A Multi-Center Study of Paclitaxel/Cyclophosphamide and High Dose Melphalan/Etoposide With Autologous Progenitor Cell Transplantation for the Treatment of Inflammatory Breast Cancer
Monoclonal Antibody 3A1
+ Monoclonal Antibody 95-5-49
+ Monoclonal Antibody 95-6-22
Maladies du sein+7
+ Néoplasmes
+ Néoplasmes par site
Étude thérapeutique
Résumé
Date de début de l'étude : 12 juillet 1996
Date à laquelle le premier participant a commencé l'étude.BACKGROUND: Efforts to cure high-risk breast cancer have increasingly focused on the application of dose intensive chemotherapy. To date, the use of dose intensive and high-dose chemotherapy has not significantly changed the survival for the majority of high risk and metastatic patients. The optimal schedule and combination of agents to improve the results of high-dose chemotherapy is not known. This study will pilot a combination of chemotherapy agents for the treatment of Inflammatory Breast Cancer. OBJECTIVES: To define, in a statistically relevant manner, the clinical efficacy of this chemotherapy regimen combination in the treatment of Inflammatory Breast Cancer (stage IIIB inflammatory). To examine the effects of this high-dose chemotherapy on T-cells (T-cell number, phenotype, cytokine profiles) and study the process of post-chemotherapy T-cell regeneration. ELIGIBILITY: Newly diagnosed patient with non metastatic Inflammatory Breast Cancer (stage III B). The patients treated in this study will also be eligible for entrance into other protocols of the experimental Transplantation & Immunology Branch that are examining strategies of manipulating T-cell regeneration in adults after intensive chemotherapy. DESIGN: Patients will receive multiple cycles of a dose intensive combination of Paclitaxel and Cyclophosphamide both for the mobilization of peripheral blood progenitor cells and with therapeutic intent. A second induction regimen will consist of four cycles of the combination of Doxorubicin / cyclophosphamide. Patients will subsequently receive high-dose Melphalan and Etoposide followed by the infusion of peripheral blood progenitor cells and granulocytes colony-stimulating-factor (G-CSF).
Protocole
Cette section fournit des détails sur le plan de l'étude, y compris la manière dont l'étude est conçue et ce qu'elle évalue.107 participants à inclure
Nombre total de participants que l'essai clinique vise à recruter.Traitement
Éligibilité
Les chercheurs recherchent des patients correspondant à une certaine description appelée critères d'éligibilité : état de santé général ou traitements antérieurs du patient.Tout sexe
Le sexe biologique des participants éligibles à s'inscrire.À partir de 18 ans
Tranche d'âge des participants éligibles à participer.Volontaires sains non autorisés
Indique si les individus en bonne santé et ne présentant pas la condition étudiée peuvent participer.Conditions
Pathologie
Critères
ELIGIBILITY CRITERIA: INCLUSION CRITERIA: Age greater or equal to 18 years. All patients must have a histologically confirmed diagnosis of Inflammatory Breast Carcinoma stage III B. Patients with no clinical inflammatory signs but with tumor invasion of dermal lymphatic on histology are eligible. Patients with metastatic disease and Inflammatory Breast Carcinoma are not eligible. All pathologic material must be reviewed and confirmed by the Department of Pathology of the treating institution prior to treatment (there will be no central pathology review). Patients may be untreated or may have received prior induction chemotherapy outside the NCI. If patients received prior induction chemotherapy, they may not have been unresponsive to it. They may have received chemotherapy either before (neo-adjuvant setting) or after local surgery (adjuvant setting). Karnofsky performance status of greater than 70% (ECOG 0 or 1). Ejection fraction by MUGA or 2-D echocardiogram within institution normal limits. Creatinine clearance of greater than 60 cc/mm. AST and ALT less than 3 times the upper limit of normal. Bilirubin less than 1.5 (except in cases of Gilbert's disease). ANC greater than l000/mm(3). Platelet count greater than 90,000/mm(3). DLCO greater than 50%. No history of medical or psychiatric disease which would preclude safe treatment in the view of the principal investigator. No history of abnormal bleeding tendency or predisposition to repeated infections. Patients must be able to give informed consent. EXCLUSION CRITERIA: Patients with Inflammatory Breast Cancer but with metastatic disease. Any patient may be excluded from this study at the discretion of the principal investigator if it is deemed that allowing participation would represent an unacceptable medical or psychiatric risk. Any patient with a need for chronic steroids or anticoagulation will be ineligible. Any patient testing positive for HIV (AIDS) or hepatitis B or C will be ineligible. Any female patient known or found to be pregnant will be considered ineligible. Patients of childbearing potential unwilling to practice contraception will be ineligible. Any patient with an active second malignancy (excluding treated skin cancers or carcinoma in situ) will be ineligible.
Centres d'étude
Ce sont les hôpitaux, cliniques ou centres de recherche où l'essai est conduit. Vous pouvez trouver le site le plus proche de vous ainsi que son statut.Cette étude comporte 1 site
National Institutes of Health Clinical Center, 9000 Rockville Pike
Bethesda, United StatesOuvrir National Institutes of Health Clinical Center, 9000 Rockville Pike dans Google Maps