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Trastuzumab in Treating Women With Primary Breast Cancer

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborators:
Breast International Group
European Organisation for Research and Treatment of Cancer - EORTC
NCIC Clinical Trials Group
International Breast Cancer Study Group
Information provided by:
Hoffmann-La Roche
ClinicalTrials.gov Identifier:
NCT00045032
First received: September 6, 2002
Last updated: June 4, 2012
Last verified: March 2012
  Purpose

RATIONALE: Monoclonal antibodies such as trastuzumab can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. It is not yet known whether trastuzumab is effective in treating primary breast cancer in women who have completed adjuvant chemotherapy.

PURPOSE: This randomized phase III trial is studying two different regimens of trastuzumab and observation only to compare how well they work in treating women with breast cancer.


Condition Intervention Phase
Breast Cancer
Biological: trastuzumab
Procedure: adjuvant therapy
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: HERA: A Randomised Three-Arm Multi-Centre Comparison Of 1 Year And 2 Years Of Herceptin Versus No Herceptin In Women With HER2-Positive Primary Breast Cancer Who Have Completed Adjuvant Chemotherapy

Resource links provided by NLM:


Further study details as provided by Hoffmann-La Roche:

Primary Outcome Measures:
  • Disease-free survival [ Designated as safety issue: No ]
  • Relapse-free survival [ Designated as safety issue: No ]
  • Distant disease-free survival [ Designated as safety issue: No ]
  • Incidence of cardiac dysfunction [ Designated as safety issue: No ]
  • Safety and tolerability [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Overall survival [ Designated as safety issue: No ]
  • Time to recurrence [ Designated as safety issue: No ]
  • Time to distant recurrence [ Designated as safety issue: No ]

Estimated Enrollment: 5043
Study Start Date: December 2001
Estimated Study Completion Date: September 2015
Estimated Primary Completion Date: September 2015 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Compare the disease-free survival of women with HER2-positive primary breast cancer treated with trastuzumab (Herceptin®) for 1 year vs trastuzumab for 2 years vs standard supportive care.
  • Compare the overall survival of patients treated with these regimens.
  • Compare the relapse-free survival of patients treated with these regimens.
  • Compare the distant disease-free survival of patients treated with these regimens.
  • Compare the incidence of cardiac dysfunction in patients treated with these regimens.
  • Evaluate the safety and tolerability of these regimens in these patients.

Secondary

  • Compare time to recurrence in patients treated with these regimens.
  • Compare time to distant recurrence in patients treated with these regimens.
  • Compare outcomes, in terms of disease-free survival, overall survival, recurrence-free survival, distant disease-free survival, time to recurrence, time to distant recurrence, cardiac safety, and overall safety, in patients treated with trastuzumab for 1 year vs 2 years.

OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to nodal status (any nodal status and prior neoadjuvant chemotherapy vs no positive nodes and no prior neoadjuvant chemotherapy vs 1-3 positive nodes and no prior neoadjuvant chemotherapy vs 4 or more positive nodes and no prior neoadjuvant chemotherapy), prior adjuvant chemotherapy regimen (no anthracyclines or taxanes vs anthracyclines only vs anthracyclines and taxanes), receptor status and endocrine therapy (negative vs positive and no prior endocrine therapy vs positive and prior endocrine therapy), age (18 to 34 vs 35 to 49 vs 50 to 59 vs 60 and over), and participating center. Patients are randomized to 1 of 3 treatment arms.

  • Arm I: Patients receive trastuzumab (Herceptin®) IV over 1.5 hours on day 1. Courses repeat every 3 weeks for up to 1 year in the absence of disease progression or unacceptable toxicity.
  • Arm II: Patients receive trastuzumab as in arm I. Courses repeat every 3 weeks for up to 2 years in the absence of disease progression or unacceptable toxicity.
  • Arm III: Patients receive no trastuzumab. Patients may later receive trastuzumab as in arm I or arm II.

Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.

PROJECTED ACCRUAL: Approximately 4,482 patients (1,494 per treatment arm) will be accrued for this study within 4 years.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed nonmetastatic primary invasive adenocarcinoma of the breast

    • Adequately excised
    • Axillary nodes positive or negative
    • No positive or suspicious internal mammary nodes identified by sentinel node technique that have not been irradiated
    • No supraclavicular lymph node involvement
  • HER2-positive disease with one of the following:

    • 3+ overexpression by immunohistochemistry (IHC)
    • 2+ overexpression by IHC and fluorescence in situ hybridization (FISH) with c-erbB2 gene amplification
    • c-erbB2 gene amplification by FISH
  • Previously treated with at least 3 months or 4 courses of approved neoadjuvant or adjuvant chemotherapy with or without radiotherapy
  • No synchronous bilateral or multifocal breast cancer that is not HER2-positive
  • No locally advanced or inflammatory breast cancer
  • No clinical T4 primary breast tumor
  • Prior curatively treated ipsilateral ductal carcinoma in situ of the breast is allowed
  • Hormone receptor status:

    • Estrogen receptor and progesterone receptor status known OR
    • Estrogen receptor status known

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Sex

  • Female

Menopausal status

  • Not specified

Performance status

  • ECOG 0-1

Life expectancy

  • Not specified

Hematopoietic

  • WBC at least 2,500/mm^3
  • Absolute neutrophil count at least 1,500/mm^3
  • Platelet count at least 100,000

Hepatic

  • Bilirubin no greater than 2 times upper limit of normal (ULN)
  • AST and ALT no greater than 2.5 times ULN
  • Alkaline phosphatase no greater than 2.5 times ULN

Renal

  • Creatinine no greater than 2 times ULN

Cardiovascular

  • LVEF at least 55% by echocardiography or MUGA
  • No serious cardiac illness
  • No documented congestive heart failure
  • No high-risk uncontrolled arrhythmias
  • No angina pectoris requiring antianginal medication
  • No clinically significant valvular heart disease
  • No evidence of transmural infarction on EKG
  • No poorly controlled hypertension (i.e., systolic greater than 180 mm Hg or diastolic greater than 100 mm Hg)

Pulmonary

  • No severe pulmonary disease/illness

Other

  • No other malignancy except for curatively treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or other cancer that has been curatively treated, with no evidence of disease, and has less than 15% risk of recurrence over the next 10 years
  • No other concurrent serious disease that would preclude study participation
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective barrier contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • No prior peripheral stem cell or bone marrow stem cell transplantation as part of prior neoadjuvant or adjuvant chemotherapy regimen
  • No prior biologic therapy or immunotherapy for breast cancer
  • No prior anti-HER2 therapy for any reason
  • No concurrent immunotherapy for breast cancer

Chemotherapy

  • See Disease Characteristics
  • See Biologic therapy
  • No prior cumulative dose of doxorubicin more than 360 mg/m^2 or epirubicin more than 720 mg/m^2
  • No prior anthracyclines for another malignancy
  • No more than 7 weeks since day 1 of last chemotherapy course
  • No concurrent adjuvant chemotherapy

Endocrine therapy

  • No concurrent hormonal therapy, including aromatase inhibitors, pure antiestrogens, or progestational agents, for breast cancer
  • Concurrent systemic adjuvant hormonal therapy for estrogen receptor-positive patients allowed
  • Concurrent tamoxifen allowed

Radiotherapy

  • See Disease Characteristics
  • No more than 6 weeks since completion of prior radiotherapy
  • No prior mediastinal irradiation except for internal mammary node irradiation for the present breast cancer

Surgery

  • See Disease Characteristics
  • No more than 6 weeks since prior definitive surgery
  • Concurrent ovarian ablation allowed

Other

  • No other concurrent investigational therapy for breast cancer
  • Concurrent bisphosphonate therapy allowed if started prior to study
  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: NCT00045032

  Show 203 Study Locations
Sponsors and Collaborators
Hoffmann-La Roche
Breast International Group
European Organisation for Research and Treatment of Cancer - EORTC
NCIC Clinical Trials Group
International Breast Cancer Study Group
Investigators
Study Chair: Martine J. Piccart-Gebhart, MD, PhD Institut Jules Bordet
Study Chair: Robert E. Coleman, MD, FRCP Cancer Research Centre at Weston Park Hospital
Study Chair: Karen A. Gelmon, MD British Columbia Cancer Agency
Study Chair: Kathleen I. Pritchard, MD Odette Cancer Centre at Sunnybrook
Study Chair: Olivia Pagani, MD Ospedale Beata Vergine
  More Information

Additional Information:
Publications:
McCaskill-Stevens W, Procter M, Goodbrand J, et al.: Disease-free survival according to local immunohistochemistry for HER2 and central fluorescence in situ hydridization for patients treated with adjuvant chemotherapy with and without trastuzumab in the HERA (BIG 01-01) trial. [Abstract] Breast Cancer Res Treat 106 (1): A-71, S18, 2007.

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
ClinicalTrials.gov Identifier: NCT00045032     History of Changes
Other Study ID Numbers: BO16348, BIG-01-01, EU-20216, ROCHE-B016348E, ROCHE-B016348C, EORTC-10011, CAN-NCIC-MA24, IBCSG-28-02
Study First Received: September 6, 2002
Last Updated: June 4, 2012
Health Authority: Sweden: Swedish Medical Products Agency

Keywords provided by Hoffmann-La Roche:
stage I breast cancer
stage II breast cancer
stage IIIA breast cancer

Additional relevant MeSH terms:
Breast Neoplasms
Breast Diseases
Neoplasms
Neoplasms by Site
Skin Diseases
Trastuzumab
Antineoplastic Agents
Pharmacologic Actions
Therapeutic Uses

ClinicalTrials.gov processed this record on November 27, 2014