Cisplatin, Paclitaxel, and Everolimus in Treating Patients With Metastatic Breast Cancer

This study has been completed.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Ingrid Mayer, MD, Vanderbilt-Ingram Cancer Center
ClinicalTrials.gov Identifier:
NCT00680758
First received: May 18, 2008
Last updated: March 7, 2013
Last verified: March 2013
  Purpose

RATIONALE: Drugs used in chemotherapy, such as cisplatin and paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Everolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving more than one drug (combination chemotherapy) together with everolimus may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of cisplatin, paclitaxel, and everolimus when given together for the treatment of patients with metastatic breast cancer.


Condition Intervention Phase
Breast Cancer
Drug: cisplatin
Drug: everolimus
Drug: paclitaxel
Phase 1

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase I Study of Cisplatin, Paclitaxel, and RAD001 Patients With Metastatic Breast Cancer

Resource links provided by NLM:


Further study details as provided by Vanderbilt-Ingram Cancer Center:

Primary Outcome Measures:
  • Safety profile and maximum tolerated dose [ Time Frame: At 4 weeks ] [ Designated as safety issue: Yes ]
    The Maximum Tolerated Dose (MTD) will be the dose level at which fewer than 2 of 6 (or 33% of) patients experience dose limiting toxicity (DLT).


Secondary Outcome Measures:
  • Antitumor activity [ Time Frame: Date of study entry to date of progression of disease ] [ Designated as safety issue: No ]
    Cisplatin + Paclitaxel + RAD001 combination by determining response rates (RR) and time to progression (TTP) achieved with treatment

  • Response rate [ Time Frame: at baseline and every 8 weeks to disease progression ] [ Designated as safety issue: No ]
  • Time to progression [ Time Frame: date of study entry to date of disease progression ] [ Designated as safety issue: No ]

Enrollment: 18
Study Start Date: May 2008
Study Completion Date: December 2010
Primary Completion Date: August 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Therapeutic Intervention Drug: cisplatin
  • Dose Level: -3 20mg/m2/week 3-6 patients
  • Dose Level: -2 20mg/m2/week 3-6 patients
  • Dose Level: -1 25mg/m2/week 3-6 patients
  • Dose Level: 1 25mg/m2/week 3-6 patients
  • Dose Level: 2 25mg/m2/week 3-6 patients
  • Dose Level: 3 25mg/m2/week 3-6 patients
Other Name: Platinol
Drug: everolimus
  • Dose Level: -3 20mg/m2/week 3-6 patients
  • Dose Level: -2 20mg/m2/week 3-6 patients
  • Dose Level: -1 20mg/m2/week 3-6 patients
  • Dose Level: 1 20mg/m2/week 3-6 patients
  • Dose Level: 2 25mg/m2/week 3-6 patients
  • Dose Level: 3 30mg/m2/week 3-6 patients
Other Name: RAD001
Drug: paclitaxel
  • Dose Level: -3 65mg/m2/week 3-6 patients
  • Dose Level: -2 70mg/m2/week 3-6 patients
  • Dose Level: -1 70mg/m2/week 3-6 patients
  • Dose Level: 1 80mg/m2/week 3-6 patients
  • Dose Level: 2 80mg/m2/week 3-6 patients
  • Dose Level: 3 80mg/m2/week 3-6 patients
Other Name: Taxol

Detailed Description:

OBJECTIVES:

Primary

  • To establish the safety profile and the maximum tolerated dose of the combination of cisplatin, paclitaxel, and everolimus in patients with metastatic breast cancer.

Secondary

  • To explore the antitumor activity of this regimen, in terms of response rate and time to progression in these patients.

OUTLINE: This is a multicenter study.

Patients receive cisplatin intravenously (IV) over 1 hour and paclitaxel IV over 1 hour on days 1, 8, and 15. Patients receive oral everolimus on days 1, 8, 15, and 21. Courses repeat every 4 weeks in the absence of disease progression and unaccepted toxicity.

After completion of study therapy, patients are followed at 4 weeks.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

DISEASE CHARACTERISTICS:

  • Histologically confirmed invasive mammary carcinoma

    • Stage IV disease
  • No locally recurrent breast cancer
  • Patients with HER2/neu overexpressing tumors must have received prior trastuzumab (Herceptin®) in first-line treatment of metastatic breast cancer
  • Patients with estrogen receptor- or progesterone receptor-expressing tumors must have received prior endocrine therapy (i.e., aromatase inhibitors, fulvestrant, tamoxifen, or ovarian ablation) in first-line treatment of metastatic breast cancer
  • No symptomatic brain metastases

    • Patients with a history of brain metastases must be clinically stable and not taking steroids or therapeutic anticonvulsants that are CYP3A4 modifiers
    • Patients with asymptomatic brain metastases on prophylactic convulsants that are CYP3A4 modifiers are not eligible
  • Hormone receptor status not specified

PATIENT CHARACTERISTICS:

  • Menopausal status not specified
  • ECOG performance status 0-1
  • Life expectancy ≥ 6 months
  • ANC ≥ 1000/mm^3
  • Platelet count ≥ 100,000/mm^3
  • Creatinine ≤ 1.5 times upper limit of normal (ULN)
  • Bilirubin ≤ 1.5 times ULN (3 times ULN if liver metastasis present)
  • SGOT and SGPT ≤ 1.5 times ULN (3 times ULN if liver metastasis present)
  • Alkaline phosphatase ≤ 3 times ULN if liver metastasis present
  • Able to swallow and retain oral medication
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 3 months after completion of study treatment
  • Must be disease-free from prior invasive cancers for > 5 years with the exception of completely resected basal cell or squamous cell carcinoma of the skin or successfully treated cervical carcinoma in situ
  • No malabsorption syndrome, disease significantly affecting gastrointestinal function, or ulcerative colitis
  • No uncontrolled intercurrent illness including, but not limited to:

    • Ongoing or active infection requiring parenteral antibiotics
    • Impairment of lung function (i.e., chronic obstructive pulmonary disease or lung conditions requiring oxygen therapy)
    • Symptomatic New York Heart Association class III-IV congestive heart failure
    • Unstable angina pectoris, angioplasty, stenting, or myocardial infarction within the past 6 months
    • Uncontrolled hypertension (systolic blood pressure [BP] > 180 mm Hg or diastolic BP > 100 mm Hg)
    • Clinically significant cardiac arrhythmia (i.e., multifocal premature ventricular contractions, bigeminy, trigeminy, or ventricular tachycardia that is symptomatic or requires treatment)
    • Uncontrolled diabetes
    • Psychiatric illness/social situations that would preclude compliance with study requirements
  • No known history of uncontrolled or symptomatic neuropathy ≥ grade 2
  • No hypersensitivity to paclitaxel, or drugs using the vehicle Cremophor, Chinese hamster ovary cell products, or other recombinant human antibodies

Exclusion Criteria:

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Recovered from all prior treatment
  • Must not have exceeded a total cumulative dose of life-time exposure of doxorubicin hydrochloride ≤ 360 mg/m² or epirubicin hydrochloride ≤ 640 mg/m²
  • At least 2 weeks since other prior investigational drugs
  • No prior resection of the stomach or small bowel
  • No more than 4 prior chemotherapy regimens in the metastatic setting

    • This restriction does not include endocrine therapies or single agent biologic therapies (i.e., trastuzumab)
  • Concurrent radiotherapy to painful bone metastases or areas of impending bone fracture allowed as long as radiotherapy is initiated prior to study entry
  • No concurrent trastuzumab
  • No concurrent endocrine therapy
  • No concurrent CYP3A4 modifiers
  • No concurrent herbal supplement
  • No other concurrent anticancer therapy (chemotherapy, radiotherapy, surgery, immunotherapy, hormonal therapy, or biological therapy)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00680758

Locations
United States, Tennessee
Sarah Cannon Cancer Center at Centennial Medical Center
Nashville, Tennessee, United States, 37203
Vanderbilt-Ingram Cancer Center
Nashville, Tennessee, United States, 37232-6838
Vanderbilt-Ingram Cancer Center - Cool Springs
Nashville, Tennessee, United States, 37064
Vanderbilt-Ingram Cancer Center at Franklin
Nashville, Tennessee, United States, 37064
Sponsors and Collaborators
Vanderbilt-Ingram Cancer Center
Investigators
Study Chair: Ingrid Mayer, MD Vanderbilt-Ingram Cancer Center
  More Information

No publications provided

Responsible Party: Ingrid Mayer, MD, Assistant Professor of Medicine; Clinical Director, Breast Cancer Program; Medical Oncologist, Vanderbilt-Ingram Cancer Center
ClinicalTrials.gov Identifier: NCT00680758     History of Changes
Other Study ID Numbers: VICC BRE 0770, VU-VICC-BRE-0770
Study First Received: May 18, 2008
Last Updated: March 7, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by Vanderbilt-Ingram Cancer Center:
male breast cancer
stage IV breast cancer

Additional relevant MeSH terms:
Breast Neoplasms
Breast Diseases
Neoplasms
Neoplasms by Site
Skin Diseases
Cisplatin
Everolimus
Paclitaxel
Sirolimus
Anti-Bacterial Agents
Anti-Infective Agents
Antibiotics, Antineoplastic
Antifungal Agents
Antimitotic Agents
Antineoplastic Agents
Antineoplastic Agents, Phytogenic
Immunologic Factors
Immunosuppressive Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Physiological Effects of Drugs
Radiation-Sensitizing Agents
Therapeutic Uses
Tubulin Modulators

ClinicalTrials.gov processed this record on October 21, 2014