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Breast CancerPhase 2NCT00542451

Adjuvant Paclitaxel and Trastuzumab for Node-Negative HER2-Positive Breast Cancer

A Phase 2 study testing Paclitaxel and Trastuzumab in people with Breast Cancer and Carcinoma of the Breast, run by Dana-Farber Cancer Institute at 20 sites 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

The purpose of this study is to find out what effect the postoperative combination of therapies: trastuzumab (herceptin) and paclitaxel (taxol) will have on breast cancer recurrence. A combination of trastuzuamb and chemotherapy has been used in women with node positive and high risk node negative disease. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Breast Cancer, Carcinoma of the Breast
What is being tested?
Paclitaxel and Trastuzumab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
406 participants
Where
20 sitesUnited States
Study dates
Oct 2007to 30 Aug 2022
Phase
Phase 2
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
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically confirmed invasive carcinoma of the breast
  • Tumors must be less than or equal to 3cm in greatest dimension
  • Must have node-negative breast cancer according to teh AJCC 7th edition
  • ER/PR determination is required. ER- and PR-assays should be performed by immunohistochemical methods
  • HER-2 positive: IHC 3+ or FISH >2
  • Bilateral breast cancers that individually meet eligibility criteria are allowed
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  • Patients should have tumor tissue available, and a tissue block of sufficient size to make 15 slides must be sent to DFCI for testing
  • Less than or equal to 84 days from mastectomy or from axillary dissection or sentinel node biopsy if the patient's most extensive breast surgery was a breast-sparing procedure
  • All tumor should be removed by either a modified radical mastectomy or a segmental mastectomy (lumpectomy), with either a sentinel node biopsy or axillary dissection
  • 18 years of age or older
  • ECOG Performance Status of 0 or 1
  • Adequate bone marrow function, hepatic function, and renal function as outlined in protocol
  • Left ventricular ejection fraction of greater than or equal to 50%
  • Willingness to discontinue any hormonal agent prior to registration and while on study
  • Willingness to discontinue sex hormonal therapy, e.g. birth control pills, prior to registration and while on study
  • Patients with a history of ipsilateral DCIS are eligible if they were treated with wide-excision alone, without radiation therapy
  • Patients undergoing breast conservation therapy must not have any contraindications to radiation therapy

Who cannot join

  • Pregnant or nursing women
  • Locally advanced tumors at diagnosis, including tumors fixed to the chest wall, peau d'orange, skin ulcerations/nodules, or clinical inflammatory changes
  • History of prior chemotherapy in past 5 years
  • History of prior trastuzumab therapy
  • Active, unresolved infection
  • Prior history of any other malignancy in the past 5 years, except for early stage tumors of the skin or cervix treated with curative intent
Show all 9Show fewer
  • Sensitivity to benzyl alcohol
  • Grade 2 or greater neuropathy per NCI's CTCAv3.0. (Exception: Any chronic neurologic disorder will be looked at on a case-by-case basis by the study chair).
  • Active cardiac disease as outlined in protocol.

Trial locations and contacts

20 sites in 1 country.

20 sites in 1 country

United States20 sites
  • John Hopkins University

    Baltimore, Maryland, 21231

  • Massachusetts General Hospital

    Boston, Massachusetts, 02114

  • Beth Israel Deaconess Medical Center

    Boston, Massachusetts, 02115

  • Dana-Farber at Faulkner Hospital

    Boston, Massachusetts, 02130

  • Dana-Farber Cancer Institute

    Boston, Massachusetts, 02215

  • University of Vermont Cancer Center

    Burlington, Vermont, 05401

  • University of North Carolina at Chapel Hill

    Chapel Hill, North Carolina, 27599

  • Case Western University

    Cleveland, Ohio, 44195

  • Duke Comprehensive Cancer Center

    Durham, North Carolina, 27710

  • Cape Cod Healthcare

    Hyannis, Massachusetts, 02601

  • Indiana University

    Indianapolis, Indiana, 46202

  • North Shore LIJ Health System Monter Cancer Center

    Lake Success, New York, 11042

  • Lowell General Hospital

    Lowell, Massachusetts, 01854

  • Loyola University Medical Center

    Maywood, Illinois, 60153

  • Tennessee Oncology

    Nashville, Tennessee, 37203

  • Memorial Sloan Kettering Cancer Center

    New York, New York, 10021

  • Weill Cornell Medical College

    New York, New York, 10065

  • North Shore Medical Center

    Peabody, Massachusetts, 01960

  • University of California-San Francisco

    San Francisco, California, 94115

  • Washington University

    St Louis, Missouri, 63110

Other trials in United States

About this study

Official title: A Phase II Trial of Adjuvant Paclitaxel and Trastuzumab for Node-Negative HER2-Positive Breast Cancer

The purpose of this study is to find out what effect the postoperative combination of therapies: trastuzumab (herceptin) and paclitaxel (taxol) will have on breast cancer recurrence. A combination of trastuzuamb and chemotherapy has been used in women with node positive and high risk node negative disease. This tests utilizes a well tolerated regimen of weekly paclitaxel and trastuzumab in women with T1, node negative tumors that are HER2 positive. We would like to determine how effective this drug combination is when used in women with early stage breast cancer, as well as to better define the side effects of this treatment.

Read the detailed description
  • Participants will enroll in this study at the time they are starting their adjuvant therapy for breast cancer. Participants will receive chemotherapy with paclitaxel every week for 12 weeks. They will begin to receive trastuzumab at the same time they begin paclitaxel. Once they have completed the 12 weeks of paclitaxel and trastuzumab, they will receive trastuzumab every 3 weeks or weekly for 40 weeks.
  • Participants will be followed with routine assessments such as physical exam and vital signs every 3 months for the first year, and then every 6 months for years 2-5. Then we would like to keep track of the participants medical condition by calling them on the telephone once per year.
Being tested
Paclitaxel, Trastuzumab
Keywords
node-negative breast cancer, HER-2 positive
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 Taxol

    Every week for 12 weeks

  • TrastuzumabDrug

    Also called Herceptin

    Once a week for twelve weeks Then once a week or once every three weeks for 40 weeks

Study groups in NCT00542451
Study groupRoleWhat they receive
Adjuvant Paclitaxel and Trastuzumab for Node-Negative HER2-Positive Breast CancerExperimental80 mg of paclitaxel per square meter of body-surface area weekly for 12 weeks and a loading dose of 4 mg of intravenous trastuzumab per kilogram of body weight on day 1, followed by 2 mg per kilogram weekly, for a total of 12 doses. After the completion of 12 weeks of treatment with Trastuzumab, the dosing of Trastuzumab could be continued on a weekly basis, or the regimen could be changed to 6 mg per kilogram every 3 weeks for 40 weeks to complete a full year of intravenous treatment with trastuzumab.
Receives: Drug: Paclitaxel; Drug: Trastuzumab

What is being measured

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

  1. 3-year Disease Free Survival (DFS) Rate

    Disease-free survival (DFS) is the proportion of participants ramaing disease free at 3 years based on the Kaplan-Meier method. DFS is defined to end at the time of the first of the following events: local/regional ipsilateral invasive recurrence (or ipsilateral invasive new primary), contralateral invasive breast cancer, distant recurrence, or death from any cause.

    Measured: at 3 years

Secondary outcomes (4)
  1. Disease Free Survival (DFS) in Patients With Tumors Measuring ≤1 cm or > 1 cm

    DFS is defined as the time from registration to the first of the following events: local/regional ipsilateral invasive recurrence (or ipsilateral invasive new primary), contralateral invasive breast cancer, distant recurrence, or death from any cause. Patients without an event are censored at the date of last evaluation.

    Measured: at 3 years

  2. Number of Patients With Grade III/IV Cardiac Left Ventricular Dysfunction

    cardiac left ventricular dysfunction related adverse events (AE) with any attribution of possibly, probably or definite based on CTCAEv3 as reported on case report forms were counted.

    Measured: AE evaluated on treatment every week during paclitaxel and every 9 weeks during trastuzumab monotheryapy, and at progression, and observation years 2-10. Median treatment duration was 11.4 months (range 0 - 23.5 months).

  3. Number of Patients With Grade III/IV Neurotoxicity

    Nervous system disorders related adverse events (AE) with any attribution of possibly, probably or definite based on CTCAEv3 as reported on case report forms were counted.

    Measured: AE evaluated on treatment every week during paclitaxel and every 9 weeks during trastuzumab monotheryapy, and at progression, and observation years 2-10. Median treatment duration was 11.4 months (range 0 - 23.5 months).

  4. Number of Patients With Amenorrhea

    Patients that eligible for amenorrhea assessment and data collecting will be evaluated by standard method defined per protocol 3.9, through menses assessment survey.

    Measured: Menses Assessment survey on Q6 months x 1 year, then q6months for year 2 and at progression, and observation years 2-10 or until progression.

Timeline

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

  1. First posted11 Oct 2007 (estimated)
  2. Study startOct 2007
  3. Primary completion21 Apr 2014
  4. Study completion30 Aug 2022

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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
406 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00542451
Sponsor's protocol ID
07-199
Status last verified
Jun 2024
First submitted
9 Oct 2007
Last updated
26 Jun 2024
Data monitoring committee
Yes

Publications

  • Tolaney SM, Tarantino P, Graham N, Tayob N, Pare L, Villacampa G, Dang CT, Yardley DA, Moy B, Marcom PK, Albain KS, Rugo HS, Ellis MJ, Shapira I, Wolff AC, Carey LA, Barroso-Sousa R, Villagrasa P, DeMeo M, DiLullo M, Zanudo JGT, Weiss J, Wagle N, Partridge AH, Waks AG, Hudis CA, Krop IE, Burstein HJ, Prat A, Winer EP. Adjuvant paclitaxel and trastuzumab for node-negative, HER2-positive breast cancer: final 10-year analysis of the open-label, single-arm, phase 2 APT trial. Lancet Oncol. 2023 Mar;24(3):273-285. doi: 10.1016/S1470-2045(23)00051-7.

    PubMed 36858723
  • Tolaney SM, Guo H, Pernas S, Barry WT, Dillon DA, Ritterhouse L, Schneider BP, Shen F, Fuhrman K, Baltay M, Dang CT, Yardley DA, Moy B, Marcom PK, Albain KS, Rugo HS, Ellis MJ, Shapira I, Wolff AC, Carey LA, Overmoyer B, Partridge AH, Hudis CA, Krop IE, Burstein HJ, Winer EP. Seven-Year Follow-Up Analysis of Adjuvant Paclitaxel and Trastuzumab Trial for Node-Negative, Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer. J Clin Oncol. 2019 Aug 1;37(22):1868-1875. doi: 10.1200/JCO.19.00066. Epub 2019 Apr 2.

    PubMed 30939096
  • Barroso-Sousa R, Barry WT, Guo H, Dillon D, Tan YB, Fuhrman K, Osmani W, Getz A, Baltay M, Dang C, Yardley D, Moy B, Marcom PK, Mittendorf EA, Krop IE, Winer EP, Tolaney SM. The immune profile of small HER2-positive breast cancers: a secondary analysis from the APT trial. Ann Oncol. 2019 Apr 1;30(4):575-581. doi: 10.1093/annonc/mdz047.

    PubMed 30753274
  • Tolaney SM, Barry WT, Dang CT, Yardley DA, Moy B, Marcom PK, Albain KS, Rugo HS, Ellis M, Shapira I, Wolff AC, Carey LA, Overmoyer BA, Partridge AH, Guo H, Hudis CA, Krop IE, Burstein HJ, Winer EP. Adjuvant paclitaxel and trastuzumab for node-negative, HER2-positive breast cancer. N Engl J Med. 2015 Jan 8;372(2):134-41. doi: 10.1056/NEJMoa1406281.

    PubMed 25564897

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Paclitaxel and Trastuzumab in people with Breast Cancer and Carcinoma of the Breast, run by Dana-Farber Cancer Institute at 20 sites 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 17 inclusion and 9 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 26 Jun 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 sites 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 27 Mar 2023). 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?

3-year Disease Free Survival (DFS) Rate (time frame: at 3 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 NCT00542451, which also lists 4 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 26 Jun 2024; AzTrials last refreshed its copy on 6 Nov 2026.

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