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Trial Review
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Trial registered on ANZCTR
Registration number
ACTRN12608000243314
Ethics application status
Approved
Date submitted
29/04/2008
Date registered
12/05/2008
Date last updated
15/01/2019
Date data sharing statement initially provided
15/01/2019
Date results provided
15/01/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
IBCSG 35-07 / BIG 1-07 : Study of Letrozole Extension (SOLE). Letrozole in Preventing the Return of Cancer in Postmenopausal Women Who Have Received 4-6 Years of Hormone Therapy for Hormone Receptor-Positive, Lymph Node-Positive, Early-Stage Breast Cancer.
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Scientific title
Postmenopausal women with hormone-receptor positive, node positive early breast cancer will have treatment with continuous letrozole compared with treatment with intermittent letrozole after 4 to 6 years of prior adjuvant endocrine treatment to see which is better at preventing the return of cancer.
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Secondary ID [1]
554
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NCT00553410 (ClinicalTrials.gov)
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Secondary ID [2]
555
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EUDRACT-2007-001370-88 (European Commission - European Clinical Trials Database)
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Universal Trial Number (UTN)
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Trial acronym
SOLE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Endocrine Responsive Breast Cancer
3084
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Condition category
Condition code
Cancer
3241
3241
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0
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Breast
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The study is designed to compare the following treament arms: A) Continuous oral letrozole 2.5mg daily for 5 years, and B) Intermittent oral letrozole 2.5mg daily for the first 9 months of years 1 through 4, followed by 12 months in year 5.
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Intervention code [1]
2826
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Treatment: Drugs
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Comparator / control treatment
Continuous oral letrozole 2.5mg given daily for 5 years
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Control group
Active
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Outcomes
Primary outcome [1]
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Disease-free survival (DFS). DFS is defined as the time from randomisation to local, regional, or distant relapse, contralateral breast cancer, appearance of a second (non-breast) malignancy, or death from any cause, whichever occurs first.
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Assessment method [1]
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Timepoint [1]
4124
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Two interim and one final analyses are planned. The target number of events for the final analysis is 647, and interim analyses are planned after 40% and 70% information (259 and 453 events observed respectively).
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Secondary outcome [1]
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Overall survival (OS). OS is defined as the time from randomisation to death from any cause.
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Assessment method [1]
6941
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Timepoint [1]
6941
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The target number of events for the final analysis is 647, and interim analyses are planned after 40% and 70% information (259 and 453 events observed respectively).
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Secondary outcome [2]
6942
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Distant disease-free survival (DDFS). DDFS is defined as the time from randomisation to any recurrent or metastatic disease in distant sites (i.e., other than the local mastectomy scar/chest wall/skin, the ipsilateral breast in case of breast conservation, or the ipsilateral axilla and internal mammary lymph nodes), second (non-breast) malignancy, or death from any cause, whichever occurs first.
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Assessment method [2]
6942
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Timepoint [2]
6942
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Two interim and one final analyses are planned. The target number of events for the final analysis is 647, and interim analyses are planned after 40% and 70% information (259 and 453 events observed respectively).
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Secondary outcome [3]
6943
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Breast Cancer Free Interval (BCFI). BCFI is defined as the time from randomisation to local (including recurrence restricted to the breast after breast conserving treatment), regional, or distant relapse, or contralateral breast cancer. Second (non-breast) malignancies are ignored and deaths without cancer event are censored at the time of death as a competing event.
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Assessment method [3]
6943
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Timepoint [3]
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Two interim and one final analyses are planned. The target number of events for the final analysis is 647, and interim analyses are planned after 40% and 70% information (259 and 453 events observed respectively).
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Secondary outcome [4]
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Sites of first DFS failure
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Assessment method [4]
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Timepoint [4]
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Two interim and one final analyses are planned. The target number of events for the final analysis is 647, and interim analyses are planned after 40% and 70% information (259 and 453 events observed respectively).
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Secondary outcome [5]
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Second (non-breast) malignancies
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Assessment method [5]
6945
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Timepoint [5]
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Two interim and one final analyses are planned. The target number of events for the final analysis is 647, and interim analyses are planned after 40% and 70% information (259 and 453 events observed respectively).
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Secondary outcome [6]
6946
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Deaths without prior cancer event
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Assessment method [6]
6946
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Timepoint [6]
6946
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Two interim and one final analyses are planned. The target number of events for the final analysis is 647, and interim analyses are planned after 40% and 70% information (259 and 453 events observed respectively).
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Secondary outcome [7]
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Incidence of targeted adverse events
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Assessment method [7]
6947
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Timepoint [7]
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Two interim and one final analyses are planned. The target number of events for the final analysis is 647, and interim analyses are planned after 40% and 70% information (259 and 453 events observed respectively).
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Eligibility
Key inclusion criteria
Patients must be postmenopausal. Have had operable, non-inflammatory breast cancer at diagnosis. Must be clinically disease-free at randomisation. Have had ER and/or PgR positive tumours after primary surgery and before commencement of prior endocrine therapy. Following primary surgery, patients must have had evidence of lymph node involvement either in the axillary or internal mammary nodes, but not supraclavicular nodes. Must have had proper local treatment including surgery with/without radiotherapy for primary breast cancer with no known clinical residual loco-regional disease. Patients must have clinically adequate hepatic function. Patients must have completed 4 to 6 years of prior adjuvant endocrine therapy with selective estrogen receptor modulators (SERM(s)), aromatase inhibitors(AI(s)), or a sequential combination of both (neoadjuvant endocrine therapy should not be included). Patients must have stopped prior endocrine SERM/AI therapy, and must be randomised within 12 months of the last dose of prior endocrine SERM/AI therapy. Patients may have received any type of prior adjuvant therapy, including but not limited to neoadjuvant chemotherapy, neoadjuvant endocrine therapy, adjuvant chemotherapy, trastuzumab, ovarian ablation, GnRH analogues, lapatinib. Pathology material from the primary tumour must be available for submission for central review. Written Informed Consent, and written consent to pathology material submission. Must be accessible for follow-up.
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Minimum age
No limit
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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
Evidence of recurrent disease or distant metastatic disease at any time prior to randomisation. Patients who have had bilateral breast cancer. Bone fracture due to osteoporosis at any time during the 4-6 years of prior SERM/AI therapy. Previous or concomitant malignancy EXCEPT adequately treated: basal or squamous cell carcinoma of the skin, in situ carcinoma of the cervix or bladder, contra- or ipsilateral in situ breast carcinoma. Other non-malignant systemic diseases (cardiovascular, renal, lung, etc.) that would prevent prolonged follow-up. Psychiatric, addictive, or any disorder which compromises compliance with protocol rquirements. Concurrent hormone replacement therapy, bisphosphonates (except for treatment of bone loss), or any investigational agent at randomisation.
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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)
Central randomisation by phone/fax/computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated stratified blocks. Patients will be stratified according to the institution of recruitment and prior adjuvant endocrine therapy (AI(s) & SERM(s)): AI alone, SERM alone, both SERM and AI.
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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
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/06/2008
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Actual
1/09/2009
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Date of last participant enrolment
Anticipated
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Actual
17/08/2012
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Date of last data collection
Anticipated
31/03/2018
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Actual
31/12/2018
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Sample size
Target
4800
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Accrual to date
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Final
4884
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Recruitment in Australia
Recruitment state(s)
NSW,VIC,QLD,WA,TAS
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Recruitment postcode(s) [1]
659
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2350
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Recruitment postcode(s) [2]
660
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2298
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Recruitment postcode(s) [3]
661
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2139
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Recruitment postcode(s) [4]
662
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2444
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Recruitment postcode(s) [5]
663
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2031
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Recruitment postcode(s) [6]
664
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2348
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Recruitment postcode(s) [7]
665
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2485
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Recruitment postcode(s) [8]
666
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7250
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Recruitment postcode(s) [9]
667
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7000
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Recruitment postcode(s) [10]
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3084
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Recruitment postcode(s) [11]
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3128
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Recruitment postcode(s) [12]
670
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3135
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Recruitment postcode(s) [13]
671
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3002
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Recruitment postcode(s) [14]
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6000
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Recruitment postcode(s) [15]
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6008
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Recruitment postcode(s) [16]
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6099
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
952
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Christchurch
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Country [2]
953
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New Zealand
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State/province [2]
953
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Waikato
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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IBCSG (International Breast Cancer Study Group)
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Address [1]
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IBCSG Coordinating Center
Effingerstrasse 40
CH- 3008 BERN
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Country [1]
3336
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Switzerland
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Funding source category [2]
3337
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Self funded/Unfunded
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Name [2]
3337
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BIG (Breast International Group)
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Address [2]
3337
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c/o Institut Jules Bordet
121 Blvd de Waterloo, 7th floor
B-1000 Brussels
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Country [2]
3337
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Belgium
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Primary sponsor type
Commercial sector/Industry
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Name
Novartis Pharma AG
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Address
Lichtstrasse 35
4056 Basel
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Country
Switzerland
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
2982
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Country [1]
2982
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
5350
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Hunter New England Health Service
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Ethics committee address [1]
5350
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Ethics committee country [1]
5350
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Australia
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Date submitted for ethics approval [1]
5350
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28/04/2008
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Approval date [1]
5350
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26/08/2008
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Ethics approval number [1]
5350
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Ethics committee name [2]
5351
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Royal Hobart Hospital
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Ethics committee address [2]
5351
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Ethics committee country [2]
5351
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Australia
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Date submitted for ethics approval [2]
5351
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14/04/2008
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Approval date [2]
5351
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Ethics approval number [2]
5351
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Ethics committee name [3]
5352
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Launceston General Hospital
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Ethics committee address [3]
5352
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Ethics committee country [3]
5352
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Date submitted for ethics approval [3]
5352
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01/05/2008
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Approval date [3]
5352
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Ethics approval number [3]
5352
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Ethics committee name [4]
5353
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Austin Health
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Ethics committee address [4]
5353
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Ethics committee country [4]
5353
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Australia
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Date submitted for ethics approval [4]
5353
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01/08/2008
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Approval date [4]
5353
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Ethics approval number [4]
5353
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Ethics committee name [5]
5354
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Box Hill Hospital
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Ethics committee address [5]
5354
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Ethics committee country [5]
5354
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Australia
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Date submitted for ethics approval [5]
5354
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02/06/2008
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Approval date [5]
5354
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Ethics approval number [5]
5354
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Ethics committee name [6]
5355
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Maroondah Hospital
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Ethics committee address [6]
5355
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Ethics committee country [6]
5355
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Australia
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Date submitted for ethics approval [6]
5355
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02/06/2008
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Approval date [6]
5355
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Ethics approval number [6]
5355
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Ethics committee name [7]
5356
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Peter MacCallum Cancer Institute
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Ethics committee address [7]
5356
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Ethics committee country [7]
5356
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Australia
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Date submitted for ethics approval [7]
5356
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01/05/2008
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Approval date [7]
5356
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Ethics approval number [7]
5356
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Ethics committee name [8]
5357
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Royal Perth Hospital
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Ethics committee address [8]
5357
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Ethics committee country [8]
5357
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Australia
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Date submitted for ethics approval [8]
5357
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02/06/2008
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Approval date [8]
5357
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Ethics approval number [8]
5357
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Ethics committee name [9]
5358
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St John of God Hospital, Subiaco
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Ethics committee address [9]
5358
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Ethics committee country [9]
5358
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Australia
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Date submitted for ethics approval [9]
5358
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30/06/2008
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Approval date [9]
5358
0
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Ethics approval number [9]
5358
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Ethics committee name [10]
5359
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Royal Perth Hospital
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Ethics committee address [10]
5359
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Ethics committee country [10]
5359
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Australia
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Date submitted for ethics approval [10]
5359
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02/06/2008
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Approval date [10]
5359
0
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Ethics approval number [10]
5359
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Ethics committee name [11]
5360
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Christchurch Hospital
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Ethics committee address [11]
5360
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Ethics committee country [11]
5360
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New Zealand
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Date submitted for ethics approval [11]
5360
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05/08/2008
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Approval date [11]
5360
0
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Ethics approval number [11]
5360
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Ethics committee name [12]
5361
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Waikato Hospital
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Ethics committee address [12]
5361
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Ethics committee country [12]
5361
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New Zealand
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Date submitted for ethics approval [12]
5361
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05/08/2008
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Approval date [12]
5361
0
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Ethics approval number [12]
5361
0
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Summary
Brief summary
This study aims to determine whether intermittent treatment with the drug letrozole is more effective than continuous letrozole treatment in preventing the return of cancer in postmenopausal women with endocrine responsive breast cancer who have undergone 4 to 6 years of prior endocrine therapy. Who is it for? You may be eligible join this study if you are a postmenopausal woman who has had operable, non-inflammatory breast cancer but are now clinically disease-free. You must have completed 4 to 6 years of prior endocrine therapy with selective estrogen receptor modulators (SERM(s)), aromatase inhibitors (AI(s)), or a combination of both. Trial details Participants in this trial will be randomly (by chance) allocated to one of two groups. One group will take one 2.5mg letrozole tablet per day for 5 years. Participants in the other group will take letrozole 2.5mg tablets intermittently, i.e. once daily for the first 9 months of years 1 through 4, followed by 12 months in year 5. Participants will be regularly assessed over the duration of the trial to determine whether continuous or intermittent letrozole treatment is more effective in preventing the return of cancer and prolonging survival.
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Trial website
www.breastcancertrials.org.au
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Trial related presentations / publications
Badger HD, Hunter LM, Chirgwin J, Forbes JF, Lindsay DF, Laycock I, Dempsey A. Strategies for Participant Recruitment: The SOLE Initiative. COSA 2010; Poster 222. Forbes JF, Boyle F, Wilcken N, Lindsay DF, Leong E. Clinical Trials Open for Participant Entry. COSA 2010; Poster 242. Colleoni M for the SOLE Collaborative and International Breast Cancer Study Groups. The SOLE Trial: International Breast Cancer Study Group (IBCSG 35-07) and Breast International Group (BIG 1-07) Study of Letrozole Extension. SABCS 2011;Poster OT2-02-01. Colleoni M, Luo W, Karlsson P, Chirgwin JH, Aebi SP, Jerusalem GHM, Neven P, Hitre E, Graas M-P, Simoncini E, Kamby C, Thompson AM, Loibl S, Gavila J, Kuroi K, Gnant M, Rabaglio-Poretti, Regan MM, Coates AS, Goldhirsch A. SOLE (Study of Letrozole Extension): A phase III randomized clinical trial of continuous vs intermittent letrozole in postmenopausal women who have received 4-6 years of adjuvant endocrine therapy for lymph node-positive, early breast cancer (BC). Journal of Clinical Oncology 2017; 35, (suppl; abstr 503) [oral abstract][ASCO].
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Public notes
Breast Cancer Trials formerly known as the Australia & New Zealand Breast Cancer Trials Group.
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Contacts
Principal investigator
Name
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A/Prof Jacquie Chirgwin
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Address
28550
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Maroondah Breast Clinic
Maroondah Hospital
20 Grey Street
RINGWOOD EAST VIC 3135
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Country
28550
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Australia
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Phone
28550
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+61 (03) 9871-3582
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Fax
28550
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Email
28550
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[email protected]
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Contact person for public queries
Name
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Corinna Beckmore
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Address
11707
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BCT
PO Box 283
The Junction NSW 2291
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Country
11707
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Australia
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Phone
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+61 2 4925 5235
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Fax
11707
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+61 2 4925 3068
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Email
11707
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[email protected]
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Contact person for scientific queries
Name
2635
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Jacquie Chirgwin
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Address
2635
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Maroondah Breast Clinic
Maroondah Hospital
20 Grey Street
RINGWOOD EAST VIC 3135
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Country
2635
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Australia
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Phone
2635
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+61 (03) 9871-3582
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Fax
2635
0
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Email
2635
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF