Breast CancerPhase 3TACT2NCT00301925
Combination Chemotherapy in Treating Patients With Early Stage Breast Cancer That Has Been Removed By Surgery
A Phase 3 study testing pegfilgrastim, capecitabine and cyclophosphamide in people with Breast Cancer, run by Institute of Cancer Research, United Kingdom at 152 sites in United Kingdom.
Trial summary
RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Read more about this study
- Who is it for?
- Ages 18 to 120 years
- Conditions the study is for
- Breast Cancer
- What is being tested?
- pegfilgrastim, capecitabine and cyclophosphamide
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 4,400 participants
- Where
- 152 sitesUnited Kingdom
- Study dates
- 16 Dec 2005to Sep 2024
- 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 to 120 years
- All sexes
- No healthy volunteers
- Adult, Older adult
DISEASE CHARACTERISTICS:
- Histological diagnosis of invasive breast carcinoma
- Cytological proof of malignancy alone is not sufficient
- Early stage disease (T0-3, N0-2, M0) without clinical suspicion or evidence of distant metastases on routine staging
- No locally advanced breast cancer (T4 and/or N3 disease)
- Completely resected disease by breast-conserving surgery with axillary node clearance or modified radical mastectomy within the past 4-8 weeks
- Negative surgical margins required, unless either of the following are true:
- Deep surgical margins after full thickness resection
- Noninvasive cancer at surgical margins for which a mastectomy is planned after completion of study chemotherapy
- No contraindication for or refusal of postoperative radiotherapy in patients who underwent prior breast-conserving surgery
- Definite indication for adjuvant chemotherapy
- No prior or current invasive breast cancer or bilateral breast cancer
- Prior surgically-treated ductal carcinoma in situ or lobular carcinoma in situ allowed
- Hormone receptor status:
- Estrogen receptor- and/or progesterone receptor-positive or -negative tumor
PATIENT CHARACTERISTICS:
- Sex: male or female
- Menopausal status: premenopausal or postmenopausal
- No previous malignancy except basal cell carcinoma, carcinoma in situ of the cervix, or any cancer from which the patient has been disease-free for 10 years and for which treatment consisted solely of resection
- ECOG status 0 or 1
- Hemoglobin > 9 g/dL
- WBC > 3,000/mm³
- Platelet count > 10,000/mm³
- Bilirubin normal (unless due to known Gilbert's disease)
- AST and ALT ≤ 1.5 times upper limit of normal (ULN)
- Albumin normal
- Creatinine ≤ 1.5 times ULN
- Creatinine clearance > 50 mL/min
- No active, uncontrolled infection
- Not pregnant or nursing
- Fertile patients must use effective contraception
- No concurrent medical, psychiatric, or geographic problems that might prevent completion of treatment or follow-up
- Available for a minimum of 5 years' follow-up
- No known serious viral infection such as active hepatitis B, hepatitis C, or HIV
- No significant cardiac disease, such as impaired left ventricular function or active angina requiring regular anti-anginal medication and/or resulting in restricted physical activity
- No history of significant renal impairment or disease
PRIOR CONCURRENT THERAPY:
- No simultaneous participation in the active intervention phase of another treatment trial
- Not being approached or recruited for another trial within 2 months of study entry
- No previous chemotherapy, hormonal therapy or radiotherapy for the treatment of pre-invasive or invasive cancer except for either of the following:
- Previous radiotherapy for basal cell carcinoma
- Previous preoperative endocrine therapy, provided there was no evidence of progression during this therapy, it lasted for less than 6 weeks in duration, and it was stopped at least one month prior to trial entry
- Concurrent luteinizing hormone-releasing hormone analog therapy allowed for premenopausal patients
- More than 4 weeks since prior hormone replacement therapy (HRT) or pre-operative endocrine therapy
- No prior breast conserving surgery if there is a contradiction for or refusal of postoperative radiotherapy
Trial locations and contacts
152 sites in 1 country.
152 sites in 1 country
United Kingdom152 sites
Aberdeen Royal Infirmary
Aberdeen, Scotland, AB25 2ZN
Bronglais District General Hospital
Aberystwyth, Wales, SY23 1ER
William Harvey Hospital
Ashford-Kent, England, TN24 0LZ
Wansbeck General Hospital
Ashington, England, NE63 9JJ
Tameside General Hospital
Ashton-under-Lyne, England, OL6 9RW
Ayr Hospital
Ayr, Scotland, KA6 6DX
Ysbyty Gwynedd
Bangor, Wales, LL57 2PW
Barnet General Hospital
Barnet, Hertfordshire, EN5 3DJ
North Devon District Hospital
Barnstaple, England, EX31 4JB
Furness General Hospital
Barrow in Furness, England, LA14 4LF
Basildon University Hospital
Basildon, England, SS16 5NL
Basingstoke and North Hampshire NHS Foundation Trust
Basingstoke, England, RG24 9NA
Belfast City Hospital Trust Incorporating Belvoir Park Hospital
Belfast, Northern Ireland, BT8 8JR
Centre for Cancer Research and Cell Biology at Queen's University Belfast
Belfast, Northern Ireland, BT9 7AB
Queen Elizabeth Hospital at University Hospital of Birmingham NHS Trust
Birmingham, England, B15 2TH
City Hospital - Birmingham
Birmingham, England, B18 7QH
Birmingham Heartlands Hospital
Birmingham, England, B9 5SS
Royal Blackburn Hospital
Blackburn, England, BB2 3HH
Blackpool Victoria Hospital
Blackpool, England, FY3 8NR
Royal Bolton Hospital
Bolton, Lancashire, England, BL4 0JR
Bradford Royal Infirmary
Bradford, England, BD9 6RJ
Princess of Wales Hospital
Bridgend, Wales, CF31 1JP
Sussex Cancer Centre at Royal Sussex County Hospital
Brighton, England, BN2 5BF
Bristol Haematology and Oncology Centre
Bristol, England, BS2 8ED
Broomfield Hospital
Broomefield, England, CM1 7ET
Burnley General Hospital
Burnley, England, BB10 2PQ
Queen's Hospital
Burton-on-Trent, England, DE13 0RB
West Suffolk Hospital
Bury St Edmunds, England, IP33 2QZ
Addenbrooke's Hospital
Cambridge, England, CB2 2QQ
Kent and Canterbury Hospital
Canterbury, England, CT2 3NG
Velindre Cancer Center at Velindre Hospital
Cardiff, Wales, CF14 2TL
Cheltenham General Hospital
Cheltenham, England, GL53 7AN
Halton Hospital
Cheshire, England, WA7 2DA
Chesterfield Royal Hospital
Chesterfield, England, S44 5BL
Saint Richards Hospital
Chichester, England, P019 4SE
Essex County Hospital
Colchester, England, C03 3NB
Walsgrave Hospital
Coventry, England, CV2 2DX
Darent Valley Hospital
Dartford Kent, England, DA2 8DA
Derbyshire Royal Infirmary
Derby, England, DE1 2QY
Dewsbury and District Hospital
Dewsbury, England, WF13 4HS
Doncaster Royal Infirmary
Doncaster, England, DN2 5LT
Russells Hall Hospital
Dudley, England, DY1 2HQ
Dumfries & Galloway Royal Infirmary
Dumfries, Scotland, DG1 4AP
Ninewells Hospital
Dundee, Scotland, DD1 9SY
Queen Margaret Hospital - Dunfermline
Dunfermline, Scotland, KY12 0SU
University Hospital of North Durham
Durham, England, DH1 5TW
Hairmyres Hospital
East Kilbride, Scotland, G75 8RG
Eastbourne District General Hospital
Eastbourne, England, BN21 2UD
Edinburgh Cancer Centre at Western General Hospital
Edinburgh, Scotland, EH4 2XU
Dr Gray's Hospital
Elgin, Scotland, IV30 1SN
Royal Devon and Exeter Hospital
Exeter, England, EX2 5DW
Falkirk & District Royal Infirmary
Falkirk, Scotland, FK1 5QE
Queen Elizabeth Hospital
Gateshead, England, NE9 6SX
Beatson West of Scotland Cancer Centre
Glasgow, Scotland, G11 6NT
Royal Infirmary - Castle
Glasgow, Scotland, G4 0SF
Gloucestershire Royal Hospital
Gloucester, England, GL1 3NN
Inverclyde Royal Hospital
Greenock, Scotland, PA16 0XN
Diana Princess of Wales Hospital
Grimsby, England, DN33 2BA
St. Luke's Cancer Centre at Royal Surrey County Hospital
Guildford, England, GU2 7XX
UCL Cancer Institute
Hampstead, London, England, NW3 2QG
Withybush General Hospital
Haverfordwest, Wales, SA61 2PZ
Hereford Hospitals NHS Trust
Hereford, England, HR1 2ER
Wycombe General Hospital
High Wycombe, England
Huddersfield Royal Infirmary
Huddersfield, West Yorks, England, HD3 3EA
Princess Royal Hospital at Hull and East Yorkshire NHS Trust
Hull, England, HU8 9HE
King George Hospital
Ilford, Essex, England, IG3 8YB
Raigmore Hospital
Inverness, Scotland, 1V2 3UJ
Ipswich Hospital
Ipswich, England, IP4 5PD
West Middlesex University Hospital
Isleworth, England, TW7 6AF
Airedale General Hospital
Keighley, England, BD20 6TD
Kettering General Hosptial
Kettering, Northants, England, NNI6 8UZ
Kidderminster Hospital
Kidderminster Worcestershire, England, DY11 6RJ
Crosshouse Hospital
Kilmarnock, Scotland, KA2 OBE
Queen Elizabeth Hospital
Kings Lynn, England, PE30 4ET
Royal Albert Edward Infirmary
Lancanshire, England, WN1 2NN
Royal Lancaster Infirmary
Lancaster, England, LA1 4RP
Cookridge Hospital
Leeds, England, LS16 6QB
National Cancer Research Network
Leeds, England, LS2 9LN
Cancer Research UK Clinical Centre at St. James's University Hospital
Leeds, England, LS9 7TF
Leeds Cancer Centre at St. James's University Hospital
Leeds, England, LS9 7TF
Royal Glamorgan Hospital
Lhantrisant, Wales, CF72 8XR
Royal Liverpool University Hospital
Liverpool, England, L7 8XP
Aintree University Hospital
Liverpool, England, L9 7AL
St. John's Hospital
Livingston, Scotland, EH54 6PP
Barts and the London School of Medicine
London, England, EC1M 6BQ
Whittington Hospital
London, England, N19 5NF
University College Hospital
London, England, NW1 2BU
Guy's Hospital
London, England, SE1 9RT
King's College Hospital
London, England, SE5 9RS
St. George's Hospital
London, England, SW17 0QT
St. Mary's Hospital
London, England, W2 1NY
Charing Cross Hospital
London, England, W6 8RF
Altnagelvin Area Hospital
Londonderry, Northern Ireland, BT47 1SB
Macclesfield District General Hospital
Macclesfield, England, SK10 3BL
Maidstone Hospital
Maidstone, England, ME16 9QQ
Christie Hospital
Manchester, England, M20 4BX
Withington Hospital
Manchester, England, M20 8LR
North Manchester General Hospital - Penine Actute Hospitals Trust
Manchester, England, M8 6RB
Queen Elizabeth The Queen Mother Hospital
Margate, England, CT9 4AN
Clatterbridge Centre for Oncology
Merseyside, England, CH63 4JY
Prince Charles Hospital
Mid Glamorgan, Wales, CF47 9DT
James Cook University Hospital
Middlesbrough, England, TS4 3BW
Northern Centre for Cancer Treatment at Newcastle General Hospital
Newcastle upon Tyne, England, NE4 6BE
St. Mary's Hospital
Newport, England, PO30 5TG
Royal Gwent Hospital
Newport Gwent, Wales, NP9 2UB
James Paget Hospital
Norfolk, England, NR31 6LA
North Tyneside Hospital
North Shields, England, NE29 8NH
Friarage Hospital
North Yorks, England, DL6 1JG
Northampton General Hospital NHS Trust
Northampton, England, NN6 8BJ
Norfolk and Norwich University Hospital
Norwich, England, NR4 7UY
Nottingham City Hospital NHS Trust
Nottingham, England, NG5 1PB
King's Mills Hospital
Nottinghamshire, England, NG17 4JL
George Eliot Hospital
Nuneaton, England, CV10 7DJ
Royal Oldham Hospital
Oldham, England, OL1 2JH
Radcliffe Infirmary NHS Trust
Oxford, England, OX2 6HE
Churchill Hospital
Oxford, England, OX3 7LJ
Peterborough Hospitals Trust
Peterborough, England, PE3 6DA
Pontefract General Infirmary
Pontefract West Yorkshire, England, WF8 1PL
Whiston Hospital
Prescot Merseyside, England, L35 5DR
Royal Preston Hospital
Preston, England, PR2 4QF
Alexandra Healthcare NHS
Redditch, Worcestershire, England, B98 7UB
Glan Clwyd Hospital
Rhyl, Denbighshire, Wales, LL 18 5UJ
Oldchurch Hospital
Romford, England, RM7 OBE
Conquest Hospital
Saint Leonards-on-Sea, England, TN37 7RD
Salisbury District Hospital
Salisbury, England, SP2 8BJ
Scarborough General Hospital
Scarborough, Scotland, YO12 6QL
Scunthorpe General Hospital
Scunthorpe, England, DN15 7BH
Cancer Research Centre at Weston Park Hospital
Sheffield, England, S1O 2SJ
Royal Shrewsbury Hospital
Shrewsbury, England, SY3 8XQ
Solihull Hospital
Solihull, England, B91 2JL
Southampton General Hospital
Southampton, England, SO16 6YD
Southport and Formby District General Hospital
Southport, England, PR8 6PN
Stepping Hill Hospital
Stockport, England, SK2 7JE
University Hospital of North Staffordshire
Stoke-on-Trent, England, ST4 7LN
Sunderland Royal Hospital
Sunderland, England, SR4 7TP
Great Western Hospital
Swindon, England, SN3 6BB
Taunton and Somerset Hospital
Taunton, England, TA1 5DA
Torbay Hospital
Torquay, England, TQ2 7AA
Royal Cornwall Hospital
Truro, Cornwall, England, TR1 3LJ
Pinderfields General Hospital
Wakefield, Scotland, WF1 4DG
Walsall Manor Hospital
Walsall, England, WS2 9PS
Warrington Hospital NHS Trust
Warrington, England, WA5 1QG
South Warwickshire Hospital
Warwick, Warwickshire, England, CV34 5BJ
Sandwell General Hospital
West Bromwich, England, B71 4HJ
Southend University Hospital NHS Foundation Trust
Westcliff-on-Sea, England, SS0 0RY
Weston General Hospital
Weston-super-Mare, England, BS23 4TQ
Royal Hampshire County Hospital
Winchester, England, SO22 5DG
Wishaw General Hospital
Wishaw, Scotland, ML2 0DP
New Cross Hospital
Wolverhampton, England, WV10 0QP
Worcester Royal Hospital
Worcester, England, WR5 1DD
Wrexham Maelor Hospital
Wrexham, Wales, LL13 7NT
Yeovil District Hospital
Yeovil - Somerset, England, BA21 4AT
About this study
Official title: Trial of Accelerated Adjuvant Chemotherapy With Capecitabine in Early Breast Cancer (TACT2)
RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Giving combination chemotherapy after surgery may kill any remaining tumor cells. It is not yet known which combination chemotherapy regimen is more effective in treating early stage breast cancer that has been removed by surgery.
PURPOSE: This randomized phase III trial is studying four different combination chemotherapy regimens to compare how well they work in treating patients with early stage breast cancer that has been removed by surgery.
Read the detailed description
OBJECTIVES:
Primary
- Compare the disease-free survival (DFS) of patients with completely resected early stage breast cancer receiving 1 of 2 different schedules of adjuvant chemotherapy comprising epirubicin, cyclophosphamide, methotrexate, and fluorouracil versus 1 of 2 different schedules of adjuvant chemotherapy comprising epirubicin and capecitabine.
Secondary
- Compare overall survival (OS) and distant disease-free survival (DFS).
- Compare the tolerability (including serious adverse events [SAE], dose-intensity, and toxicity) of these regimens.
- Determine the detailed toxicity of these regimens.
- Determine the quality of life of a subset of these patients.
OUTLINE: This is a multi-center, randomized study. Patients are stratified according to participating center, nodal status (N0 vs N1-3 vs N≥ 4), age (≤ 50 years vs > 50 years), and estrogen receptor (ER) status (negative vs positive). Patients are randomized to 1 of 4 treatment arms.
- Arm I: Patients receive epirubicin on day 1. Treatment repeats every 3 weeks for 4 courses. Patients then receive cyclophosphamide orally once daily on days 1-14 or IV on days 1 and 8 and methotrexate and fluorouracil on days 1 and 8. Treatment repeats every 28 days for 4 courses.
- Arm II: Patients receive epirubicin on day 1 and pegfilgrastim on day 2. Treatment repeats every 2 weeks for 4 courses. Patients then receive cyclophosphamide, methotrexate and fluorouracil as in arm I.
- Arm III: Patients receive epirubicin as in arm I. Patients then receive oral capecitabine twice daily on days 1-14. Treatment with capecitabine repeats every 3 weeks for 4 courses.
- Arm IV: Patients receive epirubicin and pegfilgrastim as in arm II. Patients then receive capecitabine as in arm III.
In all arms, treatment continues in the absence of unacceptable toxicity.
Beginning 3-6 months later, all patients may undergo radiotherapy at the discretion of the principal investigator. Patients with ER- and/or progesterone receptor-positive disease then receive tamoxifen citrate or an aromatase inhibitor for up to 5 years.
Quality of life is assessed in a cohort of 1,000 patients in week 6, week 8 or 12, and week 20 or 24 during treatment and then at 12 and 24 months after randomization.
After completion of study therapy, patients are followed every 6 months for 2 years and then annually for at least 10 years.
Peer Reviewed and Funded or Endorsed by Cancer Research UK.
PROJECTED ACCRUAL: A total of 4,400 patients will be accrued for this study.
- Conditions
- Breast Cancer
- Being tested
- pegfilgrastim, capecitabine, cyclophosphamide, epirubicin hydrochloride, fluorouracil
- Keywords
- stage I breast cancer, stage II breast cancer, stage IIIA breast cancer, male breast cancer
- Medical subject headings
- Breast Neoplasms, Breast Neoplasms, Male
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
pegfilgrastimBiological
capecitabineDrug
cyclophosphamideDrug
epirubicin hydrochlorideDrug
fluorouracilDrug
methotrexateDrug
adjuvant therapyProcedure or surgery
| Study group | Role | What they receive |
|---|---|---|
| Epi-CMF | Active comparator | Not described Receives: Drug: cyclophosphamide; Drug: epirubicin hydrochloride; Drug: fluorouracil; Drug: methotrexate; Procedure: adjuvant therapy |
| Accelerated Epi-CMF | Experimental | Not described Receives: Biological: pegfilgrastim; Drug: cyclophosphamide; Drug: epirubicin hydrochloride; Drug: fluorouracil; Drug: methotrexate; Procedure: adjuvant therapy |
| Epi-Capecitabine | Experimental | Not described Receives: Drug: capecitabine; Drug: epirubicin hydrochloride; Procedure: adjuvant therapy |
| Accelerated Epi-Capecitabine | Experimental | Not described Receives: Biological: pegfilgrastim; Drug: capecitabine; Drug: epirubicin hydrochloride; Procedure: adjuvant therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Disease-free survival (DFS) at 5 years
Secondary outcomes (5)
Overall survival at 5 years
Distant DFS at 5 years
Tolerability (including serious adverse events, dose-intensity, and toxicity)
Detailed toxicity
Quality of life
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Mar 2006 (estimated)
- Study start16 Dec 2005
- Primary completionSep 2024 (estimated)
- Study completionSep 2024 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- More trials run by Institute of Cancer Research, United KingdomThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Factorial
- Enrolment
- 4,400 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Institute of Cancer Research, United Kingdom
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- David Cameron, MD, Study chair, National Cancer Research Network
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00301925
- Sponsor's protocol ID
- CDR0000463447
- Other IDs
- ICR-TACT2, EU-205114, EUDRACT-2004-000066-13, MREC-04/MRE00/88, ISRCTN68068041
- Acronym
- TACT2
- Status last verified
- Aug 2018
- First submitted
- 9 Mar 2006
- Last updated
- 8 Aug 2018
- Results posted
- No
Publications
Velikova G, Morden JP, Haviland JS, Emery C, Barrett-Lee P, Earl H, Bloomfield D, Brunt AM, Canney P, Coleman R, Verrill M, Wardley A, Bertelli G, Ellis P, Stein R, Bliss JM, Cameron D; TACT2 Trial Management Group. Accelerated versus standard epirubicin followed by cyclophosphamide, methotrexate, and fluorouracil or capecitabine as adjuvant therapy for breast cancer (UK TACT2; CRUK/05/19): quality of life results from a multicentre, phase 3, open-label, randomised, controlled trial. Lancet Oncol. 2023 Dec;24(12):1359-1374. doi: 10.1016/S1470-2045(23)00460-6. Epub 2023 Nov 2.
PubMed 37926100Hoon SN, Lau PK, White AM, Bulsara MK, Banks PD, Redfern AD. Capecitabine for hormone receptor-positive versus hormone receptor-negative breast cancer. Cochrane Database Syst Rev. 2021 May 26;5(5):CD011220. doi: 10.1002/14651858.CD011220.pub2.
PubMed 34037241Cameron D, Morden JP, Canney P, Velikova G, Coleman R, Bartlett J, Agrawal R, Banerji J, Bertelli G, Bloomfield D, Brunt AM, Earl H, Ellis P, Gaunt C, Gillman A, Hearfield N, Laing R, Murray N, Couper N, Stein RC, Verrill M, Wardley A, Barrett-Lee P, Bliss JM; TACT2 Investigators. Accelerated versus standard epirubicin followed by cyclophosphamide, methotrexate, and fluorouracil or capecitabine as adjuvant therapy for breast cancer in the randomised UK TACT2 trial (CRUK/05/19): a multicentre, phase 3, open-label, randomised, controlled trial. Lancet Oncol. 2017 Jul;18(7):929-945. doi: 10.1016/S1470-2045(17)30404-7. Epub 2017 Jun 7.
PubMed 28600210
Study at a glance
From the registry record, last updated by the sponsor on 8 Aug 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Trial of Accelerated Adjuvant Chemotherapy With Capecitabine in Early Breast Cancer (TACT2)
- ClinicalTrials.gov ID
- NCT00301925
- Acronym / sponsor ID
- TACT2 / CDR0000463447
- Conditions
- Breast Cancer
- Keywords
- stage I breast cancer, stage II breast cancer, stage IIIA breast cancer, male breast cancer
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 4,400 participants (estimated)
- Lead sponsor
- Institute of Cancer Research, United KingdomUniversity, hospital or other
- Study start
- 16 Dec 2005 (actual)
- Primary completion
- Sep 2024 (estimated)
- Study completion
- Sep 2024 (estimated)
- First posted
- 13 Mar 2006 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Giving combination chemotherapy after surgery may kill any remaining tumor cells. It is not yet known which combination chemotherapy regimen is more effective in treating early stage breast cancer that has been removed by surgery.
PURPOSE: This randomized phase III trial is studying four different combination chemotherapy regimens to compare how well they work in treating patients with early stage breast cancer that has been removed by surgery.
Detailed description
OBJECTIVES:
Primary
- Compare the disease-free survival (DFS) of patients with completely resected early stage breast cancer receiving 1 of 2 different schedules of adjuvant chemotherapy comprising epirubicin, cyclophosphamide, methotrexate, and fluorouracil versus 1 of 2 different schedules of adjuvant chemotherapy comprising epirubicin and capecitabine.
Secondary
- Compare overall survival (OS) and distant disease-free survival (DFS).
- Compare the tolerability (including serious adverse events [SAE], dose-intensity, and toxicity) of these regimens.
- Determine the detailed toxicity of these regimens.
- Determine the quality of life of a subset of these patients.
OUTLINE: This is a multi-center, randomized study. Patients are stratified according to participating center, nodal status (N0 vs N1-3 vs N≥ 4), age (≤ 50 years vs > 50 years), and estrogen receptor (ER) status (negative vs positive). Patients are randomized to 1 of 4 treatment arms.
- Arm I: Patients receive epirubicin on day 1. Treatment repeats every 3 weeks for 4 courses. Patients then receive cyclophosphamide orally once daily on days 1-14 or IV on days 1 and 8 and methotrexate and fluorouracil on days 1 and 8. Treatment repeats every 28 days for 4 courses.
- Arm II: Patients receive epirubicin on day 1 and pegfilgrastim on day 2. Treatment repeats every 2 weeks for 4 courses. Patients then receive cyclophosphamide, methotrexate and fluorouracil as in arm I.
- Arm III: Patients receive epirubicin as in arm I. Patients then receive oral capecitabine twice daily on days 1-14. Treatment with capecitabine repeats every 3 weeks for 4 courses.
- Arm IV: Patients receive epirubicin and pegfilgrastim as in arm II. Patients then receive capecitabine as in arm III.
In all arms, treatment continues in the absence of unacceptable toxicity.
Beginning 3-6 months later, all patients may undergo radiotherapy at the discretion of the principal investigator. Patients with ER- and/or progesterone receptor-positive disease then receive tamoxifen citrate or an aromatase inhibitor for up to 5 years.
Quality of life is assessed in a cohort of 1,000 patients in week 6, week 8 or 12, and week 20 or 24 during treatment and then at 12 and 24 months after randomization.
After completion of study therapy, patients are followed every 6 months for 2 years and then annually for at least 10 years.
Peer Reviewed and Funded or Endorsed by Cancer Research UK.
PROJECTED ACCRUAL: A total of 4,400 patients will be accrued for this study.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Factorial
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Epi-CMF | Active comparator | Drug: cyclophosphamide, Drug: epirubicin hydrochloride, Drug: fluorouracil, Drug: methotrexate, Procedure: adjuvant therapy |
| Accelerated Epi-CMF | Experimental | Biological: pegfilgrastim, Drug: cyclophosphamide, Drug: epirubicin hydrochloride, Drug: fluorouracil, Drug: methotrexate, Procedure: adjuvant therapy |
| Epi-Capecitabine | Experimental | Drug: capecitabine, Drug: epirubicin hydrochloride, Procedure: adjuvant therapy |
| Accelerated Epi-Capecitabine | Experimental | Biological: pegfilgrastim, Drug: capecitabine, Drug: epirubicin hydrochloride, Procedure: adjuvant therapy |
Who may qualify
- Ages
- 18 to 120 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| pegfilgrastim | Biological | Accelerated Epi-CMF, Accelerated Epi-Capecitabine |
| capecitabine | Drug | Accelerated Epi-Capecitabine, Epi-Capecitabine |
| cyclophosphamide | Drug | Accelerated Epi-CMF, Epi-CMF |
| epirubicin hydrochloride | Drug | Accelerated Epi-CMF, Accelerated Epi-Capecitabine, Epi-CMF, Epi-Capecitabine |
| fluorouracil | Drug | Accelerated Epi-CMF, Epi-CMF |
| methotrexate | Drug | Accelerated Epi-CMF, Epi-CMF |
| adjuvant therapy | Procedure or surgery | Accelerated Epi-CMF, Accelerated Epi-Capecitabine, Epi-CMF, Epi-Capecitabine |
Primary outcome
Disease-free survival (DFS) at 5 years
5 secondary outcomes
Overall survival at 5 years
Distant DFS at 5 years
Tolerability (including serious adverse events, dose-intensity, and toxicity)
Detailed toxicity
Quality of life
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Aug 2018.
- Derived from this study: PubMed 37926100Velikova G, Morden JP, Haviland JS, Emery C, Barrett-Lee P, Earl H, Bloomfield D, Brunt AM, Canney P, Coleman R, Verrill M, Wardley A, Bertelli G, Ellis P, Stein R, Bliss JM, Cameron D; TACT2 Trial Management Group. Accelerated versus standard epirubicin followed by cyclophosphamide, methotrexate, and fluorouracil or capecitabine as adjuvant therapy for breast cancer (UK TACT2; CRUK/05/19): quality of life results from a multicentre, phase 3, open-label, randomised, controlled trial. Lancet Oncol. 2023 Dec;24(12):1359-1374. doi: 10.1016/S1470-2045(23)00460-6. Epub 2023 Nov 2.
- Derived from this study: PubMed 34037241Hoon SN, Lau PK, White AM, Bulsara MK, Banks PD, Redfern AD. Capecitabine for hormone receptor-positive versus hormone receptor-negative breast cancer. Cochrane Database Syst Rev. 2021 May 26;5(5):CD011220. doi: 10.1002/14651858.CD011220.pub2.
- Derived from this study: PubMed 28600210Cameron D, Morden JP, Canney P, Velikova G, Coleman R, Bartlett J, Agrawal R, Banerji J, Bertelli G, Bloomfield D, Brunt AM, Earl H, Ellis P, Gaunt C, Gillman A, Hearfield N, Laing R, Murray N, Couper N, Stein RC, Verrill M, Wardley A, Barrett-Lee P, Bliss JM; TACT2 Investigators. Accelerated versus standard epirubicin followed by cyclophosphamide, methotrexate, and fluorouracil or capecitabine as adjuvant therapy for breast cancer in the randomised UK TACT2 trial (CRUK/05/19): a multicentre, phase 3, open-label, randomised, controlled trial. Lancet Oncol. 2017 Jul;18(7):929-945. doi: 10.1016/S1470-2045(17)30404-7. Epub 2017 Jun 7.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
David Cameron, MD study chair
National Cancer Research Network
152 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing pegfilgrastim, capecitabine and cyclophosphamide in people with Breast Cancer, run by Institute of Cancer Research, United Kingdom at 152 sites in United Kingdom.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
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 8 Aug 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 152 sites in United Kingdom. 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?
Results are not available in the source record.
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?
Disease-free survival (DFS) at 5 years. 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 NCT00301925, which also lists 3 linked publications.
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 8 Aug 2018.