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Prediction of Response to Neoadjuvant Chemotherapy in Women With Operable Breast Cancer (PT-304)

4 ottobre 2012 aggiornato da: Precision Therapeutics
The objective of this study is to develop a biomarker to predict pathological complete response in women treated with neoadjuvant chemotherapy for breast cancer. Such a biomarker would assist physicians in selecting the most effective chemotherapy for the individual patient.

Panoramica dello studio

Stato

Terminato

Condizioni

Intervento / Trattamento

Descrizione dettagliata

The objective of this study is to develop a biomarker to predict pathological complete response in women treated with neoadjuvant chemotherapy for breast cancer. Such a biomarker would assist physicians in selecting the most effective chemotherapy for the individual patient. The anticipated biomarker will take into account clinical factors (such as tumor stage, tumor size, and age), phenotypic characteristics of the tumor (determined by pathological immunohistochemistry and ex vivo ChemoResponse assay), and genotypic characteristics of the tumor and patient (determined by genomic profiling via gene expression analysis of tumor RNA). It is expected that collective consideration of all of these factors will be more predictive of patient response to therapy than any of them alone.

Approximately 224 evaluable subjects will be recruited from approximately 30 US sites. Women with measurable operable invasive breast cancer diagnosed by core needle biopsy will be eligible for this study. Additional tumor specimens will be obtained prior to the start of chemotherapy via core needle biopsies to be used for the ex vivo ChemoResponse Assay and tumor genomic analysis (gene expression), respectively.

All subjects will receive neoadjuvant chemotherapy with one of two standard of care regimens that must consist of the following agents: doxorubicin (A), cyclophosphamide (C), and a taxane (T) such as docetaxel, paclitaxel, or Abraxane (nanoparticle albumin-bound paclitaxel [nab-paclitaxel]); or, docetaxel (T) and cyclophosphamide (C). These must be administered per NCCN guidelines by the treating physician.

Upon completion of chemotherapy treatment, women will undergo lumpectomy, modified radical mastectomy or other surgical procedure determined appropriate by the investigator and at that time will be evaluated for pathological response. At the time of lumpectomy, modified radical mastectomy, or other surgical procedure, additional tumor excess will be sent to Precision Therapeutics, Inc. (Precision) for exploratory analysis if there is no pathologic complete response (pCR), if there are sufficient tumor cells to send, and if the patient agrees to have her excess tumor cells sent to Precision for this purpose.

During the patient's course of participation on the study, the treating physician will remain blinded to the results of the ChemoResponse Assay and genomic analysis. If it is determined there is no pCR at the time of lumpectomy, modified radical mastectomy or other surgical procedure, Precision will make available a subsequent report to the physician containing additional information about chemotherapy drugs other than ACT that could benefit the further treatment decisions for the patient.

Tipo di studio

Osservativo

Iscrizione (Effettivo)

134

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

  • Stati Uniti
    • California
      • Long Beach, California, Stati Uniti, 90806
        • Breastlink Medical Group, Inc
      • Los Angeles, California, Stati Uniti, 90033
        • USC/Norris Comprehensive Cancer Center
    • Florida
      • Miami, Florida, Stati Uniti, 33176
        • Advanced Medical Specialties
    • Georgia
      • Marietta, Georgia, Stati Uniti, 30060
        • Advanced Breast Care
    • Missouri
      • Columbia, Missouri, Stati Uniti, 65201
        • Missouri Cancer Associates
    • Nevada
      • Henderson, Nevada, Stati Uniti, 89074
        • Comprehensive Cancer Centers of Nevada
      • Las Vegas, Nevada, Stati Uniti, 89106
        • Breast Care
    • New Jersey
      • Morristown, New Jersey, Stati Uniti, 07962
        • Morristown Memorial Hospital
    • New York
      • New York, New York, Stati Uniti, 10003
        • Beth Israel Medical Center
    • Oklahoma
      • Oklahoma City, Oklahoma, Stati Uniti, 73104
        • OU Medical Center
    • Oregon
      • Springfield, Oregon, Stati Uniti, 97477
        • Willamette Valley Cancer Institute and Research Center
    • Pennsylvania
      • Allentown, Pennsylvania, Stati Uniti, 18104
        • Breast Care Specialists, P.C.
      • Pittsburgh, Pennsylvania, Stati Uniti, 15213
        • Magee Womens Hospital
    • Rhode Island
      • Providence, Rhode Island, Stati Uniti, 02905
        • Women & Infants Hospital
    • Tennessee
      • Germantown, Tennessee, Stati Uniti, 38138
        • Breast Clinic of Memphis
      • Nashville, Tennessee, Stati Uniti, 37203
        • Tennessee Breast Specialists
      • Nashville, Tennessee, Stati Uniti, 37203
        • Advantage Clinical Research
    • Texas
      • Bedford, Texas, Stati Uniti, 76022
        • Texas Oncology - Bedford
      • Dallas, Texas, Stati Uniti, 75231
        • Texas Oncology - Dallas Presbyterian Hospital
      • Dallas, Texas, Stati Uniti, 75246
        • Texas Oncology - Baylor Charles A. Sammons Cancer Center
      • Dallas, Texas, Stati Uniti, 75230
        • Dallas Surgical Group
      • Dallas, Texas, Stati Uniti, 75230
        • Leading Edge Research, PA
      • Houston, Texas, Stati Uniti, 77024
        • Texas Oncology - Memorial City
      • San Antonio, Texas, Stati Uniti, 78217
        • Cancer Care Centers of South Texas
      • Southlake, Texas, Stati Uniti, 76092
        • Southlake Oncology
      • Tyler, Texas, Stati Uniti, 75702
        • Texas Oncology - Tyler
    • Virginia
      • Norfolk, Virginia, Stati Uniti, 23502
        • Virginia Oncology Associates
    • Wisconsin
      • Milwaukee, Wisconsin, Stati Uniti, 53233
        • Aurora Sinai Medical Center

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Femmina

Metodo di campionamento

Campione non probabilistico

Popolazione di studio

Women 18 years or older with Palpable Operable Breast Cancer Measurable Disease

Descrizione

Inclusion Criteria

Female subjects who satisfy the following conditions will be considered for enrollment into the study:

  1. The subject must consent to be in the research study and must have signed an approved consent form conforming to institutional guidelines prior to study entry.
  2. The diagnosis of breast cancer can be made by FNA or biopsy (other than incisional or excisional). The tumor specimen must demonstrate a diagnosis of invasive adenocarcinoma.
  3. The primary breast cancer must be operable and measurable "greater than or equal to" 2.0 cm by use of physical exam and/or ultrasound, MRI, CT scan, or mammogram.
  4. T1c, T2, T3, or T4 patients clinically staged as M0 (non-inflammatory) are eligible.
  5. Patients with a prior diagnosis and treatment for DCIS are eligible.
  6. Patients with multi-focal breast cancer are eligible.
  7. The tumor must be confined to either the breast or to the breast and ipsilateral axilla.
  8. The subject must be 18 years or older.
  9. The interval between initial cytologic or histologic diagnosis of breast cancer and registration must be no more than 10 weeks.
  10. ECOG Performance Status of 0 or 1 (see Appendix A) is required.
  11. The subject must receive standard of care chemotherapy regimens consisting of either doxorubicin (A), cyclophosphamide (C), and a taxane (T) such as docetaxel, paclitaxel, or nab-paclitaxel administered in any sequence and combination the treating physician determines or docetaxel (T) plus cyclophosphamide (C).

Exclusion Criteria

Male subjects are not eligible for this study as the incidence of breast cancer in male subjects is significantly lower than female subjects. Those subjects who are strongly HER2-positive will be excluded as they will require treatment by biological agents for which the ChemoResponse Assay has not yet been validated. Subjects with evidence of distant metastatic disease are excluded as these subjects would not be good candidates for neoadjuvant therapy. Women who have had an excisional or incisional biopsy prior to entry would not have sufficient tumor sample to test or to be measured by physical exam for the study. Women who have nonmalignant comorbid conditions and diseases that would preclude them from being treated with doxorubicin (A), cyclophosphamide (C), and a taxane (T), and from completing the study are also excluded. Women with psychiatric or addictive disorders are excluded to protect those vulnerable subjects who may not be able to adequately give informed consent.

Women with one or more of the following conditions will be ineligible for this study:

  1. Tumor determined to be strongly HER2-positive by immunohistochemistry (3+) or by fluorescent in situ hybridization (positive for gene amplification)
  2. Definitive clinical or radiologic evidence of distant metastatic disease.
  3. Excisional or incisional biopsy for this primary breast tumor.
  4. Inflammatory breast cancer.
  5. Synchronous contra-lateral breast cancer.
  6. Multi-centric breast cancer.
  7. Participation in the NSABP B-40 study.

  8. Prior therapy for invasive breast cancer, including irradiation, chemo-, immuno-, and/or hormonal therapy.

    a. Note: the only exception is hormonal therapy, which may have been given anytime after diagnosis and before study entry as long as the hormonal therapy is discontinued at or before registration. After surgery, hormonal therapy may be re-started, at the discretion of the treating physician.

  9. Current therapy with any hormonal agent such as raloxifene, tamoxifen, or other selective estrogen receptor modulator (SERM), either for osteoporosis or breast cancer prevention, or sex hormonal therapy such as birth control pills, ovarian hormonal replacement therapy, etc. These patients are eligible IF these medications are discontinued prior to registration.

  10. Surgical axillary staging procedure prior to study entry.

    a. Note: exceptions include FNA of an axillary node and pre-neoadjuvant sentinel lymph node biopsy for patients with clinically negative axillary nodes.

  11. Nonmalignant systemic disease (cardiovascular, renal, hepatic, etc.) that would preclude the woman from being treated with doxorubicin (A), cyclophosphamide (C), and a taxane (T), and from completing the study.
  12. Psychiatric or addictive disorders that would preclude obtaining informed consent.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Lasso di tempo
Primary clinical endpoint pCR will be a dichotomous outcome variable with two levels: complete response and no complete response.
Lasso di tempo: 24 months
24 months

Misure di risultato secondarie

Misura del risultato
Lasso di tempo
Secondary clinical endpoint cOR will be an ordinal outcome variable with complete response (CR), partial response (PR), stable disease (SD) and progression disease (PD) four levels.
Lasso di tempo: 24 months
24 months

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Precision Therapeutics

Collaboratori

United States Department of Defense

Investigatori

  • Direttore dello studio: Darrell Lis, RN, MSN, Precision Therapeutics

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Collegamenti utili

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 novembre 2009

Completamento primario (Effettivo)

1 ottobre 2012

Completamento dello studio (Effettivo)

1 ottobre 2012

Date di iscrizione allo studio

Primo inviato

3 novembre 2009

Primo inviato che soddisfa i criteri di controllo qualità

3 novembre 2009

Primo Inserito (Stima)

5 novembre 2009

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Stima)

5 ottobre 2012

Ultimo aggiornamento inviato che soddisfa i criteri QC

4 ottobre 2012

Ultimo verificato

1 ottobre 2012

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • PT-304

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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