This is a biomarker study designed to test the preclinically generated hypothesis of anti-tumoral activity of denosumab in patients with early breast cancer candidates a tumour excision
This is a biomarker study designed to test in patients the preclinically generated hypothesis of anti-tumoral activity of denosumab.The main objective is to demonstrate the antiproliferative and/or pro-apoptotic activity of denosumab in early breast cancer. Other endpoints are to correlate denosumab activity with RANK and RANKL expressions through mRNA and protein; to characterize the differential antiproliferative activity of denosumab between different phenotypes of breast cancer; to identify biomarkers, to identify global changes in gene expression and validate the activity of RANKL antibody in clinical samples. A total of 60 patients with early breast cancer (Stages I and II) candidates to tumor excision as first therapeutic approach will be randomized 2:1, a treatment arm that will receive two doses of denosumab following diagnosis, and a control arm that will not receive treatment. At least 24 patients with hormone receptor negative breast cancer and 24 premenopausal patients will be included in the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Two injections on days 1 and 8 previous to surgery breast cancer excision
Institut Català d'Oncologia - L'Hospitalet
L'Hospitalet de Llobregat, Barcelona, Spain
Antiproliferative and/or pro-apoptotic activity of denosumab
Changes in the percentage of tumor cells expressing Ki67 and/or cleaved caspase 3 between Biopsy A and Biopsy B.
Time frame: From first biopsy until surgery intervention, which is around four weeks after enrolment
Correlation between antiproliferative activity of denosumab and Rank/RankL expression
Modified ratio of Rank/RankL: MR={log(RANK) -1.2} / log(RANKL) as described in Palafox et al \[10\].
Time frame: From first biopsy until surgery intervention, which is around four weeks after enrolment
Differential antiproliferative activity of denosumab among the different phenotypes of breast cancers.
Ki67 estimations for each phenotype
Time frame: From first biopsy until surgery intervention, which is around four weeks after enrolment
Differential antiproliferative activity of denosumab among pre and post menopausal patients
Ki67 estimations for each menopausal group
Time frame: From first biopsy until surgery intervention, which is around four weeks after enrolment
Safety of denosumab and biopsy procedures in terms of Frequency of adverse events (CTCAE V4.)
Frequency of adverse events derived from denosumab treatment and biopsy procedures
Time frame: From first biopsy until surgery intervention, which is around four weeks after enrolment
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