IST Neoadjuvant Abraxane in Newly Diagnosed Breast Cancer
Neonab
Tailored Neoadjuvant Epirubicin and Cyclophosphamide (EC) and Nanoparticle Albumin Bound (Nab) Paclitaxel for Newly Diagnosed Breast Cancer
1 other identifier
interventional
60
1 country
5
Brief Summary
The aim of this project is to evaluate tailored primary systemic therapy with sequential nab paclitaxel and epirubicin and cyclophosphamide in early breast cancer. This study will be an open label phase II clinical trial. The hypothesis is that tailored neoadjuvant chemotherapy with sequential nab paclitaxel and epirubicin and cyclophosphamide is feasible and achieves high response rates. It is proposed that 60 patients will be enrolled in this study including 40 patients which are likely to have chemotherapy sensitive tumors and 20 patients who have ER positive tumors and are more likely to respond to hormonal treatment as an exploratory cohort. The target population is women with early breast cancer who are eligible for primary systemic therapy. The overall response rate in the breast will be measured. Secondary endpoints will include response rates in axillary lymph nodes, safety and tolerability and the rate of breast conservation. Participants will have a blood test to determine a specific genotype status that may help in predicting sensitivity to chemotherapy. This genotype test result is exploratory and will not influence selection of therapy for participants. Patients will also be given the option of having he their tumour tissues used in laboratory studies involving isolating cancer initiating cells from the tumor to subsequently generate breast cancer models in the laboratory and using aptamers (chemical antibodies) to target tumours.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for phase_2 breast-cancer
Started Apr 2013
Longer than P75 for phase_2 breast-cancer
5 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
March 27, 2013
CompletedStudy Start
First participant enrolled
April 1, 2013
CompletedFirst Posted
Study publicly available on registry
April 12, 2013
CompletedPrimary Completion
Last participant's last visit for primary outcome
September 1, 2015
CompletedStudy Completion
Last participant's last visit for all outcomes
June 1, 2020
CompletedJuly 2, 2017
June 1, 2017
2.4 years
March 27, 2013
June 28, 2017
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Pathological complete response in the breast
Pathological complete response defined as breast only, ypT0/ ypTis regardless of nodal status
24 weeks (time window + 4 weeks)
Secondary Outcomes (5)
Pathologic Response rate in breast and axillary lymph nodes
24 weeks (time window + 4 weeks)
Rate of pathologic complete response and near complete response in the breast combined
24 weeks (time window + 4 weeks)
Breast conservation rate
24 weeks (time window + 4 weeks)
Progression Free Survival
5 years
Safety and tolerability
During treatment (24 weeks)
Other Outcomes (1)
NQ01*2 genotype (P187S) status
Baseline
Study Arms (1)
Nab-Paclitaxel 125mg/m2
EXPERIMENTALEpirubicin 90 mg/m2 and cyclophosphamide 600mg/m2 IV every 3 weeks for 4 cycles. Nab paclitaxel 125mg/m2 IV days 1, 8 and 15 for 12 weeks In case of HER2 positive tumour patients will receive trastuzumab in combination with nab-Paclitaxel
Interventions
Nab-Paclitaxel- 125 mg/m2 days 1,8, 15 for 12 weeks
Eligibility Criteria
You may qualify if:
- The patient must have consented to participate and must have signed and dated an appropriate approved consent form.
- Female 18 Years and older
- The Eastern Cooperative Oncology Group (ECOG) performance status must be 0 or 1
- The diagnosis of invasive adenocarcinoma of the breast must have been made by core needle biopsy or limited incisional biopsy.
- Patients must have tumor diameter \>2 cm measurable at least clinically; by physical exam, unless the patient has inflammatory breast cancer, in which case measurable disease by physical exam is not required or ultrasonographic staging (T2, T3 or T4 a, b, c tumours with any clinical node status N0-N2).
- Left ventricular ejection fraction (LVEF) assessment by 2-D echocardiogram or Multi Gated Acquisition Scan (MUGA scan) performed within 3 months prior to study entry must be greater or equal to 50%.
- Adequate haematological, renal and hepatic function (neutrophils \>=2 Ă— 109/L, platelets ≥100 Ă— 109/L, hemoglobin \>=100g/L, total bilirubin ≤ 1.5 upper limit of normal (ULN), aspartate aminotransferase and alanine aminotransferase ≤1.5 Ă— ULN, alkaline phosphatases ≤2.5 ULN, creatinine ≤ 1.5 ULN).
- Negative pregnancy test
You may not qualify if:
- Severe cardiovascular, hepatic, neurologic or renal comorbid conditions
- Primary surgical treatment of the tumor or excisional biopsy or lumpectomy performed prior to study entry.
- Surgical axillary staging procedure prior to study entry.
- Definitive clinical or radiologic evidence of metastatic disease.
- History of ipsilateral invasive breast cancer regardless of treatment or ipsilateral ductal carcinoma in situ (DCIS) treated with radiotherapy (RT).
- Non-breast malignancies unless the patient is considered to be disease-free for 5 or more years prior to study entry and is deemed by her physician to be at low risk for recurrence. Patients with the following cancers are eligible if diagnosed and treated within the past 5 years: carcinoma in situ of the cervix, melanoma in situ, and basal cell and squamous cell carcinoma of the skin.
- Previous therapy with anthracyclines or taxanes for any malignancy.
- Treatment including RT, chemotherapy, and/or targeted therapy, administered for the currently diagnosed breast cancer prior to study entry.
- Continued therapy with any hormonal agent such as raloxifene, tamoxifen, or other Selective estrogen receptor modulator (SERM).
- Any sex hormonal therapy, e.g., birth control pills and ovarian hormone replacement therapy
- History of hepatitis B or C.
- Sensory/motor neuropathy greater or equal to grade 2, as defined by the current version of the NCI's CTCAE.
- Pregnancy or continuing lactation at the time of study entry.
- Use of any investigational agent within 4 weeks prior to enrollment in the study.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Barwon Healthlead
Study Sites (5)
Bankstown Lidcome Hospital
Bankstown, New South Wales, 2200, Australia
Royal North Shore Hospital
Sydney, New South Wales, 2065, Australia
Barwon Health
Geelong, Victoria, 3220, Australia
St John of God Healthcare, Geelong
Geelong, Victoria, 3220, Australia
South West Healthcare
Warrnambool, Victoria, 3280, Australia
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PMID: 18511948BACKGROUNDMurphy C, Muscat A, Ashley D, Mukaro V, West L, Liao Y, Chisanga D, Shi W, Collins I, Baron-Hay S, Patil S, Lindeman G, Khasraw M. Tailored NEOadjuvant epirubicin, cyclophosphamide and Nanoparticle Albumin-Bound paclitaxel for breast cancer: The phase II NEONAB trial-Clinical outcomes and molecular determinants of response. PLoS One. 2019 Feb 14;14(2):e0210891. doi: 10.1371/journal.pone.0210891. eCollection 2019.
PMID: 30763338DERIVEDMurphy C, Mukaro V, Tobler R, Asher R, Gibbs E, West L, Giuffre B, Baron-Hay S, Khasraw M. Evaluating the role of magnetic resonance imaging post-neoadjuvant therapy for breast cancer in the NEONAB trial. Intern Med J. 2018 Jun;48(6):699-705. doi: 10.1111/imj.13617.
PMID: 28869790DERIVED
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Mustafa Khasraw, MD
Barwon Health
Study Design
- Study Type
- interventional
- Phase
- phase 2
- Allocation
- NA
- Masking
- NONE
- Purpose
- TREATMENT
- Intervention Model
- SINGLE GROUP
- Sponsor Type
- OTHER GOV
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
March 27, 2013
First Posted
April 12, 2013
Study Start
April 1, 2013
Primary Completion
September 1, 2015
Study Completion
June 1, 2020
Last Updated
July 2, 2017
Record last verified: 2017-06