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A Trial of Doxorubicin/Cyclophosphamide (AC), Docetaxel (D), and Alternating AC and D for Metastatic Breast Cancer

This study has been completed.
Ministry of Health, Labour and Welfare, Japan
Information provided by:
Japan Clinical Oncology Group Identifier:
First received: September 12, 2005
Last updated: August 31, 2016
Last verified: August 2016
To investigate the clinical benefits of Docetaxel or alternating AC-Docetaxel in comparison with standard AC for metastatic breast cancer

Condition Intervention Phase
Breast Cancer
Neoplasm Metastasis
Drug: AC (ADM 40mg/m2+CPA 500mg/m2) q21 days x 6 cycles
Drug: Docetaxel 60mg/m2 every 21 days for 6 cycles
Drug: AC and Docetaxel 60mg/m2 alternately q21 days for 6 cycles
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase III Trial of Doxorubicin /Cyclophosphamide (AC), Docetaxel (D), and Alternating AC and D (AC-D) as Front-line Chemotherapy for Metastatic Breast Cancer: Japan Clinical Oncology Group Trial (JCOG9802)

Resource links provided by NLM:

Further study details as provided by Japan Clinical Oncology Group:

Primary Outcome Measures:
  • time to treatment failure

Secondary Outcome Measures:
  • overall survival
  • progression-free survival
  • response rate
  • adverse events

Estimated Enrollment: 450
Study Start Date: January 1999
Study Completion Date: May 2006
Primary Completion Date: May 2006 (Final data collection date for primary outcome measure)
Detailed Description:

power to detect a 50% increase in median TTF at 0.025 one-sided alpha in AC vs. D and AC vs. AC-D.

Results: 441pts (146 in AC, 147 in D, 148 in AC-D) were randomized between 01/99 and 05/03. Major grade 3-4 toxicities were neutropenia (26/45/46% for AC/D/AC-D), febrile neutropenia (3/4/6%), nausea/vomiting (3/3/4%). There was no toxic death. One grade 4 diarrhea in AC-D and 1 secondary leukemia (APL) in D were reported. Response (CR/PR) rates were 30, 41, and 35% for AC, D, and AC-D respectively. Median TTF (AC, D, and AC-D) are 6.4, 6.4, and 6.7 months (p =.255 for AC vs. D, p =.275 for AC vs. AC-D), and median overall survival are 22.4, 25.7, and 25.0 months (p=.092 for AC vs. D, p=.076 for AC vs. AC-D). The same difference was shown by the adjusted Cox model.

Conclusions: No benefit was demonstrated in D and AC-D over AC in TTF, however, D and AC-D tended to be superior to AC in response rate and overall survival. Survival benefit of front-line docetaxel should be re-evaluated by further long follow-up.


Ages Eligible for Study:   20 Years to 75 Years   (Adult, Senior)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Hormonal therapy-resistant MBC
  2. ER (-), failure of hormonal therapy for MBC, or relapse within 6 months after adjuvant hormonal therapy
  3. No anthracyclines for MBC and no prior taxanes
  4. At least 6 months from the completion of adjuvant chemotherapy
  5. Measurable or evaluable lesions
  6. Age: 20 to 75 years
  7. PS: 0-3
  8. WBC >= 4,000 /mm3 or ANC >=1,000 /mm3, Platelet >= 100,000 /mm3, SGOT/SGPT <= 1.5 x ULN, T-Bil <= 1.5 mg/dL, Cr <= 1.5 mg/dL
  9. normal ECG
  10. Written informed consent

Exclusion Criteria:

  1. pregnant
  2. malignant pleural effusion, ascites, or pericardial effusion that requires emergent treatment
  3. Active infection
  4. other cancer present within the last 5 years
  5. previous stem cell transplantation
  6. brain metastasis that requires emergent treatment
  7. relapse within 6 months after completion anthracycline or during anthracycline
  8. more than 250mg/m2 of anthracyclines
  9. hypersensitivity of drug
  10. interstitial pneumonitis or pulmonary fibrosis
  11. positive HBs
  12. antipsychotic medication
  13. doctor's judgement
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Please refer to this study by its identifier: NCT00190489

National Cancer Center Hospital
Chuo-ku, Tsukiji, 5-1-1, Tokyo, Japan, 104-0045
Sponsors and Collaborators
Japan Clinical Oncology Group
Ministry of Health, Labour and Welfare, Japan
Study Chair: Shigemitsu Takashima, MD, PhD National Shikoku Cancer Center
  More Information

Additional Information:
Responsible Party: Japan Clinical Oncology Group Identifier: NCT00190489     History of Changes
Other Study ID Numbers: JCOG9802
Study First Received: September 12, 2005
Last Updated: August 31, 2016

Keywords provided by Japan Clinical Oncology Group:
metastatic breast cancer
drug therapy

Additional relevant MeSH terms:
Breast Neoplasms
Neoplasm Metastasis
Neoplasms by Site
Breast Diseases
Skin Diseases
Neoplastic Processes
Pathologic Processes
Liposomal doxorubicin
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antirheumatic Agents
Antineoplastic Agents, Alkylating
Alkylating Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Myeloablative Agonists
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Antibiotics, Antineoplastic
Topoisomerase II Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors processed this record on April 28, 2017