Breast CancerPhase 3NCT03324932
Efficacy of Denosumab on Normal BMD in Women Receiving Adjuvant Aromatase Inhibitors for Early Breast Cancer
A Phase 3 study testing Denosumab Injection in people with Breast Cancer, run by Kyoto Prefectural University of Medicine at 1 site in Japan.
Trial summary
This multicenter, randomized, comparative study will evaluate the efficacy of denosumab to prevent the adjuvant therapy of aromatase inhibitors-induced loss of bone mineral density (BMD) in breast cancer patients with normal BMD. Read more about this study
- Who is it for?
- Ages 20 years and older, women only
- Conditions the study is for
- Breast Cancer
- What is being tested?
- Denosumab Injection
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 160 participants
- Where
- 1 siteJapan
- Study dates
- 25 Sep 2017to Dec 2027
- Phase
- Phase 3
- Are there results?
- Not yet: the study is under way
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 20 years and older
- Women only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients must meet all of the following items at the time of case registration:
- Patients with infiltrative breast cancer, aged ≥20 years, meeting the following definitions:
- Those pathologically diagnosed with stage I, II, or IIIA breast cancer (Cancer Management Regulations, 11th version)
- Those who underwent appropriate surgery, such as mastectomy and breast-preserving surgery
- Estrogen receptor (ER)- or progesterone receptor (PgR)-positive patients on immunohistochemical (IHC) staining
- Females meeting one of the following criteria for menopause:
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- Those, aged ≥55 years, without menstruation
- Those, aged <55 years, with amenorrhea for ≥12 months, or those diagnosed with menopause by attending physicians based on the FSH and estradiol levels
- Those who underwent bilateral oophorectomy
- Patients in whom the BMD for the lumbar vertebrae (L1-L4) on DXA before the start of this study is ≥-1.0SD of the mean value of young adult females (YAM), and the BMD for the femoral neck is ≥-1.0SD of YAM
- Patients without lumbar vertebral or femoral fracture
- Those with an ECOG PS of 0-2
- Those with adequate organ functions (laboratory data within 4 weeks before case registration)
- Leukocyte count, ≥3,000/mm3 or Neutrophil count, ≥1,500/mm3
- AST, ALT, ≤1.5-fold of the upper limit of the institutional reference range
- Serum creatinine, ≤1.5-fold of the upper limit of the institutional reference range
- Case registration should be performed before the following point:Twelve weeks after the completion of surgery or postoperative chemotherapy (The completion of chemotherapy refers to the completion of the final course, involving the recovery phase.)
- Patients with an interval of ≥4 weeks after the discontinuation of therapy with bisphosphonates (oral preparations), estrogen preparations, raloxifene, calcitonin preparations, vitamin K preparations, active vitamin D preparations, or ipriflavone preparations, which influence bones
- Those from whom written informed consent regarding study participation was obtained
Who cannot join
- Whether each patient meets any of the following items must be checked on case registration:
- Patients in whom distant metastasis was confirmed clinically or using imaging procedures at the time of case registration
- Those with bilateral breast cancer
- Those for whom postoperative hormonal therapy was started before consenting to study participation
- Those who received endocrine therapy within 52 weeks before consenting to study participation
- Those to whom bisphosphonate preparations were intravenously administered within 52 weeks before consenting to study participation
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- Those with the following diseases that may affect DXA
- Severe scoliosis, immobility, hyperostosis or osteosclerosis of the lumbar vertebrae, calcification of the abdominal aorta, and vertebral disease
- Those with a history of malignant tumors other than breast cancer within 260 weeks before consenting to study participation
- Those with dental diseases, such as infectious diseases of the teeth or jaw and tooth trauma. Those for whom tooth or jaw surgery is scheduled within 6 weeks after consenting to study participation (tooth extraction, implantation)
- Others who are considered to be ineligible by the chief investigator
Trial locations and contacts
1 site in 1 country.
About this study
Official title: A Multicenter, Randomized, Comparative Study Regarding the Efficacy of Denosumab on Normal Bone Mineral Density in Women Receiving Adjuvant Aromatase Inhibitors for Early Breast Cancer (ENDEAVOR Trial)
This multicenter, randomized, comparative study will evaluate the efficacy of denosumab to prevent the adjuvant therapy of aromatase inhibitors-induced loss of bone mineral density (BMD) in breast cancer patients with normal BMD. Investigators will compare the inhibitory effects of denosumab on bone loss between participants with normal BMD to whom Letrozole or Arimidex will be administered as postoperative endocrine therapy for stage I-IIIA postmenopausal hormone-sensitive breast cancer and controls.
Read the detailed description
Normal BMD means T score is ≥-1.0 for the lumbar vertebrae (L1-L4) and/or the femoral neck.
- Conditions
- Breast Cancer
- Being tested
- Denosumab Injection
- Keywords
- bone health, hormone-sensitive breast cancer, postmenopausal, aromatase inhibitor, bone mineral density
- Medical subject headings
- Breast Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Denosumab InjectionDrug
Also called pralia
AI intake + denosumab injection per 6 months VS only AI intake
| Study group | Role | What they receive |
|---|---|---|
| AI+denosumab VS only AI | Other | We compare AI intake+denosumab injection and AI intake only in patients with normal BMD to whom Letrozole or Arimidex will be administered as postoperative endocrine therapy, and we assess the efficacy of denosumab injection on bone loss by adjuvant endocrine therapy. Receives: Drug: Denosumab Injection |
What is being measured
The primary outcome is the main question the study is designed to answer.
percentage change in the bone mineral density (BMD) for the lumbar vertebrae (L1-L4) on dual-energy X-ray absorptiometry (DXA)
The change is a value obtained by subtracting 1 from the BMD after 12 months/baseline BMD is expressed as a percentage
Measured: 12 months after the start of this study
Secondary outcomes (9)
percentage change in the BMD for the lumbar vertebrae (L1-L4) on DXA
percentage change in the BMD for the femoral neck: After 2/3/4/5 years
Measured: after 2, 3, 4, and 5 years
percentage change in the BMD for the femoral neck
percentage change in the BMD for the femoral neck: After 12 months and 2/3/4/5 years
Measured: after 12 months and 2/3/4/5 years
percentage change in the BMD for the radius (an ultrasonic bone densimeter is used)institutions in which ultrasonic bone densimeters are used)
percentage change in the BMD for the radius (an ultrasonic bone densimeter is used): After 2 and 4 weeks, every 4 weeks thereafter (for 2 years after registration)(only institutions in which ultrasonic bone densimeters are used)
Measured: after 2 and 4 weeks, every 4 weeks thereafter (for 2 years after registration)(only
Changes in Ca and bone metabolism markers
Changes in Ca (mg/dL corrected by albumin level) and bone metabolism markers such as TRAP5b, bone-specific alkaline phosphatase (BSAP), blood pentosidine) by blood sampling at every 6 months
Measured: after 24 weeks
Appearance rate of morbid fracture in all participants
Appearance rate of morbid fracture up to 3 years in all participants. Morbid fractures include all types of fractures.
Measured: up to 3 years
Disease-free survival
Disease-free survival at the end of the study
Measured: at least 5 year
Overall survival
Overall survival at the end of the study
Measured: at least 5 year
Appearance of adverse events
Appearance rate of adverse events (such as hypocalcemia and necrosis of the jaw)
Measured: at least 5 year
Quality of life (QOL)
Quality of life(QOL), Japanese version Euro-Qol (EQ-5D-5L) evaluated by questionnaire at every 6 months
Measured: after 24 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Oct 2017
- Study start25 Sep 2017
- Primary completionDec 2023 (estimated)
- Study completionDec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- 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 3
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 160 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Kyoto Prefectural University of Medicine
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Hisako Ono, MD, PhD, Kyoto Prefectural University of Medicine
- Investigators
- Hisako Ono, PhD, Study director, Kyoto Prefectural University of MedicineTetsuya Taguchi, PhD, Principal investigator, Kyoto Prefectural University of Medicine
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03324932
- Sponsor's protocol ID
- CQARD-EBS-160402
- Other IDs
- jRCTs051180211
- Status last verified
- Oct 2023
- First submitted
- 21 Sep 2017
- Last updated
- 6 Oct 2023
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Nakatsukasa K, Koyama H, Ouchi Y, Ono H, Sakaguchi K, Matsuda T, Kato M, Ishikawa T, Yamada K, Yoshimura M, Koizumi K, Sakurai T, Shigematsu H, Takahashi S, Taira S, Suzuki M, Narui K, Niikura N, Hasegawa Y, Miura D, Konishi E, Taguchi T; Collaborative Study Group of Scientific Research of the Japanese Breast Cancer Society. Effect of denosumab on low bone mineral density in postmenopausal Japanese women receiving adjuvant aromatase inhibitors for non-metastatic breast cancer: 24-month results. Breast Cancer. 2019 Jan;26(1):106-112. doi: 10.1007/s12282-018-0896-y. Epub 2018 Jul 27.
PubMed 30054855Adams A, Jakob T, Huth A, Monsef I, Ernst M, Kopp M, Caro-Valenzuela J, Wockel A, Skoetz N. Bone-modifying agents for reducing bone loss in women with early and locally advanced breast cancer: a network meta-analysis. Cochrane Database Syst Rev. 2024 Jul 9;7(7):CD013451. doi: 10.1002/14651858.CD013451.pub2.
PubMed 38979716Sakaguchi K, Ono H, Nakatsukasa K, Ishikawa T, Hasegawa Y, Takahashi M, Niikura N, Koizumi K, Sakurai T, Shigematsu H, Takahashi S, Taira S, Suzuki M, Narui K, Miura D, Yamada K, Yoshimura M, Shioya H, Konishi E, Isao Y, Imai K, Fujikawa K, Taguchi T; Collaborative Study Group of Scientific Research of the Japanese Breast Cancer Society. Efficacy of denosumab for restoring normal bone mineral density in women receiving adjuvant aromatase inhibitors for early breast cancer. Medicine (Baltimore). 2019 Aug;98(32):e16770. doi: 10.1097/MD.0000000000016770.
PubMed 31393399
Study at a glance
From the registry record, last updated by the sponsor on 6 Oct 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Multicenter, Randomized, Comparative Study Regarding the Efficacy of Denosumab on Normal Bone Mineral Density in Women Receiving Adjuvant Aromatase Inhibitors for Early Breast Cancer (ENDEAVOR Trial)
- ClinicalTrials.gov ID
- NCT03324932
- Acronym / sponsor ID
- CQARD-EBS-160402
- Conditions
- Breast Cancer
- Keywords
- bone health, hormone-sensitive breast cancer, postmenopausal, aromatase inhibitor, bone mineral density
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 160 participants (estimated)
- Lead sponsor
- Kyoto Prefectural University of MedicineUniversity, hospital or other
- Study start
- 25 Sep 2017 (actual)
- Primary completion
- Dec 2023 (estimated)
- Study completion
- Dec 2027 (estimated)
- First posted
- 30 Oct 2017 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This multicenter, randomized, comparative study will evaluate the efficacy of denosumab to prevent the adjuvant therapy of aromatase inhibitors-induced loss of bone mineral density (BMD) in breast cancer patients with normal BMD. Investigators will compare the inhibitory effects of denosumab on bone loss between participants with normal BMD to whom Letrozole or Arimidex will be administered as postoperative endocrine therapy for stage I-IIIA postmenopausal hormone-sensitive breast cancer and controls.
Detailed description
Normal BMD means T score is ≥-1.0 for the lumbar vertebrae (L1-L4) and/or the femoral neck.
Study design
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| AI+denosumab VS only AI | Other | Drug: Denosumab InjectionWe compare AI intake+denosumab injection and AI intake only in patients with normal BMD to whom Letrozole or Arimidex will be administered as postoperative endocrine therapy, and we assess the efficacy of denosumab injection on bone loss by adjuvant endocrine therapy. |
Who may qualify
- Ages
- 20 years and older
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (19 listed)
- Patients with infiltrative breast cancer, aged ≥20 years, meeting the following definitions:
- Estrogen receptor (ER)- or progesterone receptor (PgR)-positive patients on immunohistochemical (IHC) staining
- Females meeting one of the following criteria for menopause:
- Patients in whom the BMD for the lumbar vertebrae (L1-L4) on DXA before the start of this study is ≥-1.0SD of the mean value of young adult females (YAM), and the BMD for the femoral neck is ≥-1.0SD of YAM
- Patients without lumbar vertebral or femoral fracture
Key exclusion criteria (11 listed)
- Whether each patient meets any of the following items must be checked on case registration:
- Patients in whom distant metastasis was confirmed clinically or using imaging procedures at the time of case registration
- Those with bilateral breast cancer
- Those for whom postoperative hormonal therapy was started before consenting to study participation
- Those who received endocrine therapy within 52 weeks before consenting to study participation
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 |
|---|---|---|
| Denosumab InjectionAlso: praliaAI intake + denosumab injection per 6 months VS only AI intake | Drug | AI+denosumab VS only AI |
Primary outcome
percentage change in the bone mineral density (BMD) for the lumbar vertebrae (L1-L4) on dual-energy X-ray absorptiometry (DXA)
Time frame: 12 months after the start of this study
The change is a value obtained by subtracting 1 from the BMD after 12 months/baseline BMD is expressed as a percentage
9 secondary outcomes
percentage change in the BMD for the lumbar vertebrae (L1-L4) on DXA
Time frame: after 2, 3, 4, and 5 years
percentage change in the BMD for the femoral neck
Time frame: after 12 months and 2/3/4/5 years
percentage change in the BMD for the radius (an ultrasonic bone densimeter is used)institutions in which ultrasonic bone densimeters are used)
Time frame: after 2 and 4 weeks, every 4 weeks thereafter (for 2 years after registration)(only
Changes in Ca and bone metabolism markers
Time frame: after 24 weeks
Appearance rate of morbid fracture in all participants
Time frame: up to 3 years
Disease-free survival
Time frame: at least 5 year
Overall survival
Time frame: at least 5 year
Appearance of adverse events
Time frame: at least 5 year
Quality of life (QOL)
Time frame: after 24 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Oct 2023.
- Background: PubMed 30054855Nakatsukasa K, Koyama H, Ouchi Y, Ono H, Sakaguchi K, Matsuda T, Kato M, Ishikawa T, Yamada K, Yoshimura M, Koizumi K, Sakurai T, Shigematsu H, Takahashi S, Taira S, Suzuki M, Narui K, Niikura N, Hasegawa Y, Miura D, Konishi E, Taguchi T; Collaborative Study Group of Scientific Research of the Japanese Breast Cancer Society. Effect of denosumab on low bone mineral density in postmenopausal Japanese women receiving adjuvant aromatase inhibitors for non-metastatic breast cancer: 24-month results. Breast Cancer. 2019 Jan;26(1):106-112. doi: 10.1007/s12282-018-0896-y. Epub 2018 Jul 27.
- Derived from this study: PubMed 38979716Adams A, Jakob T, Huth A, Monsef I, Ernst M, Kopp M, Caro-Valenzuela J, Wockel A, Skoetz N. Bone-modifying agents for reducing bone loss in women with early and locally advanced breast cancer: a network meta-analysis. Cochrane Database Syst Rev. 2024 Jul 9;7(7):CD013451. doi: 10.1002/14651858.CD013451.pub2.
- Derived from this study: PubMed 31393399Sakaguchi K, Ono H, Nakatsukasa K, Ishikawa T, Hasegawa Y, Takahashi M, Niikura N, Koizumi K, Sakurai T, Shigematsu H, Takahashi S, Taira S, Suzuki M, Narui K, Miura D, Yamada K, Yoshimura M, Shioya H, Konishi E, Isao Y, Imai K, Fujikawa K, Taguchi T; Collaborative Study Group of Scientific Research of the Japanese Breast Cancer Society. Efficacy of denosumab for restoring normal bone mineral density in women receiving adjuvant aromatase inhibitors for early breast cancer. Medicine (Baltimore). 2019 Aug;98(32):e16770. doi: 10.1097/MD.0000000000016770.
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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.
Hisako Ono, PhD study director
Kyoto Prefectural University of Medicine
Tetsuya Taguchi, PhD principal investigator
Kyoto Prefectural University of Medicine
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Denosumab Injection in people with Breast Cancer, run by Kyoto Prefectural University of Medicine at 1 site in Japan.
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 19 inclusion and 11 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: under way, not looking for participants, as of the sponsor's last update on 6 Oct 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Japan. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
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?
percentage change in the bone mineral density (BMD) for the lumbar vertebrae (L1-L4) on dual-energy X-ray absorptiometry (DXA) (time frame: 12 months after the start of this study). 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 NCT03324932, which also lists 3 linked publications.
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 6 Oct 2023.