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NCT02413008: BLISSAFE

A Clinical Trial to Assess the Safety of 0.005 % Estriol Vaginal Gel in Hormone Receptor-Positive Postmenopausal Women With Early Stage Breast Cancer in Treatment With Aromatase Inhibitor in the Adjuvant Setting

Completed Phase 2 Results posted Last updated 5 August 2019
What this trial tests

Phase 2 trial testing estriol in Vaginal Atrophy in 61 participants. Completed in 10 February 2017.

Timeline
16 October 2015
Primary endpoint
10 February 2017
10 February 2017

Quick facts

Lead sponsorITF Research Pharma, S.L.U.
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingquadruple
Primary purposetreatment
Enrollment61
Start date16 October 2015
Primary completion10 February 2017
Estimated completion10 February 2017
Sites6 locations across Sweden, Spain

Drugs / interventions tested

Conditions studied

Sponsor

ITF Research Pharma, S.L.U.

Who can join

Eligibility, female only, with Vaginal Atrophy. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Variation in Serum Levels of Follicle Stimulating Hormone (FSH) Primary · from baseline to 12 weeks of treatment

Change from Baseline (mean screening-baseline) to Week 12 in Serum Levels of Follicle Stimulating Hormone (FSH) compare to natural physiological variability (screening-baseline variation)

GroupValue95% CI
0.005% Estriol Vaginal Gel-2.8-13.1 – 7.4
Placebo Vaginal Gel1.4-5.4 – 15.7
Variation in Serum Levels of FSH at Week 1, Week 3 and Week 8 Secondary · Change from baseline to week 1, week 3 and week 8

Change from Baseline (mean screening-baseline) to Week 1, Week 3 and Week 8 in Serum Levels of Follicle Stimulating Hormone (FSH) compare to natural physiological variability ( screening-baseline variation)

change from baseline to week 1
GroupValue95% CI
0.005% Estriol Vaginal Gel-4.8-11.6 – 2.6
Placebo Vaginal Gel4.2-7.8 – 7.3
change from baseline to week 3
GroupValue95% CI
0.005% Estriol Vaginal Gel-4.2-12.0 – 3.5
Placebo Vaginal Gel-0.9-4.0 – 2.3
change from baseline to week 8
GroupValue95% CI
0.005% Estriol Vaginal Gel-2.6-10.1 – 7.9
Placebo Vaginal Gel5.2-11.8 – 9
Variation in Serum Levels of Luteinizing Hormone (LH) Secondary · Change from baseline to week 1, week 3, week 8 and week 12

Change from (mean screening-baseline) in plasma levels of LH to Week 1, Week 3, Week 8 and Week 12 in Serum Levels of LH compare to natural physiological variability ( screening-baseline variation)

change from LH baseline to week 1
GroupValue95% CI
0.005% Estriol Vaginal Gel-0.6-3.7 – 2.8
Placebo Vaginal Gel0.2-1.8 – 8.1
change from LH baseline to week 3
GroupValue95% CI
0.005% Estriol Vaginal Gel-0.5-4.1 – 3.5
Placebo Vaginal Gel0.3-1.8 – 7.7
change from LH baseline to week 8
GroupValue95% CI
0.005% Estriol Vaginal Gel-0.3-4.9 – 3.1
Placebo Vaginal Gel-1.3-2.0 – 6.0
change from LH baseline to week 12
GroupValue95% CI
0.005% Estriol Vaginal Gel-0.8-5.3 – 2.9
Placebo Vaginal Gel1.3-1.6 – 7.1
Variation in Plasma Levels of Estriol Secondary · Change from baseline to week 1, week 3, week 8 and week 12

Change in plasma levels of estriol at weeks 1, 3, 8 and 12 compared to baseline

Change between baseline and week 1
GroupValue95% CI
0.005% Estriol Vaginal Gel-1.7-10.7 – 0.0
Placebo Vaginal Gel0.00.0 – 0.0
Change between baseline and week 3
GroupValue95% CI
0.005% Estriol Vaginal Gel0.0-3.4 – 0.5
Placebo Vaginal Gel0.00.0 – 0.0
Change between baseline and week 8
GroupValue95% CI
0.005% Estriol Vaginal Gel0.0-5.0 – 0.5
Placebo Vaginal Gel0.00.0 – 0.0
Change between baseline and week 12
GroupValue95% CI
0.005% Estriol Vaginal Gel0.0-6.8 – 0.5
Placebo Vaginal Gel0.00.0 – 0.0
Variation in Plasma Levels of Estradiol Secondary · Change from baseline to week 1, week 3, week 8 and week 12

Change in plasma levels of estradiol at weeks 1, 3, 8 and 12 compared to baseline.

Change between baseline and week 1
GroupValue95% CI
0.005% Estriol Vaginal Gel0.00.0 – 0.0
Placebo Vaginal Gel0.00.0 – 0.0
Change between baseline and week 3
GroupValue95% CI
0.005% Estriol Vaginal Gel0.00.0 – 0.0
Placebo Vaginal Gel0.00.0 – 0.0
Change between baseline and week 8
GroupValue95% CI
0.005% Estriol Vaginal Gel0.00.0 – 0.0
Placebo Vaginal Gel0.00.0 – 0.0
Change between baseline and week 12
GroupValue95% CI
0.005% Estriol Vaginal Gel0.00.0 – 0.0
Placebo Vaginal Gel0.00.0 – 0.0
Variation in Plasma Levels of Estrona Secondary · Change from baseline to week 1, week 3, week 8 and week 12

Change in plasma levels of estrona at weeks 1, 3, 8 and 12 compared to baseline.

Change from baseline to week 1
GroupValue95% CI
0.005% Estriol Vaginal Gel0.00.0 – 0.0
Placebo Vaginal Gel0.00.0 – 0.0
Change between baseline and week 3
GroupValue95% CI
0.005% Estriol Vaginal Gel0.00.0 – 0.0
Placebo Vaginal Gel0.00.0 – 0.0
change from baseline to week 8
GroupValue95% CI
0.005% Estriol Vaginal Gel0.00.0 – 0.0
Placebo Vaginal Gel0.00.0 – 0.0
Change from baseline to week 12
GroupValue95% CI
0.005% Estriol Vaginal Gel0.00.0 – 0.0
Placebo Vaginal Gel0.00.0 – 0.0
Changes in Vaginal pH Between Baseline and Week 3 and Week 12 Secondary · week 3 and week 12 vs baseline

Measurement of vaginal pH on the vaginal secretion using a reactive strip and compare pH value between baseline and the diferent timepoints

Change from baseline to Week 3
GroupValue95% CI
0.005% Estriol Vaginal Gel2.00.5 – 2.5
Placebo Vaginal Gel0.5-0.5 – 1.0
Change from baseline to Week 12
GroupValue95% CI
0.005% Estriol Vaginal Gel1.30.5 – 2.5
Placebo Vaginal Gel0.50.0 – 1.5
Changes in Dyspareunia Secondary · week 3 and week 12 vs baseline

Changes in dyspareunia from baseline to week 3 and week 12 Each symptom will be scored in a numeric scale from 0 to 3, as shown 0 Absence. The symptom is not present 1. The symptom is of mild intensity, without interfering in the patient's activity 2. The symptom is of moderate intensity, causing obvious discomfort to the patient 3. The symptom is stated as very irritating and severe in intensity

Change between baseline and week 3
GroupValue95% CI
0.005% Estriol Vaginal Gel1.01.0 – 2.0
Placebo Vaginal Gel1.00.0 – 1.0
Change between baseline and week 12
GroupValue95% CI
0.005% Estriol Vaginal Gel2.01.0 – 2.5
Placebo Vaginal Gel1.00.0 – 2.0
Change in Pruritus or Itching From Baseline to Week 3 and Week 12 Secondary · Change from baseline to week 3 and week 12

Change in pruritus or itching from baseline to week 3 and week 12 Each symptom will be scored in a numeric scale from 0 to 3, as shown below: 0 Absence. The symptom is not present 1. The symptom is of mild intensity, without interfering in the patient's activity 2. The symptom is of moderate intensity, causing obvious discomfort to the patient 3. The symptom is stated as very irritating and severe in intensity

Changes between baseline and week 3
GroupValue95% CI
0.005% Estriol Vaginal Gel0.00.0 – 1.0
Placebo Vaginal Gel0.0-1.0 – 2.0
Changes between baseline and week 12
GroupValue95% CI
0.005% Estriol Vaginal Gel0.00.0 – 2.0
Placebo Vaginal Gel0.00.0 – 1.0
Changes in Vaginal Dryness Secondary · week 3 and week 12 vs baseline

Change in vaginal dryness puntuation score from baseline to w3 and w12 Each symptom will be scored in a numeric scale from 0 to 3, as shown below: 0 Absence. The symptom is not present 1. The symptom is of mild intensity, without interfering in the patient's activity 2. The symptom is of moderate intensity, causing obvious discomfort to the patient 3. The symptom is stated as very irritating and severe in intensity

Change between baseline and week 3
GroupValue95% CI
0.005% Estriol Vaginal Gel1.01.0 – 2.0
Placebo Vaginal Gel1.00.0 – 1.0
Change between baseline and week 12
GroupValue95% CI
0.005% Estriol Vaginal Gel2.01.0 – 2.0
Placebo Vaginal Gel1.01.0 – 1.0
Changes in Total Score of Symptoms of Vaginal Atrophy Secondary · week 3 and week 12 vs baseline

Changes in Symptoms of vaginal atrophy (vaginal dryness, dyspareunia and pruritus) at week 3 and week 12 vs baseline. Each symptom will be scored in a numeric scale from 0 to 3, as shown below: 0 Absence. The symptom is not present 1. The symptom is of mild intensity, without interfering in the patient's activity 2. The symptom is of moderate intensity, causing obvious discomfort to the patient 3. The symptom is stated as very irritating and severe in intensity A Global Symptoms Score will be calculated by summing the intensities of all the three symptoms of vaginal atrophy in a certain tim

Change between baseline and week 3
GroupValue95% CI
0.005% Estriol Vaginal Gel3.02.0 – 4.5
Placebo Vaginal Gel1.00.5 – 3.0
Change between baseline and week 12
GroupValue95% CI
0.005% Estriol Vaginal Gel4.53.0 – 7.0
Placebo Vaginal Gel2.01.5 – 4.0
Changes in Dryness of the Mucosa Secondary · week 3 and week 12 vs baseline

It will be scored by the investigator on a numerical scale in accordance with their presence and degree of severity as follows: 0 Absence. The sign is not present. 1. The sign is present and is considered a mild alteration 2. The sign is present and is considered a moderate alteration 3. The sign is present and is considered a severe alteration

Changes between baseline and week 3
GroupValue95% CI
0.005% Estriol Vaginal Gel2.01.0 – 2.0
Placebo Vaginal Gel1.00.0 – 1.0
Changes between baseline and week 12
GroupValue95% CI
0.005% Estriol Vaginal Gel2.01.0 – 2.0
Placebo Vaginal Gel1.00.0 – 1.0

Adverse events — posted to ClinicalTrials.gov

Time frame: From baseline to last visit (up to 16 weeks). Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

0.005% Estriol Vaginal Gel
Serious: 1/50 (2%)
Deaths: 0/50
Placebo Vaginal Gel
Serious: 0/11 (0%)
Deaths: 0/11

Serious adverse events (1 terms)

ReactionSystem0.005% Estriol Vaginal GelPlacebo Vaginal Gel
LymphomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Other adverse events (1 terms — click to expand)

ReactionSystem0.005% Estriol Vaginal GelPlacebo Vaginal Gel
Urinary tract infectionInfections and infestations

Most-reported serious reactions: Lymphoma.

Data from ClinicalTrials.gov NCT02413008 adverse events section.

Sponsor's own description

This is a phase II, prospective, randomized, double-blind, placebo-controlled, international (Spain and Sweden) and multicentre study to explore the safety of 0.005% estriol vaginal gel in women with early stage breast cancer in treatment with Non-Steroidal Aromatase Inhibitors (NSAIs) in the adjuvant setting and symptoms of vaginal atrophy.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

  1. A Phase II Prospective, Randomized, Double-Blind, Placebo-Controlled and Multicenter Clinical Trial to Assess the Safety of 0.005% Estriol Vaginal Gel in Hormone Receptor-Positive Postmenopausal Women with Early Stage Breast Cancer in Treatment with Aromatase Inhibitor in the Adj
    Sánchez-Rovira P, Hirschberg AL, Gil-Gil M, Bermejo-De Las Heras B, et al · · 2020 · cited 24× · PMID 32459035 · DOI 10.1634/theoncologist.2020-0417

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