Evidence map›Paper›PMID 35015210›Full record

Trial reportBreast cancer research and treatment2022

The progesterone-receptor modulator, ulipristal acetate, drastically lowers breast cell proliferation.

Carolyn L Westhoff, Hua Guo, Zhong Wang, Hanina Hibshoosh, Margaret Polaneczky, Malcolm C Pike, Richard Ha

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Breast cancer research and treatment, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02922127 (A Prospective, Randomized, Single-blind Study to Compare the Effects of Daily Ulipristal Acetate), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
4.3field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02922127 phase1completednot on this map

A Prospective, Randomized, Single-blind Study to Compare the Effects of Daily Ulipristal Acetate (UPA) 10mg With a Combined Oral Contraceptive (COC) Pill on Breast Epithelial Cell Proliferation in Reproductive Age Women

TypeinterventionalSponsorColumbia UniversityRan2016 to 2019Enrolled29ConditionsContraceptionArmsUlipristal Acetate, Combined Oral Contraceptive Pill
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 23 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Carolyn L WesthoffDepartment of Obstetrics and Gynecology, Columbia University Irving Medical Center, PH 16-69, 630 West 168th Street, New York, NY, 10032, USA. clw3@columbia.edu.ORCID http://orcid.org/0000-0002-3622-8846
Hua GuoDepartment of Pathology, Columbia University Irving Medical Center, New York, NY, USA.
Zhong WangDepartment of Pathology, Columbia University Irving Medical Center, New York, NY, USA.
Hanina HibshooshDepartment of Pathology, Columbia University Irving Medical Center, New York, NY, USA.
Margaret PolaneczkyDepartment of Obstetrics and Gynecology, Weill-Cornell Medical Center, New York, NY, USA.
Malcolm C PikeDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Richard HaDepartment of Radiology, Columbia University Irving Medical Center, New York, NY, USA.
Columbia University Irving Medical Center · USCornell University · USMemorial Sloan Kettering Cancer Center · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI SELWYN M VICKERS · 1985 to 2026
$347.4M
Clinical and Translational Science AwardUL1TR001873 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI REILLY, MUREDACH P · 2016 to 2025
$99.0M
Disparities in COVID Disease Severity and Outcomes in New York CityUL1TR002384 · NCATS · WEILL MEDICAL COLL OF CORNELL UNIV · PI JULIANNE L IMPERATO-MCGINLEY · 2017 to 2026
$86.2M
A Prospective, Randomized Study to Compare Effects of Ulipristal Acetate with a Combined Oral Contraceptive on Breast Epithelial Cell Proliferation.R01CA200795 · NCI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI WESTHOFF, CAROLYN L · 2016 to 2019
$1.6M
NCATS NIH HHS UL1 TR001873NCATS NIH HHS UL1 TR002384NCI NIH HHS 5RO1 CA200795NCI NIH HHS P30 CA008748NCI NIH HHS R01 CA200795
6 · The paper itself

Abstract

purposeThe proliferation of breast epithelial cells increases during the luteal phase of the menstrual cycle, when they are exposed to progesterone, suggesting that ulipristal acetate, a selective progestin-receptor modulator (SPRM), may reduce breast cell proliferation with potential use in breast cancer chemoprevention.

methodsWomen aged 18-39 were randomized 1:1 to ulipristal 10-mg daily or to a combination oral contraceptive (COC) for 84 days. Participants underwent a breast biopsy and breast MRI at baseline and at end of study treatment. Proliferation of breast TDLU cells was evaluated by Ki67 immunohistochemical stain. We evaluated the breast MRIs for background parenchymal enhancement (BPE). All slides and images were masked for outcome evaluation.

resultsTwenty-eight treatment-compliant participants completed the study; 25 of whom had evaluable Ki67 results at baseline and on-treatment. From baseline to end of treatment, Ki67 % positivity (Ki67%+) decreased a median of 84% in the ulipristal group (N = 13; 2-sided p (2p) = 0.040) versus a median increase of 8% in the COC group (N = 12; 2p = 0.85). Median BPE scores decreased from 3 to 1 in the ulipristal group (p = 0.008) and did not decrease in the COC group.

conclusionUlipristal was associated with a major decrease in Ki67%+ and BPE. Ulipristal would warrant further investigation for breast cancer chemoprevention were it not for concerns about its liver toxicity. Novel SPRMs without liver toxicity could provide a new approach to breast cancer chemoprevention.

trial registrationNCT02922127, 4 October 2016.

Indexed as

Breast NeoplasmsLeiomyomaAdolescentAdultCell ProliferationFemaleHumansNorpregnadienesProgesteroneReceptors, ProgesteroneYoung AdultNorpregnadienesProgesteroneReceptors, Progesteroneulipristal acetateBreast cell proliferationCombination oral contraceptiveSelective progesterone-receptor modulatorUlipristal acetate

Identifiers

PMID35015210
PMCPMC10088437
OpenAlexW4206052499

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.