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Metastatic Breast CancerPhase 3NCT00262067

A Study Evaluating the Efficacy and Safety of Bevacizumab in Combination With Chemotherapy in Untreated Metastatic Breast Cancer (RIBBON 1)

A Phase 3 study testing Bevacizumab and Chemotherapy in people with Metastatic Breast Cancer, run by Genentech, Inc. at 92 sites in 22 countries.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This is a Phase III, multicenter, randomized, placebo-controlled trial designed to evaluate the efficacy and safety of bevacizumab in combination with chemotherapy compared with chemotherapy alone in subjects with previously untreated metastatic breast cancer. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Metastatic Breast Cancer
What is being tested?
Bevacizumab and Chemotherapy
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
1,237 participants
Where
92 sitesin 22 countries
Study dates
Dec 2005to Dec 2013
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

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
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically or cytologically confirmed adenocarcinoma of the breast, with measurable or non-measurable locally recurrent or metastatic disease.
  • Signed Informed Consent Form.
  • Age ≥ 18 years.
  • For women of childbearing potential, use of accepted and effective method of non-hormonal contraception.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Ability and capacity to comply with study and follow-up procedures.
  • For anthracycline cohort only: Adequate left ventricular function at study entry, defined as a left ventricular ejection fraction (LVEF) ≥ 50% by either multigated acquisition (MUGA) scan scan or echocardiography (ECHO).
  • For subjects who have received recent radiation therapy, recovery prior to baseline (Day 0) from any significant (Grade ≥ 3) acute toxicity.

Who cannot join

  • Unknown human epidermal growth factor receptor 2 (HER2) status or known HER2-positive status.
  • Prior chemotherapy for locally recurrent or metastatic disease.
  • Prior hormonal therapy less than 1 week prior to Day 0.
  • Prior adjuvant or neoadjuvant chemotherapy within 12 months prior to Day 0.
  • For anthracycline cohort only: Prior anthracycline as part of neoadjuvant or adjuvant therapy for localized breast cancer.
  • Investigational therapy within 28 days of Day 0.
Show all 24Show fewer
  • Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to Day 0, or anticipation of need for major surgical procedure during the course of the study.
  • Minor surgical procedures, such as fine needle aspirations or core biopsies, within 7 days prior to Day 0.
  • Prior therapy with bevacizumab, sorafenib, sunitinib, or other vascular endothelial growth factor (VEGF) pathway-targeted therapy.
  • Known brain or other central nervous system (CNS) metastases.
  • Blood pressure of > 150/100 mmHg.
  • Unstable angina.
  • New York Heart Association (NYHA) Grade II or greater congestive heart failure (CHF).
  • History of myocardial infarction within 6 months prior to Day 0.
  • History of stroke or transient ischemic attack within 6 months prior to Day 0.
  • Clinically significant peripheral vascular disease.
  • Evidence of bleeding diathesis or coagulopathy.
  • History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to Day 0.
  • Serious non-healing wound, ulcer, or bone fracture.
  • Pregnancy (positive serum pregnancy test) or lactation.
  • Inadequate organ function, as evidenced by any of the following laboratory values: Absolute neutrophil count < 1500/uL; platelet count < 100,000/uL; total bilirubin > 1.5 mg/dL; alkaline phosphatase, AST, and/or ALT > 2x upper limit of normal (ULN) (> 5x ULN in subjects with known liver or, for alkaline phosphatase elevations, bone involvement); alkaline phosphatase > 2x ULN (> 7x ULN in subjects with known bone involvement); serum creatinine > 2.0 mg/dL; partial thromboplastin time (PTT) and/or either international normalized ratio (INR) or prothrombin time (PT) > 1.5x upper limit of normal (except for subjects receiving anti-coagulation therapy); urine protein/creatinine ratio > 1.0 at screening for U.S. subjects, or urine dipstick for proteinuria >/= 1+ at screening followed by 24-hour urine collection demonstrating > 1 g protein/24 hr for ex-U.S. subjects.
  • Uncontrolled serious medical or psychiatric illness.
  • Active infection requiring intravenous (iv) antibiotics at Day 0.
  • History of other malignancies within 5 years of Day 0 except for tumors with a negligible risk for metastasis or death, such as adequately controlled basal cell carcinoma or squamous-cell carcinoma of the skin or carcinoma in situ of the cervix (subjects with a history of bilateral breast cancer will be eligible).

Trial locations and contacts

92 sites in 22 countries.

92 sites in 22 countries

Russia13 sites
  • Study site

    Chelyabinsk, 454 087

  • Study site

    Ivanovo, 153040

  • Study site

    Kazan', 420029

  • Study site

    Kazan', 420111

  • Study site

    Moscow, 115478

  • Study site

    Moscow, 117837

  • Study site

    Moscow, 129128

  • Study site

    Novosibirsk, 630047

  • Study site

    Obninsk, 249036

  • Study site

    Ryazan, 390011

  • Study site

    Saint Petersburg, 197758

  • Study site

    Samara, 443066

  • Study site

    Ufa, 450054

Other trials in Russia

Spain10 sites
  • Study site

    A Coruña, 15006

  • Study site

    Córdoba, 14004

  • Study site

    Elche, 03203

  • Study site

    Girona, 17007

  • Study site

    Madrid, 28034

  • Study site

    San Cristóbal de La Laguna, 38320

  • Study site

    Santander, 39008

  • Study site

    Seville, 41013

  • Study site

    Valencia, 46010

  • Study site

    Zaragoza, 50009

Other trials in Spain

Australia8 sites
  • Study site

    Geelong, 3220

  • Study site

    Malvern, 3144

  • Study site

    Melbourne, 3002

  • Study site

    Perth, 6008

  • Study site

    Southport, 4215

  • Study site

    Wahroonga, 2076

  • Study site

    Waratah, 2298

  • Study site

    Wollongong, 2500

Other trials in Australia

United Kingdom7 sites
  • Study site

    Chelsmford, CM1 7ET

  • Study site

    Cottingham, HU16 5JQ

  • Study site

    Epping, CM16 6TN

  • Study site

    Huddersfield, HD3 3EA

  • Study site

    Nottingham, NG5 1PB

  • Study site

    Sheffield, S1O 2SJ

  • Study site

    Swansea, SA2 8QA

Other trials in United Kingdom

Ukraine6 sites
  • Study site

    Cherkassy, 18009

  • Study site

    Dnipropetrovsk, 49102

  • Study site

    Kiev, 03115

  • Study site

    Lviv, 79031

  • Study site

    Odesa, 65055

  • Study site

    Zaporizhzhya, 69104

Other trials in Ukraine

United States5 sites
  • Study site

    Fullerton, California, 92835

  • Study site

    Iowa City, Iowa, 52242

  • Study site

    Santa Barbara, California, 93105

  • Study site

    Sioux City, Iowa, 51101

  • Study site

    Wichita, Kansas, 67214-3728

Other trials in United States

Brazil5 sites
  • Study site

    Porto Alegre, 91350-200

  • Study site

    Rio de Janeiro, 22260-020

  • Study site

    Salvador, 40170-110

  • Study site

    Santo André, 09060-870

  • Study site

    São Paulo, 03102-002

Other trials in Brazil

France5 sites
  • Study site

    Marseille, 13273

  • Study site

    Paris, 75248

  • Study site

    Reims, 51100

  • Study site

    Saint-Herblain, 44805

  • Study site

    Strasbourg, 67010

Other trials in France

Greece5 sites
  • Study site

    Athens, 11521

  • Study site

    Chania, 73300

  • Study site

    Heraklion, 71110

  • Study site

    Pátrai, 26500

  • Study site

    Thessaloniki, 57001

Other trials in Greece

Mexico5 sites
  • Study site

    Acapulco, 39670

  • Study site

    Aguascalientes, 20230

  • Study site

    Mérida, 97500

  • Study site

    Monterrey, 64020

  • Study site

    Monterrey, 64380

Other trials in Mexico

Canada3 sites
  • Study site

    Montreal, Quebec, H2L 4M1

  • Study site

    Montreal, Quebec, H2W 1S6

  • Study site

    Winnipeg, Manitoba, R2H 2A6

Other trials in Canada

Netherlands3 sites
  • Study site

    Amstelveen, 1186 AH

  • Study site

    Apeldoorn, 7334 DZ

  • Study site

    Delft, 2600 GA

Other trials in Netherlands

South Korea3 sites
  • Study site

    Kyunggi-do, 411-769

  • Study site

    Seoul, 110-744

  • Study site

    Seoul, 120-752

Other trials in South Korea

Sweden3 sites
  • Study site

    Gävle, 80187

  • Study site

    Örebro, 701 85

  • Study site

    Uppsala, 751 85

Other trials in Sweden

Norway2 sites
  • Study site

    Oslo, 0310

  • Study site

    Oslo, 0407

Other trials in Norway

Singapore2 sites
  • Study site

    Singapore, 119228

  • Study site

    Singapore, 169610

Other trials in Singapore

Taiwan2 sites
  • Study site

    Tainan, 704

  • Study site

    Taoyuan, 333

Other trials in Taiwan

Guatemala1 site
  • Study site

    Guatemala City, 01015

Other trials in Guatemala

Panama1 site
  • Study site

    Panama City

Other trials in Panama

Peru1 site
  • Study site

    Callao

Other trials in Peru

Philippines1 site
  • Study site

    Quezon City, 1114

Other trials in Philippines

Uruguay1 site
  • Study site

    Montevideo, 11200

Other trials in Uruguay

About this study

Official title: A Multicenter, Phase III, Randomized, Placebo-controlled Trial Evaluating the Efficacy and Safety of Bevacizumab in Combination With Chemotherapy Regimens in Subjects With Previously Untreated Metastatic Breast Cancer

This is a Phase III, multicenter, randomized, placebo-controlled trial designed to evaluate the efficacy and safety of bevacizumab in combination with chemotherapy compared with chemotherapy alone in subjects with previously untreated metastatic breast cancer.

Read the detailed description

This study includes a blinded treatment phase, an optional open-label post-progression phase, and a survival follow-up phase. During the blinded treatment phase, patients receive chemotherapy and study drug (bevacizumab or placebo) every 3 weeks until disease progression, treatment-limiting toxicity, or death due to any cause. The optional open-label post-progression phase consists of chemotherapy treatment (per investigator discretion) and optional treatment with open-label bevacizumab. Patients who complete the study or who discontinue from treatment (regardless of participation in the optional open-label post-progression phase) will be followed for survival and subsequent anti-cancer therapies every 4 months until death, withdrawal of consent, loss to follow-up, or study termination. Patients who discontinue from treatment during the blinded treatment phase for reasons other than disease progression will have tumor assessments every 9 weeks until documented disease progression or death.

Being tested
Bevacizumab, Placebo, Chemotherapy
Medical subject headings
Breast Neoplasms

What participants receive

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

  • BevacizumabDrug

    Also called Avastin

    Patients received bevacizumab until disease progression, treatment limiting toxicity, or death due to any cause up to a maximum treatment duration of 48 months. The dose of bevacizumab was based on the patient's weight at either screening or baseline and remained the same throughout the blinded treatment phase of the study. The initial dose was delivered over 90±10 minutes. If there were no infusion related adverse events (fever and/or chills), the second infusion was delivered over 60±10 minutes. If the 60 minute infusion was well tolerated, all subsequent infusions were delivered over 30±10 minutes.

  • PlaceboDrug

    Placebo consisted of the vehicle for bevacizumab without the antibody.

  • ChemotherapyDrug

    The chemotherapy was selected by the investigator prior to randomization. Chemotherapy treatment continued until disease progression, unacceptable toxicity, investigator/patient decision, or death, whichever occurred first, except for the anthracycline-based regimens, which had a maximum treatment duration of 8 cycles.

    Taxanes - 1 of the following 2 taxanes on Day 1 of every 21-day cycle

    1. Docetaxel 75-100 mg/m^2 IV
    2. Paclitaxel protein-bound particles (Abraxane®) 260 mg/m^2 IV

    Anthracyclines - 1 of the following 4 anthracycline-based regimens on Day 1 of every 21-day cycle

    1. 5-fluorouracil 500 mg/m^2 IV + epirubicin 90-100 mg/m^2 IV + cyclophosphamide 500 mg/m^2 IV
    2. 5-fluorouracil 500 mg/m^2 IV + doxorubicin 50 mg/m^2 IV + cyclophosphamide 500 mg/m^2 IV
    3. Doxorubicin 50-60 mg/m^2 IV + cyclophosphamide 500-600 mg/m^2 IV
    4. Epirubicin 90-100 mg/m^2 IV + cyclophosphamide 500-600 mg/m^2 IV

    Capecitabine: 1000 mg/m^2 orally twice daily on Days 1-14 of each 21-day cycle

Study groups in NCT00262067
Study groupRoleWhat they receive
Bevacizumab + chemotherapyExperimentalPatients received bevacizumab 15 mg/kg intravenously (IV) on Day 1 of every 21-day cycle plus one of several standard chemotherapies (taxanes, anthracycline-based regimens, or capecitabine) for metastatic breast cancer.
Receives: Drug: Bevacizumab; Drug: Chemotherapy
Placebo + chemotherapyPlacebo comparatorPatients received placebo to bevacizumab administered IV on Day 1 of every 21-day cycle + 1 of several standard chemotherapies (taxanes, anthracycline-based regimens, or capecitabine) for metastatic breast cancer.
Receives: Drug: Placebo; Drug: Chemotherapy

What is being measured

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

  1. Progression-free Survival (PFS) as Determined by the Investigator Using Response Evaluation Criteria in Solid Tumors (RECIST)

    PFS was defined as the time from randomization to first documented disease progression (PD) as determined by the investigator using Response Evaluation Criteria in Solid Tumors (RECIST) or death due to any cause, whichever occurred first. For target lesions, PD was defined as at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum of the longest diameter recorded since treatment started or the appearance of 1 or more new lesions. For non-target lesions, PD was defined as the appearance of 1 or more new lesions and/or unequivocal progression of existing non-target lesions. Target lesions should be selected on the basis of their size (those with the longest diameter) and their suitability for accurate repeated measurements by imaging techniques or clinically. All measurable lesions up to a maximum of 5 lesions per organ and 10 lesions in total, representative of all involved organs, should be identified as target lesions.

    Measured: Baseline to the data cut-off date of 31 Jul 2008 (up to 2 years, 7 months)

Secondary outcomes (5)
  1. Objective Response as Determined by the Investigator Using Response Evaluation Criteria in Solid Tumors (RECIST)

    An objective response was defined as a complete response or a partial response determined on two consecutive occasions ≥ 4 weeks apart as determined by the investigator using RECIST. For target lesions, a complete response was defined as the disappearance of all target lesions; a partial response was defined as at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum longest diameter. For non-target lesions, a complete response was defined as the disappearance of all non-target lesions; a partial response was defined as the persistence of 1 or more non-target lesions.

    Measured: Baseline to the data cut-off date of 31 Jul 2008 (up to 2 years, 7 months)

  2. Duration of Objective Response as Determined by the Investigator Using Response Evaluation Criteria in Solid Tumors (RECIST)

    Duration of objective response was defined as the time from the first tumor assessment that led to a determination of an objective response to the time of disease progression or death due to any cause, whichever occurred first.

    Measured: Baseline to the data cut-off date of 31 Jul 2008 (up to 2 years, 7 months)

  3. Overall Survival

    Overall survival was defined as the time from randomization until death from any cause.

    Measured: Baseline to the data cut-off of 23 Feb 2009 (up to 3 years, 2 months)

  4. 1-year Survival

    1-year survival was defined as the percentage of patients who were alive 1 year after randomization.

    The percentage of patients alive at 1 year was determined using Kaplan-Meier analyses and the 95% confidence intervals were computed using the Brookmeyer-Crowley method.

    Measured: Baseline to the data cut-off of 23 Feb 2009 (up to 3 years, 2 months)

  5. Progression-free Survival (PFS) as Determined by the Independent Review Committee Using Response Evaluation Criteria in Solid Tumors (RECIST)

    PFS was defined as the time from randomization to first documented disease progression (PD) as determined by the Independent Review Committee using Response Evaluation Criteria in Solid Tumors (RECIST) or death due to any cause, whichever occurred first.

    Measured: Baseline to the data cut-off date of 31 Jul 2008 (up to 2 years, 7 months)

Timeline

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

  1. First posted6 Dec 2005 (estimated)
  2. Study startDec 2005
  3. Primary completionJul 2008
  4. Study completionDec 2013 (estimated)

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
1,237 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00262067
Sponsor's protocol ID
AVF3694g
Other IDs
BO20094
Status last verified
Nov 2013
First submitted
2 Dec 2005
Last updated
13 Dec 2013

Publications

  • Wedam SB, Beaver JA, Amiri-Kordestani L, Bloomquist E, Tang S, Goldberg KB, Sridhara R, Ibrahim A, Kim G, Kluetz P, McKee A, Pazdur R. US Food and Drug Administration Pooled Analysis to Assess the Impact of Bone-Only Metastatic Breast Cancer on Clinical Trial Outcomes and Radiographic Assessments. J Clin Oncol. 2018 Apr 20;36(12):1225-1231. doi: 10.1200/JCO.2017.74.6917. Epub 2018 Mar 9.

    PubMed 29522361

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Bevacizumab and Chemotherapy in people with Metastatic Breast Cancer, run by Genentech, Inc. at 92 sites in 22 countries.

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 8 inclusion and 24 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: status not confirmed, as of the sponsor's last update on 13 Dec 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 92 sites in Russia, Spain, Australia, United Kingdom, Ukraine and 17 more countries. 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. Some participants in this study may receive a placebo. 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?

Yes. Results are posted in the registry (first posted 25 Oct 2013). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Progression-free Survival (PFS) as Determined by the Investigator Using Response Evaluation Criteria in Solid Tumors (RECIST) (time frame: Baseline to the data cut-off date of 31 Jul 2008 (up to 2 years, 7 months)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00262067, which also lists 1 linked publication.

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 13 Dec 2013.

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