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

4 oktober 2012 bijgewerkt door: 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.

Studie Overzicht

Toestand

Beëindigd

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

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.

Studietype

Observationeel

Inschrijving (Werkelijk)

134

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

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

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Vrouw

Bemonsteringsmethode

Niet-waarschijnlijkheidssteekproef

Studie Bevolking

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

Beschrijving

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.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Tijdsspanne
Primary clinical endpoint pCR will be a dichotomous outcome variable with two levels: complete response and no complete response.
Tijdsspanne: 24 months
24 months

Secundaire uitkomstmaten

Uitkomstmaat
Tijdsspanne
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.
Tijdsspanne: 24 months
24 months

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Precision Therapeutics

Medewerkers

United States Department of Defense

Onderzoekers

  • Studie directeur: Darrell Lis, RN, MSN, Precision Therapeutics

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Nuttige links

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 november 2009

Primaire voltooiing (Werkelijk)

1 oktober 2012

Studie voltooiing (Werkelijk)

1 oktober 2012

Studieregistratiedata

Eerst ingediend

3 november 2009

Eerst ingediend dat voldeed aan de QC-criteria

3 november 2009

Eerst geplaatst (Schatting)

5 november 2009

Updates van studierecords

Laatste update geplaatst (Schatting)

5 oktober 2012

Laatste update ingediend die voldeed aan QC-criteria

4 oktober 2012

Laatst geverifieerd

1 oktober 2012

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • PT-304

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