ClinicalTrials.gg
RecruitingNCT03351062Updated Nov 22, 2017

Efficacy of Tamoxifen Versus Toremifene in CYP2D6 IM/PM of Premenopausal Patients With ER-positive Early Breast Cancer

A Phase 3 interventional study of Tamoxifen and Toremifene in Breast Cancer Female, sponsored by Chinese Anti-Cancer Association. Recruiting at 21 sites in China. Open to female participants aged 18 Years to 50 Years. Per ClinicalTrials.gov, last updated 2017-11-22.

Sponsored by Chinese Anti-Cancer Association · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Dec 2025, 11 months ago, but the record still lists the study as recruiting.
Phase
Phase 3
Study type
Interventional
Enrollment
844
Allocation
Randomized
Ages
18 Years to 50 Years
Sex
Female
01

Study summary

This clinical trial is designed to be a multi-center prospective, parallel-controlled Phase III clinical study. In this study, the efficacy of tamoxifen versus toremifene shall be compared in CYP2D6 intermediate/poor metabolizers of premenopausal patients with estrogen receptor-positive early breast cancer.

Read the detailed description

STUDY BACKGROUND Breast cancer is a serious disease that threatens human health and life. Especially in China, the incidence rate is increasing year by year. According to WHO data, the incidence of breast cancer in China in 2020 will reach 214,000. Selective estrogen receptor modulators (SERMs) are a classic form of endocrine therapy for early breast cancers, but not all hormone receptor positive breast cancers benefit from specific SERMs. Numerous studies have shown that CYP2D6 variant carriers (around 50% CYP2D6 variant carriers in Chinese population) will not benefit a lot from tamoxifen, and combined use of CYP2D6 inhibitors will further affect the efficacy of tamoxifen. However, studies on another SERM drug - toremifene have shown that its metabolism and pharmacological effects are not influenced by CYP2D6 genotype or enzyme activity. Therefore, in the principle of individualized medicine, it is necessary to compare the efficacy of using tamoxifen and toremifene in CYP2D6 variant carriers in China so as to provide more guidance for clinical use.

OBJECTIVES:

  1. The main purpose of this study is to compare 5-year disease-free survival rate of adjuvant endocrine therapy with tamoxifen and toremifene in premenopausal women with estrogen receptor-positive early breast cancer who are CYP2D6 intermediate/poor metabolizers.
  2. The secondary purpose of this study includes:

    1. To compare 5-year overall survival (OS) and safety of adjuvant endocrine therapy with tamoxifen and toremifene in premenopausal patients with estrogen receptor-positive early breast cancer who are CYP2D6 intermediate/poor metabolizers.
    2. To compare the changes of plasma concentration of the parent drugs and metabolites of tamoxifen and toremifene in premenopausal patients with estrogen receptor-positive early breast cancer who are CYP2D6 intermediate/poor metabolizers.
    3. To assess the pharmacokinetics of tamoxifen and toremifene in premenopausal patients with estrogen receptor-positive early breast cancer who are CYP2D6 intermediate/poor metabolizers.

OUTLINE:

First, CYP2D6 genotype screening shall be conducted in premenopausal patients with estrogen receptor-positive early breast cancer in order to determine the frequency of different alleles. Then, patients who are CYP2D6 intermediate/poor metabolizers (with *4, *5, *10, *14, *17, *41 alleles) shall be stratified and randomized at the ratio of 1:1 ratio: allele status of CYP2D6 CYP2D6 intermediate/poor metabolizer (Heterozygous or homozygous), lymph node metastasis (with vs. without), prior chemotherapy (with vs. without), and HER2 status (positive vs. negative). Included patients shall be divided into two groups. One group will be given Tamoxifen (10mg Bid) for 5 years and the other group will be given toremifene (60mg qd) for 5 years. Then 5-year disease-free rate and overall survival and safety will be compared between these two groups. At Month 6, pharmacokinetic study on tamoxifen, toremifene and their metabolites will be conducted on patients.

02

Conditions studied

  • Breast Cancer Female

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Keywords

  • premenopausal
  • early breast cancer
  • estrogen receptor positive
03

In context

Breast Neoplasms

14,825 studies on the registry are indexed under Breast Neoplasms; 3,319 are open to participants now.

This study's planned enrollment of 844 is above the median of 72 across 10,896 interventional studies indexed under Breast Neoplasms.

Browse Breast Neoplasms studies →

Lead sponsor

Chinese Anti-Cancer Association is the lead sponsor of 4 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 50 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Premenopausal women aged 18-50 years;
  2. PS: 0-2 points;
  3. Invasive breast cancer confirmed by histology with ER ≥ 10% (all test results should be reviewed and confirmed by Department of Pathology of the participant institution);
  4. Participants have completed the standard local radical treatment (modified or conservative radical mastectomy) with or without /adjuvant chemotherapy or radiotherapy;
  5. Participants must be able to understand this study and are willing to participate, agree to genotype screening and sign form with good compliance and cooperation in follow-ups;
  6. Polymorphism analysis showed that patients are CYP2D6 * 4, * 5, * 10, * 14, * 17, * 41 allele carriers;
  7. ≥ 90g/L, neutrophils ≥ 1.5 × 109/L, ≥ 75 × 109/L, and ALT ≤ 2.5 times the (ULN), serum creatinine and urea nitrogen ≤ ULN.

Exclusion criteria

Exclusion Criteria:

  1. Patients have previously received endocrine therapy or have started adjuvant endocrine therapy;
  2. There are any comorbidities that may increase the level of sex hormones: such as pituitary adenomas, ovarian tumors, thymic carcinomas, etc.;
  3. There are any comorbidities that may reduce the level of sex hormones such as hyperthyroidism, hypothyroidism, cirrhosis, severe malnutrition, Turner syndrome, lack of sex hormone synthetase, intracranial tumors, pituitary atrophy etc.;
  4. Patients have undergone or planned to conduct ovariectomy or ovarian function inhibition;
  5. Patients needs to take other medicines which can influence the activity of CYP2D6 (such as fluoxetine, paroxetine, quinidine, bupropion), (such as erythromycin, acetylspiramycin, ritonavir, ketoconazole, nicardipine);
  6. Patients have been treated with other trial medications in the past 2 weeks;
  7. Pregnant or lactating women (women of childbearing age must have a negative pregnancy test within 14 days of the first dosing, and if pregnant, Patients are required for ultrasound examination to exclude pregnancy);
  8. Women of childbearing age who are not willing to take effective during treatment;
  9. There are serious non-malignant tumor comorbidities that may affect long-term follow-up;
  10. Patients have family history of endometrial, ovarian or other gynecologic ;
  11. Transvaginal ultrasound suggested more serious ovarian abnormalities or endometrial thickening;
  12. Patients have had thrombotic events such as cerebrovascular accident (including ), deep venous thrombosis, and pulmonary embolism within 6 months prior to study initiation;
  13. Serious liver insufficiency with C grade;
  14. Serious cardiac insufficiency with (NYHA) grade ≥III;
  15. Patients are known severely allergic to study drug;
  16. Patients have history of other malignancies in the past five years, except for cutaneous basal cell carcinoma and cervical carcinoma in situ which have been cured;
  17. In other cases, the researchers don't think the subjects are suitable for participate in the study.
Terms in these criteria, in plain language(13)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

Child-Pugh class

A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
844 participants (estimated)

Study arms

  • Active comparator
    Tamoxifen treatment group

    Patients in this group will receive tamoxifen treatment.

    Drug: Tamoxifen

  • Active comparator
    Toremifene treatment group

    Patients in this group will receive Toremifene treatment.

    Drug: Toremifene

Interventions

  • Patients will be given 10mg Tamoxifen twice a day.

    Also known as: Tamoxifen citrate

  • Patients will be given 60mg Toremifene once a day.

    Also known as: fareston

06

What researchers measure

Primary outcomes

  1. Disease-Free Survival

    The time period from randomization to local or distant invasive cancer recurrence, contralateral invasive breast cancer, second (non-breast) primary invasive cancer and all-cause death

    Time frame: Within 5 years after randomization

Secondary outcomes

  1. Overall Survival

    The time period from randomization to all-cause death

    Time frame: Within 5 years after randomization

  2. Adverse drug reaction

    The time period from administration to adverse events (dyslipidemia, endometrial hyperplasia) with confirmed, probably and possibly relevant relationship to trial medicine.

    Time frame: Within 5 years after administration

  3. Serum drug concentration

    Blood level of trial medicines and their metabolites

    Time frame: Within 6 months after administration

07

Study locations

21 of 21 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Nov 2017; primary completion for Dec 2025, 97 months later.

Of 328 non-industry phase 3 interventional studies under Breast Neoplasms, half reached primary completion within 79 months of starting (the median), counting those still running; a quarter within 50 and three quarters within 127. This study's planned 97 months is above that.

Counting every sponsor, half of 600 studies reached it within 59 months; a quarter within 36 and three quarters within 96.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 20, 2017
First posted
Nov 22, 2017
StartEst.
Nov 2017
Primary completionEst.
Dec 2025
CompletionEst.
Dec 2025
Last update
Nov 22, 2017
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Nov 22, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03351062
Lead sponsor
Chinese Anti-Cancer Association
Collaborators
Fudan University, Henan Cancer Hospital, The First Hospital of Jilin University, Southwest Hospital, China, First Hospital of China Medical University, Guangdong Provincial People's Hospital, Harbin Medical University, First Affiliated Hospital of Chongqing Medical University, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Jiangsu Provincial People's Hospital, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Zhejiang Cancer Hospital, Tianjin Medical University Cancer Institute and Hospital, Union hospital of Fujian Medical University, Hebei Tumor Hospital, Hunan Cancer Hospital, Affiliated Hospital of Qinghai University, Wuhan TongJi Hospital, Hainan People's Hospital, The Third Affiliated Hospital of Kunming Medical College., The Third Affiliated Hospital of Nanchang University
Responsible party
Sponsor
First posted
Nov 22, 2017
Start date
Nov 2017 (estimated)
Primary completion
Dec 2025 (estimated)
Completion
Dec 2025 (estimated)
Last update
Nov 22, 2017

Study contacts

Zhimin Shao, M. D.
Contact
zhimingshao@yahoo.com
13611709888
Ayong Cao, M. D.
Contact
caca_163@sina.com
18017317218
Zhimin Shao, Master
principal investigator · Fudan University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drugs tested here: Tamoxifen · Toremifene

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