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Efficacy and Tolerance Study of Bevacizumab in Her2- Inflammatory Breast Cancer Patients (Beverly1)

18. oktober 2019 opdateret af: UNICANCER

Phase II Study Evaluating the Efficacy and Tolerance of Bevacizumab (Avastin) in HER2- Inflammatory Breast Cancer

RATIONALE: Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Drugs used in chemotherapy work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving bevacizumab and combination chemotherapy before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. Giving bevacizumab and radiation therapy after surgery may kill any tumor cells that remain after surgery.

PURPOSE: This phase II trial is studying giving bevacizumab together with chemotherapy before surgery and bevacizumab and radiation therapy after surgery to see how well it works in treating patients with inflammatory breast cancer.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

OBJECTIVES:

Primary

  • Evaluate the complete histological response rate in patients with inflammatory HER2-negative breast cancer treated with bevacizumab and concurrent chemotherapy followed by bevacizumab and concurrent hormonal therapy after surgery and radiotherapy.

Secondary

  • Evaluate the progression-fee and overall survival of these patients at 3 and 5 years.
  • Evaluate the tolerance of bevacizumab in these patients.
  • Assess circulating metastatic disease before, during, and after treatment.
  • Assess circulating endothelial cells before, during, and after treatment.
  • Assess predictive factors of response by genomic and proteomic studies on frozen tumor samples and fluid samples (i.e., serum and plasma).

OUTLINE: This is a multicenter study.

  • Neoadjuvant induction therapy:

    • Courses 1-4: Patients receive bevacizumab IV over 30-90 minutes, fluorouracil IV, epirubicin hydrochloride IV over 10 minutes, and cyclophosphamide IV over 5 minutes on day 1.
    • Courses 5-8: Patients receive bevacizumab IV over 30-90 minutes and docetaxel IV over 1 hour on day 1.

Treatment repeats every 21 days for 8 courses in the absence of disease progression or unacceptable toxicity.

  • Surgery: Patients undergo surgery 4-6 weeks after completion of bevacizumab.

  • Adjuvant therapy: Beginning 2-4 weeks after surgery, patients undergo radiotherapy for 6 weeks. Patients also receive bevacizumab IV over 30-90 minutes beginning 2-4 weeks after surgery, during the radiotherapy period. Treatment with bevacizumab repeats every 3 weeks for 30 weeks in the absence of disease progression or unacceptable toxicity. Patients who are estrogen receptor- or progesterone receptor-positive (≥ 10% by IHC) receive the following concurrent hormonal therapy beginning in week 7:

    • Premenopausal patients: Patients receive tamoxifen citrate for 5 years.
    • Postmenopausal patients: Patients receive aromatase-inhibitor therapy (or tamoxifen citrate if unable to tolerate anti-aromatase therapy) for 5 years.
    • Perimenopausal patients: Patients receive tamoxifen citrate for 2-3 years and aromatase-inhibitor therapy for 2-3 years OR tamoxifen citrate for 5 years followed by aromatase-inhibitor therapy for 2-3 years (if follicle-stimulating hormone > 30 IU/L and/or estradiol < 30 ng/L).

After completion of study treatment, patients are followed for at least 3 years.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

100

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Frankrig
      • Angers, Frankrig, 49036
        • Centre Paul Papin
      • Avignon, Frankrig, 84000
        • Institut Sainte Catherine
      • Besancon, Frankrig, 25030
        • Centre Hospitalier Regional de Besancon - Hopital Jean Minjoz
      • Bordeaux, Frankrig, 33076
        • Institut Bergonié
      • Bordeaux, Frankrig, 33300
        • Polyclinique Bordeaux Nord Aquitaine
      • Caen, Frankrig, 14076
        • Centre Regional Francois Baclesse
      • Clermont-Ferrand, Frankrig, 63011
        • Centre Jean Perrin
      • Dijon, Frankrig, 21079
        • Centre de Lutte Contre le Cancer Georges-Francois Leclerc
      • Le Havre, Frankrig, 76600
        • CMC Les Ormeaux
      • Lille, Frankrig, 59020
        • Centre Oscar Lambret
      • Lyon, Frankrig, 69373
        • Centre léon bérard
      • Marseille, Frankrig, 13273
        • Marseille Institute of Cancer - Institut J. Paoli and I. Calmettes
      • Montbeliard, Frankrig, 25209
        • Centre Hospitalier General Andre Boulloche
      • Montpellier, Frankrig, 34298
        • Centre Regional de Lutte Contre le Cancer - Centre Val d'Aurelle
      • Nantes, Frankrig, 02
        • Centre Catherine de Sienne
      • Nice, Frankrig, 06189
        • Centre Antoine Lacassagne
      • Paris, Frankrig, 75248
        • Institut Curie Hopital
      • Reims, Frankrig, 51056
        • Institut Jean Godinot
      • Rennes, Frankrig, 35042
        • Centre Eugène Marquis
      • Rouen, Frankrig, 76038
        • Centre Henri Becquerel
      • Saint Brieuc, Frankrig, F-22015
        • Clinique Armoricaine de Radiologie
      • Saint Cloud, Frankrig, 92211
        • Centre Rene Huguenin
      • Saint-Herblain, Frankrig, 44805
        • CRLCC Nantes - Atlantique
      • Strasbourg, Frankrig, 67065
        • Centre Paul Strauss
      • Strasbourg, Frankrig, 67091
        • Hopitaux Universitaire de Strasbourg
      • Toulouse, Frankrig, 31052
        • Institut Claudius Regaud
      • Vandoeuvre-les-Nancy, Frankrig, 54511
        • Centre Alexis Vautrin
      • Villejuif, Frankrig, F-94805
        • Institut Gustave Roussy

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

DISEASE CHARACTERISTICS:

  • Histologically confirmed inflammatory breast cancer, meeting 1 of the following staging criteria:

    • T4d, any N (AJCC stage IIIB or IIIC)

    • Gustave-Roussy Institute (IGR) classification Poussee evolutirie (PEV; measures tumor growth over time) 2

      • PEV 2: tumor with underlying breast tissue, especially skin, that is affected by subacute inflammation and edema involving < ½ of breast surface

    • IGR classification PEV 3

      • PEV 3: acute or subacute inflammation and edema involving > ½ of breast surface
    • Biopsy-confirmed presence of tumor embolism in surface lymph nodes
  • HER2-negative (HER2 0 or 1+, or HER2 2+ by IHC if FISH-negative allowed)
  • No metastatic disease
  • No non-inflammatory breast cancer with edema, ulceration, or satellite skin nodules
  • No bilateral breast cancer
  • Hormone receptor status known

PATIENT CHARACTERISTICS:

  • Any menopausal status allowed
  • WHO performance status 0-2
  • Life expectancy ≥3 months
  • LVEF normal by ECHO
  • ANC >1.5 x 10^9/L
  • Platelet count >100 x 10^9/L
  • INR ≤1.5 (except for patients on prophylactic anticoagulants)
  • aPTT ≤1.5 times upper limit of normal (ULN)
  • Total bilirubin normal
  • SGOT and SGPT ≤1.25 times ULN
  • Alkaline phosphatase ≤2.5 times ULN
  • Creatinine clearance ≥60 mL/min
  • Proteinuria <2+ or 24-hour urine protein ≤1 g
  • No unhealed wound, stomach ulcer, or bone fracture
  • No history of thrombotic or hemorrhagic disorders

  • No significant cardiovascular disease including the following:

    • Cerebrovascular accident within the past 6 months
    • Unstable angina
    • Cardiac failure
    • Myocardial infarction
    • Arrhythmia requiring treatment
  • No uncontrolled hypertension (i.e., systolic BP >150 mm Hg and/or diastolic BP >100 mm Hg)
  • No other active infection or serious illness that would preclude patient from receiving study treatment
  • No hypersensitivity to any active products or excipients of study drugs
  • Not pregnant or nursing
  • Fertile patients must use effective contraception during and for 6 months after completion of study treatment
  • No social or psychologic reasons that would prevent study compliance or follow-up
  • No patients who are incarcerated or on probation

PRIOR CONCURRENT THERAPY:

  • No prior chemotherapy, radiotherapy, or hormonal therapy for this disease
  • More than 4 weeks since prior surgery (diagnostic biopsy or installation of implant allowed)
  • More than 10 days since prior chronic non-inflammatory steroids (e.g., acetylsalicylic acid >325 mg/day) or platelet anticoagulation treatment (e.g., dipyridamole, ticlopidine, clodiprogel, cilostazol)
  • More than 10 days since prior oral or parenteral anticoagulant or thrombolytic drugs (preventative thrombolytic drugs allowed)
  • No concurrent participation in another experimental clinical trial

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: (FEC / Docetaxel) + Bevacizumab
Neoadjuvant treatment: 4 cycles FEC + Bevacizumab followed by 4 cycles Docetaxel + Bevacizumab Adjuvant: Bevacizumab for 1 year
Medicin: epirubicin hydrochlorid
Neoadjuvans: 100 mg/m2, d1 q3w, 4 cyklusser
Medicin: fluorouracil
Neoadjuvans: 500 mg/m2, d1 q3w, 4 cyklusser
Biologisk: bevacizumab
During neoadjuvant phase: 15 mg/kg, d1 q3w, 8 cycles During adjuvant phase:15 mg/kg, d1 q3w, 10 cycles
Medicin: cyclophosphamide
Neoadjuvant: 500 mg/m2 d1 q3w, 4 cycles
Medicin: docetaxel
Neoadjuvant: 100 mg/m2 q3w, 4 cycles

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
Complete histologic response rate
Tidsramme: Post surgery
Post surgery

Sekundære resultatmål

Resultatmål
Tidsramme
Progressionsfri overlevelse
Tidsramme: 3 og 5 år
3 og 5 år
Samlet overlevelse
Tidsramme: 3 og 5 år
3 og 5 år
Toxicity as assessed by CTCAE v3.0
Tidsramme: 3 and 5 years
3 and 5 years
Predictive factors of response to bevacizumab
Tidsramme: 3 and 5 years
3 and 5 years
Circulating peripheral cells (circulating endothelial and tumor cells): correlation of initial rate and association with histological response after surgery
Tidsramme: Post-surgery
Post-surgery
Genomic and proteomic analyses and correlation with histologic response
Tidsramme: Post surgery
Post surgery

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

UNICANCER

Efterforskere

  • Ledende efterforsker: Patrice Viens, MD, Institut Paoli-Calmettes

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Hjælpsomme links

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. januar 2009

Primær færdiggørelse (Faktiske)

1. april 2015

Studieafslutning (Faktiske)

1. september 2019

Datoer for studieregistrering

Først indsendt

9. januar 2009

Først indsendt, der opfyldte QC-kriterier

9. januar 2009

Først opslået (Skøn)

12. januar 2009

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

22. oktober 2019

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

18. oktober 2019

Sidst verificeret

1. oktober 2019

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • PACS09 UC-0140/0802
  • UNICANCER-PACS-09-0802 (Anden identifikator: Internal Id Number)
  • 2008-001807-53 (EudraCT nummer)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

Unicancer will share de-identified individual data that underlie the results reported under the following conditions: the data shared will be limit to that required for independent mandated verification of the published results, the applicant will need authorization from Unicancer for personal access, and data will only be transferred after signing of a data access agreement. A decision concerning the sharing of other study documents, including protocol and statistical analysis plan will be examined upon request.

IPD-delingstidsramme

Unicancer will consider access to study data upon written detailed request sent to Unicancer, from 6 months until 5 years after publication of summary data.

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL
  • SAP

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Brystkræft

Kliniske forsøg med epirubicin hydrochlorid

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