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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00887380
Registration number
NCT00887380
Ethics application status
Date submitted
23/04/2009
Date registered
24/04/2009
Date last updated
18/11/2022
Titles & IDs
Public title
STARS Breast Trial (Study of Anastrozole and Radiotherapy Sequencing)
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Scientific title
A Randomised Comparison of Anastrozole Commenced Before and Continued During Adjuvant Radiotherapy for Breast Cancer Versus Anastrozole and Subsequent Anti-oestrogen Therapy Delayed Until After Radiotherapy.
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Secondary ID [1]
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ACTRN12610000307000
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Secondary ID [2]
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TROG 08.06
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Universal Trial Number (UTN)
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Trial acronym
STARS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Breast Cancer
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Condition category
Condition code
Cancer
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Breast
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Pre-radiotherapy commencement of anastrozole
Treatment: Other - Radiotherapy
Treatment: Drugs - Post radiotherapy commencement of anastrozole
Active comparator: Arm A: Concurrent - Investigational treatment: Anastrozole commenced before (Pre-radiotherapy commencement of anastrozole) and continued during radiotherapy.
Active comparator: Arm B: Sequential - Standard Treatment: Anastrozole and subsequent anti-oestrogen therapy delayed until after radiotherapy (Post radiotherapy commencement of anastrozole)
Treatment: Drugs: Pre-radiotherapy commencement of anastrozole
Anastrozole: 1mg per day will be prescribed for 12 weeks. Commencing within 1 week of randomisation, to be administered from a min of 1 week before and a max of 4 weeks before commencement of radiotherapy and continued throughout radiotherapy. After 12 weeks administration of anastrozole according to trial regimen, anastrozole can be continued at the treating clinician's discretion and in accordance with the preference selected at the time of randomisation and stratification. The alternative options to long-term anastrozole are tamoxifen or cessation of anti-oestrogen therapy.
Treatment: Other: Radiotherapy
Radiotherapy must commence within 1 month of randomisation. Radiotherapy planning and treatment is as per the protocol.
Treatment: Drugs: Post radiotherapy commencement of anastrozole
Anastrozole 1mg per day will be prescribed for 12 weeks after radiotherapy is completed. Anastrozole should commence within 1 week of the last fraction of radiotherapy and be continued for a total of 12 weeks. After 12 weeks administration according to the trial regimen, any subsequent hormone therapy is as for the concurrent arm.
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Treatment: Other
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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To determine if commencement of anastrozole prior to radiotherapy results in improved local control compared to anastrozole commenced after radiotherapy.
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Assessment method [1]
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Timepoint [1]
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10 years post radiotherapy
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Secondary outcome [1]
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Rates of distant failure
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Assessment method [1]
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Timepoint [1]
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10 years post radiotherapy
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Secondary outcome [2]
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Overall Survival
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Assessment method [2]
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Timepoint [2]
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10 years post radiotherapy
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Secondary outcome [3]
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Normal tissue complications
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Assessment method [3]
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Timepoint [3]
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10 years post radiotherapy
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Secondary outcome [4]
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Cosmesis
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Assessment method [4]
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Timepoint [4]
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10 years post radiotherapy
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Eligibility
Key inclusion criteria
* Women aged 18 years or older
* Post total mastectomy or lumpectomy. All planned cancer resection surgery complete.
* Histologic or pathologic reports must verify either:
* No tumour contacting the inked margin of surgically removed tissue, or
* Focal involvement (<2mm front) if the margin is at the deep (posterior part) of the breast and the surgeon confirms that surgery extended to the deep fascia, or
* Focal involvement (<2mm front) if the margin is superficial (anterior part of the breast or subcutaneous) and the surgeon confirms that surgery extended to the subcutis NB: In the case of focally involved deep or superficial margins, the medical records or multidisciplinary meeting notes or correspondence from the surgeon must indicate that the surgeon confirms the surgery extended to the deep fascia or subcutis as appropriate. Patients should routinely receive a lumpectomy bed boost in the conserved breast setting if there is focal superficial or focal deep involvement as defined above.
* Tumour oestrogen receptor and/or progesterone receptor positive (=10% cells positive).
* Radiotherapy not yet commenced
* Planned radiotherapy dose prescribed to ICRU reference points in the irradiated breast / chest wall volumes at least the biological equivalent of 45 Gy in 25 fractions or more. (BED Gy4 = 65, BED Gyx=D(1+n/x) where D=total dose, n=dose per fraction, x=alpha beta ratio, Gy4 selected as appropriate alpha-beta ratio for human breast cancer lines)
* An ECOG performance status score of 2 or less.
* Female and post menopausal shown by satisfying at least one of the following criteria (as per the ATAC study criteria16):
* bilateral oophorectomy
* age greater than 60
* age 45-59 years with intact uterus and amenorrhoeic at least 12 months
* Amenorrhoeic less than 12 months with follicle stimulating hormone (FSH) levels within the post menopausal range (including patients with amenorrhoea due to chemotherapy, LHRH use or who have had hormone replacement following hysterectomy) Note: it is recommended for women under the age of 45 who have been rendered menopausal by chemotherapy that they be enrolled onto the strata which switches to Tamoxifen after the initial 3 months of anastrozole.
* Is not receiving chemotherapy, or is receiving chemotherapy but the course will be completed at least 3 weeks prior to commencing radiotherapy
* Unilateral treatment
* Has provided written informed consent for participation in this trial
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Previous radiotherapy to the area to be treated
* Previous invasive malignancy within 5 years of current breast cancer diagnosis with the exception of cervix in-situ or skin cancer other than melanoma.
* Patients with clinical evidence of metastatic disease.
* Previous hormonal breast cancer therapy.
* Ongoing hormone replacement therapy
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
16/09/2009
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/12/2024
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Actual
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Sample size
Target
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Accrual to date
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Final
2023
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,NT,QLD,SA,TAS,VIC,WA
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Recruitment hospital [1]
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The Canberra Hospital - Canberra
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Recruitment hospital [2]
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Campbelltown Hospital - Campbelltown
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Recruitment hospital [3]
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Royal Prince Alfred Hospital - Camperdown
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Recruitment hospital [4]
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Genesis Cancer Care Hurstville - Hurstville
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Recruitment hospital [5]
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St George Hospital - Kogarah
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Recruitment hospital [6]
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Liverpool Hospital - Liverpool
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Recruitment hospital [7]
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Calvary Mater Newcastle - Newcastle
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Recruitment hospital [8]
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Central West Cancer Service - Orange
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Recruitment hospital [9]
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Prince of Wales Hospital - Randwick
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Recruitment hospital [10]
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Royal North Shore Hospital - St Leonards
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Recruitment hospital [11]
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Riverina Cancer Centre - Wagga Wagga
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Recruitment hospital [12]
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Illawarra Cancer Care Centre - Wollongong
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Recruitment hospital [13]
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Alan Walker Cancer Centre - Darwin
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Recruitment hospital [14]
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Genesis Cancer Care - Auchenflower
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Recruitment hospital [15]
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Cairns ROQ - Cairns
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Recruitment hospital [16]
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Genesis Cancer Care - Chermside
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Recruitment hospital [17]
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The Townsville Hospital - Douglas
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Recruitment hospital [18]
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Radiation Oncology Gold Coast - Gold Coast
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Recruitment hospital [19]
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Royal Brisbane and Women's Hospital - Herston
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Recruitment hospital [20]
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Radiation Oncology - Mater Centre - South Brisbane
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Recruitment hospital [21]
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Genesis Southport - Southport
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Recruitment hospital [22]
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St Andrew's Toowoomba Hospital - Toowoomba
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Recruitment hospital [23]
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Genesis Care - Tugun
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Princess Alexandra Hospital - Woolloongabba
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Recruitment hospital [25]
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Royal Adelaide Hospital - Adelaide
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Recruitment hospital [26]
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Royal Hobart Hospital - Hobart
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Recruitment hospital [27]
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Geelong Hospital - Geelong
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Recruitment hospital [28]
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Genesis Cancer Care - Bunbury
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Recruitment hospital [29]
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Fiona Stanley Hospital - Murdoch
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Recruitment hospital [30]
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Royal Perth Hospital - Perth
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Recruitment hospital [31]
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Perth Radiation Oncology - Wembley
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Recruitment postcode(s) [1]
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2605 - Canberra
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Recruitment postcode(s) [2]
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2560 - Campbelltown
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Recruitment postcode(s) [3]
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2050 - Camperdown
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Recruitment postcode(s) [4]
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2220 - Hurstville
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Recruitment postcode(s) [5]
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2217 - Kogarah
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Recruitment postcode(s) [6]
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2170 - Liverpool
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Recruitment postcode(s) [7]
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2298 - Newcastle
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Recruitment postcode(s) [8]
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- Orange
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Recruitment postcode(s) [9]
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2031 - Randwick
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Recruitment postcode(s) [10]
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2065 - St Leonards
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Recruitment postcode(s) [11]
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2650 - Wagga Wagga
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Recruitment postcode(s) [12]
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2500 - Wollongong
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Recruitment postcode(s) [13]
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811 - Darwin
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Recruitment postcode(s) [14]
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4066 - Auchenflower
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Recruitment postcode(s) [15]
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4350 - Cairns
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Recruitment postcode(s) [16]
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4032 - Chermside
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Recruitment postcode(s) [17]
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4810 - Douglas
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Recruitment postcode(s) [18]
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4217 - Gold Coast
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Recruitment postcode(s) [19]
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4029 - Herston
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Recruitment postcode(s) [20]
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4101 - South Brisbane
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Recruitment postcode(s) [21]
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- Southport
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Recruitment postcode(s) [22]
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4350 - Toowoomba
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Recruitment postcode(s) [23]
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4224 - Tugun
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Recruitment postcode(s) [24]
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4102 - Woolloongabba
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Recruitment postcode(s) [25]
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5000 - Adelaide
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Recruitment postcode(s) [26]
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7000 - Hobart
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Recruitment postcode(s) [27]
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3220 - Geelong
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Recruitment postcode(s) [28]
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- Bunbury
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Recruitment postcode(s) [29]
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6150 - Murdoch
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Recruitment postcode(s) [30]
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6001 - Perth
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Recruitment postcode(s) [31]
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6014 - Wembley
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Auckland
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Country [2]
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New Zealand
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State/province [2]
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Christchurch
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Country [3]
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New Zealand
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State/province [3]
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Palmerston North
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Funding & Sponsors
Primary sponsor type
Other
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Name
Trans Tasman Radiation Oncology Group
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to determine whether starting anastrozole prior to radiotherapy, so that it is taken during radiotherapy, decreases local recurrence of breast cancer in post-menopausal women in comparison to waiting until after radiotherapy to commence anastrozole.
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Trial website
https://clinicaltrials.gov/study/NCT00887380
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Trial related presentations / publications
Browne LH, Graham PH. Good intentions and ICH-GCP: Trial conduct training needs to go beyond the ICH-GCP document and include the intention-to-treat principle. Clin Trials. 2014 Dec;11(6):629-34. doi: 10.1177/1740774514542620. Epub 2014 Jul 14.
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Public notes
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Contacts
Principal investigator
Name
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Peter Graham, MBBS
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Address
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Trans Tasman Radiation Oncology Group
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Phone
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Fax
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Email
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Contact person for public queries
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT00887380
Download to PDF