- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT01367028
Her2-pos에서 Neoadjuvant Trastuzumab+Docetaxel+NPLD+/-Bevacizumab의 II상 연구. 조기 유방암 (ABCSG 32)
HER2 양성 조기 유방암에서 베바시주맙 병용 및 비베바시주맙 병용 및 비베바시주맙 병용 및 병용 트라스투주맙 병용 독소루비신(NPLD) 및 베바시주맙 병용 및 병용 트라스투주맙 병용 독소루비신(NPLD)의 다기관 무작위 2상 연구
연구 개요
상태
정황
상세 설명
표적 연구 모집단은 신보강 세포독성 치료를 받을 예정인 HER2 양성 유방 선암종(염증성 유방암 제외, T4d)이 있는 폐경 전후의 남성 및 여성 환자로 구성됩니다.
환자는 조직학적으로 확인된 HER2 과발현과 함께 병리학적으로 확인된 유방암이 있어야 합니다. 스크리닝 시 환자는 적절한 좌심실 박출률(LVEF)을 가져야 합니다. 0 또는 1의 ECOG 수행 상태; 적절한 간, 신장 및 골수 기능; 프로토콜 준수 또는 결과 해석에 영향을 줄 수 있는 다른 심각한 질병이 없어야 합니다.
환자는 위장관 천공, 고혈압, 단백뇨, 상처 치유 합병증, 혈전색전증 또는 출혈의 위험이 높아져서는 안 됩니다. 환자는 프로토콜 준수 또는 결과 해석에 영향을 미칠 수 있는 다른 원발성 악성 종양이 없어야 합니다. 중추신경계(CNS) 전이가 있는 환자는 제외됩니다. 임신 또는 수유 여성은 제외됩니다. 고혈압 환자(수축기 >150mmHG 또는 이완기 >100mmHG) 및 연구 시작 6개월 이내에 위장관 천공, 복부 누공 또는 복강내 농양의 병력이 있는 환자는 제외됩니다.
환자가 연구 치료 시작 시점에서 최소 2주 동안 안정적인 수준의 항응고제를 유지하는 한 연구 시작 시 전체 항응고 요법이 허용됩니다.
연구 유형
등록 (실제)
단계
- 2 단계
연락처 및 위치
연구 장소
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Salzburg, 오스트리아, 5020
- Paracelsus Medical University Salzburg-Oncology, Coop. Group
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Vienna, 오스트리아, 1090
- Medical University Vienna, General Hospital
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Vienna, 오스트리아, 1130
- State Hospital Vienna-Hietzing
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Vienna, 오스트리아, 1090
- Med. Univ. Vienna; General Hospital Vienna
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Styria
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Graz, Styria, 오스트리아, 8036
- Medical University of Graz-Oncology; Coop. Group
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Leoben, Styria, 오스트리아, 8700
- State Hospital Leoben
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Tyrol
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Innsbruck, Tyrol, 오스트리아, 6020
- Gynaegological Medical University Innsbruck
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Kufstein, Tyrol, 오스트리아, 6330
- District Hospital Kufstein
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Upper Austria
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Linz, Upper Austria, 오스트리아, 4010
- Hospital BHS Linz, Coop. Study Group
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Linz, Upper Austria, 오스트리아, 4020
- AKH Linz
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Vorarlberg
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Feldkirch, Vorarlberg, 오스트리아, 6807
- State Hospital Feldkirch, Coop. Group
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
포함 기준:
- 여성 또는 남성, ≥ 18세
- 만져지는 림프절이 있거나 없는 신보조 전신 치료를 포함하는 탁산이 예정된 병리학적으로 확인된 침습성 원발성 유방 선암종(염증성 유방암 제외, T4d).
- 면역조직화학(IHC) 3+ 또는 현지 실험실에서 입증된 원발성 종양의 HER2/c-erbB2 유전자 증폭에 의해 결정된 문서화된 HER2 단백질 과발현.
- 무작위 배정 전 4주 이내에 심초음파 또는 MUGA로 측정한 LVEF ≥ 55%
- ECOG 수행 상태 ≤ 1
- 예정된 방문, 치료 계획, 실험실 테스트 및 기타 연구 절차를 준수할 수 있고 준수할 의향이 있습니다.
- 서면 동의서
제외 기준:
현재 치료
- 항바이러스제인 소리부딘 또는 브리부딘과 같은 화학적으로 관련된 유사체의 병용 요건.
- 코르티코 스테로이드를 제외한 만성 일일 치료. 흡입 스테로이드.
- 아스피린 및 아스피린 유사체 또는 클로피도그렐을 사용한 만성 일일 치료
- 무작위 배정 전 28일 이내의 대수술, 개복 생검 또는 중대한 외상성 손상 또는 연구 치료 과정 동안 대수술의 필요성이 예상되는 경우
- 현재 또는 최근(무작위 배정 전 30일 이내) 다른 조사 약물을 사용한 치료 또는 다른 조사 연구 참여.
실혐실
- 부적절한 골수 기능
- 부적절한 간 기능
- 부적절한 신장 기능
- 주기 1의 1일 전 7일 이내에 활성화된 부분 트롬보플라스틴 시간(aPTT)이 있는 항응고제를 투여받지 않은 환자.
수반되는 조건
- 근치적으로 치료된 자궁경부 상피내암종 또는 비흑색종성 피부암을 제외한 무작위 배정 전 지난 5년 이내의 기타 악성 종양
- 임상적으로 그리고 적어도 흉부 X-레이, 간-초음파 및 뼈 스캔으로 판단되는 원격 전이의 증거. 임상적으로 뇌 전이가 의심되는 경우, 무작위 배정 전 4주 이내에 뇌의 CT 스캔 또는 MRI를 실시해야 합니다.
다음을 포함하되 이에 국한되지 않는 프로토콜 준수 또는 결과 해석에 영향을 미칠 수 있는 심각한 동시 질환:
- i.v.가 필요한 활동성 감염 항생제
- 조절되지 않는 고혈압
- 다음과 같은 심혈관 질환의 임상적으로 중요한 병력: 뇌혈관 사고 또는 뇌졸중; 심근 경색증; 불안정 협심증; NYHA 등급 II 이상 CHF, 약물 치료가 필요한 심장 부정맥; 임상적으로 중요한 판막 심장 질환.
- 지지적 산소 요법이 필요하거나 심각한 흉막삼출이 있는 휴식 시 호흡곤란
- 잘 조절되지 않는 당뇨병
- 암과 무관한 CNS 질환의 신체/신경학적 검사에서 병력 또는 증거(예: 조절되지 않는 발작) 표준 의학 요법으로 적절하게 치료하지 않는 한
- 유전성 출혈 체질 또는 출혈 위험이 있는 응고병증의 병력 또는 증거
- 무작위 배정 6개월 이내에 복강 누공, 위장관 천공 또는 복강 내 농양의 병력
- 심각한 치유되지 않는 상처, 소화성 궤양 또는 골절
- 임상적으로 유의한 흡수장애 증후군, 궤양성 대장염, 위장관 기능에 영향을 미치는 질환, 위 또는 소장의 절제 또는 내복약 복용 불능
- 교정되지 않은 저칼륨혈증 또는 저마그네슘혈증
- 면역억제 요법이 필요한 장기 동종이식
- 다른 질병의 증거, 대사 또는 심리적 기능 장애, 신체 검사 소견 또는 연구 약물의 사용을 금하는 질병 또는 상태에 대한 합리적인 의심을 주는 임상 실험실 소견, 연구 루틴에 대한 환자 순응도에 영향을 미치거나 환자를 높은 상태에 놓이게 할 수 있습니다. 치료 관련 합병증의 위험.
- 임의의 연구 약물/부형제에 대해 알려진 과민성.
- 차이니즈 햄스터 난소 세포 제품 또는 기타 재조합 인간 또는 인간화 항체에 대한 과민성.
다른
- 임신, 수유 중인 여성 또는 음성 임신 검사가 없는 가임 여성
- 임신 가능성이 있는 가임 남성 또는 여성
- 치료 또는 후속 조치를 위해 접근할 수 없는 환자
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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다른: A: 트라스투주맙+도세탁셀
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6주기 - 1일(22일 = 1일): 트라스투주맙: 8 mg/kg 부하 용량(1차 주기) i.v.; 후속 주기에서 6 mg/kg 유지 용량 i.v. 도세탁셀: 100 mg/m2 by 60 min i.v. 주입
다른 이름들:
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실험적: B: 트라스투주맙+도세탁셀+베바시주맙
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6주기 - 1일(22일 = 1일): 트라스투주맙: 8 mg/kg 부하 용량(1차 주기) i.v.; 후속 주기에서 6 mg/kg 유지 용량 i.v. 도세탁셀: 100 mg/m2 by 60 min i.v. 주입 베바시주맙 15 mg/kg
다른 이름들:
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실험적: C: 트라스투주맙+도세탁셀+NPLD
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6주기 - 1일(22일 = 1일): 트라스투주맙: 8 mg/kg 부하 용량(1차 주기) i.v.; 후속 주기에서 6 mg/kg 유지 용량 i.v. 도세탁셀: 60분 동안 75mg/m2 정맥 주사 NPLD 60분 동안 정맥 주사 50mg/m2 주입
다른 이름들:
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실험적: D: 트라스투주맙+도세탁셀+NPLD+베바시주맙
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6주기 - 1일(22일 = 1일): 트라스투주맙: 8 mg/kg 로딩 용량(1차 주기) i.v.; 후속 주기에서 6 mg/kg 유지 용량 i.v. 도세탁셀: 75 mg/m2 by 60 min i.v. 주입 NPLD: 50 mg/m2 by 60 min i.v. 주입; 베바시주맙 15 mg/kg
다른 이름들:
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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심장 독성
기간: 1주기 1일차부터 최종 수술일 후 28일차 사이
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표준 요법인 트라스투주맙+도세탁셀과 비교하여 트라스투주맙+도세탁셀+베바시주맙 및 트라스투주맙+도세탁셀+NPLD +/- 베바시주맙 조합의 심장 독성을 평가하기 위해 주기 1의 1일과 28일 사이에 나타나는 복합 종점을 사용합니다. 최종 수술의.
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1주기 1일차부터 최종 수술일 후 28일차 사이
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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병리학적 완전 반응(ypCR)
기간: 최대 22주
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최종 수술 시 침습성 종양이 없는 것으로 정의되는 ypCR
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최대 22주
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전체 병리학적 완전 반응(ytpCR)
기간: 최대 22주
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ytpCR은 유방과 액와 림프절에 침습성 종양 및 종양 세포가 없는 것으로 정의됩니다(ypT0 또는 yDCIS 및 ypN=0).
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최대 22주
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전체 임상 반응률(cORR)
기간: 최대 22주
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cORR은 완전한 임상 반응(cCR) 또는 부분 임상 반응(cPR)이 있지만 ypCR은 없는 환자의 백분율로 정의됩니다.
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최대 22주
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AEs, SAEs, Lab test 이상 환자 수에 따른 안전성 평가, 심장 평가, 임상 평가
기간: 최대 22주
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최종 수술 시 트라스투주맙 및 도세탁셀과 베바시주맙 및 트라스투주맙, 도세탁셀 및 NPLD 플러스/마이너스 베바시주맙 조합의 안전성(AE, SAE, 실험실 검사 이상, 심장 평가, 임상 평가)
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최대 22주
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공동 작업자 및 조사자
수사관
- 수석 연구원: Guenther Steger, MD, Austrian Breast & Colorectal Cancer Study Group
간행물 및 유용한 링크
일반 간행물
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- Ferrara N, Davis-Smyth T. The biology of vascular endothelial growth factor. Endocr Rev. 1997 Feb;18(1):4-25. doi: 10.1210/edrv.18.1.0287. No abstract available.
- Miller K, Wang M, Gralow J, Dickler M, Cobleigh M, Perez EA, Shenkier T, Cella D, Davidson NE. Paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer. N Engl J Med. 2007 Dec 27;357(26):2666-76. doi: 10.1056/NEJMoa072113.
- Kerbel RS, Kamen BA. The anti-angiogenic basis of metronomic chemotherapy. Nat Rev Cancer. 2004 Jun;4(6):423-36. doi: 10.1038/nrc1369. No abstract available.
- Romond EH, Perez EA, Bryant J, Suman VJ, Geyer CE Jr, Davidson NE, Tan-Chiu E, Martino S, Paik S, Kaufman PA, Swain SM, Pisansky TM, Fehrenbacher L, Kutteh LA, Vogel VG, Visscher DW, Yothers G, Jenkins RB, Brown AM, Dakhil SR, Mamounas EP, Lingle WL, Klein PM, Ingle JN, Wolmark N. Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med. 2005 Oct 20;353(16):1673-84. doi: 10.1056/NEJMoa052122.
- Relf M, LeJeune S, Scott PA, Fox S, Smith K, Leek R, Moghaddam A, Whitehouse R, Bicknell R, Harris AL. Expression of the angiogenic factors vascular endothelial cell growth factor, acidic and basic fibroblast growth factor, tumor growth factor beta-1, platelet-derived endothelial cell growth factor, placenta growth factor, and pleiotrophin in human primary breast cancer and its relation to angiogenesis. Cancer Res. 1997 Mar 1;57(5):963-9.
- Cobleigh MA, Langmuir VK, Sledge GW, Miller KD, Haney L, Novotny WF, Reimann JD, Vassel A. A phase I/II dose-escalation trial of bevacizumab in previously treated metastatic breast cancer. Semin Oncol. 2003 Oct;30(5 Suppl 16):117-24. doi: 10.1053/j.seminoncol.2003.08.013.
- Ramaswamy B, Elias AD, Kelbick NT, Dodley A, Morrow M, Hauger M, Allen J, Rhoades C, Kendra K, Chen HX, Eckhardt SG, Shapiro CL. Phase II trial of bevacizumab in combination with weekly docetaxel in metastatic breast cancer patients. Clin Cancer Res. 2006 May 15;12(10):3124-9. doi: 10.1158/1078-0432.CCR-05-2603.
- Warren RS, Yuan H, Matli MR, Gillett NA, Ferrara N. Regulation by vascular endothelial growth factor of human colon cancer tumorigenesis in a mouse model of experimental liver metastasis. J Clin Invest. 1995 Apr;95(4):1789-97. doi: 10.1172/JCI117857.
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유용한 링크
연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (실제)
연구 완료 (실제)
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
키워드
추가 관련 MeSH 약관
기타 연구 ID 번호
- ABCSG 32
- 2010-023324-25 (EudraCT 번호)
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