Evaluation of Trastuzumab Without Chemotherapy as a Postoperative Adjuvant Therapy in HER2 Positive Elderly Breast Cancer Patients (RESPECT)
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Purpose
To investigate clinical positioning between trastuzumab (Herceptin) monotherapy (H group) and combination therapy of trastuzumab and chemotherapy (H+CT group) based on a randomized controlled trial in women over 70 years with human epidermal growth factor receptor type-2 (HER2) positive primary breast cancer.
| Condition | Intervention | Phase |
|---|---|---|
|
Breast Cancer |
Drug: trastuzumab Drug: chemotherapy |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Evaluation of Trastuzumab Without Chemotherapy as a Postoperative Adjuvant Therapy in HER2 Positive Elderly Breast Cancer Patients: Randomized Controlled Trial |
- Disease free survival [ Time Frame: Patients are followed up for 7 years after initial enrollment (from Oct. 2009 through Oct. 2016). ] [ Designated as safety issue: No ]
Disease-free survival is defined as the interval from the date of enrollment to the date of any of the following events.
- Local recurrence, distant metastasis
- Metachronous breast cancer, secondary cancer
- Death
- Overall survival [ Time Frame: Patients are followed up for 7 years after initial enrollment (from Oct. 2009 through Oct. 2016). ] [ Designated as safety issue: No ]Overall survival is defined as the interval from the date of enrollment to the date of death from any cause.
- Relapse-free survival [ Time Frame: Patients are followed up for 7 years after initial enrollment (from Oct. 2009 through Oct. 2016). ] [ Designated as safety issue: No ]
Relapse-free survival is defined as the interval from the date of enrollment to the date of any of the following events.
- Local recurrence, distant metastasis
- Death
- Percentage of participants with adverse events as a measure of safety [ Time Frame: Evaluations are performed at the time of starting the specified treatment and 2, 3, and 6 month, 1 year, 1 year 6 months, 2 years, 2 years 6 months, and 3 years after the start of treatment. Subsequently, evaluations are done at 1-year intervals. ] [ Designated as safety issue: Yes ]The following variables are evaluated: left ventricular ejection fraction, white-cell count, neutrophil count, platelet count, bilirubin level, alanine aminotransferase level, aspartate aminotransferase level, alkaline phosphatase level, and creatinine level.
- Health-related QOL (HRQOL) [ Time Frame: Evaluations are performed at the time of starting the specified treatment and 2 months, 1 year, and 3 years after the start of treatment. ] [ Designated as safety issue: No ]The following QOL questionnaire forms (in Japanese) are used for evaluations: FACT-G, HADS, EQ-5D, and PNQ.
- Cost effectiveness analysis [ Time Frame: Data on direct medical costs for the 3-year period after the start of the treatment are obtained from CRF. Data on direct nonmedical costs and indirect costs are obtained from questionnaires 2, 12, and 36 months after starting the treatment. ] [ Designated as safety issue: No ]
Survey items are as follows.
- Direct medical costs: medical costs associated with therapy, the management of adverse events, etc.
- Direct nonmedical costs: transportation expenses required for medical examinations, costs of health foods, etc.
- Indirect costs: work-loss costs associated with treatment that are incurred directly by the patient and by their caregivers
| Estimated Enrollment: | 300 |
| Study Start Date: | October 2009 |
| Estimated Primary Completion Date: | October 2016 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: trastuzumab and chemotherapy |
Drug: trastuzumab
|
| Experimental: trastuzumab monotherapy |
Drug: trastuzumab
|
Eligibility| Ages Eligible for Study: | 70 Years to 80 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Histologically diagnosed as invasive breast cancer and received curative operation for primary breast cancer.
- Stage: 1 (tumor size [pT] > 0.5 cm), 2A, 2B or 3A/ M0
- Female between 69 and 81 years old
- Primary region is HER 2 positive: either 3+ overexpression by IHC or positive by FISH
- Baseline left ventricular ejection fraction (LVEF) is ≥55% measured by echocardiography or MUGA scan within 4 weeks before registration.
- PS: 0-1 (ECOG)
Sufficient organ function meeting following criteria within 4 weeks before registration:
- Leukocyte ≥2500 mm3
- Neutrophil ≥1500 mm3
- Platelet ≥100 000 mm3
- Serum total bilirubin ≤2.0 x upper limit of normal (ULN)
- ALT (GPT) or AST (GOT) ≤2.5 x ULN
- Serum creatinine ≤2.0 x ULN
- ALP ≤2.5 x ULN
- No previous endocrine therapy or chemotherapy for breast cancer
- Signed written informed consent (Appendix A)
Exclusion Criteria:
- Active multiple primary cancer (synchronous multiple primary cancer and invasive cancer of other organs)
- Postoperative histological axillary lymph node metastasis ≥4
- Axillary lymph node is not histologically evaluated
- Histologically confirmed positive margin in breast conservation surgery (evaluation of margin status is based on policy of site)
- History of drug-related allergy which could hinder planned treatment
Any history or complication of following cardiac disorders
- History of congestive heart failure, cardiac infarction
- Complication requires treatment such as: ischemic cardiac disorder, arrhythmia, valvular heart disease
- Poorly controlled hypertension (ex. Systolic arterial pressure ≥180 mmHg or diastolic blood pressure ≥100 mmHg)
- Poorly controlled diabetes
- Continuous visit to a medial institution is considered difficult due to deterioration of activity of daily living (ADL)
- Difficult to participate in the trial because of psychiatric disorder or psychiatric symptoms
- Ineligible to the trial based on decision of an investigator
Contacts and Locations| Contact: Masataka Sawaki | +81 52-762-6111 | m-sawaki@aichi-cc.jp |
| Contact: CSPOR Office | +81352872633 | support@csp.or.jp |
| Japan | |
| Aichi Cancer Center | Recruiting |
| Nagoya, Aichi, Japan, 464-8681 | |
| Contact: Masataka Sawaki +81 52-762-6111 m-sawaki@aichi-cc.jp | |
| Principal Investigator: | Masataka Sawaki | Department of Breast Oncology, Aichi Cancer Center |
More Information
Additional Information:
No publications provided
| Responsible Party: | Comprehensive Support Project for Oncology Research |
| ClinicalTrials.gov Identifier: | NCT01104935 History of Changes |
| Other Study ID Numbers: | N-SAS BC 07, RESPECT |
| Study First Received: | November 6, 2009 |
| Last Updated: | April 17, 2012 |
| Health Authority: | Japan: Ministry of Health, Labor and Welfare |
Additional relevant MeSH terms:
|
Breast Neoplasms Neoplasms by Site Neoplasms Breast Diseases Skin Diseases |
Trastuzumab Antineoplastic Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on June 13, 2013