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Tamoxifen Versus Anastrozole, Alone or in Combination With Zoledronic Acid

Phase 3
Completed
Conditions
Breast Cancer
Interventions
Registration Number
NCT00295646
Lead Sponsor
Austrian Breast & Colorectal Cancer Study Group
Brief Summary

The primary objective is, first, the comparison of tamoxifen and anastrozole and, second, the comparison of zoledronate added to standard adjuvant therapy with controls according to disease-free survival (DFS) in premenopausal patients with non-metastatic breast cancer treated with tamoxifen or anastrozole. To assess whether zoledronate added to standard adjuvant therapy can decrease or even prevent bone loss in patients treated with hormonal blockade combined with an antiestrogen or aromatase inhibitor.

Detailed Description

The trial is conducted as an open multi-center phase III study, in a two-factorial study design and according to Good Clinical Practice (GCP) guidelines. Patients will be randomly assigned to a total of 4 study groups in a 1:1:1:1 assignment ratio. Several stratification criteria will be used in order to ensure balanced distribution of known risk factors.

A total of 1.803 patients will be enrolled in 4 arms. Patients will either be treated with anastrozole (1mg daily for 3 years) or tamoxifen (20mg daily for 3 years), and will additionally receive either zoledronate (8mg q4 weeks for 3 years) or no zoledronate (arm A: Nolvadex alone; arm B: Nolvadex plus zoledronate; arm C: Arimidex alone; arm D: Arimidex plus zoledronate).

Zoledronate will be administered by i.v. injection at a dose of 4 mg/month for the treatment period of 3 years. Five Bone Mineral Density (BMD) measurements will be performed in a subgroup of patients (404 patients, enrolled in 3 centres).

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
1803
Inclusion Criteria
  • Premenopausal, hormone receptor-positive patient
  • Histologically verified (minimally) invasive breast cancer, local radical treatment
  • 0-9 involved axillary lymph nodes (≥ 10 histologically examined nodes)
  • Tumor stage: pT1b-3, yT0 or yT1a
Exclusion Criteria
  • T1a, T4d, yT4; M1
  • Previous breast tumor irradiation
  • Previous or concurrent chemotherapy (except for preoperative chemotherapy)
  • Serum creatinine > 1.5 x UNL or creatinine clearance < 60 ml/min

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
TC (Tamoxifen Control)goserelinStudy Drug Nolvadex (Tamoxifen)
AZ (Arimidex+Zoledronate)goserelinStudy Drugs Arimidex (Anastrozole), Zometa (Zoledronate; zoledronic acid)
AC (Arimidex Control)goserelinStudy Drug Arimidex (Anastrozole)
TZ (Tamoxifen+Zoledronate)goserelinStudy Drugs Nolvadex (Tamoxifen), Zometa (Zoledronate; zoledronic acid)
AZ (Arimidex+Zoledronate)anastrozoleStudy Drugs Arimidex (Anastrozole), Zometa (Zoledronate; zoledronic acid)
AZ (Arimidex+Zoledronate)zoledronic acidStudy Drugs Arimidex (Anastrozole), Zometa (Zoledronate; zoledronic acid)
TZ (Tamoxifen+Zoledronate)tamoxifenStudy Drugs Nolvadex (Tamoxifen), Zometa (Zoledronate; zoledronic acid)
TZ (Tamoxifen+Zoledronate)zoledronic acidStudy Drugs Nolvadex (Tamoxifen), Zometa (Zoledronate; zoledronic acid)
AC (Arimidex Control)anastrozoleStudy Drug Arimidex (Anastrozole)
TC (Tamoxifen Control)tamoxifenStudy Drug Nolvadex (Tamoxifen)
Primary Outcome Measures
NameTimeMethod
Comparison of Zoledronate vs no Zoledronate in Premenopausal Patients With Non-metastatic Breast Cancer With Respect to Disease-free Survival (DFS)Time from randomization to the analysis data cut-off date when 124 DFS events had occurred. On the analysis data cut-off date, maximum time on study per patient was 102 months.

DFS is defined as time from randomization to first occurrence of a local, regional, or distant recurrence, second primary carcinoma (including contralateral breast cancer), or death from any cause

Comparison of Anastrozole vs Tamoxifen in Premenopausal Patients With Non-metastatic Breast Cancer With Respect to Disease-free Survival (DFS)Time from randomization to the analysis data cut-off date when 124 DFS events had occurred. On the analysis data cut-off date, maximum time on study per patient was 102 months.

DFS is defined as time from randomization to first occurrence of a local, regional, or distant recurrence, second primary carcinoma (including contralateral breast cancer), or death from any cause

Secondary Outcome Measures
NameTimeMethod
Comparison of Zoledronate vs no Zoledronate in Premenopausal Patients With Non-metastatic Breast Cancer With Respect to Recurrence-free Survival (RFS)Time from randomization to the analysis data cut-off date when 124 DFS events had occurred. On the analysis data cut-off date, maximum time on study per patient was 102 months.

RFS is defined as time from randomization to first occurrence of a local, regional, or distant recurrence, second primary carcinoma (including contralateral breast cancer), or death from breast cancer

Comparison of Anastrozole vs Tamoxifen in Premenopausal Patients With Non-metastatic Breast Cancer With Respect to Recurrence-free Survival (RFS)Time from randomization to the analysis data cut-off date when 124 DFS events had occurred. On the analysis data cut-off date, maximum time on study per patient was 102 months.

RFS is defined as time from randomization to first occurrence of a local, regional, or distant recurrence, second primary carcinoma (including contralateral breast cancer), or death from breast cancer

Comparison of Anastrozole vs Tamoxifen in Premenopausal Patients With Non-metastatic Breast Cancer With Respect to Overall Survival (OS)Time from randomization to the analysis data cut-off date when 124 DFS events had occurred. On the analysis data cut-off date, maximum time on study per patient was 102 months.

OS is defined as time from randomization to death from any cause

Comparison of Zoledronate vs no Zoledronate in Premenopausal Patients With Non-metastatic Breast Cancer With Respect to Overall Survival (OS)Time from randomization to the analysis data cut-off date when 124 DFS events had occurred. On the analysis data cut-off date, maximum time on study per patient was 102 months.

OS is defined as time from randomization to death from any cause

Trial Locations

Locations (72)

State Hospital Klagenfurt, Surgery

🇦🇹

Klagenfurt, Carinthia, Austria

State Hospital Klagenfurt

🇦🇹

Klagenfurt, Carinthia, Austria

Medical University Kiel

🇩🇪

Kiel, Schleswig-Holstein, Germany

Hospital BHB St. Veit

🇦🇹

St. Veit a. d. Glan, Carinthia, Austria

Hospital Krems

🇦🇹

Krems, Lower Austria, Austria

District Hospital Kufstein

🇦🇹

Kufstein, Tyrol, Austria

General Hospital Linz

🇦🇹

Linz, Upper Austria, Austria

Hospital BHS Ried

🇦🇹

Ried, Upper Austria, Austria

Hospital Oberwart

🇦🇹

Oberwart, Burgenland, Austria

Frauenklinik vom Roten Kreuz

🇩🇪

Muenchen, Bavaria, Germany

Hospital Mistelbach

🇦🇹

Mistelbach, Lower Austria, Austria

Gynaegological Medical University Innsbruck

🇦🇹

Innsbruck, Tyrol, Austria

Brustgesundheitszentrum-Süd Institut / Dr. Thiel

🇦🇹

Weiz, Styria, Austria

Hospital of Guessing

🇦🇹

Guessing, Burgenland, Austria

State Hospital Leoben

🇦🇹

Leoben, Styria, Austria

Hospital St. Poelten

🇦🇹

St. Poelten, Lower Austria, Austria

Klinikum Wels-Grieskirchen

🇦🇹

Wels, Upper Austria, Austria

Hospital Klosterneuburg, Internal Medicine

🇦🇹

Klosterneuburg, Lower Austria, Austria

Hospital Neunkirchen

🇦🇹

Neunkirchen, Lower Austria, Austria

District Hospital Hall in Tirol

🇦🇹

Hall in Tirol, Tyrol, Austria

State Hospital Schärding

🇦🇹

Schärding, Upper Austria, Austria

State Hospital Rottenmann

🇦🇹

Rottenmann, Styria, Austria

Elisabeth-Hospital

🇩🇪

Kassel, Hesse, Germany

Hospital Oberpullendorf

🇦🇹

Oberpullendorf, Burgenland, Austria

Ordination Dr. Wette

🇦🇹

St. Veit a. d. Glan, Carinthia, Austria

State Hospital Villach

🇦🇹

Villach, Carinthia, Austria

Privat Hospital Villach

🇦🇹

Villach, Carinthia, Austria

State Hospital Wolfsberg

🇦🇹

Wolfsberg, Carinthia, Austria

Hospital Hainburg

🇦🇹

Hainburg An Der Donau, Lower Austria, Austria

Hospital Melk

🇦🇹

Melk, Lower Austria, Austria

Hospital Mödling

🇦🇹

Mödling, Lower Austria, Austria

Hospital Scheibbs

🇦🇹

Scheibbs, Lower Austria, Austria

Hospital Tulln

🇦🇹

Tulln, Lower Austria, Austria

Hospital Waidhofen/Thaya

🇦🇹

Waidhofen An Der Thaya, Lower Austria, Austria

Hospital of Wiener Neustadt

🇦🇹

Wiener Neustadt, Lower Austria, Austria

Kardinal Schwarzenberg'sches Hospital

🇦🇹

Schwarzach, Salzburg, Austria

State Hospital Feldbach

🇦🇹

Feldbach, Styria, Austria

Gynaegological Medical University of Graz

🇦🇹

Graz, Styria, Austria

Medical University of Graz, Oncology

🇦🇹

Graz, Styria, Austria

District Hospital Lienz

🇦🇹

Lienz, Tyrol, Austria

Hospital St. Vinzenz

🇦🇹

Zams, Tyrol, Austria

State Hospital Freistadt

🇦🇹

Freistadt, Upper Austria, Austria

State Hospital Bad Ischl

🇦🇹

Bad Ischl, Upper Austria, Austria

State Hospital Gmunden

🇦🇹

Gmunden, Upper Austria, Austria

State Hospital Kirchdorf

🇦🇹

Kirchdorf, Upper Austria, Austria

Hospital BHS Linz

🇦🇹

Linz, Upper Austria, Austria

Hospital Elisabethinen Linz

🇦🇹

Linz, Upper Austria, Austria

Hospital BHB Linz

🇦🇹

Linz, Upper Austria, Austria

State Hospital Rohrbach

🇦🇹

Rohrbach, Upper Austria, Austria

State Hospital Steyr

🇦🇹

Steyr, Upper Austria, Austria

State Hospital Voecklabruck, Internal Medicine

🇦🇹

Voecklabruck, Upper Austria, Austria

State Hospital Voecklabruck, Surgery Dept.

🇦🇹

Voecklabruck, Upper Austria, Austria

State Hospital Bregenz

🇦🇹

Bregenz, Vorarlberg, Austria

State Hospital of Dornbirn

🇦🇹

Dornbirn, Vorarlberg, Austria

State Hospital Feldkirch

🇦🇹

Feldkirch, Vorarlberg, Austria

Paracelsus Medical University Salzburg - Oncology

🇦🇹

Salzburg, Austria

Hospital BHB Vienna, Surgery

🇦🇹

Vienna, Austria

Hospital Sanatorium Hera

🇦🇹

Vienna, Austria

Medical University of Vienna, General Hospital, Gynaecology and Obstetrics

🇦🇹

Vienna, Austria

Medical University of Vienna, General Hospital

🇦🇹

Vienna, Austria

Medical University Vienna, General Hospital

🇦🇹

Vienna, Austria

State Hospital Vienna-Hietzing

🇦🇹

Vienna, Austria

Hanusch Hospital

🇦🇹

Vienna, Austria

Wilheminenspital, Internal Medicin I

🇦🇹

Vienna, Austria

Practice Dr. Marschner

🇩🇪

Freiburg, Baden-Wuerttemberg, Germany

Medical Care Center

🇩🇪

Ulm, Baden-Wuerttemberg, Germany

Klinikum St. Marien

🇩🇪

Amberg, Bavaria, Germany

Med. University of Munich

🇩🇪

Munich, Bavaria, Germany

Internal-haematological Practice Oldenburg

🇩🇪

Oldenburg, Lower Saxony, Germany

General Hospital Gifhorn

🇩🇪

Gifhorn, Saxony, Germany

Vivantes-Klinikum Friedrichshain

🇩🇪

Berlin, Germany

Ordination Dr. Pöstlberger

🇦🇹

Linz, Upper Austria, Austria

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