NCT01159236

Brief Summary

The goal of this clinical research study is to learn if using "gene signatures" can be an effective way to decide the best treatment for breast cancer patients. Gene signatures may be able to help researchers predict who will respond to chemotherapy given before surgery.

Trial Health

10
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Status
withdrawn

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

July 7, 2010

Completed
2 days until next milestone

First Posted

Study publicly available on registry

July 9, 2010

Completed
2 months until next milestone

Study Start

First participant enrolled

September 1, 2010

Completed
Last Updated

July 31, 2012

Status Verified

July 1, 2012

First QC Date

July 7, 2010

Last Update Submit

July 27, 2012

Conditions

Keywords

Gene signaturesHER-2 normal stage I-III breast cancerEstrogen ReceptorER-positiveER-negativeRCB categories II-IIINeoadjuvant Chemotherapyadjuvant systemic therapymolecular testingFluorouracil5-fluorouracil5-FUDoxorubicinAdriamycinRubexEpirubicinEllenceCyclophosphamideCytoxanNeosarBevacizumabAvastinAnti-VEGF monoclonalrhu-MAb-VEGF

Outcome Measures

Primary Outcomes (1)

  • Pathological Response Rate in Patients

    Response is defined as pathologic complete (pCR/RCB-0) or near complete (RCB-I) response pathologic finding after completion of chemotherapy.

    Every 3-4 weeks during chemotherapy.

Study Arms (3)

Group 1: ER-Positive

EXPERIMENTAL

Participants with Estrogen Receptor (ER)-Positive breast cancers receive Standard T/FAC or T/FEC chemotherapy before surgery. T/FAC or T/FEC: Combination chemotherapy with sequential paclitaxel (80 mg/m2) weekly x 12 weeks followed by 5-fluorouracil (500 mg/m2), cyclophosphamide (500 mg/m2) and doxorubicin (50 mg/m2) or epirubicin (100 mg/m2) (FAC or FEC) once every 3 weeks for 4 treatments.

Drug: PaclitaxelDrug: FluorouracilDrug: DoxorubicinDrug: EpirubicinDrug: Cyclophosphamide

Group 2: ER-Negative

EXPERIMENTAL

Participants with ER-negative cancers (randomized between Group 2 \& Group 3), Standard T/FAC or T/FEC chemotherapy before surgery.

Drug: PaclitaxelDrug: FluorouracilDrug: DoxorubicinDrug: EpirubicinDrug: Cyclophosphamide

Group 3: ER-Negative + Bevacizumab

EXPERIMENTAL

Participants with ER-negative cancers (randomized between Group 2 \& Group 3), T/FEC chemotherapy combined with 10 mg Bevacizumab every 2 weeks during first 3 treatments before surgery.

Drug: PaclitaxelDrug: FluorouracilDrug: EpirubicinDrug: CyclophosphamideDrug: Bevacizumab

Interventions

80 mg/m2 by vein over about 1-2 hours once every 7 days x 12 courses.

Also known as: Taxol
Group 1: ER-PositiveGroup 2: ER-NegativeGroup 3: ER-Negative + Bevacizumab

500 mg/m2 for 4 courses (once every 7 days)

Also known as: 5-FU, Adrucil, Efudex
Group 1: ER-PositiveGroup 2: ER-NegativeGroup 3: ER-Negative + Bevacizumab

50 mg/m2 by vein given on day 1 and repeated once every 21 days for 4 treatments

Also known as: Rubex, Adriamycin
Group 1: ER-PositiveGroup 2: ER-Negative

100 mg/m2 by vein given on day 1 and repeated once every 21 days for 4 treatments, may be given instead of Doxorubicin in Group 1 and 2.

Also known as: Ellence
Group 1: ER-PositiveGroup 2: ER-NegativeGroup 3: ER-Negative + Bevacizumab

500 mg/m2 by vein given on day 1 and repeated once every 21 days for 4 treatments.

Also known as: Cytoxan, Neosar
Group 1: ER-PositiveGroup 2: ER-NegativeGroup 3: ER-Negative + Bevacizumab

10 mg/kg intravenously every 2 weeks, discontinued 6 weeks before surgery (i.e. after 3rd course of FEC or FAC)

Also known as: Avastin, Anti-VEGF monoclonal, rhuMAb-VEGF
Group 3: ER-Negative + Bevacizumab

Eligibility Criteria

Age18 Years+
Sexfemale
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients 18 years of age or older with histologically confirmed HER2-normal (defined as fluorescence in situ hybridization, FISH \< 2.2 or immunohistochemistry, IHC \<3+ if FISH result is not available) invasive carcinoma of the breast for whom systemic adjuvant therapy is clinically indicated.
  • Patients must have intact cancer in the breast and intact regional lymph nodes (diagnostic core needle or fine needle biopsies are allowed).
  • Routine estrogen, progesterone and HER-2 receptor determination must be performed before starting therapy.
  • Patients with prior history of breast cancer are eligible.
  • Patients with bilateral breast cancers are eligible.
  • Women of childbearing potential must have a negative serum pregnancy test within 2 weeks of starting chemotherapy. Patients must agree to barrier contraception (condom) while on study.
  • Patients must agree to undergo pretreatment needle biopsy of the primary tumor in the breast for molecular profiling.
  • Patients must agree to undergo surgery at MDACC and if assigned to bevacizumab containing chemotherapy it must be administered at MDACC.

You may not qualify if:

  • Patients for whom anthracycline or paclitaxel chemotherapies are contraindicated, including: uncompensated congestive heart failure, myocardial infarction within the past 12 months, pre-existing peripheral neuropathy \> grade 2, prior doxorubicin therapy with \> cumulative dose of 240 mg/m\^2
  • Women who had lumpectomy or surgical partial excisional biopsy of the cancer, or sentinel lymph node biopsy of a positive node, before starting preoperative therapy.
  • Proteinuria within 1 months of starting therapy as demonstrated by either (a) Urine protein:creatinine (UPC) ratio \>/= 1.0 or (b) proteinuria \>/= 2+ by urine dipstick test. Patients discovered to have \>/=2+ proteinuria on dipstick urinalysis at baseline should undergo a 24 hour urine collection and must demonstrate \</= 1g of protein in 24 hours to be eligible.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Links

MeSH Terms

Conditions

Breast Neoplasms

Interventions

PaclitaxelFluorouracilDoxorubicinEpirubicinCyclophosphamideBevacizumab

Condition Hierarchy (Ancestors)

Neoplasms by SiteNeoplasmsBreast DiseasesSkin DiseasesSkin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

TaxoidsCyclodecanesCycloparaffinsHydrocarbons, AlicyclicHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsDiterpenesTerpenesUracilPyrimidinonesPyrimidinesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsDaunorubicinAnthracyclinesNaphthacenesPolycyclic Aromatic HydrocarbonsHydrocarbons, AromaticPolycyclic CompoundsAminoglycosidesGlycosidesCarbohydratesPhosphoramide MustardsNitrogen Mustard CompoundsMustard CompoundsHydrocarbons, HalogenatedPhosphoramidesOrganophosphorus CompoundsAntibodies, Monoclonal, HumanizedAntibodies, MonoclonalAntibodiesImmunoglobulinsImmunoproteinsBlood ProteinsProteinsAmino Acids, Peptides, and ProteinsSerum GlobulinsGlobulins

Study Officials

  • Lajos Pusztai, MD, DPHIL

    UT MD Anderson Cancer Center

    STUDY CHAIR
0

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

July 7, 2010

First Posted

July 9, 2010

Study Start

September 1, 2010

Last Updated

July 31, 2012

Record last verified: 2012-07