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Continued Efficacy and Safety of Zoledronic Acid (q 4 Wks vs. q 12 Wks) in the 2nd Year of Treatment in Patients With Bone Metastases From Breast Cancer

Phase 3
Completed
Conditions
Breast Cancer
Interventions
Registration Number
NCT00320710
Lead Sponsor
Novartis Pharmaceuticals
Brief Summary

Clinical trial in breast cancer patients with bone metastases pretreated for approximately 1 year with a standard zoledronic acid regimen. Looking at the continued effectiveness and safety of giving zoledronic acid every 4 weeks versus every 12 weeks given over 1 year. This study is prospective, double-blind, stratified, multi-center, and two-arm.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
416
Inclusion Criteria

Female patients ≥ 18 years of age. Confirmed breast cancer with bone metastasis. Pretreated with Zometa®, or Aredia (pamidronate) or all sequential regimens of both, for a minimum of 9 doses;

Exclusion Criteria

Abnormal kidney function determined by serum creatinine levels. Current active dental problems including: ongoing infection of the teeth or jawbone; current exposed bone in the mouth; and current or prior diagnosis of osteonecrosis of the jaw.

Recent (within 8 weeks) or planned dental or jaw surgery (e.g., extraction, implants).

Diagnosis of metabolic bone disease other than osteoporosis (e.g., Paget's disease of bone).

Known hypersensitivity to Zometa. Treatment with other investigational drugs within 30 days prior to randomization.

Other protocol-defined exclusion criteria may have applied.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Zoledronic acid q 12 weeksPlaceboParticipants received 4 mg zoledronic acid IV q 12 weeks and received placebo to Zometa IV at the 4 week intervals between the q 12 week zoledronic acid infusions in order to maintain the blind.
Placebo / zoledronic acidPlaceboParticipants randomized to this arm received placebo but the arm was later dropped and participants in this arm were swithced to the zoledronic acid q 4 weeks according to a study amendment.
Zoledronic acid every (q) 4 weeksZoledronic acidParticipants received 4mg of zoledronic acid intravenously (IV) infusion q 4 weeks.
Zoledronic acid q 12 weeksZoledronic acidParticipants received 4 mg zoledronic acid IV q 12 weeks and received placebo to Zometa IV at the 4 week intervals between the q 12 week zoledronic acid infusions in order to maintain the blind.
Placebo / zoledronic acidZoledronic acidParticipants randomized to this arm received placebo but the arm was later dropped and participants in this arm were swithced to the zoledronic acid q 4 weeks according to a study amendment.
Primary Outcome Measures
NameTimeMethod
Proportion of Patients Who Experienced at Least One Skeletal Related Event (SRE)52 weeks

An SRE was defined as a pathologic fracture (vertebral and non-vertebral), spinal cord compression, radiation to bone or surgery to bone.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline in Mean Composite Brief Pain Inventory (BPI) Scorebaseline, 52 weeks

Participants completed a BPI short form which is a 9 item self-administered questionnaire used to evaluate the severity of a participant's pain and the impact of this pain on the participant's daily functioning. The participant rates his or her worst, least, average, and current pain intensity, lists current treatments and perceived effectiveness, and rates the degree that pain interferes with general activity, mood, walking ability, normal work, relations with other persons, sleep, and enjoyment of life on a 10 point scale. The BPI composite score, which was calculated as the average of items 3, 4, 5 and 6 (worst pain, least pain, average pain and pain right now), ranged from 0 (best possible outcome, no pain) to 10 (worst possible outcome, pain as bad as you can imagine). A positive change from baseline indicates worsening.

Time to First Individual Type of SRE52 weeks

Types of SREs analyzed were pathologic fractures (vertebral and non-vertebral), spinal cord compression, radiation to bone and surgery to bone. The time to first indvidual SRE was defined as the date of randomization to the date of the first occurrence of any individual SRE.

Change From Baseline in Urinary N-telopeptide / Creatinine Ratiobaseline, 48 weeks

Urine samples were collected to obtain n-telopeptide and creatinine values.

Change From Baseline in Serum Bone Specific Alkaline Phosphatasebaseline, 48 weeks

Serum samples were collected to obtain bone specific alkaline phosphatase values.

Skeletal Morbidity Rate52 weeks

An SMR for a patient was defined as the "number of occurrences" of any (or a particular) SRE allowing for only 1 event in any 3-week interval, divided by the "time at risk" in years. The "number of occurrences" and the "time at risk" were counts of SRE and the time from the randomization date. Counting began from randomization in the way that every counted event was followed by a 20-day period during which no SRE was counted, nor was the time counted as "at risk". For example, if a patient had 1 SRE during the study, the "time at risk" was calculated as the total number of days in the study minus the 20-day follow-up period for that SRE. If a patient had no SRE events, the entire study period was counted as "time at risk". This SMR calculation method had the advantage of avoiding multiple counts of possibly interdependent SREs (e.g. having 1 fracture increases the probability of having a subsequent SRE).

Change From Baseline in Mean Analgesic Scorebaseline, 52 weeks

The analgesic score indicates the types of pain medication used. The scores range as follows: 0 = none medication; 1 = minor analgesics (aspirin, NSAID, acetaminophen, propoxyphene, etc.); 2 = Tranquilizers, antidepressants, muscle relaxants, and steroids; 3 = Mild narcotics (oxycodone, meperidine, codeine, etc.); and 4 = Strong narcotics (morphine, hydromorphone, etc.). A positive change from baseline indicates worsening.

Time to First SRE52 weeks

An SRE was defined as a pathologic bone fracture (vertebral and non-vertebral), spinal cord compression, radiation to bone, or surgery to bone. The time to first individual SRE was defined as the date of randomization to the date of first occurrence of any SRE.

Trial Locations

Locations (92)

Greenbaum Cancer Center

🇺🇸

Baltimore, Maryland, United States

U of Pittsburgh Cancer Institute Magee-Womens Hospital

🇺🇸

Pittsburgh, Pennsylvania, United States

Frederick Memorial Hospital

🇺🇸

Frederick, Maryland, United States

Heritage Physicians Group Oncology

🇺🇸

Hot Springs, Arkansas, United States

Providence Alaska Medical Center Cancer Research

🇺🇸

Anchorage, Alaska, United States

The Center for Chest Care

🇺🇸

Springdale, Arkansas, United States

Pacific Cancer Medical Center, Inc.

🇺🇸

Anaheim, California, United States

South Bay Oncology Hematology Partners

🇺🇸

Campbell, California, United States

Bay Area Cancer Research

🇺🇸

Concord, California, United States

Pacific Coast Hem/Onc

🇺🇸

Fountain Valley, California, United States

Kenmar Research Institute

🇺🇸

Los Angeles, California, United States

Wilshire Oncology Medical Group

🇺🇸

La Verne, California, United States

North Valley Hematology/Oncology Providence Holy Cross Medical

🇺🇸

Northridge, California, United States

Medical Oncology Care Associates

🇺🇸

Orange, California, United States

Ventura County Hematology and Oncology

🇺🇸

Oxnard, California, United States

The Office of Dr. Swarna Chanduri, MD

🇺🇸

Pomona, California, United States

University of California at Los Angeles

🇺🇸

Sylmar, California, United States

Cancer and Blood of the Desert

🇺🇸

Rancho Mirage, California, United States

Access Clinical Research

🇺🇸

Rancho Mirage, California, United States

Eastern Connecticut Hematology & Oncology Associates

🇺🇸

Norwich, Connecticut, United States

Georgetown University/Lombardi Cancer Center

🇺🇸

Washington, District of Columbia, United States

Washington Hospital Center

🇺🇸

Washington, District of Columbia, United States

Baptist Cancer Center

🇺🇸

Jacksonville, Florida, United States

The Office of Dr. Elizabeth Tan-Chiu, MD PA

🇺🇸

Planatation, Florida, United States

Pasco Hernando Oncology

🇺🇸

New Port Richey, Florida, United States

Suburban Hematology-Oncology

🇺🇸

Lawrenceville, Georgia, United States

NorthwesternUniv.Med.School/Robert H. Lurie Comp.Cancer Ctr

🇺🇸

Chicago, Illinois, United States

Edward Cancer Center

🇺🇸

Naperville, Illinois, United States

Evanston Northwestern Healthcare Medical Group

🇺🇸

Evanston, Illinois, United States

Midwest Cancer Research Group

🇺🇸

Skokie, Illinois, United States

Associated Physicians & Surgeons Clinic

🇺🇸

Terre Haute, Indiana, United States

Cancer Care Center

🇺🇸

New Albany, Indiana, United States

Medical Associates Clinic, PC

🇺🇸

Dubuque, Iowa, United States

Siouxland Hematology-Oncology Associates LLP

🇺🇸

Sioux City, Iowa, United States

University of Iowa Health Care

🇺🇸

Iowa City, Iowa, United States

Cotton O'Neil Oncology Clinic

🇺🇸

Topeka, Kansas, United States

Cancer Center of Kansas

🇺🇸

Witchita, Kansas, United States

Southwest Oncology Associates Ltd.

🇺🇸

Lafayette, Louisiana, United States

Kentucky Lung Clinic & Kentucky Sleep Clinic

🇺🇸

Hazard, Kentucky, United States

Cabrini Center for Cancer Care

🇺🇸

Alexandria, Louisiana, United States

Lexington Oncology Associates

🇺🇸

Lexington, Kentucky, United States

St. Agnes Hospital

🇺🇸

Baltimore, Maryland, United States

The Harry and Jeanette Weinberg Cancer Institute at Franklin

🇺🇸

Baltimore, Maryland, United States

Caritas Holy Family Hospital

🇺🇸

Methuen, Massachusetts, United States

St. Luke's Hospital and Health Network

🇺🇸

Duluth, Minnesota, United States

Oncology Care Associates, PLLC

🇺🇸

St. Joseph, Michigan, United States

Jackson Oncology Associates

🇺🇸

Jackson, Mississippi, United States

Hubert H. Humphrey Cancer Center

🇺🇸

Robbinsdale, Minnesota, United States

Capitol Comprehensive Cancer Care Clinic

🇺🇸

Jefferson City, Missouri, United States

The Center for Cancer Care and Research

🇺🇸

St. Louis, Missouri, United States

Nebraska Hematology-Oncology PC

🇺🇸

Lincoln, Nebraska, United States

Center for Cancer and Hematologic Disease

🇺🇸

Cherry Hill, New Jersey, United States

Somerset Hematology Oncology Associates

🇺🇸

Somerset, New Jersey, United States

Advanced Oncology Associates

🇺🇸

Armonk, New York, United States

Arena Oncology Associates, PC

🇺🇸

Great Neck, New York, United States

Benedictine Hospital

🇺🇸

Kingston, New York, United States

Beth Israel Medical Center

🇺🇸

New York, New York, United States

Columbia Presbyterian Medical Center

🇺🇸

New York, New York, United States

Jmaes P. Wilmot Cancer Center

🇺🇸

Rochester, New York, United States

Alamance Regional Medical Cancer Center

🇺🇸

Burlington, North Carolina, United States

Barberton Citizens Hospital

🇺🇸

Barberton, Ohio, United States

Northeast Oncology Associates Suite 250

🇺🇸

Concord, North Carolina, United States

Trilogy Cancer Care

🇺🇸

Wooster, Ohio, United States

Gabrail Cancer Center

🇺🇸

Canton, Ohio, United States

Hematology/Oncology Consultants Inc.

🇺🇸

West Worthington, Ohio, United States

Ohio Cancer Specialists

🇺🇸

Mansfield, Ohio, United States

Bay Area Hospital - Pharmacy

🇺🇸

Coos Bay, Oregon, United States

The Corvallis Clinic, P.C.

🇺🇸

Corvallis, Oregon, United States

Milton S Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

Lancaster Cancer Center

🇺🇸

Lancaster, Pennsylvania, United States

Guthrie Cancer Center

🇺🇸

Sayre, Pennsylvania, United States

Mainline Oncology Hematology Assoc.

🇺🇸

Wynnewood, Pennsylvania, United States

M. Francisco Gonzalez, MD., FACP

🇺🇸

Columbia, South Carolina, United States

MD Anderson Cancer Center/University of Texas 1155 Herman Pressler Street

🇺🇸

Houston, Texas, United States

Santee Hematology/Oncology

🇺🇸

Sumter, South Carolina, United States

Seattle Cancer Care Alliance Seattle Cancer Care Alliance

🇺🇸

Seattle, Washington, United States

Providence Everett Medical Clinic

🇺🇸

Everett, Washington, United States

Rockwood Clinic Rockwood Clinic, PS

🇺🇸

Spokane, Washington, United States

Saint Barnabas Medical Center

🇺🇸

Livingston, New Jersey, United States

Denver Health Medical Center CACZ885M2301

🇺🇸

Denver, Colorado, United States

Investigative Clinical Research

🇺🇸

Indianapolis, Indiana, United States

Center for Cancer & Blood Disorders

🇺🇸

Bethesda, Maryland, United States

Wayne State University

🇺🇸

Detroit, Michigan, United States

Henry Ford Hospital Oncology

🇺🇸

Detroit, Michigan, United States

Fairview Clinical Trial Services

🇺🇸

Minneapolis, Minnesota, United States

Univ. of Minnesota Cancer Center 420 Delaware St.

🇺🇸

Minneapolis, Minnesota, United States

Nevada Cancer Centers 2851 North Tenaya Way

🇺🇸

Las Vegas, Nevada, United States

Medical College of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

Cancer Centers of South Texas

🇺🇸

San Antonio, Texas, United States

Memorial Sloan Kettering Cancer Center

🇺🇸

New York, New York, United States

University of Michigan Clinical Trials Office

🇺🇸

Ann Arbor, Michigan, United States

University of California Davis Cancer Center

🇺🇸

Sacramento, California, United States

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