Investigating the Biological Effects of the Addition of Zoledronic Acid to Pre-operative Chemotherapy in Breast Cancer (ANZAC)
A Randomised Phase II Feasibility Study Investigating the Biological Effects of the Addition of Zoledronic Acid to Neoadjuvant Combination Chemotherapy on Invasive Breast Cancer
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
South Yorkshire
-
Sheffield, South Yorkshire, United Kingdom, S10 2SJ
- Sheffield Teaching Hospitals NHS Foundation Trust / Weston Park Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Women with histological diagnosis of invasive breast cancer requiring neoadjuvant chemotherapy
- T2 tumour or above
- WHO Performance status of 0,1 or 2
- Must consent to or have undergone a core biopsy for diagnosis of breast cancer AND consent to undergo an additional core biopsy prior to the second cycle of chemotherapy (Day 5 +/- Day 21)
- Written informed consent
Exclusion Criteria:
- Previous chemotherapy or radiotherapy to treated breast
- Evidence of metastatic disease or recurrent breast cancer or previous malignancy (some exceptions)
- Calculated creatinine clearance < 40mls/min
- Prior treatment with bisphosphonates in last year or known contraindications to bisphosphonate therapy
- Concurrent tamoxifen or aromatase inhibitor medication
- Pregnant or lactating women
- Cardiac dysfunction that precludes use of anthracycline chemotherapy
- Unwilling to have extra interim biopsy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: A
Neoadjuvant chemotherapy alone
|
3 cycles of FEC q3w, followed by 3 cycles of docetaxel q3w FEC: 5FU 500mg/m2 intravenous bolus D1, Epirubicin 100mg/m2 intravenous bolus D1, Cyclophosphamide 500mg/m2 intravenous bolus D1) every 21 days Docetaxel: (100mg/ m2 intravenous infusion) every 21 days
|
|
Experimental: B
Neoadjuvant chemotherapy + zoledronic acid
|
3 cycles of FEC q3w, followed by 3 cycles of docetaxel q3w FEC: 5FU 500mg/m2 intravenous bolus D1, Epirubicin 100mg/m2 intravenous bolus D1, Cyclophosphamide 500mg/m2 intravenous bolus D1) every 21 days Docetaxel: (100mg/ m2 intravenous infusion) every 21 days Zoledronic acid: 4mg intravenous infusion Day 2, AFTER FIRST CYCLE CHEMOTHERAPY ONLY
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Increase in apoptotic index between diagnostic core biopsy and repeat core biopsy taken on day 5
Time Frame: Repeat biopsy on day 5 (+/- day 21)
|
Repeat biopsy on day 5 (+/- day 21)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Reduction in Ki67 immunostaining between preoperative core biopsy, repeat core biopsy on day 5, +/- day 21, and operative specimen
Time Frame: Day 5, +/- Day 21, surgical specimen
|
Day 5, +/- Day 21, surgical specimen
|
|
Changes in serum angiogenesis markers between pre-treatment and operative time points
Time Frame: Pre-treatment, Day 5, day 21, pre-surgery
|
Pre-treatment, Day 5, day 21, pre-surgery
|
|
Changes in bone biochemical markers between pre-treatment, treatment and operative timepoints
Time Frame: Pre-treatment, Day 5, day 21, pre-surgery
|
Pre-treatment, Day 5, day 21, pre-surgery
|
|
Detection of, and changes in, circulating tumour cells in peripheral blood taken pre-treatment, during treatment and following treatment
Time Frame: Pre-treatment, day 5, day 21, pre-surgery
|
Pre-treatment, day 5, day 21, pre-surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Robert E Coleman, MB BS, MD, Academic Unit of Clinical Oncology, University of Sheffield
Publications and helpful links
General Publications
- Jagdev SP, Coleman RE, Shipman CM, Rostami-H A, Croucher PI. The bisphosphonate, zoledronic acid, induces apoptosis of breast cancer cells: evidence for synergy with paclitaxel. Br J Cancer. 2001 Apr 20;84(8):1126-34. doi: 10.1054/bjoc.2001.1727.
- Neville-Webbe HL, Rostami-Hodjegan A, Evans CA, Coleman RE, Holen I. Sequence- and schedule-dependent enhancement of zoledronic acid induced apoptosis by doxorubicin in breast and prostate cancer cells. Int J Cancer. 2005 Jan 20;113(3):364-71. doi: 10.1002/ijc.20602.
- Ottewell PD, Jones M, Coleman RE, Holen I. Synergistic effects of cytotoxic drugs and anti-resorptive agents in vitro and in vivo. In 29th Annual San Antonio Breast Cancer Symposium Vol.100 Suppl.1 Abstract 6102, Breast Cancer Research and Treatment
- Winter MC, Wilson C, Syddall SP, Cross SS, Evans A, Ingram CE, Jolley IJ, Hatton MQ, Freeman JV, Mori S, Holen I, Coleman RE. Neoadjuvant chemotherapy with or without zoledronic acid in early breast cancer--a randomized biomarker pilot study. Clin Cancer Res. 2013 May 15;19(10):2755-65. doi: 10.1158/1078-0432.CCR-12-3235. Epub 2013 Mar 20.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Skin Diseases
- Neoplasms
- Neoplasms by Site
- Breast Diseases
- Breast Neoplasms
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antirheumatic Agents
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Myeloablative Agonists
- Topoisomerase II Inhibitors
- Topoisomerase Inhibitors
- Antibiotics, Antineoplastic
- Bone Density Conservation Agents
- Docetaxel
- Cyclophosphamide
- Fluorouracil
- Epirubicin
- Zoledronic Acid
Other Study ID Numbers
Other Study ID Numbers
- STH14707
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