TC Avastin. ICORG 08-10, V6

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
ICORG- All Ireland Cooperative Oncology Research Group
ClinicalTrials.gov Identifier:
NCT00911716
First received: May 30, 2009
Last updated: January 23, 2014
Last verified: January 2014
  Purpose

RATIONALE: Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Drugs used in chemotherapy, such as docetaxel and cyclophosphamide, 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) together with bevacizumab may kill more tumor cells.

PURPOSE: This clinical trial is studying the side effects of giving bevacizumab together with docetaxel and cyclophosphamide and to see how well it works in treating patients with early-stage high-risk breast cancer.

This is a single arm, non randomised pilot study investigating the safety of the combination of Docetaxel + Cyclophosphamide+ Bevacizumab in the adjuvant treatment of patients with early stage, HER 2 negative, high risk breast cancer.


Condition Intervention
Breast Cancer
Biological: bevacizumab
Drug: cyclophosphamide
Drug: docetaxel
Procedure: adjuvant therapy

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Pilot Evaluation of Bevacizumab, in Combination With Docetaxel and Cyclophosphamide in the Adjuvant Treatment of Patients With HER 2 Negative Breast Cancer

Resource links provided by NLM:


Further study details as provided by ICORG- All Ireland Cooperative Oncology Research Group:

Primary Outcome Measures:
  • Percentage of patients experiencing heart failure [ Time Frame: 5 years ] [ Designated as safety issue: Yes ]
    Patients will be followed up through 5 years (i.e. from the time of registration through to end of Year 5 / 1 year treatment and 4 years follow up)

  • Measurements of left ventricular ejection fraction by echocardiography or MUGA [ Time Frame: Sceening, day 1 of cycles 3, 5, 9, 13`.(the window of 5 days in advance to 1st day of treatment is allowed), end of treatment, follow- up annually ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Non comparative efficacy by disease-free and overall survival [ Time Frame: 5 years ] [ Designated as safety issue: No ]
  • Topo II overexpression [ Time Frame: Serum samples for assssment of Topo II overexpression collected prior to commencement of treatment, after cycle 4, at 6 months, 1 year and 12 months post last dose of bevacizumab. ] [ Designated as safety issue: No ]

Enrollment: 106
Study Start Date: October 2008
Estimated Study Completion Date: July 2016
Primary Completion Date: July 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: cyclophosphamide, Docetaxel, bevacizumab Biological: bevacizumab Drug: cyclophosphamide Drug: docetaxel Procedure: adjuvant therapy

Detailed Description:

OBJECTIVES:

Primary

  • Assess the feasibility of the combination of adjuvant bevacizumab, docetaxel, and cyclophosphamide in patients with early-stage HER2-negative high-risk breast cancer.
  • Determine the safety of this regimen with regards to cardiac toxicity, hypertension, and bleeding complications in these patients.

Secondary

  • Evaluate the efficacy of this regimen by measuring Topo II overexpression in these patients.

OUTLINE: This is a multicenter study.

Patients will receive 4 cycles of Docetaxel 75mg/m2 + 4 cycles of Cyclophosphamide 600mg/m2 (each cycle lasts 21 days) (+/- 3 days if a due date could not be met because of public holidays, etc) and concomitant Avastin (Bevacizumab) 15mg/kg q 3weeks for treatment duration of one year.

Bevacizumab at a dose of 15mg/kg will be administered as an intravenous infusion every 3 weeks for a treatment period of one year, regardless of missed doses.

Patients will be followed up through 5 years (i.e. from the time of registration through to end of Year 5/ 1 year treatment and 4 years follow up).

  Eligibility

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

Inclusion Criteria:

  1. The patient must have histologically confirmed, invasive adenocarcinoma of the breast with:

    -Involvement of at least one axillary lymph node on routine histologic examination.

    or

    • ER negative tumour >2 cm invasive cancer or
    • ER positive tumour > 3cm invasive cancer. Note : Pre-menopausal patients with ER positive tumour may participate in the International Breast Cancer Study Group (IBCSG) SOFT study. High risk and registered and intermediate risk and randomized for chemotherapy patients enrolled in the TAILOR x study may participate in this study (once prior approval from IBCSG and ECOG is received)
  2. Patients must have undergone standard surgical treatment for their breast cancer, consisting either of mastectomy or a standard breast-conserving operation, which included appropriate axillary surgery. Such axillary procedures will include either sentinel node biopsy or an axillary dissection.
  3. Patients must have disease which is HER2 negative (0, or 1+ by immunohistochemistry (IHC) or fluorescence in situ hybridization FISH non amplified)
  4. Patients must have negative evaluations for metastatic disease, including chest x-ray or CT scan, isotope bone scan, and either computed tomography (CT), MRI or ultrasound of the liver. Position emission tomography (PET) scan would also suffice in place of the above tests (unless a bone scan is clinically indicated) within 3 months prior to registration.
  5. Patients must have a normal cardiac ejection fraction by echocardiogram (ECHO) or multigated acquisition (MUGA) scan within 3 months prior to registration.
  6. The electrocardiogram (ECG) performed within 3 months prior to registration must not have any clinically significant abnormalities reported.
  7. Margins of breast conservation surgery or mastectomy must be histologically free of invasive breast cancer and ductal carcinoma in situ (DCIS). Patients with resection margins positive for lobular carcinoma in situ (LCIS) are eligible.
  8. The interval between the last surgery for breast cancer (breast conservation surgery, mastectomy, sentinel node biopsy, axillary dissection or re-excision of breast conservation surgery margins) and Day 1 of treatment must be > 21 days and no more than 84 days.
  9. ECOG performance status of 0-1.
  10. Patients must have adequate organ function within < 8 weeks prior to registration, as measured by:

    • Absolute neutrophil count > 1.2 x 10^9/L
    • Platelet count > 100 x 10^9/L
    • Normal bilirubin (except for patients with congenital hyperbilirubinemia)
    • total bilirubin must be ≤ upper limit of normal (ULN) for the lab unless the patient has a bilirubin elevation > ULN to 1.5 x ULN due to Gilberts disease or similar syndrome involving slow conjugation of bilirubin
    • Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) < 2x ULN
    • Serum creatinine must be ≤ ULN for the lab
    • Measured or creatinine clearance must be ≥60ml/min
    • Urinary protein should be 0- 1+ on dipstick urinalysis. If dipstick reading is ≥_2+ protein value must be < 500 mg in a 24-hour urine specimen.
  11. Activated partial thromboplastin time (APTT) < 1.5 x ULN
  12. Patients with synchronous bilateral breast cancer (diagnosed within one month) are eligible if the higher tumour node metastasis (TNM) stage tumour meets the eligibility criteria for this study and both are HER-2 negative.
  13. Male or female patients age > 18 years of age are eligible.
  14. Women must not be pregnant or breast-feeding due to the potential harmful effects of bevacizumab on the developing fetus. (Note: All females of childbearing potential must have a serum pregnancy test within 7 days prior to registration).
  15. Women of childbearing potential and sexually active males must use an accepted and effective method of contraception ( such as non hormonal intra uterine device (IUD), condoms, sexual abstinence or vasectomized partner).

Exclusion Criteria:

  1. Any active serious medical illness.
  2. Patients must not have clinically significant cardiovascular or cerebrovascular disease, including any history of

    • Symptomatic heart disease or heart disease requiring ongoing treatment
    • Cerebrovascular disease including transient ischemic attack (TIA), stroke or subarachnoid haemorrhage
    • Ischemic bowel
    • Myocardial infarction
    • Unstable angina
  3. New York Heart Association (NYHA) grade II or greater congestive heart failure
  4. Grade II or greater peripheral vascular disease active at study entry
  5. Patients receiving anticoagulation therapy are excluded.
  6. Uncontrolled hypertension defined as systolic blood pressure (BP) >145mmHg or diastolic BP >85mmHg, with or without anti-hypertensive medication.(BP must be assessed within 28 days prior to registration).
  7. Uncontrolled or clinically significant arrhythmia.
  8. Clinical evidence of inflammatory breast cancer or fixed axillary nodes at diagnosis.
  9. Any major surgical procedure within 21 days of day 1 treatment. (NOTE: Non-operative biopsy or placement of a vascular access device is not considered a major surgery).
  10. Placement of a vascular access device within 24 hours of planned Day 1 of treatment.
  11. Bleeding diathesis, hereditary or acquired bleeding disorder or coagulopathy.
  12. A non-healing wound or fracture. Patients with an abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to registration are not eligible.
  13. Axillary node involvement only demonstrated by immunohistochemistry are not eligible unless they meet one of the other eligibility criteria below:

    • ER negative tumour >2 cm invasive cancer
    • ER positive tumour > 3 cm invasive cancer
  14. Prior cancer except for basal cell skin cancer and cancer in situ of the cervix and uterus
  15. Hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies.
  16. Patients must not have received prior cytotoxic chemotherapy for any cancer or received hormonal therapy for this breast cancer.

NOTE: Prior use of tamoxifen for chemoprevention is allowed but must be discontinued at study entry. Similarly, prior raloxifene use is allowed but must be discontinued at study entry.

  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: NCT00911716

Locations
Ireland
Mater Misericordiae University Hospital
Dublin, Ireland, 7
Beaumont Hospital
Dublin, Ireland, 9
St. James's Hospital
Dublin, Ireland, 8
St. Vincent's University Hospital
Dublin, Ireland, 4
Mater Private Hospital
Dublin, Ireland, 7
Adelaide and Meath Hospital, Dublin Incorporating the National Children's Hospital
Dublin, Ireland, 24
University College Hospital
Galway, Ireland
Mid-Western Cancer Centre at Mid-Western Regional Hospital
Limerick, Ireland, 0009
Sligo General Hospital
Sligo, Ireland
Waterford Regional Hospital
Waterford, Ireland
Sponsors and Collaborators
ICORG- All Ireland Cooperative Oncology Research Group
Investigators
Principal Investigator: John Crown, MD ICORG- All Ireland Cooperative Oncology Research Group
  More Information

Additional Information:
No publications provided

Responsible Party: ICORG- All Ireland Cooperative Oncology Research Group
ClinicalTrials.gov Identifier: NCT00911716     History of Changes
Other Study ID Numbers: CDR0000637732, ICORG-08-10, EUDRACT-2008-004552-76, EU-20915
Study First Received: May 30, 2009
Last Updated: January 23, 2014
Health Authority: Ireland: Irish Medicines Board

Keywords provided by ICORG- All Ireland Cooperative Oncology Research Group:
estrogen receptor-negative breast cancer
estrogen receptor-positive breast cancer
HER2-negative breast cancer
stage IA breast cancer
stage IB breast cancer
stage II breast cancer
stage IIIA breast cancer
male breast cancer

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Bevacizumab
Docetaxel
Cyclophosphamide
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Physiological Effects of Drugs
Pharmacologic Actions
Growth Inhibitors
Antineoplastic Agents
Therapeutic Uses
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Immunosuppressive Agents
Immunologic Factors
Antirheumatic Agents
Antineoplastic Agents, Alkylating
Alkylating Agents
Myeloablative Agonists

ClinicalTrials.gov processed this record on September 30, 2014