Pegylated Liposomal Doxorubicin and Docetaxel in Treating Women With Locally Advanced Breast Cancer That Can Be Removed By Surgery
Phase II Study of Neoadjuvant Pegylated Liposomal Doxorubicin and Docetaxel in Locally Advanced Operable Breast Cancer
RATIONALE: Drugs used in chemotherapy, such as liposomal doxorubicin and docetaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) and giving them before surgery may kill more tumor cells.
PURPOSE: This phase II trial is studying the side effects of giving liposomal doxorubicin together with docetaxel before surgery and to see how well it works in treating women with locally advanced breast cancer that can be removed by surgery.
調査の概要
詳細な説明
OBJECTIVES:
Primary
- To evaluate the rate of pathological complete response and clinical complete response in women with locally advanced breast cancer treated with pegylated doxorubicin hydrochloride liposome and docetaxel.
Secondary
- To assess the overall clinical local regional response in patients treated with this preoperative chemotherapy regimen.
- To evaluate the number of patients who would have required a mastectomy upfront but who underwent breast conservation therapy instead after neoadjuvant chemotherapy.
- To assess the safety, particularly with regard to neutropenia and cardiac toxicity, of pegylated doxorubicin hydrochloride liposome and docetaxel.
OUTLINE: This is a multicenter study.
Patients receive pegylated doxorubicin hydrochloride liposome IV over 90 minutes and docetaxel IV over 90 minutes on day 1. Patients receive pegylated filgrastim subcutaneously on days 2 or 3 post-chemotherapy in courses 1-5. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Within 8 weeks after completion of chemotherapy, patients undergo a lumpectomy or mastectomy to remove the tumor. Some patients may receive additional therapy after surgery, including hormonal therapy, chemotherapy, or radiotherapy.
After completion of study therapy, patients are followed periodically for up to 5 years.
研究の種類
入学 (実際)
段階
- フェーズ2
連絡先と場所
研究場所
-
-
New York
-
Buffalo、New York、アメリカ、14263-0001
- Roswell Park Cancer Institute
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed breast cancer using core biopsies
- Locally advanced disease
- Resectable disease
- Fine needle aspiration cytology allowed and must demonstrate invasive adenocarcinoma
- No more than 8 weeks since initial cytologic or histologic diagnosis of breast cancer
Tumor must meet the following criteria:
- Palpable on clinical examination and confined to either the breast or to the breast and ipsilateral axilla
- Measured clinically as greater than 2 cm in size (T2)
Patients with skeletal pain are eligible if bone scan and/or roentgenological examination fail to disclose metastatic disease
- Suspicious findings must be confirmed as benign by x-ray, MRI scan, or biopsy
- Hormonal status not specified
PATIENT CHARACTERISTICS:
Inclusion criteria:
- Female
- Menopausal status not specified
- ECOG performance status 0-2
- Life expectancy ≥ 10 years
- Platelet count ≥ 100,000/mm³
- ANC ≥ 1,500/mm³
- Hemoglobin ≥ 9.0 g/dL
- Bilirubin normal
- AST or ALT normal
- Alkaline phosphatase normal
- Serum creatinine normal
- Negative pregnancy test
- Fertile patients must use effective contraception (e.g., abstinence, intrauterine device, barrier device with spermicide, or surgical sterilization) during and for 3 months after completion of study therapy
- Normal cardiac function by LVEF or MUGA scan
Patients with prior non-breast malignancies are eligible if they have been disease-free for ≥ 10 years
The following are allowed even if diagnosed within the past 10 years:
- Squamous or basal cell carcinoma of the skin that has been effectively treated
- Carcinoma in situ of the cervix that has been treated by operation only
- Lobular carcinoma in situ of the ipsilateral or contralateral breast treated by segmental resection only
Exclusion criteria:
- Pregnant or lactating women
- Male patients
- Hyperbilirubinemia
Female patients with 1 or more of the following conditions:
Ulceration, erythema, infiltration of the skin (complete fixation), or peau d'orange (edema) of any magnitude
- Tethering or dimpling of the skin or nipple inversion should not be interpreted as skin infiltration
- Ipsilateral lymph nodes that are clinically fixed to one another or to other structures (N2 disease)
- Bilateral malignancy or a mass in the opposite breast suspicious for malignancy, unless there is biopsy proof that the mass is not malignant
- Suspicious palpable nodes in the contralateral axilla or palpable supraclavicular or infraclavicular nodes, unless there is biopsy evidence that these are not involved with the tumor
- Nonmalignant systemic disease (e.g., cardiovascular, renal, or hepatic) that would preclude study therapy
Active cardiac disease that would preclude the use of doxorubicin hydrochloride, including any of the following:
- Documented myocardial infarction
- Angina pectoris that requires the use of antianginal medication
- History of documented New York Heart Association class II-IV heart failure
- Valvular disease with documented cardiac function compromise
Poorly controlled hypertension (i.e., diastolic BP > 100 mm Hg)
- Patients with well-controlled hypertension and on medication are eligible for study
- Psychiatric or addictive disorders that would preclude obtaining informed consent
PRIOR CONCURRENT THERAPY:
Inclusion criteria:
- Concurrent noncancer therapies allowed if used for conditions other than breast cancer
- Adjuvant therapy after surgery allowed
Exclusion criteria:
- Prior radiotherapy, chemotherapy, immunotherapy, and/or hormonal therapy for breast cancer
- Prior anthracycline therapy for any condition
- Concurrent hormonal therapy including tamoxifen, aromatase inhibitors, or raloxifene
- Concurrent sex hormonal therapy including birth-control pills or ovarian hormonal replacement therapy
- Concurrent other cancer therapy
- Concurrent herbal or alternative therapies for breast cancer
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:非ランダム化
- 介入モデル:単一グループの割り当て
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
|
Pathological Complete Response
時間枠:Mammogram done pre-treatment and after four and six cycles of study chemotherapy treatment.
|
Mammogram done pre-treatment and after four and six cycles of study chemotherapy treatment.
|
|
Clinical Complete Response
時間枠:Surgery done after completion of six cycles of study chemotherapy treatment.
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Surgery done after completion of six cycles of study chemotherapy treatment.
|
二次結果の測定
結果測定 |
時間枠 |
|---|---|
|
Overall Clinical Local Regional Response
時間枠:Mammogram done pre-treatment and after four and six cycles of study chemotherapy treatment.
|
Mammogram done pre-treatment and after four and six cycles of study chemotherapy treatment.
|
|
Number of Women Who Would Have Required a Mastectomy Upfront But Who Underwent Breast Conservation Therapy Instead After Neoadjuvant Chemotherapy
時間枠:Baseline (pre-treatment) surgical assessment, and post-chemotherapy surgical outcome.
|
Baseline (pre-treatment) surgical assessment, and post-chemotherapy surgical outcome.
|
|
Safety, in Terms of Neutropenia and Cardiac Toxicity
時間枠:Every cycle during study treatment and 8 weeks post-treatment.
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Every cycle during study treatment and 8 weeks post-treatment.
|
協力者と研究者
捜査官
- 主任研究者:Tracey O'Connor, MD、Roswell Park Cancer Institute
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- I 75506
- RPCI-I-75506
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
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