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HER2-negative Breast CancerPhase 3NCT00003440

Paclitaxel With or Without Trastuzumab in Treating Patients With or Without HER-2/Neu Breast Cancer That is Inoperable, Recurrent, or Metastatic

A Phase 3 study testing paclitaxel, trastuzumab and quality-of-life assessment in people with HER2-negative Breast Cancer and HER2-positive Breast Cancer, run by National Cancer Institute (NCI) at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This randomized phase III studies how well two different regimens of paclitaxel with or without trastuzumab works in treating patients with or without HER-2/Neu breast cancer that is inoperable, recurrent, or metastatic. Read more about this study

Who is it for?
Ages 18 years and older, women only
What is being tested?
paclitaxel, trastuzumab and quality-of-life assessment
Could I receive a placebo?
No, everyone receives an active treatment
How many people
580 participants
Where
1 siteUnited States
Study dates
Jul 1998to Jul 2004
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically confirmed adenocarcinoma of the female breast which is inoperable, recurrent or metastatic
  • HER-2/neu status must be known at the time of protocol registration; HER-2/neu assessment will be based on FISH analysis of either the primary tumor or a metastatic site; a scoring of 0 or 1+ by immunohistochemistry (IHC) is considered negative; 2+ is considered negative unless confirmed by FISH positivity, in which case it should be considered positive; 3+ by IHC is considered positive; for centers using FISH only, a positive FISH assay by itself is sufficient to determine HER-2 positivity
  • Patients with the following prior therapy are eligible:
  • Patients with 0-1 prior chemotherapy regimens for metastatic or locally advanced breast cancer, with the following exception: no prior taxane for metastatic/locally advanced breast cancer
  • Patients with 0-1 prior chemotherapy regimens in the adjuvant setting; if adjuvant regimen included a taxane, patient must have been disease free for at least 12 months from completion of adjuvant therapy until relapse
  • Patients must be > 2 weeks from prior surgery, other than simple biopsy or placement of venous access device; patients must be > 4 weeks from prior chemotherapy; patients must be >6 weeks from nitrosoureas, melphalan, or mitomycin
Show all 25Show fewer
  • Patients must be > 4 weeks from prior hormonal therapy unless tumor measurements document clear progression while on treatment; if progression is documented and toxicity from hormonal regimen has resolved, patients may be placed on study > 1 week from prior hormonal therapy
  • Prior Herceptin therapy is not allowed
  • Patients with central nervous system metastases are eligible only if the patient has completed cranial irradiation at least 6 months prior, is currently asymptomatic, and is not currently receiving corticosteroids for this condition; patients with leptomeningeal carcinoma (carcinomatous meningitis) are not eligible
  • MESURABLE DISEASE: Any mass reproducibly measurable in two perpendicular dimensions, examples include:
  • Pulmonary nodules
  • Hepatic lesions
  • Skin nodules (if two measurements can be assigned)
  • Lymph nodes
  • The following lesions do not qualify as measurable:
  • Central nervous system (CNS) lesions
  • Bone disease only; lytic lesions should be documented and followed
  • Lymphangitic pulmonary metastases (patients with lymphangitic metastases are eligible if there are other sites of metastatic disease which can be measured)
  • Lesions which have been irradiated unless there is definite documentation of progression since radiotherapy
  • A baseline assessment of left ventricular ejection fraction within 8 weeks of registration is required (echocardiogram or resting multi gated acquisition scan [MUGA] (radionuclide cineangiography [RNCA]) nuclear scintigraphy); patients with a left ventricular ejection fraction (LVEF) < 45% are ineligible
  • Granulocytes >= 1500/ul
  • Platelet count >= 100,000/ul
  • Creatinine =< 2.0 mg/dl
  • Bilirubin within institutional normal limits
  • Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST])

Who cannot join

None listed.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Cancer and Leukemia Group B

    Chicago, Illinois, 60606

Other trials in United States

About this study

Official title: A Phase III Study of Paclitaxel Via Weekly 1 Hour Infusion Versus Standard 3 Hour Infusion Every 3 Weeks With Herceptin (Trastuzumab) (NSC #688097) in the Treatment of Patients With/Without HER-2/Neu-Overexpressing Metastatic Breast Cancer

This randomized phase III studies how well two different regimens of paclitaxel with or without trastuzumab works in treating patients with or without HER-2/Neu breast cancer that is inoperable, recurrent, or metastatic. Drugs used in chemotherapy, such as paclitaxel, use different ways to stop tumor cells from dividing so they stop growing or die. Monoclonal antibodies, such as trastuzumab, can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. It is not yet known what regimen of paclitaxel is more effective with or without trastuzumab in treating patients with breast cancer.

Read the detailed description

PRIMARY OBJECTIVES:

  1. To determine whether "dose dense" (DD) treatment with paclitaxel via weekly 1-hour infusion has a significantly higher response rate than "standard" (S) paclitaxel treatment, regardless of human epidermal growth factor receptor 2 (HER-2/neu) status and assignment to Herceptin (trastuzumab).

II. To determine if the addition of Herceptin to DD or S paclitaxel significantly improves the response rate as compared to DD or S paclitaxel alone for HER-2/neu non-overexpressing metastatic breast cancer (e.g., 0 or 1+).

III. To determine whether the addition of Herceptin to chemotherapy treatment modifies the quality of life experienced by patients with HER-2/neu non-overexpressing metastatic breast cancer.

IV. To determine whether the quality of life experienced by patients with metastatic breast cancer who have been treated with "standard" paclitaxel treatment differ from that of patients treated with "dose dense" paclitaxel treatment.

  1. To correlate amplification and overexpression of the growth factor receptor ErbB2 by immunohistochemistry and fluorescent in-situ hybridization (FISH) with response rate, time to progression, and overall survival of patients with metastatic breast cancer treated with paclitaxel chemotherapy and paclitaxel + Herceptin.

VI. To correlate ErbB2 shed extracellular domain (ECD) with response rate, time to progression, and overall survival of patients with metastatic breast cancer treated with different doses and schedules of paclitaxel and paclitaxel + Herceptin. In addition, to follow patterns of ErbB2/ECD after treatment and upon relapse.

SECONDARY OBJECTIVES:

  1. To evaluate time to progression and survival of patients with HER-2 overexpressing metastatic breast cancer treated with either DD or S paclitaxel plus weekly Herceptin.

II. To evaluate time to progression and survival of patients with HER-2 non-overexpressing metastatic breast cancer treated with either DD or S paclitaxel alone or DD or S paclitaxel plus weekly Herceptin.

III. To evaluate cardiac toxicity as measured by changes in LVEF from baseline to follow-up measurements.

OUTLINE; Patients are assigned to 1 of 2 treatment groups.

GROUP I (HER2/neu non-overexpressors): Patients are randomized to 1 of 4 treatment arms.

ARM A: Patients receive paclitaxel intravenously (IV) over 3 hours every 3 weeks.

ARM B: Patients receive paclitaxel IV over 1 hour weekly.

ARM C: Patients receive paclitaxel as in Arm A. Patients also receive trastuzumab IV weekly.

ARM D: Patients receive paclitaxel as in Arm B and trastuzumab as in Arm C.

GROUP II (HER2/neu overexpression): Patients are assigned to 1 of 2 treatment arms.

ARM E: Patients receive paclitaxel and trastuzumab as in Arm C.

ARM F: Patients receive paclitaxel and trastuzumab as in Arm D.

In all arms, courses repeat every 3 weeks in the absence of disease progression or unacceptable toxicity.

After the completion of study treatment, patients are followed up periodically for up to 5 years.

Being tested
paclitaxel, trastuzumab, quality-of-life assessment, laboratory biomarker analysis
Medical subject headings
Breast Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • paclitaxelDrug

    Also called Anzatax, Asotax, TAX, Taxol

    Given IV over 1 hour or 3 hours

  • trastuzumabBiological

    Also called anti-c-erB-2, Herceptin, MOAB HER2

    Given IV

  • quality-of-life assessmentProcedure or surgery

    Also called quality of life assessment

    Ancillary studies

  • laboratory biomarker analysisOther

    Correlative studies

Study groups in NCT00003440
Study groupRoleWhat they receive
Arm A (paclitaxel)ExperimentalPatients receive paclitaxel intravenously (IV) over 3 hours every 3 weeks.
Receives: Drug: paclitaxel; Procedure: quality-of-life assessment; Other: laboratory biomarker analysis
Arm B (paclitaxel)Active comparatorPatients receive paclitaxel IV over 1 hour weekly.
Receives: Drug: paclitaxel; Procedure: quality-of-life assessment; Other: laboratory biomarker analysis
Arm C (paclitaxel, trastuzumab)ExperimentalPatients receive paclitaxel as in Arm I. Patients also receive trastuzumab IV weekly.
Receives: Drug: paclitaxel; Biological: trastuzumab; Procedure: quality-of-life assessment; Other: laboratory biomarker analysis
Arm D (paclitaxel, trastuzumab)Active comparatorPatients receive paclitaxel as in Arm II and trastuzumab as in Arm III.
Receives: Drug: paclitaxel; Biological: trastuzumab; Procedure: quality-of-life assessment; Other: laboratory biomarker analysis
Am E (paclitaxel, trastuzumab)ExperimentalPatients receive paclitaxel and trastuzumab as in Arm C.
Receives: Drug: paclitaxel; Biological: trastuzumab; Procedure: quality-of-life assessment; Other: laboratory biomarker analysis
Arm F (paclitaxel, trastuzumab)Active comparatorPatients receive paclitaxel and trastuzumab as in Arm D.
Receives: Drug: paclitaxel; Biological: trastuzumab; Procedure: quality-of-life assessment; Other: laboratory biomarker analysis

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Response rate (complete response [CR]) and partial response [PR])

    Multivariate logistic regression will be used to relate patient characteristics and pretreatment clinical variables with tumor response (complete or partial). Interim analyses will use a chi square statistic to compare response incidence by treatment arm with two-sided bounds constructed from the O'Brien-Fleming approach

    Measured: Up to 5 years

Secondary outcomes (7)
  1. Overall survival

    Kaplan-Meier curves will be plotted for each of the arms. Sets of curves will be compared using the logrank statistic. A Cox proportional hazards regression model will be used to relate length of survival with paclitaxel dose schedule, HER-2/neu status, Herceptin use (for HER-2/neu negatives), number of sites of metastases at baseline, ER status,

    Measured: Up to 5 years

  2. Time to disease progression:

    Kaplan-Meier curves will be plotted for each combination of therapy. Sets of curves will be compared using the logrank statistic. A Cox proportional hazards regression model will be used to relate length of survival with paclitaxel dose schedule, HER-2/neu status, Herceptin use (for HER-2/neu negatives), number of sites of metastases at baseline, ER status, CALGB performance status, prior adjuvant chemotherapy, and prior radiotherapy.

    Measured: Up to 5 years

  3. Duration of response

    For patients who achieve response within each arm, Kaplan-Meier curves will be used to estimate probability distributions for duration of response. Distributions will be compared using the logrank statistic.

    Measured: Length of time between response and disease progression, assessed up to 5 years

  4. Cardiac toxicity as measured by changes in LVEF

    Cardiac toxicity will be evaluated using multivariate logistic regression.

    Measured: From baseline to up to 5 years

  5. Toxicity as assessed by CALGB Expanded Common Toxicity Criteria

    Toxicity frequency will be tabulated by most severe occurrence.

    Measured: Up to 5 years

  6. Change in quality of life (QOL)

    EORTC Breast Cancer Module QLQ-BR23, Changes in Function (C-616), Centers for Epidemiologic Studies-Depression (CES-d) Short Form (C-617), MOS Social Support Questionnaire (C-249), Spirituality Subscale (C-613) will be used to assess QOL. Multiple regression will be used to examine whether sociodemographic characteristics (age, gender, education, marital status, ethnicity, employment status); treatment (chemotherapy dose, Herceptin usage); clinical factors (HER2 status, performance status); and pre-treatment QOL, social support and spirituality, are significant predictors of survival.

    Measured: From baseline to up to 9 months

  7. Correlation between ErbB2 and response to treatment

    Correlation will be assessed using contingency tables for two dichotomous variables, point biserial correlation for one dichotomous and one continuous variable and Pearson correlation for two dichotomous variables.

    Measured: Up to 5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Jan 2003 (estimated)
  2. Study startJul 1998
  3. Primary completionJul 2004

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
580 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00003440
Sponsor's protocol ID
NCI-2012-02792
Other IDs
CALGB-9840, U10CA031946
Status last verified
Jun 2013
First submitted
1 Nov 1999
Last updated
4 Jun 2013
Results posted
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing paclitaxel, trastuzumab and quality-of-life assessment in people with HER2-negative Breast Cancer and HER2-positive Breast Cancer, run by National Cancer Institute (NCI) at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 25 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 4 Jun 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Response rate (complete response [CR]) and partial response [PR]) (time frame: Up to 5 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Jun 2013.

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