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Hormone Receptor-Positive Breast CancerSIMPEC-E2NCT07833501

Estradiol Levels According to Body Mass Index in Premenopausal Patients With Breast Cancer

An observational study of Hormone Receptor-Positive Breast Cancer, run by D'Or Institute for Research and Education.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

his prospective observational study will evaluate whether body mass index (BMI) is associated with serum estradiol levels in premenopausal women with hormone receptor-positive breast cancer. Read more about this study

Who is it for?
Ages 18 years and older, women onlyHealthy volunteers can take part
Conditions the study is for
Hormone Receptor-Positive Breast Cancer
How many people
172 participants
Where
No sites listed yet
Study dates
3 Sep 2026to 30 May 2027
How long will I take part?
3 Months
Phase
Observational
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 18 years and older
  • Women only
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Premenopausal adult women with histologically confirmed hormone receptor-positive invasive breast cancer receiving adjuvant endocrine therapy with an aromatase inhibitor combined with pharmacologic ovarian suppression using a gonadotropin-releasing hormone analog. Potential participants will be identified during routine outpatient visits at participating oncology centers in Brazil. Participants will be classified according to World Health Organization body mass index categories and analyzed in two groups: normal body mass index and overweight or obesity.

Who may be able to join

  • Female sex. Age 18 years or older. Histologically confirmed hormone receptor-positive invasive breast cancer, defined as estrogen receptor-positive and/or progesterone receptor-positive disease, regardless of human epidermal growth factor receptor 2 status.
  • Premenopausal status at the initiation of ovarian suppression, as determined by menstrual history and/or laboratory criteria according to medical assessment.
  • Indication for adjuvant treatment with an aromatase inhibitor (anastrozole, letrozole, or exemestane) combined with pharmacologic ovarian suppression using a gonadotropin-releasing hormone analog.
  • Continuous use of an aromatase inhibitor and a gonadotropin-releasing hormone analog for at least 3 months before the primary study assessment.
  • Documented body mass index at enrollment. Ability to understand the study information and provide written informed consent.

Who cannot join

  • Postmenopausal status at the initiation of endocrine therapy. Known endocrine disorders that may interfere with the production or metabolism of sex steroids.
  • Concomitant use of medications known to interfere with estradiol metabolism or measurement, including systemic corticosteroids at supraphysiologic doses.
  • Metastatic disease at enrollment. Technical or logistical inability to undergo serum estradiol measurement using an ultrasensitive laboratory method.
  • Concurrent participation in another clinical study that may interfere with the hormonal outcomes evaluated in this study.

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Guilherme C Ambrósio, MSc contact

11972763211

guilherme.ambrosio@idor.org

About this study

Official title: Evaluation of Serum Estradiol Levels According to Body Mass Index Categories in Premenopausal Patients With Hormone Receptor-Positive Breast Cancer Receiving Aromatase Inhibitors and Pharmacologic Ovarian Suppression

his prospective observational study will evaluate whether body mass index (BMI) is associated with serum estradiol levels in premenopausal women with hormone receptor-positive breast cancer. Participants will already be receiving standard adjuvant treatment with an aromatase inhibitor and pharmacologic ovarian suppression as part of their routine clinical care. The study will not assign or modify cancer treatment.

Approximately 172 participants will be enrolled at multiple study sites in Brazil. They will be classified into two main groups: normal BMI and overweight or obesity. Clinical information, medication use, physical activity, weight, height, and serum estradiol levels will be recorded. Estradiol will be measured using an ultrasensitive laboratory method, with the main assessment occurring after approximately three months of treatment.

The primary objective is to compare the proportion of participants with serum estradiol levels above 2.72 pg/mL between the two BMI groups. The study will also examine the relationship between BMI and absolute estradiol levels and explore whether clinical characteristics, previous chemotherapy, physical activity, or use of glucagon-like peptide-1 receptor agonists are associated with inadequate estrogen suppression.

Read the detailed description

This is a multicenter, prospective, observational cohort study designed to evaluate the association between body mass index (BMI) and serum estradiol levels in premenopausal women with hormone receptor-positive invasive breast cancer receiving adjuvant endocrine therapy with an aromatase inhibitor combined with pharmacologic ovarian suppression using a gonadotropin-releasing hormone analog.

All endocrine treatments will be prescribed as part of routine clinical care. Participation in the study will not determine the selection, dose, schedule, continuation, or modification of anticancer treatment. No experimental intervention, treatment allocation, or randomization is planned.

Approximately 172 participants will be enrolled. For the primary analysis, participants will be classified according to World Health Organization BMI categories and grouped as having normal BMI or overweight/obesity. At enrollment, demographic, anthropometric, clinical, and oncologic information will be collected, including tumor characteristics, previous cancer treatment, type and timing of aromatase inhibitor and ovarian suppression therapy, concomitant medications, physical activity, and use of glucagon-like peptide-1 receptor agonists.

Weight and height will be measured to calculate BMI. Serum estradiol will be assessed using an ultrasensitive laboratory method. A baseline estradiol measurement may be obtained when applicable, depending on the timing of enrollment. The main estradiol assessment will be performed after approximately three months of combined aromatase inhibitor therapy and pharmacologic ovarian suppression, within a protocol-defined visit window of plus or minus 14 days. If a result suggests inadequate estrogen suppression, an additional measurement may be requested within 14 days using a different laboratory method, according to institutional practice and local availability.

The primary outcome is the proportion of participants with inadequate estrogen suppression, defined as a serum estradiol concentration greater than 2.72 pg/mL after approximately three months of treatment. This proportion will be compared between participants with normal BMI and those with overweight/obesity.

Secondary and exploratory analyses will evaluate absolute estradiol concentrations across BMI categories, the correlation between BMI and serum estradiol, a potential BMI cutoff associated with inadequate estrogen suppression, and clinical characteristics associated with inadequate suppression. Exploratory subgroup analyses will consider previous chemotherapy, physical activity, and use of glucagon-like peptide-1 receptor agonists.

The primary comparison will use a chi-square test or Fisher's exact test, as appropriate. Binary logistic regression will assess the association between BMI and inadequate estrogen suppression, with BMI evaluated as both a categorical and continuous variable and adjustment for clinically relevant potential confounders. Continuous outcomes will be analyzed using parametric or nonparametric methods according to their distributions. The relationship between BMI and estradiol concentration will also be assessed using Spearman correlation, and receiver operating characteristic curve analysis will be used to explore a potential BMI cutoff associated with inadequate estrogen suppression.

Keywords
Estradiol, Body Mass Index, Premenopausal Women, Aromatase Inhibitors, Ovarian Suppression, Hormone Receptor-Positive Breast Cancer, Endocrine Therapy, Overweight, Obesity, Gonadotropin-Releasing Hormone Analogs
Medical subject headings
Overweight, Obesity

What participants receive

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

Study groups in NCT07833501
Study groupRoleWhat they receive
Normal BMIPremenopausal participants with hormone receptor-positive breast cancer receiving an aromatase inhibitor and pharmacologic ovarian suppression who have a body mass index within the normal range according to World Health Organization criteria.
Overweight or ObesityPremenopausal participants with hormone receptor-positive breast cancer receiving an aromatase inhibitor and pharmacologic ovarian suppression who are classified as having overweight or obesity according to World Health Organization body mass index criteria.

What is being measured

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

  1. Percentage of Participants With Inadequate Estrogen Suppression

    Percentage of participants with a serum estradiol concentration greater than 2.72 pg/mL after approximately 3 months of treatment with an aromatase inhibitor and pharmacologic ovarian suppression. Serum estradiol will be measured using an ultrasensitive laboratory method. The percentage will be calculated as the number of participants with estradiol greater than 2.72 pg/mL divided by the number of evaluable participants in each body mass index group, multiplied by 100. Results will be compared between participants with normal body mass index and those with overweight or obesity.

    Measured: At 3 months of treatment (visit window: ±14 days)

Secondary outcomes (5)
  1. Serum Estradiol Concentration by Body Mass Index Category

    Serum estradiol concentration, measured in pg/mL using an ultrasensitive laboratory method, will be summarized and compared across body mass index categories.

    Measured: At 3 months of treatment (visit window: ±14 days)

  2. Correlation Between Body Mass Index and Serum Estradiol Concentration

    The relationship between body mass index, measured in kg/m², and serum estradiol concentration, measured in pg/mL, will be assessed using Spearman's correlation coefficient. The coefficient ranges from -1 to 1, with higher positive values indicating a stronger positive association.

    Measured: At 3 months of treatment (visit window: ±14 days)

  3. Body Mass Index Cutoff Associated With Inadequate Estrogen Suppression

    A potential body mass index cutoff, measured in kg/m², associated with serum estradiol greater than 2.72 pg/mL will be explored using receiver operating characteristic curve analysis. The analysis will include estimation of the area under the curve, sensitivity, and specificity of the identified cutoff.

    Measured: At 3 months of treatment (visit window: ±14 days)

  4. Association Between Clinical Characteristics and Inadequate Estrogen Suppression

    Associations between prespecified clinical characteristics and inadequate estrogen suppression, defined as serum estradiol greater than 2.72 pg/mL, will be evaluated using binary logistic regression. Results will be reported as odds ratios with 95% confidence intervals. Evaluated characteristics may include body mass index, age, previous chemotherapy, endocrine treatment characteristics, concomitant medications, and other clinically relevant potential confounders collected according to the protocol.

    Measured: At 3 months of treatment (visit window: ±14 days)

  5. Serum Estradiol Outcomes in Prespecified Clinical Subgroups

    Serum estradiol concentration and the percentage of participants with estradiol greater than 2.72 pg/mL will be explored in subgroups defined by previous chemotherapy, physical activity, and use of glucagon-like peptide-1 receptor agonists. These analyses are exploratory.

    Measured: At 3 months of treatment (visit window: ±14 days)

Timeline

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

  1. First posted22 Sep 2026
  2. Study start3 Sep 2026 (estimated)
  3. Primary completion30 Dec 2026 (estimated)
  4. Study completion30 May 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
172 participants (estimated)
Target duration
3 Months
IDs, dates and publications
ClinicalTrials.gov ID
NCT07833501
Sponsor's protocol ID
SIMPEC-ESTRADIOL-001
Acronym
SIMPEC-E2
Status last verified
Sep 2026
First submitted
16 Sep 2026
Last updated
22 Sep 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data will not be made publicly available under the current protocol because the informed consent and data governance procedures do not provide for external sharing of individual-level clinical and laboratory data. Study findings will be disseminated in aggregate form to protect participant privacy and confidentiality and to comply with applicable ethical requirements and Brazilian data protection legislation.

Publications

  • Burstein HJ, Curigliano G, Loibl S, Dubsky P, Gnant M, Poortmans P, Colleoni M, Denkert C, Piccart-Gebhart M, Regan M, Senn HJ, Winer EP, Thurlimann B; Members of the St. Gallen International Consensus Panel on the Primary Therapy of Early Breast Cancer 2019. Estimating the benefits of therapy for early-stage breast cancer: the St. Gallen International Consensus Guidelines for the primary therapy of early breast cancer 2019. Ann Oncol. 2019 Oct 1;30(10):1541-1557. doi: 10.1093/annonc/mdz235.

    PubMed 31373601
  • Chumsri S, Howes T, Bao T, Sabnis G, Brodie A. Aromatase, aromatase inhibitors, and breast cancer. J Steroid Biochem Mol Biol. 2011 May;125(1-2):13-22. doi: 10.1016/j.jsbmb.2011.02.001. Epub 2011 Feb 16.

    PubMed 21335088
  • Lin J, Zheng S, Liu Q. Incomplete ovarian function suppression in premenopausal breast cancer patients treated with gonadotropin-releasing hormone agonists. Cancer Treat Rev. 2025 Feb;133:102879. doi: 10.1016/j.ctrv.2025.102879. Epub 2025 Jan 4.

    PubMed 39793457
  • McCann KE, Goldfarb SB, Traina TA, Regan MM, Vidula N, Kaklamani V. Selection of appropriate biomarkers to monitor effectiveness of ovarian function suppression in pre-menopausal patients with ER+ breast cancer. NPJ Breast Cancer. 2024 Jan 19;10(1):8. doi: 10.1038/s41523-024-00614-w.

    PubMed 38242892
  • Bellet M, Gray KP, Francis PA, Lang I, Ciruelos E, Lluch A, Climent MA, Catalan G, Avella A, Bohn U, Gonzalez-Martin A, Ferrer R, Catalan R, Azaro A, Rajasekaran A, Morales J, Vazquez J, Fleming GF, Price KN, Regan MM. Twelve-Month Estrogen Levels in Premenopausal Women With Hormone Receptor-Positive Breast Cancer Receiving Adjuvant Triptorelin Plus Exemestane or Tamoxifen in the Suppression of Ovarian Function Trial (SOFT): The SOFT-EST Substudy. J Clin Oncol. 2016 May 10;34(14):1584-93. doi: 10.1200/JCO.2015.61.2259. Epub 2016 Jan 4.

    PubMed 26729437

Questions about this trial

What is this clinical trial studying?

An observational study of Hormone Receptor-Positive Breast Cancer, run by D'Or Institute for Research and Education.

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 5 inclusion and 4 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: opening soon, as of the sponsor's last update on 22 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

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.

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?

Contact Guilherme C Ambrósio, MSc (11972763211, guilherme.ambrosio@idor.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants With Inadequate Estrogen Suppression (time frame: At 3 months of treatment (visit window: ±14 days)). 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 NCT07833501, which also lists 5 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 22 Sep 2026.

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