Title

Brain Function in Premenopausal Women Receiving Tamoxifen With or Without Ovarian Function Suppression for Early-Stage Breast Cancer on Clinical Trial IBCSG 24-02
Investigating Cognitive Function for Patients Participating in the SOFT Trial in Selected Centers
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Study Participants

    86
RATIONALE: Learning about the long-term effects of adjuvant tamoxifen (T), adjuvant tamoxifen with ovarian function suppression (T+OFS), and exemestane with ovarian function suppression (E+ OFS) on brain function may help doctors plan cancer treatment.

PURPOSE: This study is looking at brain function in premenopausal women who are receiving adjuvant tamoxifen (T) alone against those receive adjuvant tamoxifen (T+OFS) or exemestane (E+OFS) with ovarian function suppression (OFS) for early-stage breast cancer on clinical trial IBCSG-2402.
OBJECTIVES:

Primary:

* To evaluate and compare the changes in cognitive function over one year in premenopausal breast cancer patients who receive adjuvant tamoxifen (T) alone against those receive adjuvant tamoxifen (T+OFS) or exemestane (E+OFS) with ovarian function suppression (OFS).

OUTLINE: This is a multicenter study.

Objective cognitive function was measured with the CogState computerized test battery. The CogState battery consists of seven tasks: Detection, Identification, Monitoring, Memory, Learning, International Shopping List Task (ISLT), and ISLT-Delayed Recall. Performance speed is measured for the Detection, Identification and Monitoring tasks and performance accuracy is measured for the Memory, Learning, ISLT, and ISLT-Delayed Recall. Measures of performance speed are normalized using measures of performance accuracy (%) are normalized using arcsine transformation. The main outcome measure is a composite score which is the average of these task scores (after transformation and standardization by age-specific norms). Patients complete these assessments at baseline (i.e. before start of protocol hormonal therapy) and approximately one year after randomization to the parent IBCSG 24-02 (SOFT) study.

Data were collected separately for the T+OFS and E+OFS participants in the parent study, IBCSG 24-02 (SOFT). The sample size for this Co-SOFT substudy was small, so the analysis plan was revised to pre-specify collective analysis for all patients receiving OFS.
Study Started
Dec 31
2007
Primary Completion
Dec 31
2014
Study Completion
Apr 30
2016
Results Posted
Jul 25
2016
Estimate
Last Update
Jul 25
2016
Estimate

Drug Tamoxifen

  • Other names: Nolvadex

Drug triptorelin

  • Other names: GnRH analogue, Trelstar Depot, Decapeptyl Depot

Drug Exemestane

  • Other names: Aromasin

Tamoxifen Active Comparator

Tamoxifen 20mg orally daily for 5 years

T+OFS Experimental

Tamoxifen 20mg orally daily for 5 years plus ovarian function suppression (OFS; triptorelin (GnRH analogue) 3.75 mg by im injection q28 days for 5 years; or surgical oophorectomy; or ovarian irradiation)

E+OFS Experimental

Exemestane 25mg orally daily for 5 years plus ovarian function suppression (OFS; triptorelin (GnRH analogue) 3.75 mg by im injection q28 days for 5 years; or surgical oophorectomy; or ovarian irradiation)

Criteria

DISEASE CHARACTERISTICS:

Histologically confirmed breast cancer

Completely resected disease

Registered for clinical trial IBCSG-2402, but not yet started protocol hormonal therapy

Has not yet received any of the following adjuvant endocrine therapy, either before or after registration on IBCSG-2402:

Tamoxifen, exemestane, or gonadotropin-releasing hormone (GnRH) agonist
Ovarian irradiation
Bilateral oophorectomy

Hormone receptor status:

Estrogen and/or progesterone receptor positive

Each tumor must be hormone receptor positive

PATIENT CHARACTERISTICS:

Premenopausal
Can speak and read the local language(s) fluently

PRIOR CONCURRENT THERAPY:

See Disease Characteristics

Summary

Tamoxifen

Ovarian Function Suppression

All Events

Event Type Organ System Event Term

Change in Cognitive Function Over 1 Year in Premenopausal Breast Cancer Patients Who Receive Adjuvant Tamoxifen (T) Alone Against Those Receive Adjuvant Tamoxifen (T+OFS) or Exemestane (E+OFS) With Ovarian Function Suppression (OFS)

Objective cognitive function measured with CogState, a computerized test battery of 7 tasks: Detection, Identification, Monitoring, Memory, Learning, International Shopping List Task (ISLT) and ISLT-Delayed Recall. Performance speed is measured for Detection/Identification/Monitoring and performance accuracy is measured for Memory/Learning/ISLT/ISLT-Delayed Recall. Performance speed calculated as mean of the log10 transformed reaction time for correct responses (lower score=better); performance accuracy calculated as arcsine transformation of the proportion of correct responses (higher scores=better). Main outcome measure is a composite score (average of task scores after transformation and standardization by age-specific norms). A positive standardized score indicates that a patient performed better than average; a negative standardized score indicates below average results. Patients complete assessments at baseline and 1 year after randomization to parent IBCSG 24-02 (SOFT) study.

Tamoxifen

-0.04
standardized units (Mean)
Standard Deviation: 0.49

Ovarian Function Suppression

-0.21
standardized units (Mean)
Standard Deviation: 0.92

Total

74
Participants

Age, Continuous

45
years (Median)
Inter-Quartile Range: 41.0 to 49.0

Sex: Female, Male

Overall Study

Tamoxifen

Ovarian Function Suppression

Drop/Withdrawal Reasons

Tamoxifen

Ovarian Function Suppression