Phase 2b Study of Taxol Plus Sorafenib or Placebo in Patients With Advanced Breast Cancer

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Onyx Pharmaceuticals
Information provided by (Responsible Party):
Northwestern University
ClinicalTrials.gov Identifier:
NCT00499525
First received: July 10, 2007
Last updated: July 18, 2013
Last verified: July 2013
  Purpose

RATIONALE: Drugs used in chemotherapy, such as paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Sorafenib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Giving paclitaxel together with sorafenib may kill more tumor cells.

PURPOSE: This randomized phase II trial is studying how well paclitaxel works when given together with or without sorafenib in treating patients with locally recurrent or metastatic breast cancer.


Condition Intervention Phase
Breast Cancer
Drug: paclitaxel
Drug: sorafenib tosylate
Other: placebo
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Double-Blind, Randomized Phase 2b Study Evaluating the Efficacy and Safety of Sorafenib Compared to Placebo When Administered in Combination With Paclitaxel in Patients With Locally Recurrent or Metastatic Breast Cancer

Resource links provided by NLM:


Further study details as provided by Northwestern University:

Primary Outcome Measures:
  • Progression-free survival [ Time Frame: At disease progression or death ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Overall survival [ Time Frame: At time of death ] [ Designated as safety issue: No ]
  • Time to progression [ Time Frame: At time of disease progression ] [ Designated as safety issue: No ]
  • Overall response rate [ Time Frame: At the time of progression of disease ] [ Designated as safety issue: No ]
  • Duration of overall response [ Time Frame: At time of disease progression ] [ Designated as safety issue: No ]
  • Treatment-emergent adverse events as assessed by NCI CTCAE v3.0 [ Time Frame: During treatment and up to 30 days post-treatment ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 180
Study Start Date: June 2007
Estimated Study Completion Date: December 2015
Estimated Primary Completion Date: December 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm I
Patients receive paclitaxel IV over 1 hour once weekly for 3 weeks. Patients also receive oral sorafenib tosylate twice daily on days 1-28. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Drug: paclitaxel
given IV
Drug: sorafenib tosylate
given orallly
Active Comparator: Arm II
Patients receive paclitaxel as in arm I and oral placebo twice daily on days 1-28. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Drug: paclitaxel
given IV
Other: placebo
given orally

Detailed Description:

OBJECTIVES:

Primary

  • Compare progression-free survival of patients with locally recurrent or metastatic breast cancer treated with sorafenib tosylate and paclitaxel versus placebo and paclitaxel as first-line therapy.

Secondary

  • Compare the objective response rate and duration of response in patients treated with these regimens.
  • Compare the time to progression in patients treated with these regimens.
  • Compare the survival of patients treated with these regimens.
  • Compare the safety of patients treated with these regimens.
  • Compare the change from baseline in the Functional Assessment of Cancer Therapy for Breast Cancer quality of life assessment score in patients treated with these regimens.

OUTLINE: This is a double-blind, randomized, multicenter study. Patients are stratified according to site of metastatic disease (visceral [i.e., soft internal organs of the body, including lungs, heart, and the organs of the digestive, excretory, and reproductive systems] vs nonvisceral [i.e., osseous or soft tissue] sites). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive paclitaxel IV over 1 hour once weekly for 3 weeks. Patients also receive oral sorafenib tosylate twice daily on days 1-28.
  • Arm II: Patients receive paclitaxel as in arm I and oral placebo twice daily on days 1-28.

In both arms, treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Quality of life is assessed at baseline, and every 8 weeks for 24 weeks, and then every 12 weeks for the duration of study participation.

After completion of study therapy, patients are followed every 4 months.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed adenocarcinoma of the breast

    • Locally recurrent or metastatic disease

      • Locally recurrent disease not amenable to resection with curative intent
  • Measurable or evaluable disease
  • No HER-2 overexpression (defined as positive for gene amplification by FISH or 3+ overexpression by IHC)

    • No unknown HER-2 status
  • No active brain metastases

    • Patients with neurological symptoms and known brain metastases treated with definitive therapy must undergo contrast CT scan or brain MRI to exclude active brain metastasis

      • Previously treated brain metastases allowed provided at least 3 months since prior definitive therapy (including steroids) AND no evidence of disease
  • Hormone receptor status not specified

PATIENT CHARACTERISTICS:

  • Male or female
  • Menopausal status not specified
  • ECOG performance status 0-1
  • Not pregnant or nursing for ≥ 2 weeks after completion of study therapy
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for ≥ 2 weeks after completion of study therapy
  • Hemoglobin ≥ 9.0 g/dL
  • ANC ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Total bilirubin ≤ 1.5 times the upper limit of normal (ULN)
  • ALT and AST ≤ 2.5 times ULN (≤ 5 times ULN for patients with liver involvement)
  • INR ≤ 1.5 and aPTT within normal limits

    • Anticoagulation therapy (e.g., warfarin or heparin) allowed

      • Stable INR required for patients on warfarin
  • Creatinine ≤ 1.5 times the ULN
  • Able to swallow and retain oral medication
  • More than 4 weeks since prior significant traumatic injury
  • No evidence or history of bleeding diathesis or coagulopathy
  • No serious nonhealing wound, ulcer, or bone fracture
  • No substance abuse or medical, psychological, or social condition that would interfere with study participation or evaluation of study results
  • No pre-existing peripheral neuropathy ≥ grade 2
  • No clinically significant cardiac disease, including any of the following:

    • New York Heart Association class II-IV congestive heart failure
    • Unstable angina (i.e., angina symptoms at rest) or new-onset angina within the past 3 months
    • Myocardial infarction within the past 6 months
  • No cardiac ventricular arrhythmias requiring anti-arrhythmic therapy
  • No uncontrolled hypertension (i.e., systolic blood pressure [BP] > 150 mm Hg or diastolic BP > 90 mm Hg despite optimal medical management)
  • No thrombolic, embolic, venous, or arterial events such as a cerebrovascular accident, including transient ischemic attacks within the past 6 months
  • No pulmonary hemorrhage or bleeding event > grade 2 within the past 4 weeks
  • No other hemorrhage or bleeding event ≥ grade 3 within the past 4 weeks
  • No active clinically serious infection > grade 2
  • No known HIV infection or chronic hepatitis B or C
  • No other prior or concurrent cancer except carcinoma in situ of the cervix, treated basal cell skin cancer, superficial bladder tumors (e.g., Ta and Tis), or any cancer curatively treated for > 5 years
  • No known or suspected allergy to sorafenib tosylate or hypersensitivity to paclitaxel or drugs using the vehicle Cremophor

PRIOR CONCURRENT THERAPY:

  • More than 12 months since prior adjuvant or neoadjuvant taxane therapy
  • At least 3 weeks since other prior adjuvant chemotherapy
  • At least 3 weeks since prior hormonal therapy for locally recurrent or metastatic disease
  • No prior chemotherapy for locally recurrent or metastatic breast cancer
  • More than 4 weeks since prior major surgery or open biopsy
  • At least 3 weeks since prior radiotherapy

    • Previously irradiated area must not be the only site of disease
  • More than 30 days or 5 half-lives, whichever is longer, since prior investigational drug

    • No prior or concurrent bevacizumab or any other licensed or investigational drugs that target VEGF or VEGF-receptor
  • More than 3 weeks since prior and no concurrent Hypericum perforatum (St. John's wort ) or rifampin (rifampicin)
  • No concurrent cytochrome P450 enzyme-inducing antiepileptic drugs (e.g., phenytoin, carbamazepine, or phenobarbital)
  • No concurrent irinotecan hydrochloride or doxorubicin hydrochloride
  • No other concurrent anticancer therapy (i.e., chemotherapy, radiotherapy, surgery, immunotherapy, biologic therapy, or tumor embolization)
  • No concurrent nonconventional therapies (e.g., herbal)
  • No concurrent palliative radiotherapy
  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: NCT00499525

  Show 43 Study Locations
Sponsors and Collaborators
Northwestern University
Onyx Pharmaceuticals
Investigators
Study Chair: William J. Gradishar, MD Robert H. Lurie Cancer Center
  More Information

No publications provided

Responsible Party: Northwestern University
ClinicalTrials.gov Identifier: NCT00499525     History of Changes
Other Study ID Numbers: NU 07B1, NU 07B1, STU00000776
Study First Received: July 10, 2007
Last Updated: July 18, 2013
Health Authority: United States: Federal Government
United States: Food and Drug Administration
United States: Institutional Review Board

Keywords provided by Northwestern University:
male breast cancer
recurrent breast cancer
stage IIIB breast cancer
stage IIIC breast cancer
stage IV breast cancer
stage IIIA breast cancer

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Paclitaxel
Sorafenib
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Antineoplastic Agents, Phytogenic
Antineoplastic Agents
Therapeutic Uses
Protein Kinase Inhibitors
Enzyme Inhibitors

ClinicalTrials.gov processed this record on July 28, 2014