Letrozole for Hormone Receptor-Positive Breast Cancer

Not currently recruiting at 826 trial locations
Age: 18+
Sex: Female
Trial Phase: Phase 3
Sponsor: NSABP Foundation Inc
Must be taking: Aromatase inhibitors
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial
Approved in 3 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether letrozole, a hormone therapy, can more effectively treat breast cancer by lowering estrogen levels compared to a placebo. It targets postmenopausal women who have already undergone hormone therapy for hormone receptor-positive breast cancer. Eligible participants must have remained disease-free since their breast cancer diagnosis and completed about five years of hormonal therapy. The trial seeks to determine if letrozole can prevent breast cancer recurrence more effectively than taking no active medication. As a Phase 3 trial, it represents the final step before FDA approval, offering participants the chance to contribute to potentially groundbreaking advancements in breast cancer treatment.

Do I need to stop my current medications for the trial?

Yes, you will need to stop certain medications. If you are on sex hormonal therapy or medications like raloxifene for osteoporosis, you must discontinue them before joining the trial.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that letrozole is generally well-tolerated by patients. In a study with Korean postmenopausal women who had estrogen receptor-positive breast cancer, letrozole treatment led to good results and was well-tolerated. Another study found that letrozole's safety was similar to that of another breast cancer treatment, anastrozole, suggesting that severe side effects are uncommon.

Moreover, long-term survival rates are encouraging. Specifically, one study found that the five-year survival rate for patients taking letrozole was very high, around 95%. This high rate supports the idea that letrozole is safe for long-term use in treating breast cancer.

Overall, letrozole appears to be a safe treatment option with manageable side effects for those with hormone receptor-positive breast cancer.12345

Why do researchers think this study treatment might be promising?

Letrozole is unique because it specifically targets hormone receptor-positive breast cancer by inhibiting aromatase, an enzyme involved in estrogen production. Unlike other treatments that might use chemotherapy or rely on tamoxifen, letrozole directly reduces estrogen levels, which can slow or stop the growth of certain cancer cells. Researchers are excited about letrozole because it offers a more targeted approach, potentially leading to fewer side effects compared to broader treatments, while maintaining effectiveness over a long duration.

What evidence suggests that letrozole might be an effective treatment for hormone receptor-positive breast cancer?

Research has shown that letrozole, which participants in this trial may receive, can effectively treat hormone receptor-positive breast cancer. One study found that letrozole significantly reduced the risk of cancer recurrence, resulting in fewer cases of recurrence. Specifically, it increased the time patients remained free from breast cancer by 25% compared to those not taking letrozole. Another study discovered that combining letrozole with ribociclib extended patients' lives, with an average survival time of 63.9 months. These findings suggest that letrozole is a strong option for managing this type of breast cancer.14678

Who Is on the Research Team?

NW

Norman Wolmark, MD

Principal Investigator

NSABP Foundation Inc

Are You a Good Fit for This Trial?

This trial is for postmenopausal women who have been disease-free since their initial breast cancer diagnosis and completed 57-63 months of hormone therapy. They must have had estrogen or progesterone receptor-positive tumors, undergone specific surgeries with axillary nodal staging, and be in good physical condition (ECOG status 0 or 1). Women on sex hormonal therapies or with certain health conditions are excluded.

Inclusion Criteria

The patient must have remained disease-free from the time of initial breast cancer diagnosis until the time of randomization.
The duration of the patient's hormonal therapy following breast cancer diagnosis must have been 57-63 months from the first dose regardless of the number of missed doses. Hormonal therapy must have consisted of an AI or a combination of up to 3 years of tamoxifen followed by an AI. Tamoxifen may not have been given during years 4 and 5 of the 5 years of adjuvant hormonal therapy. (Note: Patients must discontinue their adjuvant AI therapy at the time of randomization.)
B-42 randomization must be within 6 months following completion of 5 years (57-63 months) of initial adjuvant hormonal therapy.
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Exclusion Criteria

Diagnosis of bilateral breast cancer including ductal carcinoma in situ (DCIS)[(synchronous or metachronous].
Administration of any investigational agent within 30 days before study entry.
Sex hormonal therapy, e.g., estrogen- or progesterone-replacement therapy or oral contraceptives. These patients are eligible only if this therapy is discontinued prior to randomization.
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Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive oral letrozole or placebo once daily for up to 5 years

5 years

Follow-up

Participants are monitored for safety and effectiveness after treatment

7 years
Annual visits

What Are the Treatments Tested in This Trial?

Interventions

  • Letrozole
  • Placebo
Trial Overview The study is testing the effectiveness of Letrozole, a drug that lowers estrogen levels to treat hormone receptor-positive breast cancer, against a placebo. It's designed to see if continuing treatment with Letrozole after standard hormone therapy provides additional benefits.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Placebo Group
Group I: Group 2 LetrozoleExperimental Treatment1 Intervention
Group II: Group 1 PlaceboPlacebo Group1 Intervention

Letrozole is already approved in United States, European Union, Canada for the following indications:

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Approved in United States as Femara for:
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Approved in European Union as Letrozole for:
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Approved in Canada as Letrozole for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

NSABP Foundation Inc

Lead Sponsor

Trials
89
Recruited
140,000+

National Cancer Institute (NCI)

Collaborator

Trials
14,080
Recruited
41,180,000+

Novartis

Industry Sponsor

Trials
1,646
Recruited
2,778,000+
Vasant Narasimhan profile image

Vasant Narasimhan

Novartis

Chief Executive Officer since 2018

MD from Harvard Medical School, Bachelor's in Biological Sciences from University of Chicago, Master's in Public Policy from John F. Kennedy School of Government

Shreeram Aradhye profile image

Shreeram Aradhye

Novartis

Chief Medical Officer since 2022

MD from Yale University, MSc in Clinical Epidemiology from University of Pennsylvania

Citations

Clinical Outcomes Following Letrozole Treatment according to ...Treatment with adjuvant letrozole showed very favorable treatment outcomes and good tolerability among Korean postmenopausal women with ER-positive breast ...
Ten-year update: NRG Oncology/National Surgical ...Letrozole statistically significantly reduced breast cancer–free interval events (HR = 0.75, 95% CI = 0.62 to 0.91; P = .003; absolute difference in cumulative ...
Overall Survival with Ribociclib plus Letrozole in Advanced ...Median overall survival was 63.9 months (95% confidence interval [CI], 52.4 to 71.0) with ribociclib plus letrozole and 51.4 months (95% CI, ...
Study Details | NCT00382070 | Letrozole in Treating ...It is not yet known whether letrozole is more effective than a placebo in treating patients with hormone receptor-positive breast cancer. PURPOSE: This ...
Comparative Efficacy and Safety of Adjuvant Letrozole ...Letrozole did not demonstrate significantly superior efficacy or safety compared with anastrozole in postmenopausal patients with HR-positive, node-positive ...
Comparative Efficacy and Safety of Adjuvant Letrozole ...Letrozole did not demonstrate significantly superior efficacy or safety compared with anastrozole in postmenopausal patients with HR-positive, node-positive eBC ...
Long-term Follow-up and Safety of Patients after an Upfront ...Overall survival was very good with five-year survival probability of 95% (95% CI: 94–96%) in the total patient population and 91% (95% CI: 89–93%) for nodal ...
327P A phase IV prospective study of efficacy and safety ...Conclusions. Ribociclib with letrozole showed clear antitumor efficacy in older patients with advanced breast cancer regardless of fitness. Frequent dose ...
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