Completed

A Phase III Study of Paclitaxel Via Weekly 1 Hour Infusion Versus Standard 3 Hour Infusion Every 3 Weeks With Herceptin (Trastuzumab) (NSC #688097) in the Treatment of Patients With/Without HER-2/Neu-Overexpressing Metastatic Breast Cancer

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What is being tested

paclitaxel

+ quality-of-life assessment

+ laboratory biomarker analysis

DrugProcedureOtherBiological
Who is being recruted

Breast Diseases+3

+ Neoplasms

+ Neoplasms by Site

Over 18 Years
See all eligibility criteria
How is the trial designed

Treatment Study

Phase 3
Interventional
Study Start: July 1998
See protocol details

Summary

Principal SponsorNational Cancer Institute (NCI)
Last updated: June 4, 2013
Sourced from a government-validated database.Claim as a partner

Study start date: July 1, 1998

Actual date on which the first participant was enrolled.

PRIMARY OBJECTIVES: I. To determine whether "dose dense" (DD) treatment with paclitaxel via weekly 1-hour infusion has a significantly higher response rate than "standard" (S) paclitaxel treatment, regardless of human epidermal growth factor receptor 2 (HER-2/neu) status and assignment to Herceptin (trastuzumab). II. To determine if the addition of Herceptin to DD or S paclitaxel significantly improves the response rate as compared to DD or S paclitaxel alone for HER-2/neu non-overexpressing metastatic breast cancer (e.g., 0 or 1+). III. To determine whether the addition of Herceptin to chemotherapy treatment modifies the quality of life experienced by patients with HER-2/neu non-overexpressing metastatic breast cancer. IV. To determine whether the quality of life experienced by patients with metastatic breast cancer who have been treated with "standard" paclitaxel treatment differ from that of patients treated with "dose dense" paclitaxel treatment. V. To correlate amplification and overexpression of the growth factor receptor ErbB2 by immunohistochemistry and fluorescent in-situ hybridization (FISH) with response rate, time to progression, and overall survival of patients with metastatic breast cancer treated with paclitaxel chemotherapy and paclitaxel + Herceptin. VI. To correlate ErbB2 shed extracellular domain (ECD) with response rate, time to progression, and overall survival of patients with metastatic breast cancer treated with different doses and schedules of paclitaxel and paclitaxel + Herceptin. In addition, to follow patterns of ErbB2/ECD after treatment and upon relapse. SECONDARY OBJECTIVES: I. To evaluate time to progression and survival of patients with HER-2 overexpressing metastatic breast cancer treated with either DD or S paclitaxel plus weekly Herceptin. II. To evaluate time to progression and survival of patients with HER-2 non-overexpressing metastatic breast cancer treated with either DD or S paclitaxel alone or DD or S paclitaxel plus weekly Herceptin. III. To evaluate cardiac toxicity as measured by changes in LVEF from baseline to follow-up measurements. OUTLINE; Patients are assigned to 1 of 2 treatment groups. GROUP I (HER2/neu non-overexpressors): Patients are randomized to 1 of 4 treatment arms. ARM A: Patients receive paclitaxel intravenously (IV) over 3 hours every 3 weeks. ARM B: Patients receive paclitaxel IV over 1 hour weekly. ARM C: Patients receive paclitaxel as in Arm A. Patients also receive trastuzumab IV weekly. ARM D: Patients receive paclitaxel as in Arm B and trastuzumab as in Arm C. GROUP II (HER2/neu overexpression): Patients are assigned to 1 of 2 treatment arms. ARM E: Patients receive paclitaxel and trastuzumab as in Arm C. ARM F: Patients receive paclitaxel and trastuzumab as in Arm D. In all arms, courses repeat every 3 weeks in the absence of disease progression or unacceptable toxicity. After the completion of study treatment, patients are followed up periodically for up to 5 years.

NCT00003440
Principal SponsorNational Cancer Institute (NCI)
Last updated: June 4, 2013
Sourced from a government-validated database.Claim as a partner

Protocol

This section provides details of the study plan, including how the study is designed and what the study is measuring.
Design Details

580 patients to be enrolled

Total number of participants that the clinical trial aims to recruit.

Treatment Study

These studies test new ways to treat a disease, condition, or health issue. The goal is to see if a new drug, therapy, or approach works better or has fewer side effects than existing options.



Eligibility

Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.
Conditions
Criteria

Female

Biological sex of participants that are eligible to enroll.

Over 18 Years

Range of ages for which participants are eligible to join.

Healthy volunteers not allowed

If individuals who are healthy and do not have the condition being studied can participate.

Conditions

Pathology

Breast DiseasesNeoplasmsNeoplasms by SiteSkin DiseasesSkin and Connective Tissue DiseasesBreast Neoplasms

Criteria

Inclusion Criteria: Histologically confirmed adenocarcinoma of the female breast which is inoperable, recurrent or metastatic HER-2/neu status must be known at the time of protocol registration; HER-2/neu assessment will be based on FISH analysis of either the primary tumor or a metastatic site; a scoring of 0 or 1+ by immunohistochemistry (IHC) is considered negative; 2+ is considered negative unless confirmed by FISH positivity, in which case it should be considered positive; 3+ by IHC is considered positive; for centers using FISH only, a positive FISH assay by itself is sufficient to determine HER-2 positivity Patients with the following prior therapy are eligible: Patients with 0-1 prior chemotherapy regimens for metastatic or locally advanced breast cancer, with the following exception: no prior taxane for metastatic/locally advanced breast cancer Patients with 0-1 prior chemotherapy regimens in the adjuvant setting; if adjuvant regimen included a taxane, patient must have been disease free for at least 12 months from completion of adjuvant therapy until relapse Patients must be > 2 weeks from prior surgery, other than simple biopsy or placement of venous access device; patients must be > 4 weeks from prior chemotherapy; patients must be >6 weeks from nitrosoureas, melphalan, or mitomycin Patients must be > 4 weeks from prior hormonal therapy unless tumor measurements document clear progression while on treatment; if progression is documented and toxicity from hormonal regimen has resolved, patients may be placed on study > 1 week from prior hormonal therapy Prior Herceptin therapy is not allowed Patients with central nervous system metastases are eligible only if the patient has completed cranial irradiation at least 6 months prior, is currently asymptomatic, and is not currently receiving corticosteroids for this condition; patients with leptomeningeal carcinoma (carcinomatous meningitis) are not eligible MESURABLE DISEASE: Any mass reproducibly measurable in two perpendicular dimensions, examples include: Pulmonary nodules Hepatic lesions Skin nodules (if two measurements can be assigned) Lymph nodes The following lesions do not qualify as measurable: Central nervous system (CNS) lesions Bone disease only; lytic lesions should be documented and followed Lymphangitic pulmonary metastases (patients with lymphangitic metastases are eligible if there are other sites of metastatic disease which can be measured) Lesions which have been irradiated unless there is definite documentation of progression since radiotherapy A baseline assessment of left ventricular ejection fraction within 8 weeks of registration is required (echocardiogram or resting multi gated acquisition scan [MUGA] (radionuclide cineangiography [RNCA]) nuclear scintigraphy); patients with a left ventricular ejection fraction (LVEF) < 45% are ineligible Granulocytes >= 1500/ul Platelet count >= 100,000/ul Creatinine =< 2.0 mg/dl Bilirubin within institutional normal limits Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST])

Study Plan

Find out more about all the medication administered in this study, their detailed description and what they involve.
Treatment Groups
Study Objectives

6 intervention groups are designated in this study

This study does not include a placebo group 

Treatment Groups

Group I

Experimental
Patients receive paclitaxel intravenously (IV) over 3 hours every 3 weeks.

Group II

Active Comparator
Patients receive paclitaxel IV over 1 hour weekly.

Group III

Experimental
Patients receive paclitaxel as in Arm I. Patients also receive trastuzumab IV weekly.

Group IV

Active Comparator
Patients receive paclitaxel as in Arm II and trastuzumab as in Arm III.

Group 5

Experimental
Patients receive paclitaxel and trastuzumab as in Arm C.

Group 6

Active Comparator
Patients receive paclitaxel and trastuzumab as in Arm D.

Study Objectives

Primary Objectives

Secondary Objectives

Study Centers

These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.

This study has 1 location

Cancer and Leukemia Group B

Chicago, United StatesOpen Cancer and Leukemia Group B in Google Maps
CompletedOne Study Center