RATIONALE: Letrozole may prevent breast cancer in postmenopausal women with a BRCA1 or BRCA2 mutation. PURPOSE: This randomized phase III trial is studying letrozole to see how well it works compared with a placebo in preventing breast cancer in postmenopausal women with a BRCA1 or BRCA2 mutation.
OBJECTIVES: Primary * Evaluate the reduction of the incidence of invasive breast cancer in postmenopausal women with the BRCA1/BRCA2 mutation treated with letrozole. Secondary * Determine the reduction of the incidence of in situ breast cancer in these women. * Determine the recurrence rate of local or metastatic disease in women who have had breast cancer. * Determine the incidence of non-breast cancer, especially ovarian, colon, or endometrial cancer. * Assess the tolerance of this drug in terms of lipid, cardiovascular, and bone effects. * Determine the quality of life of women treated with this drug. * Identify serological markers that allow early diagnosis of hereditary predisposition for breast cancer. * Conduct pharmacogenetic analysis. * Identify biomarkers or genes involved in the occurrence of cardiovascular and rheumatologic metabolic aromatase inhibitors. * Study the phenotypic characteristics of cancers that occur during treatment with letrozole, in particular hormonal markers (estrogen and progesterone receptor) and expression profiles of resistance to therapy. OUTLINE: This is a multicenter study. Patients are stratified according to nature of mutation (BRCA1 vs BRCA2), oophorectomy in premenopausal state (yes vs no), and prior breast cancer (yes vs no). Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients receive oral letrozole once daily. * Arm II: Patients receive oral placebo once daily. Treatment in both arms continues for 5 years in the absence of unacceptable toxicity or development of cancer or recurrent disease. Blood samples are collected periodically for pharmacogenetic studies and analysis of biomarkers or genes associated with hereditary predisposition for breast cancer, toxicities, and resistance to therapy. After completion of study treatment, patients are followed for 5 years.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
170
Institut Sainte Catherine
Avignon, France
Centre Regional Francois Baclesse
Caen, France
Survival without contralateral or unilateral invasive breast cancer at 5 years (prior breast cancer)
Time frame: 2017
Survival without invasive breast cancer at 5 years
Time frame: 2017
Invasive cancer-free survival at 10 years
Time frame: 2022
Breast cancer in situ-free survival at 5 and 10 years
Time frame: 2022
Relapse-free (local or metastatic disease) survival in patients with history of breast cancer at 5 and 10 years
Time frame: 2017 and 2022
Second cancer-free survival at 5 and 10 years
Time frame: 2017 and 2022
Event- free (local relapse or metastatic, contralateral, or second cancer) survival at 5 and 10 years
Time frame: 2017 and 2022
Overall survival at 5 and 10 years
Time frame: 2017 and 2022
Toxicity according to CTCAE version 3.0
Time frame: 2017 and 2022
Lipid tolerance or cardiovascular or bone event
Time frame: 2017 and 2022
Quality of life according to MRS and SF36 questionnaires
Time frame: 2017 and 2022
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Centre Jean Perrin
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Lille, France
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Lyon, France
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Marseille, France
Hopital Arnaud de Villeneuve
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Nice, France
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