Topical Imiquimod and Abraxane in Treating Patients With Advanced Breast Cancer
This phase II trial is studying the side effects of giving topical imiquimod together with Abraxane (paclitaxel albumin-stabilized nanoparticle formulation) to see how well it works in treating patients with advanced breast cancer. Biological therapies, such as imiquimod, may stimulate the immune system to kill tumor cells. Drugs used in chemotherapy, such as Abraxane, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving imiquimod together with Abraxane may kill more tumor cells.
Male Breast Cancer
Recurrent Breast Cancer
Stage IV Breast Cancer
Other: laboratory biomarker analysis
Genetic: RNA analysis
Other: immunoenzyme technique
|Study Design:||Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Phase II Study of Topical Imiquimod and Weekly Abraxane for the Treatment of Breast Cancer Cutaneous Metastases|
- Anti-tumor effects of imiquimod as assessed by modified World Health Organization (WHO) criteria [ Time Frame: Baseline and then every 4 weeks until week 24 ] [ Designated as safety issue: No ]Tumor responses will be determined using the sum of the products of the largest perpendicular dimensions. Target lesions will be evaluated by the following response criteria: complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD).
- Safety and systemic toxicity as assessed by a review of medical history, physical exam, systems, performance status, and clinical labs (CBC and CMP) [ Time Frame: Baseline and weeks 5, 9 13, 16, 20, and 24 ] [ Designated as safety issue: Yes ]Evaluated according to the Cancer Therapy Evaluation Program (CTEP) Common Terminology Criteria for Adverse Events (CTCAE) v3.0 and monitoring of adverse events will be done per Food and Drug Administration (FDA) and National Cancer Institute (NCI) guidelines
- Pathologic response as assessed by skin punch biopsy [ Time Frame: Pre-and post-treatment ] [ Designated as safety issue: No ]
- Endogenous immunity to common breast tumor antigens (HER2, IGFBP-2, Topoisomerase II-alpha, and p53) in peripheral blood as assessed by IFN-gamma and ELISPOT assay [ Time Frame: Baseline and at weeks 13 and 24 ] [ Designated as safety issue: No ]
- Incidence of reduction of serum TGF-beta levels as assessed by ELISA and correlation with Th1 adaptive immunity and clinical response [ Time Frame: Baseline and at weeks 13 and 24 ] [ Designated as safety issue: No ]
|Study Start Date:||December 2008|
|Primary Completion Date:||January 2013 (Final data collection date for primary outcome measure)|
Experimental: Treatment (biological therapy, chemotherapy)
Patients receive Abraxane IV over 30 minutes on days 1, 8, and 15 and apply topical imiquimod to cutaneous lesions QD on days 1-4, 8-11, 15-18, and 22-25. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity.
Other Names:Drug: Abraxane
Other Names:Other: laboratory biomarker analysis
Correlative studiesGenetic: RNA analysis
Correlative studiesOther: immunoenzyme technique
Other Name: immunoenzyme techniques
I. To evaluate the safety of chemoimmunotherapy with topical imiquimod and Abraxane in breast cancer patients with recurrent chest wall disease or cutaneous metastasis.
II. To evaluate the anti-tumor effects of chemoimmunotherapy with topical imiquimod and Abraxane in breast cancer patients with recurrent chest wall disease or cutaneous metastasis.
I. To examine whether treatment with chemoimmunotherapy consisting of topical imiquimod and Abraxane augments endogenous tumor specific immunity.
II. To assess the effect of chemoimmunotherapy on circulating transforming growth factor (TGF)-beta levels.
Patients receive Abraxane intravenously (IV) over 30 minutes on days 1, 8, and 15 and apply topical imiquimod to cutaneous lesions once daily (QD) on days 1-4, 8-11, 15-18, and 22-25. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up at 1, 4, 8, and 12 weeks.
|United States, Washington|
|Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium|
|Seattle, Washington, United States, 98109|
|Principal Investigator:||Lupe Salazar||Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium|