- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00049114
Tipifarnib, Doxorubicin, and Cyclophosphamide in Treating Women With Locally Advanced Breast Cancer
A Phase I-II Study of R115777 (ZARNESTRA) Plus Doxorubicin and Cyclophosphamide in Patients With Locally Advanced Breast Cancer and Metastatic Breast Cancer
Study Overview
Status
Conditions
Detailed Description
PRIMARY OBJECTIVES:
I. Determine the maximum tolerated dose of tipifarnib when administered with doxorubicin and cyclophosphamide in women with metastatic breast cancer (non-regional stage IV disease). (Phase I closed to accrual as of 1/19/04) II. Determine the pathologic complete remission rate in patients with locally advanced breast cancer (stages IIB, IIIA, IIIB, or IIIC) treated with the recommended phase II dose of this regimen.
SECONDARY OBJECTIVES:
I. Determine the clinical complete response rate in patients treated with this regimen.
II. Determine the toxicity profile of this regimen in these patients. III. Correlate pretreatment levels of ErbB1, 2, 3, 4 and phosphorylated levels of Akt, STAT3, and Erk ½ with clinical response in these patients and with percent inhibition of proliferation (Ki-67) and percent induction of apoptosis in post-treatment tumor specimens.
IV. Correlate percent decrease of farnesyltransferase (FTase) activity levels, HDJ-2 farnesylation, phospho-Akt, phospho-STAT3, and phospho-Erk ½ with clinical response rates in these patients and with percent inhibition of proliferation (Ki-67) and percent inhibition of apoptosis.
OUTLINE: This is a multicenter, dose-escalation study of tipifarnib. Patients are stratified according to presence of inflammatory carcinoma (yes vs no).
PHASE I (nonregional stage IV disease) (closed to accrual as of 1/19/04): Patients receive doxorubicin IV over 10-15 minutes and cyclophosphamide IV over 30 minutes on day 1, oral tipifarnib twice daily on days 2-7, and filgrastim (G-CSF) subcutaneously on days 2-13. Treatment repeats every 2 weeks for 4 courses in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of tipifarnib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.
PHASE II (stage IIB, IIIA, IIIB, or IIIC): Patients receive tipifarnib at the MTD and doxorubicin, cyclophosphamide, and G-CSF as in phase I (phase I closed to accrual as of 1/19/04). After the fourth course, patients may undergo complete resection.
Patients are followed every 3-4 months for 3 years, every 6 months for 2 years, and then annually thereafter.
PROJECTED ACCRUAL: Approximately 3-12 patients will be accrued for phase I (closed to accrual as of 1/19/04) of this study. A total of 21-50 patients will be accrued for phase II of this study.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
New York
-
Bronx, New York, United States, 10461
- Albert Einstein College Of Medicine
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Histologically or cytologically confirmed adenocarcinoma of the breast
Phase I (closed to accrual as of 1/19/04):
- Nonregional stage IV disease
Phase II:
Locally advanced disease, according to AJCC staging criteria:
- Stage IIB
- Stage IIIA
- Stage IIIB
- Stage IIIC
- At least 1 bidimensionally or unidimensionally measurable indicator lesion
Hormone receptor status:
- Not specified
- Female
- Performance status - ECOG 0-1
- Performance status - Karnofsky 70-100%
- Not specified
- WBC at least 3,000/mm^3
- Absolute neutrophil count at least 1,500/mm^3
- Platelet count at least 100,000/mm^3
- Bilirubin normal
- AST/ALT no greater than 2.5 times upper limit of normal
- Creatinine normal
- Creatinine clearance at least 60 mL/min
- LVEF normal
- No symptomatic congestive heart failure
- No unstable angina pectoris
- No cardiac arrhythmia
- No other invasive malignancies within the past 5 years except curatively treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
- No prior allergic reactions attributed to compounds of similar chemical or biological composition to tipifarnib or other agents used in the study (e.g., imidazoles or quinolones)
- No ongoing or active infection
- No other concurrent uncontrolled illness that would preclude study participation
- No psychiatric illness or social situation that would preclude study compliance
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- Not specified
Phase I (closed to accrual as of 1/19/04):
- More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered
- No more than 1 prior adjuvant/neoadjuvant regimen and 1 prior regimen for metastatic disease
Prior doxorubicin allowed provided the following are true:
- Used in adjuvant setting
- Cumulative dose was no greater than 240 mg/m^2
- At least 1 year between completion of adjuvant therapy and relapse
Phase II:
- No prior chemotherapy for locally advanced breast cancer
- At least 1 week since prior tamoxifen or other selective estrogen receptor modulators for prevention or other indications (e.g., osteoporosis, ductal carcinoma in situ, or invasive breast cancer)
Phase I (closed to accrual as of 1/19/04):
- More than 4 weeks since prior radiotherapy
Phase II:
- No prior radiotherapy for locally advanced breast cancer
- Not specified
- No antacids within 2 hours of study drug administration
- No concurrent combination antiretroviral therapy for HIV-positive patients
- No other concurrent anticancer therapy
- No other concurrent investigational agents
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Treatment (doxorubicin, cyclophosphamide, tipifarnib, G-CSF)
PHASE I (nonregional stage IV disease) (closed to accrual as of 1/19/04): Patients receive doxorubicin IV over 10-15 minutes and cyclophosphamide IV over 30 minutes on day 1, oral tipifarnib twice daily on days 2-7, and G-CSF subcutaneously on days 2-13. Treatment repeats every 2 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. PHASE II (stage IIB, IIIA, IIIB, or IIIC): Patients receive tipifarnib at the MTD and doxorubicin, cyclophosphamide, and G-CSF as in phase I (phase I closed to accrual as of 1/19/04). After the fourth course, patients may undergo complete resection. |
Correlative studies
Given orally
Other Names:
Given IV
Other Names:
Other Names:
Given subcutaneously
Other Names:
Undergo complete resection
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pathological complete response in the breast
Time Frame: 8 weeks
|
95% confidence intervals of these estimates will be obtained.
|
8 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of patients who have a clinical complete response
Time Frame: 8 weeks
|
95% confidence intervals of these estimates will be obtained.
|
8 weeks
|
Grade 3 or 4 toxicities assessed using NCI CTCAE version 3.0
Time Frame: Up to 5 years
|
Toxicity will be summarized by type, frequency and severity.
This will be compared with an historical database.
|
Up to 5 years
|
Median disease-free survival
Time Frame: Up to 5 years
|
Will be summarized, and 95% confidence intervals of these estimates will be obtained.
|
Up to 5 years
|
Percentage of patients free of disease
Time Frame: 1 year
|
Will be summarized, and 95% confidence intervals of these estimates will be obtained.
|
1 year
|
Percentage of patients free of disease
Time Frame: 2 years
|
Will be summarized, and 95% confidence intervals of these estimates will be obtained.
|
2 years
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Joseph Sparano, Albert Einstein College Of Medicine
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Skin Diseases
- Neoplasms
- Neoplasms by Site
- Breast Diseases
- Breast Neoplasms
- Inflammatory Breast Neoplasms
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antirheumatic Agents
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Myeloablative Agonists
- Topoisomerase II Inhibitors
- Topoisomerase Inhibitors
- Antibiotics, Antineoplastic
- Cyclophosphamide
- Doxorubicin
- Liposomal doxorubicin
- Tipifarnib
Other Study ID Numbers
- NCI-2012-02500
- N01CM62204 (U.S. NIH Grant/Contract)
- 02-05-125
- AECM-0205125
- NCI-5598
- CDR0000257811
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