Full Text View
Tabular View
No Study Results Posted
Related Studies
Hormone Therapy in Preventing Endometrial Carcinogenesis (Cancer) in Women With a Genetic Risk For Hereditary Nonpolyposis Colon Cancer
This study is ongoing, but not recruiting participants.

First Received on April 9, 2002.   Last Updated on November 16, 2011   History of Changes
Sponsor: M.D. Anderson Cancer Center
Collaborator: National Cancer Institute (NCI)
Information provided by (Responsible Party): M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier: NCT00033358
  Purpose

RATIONALE: Hormone therapy may prevent the development of endometrial carcinogenesis (cancer) in women with a genetic risk for hereditary nonpolyposis colon cancer. It is not yet known which hormone therapy regimen is more effective in preventing endometrial cancer.

PURPOSE: Randomized phase II trial to compare two different hormone therapy regimens in preventing endometrial cancer in women who have a genetic risk for hereditary nonpolyposis colon cancer.


Condition Intervention Phase
Endometrial Cancer
Colon Cancer
Drug: Ethinyl estradiol
Drug: Medroxyprogesterone
Drug: Norgestrel
Phase II

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: Modulation Of Putative Surrogate Endpoint Biomarkers In Endometrial Biopsies From Women With HNPCC

Resource links provided by NLM:


Further study details as provided by M.D. Anderson Cancer Center:

Primary Outcome Measures:
  • Frequency of endometrial abnormalities by histology at baseline [ Time Frame: At Baseline (Day 1) ] [ Designated as safety issue: No ]
    Baseline transvaginal ultrasound and endometrial biopsy.


Secondary Outcome Measures:
  • Changes in histology and ultrasound appearance at 3 months [ Time Frame: 3 Months ] [ Designated as safety issue: No ]
  • Changes in surrogate endpoint biomarkers at 3 months [ Time Frame: 3 Months ] [ Designated as safety issue: No ]

Estimated Enrollment: 52
Study Start Date: February 2002
Estimated Study Completion Date: February 2013
Estimated Primary Completion Date: February 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm I
Medroxyprogesterone intramuscularly once on Day 1.
Drug: Medroxyprogesterone
Intramuscularly injection once on day 1.
Other Names:
  • Provera
  • MP
  • medroxyprogesterone 17-acetate
  • MPA
Experimental: Arm II
Oral contraceptive pills (OCP) comprising ethinyl estradiol and norgestrel once daily on days 1-21.
Drug: Ethinyl estradiol
Given orally once daily as part of oral contraceptive pills (OCP) on days 1-21
Other Names:
  • EE
  • Estradiol
Drug: Norgestrel
Given orally once daily as part of oral contraceptive pills (OCP) on days 1-21; repeats every 28 days for 3-4 courses (3-4 packs of OCP) in the absence of unacceptable toxicity.
Other Name: dextro-norgestrel

Detailed Description:

OBJECTIVES:

  • Compare the effect of medroxyprogesterone vs ethinyl estradiol and norgestrel on potential surrogate endpoint biomarkers relevant to endometrial carcinogenesis in women with a known hereditary non-polyposis colon cancer (HNPCC)-associated gene mutation or HNPCC-associated cancer(s).
  • Compare the 3-month changes in histology and ultrasound appearance of the endometrium in patients treated with these preventive regimens.

OUTLINE: This is a randomized, multicenter study. Patients are randomized to 1 of 2 arms.

All patients undergo a baseline transvaginal ultrasound and endometrial biopsy.

  • Arm I: Patients receive medroxyprogesterone intramuscularly once on day 1. Approximately 90 days after the injection, patients undergo a repeat transvaginal ultrasound and endometrial biopsy.
  • Arm II: Patients receive oral contraceptive pills (OCP) comprising ethinyl estradiol and norgestrel once daily on days 1-21. Treatment repeats every 28 days for 3-4 courses (3-4 packs of OCP) in the absence of unacceptable toxicity. Approximately 1 week after starting the fourth pack of OCP, patients undergo a repeat transvaginal ultrasound and endometrial biopsy.

Patients are followed at 6 weeks and are encouraged to return in 6 months to participate in continued endometrial screening.

PROJECTED ACCRUAL: A total of 44 patients (22 per arm) will be accrued for this study.

  Eligibility

Ages Eligible for Study:   25 Years to 50 Years
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Women with known mutation of an HNPCC-associated gene (hMLH-1, hMSH-2, or hMSH-6) or fulfill Amsterdam Criteria and have had one or more HNPCC-associated cancers.
  • Age >/= 25 and </= 50.
  • No prior hysterectomy. (Participants may be scheduled for prophylactic hysterectomy following the study.)
  • Voluntary consent documented by a signed and witnessed informed consent.
  • Negative serum pregnancy test at baseline evaluation.
  • No history of pelvic irradiation for whatever cause.
  • No chemotherapy for two years.
  • Women >/= 40 must have had a screening mammogram within the last 12 months prior to participation in this study.
  • Women who are at 50% risk of having a mutation and willing to have genetic testing.

Exclusion Criteria:

  • Use of oral contraceptives or depoMPA or hormonal exposure, such as hormonal IUD, tamoxifen, raloxifene, or other selective estrogen receptor modulators (SERMs) within four months of initiating study. Women will be asked to be off oral contraceptives or other hormonal exposure for 4 months prior to initiating study.
  • Medical contraindication to use of oral contraceptives or depoMPA including:

    • Known or suspected pregnancy
    • Undiagnosed vaginal bleeding
    • Known or suspected malignancy of breast or endometrium
    • Active thrombophlebitis, or current or past history of thromboembolic disorders, or cerebral vascular disease
    • Gall bladder disease or liver dysfunction or disease, including hepatic adenomas or carcinoma, or abnormal liver function tests
    • Known hypersensitivity to depoMPA contraceptive injection (medroxyprogesterone acetate or any of its other ingredients)
    • Depression that is currently not under control, in the judgement of the Principal Investigator.
    • History of epilepsy
    • History of diabetes
    • Coronary artery disease
    • Age >/=35 and a current tobacco smoker
  • Known inability to participate in the scheduled follow-up tests (i.e., alcohol dependence or illicit drug use).
  • Significant medical history or psychiatric problems which would make the participant a poor protocol candidate, in the opinion of the principal investigator.
  • Post surgical removal of both ovaries.
  • Postmenopausal women with amenorrhea greater than 12 months.
  • Previous history of endometrial biopsy, hysteroscopy, dilatation and curettage, or IUD in place within the past 3 months.
  • Known participation in a concurrent protocol with a pharmacological intervention.
  • Recent or concurrent use of systemic steroids (i.e. prednisone) within the past four months of initiating study.
  • Positive serum pregnancy test at baseline evaluation.
  • Fasting triglycerides level > 400 mg/dl.
  • Cholesterol level > 240 mg/dl.
  • LDL level > 160 mg/dl.
  • HDL level < 35 mg/dl.
  • Hypertension that is currently not under good control, in the judgement of the Principal Investigator.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00033358

Locations
United States, California
UCSF Helen Diller Family Comprehensive Cancer Center
San Francisco, California, United States, 94115
United States, Nebraska
Creighton University Medical Center
Omaha, Nebraska, United States, 68131-2197
United States, Texas
M. D. Anderson Cancer Center at University of Texas
Houston, Texas, United States, 77030-4009
Sponsors and Collaborators
M.D. Anderson Cancer Center
Investigators
Study Chair: Karen H. Lu, MD M.D. Anderson Cancer Center
  More Information

Additional Information:
No publications provided

Responsible Party: M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier: NCT00033358     History of Changes
Other Study ID Numbers: ID01-340, P30CA016672, MDA-ID-01340, NCI-P02-0218, CDR0000069277
Study First Received: April 9, 2002
Last Updated: November 16, 2011
Health Authority: United States: Food and Drug Administration

Keywords provided by M.D. Anderson Cancer Center:
endometrial cancer
hereditary non-polyposis colon cancer
Hormone Therapy
Prevention
Endometrial Carcinogenesis
Putative Surrogate Endpoint Biomarkers
Endometrial Biopsies

Additional relevant MeSH terms:
Colonic Neoplasms
Endometrial Neoplasms
Colorectal Neoplasms, Hereditary Nonpolyposis
Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Neoplasms
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Uterine Neoplasms
Genital Neoplasms, Female
Urogenital Neoplasms
Uterine Diseases
Genital Diseases, Female
Neoplastic Syndromes, Hereditary
Genetic Diseases, Inborn
DNA Repair-Deficiency Disorders
Metabolic Diseases
Contraceptives, Oral
Medroxyprogesterone
Norgestrel
Contraceptives, Oral, Combined
Estradiol
Polyestradiol phosphate
Ethinyl Estradiol
Estradiol valerate

ClinicalTrials.gov processed this record on February 09, 2012