Primary Breast CancerPhase 2NCT01779479
Efficacy and Safety of Cabazitaxel Versus Weekly Paclitaxel as Neo-adjuvant Treatment in Patients With Triple Negative or Luminal B/HER2 Normal BC (GENEVIEVE)
A Phase 2 study testing Cabacitaxel and Paclitaxel in people with Primary Breast Cancer, run by GBG Forschungs GmbH at 1 site in Germany.
Trial summary
Cabazitaxel is a new taxoid which promotes the tubulin assembly in vitro and stabilizes microtubules against cold-induced depolymerization as efficiently as docetaxel and was selected for development based on a better antiproliferative activity on resistant cell lines than docetaxel. Read more about this study
- Who is it for?
- Ages 18 years and older, women only
- Conditions the study is for
- Primary Breast Cancer
- What is being tested?
- Cabacitaxel and Paclitaxel
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 333 participants
- Where
- 1 siteGermany
- Study dates
- Feb 2013to Feb 2016
- Phase
- Phase 2
- 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
- Written informed consent for all study according to local regulatory requirements prior to beginning specific protocol procedures.
- Complete baseline documentation must be sent to GBG Forschungs GmbH.
- Unilateral or bilateral primary carcinoma of the breast, confirmed histologically by core biopsy. Fine-needle aspiration alone is not sufficient. Incisional biopsy is not allowed. In case of bilateral cancer, the investigator has to decide prospectively which side will be evaluated for the primary endpoint.
- Tumor lesion in the breast with a palpable size of >= 2 cm or a sonographical size of >= 1 cm in maximum diameter. The lesion has to be measurable in two dimensions, preferably by sonography.
- Patients must be in the following stages of disease: cT3 or cT2 or cT1c and cN+ or cT1c and pNSLN+.
- In patients with multifocal or multicentric breast cancer, the largest lesion should be evaluated.
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- Centrally confirmed triple negative or luminal B/HER2-normal subtype. ER- and PgR-negative defined as <1% stained cells. HER-2 negative defined as IHC 0+, 1+ or IHC 2+ and FISH/SISH/CISH (ratio <2.0) negative. Luminal B defined as ER and/or PgR + and > 14% Ki-67 stained cells. The formalin-fixed, paraffin-embedded (FFPE) breast tissue block from the diagnostic core biopsy has therefore to be sent to the Dept. of Pathology at the Charité, Berlin prior to randomization.
- Age >= 18 years.
- Eastern Cooperative Oncology Group (ECOG) Performance Status: 0 or 1 (see Appendix A).
- Laboratory requirements: Hemoglobin > 9.0 g/dL, Absolute neutrophil count > 1.5 x 109/L, Platelet count > 100 x 109/L, AST/SGOT and/or ALT/SGPT < 2.5 x ULN; Total bilirubin < 1.0 x ULN, Serum creatinine < 1.5 x ULN. If creatinine 1.0 - 1.5 x ULN, creatinine clearance will be calculated according to CKD-EPI formula and patients with creatinine clearance < 60 mL/min should be excluded (see Appendix 2 for formula).
- Negative pregnancy test (urine or serum) within 14 days prior to randomization for all women of childbearing potential.
- Complete staging work-up within 3 months prior to randomization. All patients must have bilateral mammography, breast ultrasound (<= 21 days), breast MRI (optional), chest X-ray (PA and lateral), abdominal ultrasound or CT scan or MRI, and bone scan done. In case of positive bone scan, bone X-ray is mandatory. Other tests may be performed as clinically indicated.
- Patients must be available and compliant for central diagnostics, treatment and follow-up.
Who cannot join
- Any prior treatment for primary breast cancer including radiation therapy
- History of ipsi/ or contra-lateral invasive breast cancer
- Locally advanced disease including N3 and metastatic disease
- Patients in the following stages of disease are not allowed: cT4
- Prior malignancy without being disease-free for more than 5 years (except carcinoma in situ of the cervix or other in situ cancer (e.g. bladder cancer) and adequately treated basal cell carcinoma of the skin.
- Clinically significant (i.e. active) cardiovascular disease, including cerebrovascular accident (≤6 months before enrolment), myocardial infarction, arterial thrombotic events (≤6 months before enrolment), unstable angina pectoris, New York Heart Association (NYHA) ≥ grade 2 congestive heart failure and/or hypertension, serious cardiac arrhythmia requiring medication during the study and that might interfere with regularity of the study treatment, or not controlled by medication
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- Any severe acute or chronic medical condition which could impair the ability of the patient to participate to the study or to comply with the study procedures or interfere with interpretation of study results (such as significant neurological or psychiatric disorders including psychotic disorders, dementia or seizures).
- Active infection.
- Sex hormones. Prior treatment must be stopped before study entry.
- Inability and unwillingness to comply with study visits, treatment, testing, and to comply with the protocol.
- Administration of any live virus vaccine within 8 weeks preceding study entry.
- Use of any investigational agent within 30 days of administration of the first dose of study drug or concurrent treatment on another clinical trial
- Requirement for radiation therapy concurrent with study anticancer treatment. Patients who require breast or chest wall radiation therapy after surgery are eligible
- Pregnancy or breastfeeding women
- Patients with childbearing potential who do not agree to use accepted and effective method of contraception (barrier methods, intrauterine contraceptive devices, sterilization) during the study treatment period and following a period of 6 months after the last study drug administration.
- History of hypersensitivity (grade ≥ 3) to polysorbate 80 or any study drugs or excipients
- Concurrent or planned treatment with potent strong inhibitors or strong inducers of cytochrome P450 3A4/5 (a two-week wash-out period is necessary for patients who are already on these treatments) (see Appendix 3)
- Contraindications to the use of corticosteroid treatment
- Symptomatic peripheral neuropathy grade ≥ 2 (National Cancer Institute Common Terminology Criteria [NCI CTCAE] v.4.03).
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Randomized, Open-label, Phase II Study Comparing the Efficacy and the Safety of Cabazitaxel Versus Weekly Paclitaxel Given as Neo-adjuvant Treatment in Patients With Operable Triple Negative or Luminal B/HER2 Normal Breast Cancer (GENEVIEVE)
Cabazitaxel is a new taxoid which promotes the tubulin assembly in vitro and stabilizes microtubules against cold-induced depolymerization as efficiently as docetaxel and was selected for development based on a better antiproliferative activity on resistant cell lines than docetaxel. It has shown superior survival against mitoxantrone (MTX) plus prednisone in docetaxel pre-treated hormone refractory metastatic prostate cancer patients leading to registration of the compound. It showed a favorable toxicity profile with an interestingly low rate of alopecia. In the Genevieve study it will be compared against weekly paclitaxel which is currently most widely used treatment of breast cancer patients. A head-to-head comparison in the neoadjuvant setting will allow a rapid and precise comparison of efficacy and tolerability of cabacitaxel versus paclitaxel to decide in how far further development of this taxoid in breast cancer is reasonable.
Read the detailed description
Primary Objective To compare the pathologic complete response (pCR) rate in the breast (ypT0/is ypN0/+) in patients with operable Triple Negative or luminal B/HER2 normal breast cancer treated with either cabazitaxel or weekly paclitaxel.
Secondary Objective To assess
- pCR rates per arm separately for the stratified subpopulations.
- Objective response rate (ORR) in the breast according to WHO criteria.
- pCR rate defined as ypT0 ypN0.
- pCR rate defined as ypT0/is ypN0.
- pCR rate in the axillary lymph nodes (ypN0).
- To determine the pCR rate and local recurrence free survival (LRFS) in patients with a clinical complete response (cCR) and a negative core biopsy before surgery.
- Breast conservation surgery rate.
- To assess the toxicity (NCI CTCAE V4.03) and compliance in both arms.
- Invasive loco-regional recurrence free survival (LRRFS), distant-disease-free survival (DDFS), invasive disease-free survival (IDFS), and overall survival (OS).
- To explore the biomarkers and profiles potentially predicting response to treatment.
- Conditions
- Primary Breast Cancer
- Being tested
- Cabacitaxel, Paclitaxel
- Keywords
- German Breast Group, GBG Forschungs GmbH, GBG, GBG 74, Genevieve, Breast Cancer, Primary Breast Cancer, Cabazitaxel, Paclitaxel, neo-adjuvant, triple negative, luminal B
- Medical subject headings
- Breast Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CabacitaxelDrug
Cabazitaxel 25 mg/m² i.v. (Day 1) every 3 weeks (cycle) as 1-hour i.v infusion for a total of up to 4 cycles over a maximum total treatment period of 15 weeks before surgery
PaclitaxelDrug
Paclitaxel 80 mg/m² as 1-hour i.v infusion. Patients will receive weekly (Days 1, 8, 15) paclitaxel administrations for a maximum of 12 infusions for a maximum of 4 cycles over a maximum total treatment period of 15 weeks before surgery (1 cycle = 3 weeks).
| Study group | Role | What they receive |
|---|---|---|
| Cabacitaxel | Experimental | Not described Receives: Drug: Cabacitaxel |
| Paclitaxel | Active comparator | Not described Receives: Drug: Paclitaxel |
What is being measured
The primary outcome is the main question the study is designed to answer.
pathologic complete response (pCR) rate
Measured: 15 months
Secondary outcomes (14)
pathologic complete response (pCR) rate separately for subpopulations
pathologic complete response (pCR) rate separately for stratified subpopulations
Measured: 15 months
Objective response rate (ORR)
Measured: 15 months
pCR rate defined as ypT0 ypN0
Measured: 15 months
pCR rate defined as ypT0/is ypN0
Measured: 15 months
pCR rate in the axillary lymph nodes (ypN0)
Measured: 15 months
pCR rate in patients with a clinical complete response (cCR)
To determine the pCR rate in patients with a clinical complete response (cCR) and a negative core biopsy before surgery
Measured: 15 months
local recurrence free survival (LRFS) in patients with a clinical complete response (cCR)
To determine the local recurrence free survival (LRFS) in patients with a clinical complete response (cCR) and a negative core biopsy before surgery
Measured: 15 months
Breast conservation surgery rate
Measured: 15 months
Toxicity
To assess the toxicity (NCI CTCAE V4.03) in both arms.
Measured: 15 months
Compliance
To assess compliance in both arms.
Measured: 15 months
Invasive loco-regional recurrence free survival (LRRFS)
Measured: 15 months
Distant-disease-free survival (DDFS)
Measured: 15 months
Invasive disease-free survival (IDFS)
Measured: 15 months
Overall survival (OS)
Measured: 15 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Jan 2013 (estimated)
- Study startFeb 2013
- Primary completionAug 2015
- Study completionFeb 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Primary Breast CancerStudies of the same condition, open and under way.
- 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 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 333 participants (actual)
Sponsor and investigators
- Lead sponsor
- GBG Forschungs GmbH
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Gunter von Minckwitz, Prof. Dr., Principal investigator, Luisenkrankenhaus Düsseldorf
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01779479
- Sponsor's protocol ID
- GBG 74
- Other IDs
- 2012-003330-16
- Status last verified
- Feb 2016
- First submitted
- 25 Jan 2013
- Last updated
- 1 Aug 2017
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Kummel S, Paepke S, Huober J, Schem C, Untch M, Blohmer JU, Eiermann W, Gerber B, Hanusch C, Hilfrich J, Jackisch C, Schneeweiss A, Denkert C, Engels K, Klare P, Fasching PA, von Minckwitz G, Burchardi N, Loibl S. Randomised, open-label, phase II study comparing the efficacy and the safety of cabazitaxel versus weekly paclitaxel given as neoadjuvant treatment in patients with operable triple-negative or luminal B/HER2-negative breast cancer (GENEVIEVE). Eur J Cancer. 2017 Oct;84:1-8. doi: 10.1016/j.ejca.2017.06.037. Epub 2017 Jul 30.
PubMed 28768217
Study at a glance
From the registry record, last updated by the sponsor on 1 Aug 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Randomized, Open-label, Phase II Study Comparing the Efficacy and the Safety of Cabazitaxel Versus Weekly Paclitaxel Given as Neo-adjuvant Treatment in Patients With Operable Triple Negative or Luminal B/HER2 Normal Breast Cancer (GENEVIEVE)
- ClinicalTrials.gov ID
- NCT01779479
- Acronym / sponsor ID
- GBG 74
- Conditions
- Primary Breast Cancer
- Keywords
- German Breast Group, GBG Forschungs GmbH, GBG, GBG 74, Genevieve, Breast Cancer, Primary Breast Cancer, Cabazitaxel
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 333 participants (actual)
- Lead sponsor
- GBG Forschungs GmbHUniversity, hospital or other
- Study start
- Feb 2013
- Primary completion
- Aug 2015 (actual)
- Study completion
- Feb 2016 (actual)
- First posted
- 30 Jan 2013 (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.
Cabazitaxel is a new taxoid which promotes the tubulin assembly in vitro and stabilizes microtubules against cold-induced depolymerization as efficiently as docetaxel and was selected for development based on a better antiproliferative activity on resistant cell lines than docetaxel. It has shown superior survival against mitoxantrone (MTX) plus prednisone in docetaxel pre-treated hormone refractory metastatic prostate cancer patients leading to registration of the compound. It showed a favorable toxicity profile with an interestingly low rate of alopecia. In the Genevieve study it will be compared against weekly paclitaxel which is currently most widely used treatment of breast cancer patients. A head-to-head comparison in the neoadjuvant setting will allow a rapid and precise comparison of efficacy and tolerability of cabacitaxel versus paclitaxel to decide in how far further development of this taxoid in breast cancer is reasonable.
Detailed description
Primary Objective To compare the pathologic complete response (pCR) rate in the breast (ypT0/is ypN0/+) in patients with operable Triple Negative or luminal B/HER2 normal breast cancer treated with either cabazitaxel or weekly paclitaxel.
Secondary Objective To assess
- pCR rates per arm separately for the stratified subpopulations.
- Objective response rate (ORR) in the breast according to WHO criteria.
- pCR rate defined as ypT0 ypN0.
- pCR rate defined as ypT0/is ypN0.
- pCR rate in the axillary lymph nodes (ypN0).
- To determine the pCR rate and local recurrence free survival (LRFS) in patients with a clinical complete response (cCR) and a negative core biopsy before surgery.
- Breast conservation surgery rate.
- To assess the toxicity (NCI CTCAE V4.03) and compliance in both arms.
- Invasive loco-regional recurrence free survival (LRRFS), distant-disease-free survival (DDFS), invasive disease-free survival (IDFS), and overall survival (OS).
- To explore the biomarkers and profiles potentially predicting response to treatment.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Cabacitaxel | Experimental | Drug: Cabacitaxel |
| Paclitaxel | Active comparator | Drug: Paclitaxel |
Who may qualify
- Ages
- 18 years and older
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (13 listed)
- Written informed consent for all study according to local regulatory requirements prior to beginning specific protocol procedures.
- Complete baseline documentation must be sent to GBG Forschungs GmbH.
- Unilateral or bilateral primary carcinoma of the breast, confirmed histologically by core biopsy. Fine-needle aspiration alone is not sufficient. Incisional biopsy is not allowed. In case of bilateral cancer, the investigator has to decide prospectively which side will be evaluated for the primary endpoint.
- Tumor lesion in the breast with a palpable size of >= 2 cm or a sonographical size of >= 1 cm in maximum diameter. The lesion has to be measurable in two dimensions, preferably by sonography.
- Patients must be in the following stages of disease: cT3 or cT2 or cT1c and cN+ or cT1c and pNSLN+.
Key exclusion criteria (19 listed)
- Any prior treatment for primary breast cancer including radiation therapy
- History of ipsi/ or contra-lateral invasive breast cancer
- Locally advanced disease including N3 and metastatic disease
- Patients in the following stages of disease are not allowed: cT4
- Prior malignancy without being disease-free for more than 5 years (except carcinoma in situ of the cervix or other in situ cancer (e.g. bladder cancer) and adequately treated basal cell carcinoma of the skin.
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 |
|---|---|---|
| CabacitaxelCabazitaxel 25 mg/m² i.v. (Day 1) every 3 weeks (cycle) as 1-hour i.v infusion for a total of up to 4 cycles over a maximum total treatment period of 15 weeks before surgery | Drug | Cabacitaxel |
| PaclitaxelPaclitaxel 80 mg/m² as 1-hour i.v infusion. Patients will receive weekly (Days 1, 8, 15) paclitaxel administrations for a maximum of 12 infusions for a maximum of 4 cycles over a maximum total treatment period of 15 weeks before surgery (1 cycle = 3 weeks). | Drug | Paclitaxel |
Primary outcome
pathologic complete response (pCR) rate
Time frame: 15 months
14 secondary outcomes
pathologic complete response (pCR) rate separately for subpopulations
Time frame: 15 months
Objective response rate (ORR)
Time frame: 15 months
pCR rate defined as ypT0 ypN0
Time frame: 15 months
pCR rate defined as ypT0/is ypN0
Time frame: 15 months
pCR rate in the axillary lymph nodes (ypN0)
Time frame: 15 months
pCR rate in patients with a clinical complete response (cCR)
Time frame: 15 months
local recurrence free survival (LRFS) in patients with a clinical complete response (cCR)
Time frame: 15 months
Breast conservation surgery rate
Time frame: 15 months
Toxicity
Time frame: 15 months
Compliance
Time frame: 15 months
Invasive loco-regional recurrence free survival (LRRFS)
Time frame: 15 months
Distant-disease-free survival (DDFS)
Time frame: 15 months
Invasive disease-free survival (IDFS)
Time frame: 15 months
Overall survival (OS)
Time frame: 15 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Aug 2017.
- Results publication: PubMed 28768217Kummel S, Paepke S, Huober J, Schem C, Untch M, Blohmer JU, Eiermann W, Gerber B, Hanusch C, Hilfrich J, Jackisch C, Schneeweiss A, Denkert C, Engels K, Klare P, Fasching PA, von Minckwitz G, Burchardi N, Loibl S. Randomised, open-label, phase II study comparing the efficacy and the safety of cabazitaxel versus weekly paclitaxel given as neoadjuvant treatment in patients with operable triple-negative or luminal B/HER2-negative breast cancer (GENEVIEVE). Eur J Cancer. 2017 Oct;84:1-8. doi: 10.1016/j.ejca.2017.06.037. Epub 2017 Jul 30.
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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.
Gunter von Minckwitz, Prof. Dr. principal investigator
Luisenkrankenhaus Düsseldorf
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Cabacitaxel and Paclitaxel in people with Primary Breast Cancer, run by GBG Forschungs GmbH at 1 site in Germany.
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 13 inclusion and 19 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 1 Aug 2017. 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 Germany. 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?
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?
pathologic complete response (pCR) rate (time frame: 15 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 NCT01779479, 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 1 Aug 2017.