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Breast CancerPhase 3NCT00295646

Tamoxifen Versus Anastrozole, Alone or in Combination With Zoledronic Acid

A Phase 3 study testing tamoxifen, anastrozole and zoledronic acid in people with Breast Cancer, run by Austrian Breast & Colorectal Cancer Study Group at 72 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The primary objective is, first, the comparison of tamoxifen and anastrozole and, second, the comparison of zoledronate added to standard adjuvant therapy with controls according to disease-free survival (DFS) in premenopausal patients with non-metastatic breast cancer treated with tamoxifen or anastrozole. Read more about this study

Who is it for?
Ages 19 to 59 years, women only
Conditions the study is for
Breast Cancer
What is being tested?
tamoxifen, anastrozole and zoledronic acid
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,803 participants
Where
72 sitesin 2 countries
Study dates
Jun 1999to 26 Jun 2018
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 19 to 59 years
  • Women only
  • No healthy volunteers
  • Adult

Who may be able to join

  • Premenopausal, hormone receptor-positive patient
  • Histologically verified (minimally) invasive breast cancer, local radical treatment
  • 0-9 involved axillary lymph nodes (≥ 10 histologically examined nodes)
  • Tumor stage: pT1b-3, yT0 or yT1a

Who cannot join

  • T1a, T4d, yT4; M1
  • Previous breast tumor irradiation
  • Previous or concurrent chemotherapy (except for preoperative chemotherapy)
  • Serum creatinine > 1.5 x UNL or creatinine clearance < 60 ml/min

Trial locations and contacts

72 sites in 2 countries.

72 sites in 2 countries

Austria62 sites
  • State Hospital Bad Ischl

    Bad Ischl, Upper Austria, 4820

  • State Hospital Bregenz

    Bregenz, Vorarlberg, 6900

  • State Hospital of Dornbirn

    Dornbirn, Vorarlberg, 6850

  • State Hospital Feldbach

    Feldbach, Styria, 8330

  • State Hospital Feldkirch

    Feldkirch, Vorarlberg, 6807

  • State Hospital Freistadt

    Freistadt, Upper Austria, 4240

  • State Hospital Gmunden

    Gmunden, Upper Austria, 4810

  • Gynaegological Medical University of Graz

    Graz, Styria, 8036

  • Medical University of Graz, Oncology

    Graz, Styria, 8036

  • Hospital of Guessing

    Guessing, Burgenland, 7540

  • Hospital Hainburg

    Hainburg an der Donau, Lower Austria, 2410

  • District Hospital Hall in Tirol

    Hall in Tirol, Tyrol, 6060

  • Gynaegological Medical University Innsbruck

    Innsbruck, Tyrol, 6020

  • State Hospital Kirchdorf

    Kirchdorf, Upper Austria, 4560

  • State Hospital Klagenfurt, Surgery

    Klagenfurt, Carinthia, 9026

  • State Hospital Klagenfurt

    Klagenfurt, Carinthia, 9026

  • Hospital Klosterneuburg, Internal Medicine

    Klosterneuburg, Lower Austria, 3400

  • Hospital Krems

    Krems, Lower Austria, 3500

  • District Hospital Kufstein

    Kufstein, Tyrol, 6330

  • State Hospital Leoben

    Leoben, Styria, 8700

  • District Hospital Lienz

    Lienz, Tyrol, 9900

  • Hospital BHS Linz

    Linz, Upper Austria, 4010

  • Hospital Elisabethinen Linz

    Linz, Upper Austria, 4010

  • General Hospital Linz

    Linz, Upper Austria, 4020

  • Hospital BHB Linz

    Linz, Upper Austria, 4020

  • Ordination Dr. Pöstlberger

    Linz, Upper Austria, 4020

  • Hospital Melk

    Melk, Lower Austria, 3390

  • Hospital Mistelbach

    Mistelbach, Lower Austria, 2130

  • Hospital Mödling

    Mödling, Lower Austria, 2340

  • Hospital Neunkirchen

    Neunkirchen, Lower Austria, 2620

  • Hospital Oberpullendorf

    Oberpullendorf, Burgenland, 7350

  • Hospital Oberwart

    Oberwart, Burgenland, 7400

  • Hospital BHS Ried

    Ried, Upper Austria, 4910

  • State Hospital Rohrbach

    Rohrbach, Upper Austria, 4150

  • State Hospital Rottenmann

    Rottenmann, Styria, 8786

  • Hospital BHB St. Veit

    Saint Veit A. D. Glan, Carinthia, 9300

  • Ordination Dr. Wette

    Saint Veit A. D. Glan, Carinthia, 9300

  • Paracelsus Medical University Salzburg - Oncology

    Salzburg, 5020

  • Hospital St. Poelten

    Sankt Pölten, Lower Austria, 3100

  • State Hospital Schärding

    Schaerding, Upper Austria, 4780

  • Hospital Scheibbs

    Scheibbs, Lower Austria, 3270

  • Kardinal Schwarzenberg'sches Hospital

    Schwarzach, State of Salzburg, 5620

  • State Hospital Steyr

    Steyr, Upper Austria, 4400

  • Hospital Tulln

    Tulln, Lower Austria, 3430

  • Hospital BHB Vienna, Surgery

    Vienna, 1020

  • Hospital Sanatorium Hera

    Vienna, 1090

  • Medical University of Vienna, General Hospital, Gynaecology and Obstetrics

    Vienna, 1090

  • Medical University of Vienna, General Hospital

    Vienna, 1090

  • Medical University Vienna, General Hospital

    Vienna, 1090

  • State Hospital Vienna-Hietzing

    Vienna, 1130

  • Hanusch Hospital

    Vienna, 1140

  • Wilheminenspital, Internal Medicin I

    Vienna, 1160

  • State Hospital Villach

    Villach, Carinthia, 9500

  • Privat Hospital Villach

    Villach, Carinthia, 9504

  • State Hospital Voecklabruck, Internal Medicine

    Vöcklabruck, Upper Austria, 4840

  • State Hospital Voecklabruck, Surgery Dept.

    Vöcklabruck, Upper Austria, 4840

  • Hospital Waidhofen/Thaya

    Waidhofen an der Thaya, Lower Austria, 3830

  • Brustgesundheitszentrum-Süd Institut / Dr. Thiel

    Weiz, Styria, 8160

  • Klinikum Wels-Grieskirchen

    Wels, Upper Austria, 4600

  • Hospital of Wiener Neustadt

    Wiener Neustadt, Lower Austria, 2700

  • State Hospital Wolfsberg

    Wolfsberg, Carinthia, 9400

  • Hospital St. Vinzenz

    Zams, Tyrol, 6511

Other trials in Austria

Germany10 sites
  • Klinikum St. Marien

    Amberg, Bavaria, 92224

  • Vivantes-Klinikum Friedrichshain

    Berlin, 10967

  • Practice Dr. Marschner

    Freiburg im Breisgau, Baden-Wurttemberg, 79106

  • General Hospital Gifhorn

    Gifhorn, Saxony, 38518

  • Elisabeth-Hospital

    Kassel, Hesse, 34117

  • Medical University Kiel

    Kiel, Schleswig-Holstein, 24105

  • Med. University of Munich

    Munich, Bavaria, 80337

  • Frauenklinik vom Roten Kreuz

    Munich, Bavaria, 80637

  • Internal-haematological Practice Oldenburg

    Oldenburg, Lower Saxony, 26121

  • Medical Care Center

    Ulm, Baden-Wurttemberg, 89073

Other trials in Germany

About this study

Official title: Tamoxifen Versus Anastrozole, Alone or in Combination With Zoledronic Acid, in Premenopausal, Hormone Receptor-positive Breast Cancer Patients (Stage I, II)

The primary objective is, first, the comparison of tamoxifen and anastrozole and, second, the comparison of zoledronate added to standard adjuvant therapy with controls according to disease-free survival (DFS) in premenopausal patients with non-metastatic breast cancer treated with tamoxifen or anastrozole. To assess whether zoledronate added to standard adjuvant therapy can decrease or even prevent bone loss in patients treated with hormonal blockade combined with an antiestrogen or aromatase inhibitor.

Read the detailed description

The trial is conducted as an open multi-center phase III study, in a two-factorial study design and according to Good Clinical Practice (GCP) guidelines. Patients will be randomly assigned to a total of 4 study groups in a 1:1:1:1 assignment ratio. Several stratification criteria will be used in order to ensure balanced distribution of known risk factors.

A total of 1.803 patients will be enrolled in 4 arms. Patients will either be treated with anastrozole (1mg daily for 3 years) or tamoxifen (20mg daily for 3 years), and will additionally receive either zoledronate (8mg q4 weeks for 3 years) or no zoledronate (arm A: Nolvadex alone; arm B: Nolvadex plus zoledronate; arm C: Arimidex alone; arm D: Arimidex plus zoledronate).

Zoledronate will be administered by i.v. injection at a dose of 4 mg/month for the treatment period of 3 years. Five Bone Mineral Density (BMD) measurements will be performed in a subgroup of patients (404 patients, enrolled in 3 centres).

Conditions
Breast Cancer
Being tested
tamoxifen, anastrozole, zoledronic acid, goserelin
Keywords
Austrian Breast & Colorectal Cancer Study Group (ABCSG), 12, Phase 3, breast cancer, anastrozole, tamoxifen, zoledronic acid, premenopausal, hormone receptor-positive, Stage I, Stage II, bone mineral density, BMD, bisphosphonate, zoledronate
Medical subject headings
Breast Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • tamoxifenDrug

    Also called Nolvadex

    20 mg/d

  • anastrozoleDrug

    Also called Arimidex

    1 mg/d

  • zoledronic acidDrug

    Also called Zoledronate, Zometa

    4 mg q6m

  • goserelinOther

    3.6 mg goserelin subcutaneously every 28 days

Study groups in NCT00295646
Study groupRoleWhat they receive
AZ (Arimidex+Zoledronate)Active comparatorStudy Drugs Arimidex (Anastrozole), Zometa (Zoledronate; zoledronic acid)
Receives: Drug: anastrozole; Drug: zoledronic acid; Other: goserelin
TZ (Tamoxifen+Zoledronate)Active comparatorStudy Drugs Nolvadex (Tamoxifen), Zometa (Zoledronate; zoledronic acid)
Receives: Drug: tamoxifen; Drug: zoledronic acid; Other: goserelin
AC (Arimidex Control)Active comparatorStudy Drug Arimidex (Anastrozole)
Receives: Drug: anastrozole; Other: goserelin
TC (Tamoxifen Control)Active comparatorStudy Drug Nolvadex (Tamoxifen)
Receives: Drug: tamoxifen; Other: goserelin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Comparison of Anastrozole vs Tamoxifen in Premenopausal Patients With Non-metastatic Breast Cancer With Respect to Disease-free Survival (DFS)

    DFS is defined as time from randomization to first occurrence of a local, regional, or distant recurrence, second primary carcinoma (including contralateral breast cancer), or death from any cause

    Measured: Time from randomization to the analysis data cut-off date when 124 DFS events had occurred. On the analysis data cut-off date, maximum time on study per patient was 102 months.

  2. Comparison of Zoledronate vs no Zoledronate in Premenopausal Patients With Non-metastatic Breast Cancer With Respect to Disease-free Survival (DFS)

    DFS is defined as time from randomization to first occurrence of a local, regional, or distant recurrence, second primary carcinoma (including contralateral breast cancer), or death from any cause

    Measured: Time from randomization to the analysis data cut-off date when 124 DFS events had occurred. On the analysis data cut-off date, maximum time on study per patient was 102 months.

Secondary outcomes (4)
  1. Comparison of Anastrozole vs Tamoxifen in Premenopausal Patients With Non-metastatic Breast Cancer With Respect to Recurrence-free Survival (RFS)

    RFS is defined as time from randomization to first occurrence of a local, regional, or distant recurrence, second primary carcinoma (including contralateral breast cancer), or death from breast cancer

    Measured: Time from randomization to the analysis data cut-off date when 124 DFS events had occurred. On the analysis data cut-off date, maximum time on study per patient was 102 months.

  2. Comparison of Zoledronate vs no Zoledronate in Premenopausal Patients With Non-metastatic Breast Cancer With Respect to Recurrence-free Survival (RFS)

    RFS is defined as time from randomization to first occurrence of a local, regional, or distant recurrence, second primary carcinoma (including contralateral breast cancer), or death from breast cancer

    Measured: Time from randomization to the analysis data cut-off date when 124 DFS events had occurred. On the analysis data cut-off date, maximum time on study per patient was 102 months.

  3. Comparison of Anastrozole vs Tamoxifen in Premenopausal Patients With Non-metastatic Breast Cancer With Respect to Overall Survival (OS)

    OS is defined as time from randomization to death from any cause

    Measured: Time from randomization to the analysis data cut-off date when 124 DFS events had occurred. On the analysis data cut-off date, maximum time on study per patient was 102 months.

  4. Comparison of Zoledronate vs no Zoledronate in Premenopausal Patients With Non-metastatic Breast Cancer With Respect to Overall Survival (OS)

    OS is defined as time from randomization to death from any cause

    Measured: Time from randomization to the analysis data cut-off date when 124 DFS events had occurred. On the analysis data cut-off date, maximum time on study per patient was 102 months.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Feb 2006 (estimated)
  2. Study startJun 1999
  3. Primary completion27 Mar 2008
  4. Study completion26 Jun 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
1,803 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00295646
Sponsor's protocol ID
ABCSG-12
Other IDs
CZOL 446 1B 01, Zol-A-01
Status last verified
Mar 2024
First submitted
23 Feb 2006
Last updated
15 Mar 2024
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Gnant M, Mlineritsch B, Luschin-Ebengreuth G, Kainberger F, Kassmann H, Piswanger-Solkner JC, Seifert M, Ploner F, Menzel C, Dubsky P, Fitzal F, Bjelic-Radisic V, Steger G, Greil R, Marth C, Kubista E, Samonigg H, Wohlmuth P, Mittlbock M, Jakesz R; Austrian Breast and Colorectal Cancer Study Group (ABCSG). Adjuvant endocrine therapy plus zoledronic acid in premenopausal women with early-stage breast cancer: 5-year follow-up of the ABCSG-12 bone-mineral density substudy. Lancet Oncol. 2008 Sep;9(9):840-9. doi: 10.1016/S1470-2045(08)70204-3. Epub 2008 Aug 19.

    PubMed 18718815
  • Gnant MF, Mlineritsch B, Luschin-Ebengreuth G, Grampp S, Kaessmann H, Schmid M, Menzel C, Piswanger-Soelkner JC, Galid A, Mittlboeck M, Hausmaninger H, Jakesz R; Austrian Breast and Colorectal Cancer Study Group. Zoledronic acid prevents cancer treatment-induced bone loss in premenopausal women receiving adjuvant endocrine therapy for hormone-responsive breast cancer: a report from the Austrian Breast and Colorectal Cancer Study Group. J Clin Oncol. 2007 Mar 1;25(7):820-8. doi: 10.1200/JCO.2005.02.7102. Epub 2006 Dec 11.

    PubMed 17159195
  • Gnant M, Mlineritsch B, Schippinger W, Luschin-Ebengreuth G, Postlberger S, Menzel C, Jakesz R, Seifert M, Hubalek M, Bjelic-Radisic V, Samonigg H, Tausch C, Eidtmann H, Steger G, Kwasny W, Dubsky P, Fridrik M, Fitzal F, Stierer M, Rucklinger E, Greil R; ABCSG-12 Trial Investigators; Marth C. Endocrine therapy plus zoledronic acid in premenopausal breast cancer. N Engl J Med. 2009 Feb 12;360(7):679-91. doi: 10.1056/NEJMoa0806285.

    PubMed 19213681
  • Gnant M, Dubsky P, Fitzal F, Blaha P, Schoppmann S, Steger G, Marth C, Samonigg H, Huttner K, Fohler H, Ruecklinger E, Jakesz R, Greil R; Austrian Breast and Colorectal Cancer Study Group. Maintaining bone density in patients undergoing treatment for breast cancer: is there an adjuvant benefit? Clin Breast Cancer. 2009 Jun;9 Suppl 1:S18-27. doi: 10.3816/CBC.2009.s.002.

    PubMed 19561003
  • Gnant M. Can oral bisphosphonates really reduce the risk of breast cancer in healthy women? J Clin Oncol. 2010 Aug 1;28(22):3548-51. doi: 10.1200/JCO.2010.29.6327. Epub 2010 Jun 21. No abstract available.

    PubMed 20567005
  • Gnant M, Mlineritsch B, Stoeger H, Luschin-Ebengreuth G, Heck D, Menzel C, Jakesz R, Seifert M, Hubalek M, Pristauz G, Bauernhofer T, Eidtmann H, Eiermann W, Steger G, Kwasny W, Dubsky P, Hochreiner G, Forsthuber EP, Fesl C, Greil R; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria. Adjuvant endocrine therapy plus zoledronic acid in premenopausal women with early-stage breast cancer: 62-month follow-up from the ABCSG-12 randomised trial. Lancet Oncol. 2011 Jul;12(7):631-41. doi: 10.1016/S1470-2045(11)70122-X. Epub 2011 Jun 5.

    PubMed 21641868
  • Gnant M. Zoledronic acid in breast cancer: latest findings and interpretations. Ther Adv Med Oncol. 2011 Nov;3(6):293-301. doi: 10.1177/1758834011420599.

    PubMed 22084643
  • Pfeiler G, Konigsberg R, Fesl C, Mlineritsch B, Stoeger H, Singer CF, Postlberger S, Steger GG, Seifert M, Dubsky P, Taucher S, Samonigg H, Bjelic-Radisic V, Greil R, Marth C, Gnant M. Impact of body mass index on the efficacy of endocrine therapy in premenopausal patients with breast cancer: an analysis of the prospective ABCSG-12 trial. J Clin Oncol. 2011 Jul 1;29(19):2653-9. doi: 10.1200/JCO.2010.33.2585. Epub 2011 May 9.

    PubMed 21555684
  • Ressler S, Mlineritsch B, Greil R. Zoledronic acid for adjuvant use in patients with breast cancer. Expert Rev Anticancer Ther. 2011 Mar;11(3):333-49. doi: 10.1586/era.11.13.

    PubMed 21417849
  • Hadji P, Coleman R, Gnant M, Green J. The impact of menopause on bone, zoledronic acid, and implications for breast cancer growth and metastasis. Ann Oncol. 2012 Nov;23(11):2782-2790. doi: 10.1093/annonc/mds169. Epub 2012 Jun 22.

    PubMed 22730099
  • Rugani P, Luschin G, Jakse N, Kirnbauer B, Lang U, Acham S. Prevalence of bisphosphonate-associated osteonecrosis of the jaw after intravenous zoledronate infusions in patients with early breast cancer. Clin Oral Investig. 2014;18(2):401-7. doi: 10.1007/s00784-013-1012-5. Epub 2013 Jun 10.

    PubMed 23749244
  • Gnant M, Mlineritsch B, Stoeger H, Luschin-Ebengreuth G, Knauer M, Moik M, Jakesz R, Seifert M, Taucher S, Bjelic-Radisic V, Balic M, Eidtmann H, Eiermann W, Steger G, Kwasny W, Dubsky P, Selim U, Fitzal F, Hochreiner G, Wette V, Sevelda P, Ploner F, Bartsch R, Fesl C, Greil R; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria. Zoledronic acid combined with adjuvant endocrine therapy of tamoxifen versus anastrozol plus ovarian function suppression in premenopausal early breast cancer: final analysis of the Austrian Breast and Colorectal Cancer Study Group Trial 12. Ann Oncol. 2015 Feb;26(2):313-20. doi: 10.1093/annonc/mdu544. Epub 2014 Nov 17.

    PubMed 25403582
  • Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Adjuvant bisphosphonate treatment in early breast cancer: meta-analyses of individual patient data from randomised trials. Lancet. 2015 Oct 3;386(10001):1353-1361. doi: 10.1016/S0140-6736(15)60908-4. Epub 2015 Jul 23.

    PubMed 26211824
  • Lipton A, Gnant M, Aapro M. Managing aromatase inhibitor-associated bone loss in breast cancer. Womens Health (Lond). 2007 Jul;3(4):441-8. doi: 10.2217/17455057.3.4.441.

    PubMed 19804020
  • Adams A, Jakob T, Huth A, Monsef I, Ernst M, Kopp M, Caro-Valenzuela J, Wockel A, Skoetz N. Bone-modifying agents for reducing bone loss in women with early and locally advanced breast cancer: a network meta-analysis. Cochrane Database Syst Rev. 2024 Jul 9;7(7):CD013451. doi: 10.1002/14651858.CD013451.pub2.

    PubMed 38979716

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing tamoxifen, anastrozole and zoledronic acid in people with Breast Cancer, run by Austrian Breast & Colorectal Cancer Study Group at 72 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Mar 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 72 sites in Austria, Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 15 Mar 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Comparison of Anastrozole vs Tamoxifen in Premenopausal Patients With Non-metastatic Breast Cancer With Respect to Disease-free Survival (DFS) (time frame: Time from randomization to the analysis data cut-off date when 124 DFS events had occurred. On the analysis data cut-off date, maximum time on study per patient was 102 months.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00295646, which also lists 16 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Mar 2024.

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