Status:

RECRUITING

Deescalation of Endocrine Therapy Duration in Women With HR+ HER2- Breast Cancer at Very Low Risk

Lead Sponsor:

UNICANCER

Collaborating Sponsors:

Agendia

Conditions:

Breast Cancer

Eligibility:

FEMALE

51+ years

Phase:

PHASE2

Brief Summary

Hormone therapy is recommended for five years in all patients with hormone receptor-positive breast cancer, but there is no consensus on its duration in low-risk tumours and especially in postmenopaus...

Detailed Description

Adjuvant ET is the cornerstone treatment of localized hormone-receptor positive breast cancer, with demonstrated benefits on overall survival (30-40% relative decrease in mortality) but also on the ri...

Eligibility Criteria

Inclusion

  • Postmenopausal women: Postmenopausal status is defined by any of the following:
  • Prior bilateral oophorectomy
  • Age ≥60 years
  • Age \>50 and \<60 years and amenorrheic for at least 12 months, and follicle-stimulating hormone (FSH) and estradiol in the postmenopausal range
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-1
  • Women with histologically proven invasive unilateral breast cancer Note: In case of a multifocal invasive tumor, all lesions (maximum 3 infiltrating lesions allowed) must be of identical phenotype and low biological risk
  • M0: Not clinically nor radiologically detectable metastases at time of inclusion
  • Primary tumor completely resected and adequate axillary surgery performed, according to current standards
  • IHC expression of the estrogen receptor and/or progesterone receptor ≥50%
  • HER2 negative according to ASCO criteria in immunohistochemistry and/or genomic analysis (HER2 negativity is defined as IHC 0-1+, or \[IHC 2+ and FISH or CISH nonamplified\])
  • No indication of adjuvant chemotherapy
  • pT1 (tumor ≤20 mm), pN0, Grade 1 or Grade 2 OR pT2 (tumor ≤30 mm) and pN0, Grade 1 or Grade 2
  • Note 1: patient with Grade 2 pT2pN0 tumor must be aged under 70 years of age and should receive a genomic test as part of standard care (RIHN reimbursement)
  • Patient considered has having a luminal A ultralow risk of metastatic recurrence (i.e.less than 5% risk of metastatic relapse at 10 years) according to MammaPrint® and Blueprint® tests.
  • Note 1: To be eligible, MammaPrint index score should be \> +0.355
  • Patients eligible to receive or have recently started (with a maximum of 4 months of adjuvant hormone therapy prior to enrollment) an adjuvant hormone therapy (letrozole, anastrozole, or exemestane)
  • Patient is willing and able to comply with the protocol for the duration of the study including scheduled visits, treatment plan, laboratory tests and other study procedures
  • Patients must be affiliated to a Social Security System (or equivalent)
  • Patient must have signed a written informed consent form prior to any trial specific procedures. When the patient is physically unable to give their written consent, a trusted person of their choice, independent from the investigator or the sponsor, can confirm in writing the patient's consent.

Exclusion

  • Patients who received a neo-adjuvant hormone therapy, a neo-adjuvant or adjuvant chemotherapy or preoperative medical treatment
  • Any local or regional recurrence or metastatic disease
  • Non-invasive carcinoma
  • Bilateral breast cancer (except in case of contralateral DCIS), or history of other invasive ipsi- or contralateral breast cancer
  • Patients with a history of another malignancy, except for properly treated cervical carcinoma in situ, and non-melanoma cancer of the skin
  • Women with high-risk breast cancer predisposing deleterious germline mutations
  • Contra-indications to the administration of anti-aromatase inhibitors
  • Patients enrolled in another therapeutic study within 30 days prior to inclusion
  • Patients with any other disease or illness, which requires hospitalization or is incompatible with the trial treatment
  • Patients unwilling or unable to comply with trial obligations for geographic, social, physical or psychological reasons, or who are unable to understand the purpose and procedures of the trial
  • Persons deprived of their liberty or under protective custody or guardianship

Key Trial Info

Start Date :

October 12 2022

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

November 1 2035

Estimated Enrollment :

696 Patients enrolled

Trial Details

Trial ID

NCT05297617

Start Date

October 12 2022

End Date

November 1 2035

Last Update

March 30 2025

Active Locations (2)

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Page 1 of 1 (2 locations)

1

Centre Hospitalier Universitaire de Limoges

Limoges, France, 87042

2

Institute Gustave Roussy

Villejuif, France, 94805