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Chemotherapy Plus Monoclonal Antibody Therapy in Treating Women With Stage II or Stage IIIA Breast Cancer That Overexpresses HER2

31. mai 2013 oppdatert av: National Cancer Institute (NCI)

Pilot Trial of Paclitaxel-Herceptin Adjuvant Therapy for Early Stage Breast Cancer

Randomized phase II trial to study the effectiveness of chemotherapy with paclitaxel and the monoclonal antibody trastuzumab followed by chemotherapy in treating women who have stage II or stage IIIA breast cancer that overexpresses HER2. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Monoclonal antibodies can locate tumor cells and deliver tumor-killing substances to them without harming normal cells. Combining monoclonal antibody therapy with chemotherapy may kill more tumor cells.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

OBJECTIVES:

I. Evaluate the safety of paclitaxel plus trastuzumab (Herceptin) followed by adjuvant chemotherapy in women with node positive stage II or IIIa breast cancer with HER2 overexpression.

II. Evaluate the safety of long term trastuzumab (Herceptin) in this patient population.

OUTLINE: This is a randomized study. Patients are stratified according to radiotherapy (none planned vs planned to breast or chest wall). Patients are randomized to one of two treatment arms.

ARM I: Patients receive paclitaxel IV over 3 hours immediately followed by trastuzumab (Herceptin) IV over 30-90 minutes on day 1. Paclitaxel repeats every 3 weeks for 4 courses and trastuzumab (Herceptin) repeats weekly for 10 courses. At 3 weeks following paclitaxel and trastuzumab (Herceptin), patients receive doxorubicin IV and cyclophosphamide IV over 1 hour every 3 weeks for 4 courses. Following chemotherapy, estrogen receptor (ER) positive and/or progesterone receptor (PR) positive patients receive oral tamoxifen twice daily for 5 years.

ARM II: Patients receive same therapy as in Arm I, except for additional trastuzumab (Herceptin) IV weekly beginning within 3 weeks following completion of chemotherapy and local therapy and continuing for 1 year. ER and/or PR positive patients receive tamoxifen as in Arm I but may be concurrent with trastuzumab (Herceptin). Following completion of doxorubicin and cyclophosphamide, post lumpectomy and post mastectomy patients may receive local radiotherapy daily for 5-6 weeks. Treatment continues in the absence of disease progression or unacceptable toxicity.

Patients are followed every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.

PROJECTED ACCRUAL: A total of 200 patients (100 per treatment arm) will be accrued for this study within 1 year.

Studietype

Intervensjonell

Registrering (Faktiske)

200

Fase

  • Fase 2

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Forente stater
    • California
      • Palo Alto, California, Forente stater, 94304
        • Veterans Affairs Medical Center - Palo Alto
      • Stanford, California, Forente stater, 94305-5408
        • Stanford University Medical Center
    • Colorado
      • Denver, Colorado, Forente stater, 80209-5031
        • CCOP - Colorado Cancer Research Program, Inc.
    • Florida
      • Tampa, Florida, Forente stater, 33612
        • H. Lee Moffitt Cancer Center and Research Institute
    • Georgia
      • Atlanta, Georgia, Forente stater, 30322
        • Emory University Hospital - Atlanta
      • Decatur, Georgia, Forente stater, 30033
        • Veterans Affairs Medical Center - Atlanta (Decatur)
    • Illinois
      • Chicago, Illinois, Forente stater, 60611
        • Robert H. Lurie Comprehensive Cancer Center, Northwestern University
      • Chicago, Illinois, Forente stater, 60611
        • Veterans Affairs Medical Center - Chicago (Lakeside)
      • Decatur, Illinois, Forente stater, 62526
        • CCOP - Central Illinois
      • Evanston, Illinois, Forente stater, 60201
        • CCOP - Evanston
      • Peoria, Illinois, Forente stater, 61602
        • CCOP - Illinois Oncology Research Association
      • Urbana, Illinois, Forente stater, 61801
        • CCOP - Carle Cancer Center
    • Indiana
      • Indianapolis, Indiana, Forente stater, 46202
        • Veterans Affairs Medical Center - Indianapolis (Roudebush)
    • Iowa
      • Cedar Rapids, Iowa, Forente stater, 52403-1206
        • CCOP - Cedar Rapids Oncology Project
    • Kansas
      • Wichita, Kansas, Forente stater, 67214-3882
        • CCOP - Wichita
    • Louisiana
      • New Orleans, Louisiana, Forente stater, 70121
        • CCOP - Ochsner
    • Maryland
      • Baltimore, Maryland, Forente stater, 21231
        • Johns Hopkins Oncology Center
    • Massachusetts
      • Boston, Massachusetts, Forente stater, 02215
        • Beth Israel Deaconess Medical Center
      • Boston, Massachusetts, Forente stater, 02111
        • New England Medical Center Hospital
    • Michigan
      • Ann Arbor, Michigan, Forente stater, 48106
        • CCOP - Ann Arbor Regional
      • Kalamazoo, Michigan, Forente stater, 49007-3731
        • CCOP - Kalamazoo
    • Minnesota
      • Rochester, Minnesota, Forente stater, 55905
        • Mayo Clinic Cancer Center
      • Saint Louis Park, Minnesota, Forente stater, 55416
        • CCOP - Metro-Minnesota
    • Nebraska
      • Omaha, Nebraska, Forente stater, 68131
        • CCOP - Missouri Valley Cancer Consortium
    • New Jersey
      • Elizabeth, New Jersey, Forente stater, 07201
        • Trinitas Hospital - Jersey Street Campus
      • Flemington, New Jersey, Forente stater, 08822
        • Hunterdon Regional Cancer Program
      • Hackensack, New Jersey, Forente stater, 07601
        • Hackensack University Medical Center
      • Hackensack, New Jersey, Forente stater, 07601
        • CCOP - Northern New Jersey
      • Morristown, New Jersey, Forente stater, 07962-1956
        • Morristown Memorial Hospital
    • New York
      • Albany, New York, Forente stater, 12208
        • Veterans Affairs Medical Center - Albany
      • Bronx, New York, Forente stater, 10461
        • Albert Einstein Comprehensive Cancer Center
      • New York, New York, Forente stater, 10016
        • Kaplan Cancer Center
      • New York, New York, Forente stater, 10010
        • Veterans Affairs Medical Center - New York
      • Rochester, New York, Forente stater, 14642
        • University of Rochester Cancer Center
    • North Dakota
      • Fargo, North Dakota, Forente stater, 58122
        • CCOP - Merit Care Hospital
    • Ohio
      • Cleveland, Ohio, Forente stater, 44106-5065
        • Ireland Cancer Center
    • Oklahoma
      • Tulsa, Oklahoma, Forente stater, 74136
        • CCOP - Sooner State
    • Pennsylvania
      • Philadelphia, Pennsylvania, Forente stater, 19104
        • University of Pennsylvania Cancer Center
      • Wynnewood, Pennsylvania, Forente stater, 19096
        • CCOP - MainLine Health
    • Tennessee
      • Nashville, Tennessee, Forente stater, 37232-6838
        • Vanderbilt Cancer Center
    • Wisconsin
      • Madison, Wisconsin, Forente stater, 53705
        • Veterans Affairs Medical Center - Madison
      • Madison, Wisconsin, Forente stater, 53792
        • University of Wisconsin Comprehensive Cancer Center
      • Milwaukee, Wisconsin, Forente stater, 53226
        • Medical College of Wisconsin
      • Milwaukee, Wisconsin, Forente stater, 53295
        • Veterans Affairs Medical Center - Milwaukee (Zablocki)
  • Sør-Afrika
      • Pretoria, Sør-Afrika, 0001
        • Pretoria Academic Hospital

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Hunn

Beskrivelse

DISEASE CHARACTERISTICS:

  • Histologically confirmed stage II or IIIa (T1-T3, N1-N2, M0) adenocarcinoma of the breast HER2 overexpression (2-3+ by immunochemistry)
  • Bilateral breast cancer allowed
  • Must have had local breast cancer surgery within past 12 weeks
  • Mastectomy or lumpectomy with clear surgical margins AND axillary lymph node dissection with at least 6 nodes removed
  • Hormone receptor status: Not specified

PATIENT CHARACTERISTICS:

  • Age: 18 and over
  • Sex: Female
  • WBC at least 3,000/mm3
  • Platelet count at least 100,000/mm3
  • Hemoglobin at least 9 g/dL
  • Bilirubin no greater than 1.5 times upper limit of normal (ULN)
  • Creatinine no greater than 1.5 times ULN
  • LVEF at least 50%
  • No history of congestive cardiomyopathy
  • No congestive heart failure or myocardial infarction within the past 6 months
  • No uncontrolled hypertension
  • No uncontrolled arrhythmia within the past 6 months
  • No other prior malignancy within the past 5 years except curatively treated basal or squamous cell skin cancer or carcinoma in situ of the cervix
  • No other serious medical illness that would limit survival to less than 2 years
  • No psychiatric condition precluding study
  • Not pregnant or nursing
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

  • No prior chemotherapy for breast cancer
  • No prior hormonal therapy for breast cancer
  • At least one year since prior tamoxifen for chemoprevention (e.g., Breast Cancer Prevention Trial)
  • No prior radiotherapy to the breast, chest wall, or regional lymph nodes

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Arm I
Patients receive paclitaxel IV over 3 hours immediately followed by trastuzumab (Herceptin) IV over 30-90 minutes on day 1. Paclitaxel repeats every 3 weeks for 4 courses and trastuzumab (Herceptin) repeats weekly for 10 courses. At 3 weeks following paclitaxel and trastuzumab (Herceptin), patients receive doxorubicin IV and cyclophosphamide IV over 1 hour every 3 weeks for 4 courses. Following chemotherapy, estrogen receptor (ER) positive and/or progesterone receptor (PR) positive patients receive oral tamoxifen twice daily for 5 years.
Legemiddel: cyklofosfamid
Legemiddel: doksorubicinhydroklorid
Legemiddel: paklitaksel
Biologisk: trastuzumab
Legemiddel: tamoxifen sitrat
Eksperimentell: Arm II
Patients receive same therapy as in Arm I, except for additional trastuzumab (Herceptin) IV weekly beginning within 3 weeks following completion of chemotherapy and local therapy and continuing for 1 year. ER and/or PR positive patients receive tamoxifen as in Arm I but may be concurrent with trastuzumab (Herceptin). Following completion of doxorubicin and cyclophosphamide, post lumpectomy and post mastectomy patients may receive local radiotherapy daily for 5-6 weeks. Treatment continues in the absence of disease progression or unacceptable toxicity.
Legemiddel: cyklofosfamid
Legemiddel: doksorubicinhydroklorid
Legemiddel: paklitaksel
Biologisk: trastuzumab

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

National Cancer Institute (NCI)

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

  • Sledge GW, O'Neill A, Thor A, et al.: Adjuvant trastuzumab: long-term results of E2198. [Abstract] Breast Cancer Res Treat 100 (Suppl 1): A-2075, S106, 2006.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. august 1999

Primær fullføring (Faktiske)

1. januar 2007

Studiet fullført (Faktiske)

1. mars 2009

Datoer for studieregistrering

Først innsendt

1. november 1999

Først innsendt som oppfylte QC-kriteriene

8. juni 2004

Først lagt ut (Anslag)

9. juni 2004

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

3. juni 2013

Siste oppdatering sendt inn som oppfylte QC-kriteriene

31. mai 2013

Sist bekreftet

1. mars 2013

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • NCI-2012-02305
  • E-2198
  • CDR0000067197 (Registeridentifikator: PDQ (Physician Data Query))

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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