- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04893109
ATEMPT 2.0: Adjuvant T-DM1 vs TH
A Randomized Phase II Trial of Adjuvant Trastuzumab Emtansine (T-DM1) Followed by Subcutaneous Trastuzumab Versus Paclitaxel in Combination With Subcutaneous Trastuzumab for Stage I HER2-positive Breast Cancer (ATEMPT 2.0)
This research study is studying how well newly diagnosed breast cancer that has tested positive for a protein called HER2 responds using one of two different combination of HER2-directed therapies as a treatment after surgery.
The name of the study drugs involved are:
- Trastuzumab-emtansine (T-DM1, Kadcyla)
- Trastuzumab SC (Herceptin Hylecta)
- Paclitaxel
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This is a randomized phase II adjuvant study for women and men with Stage I HER2-positive invasive breast cancer. Participants will be randomized into one of two treatment arms in this study and receive:
- Arm 1: trastuzumab-emtansine (T-DM1, Kadcyla) and trastuzumab SC (Herceptin Hylecta)
- Arm 2: paclitaxel and trastuzumab SC (Herceptin Hylecta) This research study is looking to see if the study drug T-DM1 followed by trastuzumab SC will have less side-effects than traditional HER2-positive breast cancer treatment of trastuzumab and paclitaxel.The study is also looking to learn about the long-term benefits and disease-free survival of participants who are treated with T-DM1 followed by trastuzumab SC.
T-DM1 is an antibody-drug conjugate; it is made up of an antibody (trastuzumab) linked to a cytotoxic drug, DM1 (chemotherapy). T-DM1 functions as a targeted cancer therapy because it targets HER2-positive breast cancer cells directly, limiting exposure of the rest of the body to chemotherapy. More specifically, the trastuzumab in T-DM1 first binds to the HER2 protein on the surface of the breast cancer cells and the DM1 then enters the cells and can cause them to die, preventing tumor growth. The FDA (the U.S. Food and Drug Administration) has not approved T-DM1 for use on its own in patients with stage I, II, or III breast cancer. However, it has been approved for use in (a) advanced or metastatic, previously treated breast cancer and (b) in some patients receiving postoperative treatment after preoperative chemotherapy and surgery have been completed.
Trastuzumab SC is a subcutaneous form of trastuzumab.Trastuzumab is a monoclonal antibody, which are disease-fighting proteins made by cloned immune cells. Paclitaxel and trastuzumab are considered a standard-of-care regimen in early breast cancer. Trastuzumab is FDA-approved to be administered as an IV (intravenous) or subcutaneous (muscular injection).
The research study procedures include screening for eligibility and study treatment including laboratory evaluations and follow up visits.
Participants will receive study treatment for a year in total and will be followed for 5 years after treatment.
It is expected that about 500 people will take part in this research study.
Genentech is supporting this research study by providing funding for the study and supplying trastuzumab-emtansine (T-DM1) and trastuzumab SC (subcutaneous).
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Sara Tolaney, MD, PhD
- Phone Number: 617-632-2335
- Email: sara_tolaney@dfci.harvard.edu
Study Locations
-
-
California
-
San Francisco, California, United States, 94158
- Recruiting
- UCSF Helen Diller Family Comprehensive Cancer Center
-
Principal Investigator:
- Hope Rugo, MD
-
Contact:
- Hope Rugo, MD
-
-
Connecticut
-
Derby, Connecticut, United States, 06418
- Recruiting
- Smilow Cancer Hospital Care Center at Derby
-
Principal Investigator:
- Daniel O'Neil, MD
-
Contact:
- Clinical Trial Offcie Yale Cancer Center
- Phone Number: (203) 734-1664
-
Fairfield, Connecticut, United States, 06824
- Recruiting
- Smilow Cancer Hospital Care center at Fairfield
-
Principal Investigator:
- Daniel O'Neil, MD
-
Contact:
- Clinical Trials Office Yale Cancer Center
- Phone Number: (203) 255-2766
-
Glastonbury, Connecticut, United States, 06033
- Recruiting
- Smilow Cancer Hospital Care Center at Glastonbury
-
Principal Investigator:
- Daniel O'Neil, MD
-
Contact:
- Clinical Trial Office Yale Cancer Center
- Phone Number: (860) 714-9170
-
Greenwich, Connecticut, United States, 06830
- Recruiting
- Smilow Cancer Hospital Care Center at Greenwich
-
Principal Investigator:
- Daniel O'Neil, MD
-
Contact:
- Clinical Trials Office Yale Cancer Center
- Phone Number: (203) 863-3700
-
Guilford, Connecticut, United States, 06437
- Recruiting
- Smilow Cancer Hospital Care Center at Guilford
-
Principal Investigator:
- Daniel O'Neil, MD
-
Contact:
- Clinical Trial Office Yale Cancer Center
- Phone Number: (203) 453-9192
-
Hartford, Connecticut, United States, 06105
- Recruiting
- Smilow Cancer Hospital Care center at St. Francis
-
Principal Investigator:
- Daniel O'Neil, MD
-
Contact:
- Clinical Trial Office Yale Cancer Center
- Phone Number: (860) 714-4680
-
Long Ridge, Connecticut, United States, 06902
- Recruiting
- Smilow Cancer Hospital Care Center at Long Ridge
-
Principal Investigator:
- Daniel O'Neil, MD
-
Contact:
- Clinical Trial Office Yale Center
- Phone Number: (203) 863-3700
-
New Haven, Connecticut, United States, 06520-8028
- Recruiting
- Yale Cancer Center at Yale University School of Medicine
-
Contact:
- Clinical Trial Office Clinical Trials Office - Yale Cancer Center
- Phone Number: 203-785-5702
-
Principal Investigator:
- Daniel O'Niel, MD
-
North Haven, Connecticut, United States, 06510
- Recruiting
- Smilow Cancer Hospital Care center at North Haven
-
Principal Investigator:
- Daniel O'Neil, MD
-
Contact:
- Clinical Trials Office Yale Cancer Center
- Phone Number: (203) 407-8002
-
Stamford, Connecticut, United States, 06904
- Recruiting
- Stamford Hospital
-
Contact:
- K.M. Steve Lo, MD
- Email: slo@stamhealth.org
-
Principal Investigator:
- K. M. Steve Lo, MD
-
Torrington, Connecticut, United States, 06790
- Recruiting
- Smilow Cancer Hospital Care center at Torrington
-
Principal Investigator:
- Daniel O'Neil, MD
-
Contact:
- Clinical Trial Office Yale Cancer Center
- Phone Number: (860) 482-5384
-
Trumbull, Connecticut, United States, 06611
- Recruiting
- Smilow Cancer Hospital Care Center at Trumbull
-
Principal Investigator:
- Daniel O'Neil, MD
-
Contact:
- Clinical Trials Office Cancer Trial
- Phone Number: (203) 502-8400
-
Waterbury, Connecticut, United States, 06708
- Recruiting
- Smilow Cancer Hospital Care center at Waterbury
-
Principal Investigator:
- Daniel O'Neil, MD
-
Contact:
- Clinical Trials Office Yale Cancer Center
- Phone Number: (203) 755-6311
-
Waterford, Connecticut, United States, 06385
- Recruiting
- Smilow Cancer Hospital Care center at Waterford
-
Principal Investigator:
- Daniel O'Neil, MD
-
Contact:
- Clinical Trials Office Yale Cancer Center
- Phone Number: (860) 444-3744
-
-
Florida
-
Miami, Florida, United States, 33176
- Recruiting
- Miami Cancer Institute/Baptist Hospital of Miami
-
Sub-Investigator:
- Reshma Mahtani, DO
-
Contact:
- Reshma Mahtani, DO
-
Plantation, Florida, United States, 33324
- Recruiting
- Miami Cancer Institute - Plantation (MCIP)
-
Contact:
- Reshma Mahtani, DO
- Email: reshma.mahtani@baptisthealth.net
-
Principal Investigator:
- Reshma Mahtani, DO
-
-
Illinois
-
Chicago, Illinois, United States, 60637
- Recruiting
- The University of Chicago Medical Center
-
Principal Investigator:
- Nan Chen, MD
-
Contact:
- Susan Cohn, MD
- Phone Number: 773-702-2571
-
-
Indiana
-
Carmel, Indiana, United States, 46032
- Active, not recruiting
- IU Health North Hospital
-
Carmel, Indiana, United States, 46032
- Active, not recruiting
- Indiana University Health Joe & Shelly Schwarz Cancer Center
-
Indianapolis, Indiana, United States, 46202
- Active, not recruiting
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center
-
Indianapolis, Indiana, United States, 46202
- Active, not recruiting
- Indiana University Sidney and Lois Eskenazi Hospital
-
-
Maine
-
Brewer, Maine, United States, 04412
- Recruiting
- Eastern Maine Medical Center (Northern Light)
-
Contact:
- Laurie Lewis
- Phone Number: 207-973-4249
- Email: llewis@northernlight.org
-
Principal Investigator:
- Sarah J Sinclair, DO
-
Scarborough, Maine, United States, 04074
- Recruiting
- New England Cancer Specialists
-
Principal Investigator:
- Chiara Battelli, MD
-
Contact:
- Rachael Farris
- Email: research@newecs.org
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02215
- Recruiting
- Beth Israel Deaconess Medical Center
-
Principal Investigator:
- Nadine Tung, MD
-
Contact:
- Nadine Tung, MD
- Phone Number: 617-667-7081
- Email: ntung@bidmc.harvard.edu
-
Boston, Massachusetts, United States, 02215
- Recruiting
- Dana Farber Cancer Institute
-
Contact:
- Sara M. Tolaney, MD MPH
- Phone Number: 617-632-2335
- Email: Sara_Tolaney@dfci.harvard.edu
-
Principal Investigator:
- Sara M. Tolaney, MD MPH
-
Boston, Massachusetts, United States, 02215
- Recruiting
- Massachusetts General Hospital
-
Contact:
- Laura Spring, MD
- Phone Number: 617-724-4000
- Email: Lspring2@partners.org
-
Principal Investigator:
- Laura Spring, MD
-
Brighton, Massachusetts, United States, 02135
- Recruiting
- Dana-Farber at St. Elizabeth's Medical Center
-
Contact:
- Wendy Loeser
- Email: Wendy_Loeser@DFCI.HARVARD.EDU
-
Principal Investigator:
- Sara Giordano, MD
-
Burlington, Massachusetts, United States, 01805
- Recruiting
- Lahey Clinic
-
Principal Investigator:
- Corrine Zarwan, MD
-
Contact:
- Corrine Zarwan
- Phone Number: 781-744-8580
- Email: corrine.zarwan@lahey.org
-
Contact:
- Amanda Pietras
- Phone Number: 781-744-3495
- Email: amanda.pietras1@lahey.org
-
Danvers, Massachusetts, United States, 01923
- Recruiting
- Mass General North Shore Cancer Center
-
Contact:
- Meegan Petersen
- Email: mpetersen1@partners.org
-
Principal Investigator:
- Katherine Harris, MD
-
Foxborough, Massachusetts, United States, 02035
- Recruiting
- Dana-Farber Brigham Cancer Center - Foxborough
-
Contact:
- Natalie Sinclair
- Phone Number: 781-624-4800
- Email: nsinclair1@partners.org
-
Principal Investigator:
- Natalie Sinclair, MD
-
Methuen, Massachusetts, United States, 01844
- Recruiting
- Dana-Farber Cancer Instiute - Merrimack Valley
-
Contact:
- Saida Hussein
- Email: saida_hussein@dfci.harvard.edu
-
Principal Investigator:
- Pedro Sanz-Altamira, MD
-
Milford, Massachusetts, United States, 01757
- Recruiting
- Dana-Farber at Milford
-
Principal Investigator:
- Natalie Sinclair, MD
-
Contact:
- Natalie Sinclair, MD
- Email: nsinclair1@partners.org
-
Newton, Massachusetts, United States, 02462
- Recruiting
- Newton Wellesley Hospital
-
Contact:
- Natassia Mazzola
- Email: NAMAZZOLA@mgh.harvard.edu
-
Principal Investigator:
- Aron Rosenstock, MD
-
Pittsfield, Massachusetts, United States, 01201
- Recruiting
- Berkshire Medical Center
-
Contact:
- Lori O'Brien
- Email: lobrien@bhs1.org
-
Principal Investigator:
- Thomas Fynan, MD
-
Weymouth, Massachusetts, United States, 02190
- Recruiting
- Dana Farber at South Shore Hospital
-
Contact:
- Meredith Faggen
- Email: meredith_faggen@dfci.harvard.edu
-
Contact:
- Phone Number: 7816244800
-
Principal Investigator:
- Meredith Faggen, MD
-
-
New Hampshire
-
Concord, New Hampshire, United States, 03301
- Recruiting
- NH Oncology-Hematology, PA - Payson Center for Cancer Care
-
Principal Investigator:
- Douglas Weckstein, MD
-
Contact:
- Ali Fleury
- Phone Number: 6032242556
- Email: a.fleury@nhoh.com
-
Londonderry, New Hampshire, United States, 03053
- Recruiting
- Dana-Farber Cancer Insitute at Londonderry Hospital
-
Contact:
- Stefani Freeman, RN
- Email: StefaniD_Freeman@DFCI.HARVARD.EDU
-
Principal Investigator:
- Jeanna Walsh, MD
-
Manchester, New Hampshire, United States, 03103
- Recruiting
- Solinsky Center for Cancer Care (NH Oncology-Hematology, PA)
-
Principal Investigator:
- Douglas Weckstein, MD
-
Contact:
- Ali Fleury
- Phone Number: 6032242556
- Email: a.fleury@nhoh.com
-
Portsmouth, New Hampshire, United States, 03801
- Recruiting
- New England Cancer Specialists - Portsmouth
-
Principal Investigator:
- Chiara Battelli, MD
-
Contact:
- NECS Research
- Email: Research@newecs.org
-
-
New York
-
Brooklyn, New York, United States, 11220
- Recruiting
- New York University Langone Hospital -Brooklyn
-
Principal Investigator:
- Nina D'Abreo, MD
-
Contact:
- Breast Cancer Center
- Phone Number: (718) 630-7000
-
Mineola, New York, United States, 11501
- Recruiting
- New York University Langone Hospital - Long Island
-
Contact:
- Mehwash "Mahi" Muhammad
- Email: mehwash.muhammad@nyulangone.org
-
Principal Investigator:
- Nina D'Abreo, MD
-
New York, New York, United States, 10016
- Recruiting
- New York University Langone Health
-
Contact:
- Sylvia Adams, MD
- Email: sylvia.adams@nyulangone.org
-
Principal Investigator:
- Nina D'Abreo, MD
-
New York, New York, United States, 10075
- Recruiting
- Northwell University
-
Principal Investigator:
- Francisco Esteva
-
Contact:
- Francisco Esteva
- Phone Number: (855)-273-2789
- Email: festeva@northwell.edu
-
-
North Carolina
-
Durham, North Carolina, United States, 27710
- Active, not recruiting
- Duke University Medical Center
-
Raleigh, North Carolina, United States, 27710
- Active, not recruiting
- Duke Women's Cancer Care Raleigh
-
-
Ohio
-
Columbus, Ohio, United States, 43212
- Recruiting
- Stefanie Spielman Comprehensive Breast Center
-
Contact:
- Breast Cancer Clinical Trials
- Phone Number: 800-293-5066
-
Principal Investigator:
- Gilbert Bader, MD
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, United States, 19104
- Recruiting
- University of Pennsylvania, Abramson Cancer Center
-
Contact:
- Igor Makhlin, MD
- Email: igor.makhlin@pennmedicine.upenn.edu
-
Principal Investigator:
- Igor Makhlin, MD
-
Pittsburgh, Pennsylvania, United States, 15213
- Recruiting
- University of Pittsburgh Medical Center Cancer UPMC- Magee Women's Hospital
-
Contact:
- Rometa Kerney
- Phone Number: (412) 641-5430
- Email: pollardrr@upmc.edu
-
Principal Investigator:
- Marija Balic, MD
-
Contact:
- Marija Balic
- Phone Number: 412-647-2811
- Email: balicm@upmc.edu
-
-
Rhode Island
-
Westerly, Rhode Island, United States, 02891
- Recruiting
- Smilow Cancer Hospital Care center at Westerly
-
Principal Investigator:
- Daniel O'Neil, MD
-
Contact:
- Clinical Trials Office Yale Cancer Center
- Phone Number: (401) 656-4950
-
-
Tennessee
-
Nashville, Tennessee, United States, 37203
- Recruiting
- SCRI Oncology Partners
-
Principal Investigator:
- Denise Yardley, MD
-
Contact:
- Lisa Simons
- Email: Lisa.Simons@scri.com
-
Nashville, Tennessee, United States, 37203
- Recruiting
- Greco-Hainsworth Centers for Research/Tennessee Oncology
-
Principal Investigator:
- Sara Nunnery, MD
-
Contact:
- PJ Patterson
- Phone Number: 629-294-0801
- Email: ppatterson@tnonc.com
-
-
Texas
-
Houston, Texas, United States, 77030
- Recruiting
- MD Anderson Cancer Center
-
Principal Investigator:
- Vicente Valero, MD
-
Contact:
- Vicente Valero, MD
- Phone Number: 713 563 0751
- Email: vvalero@mdanderson.org
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Patients must have HER2-positive Stage I histologically confirmed invasive carcinoma of the breast. Patients must have node-negative (N0) or micrometastases (N1mic) breast cancer according to the AJCC 8th edition anatomic staging table.
- If the patient has had a negative sentinel node biopsy, then no further axillary dissection is required, and the patient is determined to be node-negative. If an axillary dissection without sentinel lymph node biopsy is performed to determine nodal status, at least six axillary lymph nodes must be removed and analyzed, and determined to be negative, for the patient to be considered node-negative. Axillary nodes with single cells or tumor clusters ≤ 0.2 mm by either H&E or immunohistochemistry (IHC) will be considered node-negative.
- Any axillary lymph node with tumor clusters between 0.02 and 0.2 cm is considered a micrometastasis. Patients with a micrometastasis are eligible. An axillary dissection is not required to be performed in patients with a micrometastasis found by sentinel node evaluation. In cases where the specific pathologic size of lymph node involvement is subject to interpretation, the principal investigator will make the final determination as to eligibility. The investigator must document approval in the patient medical record.
- Patients who have an area of a T1aN0, ER+ (defined as >10%), HER2-negative cancer in addition to their primary HER2-positive tumor are eligible.
- HER2-positive by ASCO CAP 2018 guidelines, confirmed by central testing. NOTE: HER-2 status must be confirmed to be positive by central review by NeoGenomics prior to patient starting protocol therapy. Patients previously having had HER2 immunohistochemical testing by NeoGenomics do not need to undergo retesting for central confirmation of HER2 status.
NOTE: DCIS components will not be counted in the determination of HER2 status
- ER/PR determination is required. ER and PR assays should be performed by immunohistochemical methods according to the local institution standard protocol.
- Bilateral breast cancers that individually meet eligibility criteria are allowed.
- Patients with multifocal or multicentric disease are eligible, as long as each tumor individually meets eligibility criteria. Central confirmation is needed for any site of disease that is tested to be HER2-positive by local testing (unless testing was previously done by NeoGenomics).
- Patients with a history of ipsilateral DCIS are eligible if they were treated with wide excision alone, without radiation therapy, or treated with a mastectomy for this current breast cancer. Patients with a history of contralateral DCIS are not eligible.
- ≤ 90 days between the planned treatment start date and the patient's most recent breast surgery for this breast cancer
- ≥ 18 years of age with any menopausal status.
- ECOG Performance Status 0 or 1
All tumor should be removed by either a modified radical mastectomy or a segmental mastectomy (lumpectomy), with either a sentinel node biopsy or axillary dissection
- All margins should be clear of invasive cancer or DCIS (i.e. no tumor on ink). The local pathologist must document negative margins of resection in the pathology report. If all other margins are clear, a positive posterior (deep) margin is permitted, provided the surgeon documents that the excision was performed down to the pectoral fascia and all tumor has been removed. Likewise, if all other margins are clear, a positive anterior (superficial; abutting skin) margin is permitted provided the surgeon documents that all tumor has been removed.
- Patients undergoing breast conservation therapy (i.e. lumpectomy) must not have any contraindications to radiation therapy. Radiation to the conserved breast is required.
- Patients may have received up to 4 weeks of tamoxifen therapy, or other hormonal therapy, for adjuvant therapy for this cancer. Patients cannot receive adjuvant hormonal therapy during protocol treatment for the first 12 weeks.
- Prior oophorectomy for cancer prevention is allowed.
- Patients who have undergone partial breast radiation (duration ≤ 14 days) prior to registration are eligible. Partial breast radiation must be completed prior to 2 weeks before starting protocol therapy. Patients who have undergone whole breast radiation are not eligible.
- Patients who have participated in a window study (treatment with an investigational agent prior to surgery for ≤ 2 weeks) are eligible. Patients must have discontinued the investigational agent at least 14 days before participation.
Adequate bone marrow function:
- ANC ≥ 1000/mm3,
- Hemoglobin ≥ 9 g/dl
- Platelets ≥ 100,000/mm3
Adequate hepatic function:
- Total bilirubin ≤ 1.2mg/dL
- AST and ALT ≤ 1.5x Institutional ULN
- For patients with Gilbert syndrome, the direct bilirubin should be within the institutional normal range. Serum alkaline phosphatase should be ≤ 1.5x Institutional ULN.
- Left ventricular ejection fraction (LVEF) ≥ 50%
- Premenopausal patients must have a negative serum or urine pregnancy test, including women who have had a tubal ligation and for women less than 12 months after the onset of menopause.
- Women of childbearing potential and men with partners of childbearing potential must be willing to use one highly effective form of nonhormonal contraception or two effective forms of nonhormonal contraception by the patient and/or partner. Contraceptive use must be continued for the duration of the study treatment and for 7 months after the last dose of study treatment. Hormonal birth control methods are not permitted.
- Patients should have tumor tissue available, and a tissue block of sufficient size to make 15 slides, which must be sent to DFCI for correlative research. If a tissue block is unavailable, sites may send one H&E-stained slide and 15 unstained sections of paraffin-embedded tissue on uncharged slides. Slide sections should be 4-5 microns in thickness. It is also acceptable to submit 2 cores from a block of invasive tissue using a 1.2 mm diameter coring tool. If tumor is not available, the investigator must document why tissue is not available in the patient medical record, and that efforts have been made to obtain tissue.
- Willing and able to sign informed consent
- Must be able to read and understand English in order to participate in the quality of life surveys. If patient does not read and understand English, the patient is still eligible, but cannot participate in the quality of life surveys.
Exclusion Criteria:
Any of the following due to teratogenic potential of the study drugs:
- Pregnant women
- Nursing women
- Women of childbearing potential who are unwilling to employ adequate contraception (condoms, diaphragms, IUDs, surgical sterilization, abstinence, etc.).
- Men who are unwilling to employ adequate contraception (condoms, surgical sterilization, abstinence, etc.).
- Locally advanced tumors at diagnosis, including tumors fixed to the chest wall, peau d'orange, skin ulcerations/nodules, or clinical inflammatory changes (diffuse brawny cutaneous induration with an erysipeloid edge)
- Patients with a history of previous invasive breast cancer.
- History of prior chemotherapy in the past 5 years.
- History of paclitaxel therapy
- Patients with active liver disease, for example due to hepatitis B virus, hepatitis C virus, autoimmune hepatic disorder, or sclerosing cholangitis
Individuals with a history of a different malignancy are ineligible except for the following circumstances:
- Individuals with a history of other malignancies are eligible if they have been disease-free for at least 5 years and are deemed by the investigator to be at low risk for recurrence of that malignancy.
- Individuals with the following cancer are eligible regardless of when they were diagnosed and treated: cervical cancer in situ, and non-melanoma cancer of the skin.
- Intercurrent illness including, but not limited to: ongoing or active, unresolved systemic infection, renal failure requiring dialysis, active cardiac disease, prior myocardial infarction (asymptomatic changes on EKG suggestive of old MI is not an exclusion), history of CHF, current use of any therapy specifically for CHF, uncontrolled hypertension, significant psychiatric illness, or other conditions that in the opinion of the investigator limit compliance with study requirements.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Arm A. T-DM1 followed by Trastuzumab SC
Randomized participants will receive intravenous T-DM1 every 3 weeks for 6 cycles (18 weeks) and then Trastuzumab SC (subcutaneous) every 3 weeks for 11 cycles
|
intravenous infusion
Other Names:
Muscular injection
Other Names:
|
|
Experimental: Arm B: Paclitaxel with Trastuzumab SC, followed by Trastuzumab SC alone
Randomized participants will receive weekly intravenous Paclitaxel for 12 weeks (4 cycles) and Trastuzumab SC (subcutaneous) every 3 weeks for 17 cycles.
The first 4 doses Trastuzumab SC are given with Paclitaxel.
|
Muscular injection
Other Names:
intravenous infusion
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of clinically relevant toxicities (CRT)
Time Frame: First 18 weeks of treatment
|
Compare the incidence of clinically relevant toxicities (CRT) in patients with Stage I HER2-positive breast cancer treated with trastuzumab emtansine followed by trastuzumab SC to the incidence in those treated with paclitaxel in combination with trastuzumab SC as assessed by PRO-CTCAE
|
First 18 weeks of treatment
|
|
Disease Free Survival (DFS)
Time Frame: Time from randomization to first Disease Free Survival (DFS) event up to 72 months
|
Evaluate disease-free survival in the T-DM1 followed by trastuzumab SC arm
|
Time from randomization to first Disease Free Survival (DFS) event up to 72 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Grade 3 and 4 adverse events
Time Frame: Enrollment to end of treatment up to 1 year
|
Compare the incidence of all grade 3 and 4 adverse events in patients treated with adjuvant trastuzumab emtansine followed by trastuzumab SC to the incidence in those receiving paclitaxel in combination with trastuzumab SC
|
Enrollment to end of treatment up to 1 year
|
|
Quality of Life Assessment: FACT B
Time Frame: Enrollment to end of treatment up to 1 year
|
Compare responses to FACT-B quality of life (QOL) questionnaire in patients receiving trastuzumab emtansine followed by trastuzumab SC to that experienced by patients receiving paclitaxel in combination with trastuzumab SC.
|
Enrollment to end of treatment up to 1 year
|
|
Symptoms related to therapy
Time Frame: Enrollment to end of treatment up to 1 year
|
Evaluate symptoms related to therapy in patients receiving trastuzumab emtansine followed by trastuzumab SC compared to those receiving paclitaxel in combination with trastuzumab SC using the Rotterdam Symptom Checklist (RSCL)
|
Enrollment to end of treatment up to 1 year
|
|
Symptoms related to therapy
Time Frame: Enrollment to end of treatment up to 1 year
|
Evaluate symptoms related to therapy in patients receiving trastuzumab emtansine followed by trastuzumab SC compared to those receiving paclitaxel in combination with trastuzumab SC using the Patient Neurotoxicity Questionnaire (PNQ)
|
Enrollment to end of treatment up to 1 year
|
|
Effects of therapy on work productivity
Time Frame: Enrollment to end of treatment up to 1 year
|
Evaluate effects of therapy on work productivity and activity using the Work Productivity and Activity Impairment Questionnaire (WPAI-SHP) in patients receiving trastuzumab emtansine followed by trastuzumab SC compared to those receiving paclitaxel in combination with trastuzumab SC
|
Enrollment to end of treatment up to 1 year
|
|
Effect of alopecia on patients
Time Frame: Enrollment to end of treatment up to 1 year
|
Evaluate the effects of alopecia on patients receiving paclitaxel in combination with trastuzumab SC using an alopecia questionnaire
|
Enrollment to end of treatment up to 1 year
|
|
Incidence of Side Effects
Time Frame: Enrollment to end of treatment up to 1 year
|
Compare incidence of sensory neuropathy, headache, arthralgia and myalgia using PRO-CTCAE criteria in patients receiving trastuzumab emtansine followed by trastuzumab SC to that experienced by patients receiving paclitaxel in combination with trastuzumab SC
|
Enrollment to end of treatment up to 1 year
|
|
Incidence of grade 3-4 cardiac left ventricular dysfunction
Time Frame: Enrollment to end of treatment up to 1 year
|
Evaluate the incidence of grade 3-4 cardiac left ventricular dysfunction in patients treated with adjuvant trastuzumab emtansine followed by trastuzumab SC compared to those receiving paclitaxel with trastuzumab SC
|
Enrollment to end of treatment up to 1 year
|
|
Incidence of trastuzumab-emtansine-induced grade 2-4 thrombocytopenia
Time Frame: Enrollment to end of treatment up to 1 year
|
Evaluate the incidence of trastuzumab-emtansine-induced grade 2-4 thrombocytopenia
|
Enrollment to end of treatment up to 1 year
|
|
Percentage of patients with amenorrhea
Time Frame: Enrollment to end of treatment up to 1 year
|
Investigate the percentage of patients with amenorrhea at various time points after the start of treatment in premenopausal women receiving treatment with trastuzumab emtansine followed by trastuzumab SC and paclitaxel with trastuzumab SC
|
Enrollment to end of treatment up to 1 year
|
|
Evaluation of gene predictors of trastuzumab-emtansine-induced grade 2-4
Time Frame: Enrollment to end of treatment up to 1 year
|
Evaluate gene biomarkers predictive of trastuzumab-emtansine-induced grade 2-4 thrombocytopenia
|
Enrollment to end of treatment up to 1 year
|
|
Gene Profiling
Time Frame: Enrollment to end of treatment up to 1 year
|
Utilize genomic profiling to query a large panel of cancer gene mutations and gene expression in patients with Stage I HER2-positive breast cancer
|
Enrollment to end of treatment up to 1 year
|
|
Radiation therapy Toxicity
Time Frame: Enrollment to end of treatment up to 1 year
|
Evaluate the incidence of toxicities attributed to radiation therapy when given concurrently with trastuzumab SC after receipt of either trastuzumab emtansine or paclitaxel
|
Enrollment to end of treatment up to 1 year
|
|
Overall survival
Time Frame: Enrollment to end of treatment up to 1 year
|
Describe overall survival in patients with Stage I HER2-positive breast cancer treated with trastuzumab emtansine followed by trastuzumab SC
|
Enrollment to end of treatment up to 1 year
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Sara Tolaney, MD, PhD, Dana-Farber Cancer Institute
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Neoplasms by Site
- Neoplasms
- Skin Diseases
- Breast Diseases
- Skin and Connective Tissue Diseases
- Breast Neoplasms
- Amino Acids, Peptides, and Proteins
- Proteins
- Organic Chemicals
- Hydrocarbons
- Cycloparaffins
- Hydrocarbons, Alicyclic
- Hydrocarbons, Cyclic
- Terpenes
- Polycyclic Compounds
- Antibodies, Monoclonal, Humanized
- Antibodies, Monoclonal
- Antibodies
- Immunoglobulins
- Immunoproteins
- Blood Proteins
- Serum Globulins
- Globulins
- Taxoids
- Cyclodecanes
- Diterpenes
- Macrolides
- Lactones
- Lactams, Macrocyclic
- Macrocyclic Compounds
- Maytansine
- Trastuzumab
- Ado-Trastuzumab Emtansine
- Paclitaxel
Other Study ID Numbers
- 21-159
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
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 Breast Cancer
-
Baylor Breast Care CenterRecruitingBreast Cancer | Breast Neoplasm | Triple Negative Breast Cancer | Triple Negative Breast Neoplasms | HER2-positive Breast Cancer | Breast Cancer Stage II | Breast Cancer Female | Breast Cancer Stage III | Estrogen Receptor-positive Breast Cancer | Hormone Receptor-positive Breast Cancer | Breast Cancer InvasiveUnited States
-
Innocrin PharmaceuticalCompletedBreast Cancer | Advanced Breast Cancer | Metastatic Breast Cancer | Triple Negative Breast Cancer | Male Breast Cancer | ER+ Breast Cancer | Cancer of the BreastUnited States
-
Northwestern UniversityEisai Inc.UnknownMale Breast Cancer | Stage II Breast Cancer | Stage IIIA Breast Cancer | Stage IIIB Breast Cancer | Triple-negative Breast Cancer | Stage IA Breast Cancer | Stage IB Breast Cancer | Stage IIIC Breast Cancer | Estrogen Receptor-negative Breast Cancer | Progesterone Receptor-negative Breast Cancer | HER2-negative...United States
-
Fred Hutchinson Cancer CenterNational Cancer Institute (NCI)CompletedInflammatory Breast Cancer | Male Breast Cancer | Stage IV Breast Cancer | Stage IIIB Breast Cancer | Estrogen Receptor-negative Breast Cancer | Estrogen Receptor-positive Breast Cancer | Progesterone Receptor-negative Breast Cancer | Progesterone Receptor-positive Breast CancerUnited States
-
University of Colorado, DenverCompletedStage IV Breast Cancer | Stage II Breast Cancer | Stage IIIA Breast Cancer | Stage IIIB Breast Cancer | Stage IA Breast Cancer | Stage IB Breast Cancer | Stage IIIC Breast CancerUnited States
-
Rutgers, The State University of New JerseyNational Cancer Institute (NCI); Rutgers Cancer Institute of New JerseyActive, not recruitingStage IIIA Breast Cancer | Stage IIIB Breast Cancer | Triple-negative Breast Cancer | Stage IIA Breast Cancer | Stage IIB Breast Cancer | Stage IIIC Breast Cancer | Estrogen Receptor-negative Breast Cancer | Progesterone Receptor-negative Breast Cancer | HER2-negative Breast CancerUnited States
-
University of Southern CaliforniaNational Cancer Institute (NCI)TerminatedMale Breast Cancer | Stage IV Breast Cancer | Stage II Breast Cancer | Stage IIIA Breast Cancer | Stage IIIB Breast Cancer | Stage IA Breast Cancer | Stage IB Breast Cancer | Stage IIIC Breast Cancer | Recurrent Breast CancerUnited States
-
National Cancer Institute (NCI)TerminatedMale Breast Cancer | Stage IV Breast Cancer | Stage IIIA Breast Cancer | Stage IIIB Breast Cancer | Triple-negative Breast Cancer | Stage IIIC Breast Cancer | Recurrent Breast Cancer | Estrogen Receptor-negative Breast Cancer | Progesterone Receptor-negative Breast Cancer | HER2-negative Breast CancerCanada
-
Mayo ClinicMarker Therapeutics, Inc.CompletedHER2-positive Breast Cancer | Male Breast Cancer | Stage II Breast Cancer | Stage IIIA Breast Cancer | Stage IIIB Breast Cancer | Stage IIIC Breast CancerUnited States
-
University of Central FloridaFlorida Department of HealthRecruitingBreast Cancer | Breast Cancer Female | Breast Cancer Diagnosis | Breast Cancer Survivors | Breast Cancer Detection | Breast Cancer AwarenessUnited States
Clinical Trials on trastuzumab-emtansine
-
Academic and Community Cancer Research UnitedNational Cancer Institute (NCI)WithdrawnAnatomic Stage IV Breast Cancer AJCC v8 | Prognostic Stage IV Breast Cancer AJCC v8 | HER2 Positive Breast Carcinoma | Metastatic Breast CarcinomaUnited States
-
Jenny C. Chang, MDGenentech, Inc.; The Methodist Hospital Research InstituteWithdrawnBreast CancerUnited States
-
National Cancer Institute (NCI)Active, not recruitingHematopoietic and Lymphoid Cell Neoplasm | Advanced Lymphoma | Advanced Malignant Solid Neoplasm | Refractory Lymphoma | Refractory Malignant Solid Neoplasm | Refractory Multiple MyelomaUnited States
-
Hoffmann-La RocheRoche Pharma AGCompletedMetastatic Breast CancerItaly, Spain, Canada, United States, Belgium, France, Germany
-
University of WashingtonNational Cancer Institute (NCI)CompletedStage IV Breast Cancer | Recurrent Breast Carcinoma | Stage IIIB Breast Cancer | Stage IIIC Breast Cancer | HER2/Neu PositiveUnited States
-
Genentech, Inc.Completed
-
Jules Bordet InstituteHoffmann-La RocheRecruitingHER2-positive Metastatic Breast Cancer | HER2-positive Advanced Breast CancerBelgium
-
Spectrum Pharmaceuticals, IncTerminatedBreast CancerUnited States
-
Hoffmann-La RocheCompletedBreast CancerUnited States, Canada, Spain, France, Italy
-
Consorzio OncotechRoche Pharma AGRecruiting