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Brief Title: Letrozole for Lymphangioleiomyomatosis
Official Title: Trial of Letrozole in Lymphangioleiomyomatosis
Study ID: NCT01353209
Brief Summary: The hypothesis in this study is that estrogen suppression by an aromatase inhibitor in postmenopausal women with lymphangioleiomyomatosis (LAM) will prevent or delay progression of lung disease and result in a decrease in the rate of decline in FEV1
Detailed Description: Lymphangioleiomyomatosis, or LAM, is an uncommon, progressive, cystic lung disease that predominantly affects young women. Pulmonary parenchymal changes consistent with LAM are found in about one third of women with tuberous sclerosis complex (TSC), an autosomal dominant tumor suppressor syndrome. LAM also occurs in a sporadic form that is not associated with germline mutations in TSC genes. Recent evidence that recurrent LAM after lung transplantation results from seeding of the graft from a remote source and suggests a metastatic mechanism for the disease. Since LAM occurs almost exclusively in women, and is exacerbated by pregnancy, menses and hormonal therapies suggest that estrogen suppression might be expected to prevent or delay progression of disease. In postmenopausal women, estrogens are mainly derived from the action of the aromatase enzyme, which converts adrenal androgens (primarily androstenedione and testosterone) to estrone and estradiol. The suppression of estrogen biosynthesis in peripheral tissues can therefore be achieved by specifically inhibiting the aromatase enzyme. Letrozole is a nonsteroidal aromatase inhibitor (inhibitor of estrogen synthesis) that has been shown to be effective in other neoplasms that affect women, such as breast cancer.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: FEMALE
Healthy Volunteers: No
Stanford University Medical Center, Stanford, California, United States
Mayo Clinic, Jacksonville, Florida, United States
University of Miami, Miami, Florida, United States
Emory University School of Medicine, Atlanta, Georgia, United States
Loyola University Medical Center, Maywood, Illinois, United States
Washington University School of Medicine, Saint Louis, Missouri, United States
University of Cincinnati, Cincinnati, Ohio, United States
Cleveland Clinic, Cleveland, Ohio, United States
Minor and James, Seattle, Washington, United States
Name: Francis X McCormack, MD
Affiliation: University of Cincinnati
Role: PRINCIPAL_INVESTIGATOR