RECRUITING

(Z)-Endoxifen for the Treatment of Premenopausal Women With ER+/HER2- Breast Cancer

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This open-label research study is studying (Z)-endoxifen as a possible treatment for pre-menopausal women with ER+/HER2- breast cancer. (Z)-endoxifen belongs to a group of drugs called selective estrogen receptor modulators or "SERM", which help block estrogen from attaching to cancer cells. This study has two parts: a pharmacokinetic part and a treatment part. The PK part (how the body processes the drug) will enroll about 18 participants. All participants will take (Z)-endoxifen capsules daily. Twelve participants will be randomly assigned (50/50 chance) to take (Z)-endoxifen alone or (Z)-endoxifen with a monthly injection of goserelin a drug that temporarily stops the ovaries from making estrogen. This part will help determine the best dose of (Z)-endoxifen by measuring the drug levels in the blood and how long the body takes to remove it. The Treatment Cohort has been simplified to a single study arm (Z)-endoxifen + goserelin. Up to 20 participants will be enrolled that have a baseline Ki-67 ≤ 10% and 45 participants will be enrolled that have a baseline Ki-67\>10%. A key goal of the study is to see if (Z)-endoxifen can slow down or stop tumor growth as measured by a reduction in Ki-67 levels. Tumor tissue samples will be taken by breast biopsy after about 4 weeks of treatment to check levels of this biomarker. If the tumor shows signs of response, participants can continue treatment for up to 24 weeks or until they have surgery. Study participation is up to 6 months (24 weeks of treatment) followed by surgery and a one-month follow up visit.

Official Title

A Phase 2 Trial of (Z)-Endoxifen + Goserelin as Neoadjuvant Treatment for Premenopausal Women With ER+, HER2-, Breast Cancer

Quick Facts

Study Start:2023-02-14
Study Completion:2027-04
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT05607004

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years
Sexes Eligible for Study:FEMALE
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. 1. Female sex assigned at birth. Female to male transgender individuals who have not had any hormonal therapy may be considered for the trial after review and approval from the medical monitor and study sponsor.
  2. 2. Age 18 years or older
  3. 3. Not lactating, pregnant, or planning to become pregnant in the next year and agrees to take adequate steps to prevent becoming pregnant beginning at informed consent, during treatment and for 9 months after last dose and agree to not breast feed during treatment and for 3 months after last dose.
  4. 4. Must agree to use at least one non-hormonal highly effective method of contraception for the entire duration of study participation beginning at informed consent. Highly effective methods of birth control are defined as those, alone or in combination, that resulted in a low failure rate of \<1% per year when used consistently and correctly such as intrauterine devices (IUDs, non-hormonal such as copper IUD), bilateral tubal occlusion, sexual abstinence or vasectomized partner
  5. 5. Premenopausal defined as any female who:
  6. 1. is menstruating or
  7. 2. is not menstruating (last menstrual period \> 3 months prior to registration) but has a plasma estradiol in the premenopausal range as assessed locally
  8. 6. Pathologic confirmation of strongly estrogen receptor positive (ER+) (defined as estrogen receptor \[ER\] ≥ 67% or Allred Score 6-8) by local institution protocol
  9. 7. Eastern Cooperative Oncology Group ECOG Performance Status (ECOG PS) of 0 to 2
  10. 8. Nottingham (Elston-Ellis) Grade 1 or 2
  11. 9. HER2- breast cancer (histologically confirmed) using American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines
  12. 10. Clinical T2 or T3 invasive breast cancer (per American Joint Committee on Cancer \[AJCC\] 8th edition clinical staging)
  13. 11. Clinical N0 or N1 invasive breast cancer (per American Joint Committee on Cancer \[AJCC\] 8th edition clinical staging)
  14. 12. MRI ≤ 35 days of registration
  15. 13. Must have given written informed consent before any study-related activities are carried out and must be able to understand the full nature and purpose of the trial, including possible risks and adverse effects
  16. 14. Willing to provide blood and breast tissue samples for research purposes at specified timepoints for the duration of their participation in the trial.
  1. 1. Bilateral invasive breast cancer; Inflammatory breast cancer defined as clinically significant erythema of the breast and/or documented dermal lymphatic invasion or bilateral invasive breast cancer (patients with pre-malignant disease or DCIS/LCIS in contralateral breast are eligible)
  2. 2. Prior diagnosis or treatment for breast cancer, including carcinoma in situ, or history of any other active malignancy within the past 2 years prior to study entry with the exception of:
  3. 1. Adequately treated in situ carcinoma of the cervix uteri
  4. 2. Adequately treated basal cell carcinoma or localized squamous cell carcinoma of the skin
  5. 3. Any other malignancy with a life expectancy of less than 2 years
  6. 3. Any uncontrolled intercurrent illness including, but not limited to:
  7. 1. Ongoing or active infection requiring systemic treatment with strong inhibitors/inducers of CYP450 enzymes (including bacterial infection, fungal infection, or detectable viral infection).
  8. 2. Symptomatic congestive heart failure,
  9. 3. Unstable angina pectoris,
  10. 4. Uncontrolled symptomatic cardiac arrhythmias
  11. 5. Uncontrolled hypertension
  12. 6. Uncontrolled diabetes (Hemoglobin A1c \[HbA1c\] \>7%)
  13. 7. Marked baseline prolongation of QT/QTc interval (e.g., repeated demonstration of a QTc interval \> 470 milliseconds \[msec\]) using Fridericia's QT correction formula seen ≤ 28 days of registration
  14. 4. Any of the following co-morbid conditions:
  15. 1. Known cataracts or retinopathy
  16. 2. History of deep vein thrombosis (DVT)/pulmonary embolism (PE)
  17. 3. Known activated protein C (APC) resistance, an inherited coagulation disorder
  18. 4. End stage kidney disease requiring dialysis
  19. 5. Evidence of the following laboratory abnormalities ≤ 28 days prior to registration:
  20. 1. Total bilirubin ≥ 1.5 x upper limit of normal (ULN)
  21. 2. Aspartate aminotransferase (AST) or alanine amino transferase (ALT) ≥ 2.5 x ULN
  22. 3. Platelet count (PLT) ≤ 75,000/mm3
  23. 4. Hemoglobin (Hb) ≤ 10 g/dL
  24. 6. Hormonal therapies including birth control and hormone replacement therapy, or prior use of androgen-based therapy during the study or within 1 week of registration. If subject has a prior medical history of Depo-Provera®, it is recommended that the last dose of 3-month contraceptive agents are \> 2.5 months from registration.
  25. 7. Allergy to endoxifen, goserelin, or exemestane or any of their components
  26. 8. Participation in another investigational clinical trial ≤ 6 months of registration
  27. 9. Known metastatic disease

Contacts and Locations

Study Contact

Hayley Erickson
CONTACT
206-486-1872
hayley.erickson@atossainc.com

Principal Investigator

Matthew P Goetz, MD
PRINCIPAL_INVESTIGATOR
Mayo Clinic

Study Locations (Sites)

Mayo Clinic Arizona
Phoenix, Arizona, 85054
United States
University of Arizona
Tucson, Arizona, 85719
United States
California Research Institute
Los Angeles, California, 90027
United States
Mayo Clinic Florida
Jacksonville, Florida, 32224
United States
Northwestern University
Chicago, Illinois, 60611
United States
St. Elizabeth Healthcare
Edgewood, Kentucky, 41017
United States
Henry Ford Cancer Institute
Detroit, Michigan, 48202
United States
Mayo Clinic Rochester
Rochester, Minnesota, 55905
United States
Washington University School of Medicine
St Louis, Missouri, 63110
United States
Avera Cancer Institute
Sioux Falls, South Dakota, 57105
United States
Vanderbilt Ingram Cancer Center
Nashville, Tennessee, 37204
United States
Baylor University
Houston, Texas, 77054
United States
Tranquility Research
Webster, Texas, 77598
United States
Bon Secours Cancer Institute
Midlothian, Virginia, 23114
United States

Collaborators and Investigators

Sponsor: Atossa Therapeutics, Inc.

  • Matthew P Goetz, MD, PRINCIPAL_INVESTIGATOR, Mayo Clinic

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2023-02-14
Study Completion Date2027-04

Study Record Updates

Study Start Date2023-02-14
Study Completion Date2027-04

Terms related to this study

Keywords Provided by Researchers

  • breast cancer
  • ER+/HER2-
  • endocrine therapy
  • neoadjuvant
  • (Z)-endoxifen
  • exemestane
  • goserelin
  • Ki-67
  • estrogen receptor negative
  • human epidermal growth factor receptor 2 negative
  • Stage II
  • tamoxifen
  • PKCB1

Additional Relevant MeSH Terms

  • Breast Neoplasms
  • Invasive Breast Cancer
  • Estrogen-receptor-positive Breast Cancer
  • HER2-negative Breast Cancer