment Estrogen Receptor H Score

    Estrogen receptor (ER) Histologic (H) Score is calculated as the sum of intensity of staining (0 to 3+) multiplied by the proportion (%) of cells staining positive and has a dynamic range of 0 to 300. ER H score pre-treatment was determined for each of the three treatment groups.

    Measured: Baseline

  4. Post-treatment Estrogen Receptor (ER) H Score

    Estrogen receptor (ER) Histologic (H) Score is calculated as the sum of intensity of staining (0 to 3+) multiplied by the proportion (%) of cells staining positive and has a dynamic range of 0 to 300. ER H score was determined in each of the three post treatment groups.

    Measured: Day 21-27

  5. Pre-treatment Progesterone Receptor (PR) H Score

    Progesterone receptor (PR) Histologic (H) Score is calculated as the sum of intensity of staining (0 to 3+) multiplied by the proportion (%) of cells staining positive and has a dynamic range of 0 to 300. PR H Score was determined at baseline.

    Measured: Baseline

  6. Post-treatment Progesterone Receptor (PR) H Score

    Progesterone receptor (PR) Histologic (H) Score is calculated as the sum of intensity of staining (0 to 3+) multiplied by the proportion (%) of cells staining positive and has a dynamic range of 0 to 300. PR H score was determined post treatment.

    Measured: Day 21-27

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Aug 2014 (estimated)
  2. Study start30 Sep 2015
  3. Primary completion19 Jul 2024
  4. Study completion19 Jul 2024

Resources

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
201 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02206984
Sponsor's protocol ID
HCC 13-164 (ILC)
Status last verified
Jul 2026
First submitted
30 Jul 2014
Last updated
7 Aug 2026
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Sottnik JL, Bordeaux EK, Mehrotra S, Ferrara SE, Goodspeed AE, Costello JC, Sikora MJ. Mediator of DNA Damage Checkpoint 1 (MDC1) Is a Novel Estrogen Receptor Coregulator in Invasive Lobular Carcinoma of the Breast. Mol Cancer Res. 2021 Aug;19(8):1270-1282. doi: 10.1158/1541-7786.MCR-21-0025. Epub 2021 May 4.

    PubMed 33947745

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Tamoxifen, Anastrozole and Fulvestrant in people with Breast Cancer, run by Priscilla McAuliffe at 12 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 9 inclusion and 8 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 7 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 7 Aug 2026). 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?

Change in Log-transformed Ki67 Proliferative Index (time frame: Baseline, Day 21-27). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02206984, which also lists 1 linked publication.

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 7 Aug 2026.

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