A Randomized Controlled Trial of HER-2 Positive Breast Cancer Patients Treated With Lapatinib vs Herceptin
A Randomized Controlled Trial of HER-2 Positive Breast Cancer Patients Treated With Lapatinib and Paclitaxel vs Herceptin and Paclitaxel With Sequential and Synchronous Anthracycline
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This is a randomized controlled trial of HER-2 positive breast cancer patients treated with lapatinib and paclitaxel vs herceptin and paclitaxel with sequential and synchronous anthracycline. Safety and efficacy are the primary endpoint. The positive expression of HER2 was confirmed by postoperative pathology in patients with breast adenocarcinoma (IDC). Patients who had not received any chemotherapy and targeted anti HER2 therapy.
In this study, the non inferiority design method, according to the wishes of patients and signed informed consent, randomly into the group, a total of 482 patients were enrolled in the trial group: the control group =1:1. The subjects were followed up for a total of 1 years, until the disease progressed, and the toxicity was not tolerated.
We want to study 84 months. The follow-up period was 5 years (the first adjuvant treatment time to the last follow-up) or the researchers decided to end the study.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Sun Qiang, M.D.
- Phone Number: 008613001289600
- Email: wangxuefei63@pumch.cn
Study Locations
-
-
-
Beijing, China, 100730
- Recruiting
- PUMCH
-
Contact:
- Sun Qiang, M.D.
- Phone Number: 0086-13001289600
- Email: 1210548954@qq.com
-
Contact:
- Wang Xuefei
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- the first diagnosis of invasive breast cancer, confirmed by histology or cytology, and surgical resection of the primary lesions before receiving any anti breast cancer treatment;
- female patients, aged 18 years and less than 80 years of age;
- surgical resection of the primary tumor pathological examination, showed HER2 positive (defined as immunohistochemistry [IHC] 3+ or fluorescence in situ hybridization (FISH) positive);
- hormone receptor status is known, lymph node positive or sentinel lymph node negative but high risk factors
- the eastern oncology cooperative group (ECOG) patients with physical status score was 0 -2;
- baseline LVEF >50%
- the relevant institutional review board (IRB) or independent ethics committee (IEC) written informed consent
Exclusion Criteria:
- the subjects in pregnancy or lactation;
- pregnant women may be within the first 7 days before pregnancy test positive (urine or serum).
- received chemotherapy, endocrine or anti HER2 anti-tumor therapy;
- congestive heart failure, unstable angina, heart failure or myocardial infarction and other diseases;
- other invasive tumors (including the second primary breast cancer), may affect the outcome of the evaluation and program compliance; but the treatment of patients with disease free survival at least more than 5 years can be selected;
- with chronic liver disease in patients with liver dysfunction and / or with clinical manifestations: the serum total bilirubin > 2.5 * ULN; or INR = 1.5 but no bilirubin. serum ALT or AST> * 3 * ULN; alkaline phosphatase >2.5 * ULN; ALT or AST can be gradually increased, but with gradually increasing fatigue, nausea and vomiting, fever, right upper quadrant pain or tenderness
- hematopoietic dysfunction, defined as follows: neutrophil count (ANC) <1.5 * 109/L; platelet <100 * 109/L; hemoglobin <9 g/dL;
- other serious diseases, including: congestive heart failure (heart function NYHA grade II, III, IV) or occurred within 6 months of congestive heart failure, unstable angina, arrhythmia, myocardial infarction patients can't control or other severe cardiovascular disease; breathing at rest or need oxygen therapy; serious infection; uncontrolled diabetes;
- there is a serious psychological or mental abnormalities, estimated that the participants to participate in this study is not strong;
- known to study drug allergy;
- the past 30 days participated in the study of other drug clinical trials.
1, failed to complete the clinical trial of at least 1 cycles according to the program, can not carry out safety and efficacy evaluation 2, a serious violation of this research program, not in accordance with the prescribed dose, method and course of medication.
Patients will receive lapatinib treatment, until a predetermined end end point, or development of unacceptable toxicity, or withdrawal of consent, or illness or death, to appear before the subject.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: EC→PL(Epirubicin+Cyclophosphamide--Docetaxel+lapatinib)
Epirubicin 80 mg/ IV day M2 Cyclophosphamide 600 mg/m2 day IV 21 days for a total of 1 cycles, with a total of 4 cycles sequential Docetaxel 100mg/m2 IV day 1 21 days for a total of 1 cycles, with a total of 4 cycles Lapatinib 1000mg/d Po (fasting) every 30 days for a cycle Note: lapatinib in the first injection of docetaxel drug taking, once a day, oral dose of 1000mg, a total of over 1 years;
|
Lapatinib produced by glaxosmithkline.
Oral small molecule epidermal growth factor tyrosine kinase inhibitor.
Mainly used for combined with capecitabine in the treatment of ErbB-2 over expression, including received prior anthracycline, paclitaxel and trastuzumab (Herceptin) in the treatment of advanced or metastatic breast cancer.
Our clinical trial want to see its benefit in early breast cancer
|
|
EXPERIMENTAL: PEL(Paclitaxel+epirubicin+Lapatinib)
80mg/ M2 day 1 IV epirubicin Paclitaxel 150mg/m2 IV day 1 14 days for a total of 1 cycles (intensive chemotherapy), with a total of 6 cycles Also given Lapatinib 1000mg/d Po (fasting) every 30 days for a cycle Note: lapatinib in the first injection of paclitaxel drug taking, once a day, oral dose of 1000mg, a total of over 1 years;
|
Lapatinib produced by glaxosmithkline.
Oral small molecule epidermal growth factor tyrosine kinase inhibitor.
Mainly used for combined with capecitabine in the treatment of ErbB-2 over expression, including received prior anthracycline, paclitaxel and trastuzumab (Herceptin) in the treatment of advanced or metastatic breast cancer.
Our clinical trial want to see its benefit in early breast cancer
|
|
ACTIVE_COMPARATOR: EC→PH(Epirubicin+Cyclophosphamide--Docetaxel+herceptin)
Table 80mg/ day 1 IV Cyclophosphamide 600 mg/m2 day IV 21 days for a total of 1 cycles, with a total of 4 cycles Docetaxel 100mg/m2 IV day 1 21 days for a total of 1 cycles, with a total of 4 cycles Trastuzumab 2mg/kg IV QW (first dose 4 mg/kg) Note: trastuzumab was administered at the beginning of the first injection of paclitaxel, with an injection dose of 2mg/kg, 1 times a week, for a total of up to 1 years; followed by trastuzumab 2mg/kg IV, once every 3 weeks for a total of one year
|
Lapatinib produced by glaxosmithkline.
Oral small molecule epidermal growth factor tyrosine kinase inhibitor.
Mainly used for combined with capecitabine in the treatment of ErbB-2 over expression, including received prior anthracycline, paclitaxel and trastuzumab (Herceptin) in the treatment of advanced or metastatic breast cancer.
Our clinical trial want to see its benefit in early breast cancer
|
|
ACTIVE_COMPARATOR: EPH(Paclitaxel+epirubicin+herceptin)
80mg/ M2 day 1 IV epirubicin Paclitaxel 150mg/m2 IV day 1 14 days for a total of 1 cycles, with a total of 6 cycles Also given Trastuzumab 2mg/kg IV QW (first dose 4 mg/kg) Note: trastuzumab was administered at the beginning of the first injection of paclitaxel, with an injection dose of 2mg/kg, 1 times a week, for a total of up to 1 years; followed by trastuzumab 2mg/kg IV, once every 3 weeks for a total of one year
|
Lapatinib produced by glaxosmithkline.
Oral small molecule epidermal growth factor tyrosine kinase inhibitor.
Mainly used for combined with capecitabine in the treatment of ErbB-2 over expression, including received prior anthracycline, paclitaxel and trastuzumab (Herceptin) in the treatment of advanced or metastatic breast cancer.
Our clinical trial want to see its benefit in early breast cancer
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
DFS
Time Frame: 3 years& 5 years
|
Since the first randomized to disease recurrence or death occurred due to other reasons, the recurrence of the disease include local, regional, distant, ipsilateral or contralateral breast cancer (excluding breast lobular carcinoma in situ) and non malignant tumor secondary breast (except the skin basal cell carcinoma or squamous cell carcinoma, cervical cancer in situ cancer).
|
3 years& 5 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
OS
Time Frame: 5 years & 10 years
|
0S is defined as the time from randomization to death due to any cause
|
5 years & 10 years
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
biomarker
Time Frame: 5 years
|
A retrospective study was performed to examine the correlation between the prognosis of the two adjuvant and biomarkers, including but not limited to Ki67, PI3K, C-MYC, IGF1R, P95HER2, P53 and other biomarkers
|
5 years
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Chair: Sun Qiang, M.D., PUMCH
Publications and helpful links
General Publications
- Piccart-Gebhart M, Holmes E, Baselga J, de Azambuja E, Dueck AC, Viale G, Zujewski JA, Goldhirsch A, Armour A, Pritchard KI, McCullough AE, Dolci S, McFadden E, Holmes AP, Tonghua L, Eidtmann H, Dinh P, Di Cosimo S, Harbeck N, Tjulandin S, Im YH, Huang CS, Dieras V, Hillman DW, Wolff AC, Jackisch C, Lang I, Untch M, Smith I, Boyle F, Xu B, Gomez H, Suter T, Gelber RD, Perez EA. Adjuvant Lapatinib and Trastuzumab for Early Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer: Results From the Randomized Phase III Adjuvant Lapatinib and/or Trastuzumab Treatment Optimization Trial. J Clin Oncol. 2016 Apr 1;34(10):1034-42. doi: 10.1200/JCO.2015.62.1797. Epub 2015 Nov 23. Erratum In: J Clin Oncol. 2019 Feb 1;37(4):356.
- Goss PE, Smith IE, O'Shaughnessy J, Ejlertsen B, Kaufmann M, Boyle F, Buzdar AU, Fumoleau P, Gradishar W, Martin M, Moy B, Piccart-Gebhart M, Pritchard KI, Lindquist D, Chavarri-Guerra Y, Aktan G, Rappold E, Williams LS, Finkelstein DM; TEACH investigators. Adjuvant lapatinib for women with early-stage HER2-positive breast cancer: a randomised, controlled, phase 3 trial. Lancet Oncol. 2013 Jan;14(1):88-96. doi: 10.1016/S1470-2045(12)70508-9. Epub 2012 Dec 10. Erratum In: Lancet Oncol. 2013 Feb;14(2):e47.
Study record dates
Study Major Dates
Study Start (ACTUAL)
Study Start
Primary Completion (ANTICIPATED)
Primary Completion
Study Completion (ANTICIPATED)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ACTUAL)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- lapatinib
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on HER2-positive Breast Cancer
-
NCT06595563RecruitingHER2-positive Metastatic Breast Cancer | HER2-positive Advanced Breast Cancer
-
NCT07358182RecruitingHER2-positive Breast Cancer | HER2-low Breast Cancer | Trastuzumab-rezetecan
-
NCT05514717RecruitingHER2-positive Breast Cancer | HER2-positive Gastric Cancer | HER2-positive Non-Small Cell Lung Cancer | HER2-positive Colorectal Cancer | HER2-positive Tumors | HER2 Low Breast Cancer
-
NCT05868226RecruitingSolid Tumor | Metastatic Cancer | Metastatic Breast Cancer | Triple Negative Breast Cancer | HER2-positive Breast Cancer | Solid Tumor, Adult | Solid Carcinoma | HER2-positive Metastatic Breast Cancer | Progesterone Receptor-positive Breast Cancer | HER2-negative Breast Cancer
-
NCT07518173Recruiting
-
NCT07470203Not yet recruiting
-
NCT07179939Not yet recruiting
-
NCT07166367TerminatedHER2-positive Breast Cancer
-
NCT06805812RecruitingBreast Cancer | Breast Neoplasms | Breast Diseases | Breast Neoplasm | Breast Tumors | Breast Carcinoma | Breast Neoplasms, Male | Breast Cancer Stage IV | Hormone Receptor Positive Malignant Neoplasm of Breast | HR-positive Breast Cancer
Clinical Trials on lapatinib/herceptin
-
NCT01985893Withdrawn
-
NCT01454804CompletedAdvanced Cancers
-
NCT02238509Unknown
-
NCT00470847CompletedBreast Cancer | Brain Metastases
-
NCT01705340TerminatedHER2-positive Breast Cancer | Male Breast Cancer | Stage IV Breast Cancer | Stage IIIC Breast Cancer | Adenocarcinoma of the Gastroesophageal Junction | Recurrent Breast Cancer | Stage IV Gastric Cancer | Recurrent Gastric Cancer | Recurrent Esophageal Cancer | Stage IV Esophageal Cancer
-
NCT00320385Completed
-
NCT01557764Withdrawn
-
NCT00470704Completed