Gefitinib Followed By Surgery in Treating Women With Ductal Carcinoma In Situ of the Breast
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Purpose
RATIONALE: Gefitinib may stop the growth of tumor cells by blocking the enzymes necessary for their growth. It is not yet known whether surgery is more effective with or without gefitinib in treating ductal carcinoma in situ.
PURPOSE: This randomized phase II trial is studying how well gefitinib together with surgery works compared to surgery alone for the treatment of women with ductal carcinoma in situ of the breast.
| Condition | Intervention | Phase |
|---|---|---|
|
Breast Cancer |
Drug: gefitinib Procedure: Surgery |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator) Primary Purpose: Treatment |
| Official Title: | EGFR Pathway Modulation In Patients With Ductal Carcinoma In Situ Of The Breast |
- Compare epidermal growth factor receptor (EGFR) pathway biomarker modulation in tissue samples of women with ductal carcinoma in situ (DCIS) of the breast treated with gefitinib vs placebo followed by surgery. [ Time Frame: at time of surgery, after 7-14 days of gefitinib ] [ Designated as safety issue: No ]
- Compare the effect of gefitinib vs. placebo, followed by surgery on cell turnover in vivo in EGFR-positive vs. EGFR-negative patients [ Time Frame: at time of surgery, after 7-14 days of gefitinib ] [ Designated as safety issue: No ]
- Compare the effects of gefitinib in ER-positive vs. ER-negative DCIS and in HER2-positive vs. HER2-negative DCIS [ Time Frame: at time of surgery, after 7-14 days of gefitinib ] [ Designated as safety issue: No ]
- Correlate levels of HER2 extracellular domain in ER-positive vs. ER-negative and in HER2-positive cs. HER2-negative patients [ Time Frame: at time of surgery, after 7-14 days of gefitinib ] [ Designated as safety issue: No ]
| Enrollment: | 1 |
| Study Start Date: | October 2002 |
| Study Completion Date: | June 2005 |
| Primary Completion Date: | July 2004 (Final data collection date for primary outcome measure) |
-
Drug: gefitinib
OBJECTIVES:
Primary
- Compare epidermal growth factor receptor (EGFR) pathway biomarker modulation in tissue samples of women with ductal carcinoma in situ (DCIS) of the breast treated with gefitinib vs placebo followed by local surgery.
- Compare the effect of these regimens on cell turnover in vivo in EGFR-positive vs EGFR-negative patients.
Secondary
- Compare the efficacy of these regimens in estrogen-receptor (ER)-positive vs ER-negative and in HER2-positive vs HER2-negative patients with DCIS.
- Correlate levels of HER2 extracellular domain with biomarker modulation in patients treated with these regimens.
OUTLINE: This is a randomized, pilot study. Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive oral gefitinib once daily for 7-14 days or until the day before local surgery. Patients then undergo lumpectomy or mastectomy.
- Arm II: Patients receive oral placebo once daily for 7-14 days or until the day before local surgery. Patients then undergo local surgery as in arm I.
PROJECTED ACCRUAL: A total of 78 patients (39 per treatment arm) will be accrued for this study within 1.5 years.
Eligibility| Ages Eligible for Study: | 35 Years and older |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Histologically confirmed ductal carcinoma in situ (DCIS) of the breast OR mammogram highly suspicious for DCIS
- No invasive disease
- Not completely excised
- Epidermal growth factor receptor (EGFR) positive (> 10% of cells stained)
- Planned lumpectomy or mastectomy within the next 2-4 weeks
Hormone receptor status:
- Estrogen receptor status known
PATIENT CHARACTERISTICS:
Age
- 35 and over
Sex
- Female
Menopausal status
- Not specified
Performance status
- ECOG 0-1
Life expectancy
- Not specified
Hematopoietic
- Granulocyte count > 1,500/mm^3
- Platelet count > 100,000/mm^3
Hepatic
- Bilirubin < 1.5 mg/dL
- SGOT ≤ 2 times upper limit of normal (ULN)
- SGPT < 1.5 times ULN
- PT and PTT ≤ 1.5 times ULN
- INR ≤ 1.5 times ULN
Renal
- Creatinine < 1.5 mg/dL
Cardiovascular
- No New York Heart Association class I-IV heart disease
Pulmonary
- No acute asthma
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- Random blood sugar < 2.5 times ULN
- No known hypersensitivity to study drug or its excipients
- No nonhealing wound or fracture
- No active infection
- No other malignancy within the past 5 years except basal cell carcinoma, breast carcinoma, or carcinoma in situ of the cervix
- No psychosis or severe depression
- No other concurrent uncontrolled illness
PRIOR CONCURRENT THERAPY:
Biologic therapy
- No prior trastuzumab (Herceptin®)
Chemotherapy
- At least 1 year since prior chemotherapy
- No concurrent chemotherapy
Endocrine therapy
- At least 1 year since prior aromatase inhibitors
- At least 1 year since prior antiestrogens or luteinizing hormone-releasing hormone agonists or antagonists
- No concurrent glucocorticoids
- Concurrent oral contraceptives allowed
- Concurrent hormone replacement therapy allowed
Radiotherapy
- At least 1 year since prior radiotherapy
- No concurrent radiotherapy
Surgery
- See Disease Characteristics
- Recovered from prior oncologic or other major surgery
- No prior organ allograft
Other
- Recovered from all prior therapy (except alopecia)
- More than 30 days since prior non-approved or investigational drugs
- No prior definitive local therapy
- No prior immunosuppressive therapy
- No prior gefitinib
- No other prior EGFR inhibitors
- No other concurrent cytotoxic drugs
- No concurrent warfarin for anticoagulation
No concurrent CYP3A4 inducers, including any of the following:
- Phenytoin
- Carbamazepine
- Barbiturates
- Rifampin
- Phenobarbital
- Hypericum perforatum (St. John's wort)
- Ethosuximide
- Griseofulvin
- Nafcillin
- Nelfinavir
- Nevirapine
- Oxcarbazepine
- Phenylbutazone
- Primidone
- Rifabutin
- Rofecoxib
- Sulfamethazine
- Sulfinpyrazone
- Troglitazone
- No concurrent antiretroviral treatment for HIV-positive patients
Contacts and Locations| United States, Tennessee | |
| Vanderbilt-Ingram Cancer Center | |
| Nashville, Tennessee, United States, 37232-6838 | |
| Meharry Medical College | |
| Nashville, Tennessee, United States, 37208 | |
| Principal Investigator: | Mayer Mayer, MD | Vanderbilt-Ingram Cancer Center |
More Information
No publications provided
| Responsible Party: | Ingrid Mayer, MD, Assistant Professor of Medicine; Clinical Director, Breast Cancer Program; Medical Oncologist, Vanderbilt-Ingram Cancer Center |
| ClinicalTrials.gov Identifier: | NCT00082667 History of Changes |
| Other Study ID Numbers: | VICC BRE 0249, P30CA068485, VICC-BRE-0249 |
| Study First Received: | May 14, 2004 |
| Last Updated: | February 22, 2013 |
| Health Authority: | United States: Federal Government |
Keywords provided by Vanderbilt-Ingram Cancer Center:
|
breast cancer in situ ductal breast carcinoma in situ |
Additional relevant MeSH terms:
|
Breast Neoplasms Carcinoma Carcinoma in Situ Carcinoma, Intraductal, Noninfiltrating Carcinoma, Ductal, Breast Carcinoma, Ductal Neoplasms by Site Neoplasms Breast Diseases Skin Diseases Neoplasms, Glandular and Epithelial |
Neoplasms by Histologic Type Adenocarcinoma Neoplasms, Ductal, Lobular, and Medullary Gefitinib Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Protein Kinase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on May 19, 2013