- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT00398489
Docetaxel, Epirubicin, and Cyclophosphamide With or Without Trastuzumab in Treating Women With Locally Advanced Breast Cancer That Can Be Removed By Surgery
Evaluation of Response Rate to Pre-Operative Docetaxel + Herceptin Study Part A and Docetaxel Study Part B in Locally Advanced Breast Cancer Patients, Stratified by HER2-Status Trial - PHASE II [(Herceptin Docetaxel Neoadjuvant) HEDON]
RATIONALE: Drugs used in chemotherapy, such as docetaxel, epirubicin, and cyclophosphamide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as trastuzumab, 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. Giving chemotherapy with or without monoclonal antibody therapy before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. Giving these treatments after surgery may kill any tumor cells that remain after surgery.
PURPOSE: This phase II trial is studying how well giving docetaxel, epirubicin, and cyclophosphamide with or without trastuzumab works in treating women with locally advanced breast cancer that can be removed by surgery.
연구 개요
상태
정황
상세 설명
OBJECTIVES:
- Determine the efficacy of neoadjuvant therapy comprising docetaxel and trastuzumab (Herceptin®) and adjuvant therapy comprising epirubicin hydrochloride, cyclophosphamide, and trastuzumab (Herceptin®) followed by radiotherapy in women with locally advanced, HER2-positive, operable breast cancer.
- Determine the efficacy of neoadjuvant therapy with docetaxel and adjuvant therapy comprising epirubicin hydrochloride and cyclophosphamide followed by radiotherapy in women with locally advanced, HER2-negative, operable breast cancer.
OUTLINE: This is an open-label, prospective, multicenter study. Patients are stratified according to HER2 status (positive vs negative).
Neoadjuvant therapy:
- Stratum 1 (HER2-positive disease): Patients receive trastuzumab IV over 30-90 minutes on days 1, 8, and 15 and docetaxel IV over 60 minutes on day 1. Treatment repeats every 3 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity
- Stratum 2 (HER2-negative disease): Patients receive docetaxel IV alone as in stratum 1.
- Surgery: All patients undergo surgery in week 19.
Adjuvant therapy: Beginning within 2 weeks after surgery, patients receive adjuvant therapy.
- Stratum 1 (HER2-positive disease): Patients receive trastuzumab IV over 30-90 minutes on days 1, 8, and 15, epirubicin hydrochloride IV over 30 minutes on day 2, and cyclophosphamide IV over 30 minutes on day 2. Treatment repeats every 3 weeks for up to 4 courses in the absence of disease progression or unacceptable toxicity. Patients then receive trastuzumab IV alone every 3 weeks until week 52.
- Stratum 2 (HER2-negative disease): Patients receive epirubicin hydrochloride and cyclophosphamide as in stratum 1.
- Radiotherapy: Patients who undergo breast conserving surgery or patients who undergo mastectomy with ypN positive lymph nodes (i.e., > 4 positive lymph nodes) or ypT3 tumor (i.e., tumor size > 4 cm) undergo radiotherapy, beginning in approximately week 31 and continuing until up to week 38.
- Adjuvant endocrine therapy: Patients with estrogen receptor- or progesterone receptor-positive disease receive adjuvant endocrine therapy beginning in approximately week 31. Premenopausal patients ≤ 40 years of age receive goserelin for 2-3 years and tamoxifen citrate for 5 years.Premenopausal patients > 40 years of age receive tamoxifen citrate for 5 years. Postmenopausal patients receive anastrozole for 5 years years.
After completion of study treatment, patients are followed periodically for up to 5 years.
PROJECTED ACCRUAL: A total of 94 patients will be accrued for this study.
연구 유형
등록 (예상)
단계
- 2 단계
연락처 및 위치
연구 장소
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Bayreuth, 독일, D 95448
- Klinikum Bayreuth
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Cologne, 독일, D-50391
- Universitaetsfrauenklinik - Koeln
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Deggendorf, 독일, 94469
- Klinikum Deggendorf
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Jena, 독일, D-07743
- Klinikum der Friedrich-Schiller Universitaet Jena
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Munich, 독일, D-81675
- Klinikum Rechts der Isar - Technische Universitaet Muenchen
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed primary carcinoma of the breast by core biopsy
Solitaire or multifocal disease, defined as tumor manifestations within a quadrant or distance between tumor manifestations measured bilaterally < 4 cm, respectively
- No multifocal primary tumor, defined as tumor manifestations in different quadrants or distance between tumor manifestations ≥ 4 cm
Locally advanced, operable disease
Primary tumor ≥ 2 cm by clinical examination or imaging (i.e., mammogram, MRI, or ultrasound)
- Inflammatory breast cancer with bidimensionally measurable lesion, independent of nodal status, allowed
HER2 status meeting 1 of the following criteria:
HER2-positive disease
- 3+ by immunohistochemistry (IHC) and/or positive by fluorescence in situ hybridization (FISH)
HER-2 negative disease
- 0 or 1+ by IHC OR 2+ by IHC and negative by FISH
- No distant metastases by clinical or imaging diagnosis
- No prior breast cancer
- Hormone receptor status not specified
PATIENT CHARACTERISTICS:
- Female
- Pre- or post-menopausal
- ECOG performance status 0-2
- Platelet count ≥ 100,000/mm^3
- Neutrophil count ≥ 1,500/mm^3
- Hemoglobin ≥ 10 g/dL
- ALT and AST ≤ 1.5 times upper limit of normal (ULN)
- Alkaline phosphatase ≤ 2.5 times ULN
- Creatinine ≤ 1.5 times ULN
- Bilirubin normal (unless due to clearly documented Gilbert's syndrome)
- Not pregnant or nursing
- Negative pregnancy test (for premenopausal women or women with a postmenopausal status for < 1 year)
- Fertile patients must use effective contraception
- Adequate organ function for cytotoxic chemotherapy
- No known hypersensitivity reaction to the study agents or incorporated substances
- No known allergy or severe reactions to trastuzumab or its constituents (for patients with HER2-positive disease)
- No preexisting motor or sensory neuropathy ≥ grade 2
- No other invasive malignancy within the past 5 years that would preclude study compliance or affect the interpretation of study results
- LVEF ≥ 55% by MUGA or echocardiography
No other serious illness or medical condition, including any of the following:
- New York Heart Association class II-IV congestive heart failure
- History of documented congestive heart failure
- Unstable angina pectoris
- Myocardial infarction within the past 12 months
- Uncontrolled hypertension (i.e., systolic blood pressure [BP] > 180 mm Hg or diastolic BP > 100 mm Hg)
- Clinically significant valvular heart disease
- High-risk, uncontrolled arrhythmias
- Dyspnea at rest due to malignant or other disease
- Condition that requires supportive oxygen therapy
- Active serious uncontrolled infections
- Uncontrolled diabetes
PRIOR CONCURRENT THERAPY:
- No prior systemic therapy for cancer
- No prior trastuzumab (Herceptin^®) (for HER2-positive patients)
- No other concurrent anticancer therapy
- No other concurrent investigational drugs
- No concurrent immunosuppressive therapy
- No concurrent sex hormones
- No concurrent corticosteroids unless for premedication
- No concurrent bisphosphonates during active treatment with chemotherapy
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 마스킹: 없음(오픈 라벨)
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
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예측 마커의 식별
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Rate of pathologic complete remission (pCR) after neoadjuvant therapy comprising docetaxel and trastuzumab (Herceptin®) in women with locally advanced, HER2-positive, operable breast cancer
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Rate of pCR after neoadjuvant docetaxel in women with locally advanced, HER2-negative, operable breast cancer
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Tolerability of treatment as measured by the nature and frequency of adverse events in women with HER2-positive or HER2-negative disease
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2차 결과 측정
결과 측정 |
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Rate of breast conserving therapy versus mastectomy in comparison to preoperative evaluation
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Correlation of clinical/sonographical response with pathological response, including lymph node status
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Rate of clinical complete remission (cCR) after neoadjuvant therapy comprising docetaxel and trastuzumab in women with locally advanced, HER2-positive, operable breast cancer
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Rate of cCR after neoadjuvant docetaxel in women with locally advanced, HER2-negative, operable breast cancer
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Disease-free survival after 2.5 and 5 years
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Overall-survival after 2.5 and 5 years
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공동 작업자 및 조사자
수사관
- 연구 의자: Stefan Paepke, MD, Technical University of Munich
연구 기록 날짜
연구 주요 날짜
연구 시작
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (추정)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
- 피부병
- 신생물
- 부위별 신생물
- 유방 질환
- 유방 신생물
- 약물의 생리적 효과
- 약리작용의 분자기전
- 효소 억제제
- 항류마티스제
- 항종양제
- 면역억제제
- 면역학적 요인
- 튜불린 조절제
- 항유사분열제
- 유사분열 조절제
- 호르몬, 호르몬 대체물 및 호르몬 길항제
- 항종양제, 호르몬
- 항종양제, 알킬화제
- 알킬화제
- 골수 파괴 작용제
- 토포이소머라제 II 억제제
- 토포이소머라제 억제제
- 항종양제, 면역학적
- 항생제, 항종양제
- 호르몬 길항제
- 골밀도 보존제
- 아로마타제 억제제
- 스테로이드 합성 억제제
- 에스트로겐 길항제
- 선택적 에스트로겐 수용체 조절제
- 에스트로겐 수용체 조절제
- 도세탁셀
- 사이클로포스파마이드
- 트라스투주맙
- 에피루비신
- 고세렐린
- 타목시펜
- 아나스트로졸
기타 연구 ID 번호
- CDR0000516034
- KRDI-TUM-HED-324-PAE-0090-I
- EU-20634
- EUDRACT-2005-000967-24
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .