Doxorubicin, Cyclophosphamide, and/or Paclitaxel in Treating Women With Nonmetastatic Breast Cancer

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Duke University
ClinicalTrials.gov Identifier:
NCT00131963
First received: August 16, 2005
Last updated: June 18, 2014
Last verified: April 2014
  Purpose

RATIONALE: Drugs used in chemotherapy, such as doxorubicin, cyclophosphamide, and paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Giving chemotherapy after surgery may kill any tumor cells that remain after surgery.

PURPOSE: This phase II trial is studying how well doxorubicin, cyclophosphamide, and/or paclitaxel work in treating women with nonmetastatic breast cancer.


Condition Intervention
Breast Cancer
Drug: cyclophosphamide
Drug: doxorubicin
Drug: paclitaxel

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Pharmacokinetics Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Pharmacogenomics Study for Breast Cancer Patients Undergoing Adjuvant Chemotherapy With Doxorubicin (A)/Cyclophosphamide ©) and/or Weekly Paclitaxel

Resource links provided by NLM:


Further study details as provided by Duke University:

Primary Outcome Measures:
  • Treatment-induced myelosuppression (e.g., neutropenia) [ Time Frame: 12 months ] [ Designated as safety issue: No ]
  • Incidence of peripheral neuropathy [ Time Frame: 12 month ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Response (relapse in adjuvant setting) for 10 years after completion of study treatment [ Time Frame: Ten years ] [ Designated as safety issue: No ]

Estimated Enrollment: 500
Study Start Date: October 2003
Estimated Study Completion Date: April 2017
Estimated Primary Completion Date: April 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Regimen 1
Patients receive doxorubicin IV over 10 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 21 days for 4 courses.
Drug: cyclophosphamide
Given IV
Other Name: Cytoxan
Drug: doxorubicin
Given IV
Other Name: adriamycin
Experimental: Regimen 2
Patients receive doxorubicin and cyclophosphamide as in regimen 1. Patients then receive paclitaxel IV over 1 hour once weekly for 12 weeks.
Drug: cyclophosphamide
Given IV
Other Name: Cytoxan
Drug: doxorubicin
Given IV
Other Name: adriamycin
Drug: paclitaxel
Given IV
Other Name: taxol

Detailed Description:

OBJECTIVES:

Primary

  • Determine the pharmacogenomics of adjuvant chemotherapy comprising doxorubicin and cyclophosphamide and/or paclitaxel in women with nonmetastatic invasive breast cancer.
  • Determine treatment-induced myelosuppression (e.g., neutropenia) in patients treated with adjuvant doxorubicin and cyclophosphamide who have polymorphisms in drug activation and metabolism genes.
  • Correlate the incidence of peripheral neuropathy with pharmacogenomic analysis in patients treated with paclitaxel.

Secondary

  • Determine response (i.e., relapse in the adjuvant setting) during a 10-year follow-up period in patients treated with these regimens.

OUTLINE: This is a multicenter study. Patients receive treatment on The Cancer and Leukemia Group B study(CALGB) CALGB-40101 OR are assigned to receive 1 of 2 treatment regimens on this study.

  • Regimen 1: Patients receive doxorubicin IV over 10 minutes and cyclophosphamide IV over 30 minutes on day 1. Treatment repeats every 21 days for 4 courses.
  • Regimen 2: Patients receive doxorubicin and cyclophosphamide as in regimen 1. Patients then receive paclitaxel IV over 1 hour once weekly for 12 weeks.

After completion of study treatment, patients are followed at 3, 6, and 12 months and then annually for up to 10 years.

PROJECTED ACCRUAL: A total of 500 patients (300 treated with doxorubicin and cyclophosphamide and 200 treated with paclitaxel) will be accrued for this study within 3-4 years.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Eligibility Criteria

  • Histologically confirmed invasive breast cancer
  • node negative stage > T1c or T1b with poor prognostic features (high grade, Her2/neu FISH positive, ER negative) or stage 2 (T2, N0) or
  • enrolled on CALGB 40101, CALGB 49909, or the National Cancer Institute of Canada study MA-21 or
  • any node positive patient or locally advanced undergoing neoadjuvant chemotherapy with either AC or paclitaxel
  • Age greater than or equal to 18 years.
  • >/=2 weeks from major surgery (wide excision / lumpectomy / mastectomy)
  • No evidence of systemic metastasis
  • Undergoing adjuvant treatment with standard dose AC or AC followed by weekly Paclitaxel at 80mg/m2
  • Adequate bone marrow, hepatic and renal functions (absolute neutrophil count >1,500/ μl, platelet count > 100,000/ μl, serum creatinine <2.0 mg/dl, total Bilirubin <2.0 x the upper limit of normal (ULN)
  • Ability to answer and understand study surveillance questionnaires
  • No concurrent drug therapy (within 2 weeks) with agents that are known inducers or inhibitors of Cytochrome P450 (CYP450).

Exclusion Criteria

  • Other anticancer cytotoxic or endocrine therapy, immunotherapy, or biologic response modifiers,Study Drugs or other concomitant medications known to cause myelosuppression especially neutropenia and neuropathy
  • Eastern Cooperative Oncology Group Performance Status(ECOG) functional status > 2.
  • Serious co-morbidities including poorly controlled diabetes mellitus, ischaemic heart disease,uncontrolled hypertension or active infection.
  • Pregnancy
  • Use of growth factor during cycle 1 of chemotherapy (AC) under pharmacokinetic evaluation
  • Grade >/=2 peripheral neuropathy symptoms based on National Cancer Institute- Common Terminology Criteria for Adverse Events (NCI-CTCAE) Scale. Exception: a chronic neurologic disorder will be reviewed on a case by case basis by the study PI.
  • Prior treatment with weekly paclitaxelDISEASE CHARACTERISTICS:

    • Histologically confirmed invasive breast cancer, meeting 1 of the following criteria:

      • Node negative disease AND meets 1 of the following stage criteria:

        • Primary tumor > T1c
        • Primary tumor > T1b AND poor prognostic features, defined as the following:

          • High-grade disease
          • Human Epidermal Growth Factor Receptor 2 (HER2)/neu-positive disease by fluorescence in situ hybridization
          • Estrogen receptor-negative disease
        • Stage II disease (T2, N0)
      • Node positive nonmetastatic disease
      • Locally advanced disease AND receiving neoadjuvant chemotherapy comprising doxorubicin and cyclophosphamide OR paclitaxel
      • Enrolled in clinical trial CALGB-40101
    • No evidence of systemic metastasis
    • Hormone receptor status:

      • Not specified
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00131963

Locations
United States, North Carolina
Duke Cancer Institute
Durham, North Carolina, United States, 27710
Sponsors and Collaborators
Duke University
Investigators
Principal Investigator: Paul K. Marcom, MD Duke Cancer Institute
  More Information

Additional Information:
No publications provided

Responsible Party: Duke University
ClinicalTrials.gov Identifier: NCT00131963     History of Changes
Other Study ID Numbers: Pro00014267, DUMC-4522-04-1-R1, CDR0000438673
Study First Received: August 16, 2005
Last Updated: June 18, 2014
Health Authority: United States: Institutional Review Board

Keywords provided by Duke University:
stage One A (IA) breast cancer
stage Two (II) breast cancer
stage Three A (IIIA) breast cancer
stage Three B(IIIB) breast cancer
stage Three C(IIIC) breast cancer
stage One B (IB) breast cancer

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Cyclophosphamide
Liposomal doxorubicin
Doxorubicin
Paclitaxel
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions
Antirheumatic Agents
Therapeutic Uses
Antineoplastic Agents, Alkylating
Alkylating Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Myeloablative Agonists
Antibiotics, Antineoplastic
Topoisomerase II Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Antineoplastic Agents, Phytogenic
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators

ClinicalTrials.gov processed this record on August 21, 2014