Efficacy and Safety of Cabazitaxel Versus Weekly Paclitaxel as Neo-adjuvant Treatment in Patients With Triple Negative or Luminal B/HER2 Normal BC (GENEVIEVE)

NCT01779479 | Completed Phase 2 DMC

• 2 other identifiers: GBG 742012-003330-16
• Study Type: interventional
• Target: 333
• Locations: 1 country
• Sites: 1

Brief Summary

Cabazitaxel is a new taxoid which promotes the tubulin assembly in vitro and stabilizes microtubules against cold-induced depolymerization as efficiently as docetaxel and was selected for development based on a better antiproliferative activity on resistant cell lines than docetaxel. It has shown superior survival against mitoxantrone (MTX) plus prednisone in docetaxel pre-treated hormone refractory metastatic prostate cancer patients leading to registration of the compound. It showed a favorable toxicity profile with an interestingly low rate of alopecia. In the Genevieve study it will be compared against weekly paclitaxel which is currently most widely used treatment of breast cancer patients. A head-to-head comparison in the neoadjuvant setting will allow a rapid and precise comparison of efficacy and tolerability of cabacitaxel versus paclitaxel to decide in how far further development of this taxoid in breast cancer is reasonable.

Conditions

Primary Breast Cancer

Keywords

German Breast Group; GBG Forschungs GmbH; GBG; GBG 74; Genevieve; Breast Cancer; Primary Breast Cancer; Cabazitaxel; Paclitaxel; neo-adjuvant; triple negative; luminal B

Outcome Measures

Primary Outcomes (1)

• pathologic complete response (pCR) rate

  15 months

Secondary Outcomes (14)

• pathologic complete response (pCR) rate separately for subpopulations

  15 months

• Objective response rate (ORR)

  15 months

• pCR rate defined as ypT0 ypN0

  15 months

• pCR rate defined as ypT0/is ypN0

  15 months

• pCR rate in the axillary lymph nodes (ypN0)

  15 months

Study Arms (2)

Cabacitaxel

EXPERIMENTAL

Drug: Cabacitaxel

Paclitaxel

ACTIVE COMPARATOR

Drug: Paclitaxel

Interventions

Cabacitaxel DRUG

Cabazitaxel 25 mg/m² i.v. (Day 1) every 3 weeks (cycle) as 1-hour i.v infusion for a total of up to 4 cycles over a maximum total treatment period of 15 weeks before surgery

Cabacitaxel

Paclitaxel DRUG

Paclitaxel 80 mg/m² as 1-hour i.v infusion. Patients will receive weekly (Days 1, 8, 15) paclitaxel administrations for a maximum of 12 infusions for a maximum of 4 cycles over a maximum total treatment period of 15 weeks before surgery (1 cycle = 3 weeks).

Paclitaxel

Eligibility Criteria

• Age: 18 Years+
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Written informed consent for all study according to local regulatory requirements prior to beginning specific protocol procedures.
• Complete baseline documentation must be sent to GBG Forschungs GmbH.
• Unilateral or bilateral primary carcinoma of the breast, confirmed histologically by core biopsy. Fine-needle aspiration alone is not sufficient. Incisional biopsy is not allowed. In case of bilateral cancer, the investigator has to decide prospectively which side will be evaluated for the primary endpoint.
• Tumor lesion in the breast with a palpable size of \>= 2 cm or a sonographical size of \>= 1 cm in maximum diameter. The lesion has to be measurable in two dimensions, preferably by sonography.
• Patients must be in the following stages of disease: cT3 or cT2 or cT1c and cN+ or cT1c and pNSLN+.
• In patients with multifocal or multicentric breast cancer, the largest lesion should be evaluated.
• Centrally confirmed triple negative or luminal B/HER2-normal subtype. ER- and PgR-negative defined as \<1% stained cells. HER-2 negative defined as IHC 0+, 1+ or IHC 2+ and FISH/SISH/CISH (ratio \<2.0) negative. Luminal B defined as ER and/or PgR + and \> 14% Ki-67 stained cells. The formalin-fixed, paraffin-embedded (FFPE) breast tissue block from the diagnostic core biopsy has therefore to be sent to the Dept. of Pathology at the Charité, Berlin prior to randomization.
• Age \>= 18 years.
• Eastern Cooperative Oncology Group (ECOG) Performance Status: 0 or 1 (see Appendix A).
• Laboratory requirements: Hemoglobin \> 9.0 g/dL, Absolute neutrophil count \> 1.5 x 109/L, Platelet count \> 100 x 109/L, AST/SGOT and/or ALT/SGPT \< 2.5 x ULN; Total bilirubin \< 1.0 x ULN, Serum creatinine \< 1.5 x ULN. If creatinine 1.0 - 1.5 x ULN, creatinine clearance will be calculated according to CKD-EPI formula and patients with creatinine clearance \< 60 mL/min should be excluded (see Appendix 2 for formula).
• Negative pregnancy test (urine or serum) within 14 days prior to randomization for all women of childbearing potential.
• Complete staging work-up within 3 months prior to randomization. All patients must have bilateral mammography, breast ultrasound (\<= 21 days), breast MRI (optional), chest X-ray (PA and lateral), abdominal ultrasound or CT scan or MRI, and bone scan done. In case of positive bone scan, bone X-ray is mandatory. Other tests may be performed as clinically indicated.
• Patients must be available and compliant for central diagnostics, treatment and follow-up.

You may not qualify if:

• Any prior treatment for primary breast cancer including radiation therapy
• History of ipsi/ or contra-lateral invasive breast cancer
• Locally advanced disease including N3 and metastatic disease
• Patients in the following stages of disease are not allowed: cT4
• Prior malignancy without being disease-free for more than 5 years (except carcinoma in situ of the cervix or other in situ cancer (e.g. bladder cancer) and adequately treated basal cell carcinoma of the skin.
• Clinically significant (i.e. active) cardiovascular disease, including cerebrovascular accident (≤6 months before enrolment), myocardial infarction, arterial thrombotic events (≤6 months before enrolment), unstable angina pectoris, New York Heart Association (NYHA) ≥ grade 2 congestive heart failure and/or hypertension, serious cardiac arrhythmia requiring medication during the study and that might interfere with regularity of the study treatment, or not controlled by medication
• Any severe acute or chronic medical condition which could impair the ability of the patient to participate to the study or to comply with the study procedures or interfere with interpretation of study results (such as significant neurological or psychiatric disorders including psychotic disorders, dementia or seizures).
• Active infection.
• Sex hormones. Prior treatment must be stopped before study entry.
• Inability and unwillingness to comply with study visits, treatment, testing, and to comply with the protocol.
• Administration of any live virus vaccine within 8 weeks preceding study entry.
• Use of any investigational agent within 30 days of administration of the first dose of study drug or concurrent treatment on another clinical trial
• Requirement for radiation therapy concurrent with study anticancer treatment. Patients who require breast or chest wall radiation therapy after surgery are eligible
• Pregnancy or breastfeeding women
• Patients with childbearing potential who do not agree to use accepted and effective method of contraception (barrier methods, intrauterine contraceptive devices, sterilization) during the study treatment period and following a period of 6 months after the last study drug administration.

Sponsors & Collaborators

• GBG Forschungs GmbH: lead

Study Sites (1)

Luisenkrankenhaus

Düsseldorf, 40235, Germany

Location

Related Publications (1)

• Kummel S, Paepke S, Huober J, Schem C, Untch M, Blohmer JU, Eiermann W, Gerber B, Hanusch C, Hilfrich J, Jackisch C, Schneeweiss A, Denkert C, Engels K, Klare P, Fasching PA, von Minckwitz G, Burchardi N, Loibl S. Randomised, open-label, phase II study comparing the efficacy and the safety of cabazitaxel versus weekly paclitaxel given as neoadjuvant treatment in patients with operable triple-negative or luminal B/HER2-negative breast cancer (GENEVIEVE). Eur J Cancer. 2017 Oct;84:1-8. doi: 10.1016/j.ejca.2017.06.037. Epub 2017 Jul 30.

  PMID: 28768217 RESULT

MeSH Terms

Conditions

Breast Neoplasms

Interventions

Paclitaxel

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

Taxoids; Cyclodecanes; Cycloparaffins; Hydrocarbons, Alicyclic; Hydrocarbons, Cyclic; Hydrocarbons; Organic Chemicals; Diterpenes; Terpenes

Study Officials

• Gunter von Minckwitz, Prof. Dr.

  Luisenkrankenhaus Düsseldorf

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 25, 2013
• First Posted: January 30, 2013
• Study Start: February 1, 2013
• Primary Completion: August 1, 2015
• Study Completion: February 1, 2016
• Last Updated: August 1, 2017

Record last verified: 2016-02

Locations

DE (1)