Efficacy and Tolerance Study of Bevacizumab in Her2- Inflammatory Breast Cancer Patients (Beverly1)
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.
調査の概要
詳細な説明
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.
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
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Angers、フランス、49036
- Centre Paul Papin
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Avignon、フランス、84000
- Institut Sainte Catherine
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Besancon、フランス、25030
- Centre Hospitalier Regional de Besancon - Hopital Jean Minjoz
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Bordeaux、フランス、33076
- Institut Bergonie
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Bordeaux、フランス、33300
- Polyclinique Bordeaux Nord Aquitaine
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Caen、フランス、14076
- Centre Regional Francois Baclesse
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Clermont-Ferrand、フランス、63011
- Centre Jean Perrin
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Dijon、フランス、21079
- Centre de Lutte Contre le Cancer Georges-Francois Leclerc
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Le Havre、フランス、76600
- CMC Les Ormeaux
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Lille、フランス、59020
- Centre Oscar Lambret
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Lyon、フランス、69373
- Centre Leon Berard
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Marseille、フランス、13273
- Marseille Institute of Cancer - Institut J. Paoli and I. Calmettes
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Montbeliard、フランス、25209
- Centre Hospitalier General Andre Boulloche
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Montpellier、フランス、34298
- Centre Regional de Lutte Contre le Cancer - Centre Val d'Aurelle
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Nantes、フランス、02
- Centre Catherine de Sienne
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Nice、フランス、06189
- Centre Antoine Lacassagne
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Paris、フランス、75248
- Institut Curie Hopital
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Reims、フランス、51056
- Institut Jean Godinot
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Rennes、フランス、35042
- Centre Eugene Marquis
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Rouen、フランス、76038
- Centre Henri Becquerel
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Saint Brieuc、フランス、F-22015
- Clinique Armoricaine de Radiologie
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Saint Cloud、フランス、92211
- Centre Rene Huguenin
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Saint-Herblain、フランス、44805
- CRLCC Nantes - Atlantique
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Strasbourg、フランス、67065
- Centre Paul Strauss
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Strasbourg、フランス、67091
- Hopitaux Universitaire de Strasbourg
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Toulouse、フランス、31052
- Institut Claudius Regaud
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Vandoeuvre-les-Nancy、フランス、54511
- Centre Alexis Vautrin
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Villejuif、フランス、F-94805
- Institut Gustave Roussy
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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 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
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:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:(FEC / Docetaxel) + Bevacizumab
Neoadjuvant treatment: 4 cycles FEC + Bevacizumab followed by 4 cycles Docetaxel + Bevacizumab Adjuvant: Bevacizumab for 1 year
|
ネオアジュバント: 100 mg/m2、d1 q3w、4 サイクル
ネオアジュバント: 500 mg/m2、d1 q3w、4 サイクル
During neoadjuvant phase: 15 mg/kg, d1 q3w, 8 cycles During adjuvant phase:15 mg/kg, d1 q3w, 10 cycles
Neoadjuvant: 500 mg/m2 d1 q3w, 4 cycles
Neoadjuvant: 100 mg/m2 q3w, 4 cycles
|
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 |
|---|---|
|
Complete histologic response rate
時間枠:Post surgery
|
Post surgery
|
二次結果の測定
結果測定 |
時間枠 |
|---|---|
|
無増悪生存期間
時間枠:3年と5年
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3年と5年
|
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全生存
時間枠:3年と5年
|
3年と5年
|
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Toxicity as assessed by CTCAE v3.0
時間枠:3 and 5 years
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3 and 5 years
|
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Predictive factors of response to bevacizumab
時間枠: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
時間枠:Post-surgery
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Post-surgery
|
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Genomic and proteomic analyses and correlation with histologic response
時間枠:Post surgery
|
Post surgery
|
協力者と研究者
スポンサー
捜査官
- 主任研究者:Patrice Viens, MD、Institut Paoli-Calmettes
出版物と役立つリンク
便利なリンク
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (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 (実際)
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
- PACS09 UC-0140/0802
- UNICANCER-PACS-09-0802 (その他の識別子:Internal Id Number)
- 2008-001807-53 (EudraCT番号)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
IPD 共有時間枠
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
- SAP
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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