Zoledronate, Calcium, and Vitamin D in Preventing Bone Loss in Women Receiving Adjuvant Chemotherapy for Breast Cancer
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Purpose
RATIONALE: Zoledronate plus calcium and vitamin D may prevent bone loss in patients receiving adjuvant chemotherapy for breast cancer. It is not yet known which regimen is more effective in preventing bone loss.
PURPOSE: This randomized phase III trial is comparing two regimens of zoledronate plus calcium and vitamin D to see how well they work in preventing bone loss in women who are receiving adjuvant chemotherapy for breast cancer.
| Condition | Intervention | Phase |
|---|---|---|
|
Breast Cancer Osteoporosis |
Dietary Supplement: calcium salts Dietary Supplement: cholecalciferol Drug: zoledronic acid |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Supportive Care |
| Official Title: | Phase III Trial of Intravenous Zoledronic Acid (Zometa) in the Prevention of Bone Loss in Localized Breast Cancer Patients With Chemotherapy-Induced Ovarian Failure |
- Bone mineral density in the lumbar spine [ Time Frame: 12 months from randomization ] [ Designated as safety issue: No ]
- Bone mineral density in the lumbar spine [ Time Frame: 36 months post randomization ] [ Designated as safety issue: No ]
| Enrollment: | 439 |
| Study Start Date: | December 2001 |
| Study Completion Date: | February 2009 |
| Primary Completion Date: | March 2007 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Zoledronic acid initial tx
Zoledronic acid + calcium + Vit D for 2 years, followed by Calcium + vit D for 1 year
|
Dietary Supplement: calcium salts
1000 mg PO per day
Dietary Supplement: cholecalciferol
400 IU PO per day
Other Name: Vitamin D
Drug: zoledronic acid
4 mg IV infusion q 3 months, months 1-24 in Zoledronic acid initial tx arm and months 13-36 in calcium + vit D initial tx arm
Other Name: Zometa
|
|
Experimental: Calcium + Vit D initial Tx
Calcium + vitamin D for 1 year followed by zoledronic acid + calcium + vit D for 2 years
|
Dietary Supplement: calcium salts
1000 mg PO per day
Dietary Supplement: cholecalciferol
400 IU PO per day
Other Name: Vitamin D
Drug: zoledronic acid
4 mg IV infusion q 3 months, months 1-24 in Zoledronic acid initial tx arm and months 13-36 in calcium + vit D initial tx arm
Other Name: Zometa
|
Detailed Description:
OBJECTIVES:
- Compare the bone mineral density in the lumbar spine after 12 and 36 months of therapy with zoledronate, calcium, and cholecalciferol (vitamin D) in women with breast cancer receiving adjuvant chemotherapy.
OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to intent to treat with tamoxifen (yes vs no) and node status (negative vs positive vs unknown [for patients receiving neoadjuvant therapy]). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Beginning on the first day of adjuvant chemotherapy (or within 3 months after the first day), patients receive zoledronate IV over at least 15 minutes once every 3 months during months 1-24 and oral calcium and oral cholecalciferol (vitamin D) daily during months 1-36.
- Arm II: Beginning on the first day of adjuvant chemotherapy (or within 3 months after the first day), patients receive oral calcium and oral vitamin D daily during months 1-36 and zoledronate IV over at least 15 minutes once every 3 months during months 13-36.
PROJECTED ACCRUAL: Approximately 400 patients (200 per treatment arm) will be accrued for this study within 24 months.
Eligibility| Ages Eligible for Study: | 40 Years and older |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Histologically confirmed adenocarcinoma of the breast by fine needle aspirate, biopsy (tru-cut, core, stereotactic), lumpectomy, or modified radical mastectomy
- Stage I-III (any T, any N, M0)
- Stage IV due solely to supraclavicular node involvement allowed
Plan to use adjuvant chemotherapy* with or without adjuvant endocrine therapy*
- Subsequent adjuvant hormonal therapy with an aromatase inhibitor allowed in women rendered postmenopausal by adjuvant chemotherapy NOTE: *Must be specified prior to study entry
Hormone receptor status:
- Not specified
PATIENT CHARACTERISTICS:
Age:
- 40 and over
Sex:
- Female
Menopausal status:
- See Disease Characteristics
Premenopausal, defined as actively menstruating or last menstrual period occurred within 6 months prior to study entry
- Prior hysterectomy without bilateral oophorectomy and estradiol and follicle-stimulating hormone within premenopausal range prior to the initiation of chemotherapy allowed
Performance status:
- Not specified
Life expectancy:
- Not specified
Hematopoietic:
- Not specified
Hepatic:
- Not specified
Renal:
- Not specified
Other:
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- Not specified
Chemotherapy:
- See Disease Characteristics
- No more than 3 months since prior adjuvant chemotherapy
Endocrine therapy:
- See Disease Characteristics
Radiotherapy:
- Not specified
Surgery:
- See Disease Characteristics
- See Menopausal status
Other:
- No other concurrent bisphosphonates
- No concurrent digoxin
- No concurrent tetracycline
- Concurrent neoadjuvant therapy allowed
- Concurrent enrollment on therapeutic adjuvant clinical trials allowed provided the therapeutic trial does not preclude participation in this trial
Contacts and Locations
Show 107 Study Locations| Study Chair: | Charles L. Shapiro, MD | Ohio State University Comprehensive Cancer Center |
More Information
Additional Information:
Publications:
| Responsible Party: | Monica M Bertagnolli, Cancer and Leukemia Group B |
| ClinicalTrials.gov Identifier: | NCT00022087 History of Changes |
| Other Study ID Numbers: | CDR0000068781, U10CA031946, CALGB-79809, NCI-P01-0184 |
| Study First Received: | August 10, 2001 |
| Last Updated: | April 1, 2011 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Cancer and Leukemia Group B:
|
osteoporosis stage I breast cancer stage II breast cancer stage IV breast cancer |
stage IIIA breast cancer stage IIIB breast cancer stage IIIC breast cancer |
Additional relevant MeSH terms:
|
Breast Neoplasms Osteoporosis Neoplasms by Site Neoplasms Breast Diseases Skin Diseases Bone Diseases, Metabolic Bone Diseases Musculoskeletal Diseases Zoledronic acid Calcium, Dietary |
Cholecalciferol Vitamin D Ergocalciferols Diphosphonates Vitamins Bone Density Conservation Agents Physiological Effects of Drugs Pharmacologic Actions Micronutrients Growth Substances |
ClinicalTrials.gov processed this record on May 23, 2013