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Exemestane or Anastrozole in Treating Postmenopausal Women Who Have Undergone Surgery for Primary Breast Cancer

Phase 3
Completed
Conditions
Breast Cancer
Interventions
Registration Number
NCT00066573
Lead Sponsor
NCIC Clinical Trials Group
Brief Summary

RATIONALE: Estrogen can stimulate the growth of breast cancer cells. Hormone therapy, using exemestane or anastrozole, may fight breast cancer by reducing the production of estrogen. It is not yet known whether exemestane is more effective than anastrozole in preventing the recurrence of breast cancer.

PURPOSE: This randomized phase III trial is studying exemestane to see how well it works compared to anastrozole in preventing cancer recurrence in postmenopausal women who have undergone surgery for primary breast cancer.

Detailed Description

OBJECTIVES:

Primary

* Compare the event-free survival of postmenopausal women with receptor-positive primary breast cancer when treated with exemestane vs anastrozole.

Secondary

* Compare the overall survival of patients treated with these regimens.

* Compare the time to distant recurrence in patients treated with these regimens.

* Compare the incidence of new primary contralateral breast cancer in patients treated with these regimens.

* Compare the incidence of all clinical fractures, specifically hip and vertebral fractures, in patients treated with these regimens.

* Compare cardiovascular morbidity and mortality (i.e., significant coronary heart disease, which includes myocardial infarctions and angina requiring percutaneous transluminal coronary angioplasty or coronary artery bypass graft, fatal and nonfatal strokes, and all vascular deaths) in patients treated with these regimens.

* Correlate therapy induced changes in breast density with plasma hormones and growth factors, drug levels of exemestane and anastrozole, genetic variation and breast cancer recurrence or contralateral events in patients treated with these regimens.

* Compare the toxic effects of these regimens in these patients.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to lymph node status at diagnosis (negative vs positive vs unknown), prior adjuvant chemotherapy (yes vs no), and herceptin use (yes vs no). Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients receive oral exemestane (25 mg) once daily for 5 years.

* Arm II: Patients receive oral anastrozole (1 mg) once daily for 5 years. In both arms, treatment continues in the absence of disease progression or unacceptable toxicity.

Patients are followed every 6 months during the first year of study participation and annually thereafter.

PROJECTED ACCRUAL: A total of 6,840 patients will be accrued for this study.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
7576
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ExemestaneexemestanePatients receive oral exemestane (25 mg) once daily for 5 years.
AnastrozoleanastrozolePatients receive oral anastrozole (1 mg) once daily for 5 years.
Primary Outcome Measures
NameTimeMethod
Event-free Survival5 years

Event free survival, the primary endpoint of this study, is defined as the time from randomization to the time of documented locoregional or distant recurrence, new primary breast cancer, or death from any cause.

Secondary Outcome Measures
NameTimeMethod
Clinical Fracture Rate: Number of Participants With Bone Fractures.8 years

Clinical fracture at any time, including hip, spine, wrist fractures and other bone fractures.

Overall Survival: Percentage of Participants Alive at 5 Years5 years

Overall survival is defined as the time from randomization to the time of death from any cause.

Distant Disease-free Survival: Number of Participants Without Documented Distant Recurrence5 years

Time to distant disease-free survival (DDFS) is defined as the time from randomization to the time of documented distant recurrence. Distant recurrence is the cancer coming back in a part of the body away from the breast, such as the bones or liver.

Trial Locations

Locations (39)

Stronach Regional Health Centre at Southlake

🇨🇦

Newmarket, Ontario, Canada

Juravinski Cancer Centre at Hamilton Health Sciences

🇨🇦

Hamilton, Ontario, Canada

Credit Valley Hospital

🇨🇦

Mississauga, Ontario, Canada

Hopital Charles LeMoyne

🇨🇦

Greenfield Park, Quebec, Canada

Lethbridge Cancer Centre

🇨🇦

Lethbridge, Alberta, Canada

Cancer Centre of Southeastern Ontario at Kingston

🇨🇦

Kingston, Ontario, Canada

Grand River Regional Cancer Centre

🇨🇦

Kitchener, Ontario, Canada

Odette Cancer Centre

🇨🇦

Toronto, Ontario, Canada

London Regional Cancer Program

🇨🇦

London, Ontario, Canada

Regional Cancer Program of the Hopital Regional

🇨🇦

Sudbury, Ontario, Canada

Niagara Health System

🇨🇦

St. Catharines, Ontario, Canada

Mount Sinai Hospital

🇨🇦

Toronto, Ontario, Canada

CHUM - Hopital Notre-Dame

🇨🇦

Montreal, Quebec, Canada

CHA-Hopital Du St-Sacrement

🇨🇦

Quebec City, Quebec, Canada

Tom Baker Cancer Centre

🇨🇦

Calgary, Alberta, Canada

BCCA - Cancer Centre for the Southern Interior

🇨🇦

Kelowna, British Columbia, Canada

Penticton Regional Hospital

🇨🇦

Penticton, British Columbia, Canada

BCCA - Fraser Valley Cancer Centre

🇨🇦

Surrey, British Columbia, Canada

BCCA - Vancouver Island Cancer Centre

🇨🇦

Victoria, British Columbia, Canada

Atlantic Health Sciences Corporation

🇨🇦

Saint John, New Brunswick, Canada

CancerCare Manitoba

🇨🇦

Winnipeg, Manitoba, Canada

The Vitalite Health Network - Dr. Leon Richard

🇨🇦

Moncton, New Brunswick, Canada

Quinte Healthcare Corporation

🇨🇦

Belleville, Ontario, Canada

Cambridge Memorial Hospital

🇨🇦

Cambridge, Ontario, Canada

Lakeridge Health Oshawa

🇨🇦

Oshawa, Ontario, Canada

Thunder Bay Regional Health Science Centre

🇨🇦

Thunder Bay, Ontario, Canada

Algoma District Cancer Program

🇨🇦

Sault Ste. Marie, Ontario, Canada

Trillium Health Centre - West Toronto

🇨🇦

Toronto, Ontario, Canada

St. Michael's Hospital

🇨🇦

Toronto, Ontario, Canada

Univ. Health Network-Princess Margaret Hospital

🇨🇦

Toronto, Ontario, Canada

Windsor Regional Cancer Centre

🇨🇦

Windsor, Ontario, Canada

Centre de Sante et de services sociaux de Gatineau

🇨🇦

Gatineau, Quebec, Canada

Centre hospitalier universitaire de Sherbrooke

🇨🇦

Sherbrooke, Quebec, Canada

The Moncton Hospital

🇨🇦

Moncton, New Brunswick, Canada

BCCA - Vancouver Cancer Centre

🇨🇦

Vancouver, British Columbia, Canada

Dr. H. Bliss Murphy Cancer Centre

🇨🇦

St. John's, Newfoundland and Labrador, Canada

Allan Blair Cancer Centre

🇨🇦

Regina, Saskatchewan, Canada

Saskatoon Cancer Centre

🇨🇦

Saskatoon, Saskatchewan, Canada

PEI Cancer Treatment Centre,Queen Elizabeth Hospital

🇨🇦

Charlottetown, Prince Edward Island, Canada

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