- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT00436709
Bevacizumab, Doxorubicin, and Cyclophosphamide Followed By Paclitaxel Albumin-Stabilized Nanoparticle Formulation and Bevacizumab in Treating Patients Who Have Undergone Surgery for Early-Stage Breast Cancer
A Pilot Study of Bevacizumab With Dose Dense Doxorubicin and Cyclophosphamide (AC) Followed by Dose Dense Nanoparticle Albumin Bound Paclitaxel for the Treatment of Early Stage 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. Bevacizumab may also stop the growth of breast cancer by blocking blood flow to the tumor. Drugs used in chemotherapy, such as doxorubicin, cyclophosphamide, and paclitaxel albumin-stabilized nanoparticle formulation, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving bevacizumab together with chemotherapy after surgery may kill any tumor cells that remain after surgery.
PURPOSE: This clinical trial is studying the side effects and how well giving bevacizumab together with doxorubicin and cyclophosphamide followed by paclitaxel albumin-stabilized nanoparticle formulation and bevacizumab works in treating patients who have undergone surgery for early-stage breast cancer.
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
- Droga: ciclofosfamide
- Altro: analisi di laboratorio dei biomarcatori
- Altro: tecnica immunoenzimatica
- Procedura: terapia adiuvante
- Droga: doxorubicina cloridrato
- Biologico: bevacizumab
- Altro: citometria a flusso
- Droga: formulazione di nanoparticelle stabilizzate con albumina di paclitaxel
- Altro: tecnica immunologica
- Biologico: pegfilgrastim
- Procedura: immunoscintigrafia
Descrizione dettagliata
OBJECTIVES:
Primary
- Determine the cardiac safety of adjuvant concurrent bevacizumab and dose-dense doxorubicin hydrochloride and cyclophosphamide followed by dose-dense paclitaxel albumin-stabilized nanoparticle formulation and maintenance therapy comprising bevacizumab alone in patients with early-stage breast cancer.
Secondary
- Determine the noncardiac toxicity of this regimen in these patients.
- Determine the efficacy of this regimen, in terms of time to tumor recurrence and overall survival, in these patients.
- Explore changes in circulating endothelial cells and circulating tumor cells from pre-treatment levels in patients with no evidence of disease.
- Prospectively explore the use of serial troponin I as a predictor of cardiac toxicity in patients treated with this regimen.
- Prospectively explore the relationship between plasma renin activity and hypertension in patients treated with bevacizumab and chemotherapy.
OUTLINE: This is a nonrandomized, pilot, multicenter study.
Patients receive doxorubicin hydrochloride IV, cyclophophamide IV, and bevacizumab IV over 30-90 minutes on day 1 and pegfilgrastim subcutaneously (SC) on day 2. Treatment repeats every 2 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. Patients then receive paclitaxel albumin-stabilized nanoparticle formulation IV over 30 minutes on day 1 and pegfilgrastim SC on day 2. Treatment with paclitaxel albumin-stabilized nanoparticle formulation and pegfilgrastim repeats every 2 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. Patients then receive maintenance therapy comprising bevacizumab IV over 30-90 minutes on day 1. Treatment with maintenance therapy repeats every 3 weeks for 12 courses in the absence of disease progression or unacceptable toxicity.
Blood samples are collected at baseline and periodically during study treatment. Samples are analyzed for circulating endothelial cells (by flow cytomery [FC]), circulating epithelial cells (by immunocytochemistry and FC), troponin I concentrations (by enzyme immunoassay or chemiluminescent microparticle immunoassay), and plasma renin activity (by radioimmunoassay).
After completion of study treatment, patients are followed every 4-6 months for 3 years, every 6 months for 2 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 75 patients will be accrued for this study.
Tipo di studio
Iscrizione (Anticipato)
Fase
- Non applicabile
Contatti e Sedi
Luoghi di studio
-
-
New York
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New York, New York, Stati Uniti, 10021
- Memorial Sloan-Kettering Cancer Center
-
-
Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed invasive breast cancer meeting the following criteria:
Early-stage disease
- No stage IV disease
- More than one synchronous primary breast tumor
- Lymph node positive OR high-risk lymph node negative
Candidate for treatment with anthracycline- and taxane-based chemotherapy in the adjuvant setting
- Must begin therapy within 84 days after the final required surgical procedure
- HER2/neu-negative breast cancer, defined as an immunohistochemistry (IHC) score of 0, 1+ or 2+ and fluorescent in situ hybridization (FISH) not amplified
- No CNS disease (e.g., primary brain tumor or brain metastasis)
- Hormone receptor status known
PATIENT CHARACTERISTICS:
- Male or female
- Pre- or post-menopausal
- ECOG performance status 0-1
- Absolute neutrophil count ≥ 1,000/mm^3
- Platelet count ≥ 100,000/mm^3
- Bilirubin normal
- AST or ALT ≤ 2.5 times upper limit of normal
- Creatinine normal OR creatinine clearance ≥ 60 mL/min
- Urine protein:creatinine ratio ≤ 1.0
- PT and PTT normal
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 6 months after completion of study therapy
- LVEF normal by MUGA scan at baseline
- No significant bleeding within the past 6 months
- No uncontrolled underlying bleeding diathesis
No nonmalignant systemic disease (e.g., cardiovascular, renal, or hepatic) that would preclude study therapy, including any of the following conditions:
- Blood pressure > 150/100 mm Hg
- Unstable angina
- New York Heart Association class II -IV congestive heart failure
- Myocardial infarction or stroke within the past 12 months
- Clinically significant peripheral vascular disease
- No seizures not controlled with standard medical therapy
- No history of stroke
- No known allergy or hypersensitivity to study drugs (prior hypersensitivity to paclitaxel allowed)
- No significant traumatic injury within the past 28 days
- No serious nonhealing wound, ulcer, or bone fracture
- No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months
- No active gastroduodenal ulcer
- No uncontrolled intercurrent illness, including psychiatric illness or social situation that would limit compliance with study requirements
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
Prior therapy for an ipsilateral or contralateral breast cancer primary allowed provided the following criteria are met:
- No prior anthracycline therapy
- Prior hormonal therapy for this previous breast cancer is allowed, but must be stopped during study therapy
- At least 1 year since prior taxane therapy
More than 28 days since prior and no concurrent major surgery or open biopsy
- Anticipated reconstructive surgery (e.g., tissue expander exchange) is allowed during the course of the study (bevacizumab will be held during that time as per protocol guidelines)
More than 7 days since prior minor surgery, including fine-needle aspiration or core biopsy
- At least 24 hours since prior indwelling catheter placement
- No prior bevacizumab or other KDR inhibitors (e.g., VEGF Trap, semaxanib, SU6668, vandetanib, vatalanib, AEE788, or IMC-1CII)
- No concurrent full-dose anticoagulation therapy
- No concurrent hormonal therapy as chemoprevention
- Concurrent participation in adjuvant hormone therapy or correlative or companion (e.g., bisphosphonate clinic) studies allowed
- No other concurrent anticancer therapy
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Non randomizzato
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
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Sicurezza
|
Misure di risultato secondarie
Misura del risultato |
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Sopravvivenza globale
|
Noncardiac toxicity
|
Time to tumor recurrence
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Collaboratori e investigatori
Collaboratori
Investigatori
- Cattedra di studio: Maura N. Dickler, MD, Memorial Sloan Kettering Cancer Center
Studiare le date dei record
Studia le date principali
Inizio studio
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Stima)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Stima)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Malattie della pelle
- Neoplasie
- Neoplasie per sede
- Malattie del seno
- Neoplasie mammarie
- Effetti fisiologici delle droghe
- Meccanismi molecolari dell'azione farmacologica
- Inibitori enzimatici
- Agenti antireumatici
- Agenti antineoplastici
- Agenti immunosoppressivi
- Fattori immunologici
- Modulatori della tubulina
- Agenti antimitotici
- Modulatori della mitosi
- Agenti Antineoplastici, Alchilanti
- Agenti Alchilanti
- Agonisti mieloablativi
- Agenti antineoplastici, fitogenici
- Inibitori della topoisomerasi II
- Inibitori della topoisomerasi
- Agenti antineoplastici, immunologici
- Inibitori dell'angiogenesi
- Agenti di modulazione dell'angiogenesi
- Sostanze per la crescita
- Inibitori della crescita
- Antibiotici, Antineoplastici
- Ciclofosfamide
- Paclitaxel
- Bevacizumab
- Paclitaxel legato all'albumina
- Doxorubicina
- Doxorubicina liposomiale
Altri numeri di identificazione dello studio
- CDR0000529855
- MSKCC-06019
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .
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