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Omega-3 Fatty Acids in Preventing Joint Symptoms in Patients With Stage I-III Breast Cancer Receiving Anastrozole, Exemestane, or Letrozole

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The Ohio State University

Status

Completed

Conditions

Stage IIIA Breast Cancer
Stage IB Breast Cancer
Stage IIIB Breast Cancer
Stage IIIC Breast Cancer
Stage II Breast Cancer
Stage IA Breast Cancer
Recurrent Breast Cancer

Treatments

Other: Clinical assessments
Dietary Supplement: omega-3 fatty acid supplement
Other: Placebo
Procedure: Correlative/special studies
Procedure: Magnetic Resonance Imaging
Other: Assessment of therapy complications

Study type

Interventional

Funder types

Other
NETWORK

Identifiers

NCT01478477
OSU-11022
NCI-2011-03262 (Registry Identifier)

Details and patient eligibility

About

This randomized pilot trial studies omega-3 fatty acid in preventing joint symptoms in patients with stage I-III breast cancer receiving anastrozole, exemestane, or letrozole. Omega-3 fatty acid supplement may lessen or prevent joint stiffness or pain in patients receiving hormone therapy for breast cancer.

Full description

OBJECTIVES:

I. To assess the feasibility of evaluating joint symptoms in postmenopausal women with breast cancer randomized to n-3 PUFA (omega-3 fatty acid) vs. placebo supplementation using the Functional Assessment of Cancer Therapy-Breast (FACT-B) and endocrine subscale (FACT-ES), Brief Pain Inventory (BPI) and Stanford's Health Assessment -Disability Index (HAS) during the first 6 months of adjuvant aromatase inhibitor (AI) therapy.

II. To preliminarily evaluate the efficacy of n-3 PUFA vs. placebo supplementation on AI induced joint symptoms.

III. To explore blood and imaging based biomarkers (plasma and red blood cell [RBC] levels of n-3 PUFAs, inflammatory cytokines and receptors, and intra-articular tenosynovial inflammation by musculoskeletal magnetic resonance imaging [MRI] imaging) of AI-induced joint symptoms in women on AI therapy randomized to n-3 PUFAs vs. placebo supplementation.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive omega-3 fatty acid orally (PO) once daily (QD) for 6 months in the absence of disease progression or unacceptable toxicity.

ARM II: Patients receive placebo PO QD for 6 months in the absence of disease progression or unacceptable toxicity.

Enrollment

44 patients

Sex

Female

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Women diagnosed with breast cancer stages I-III initiating first adjuvant AI therapy with any of the Food and Drug Administration- (FDA) approved AIs (anastrozole, exemestane, letrozole)
  • Concurrent gonadotropin-releasing hormone (GnRH) agonist therapy is allowed
  • Concurrent breast related radiation therapy is allowed
  • Prior tamoxifen use is allowed
  • Prior chemotherapy is allowed
  • History of osteoarthritis and/or fibromyalgia is allowed
  • Ability to understand and the willingness to sign a written informed consent document

Exclusion criteria

  • Metastatic malignancy of any kind
  • Rheumatoid arthritis and other types of autoimmune and inflammatory joint disease, with the exception of osteoarthritis and fibromyalgia
  • AI use > 2 weeks prior to study enrollment
  • Known bleeding disorders
  • History of diabetes mellitus, heart disease or TIA/stroke
  • Current use of warfarin or other anticoagulants
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia,or psychiatric illness/social situation that would limit compliance with study requirements
  • Daily use of n-3 PUFA concentrates or capsules or regular or any other supplements that might interact with n-3 PUFA supplements within six months of study initiation; sporadic use of n-3 PUFA supplement may be eligible if there has been a 3-month washout period prior to randomization
  • Pregnant or nursing women
  • Known sensitivity or allergy to fish or fish oil
  • Concurrent use of daily full dose aspirin (≥ 325 mg/day), nonsteroidal anti-inflammatory drugs (NSAIDs) or NSAID-containing products or steroids; one month washout period is required prior to randomization
  • Unable to give informed consent
  • In patients consenting for optional MRIs, any contraindication to MRI examination including but not limited to ferromagnetic metal in the body, pacemaker, or severe claustrophobia

Trial design

Primary purpose

Prevention

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Double Blind

44 participants in 6 patient groups, including a placebo group

Arm I (omega-3 fatty acid supplement)
Experimental group
Description:
Omega 3 Polyunsaturated Fatty Acids(n-3 PUFA)
Treatment:
Other: Assessment of therapy complications
Procedure: Magnetic Resonance Imaging
Procedure: Correlative/special studies
Other: Clinical assessments
Dietary Supplement: omega-3 fatty acid supplement
Arm II (placebo)
Placebo Comparator group
Description:
Typical American Diet oils (TAD)
Treatment:
Other: Assessment of therapy complications
Procedure: Magnetic Resonance Imaging
Procedure: Correlative/special studies
Other: Placebo
Other: Clinical assessments
Clinical Assessments
Experimental group
Description:
Brief Pain Inventory (BPI), Stanford's Health Assessment-Disability Index (HAS), FACT-B and endocrine subscale (FACT-ES)
Treatment:
Other: Placebo
Dietary Supplement: omega-3 fatty acid supplement
Assessment of therapy complications
Experimental group
Description:
Adverse events will be monitored by self-reporting of signs and symptoms. Patients will maintain a daily diary of time of supplement intake and any possible ill effects, with instructions to contact the PI or Research Nurse to discuss and manage any possible side effects.
Treatment:
Other: Placebo
Dietary Supplement: omega-3 fatty acid supplement
Magnetic Resonance Imaging
Experimental group
Description:
Optional bilateral hand and wrist MRI imaging will be obtained
Treatment:
Other: Placebo
Dietary Supplement: omega-3 fatty acid supplement
Correlative/special studies
Experimental group
Description:
Enrolled participants will have peripheral blood samples drawn for plasma and RBC n-3 PUFA levels within 4 weeks of starting AI therapy.
Treatment:
Other: Placebo
Dietary Supplement: omega-3 fatty acid supplement

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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