Carboplatin, Abraxane, Avastin as Neoadjuvant Therapy for Her2-Negative Breast Cancer
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Purpose
In the MDACC/BrUOG neoadjuvant trial with weekly paclitaxel followed by Fluorouracil Plus Doxorubicin and Cyclophosphamide (FAC), the pathologic complete response (pCR) rate in HER2(-) patients was 20%. The investigators' goal is to develop an induction chemotherapy regimen that will have a pCR rate above 30% in patients with HER2(-) disease. Based on a 1-sided 95% confidence interval using normal approximation with an expected pCR rate of at least 35%, approximately 28 patients are required for each cohort. With an assumed pCR rate of at least 35%, the investigators will have approximately 70% statistical power to conclude, with 90% certainty, that the pCR rate with the novel regimen exceeds 20%. The study will accrue approximately 60 patients in two cohorts with an inevaluable rate that does not exceed 10%.
| Condition | Intervention | Phase |
|---|---|---|
|
Breast Cancer |
Drug: Cohort 1 and Cohort 2 |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Q3week Carboplatin With Weekly Abraxaneä And Avastin + Subsequent Dose-Dense Ac With Avastin As Neoadjuvant Therapy In Resectable And Unresectable (Stage Iia-Iiib) Her2-Negative Breast Cancer |
- pathological response rates at surgery [ Time Frame: at surgery approximately 5 months after initail treatment ] [ Designated as safety issue: No ]
- Measure of Safety and Tolerability according to CTC version 3.0 [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 60 |
| Study Start Date: | September 2008 |
| Estimated Study Completion Date: | December 2016 |
| Estimated Primary Completion Date: | December 2016 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Cohort 1
Avastin 10 mg/kg IV over 90 minutes day -14 Abraxane 100 mg/m2 IV over 30 minutes weekly x 12 weeks with Carboplatin at AUC 6 over 30 min IV and Avastin 15 mg/kg IV over 30-90 minutes weeks 1,4,7, and 10 Avastin 10 mg/kg IV over 30-60 minutes cycles 1-3 (omit dose with cycle 4) Doxorubicin 60 mg/m2* and Cyclophosphamide 600 mg/m2 IV q2weeks x 4 cycles Definitive surgery Avastin 10 mg/kg IV over 30-60 minutes q2weeks x 34 weeks
|
Drug: Cohort 1 and Cohort 2
Abraxane 100 mg/m2 IV over 30 minutes weekly x 12 weeks with Carboplatin at AUC 6 over 30 min IV and Avastin 15 mg/kg IV over 30-90 minutes weeks 1,4,7, and 10 (in Cohort 2, omit dose of Avastin on week 10)
|
|
Experimental: Cohort 2
Abraxane 100 mg/m2 IV over 30 minutes days -14 and -7 Abraxane 100 mg/m2 IV over 30 minutes weekly x 12 weeks with Carboplatin at AUC 6 over 30 min IV and Avastin 15 mg/kg IV over 30-90 minutes weeks 1,4,7, and 10 (in Cohort 2, omit dose of Avastin on week 10) Definitive surgery Avastin 10 mg/kg IV over 30-60 minutes and Doxorubicin 60 mg/m2* and Cyclophosphamide 600 mg/m2 IV q2weeks x 4 cycles followed by Avastin 10 mg/kg IV over 30-60 minutes q2weeks x 34 weeks OR Avastin 10 mg/kg IV over 30-60 minutes q2weeks x 42 weeks
|
Drug: Cohort 1 and Cohort 2
Abraxane 100 mg/m2 IV over 30 minutes weekly x 12 weeks with Carboplatin at AUC 6 over 30 min IV and Avastin 15 mg/kg IV over 30-90 minutes weeks 1,4,7, and 10 (in Cohort 2, omit dose of Avastin on week 10)
|
Detailed Description:
See above brief summary
Eligibility| Ages Eligible for Study: | 19 Years and older |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Eligibility criteria
Inclusion criteria:
- Histologically documented adenocarcinoma of the breast
- ANC > 1000 cells
- Female; age > 18
- Zubrod PS 0-1
- Platelets > 100,000
- Stage IIA-IIIB disease
- Total bilirubin < 1.5 ULN
- No evidence of any metastatic disease
- Serum Creatinine < 1.5 gm/dl
- No prior systemic therapy for breast cancer or Creat Cl > 30 ml/min
- Not pregnant or lactating
- Serum ALT < 2.0 ULN
- ER, PR and HER2 status required
- LVEF (MUGA/echo WNL)
- No baseline > 2 neuropathy
- Urine protein: creat ratio < 1.0
- HER2-negative - either IHC 0-1+ or FISH ratio < 2.0
- Hemoglobin > 9 gm/dl
- (FISH testing is required for all HER2 2-3+ tumors by IHC)
Exclusion criteria:
- No Histologically documented adenocarcinoma of the breast
- No-ANC > 1000 cells
- Female; age < 18
- Zubrod PS > 0-1
- Platelets < 100,000
- Stage IV disease
- Total bilirubin > 1.5 ULN
- metastatic disease
- Serum Creatinine > 1.5 gm/dl
- prior systemic therapy for breast cancer or Creat Cl > 30 ml/min
- pregnant or lactating
- Serum ALT > 2.0 ULN baseline > 2 neuropathy
- Urine protein: creat ratio >1.0
- HER2-positive
- Hemoglobin < 9 gm/dl
Contacts and Locations| United States, Connecticut | |
| Bridgeport Hospital | |
| Bridgeport, Connecticut, United States, 06610 | |
| Yale Smilow Cancer Center | |
| New Haven, Connecticut, United States, 06519 | |
| United States, Rhode Island | |
| Women and Infants | |
| Providence, Rhode Island, United States | |
| The Miriam Hospital | |
| Providence, Rhode Island, United States, 02906 | |
| Rhode Island Hsopital | |
| Providence, Rhode Island, United States, 02903 | |
| Principal Investigator: | William Sikov, MD | Brown University |
More Information
No publications provided
| Responsible Party: | William Sikov, Principle Investigator, Brown University |
| ClinicalTrials.gov Identifier: | NCT00723125 History of Changes |
| Other Study ID Numbers: | BrUOG-BR-211A |
| Study First Received: | July 15, 2008 |
| Last Updated: | April 21, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Brown University:
|
Breast Cancer |
Additional relevant MeSH terms:
|
Breast Neoplasms Neoplasms by Site Neoplasms Breast Diseases Skin Diseases Bevacizumab Carboplatin Antineoplastic Agents |
Therapeutic Uses Pharmacologic Actions Angiogenesis Inhibitors Angiogenesis Modulating Agents Growth Substances Physiological Effects of Drugs Growth Inhibitors |
ClinicalTrials.gov processed this record on May 16, 2013