To investigate prospectively whether short term endocrine treatment can induce molecular changes, predictive for therapy response.
We will perform a randomized, open-label, single-institution study. It will compare the efficacy of three different endocrine treatment regimens (Anastrozole +/- Fulvestrant or Tamoxifen) in changing proliferation-index and inducing apoptosis during a 2-6 week pre-operative treatment period in breast cancer patients. These results will be correlated to gene expression profiles, phosphorylation status of the ER, SNPs in CYP450 sequences, tamoxifen metabolite concentrations, changes in estrogen serum levels and protein expression patterns.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
250
1 mg,QD,PO
Anastrozole; 1 mg, QD, PO Fulvestrant; 500 mg, IM, day 1, 15, 29 and monthly thereafter
loading dose of 40 mg, TID, PO, during 7 days, Thereafter 20 mg, QD, PO
Medisch Centrum Haaglanden
The Hague, South Holland, Netherlands
NKI-AVL
Amsterdam, Netherlands
St. Antonius ziekenhuis
Nieuwegein, Netherlands
UMC St. Radboud
Nijmegen, Netherlands
Decrease in tumor cell proliferation and induced apoptosis.
Time frame: At baseline and after 2-6 weeks of endocrine treatment
Comparison of changes in gene expression after different endocrine treatment exposures
Time frame: At baseline and after endocrine treatment
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loading dose of 40 mg, TID, PO, during 7 days, Thereafter 20 mg, QD, PO