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Chemotherapy Plus Monoclonal Antibody Therapy in Treating Women With Stage II or Stage IIIA Breast Cancer That Overexpresses HER2

31 de mayo de 2013 actualizado por: National Cancer Institute (NCI)

Pilot Trial of Paclitaxel-Herceptin Adjuvant Therapy for Early Stage Breast Cancer

Randomized phase II trial to study the effectiveness of chemotherapy with paclitaxel and the monoclonal antibody trastuzumab followed by chemotherapy in treating women who have stage II or stage IIIA breast cancer that overexpresses HER2. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Monoclonal antibodies can locate tumor cells and deliver tumor-killing substances to them without harming normal cells. Combining monoclonal antibody therapy with chemotherapy may kill more tumor cells.

Descripción general del estudio

Estado

Terminado

Condiciones

Cáncer de mama

Intervención / Tratamiento

Descripción detallada

OBJECTIVES:

I. Evaluate the safety of paclitaxel plus trastuzumab (Herceptin) followed by adjuvant chemotherapy in women with node positive stage II or IIIa breast cancer with HER2 overexpression.

II. Evaluate the safety of long term trastuzumab (Herceptin) in this patient population.

OUTLINE: This is a randomized study. Patients are stratified according to radiotherapy (none planned vs planned to breast or chest wall). Patients are randomized to one of two treatment arms.

ARM I: Patients receive paclitaxel IV over 3 hours immediately followed by trastuzumab (Herceptin) IV over 30-90 minutes on day 1. Paclitaxel repeats every 3 weeks for 4 courses and trastuzumab (Herceptin) repeats weekly for 10 courses. At 3 weeks following paclitaxel and trastuzumab (Herceptin), patients receive doxorubicin IV and cyclophosphamide IV over 1 hour every 3 weeks for 4 courses. Following chemotherapy, estrogen receptor (ER) positive and/or progesterone receptor (PR) positive patients receive oral tamoxifen twice daily for 5 years.

ARM II: Patients receive same therapy as in Arm I, except for additional trastuzumab (Herceptin) IV weekly beginning within 3 weeks following completion of chemotherapy and local therapy and continuing for 1 year. ER and/or PR positive patients receive tamoxifen as in Arm I but may be concurrent with trastuzumab (Herceptin). Following completion of doxorubicin and cyclophosphamide, post lumpectomy and post mastectomy patients may receive local radiotherapy daily for 5-6 weeks. Treatment continues in the absence of disease progression or unacceptable toxicity.

Patients are followed every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.

PROJECTED ACCRUAL: A total of 200 patients (100 per treatment arm) will be accrued for this study within 1 year.

Tipo de estudio

Intervencionista

Inscripción (Actual)

200

Fase

Fase 2

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

Estados Unidos
- California
  - Palo Alto, California, Estados Unidos, 94304
    - Veterans Affairs Medical Center - Palo Alto
  - Stanford, California, Estados Unidos, 94305-5408
    - Stanford University Medical Center
- Colorado
  - Denver, Colorado, Estados Unidos, 80209-5031
    - CCOP - Colorado Cancer Research Program, Inc.
- Florida
  - Tampa, Florida, Estados Unidos, 33612
    - H. Lee Moffitt Cancer Center and Research Institute
- Georgia
  - Atlanta, Georgia, Estados Unidos, 30322
    - Emory University Hospital - Atlanta
  - Decatur, Georgia, Estados Unidos, 30033
    - Veterans Affairs Medical Center - Atlanta (Decatur)
- Illinois
  - Chicago, Illinois, Estados Unidos, 60611
    - Robert H. Lurie Comprehensive Cancer Center, Northwestern University
  - Chicago, Illinois, Estados Unidos, 60611
    - Veterans Affairs Medical Center - Chicago (Lakeside)
  - Decatur, Illinois, Estados Unidos, 62526
    - CCOP - Central Illinois
  - Evanston, Illinois, Estados Unidos, 60201
    - CCOP - Evanston
  - Peoria, Illinois, Estados Unidos, 61602
    - CCOP - Illinois Oncology Research Association
  - Urbana, Illinois, Estados Unidos, 61801
    - CCOP - Carle Cancer Center
- Indiana
  - Indianapolis, Indiana, Estados Unidos, 46202
    - Veterans Affairs Medical Center - Indianapolis (Roudebush)
- Iowa
  - Cedar Rapids, Iowa, Estados Unidos, 52403-1206
    - CCOP - Cedar Rapids Oncology Project
- Kansas
  - Wichita, Kansas, Estados Unidos, 67214-3882
    - CCOP - Wichita
- Louisiana
  - New Orleans, Louisiana, Estados Unidos, 70121
    - CCOP - Ochsner
- Maryland
  - Baltimore, Maryland, Estados Unidos, 21231
    - Johns Hopkins Oncology Center
- Massachusetts
  - Boston, Massachusetts, Estados Unidos, 02215
    - Beth Israel Deaconess Medical Center
  - Boston, Massachusetts, Estados Unidos, 02111
    - New England Medical Center Hospital
- Michigan
  - Ann Arbor, Michigan, Estados Unidos, 48106
    - CCOP - Ann Arbor Regional
  - Kalamazoo, Michigan, Estados Unidos, 49007-3731
    - CCOP - Kalamazoo
- Minnesota
  - Rochester, Minnesota, Estados Unidos, 55905
    - Mayo Clinic Cancer Center
  - Saint Louis Park, Minnesota, Estados Unidos, 55416
    - CCOP - Metro-Minnesota
- Nebraska
  - Omaha, Nebraska, Estados Unidos, 68131
    - CCOP - Missouri Valley Cancer Consortium
- New Jersey
  - Elizabeth, New Jersey, Estados Unidos, 07201
    - Trinitas Hospital - Jersey Street Campus
  - Flemington, New Jersey, Estados Unidos, 08822
    - Hunterdon Regional Cancer Program
  - Hackensack, New Jersey, Estados Unidos, 07601
    - Hackensack University Medical Center
  - Hackensack, New Jersey, Estados Unidos, 07601
    - CCOP - Northern New Jersey
  - Morristown, New Jersey, Estados Unidos, 07962-1956
    - Morristown Memorial Hospital
- New York
  - Albany, New York, Estados Unidos, 12208
    - Veterans Affairs Medical Center - Albany
  - Bronx, New York, Estados Unidos, 10461
    - Albert Einstein Comprehensive Cancer Center
  - New York, New York, Estados Unidos, 10016
    - Kaplan Cancer Center
  - New York, New York, Estados Unidos, 10010
    - Veterans Affairs Medical Center - New York
  - Rochester, New York, Estados Unidos, 14642
    - University of Rochester Cancer Center
- North Dakota
  - Fargo, North Dakota, Estados Unidos, 58122
    - CCOP - Merit Care Hospital
- Ohio
  - Cleveland, Ohio, Estados Unidos, 44106-5065
    - Ireland Cancer Center
- Oklahoma
  - Tulsa, Oklahoma, Estados Unidos, 74136
    - CCOP - Sooner State
- Pennsylvania
  - Philadelphia, Pennsylvania, Estados Unidos, 19104
    - University of Pennsylvania Cancer Center
  - Wynnewood, Pennsylvania, Estados Unidos, 19096
    - CCOP - MainLine Health
- Tennessee
  - Nashville, Tennessee, Estados Unidos, 37232-6838
    - Vanderbilt Cancer Center
- Wisconsin
  - Madison, Wisconsin, Estados Unidos, 53705
    - Veterans Affairs Medical Center - Madison
  - Madison, Wisconsin, Estados Unidos, 53792
    - University of Wisconsin Comprehensive Cancer Center
  - Milwaukee, Wisconsin, Estados Unidos, 53226
    - Medical College of Wisconsin
  - Milwaukee, Wisconsin, Estados Unidos, 53295
    - Veterans Affairs Medical Center - Milwaukee (Zablocki)
Sudáfrica
- - Pretoria, Sudáfrica, 0001
    - Pretoria Academic Hospital

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

Géneros elegibles para el estudio

Femenino

Descripción

DISEASE CHARACTERISTICS:

Histologically confirmed stage II or IIIa (T1-T3, N1-N2, M0) adenocarcinoma of the breast HER2 overexpression (2-3+ by immunochemistry)
Bilateral breast cancer allowed
Must have had local breast cancer surgery within past 12 weeks
Mastectomy or lumpectomy with clear surgical margins AND axillary lymph node dissection with at least 6 nodes removed
Hormone receptor status: Not specified

PATIENT CHARACTERISTICS:

Age: 18 and over
Sex: Female
WBC at least 3,000/mm3
Platelet count at least 100,000/mm3
Hemoglobin at least 9 g/dL
Bilirubin no greater than 1.5 times upper limit of normal (ULN)
Creatinine no greater than 1.5 times ULN
LVEF at least 50%
No history of congestive cardiomyopathy
No congestive heart failure or myocardial infarction within the past 6 months
No uncontrolled hypertension
No uncontrolled arrhythmia within the past 6 months
No other prior malignancy within the past 5 years except curatively treated basal or squamous cell skin cancer or carcinoma in situ of the cervix
No other serious medical illness that would limit survival to less than 2 years
No psychiatric condition precluding study
Not pregnant or nursing
Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

No prior chemotherapy for breast cancer
No prior hormonal therapy for breast cancer
At least one year since prior tamoxifen for chemoprevention (e.g., Breast Cancer Prevention Trial)
No prior radiotherapy to the breast, chest wall, or regional lymph nodes

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

Propósito principal: Tratamiento
Asignación: Aleatorizado
Modelo Intervencionista: Asignación paralela
Enmascaramiento: Ninguno (etiqueta abierta)

Número de brazos

Armas e Intervenciones

Grupo de participantes/brazo	Intervención / Tratamiento
Experimental: Arm I Patients receive paclitaxel IV over 3 hours immediately followed by trastuzumab (Herceptin) IV over 30-90 minutes on day 1. Paclitaxel repeats every 3 weeks for 4 courses and trastuzumab (Herceptin) repeats weekly for 10 courses. At 3 weeks following paclitaxel and trastuzumab (Herceptin), patients receive doxorubicin IV and cyclophosphamide IV over 1 hour every 3 weeks for 4 courses. Following chemotherapy, estrogen receptor (ER) positive and/or progesterone receptor (PR) positive patients receive oral tamoxifen twice daily for 5 years.	Droga: ciclofosfamida Droga: clorhidrato de doxorrubicina Droga: paclitaxel Biológico: trastuzumab Droga: citrato de tamoxifeno
Experimental: Arm II Patients receive same therapy as in Arm I, except for additional trastuzumab (Herceptin) IV weekly beginning within 3 weeks following completion of chemotherapy and local therapy and continuing for 1 year. ER and/or PR positive patients receive tamoxifen as in Arm I but may be concurrent with trastuzumab (Herceptin). Following completion of doxorubicin and cyclophosphamide, post lumpectomy and post mastectomy patients may receive local radiotherapy daily for 5-6 weeks. Treatment continues in the absence of disease progression or unacceptable toxicity.	Droga: ciclofosfamida Droga: clorhidrato de doxorrubicina Droga: paclitaxel Biológico: trastuzumab

Grupo de participantes/brazo

Intervención / Tratamiento

Experimental: Arm I

Patients receive paclitaxel IV over 3 hours immediately followed by trastuzumab (Herceptin) IV over 30-90 minutes on day 1. Paclitaxel repeats every 3 weeks for 4 courses and trastuzumab (Herceptin) repeats weekly for 10 courses. At 3 weeks following paclitaxel and trastuzumab (Herceptin), patients receive doxorubicin IV and cyclophosphamide IV over 1 hour every 3 weeks for 4 courses. Following chemotherapy, estrogen receptor (ER) positive and/or progesterone receptor (PR) positive patients receive oral tamoxifen twice daily for 5 years.

Droga: ciclofosfamida

Droga: clorhidrato de doxorrubicina

Droga: paclitaxel

Biológico: trastuzumab

Droga: citrato de tamoxifeno

Experimental: Arm II

Patients receive same therapy as in Arm I, except for additional trastuzumab (Herceptin) IV weekly beginning within 3 weeks following completion of chemotherapy and local therapy and continuing for 1 year. ER and/or PR positive patients receive tamoxifen as in Arm I but may be concurrent with trastuzumab (Herceptin). Following completion of doxorubicin and cyclophosphamide, post lumpectomy and post mastectomy patients may receive local radiotherapy daily for 5-6 weeks. Treatment continues in the absence of disease progression or unacceptable toxicity.

Droga: ciclofosfamida

Droga: clorhidrato de doxorrubicina

Droga: paclitaxel

Biológico: trastuzumab

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

National Cancer Institute (NCI)

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Publicaciones Generales

Sledge GW, O'Neill A, Thor A, et al.: Adjuvant trastuzumab: long-term results of E2198. [Abstract] Breast Cancer Res Treat 100 (Suppl 1): A-2075, S106, 2006.

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de agosto de 1999

Finalización primaria (Actual)

1 de enero de 2007

Finalización del estudio (Actual)

1 de marzo de 2009

Fechas de registro del estudio

Enviado por primera vez

1 de noviembre de 1999

Primero enviado que cumplió con los criterios de control de calidad

8 de junio de 2004

Publicado por primera vez (Estimar)

9 de junio de 2004

Actualizaciones de registros de estudio

Última actualización publicada (Estimar)

3 de junio de 2013

Última actualización enviada que cumplió con los criterios de control de calidad

31 de mayo de 2013

Última verificación

1 de marzo de 2013

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

NCI-2012-02305
E-2198
CDR0000067197 (Identificador de registro: PDQ (Physician Data Query))

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .