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Cisplatin vs Paclitaxel for Triple Neg

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ClinicalTrials.gov Identifier: NCT01982448
Recruitment Status : Active, not recruiting
First Posted : November 13, 2013
Last Update Posted : January 30, 2018
Sponsor:
Collaborators:
Myriad Genetics, Inc.
Translational Breast Cancer Research Consortium
Information provided by (Responsible Party):
Erica Mayer, MD, MPH, Dana-Farber Cancer Institute

Brief Summary:
This research study is evaluating how well triple negative breast cancer responds to preoperative treatment with Cisplatin or Paclitaxel chemotherapy, and if use of a research test Homologous Recombination Deficiency (HRD) assay can predict response to preoperative treatment.

Condition or disease Intervention/treatment Phase
Triple Negative Breast Cancer Drug: Cisplatin Drug: Paclitaxel Phase 2

  Show Detailed Description

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 165 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Randomized Phase II Study of Preoperative Cisplatin Versus Paclitaxel in Patients With Triple Negative Breast Cancer: Evaluating the Homologous Recombination Deficiency (HRD) Biomarker
Study Start Date : February 2014
Estimated Primary Completion Date : April 2018
Estimated Study Completion Date : June 2021

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Breast Cancer

Arm Intervention/treatment
Experimental: Paclitaxel
Paclitaxel will be given as an IV infusion at a dose of 80mg/m2 weekly x 12 weeks (4 cycles).
Drug: Paclitaxel
80mg/m2 weekly x 12 weeks (4 cycles).
Other Name: Taxol (NSC 125973)

Experimental: Cisplatin
Cisplatin will be given by IV at 75 mg/m2 every 3 weeks, 4 cycles.
Drug: Cisplatin
75 mg/m2 IV q 3 weeks x 4 cycles
Other Name: Platinol ®-AQ




Primary Outcome Measures :
  1. To compare the pathologic response to neoadjuvant platinum-based chemotherapy in TNBC with and without HR-deficiency, defined as a high HRD score or a BRCA mutation [ Time Frame: 2 Years ]
    To compare the pathologic response to neoadjuvant platinum-based chemotherapy in TNBC with and without HR-deficiency, defined as a high HRD score or a BRCA mutation

  2. To compare the pathologic response to neoadjuvant taxane-based chemotherapy in TNBC with and without HR-deficiency, defined as a high HRD score or a BRCA mutation [ Time Frame: 2 Years ]
    To compare the pathologic response to neoadjuvant taxane-based chemotherapy in TNBC with and without HR-deficiency, defined as a high HRD score or a BRCA mutation


Secondary Outcome Measures :
  1. To evaluate whether the positive predictive value of HR-deficiency is greater for TNBC treated with cisplatin, as compared to TNBC treated with paclitaxel. [ Time Frame: 2 Years ]
    To evaluate whether the positive predictive value of HR-deficiency is greater for TNBC treated with cisplatin, as compared to TNBC treated with paclitaxel.

  2. To determine the association of HR-deficiency with pathologic complete response (pCR) to neoadjuvant platinum-based chemotherapy in TNBC. [ Time Frame: 2 Years ]
    To determine the association of HR-deficiency with pathologic complete response (pCR) to neoadjuvant platinum-based chemotherapy in TNBC.

  3. To determine the association of HR-deficiency with pCR to neoadjuvant taxane-based therapy in TNBC. [ Time Frame: 2 Years ]
    To determine the association of HR-deficiency with pCR to neoadjuvant taxane-based therapy in TNBC.

  4. To evaluate clinical and pathologic responses in TNBC treated with preoperative cisplatin and paclitaxel. [ Time Frame: 2 Years ]
    To evaluate clinical and pathologic responses in TNBC treated with preoperative cisplatin and paclitaxel.

  5. To evaluate the performance of the HRD-LOH assay, the HRD-TAI assay, and the HRDLST assay, to predict pathologic response to cisplatin or taxane therapy in TNBC. [ Time Frame: 2 years ]
    To evaluate the performance of the HRD-LOH assay, the HRD-TAI assay, and the HRDLST assay, to predict pathologic response to cisplatin or taxane therapy in TNBC.



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Participants must meet the following criteria on screening examination to be eligible to participate in the study
  • Pathologic documentation of invasive breast cancer by biopsy (FNA alone is not adequate).
  • AJCC clinical stage I with T1 > 1.5 cm, stage II or III invasive breast cancer.
  • Participants with multicentric or bilateral disease are eligible if at least one lesion meets stage eligibility criteria for the study and no tumor is HER2-positive. In this circumstance, the investigator must determine which will represent the target lesion to be assessed for response. This should remain consistent throughout the study. The target lesion should be selected on the basis of its size (lesion with the longest diameter) and suitability for accurate repetitive measurements.
  • Tumors must be HER2 negative defined as HER2 0 or 1+ by immunohistochemistry (IHC) assays and /or lack of gene amplification by FISH defined as a ratio < 2 on invasive tumor by local review.
  • ER and PgR status by IHC must be known. Tumor must be ER and PR negative (≤5% staining) by local review.
  • Known BRCA1/2 status is not required for study entry. However patients known to have a germline deleterious BRCA1/2 mutation should be encouraged to consider a preoperative trial specifically designed for BRCA1/2 carriers, if available.
  • Breast imaging should include imaging of the ipsilateral axilla. For subjects with a clinically positive axilla, a needle aspiration, core biopsy or SLN procedure will be performed to confirm the presence of metastatic disease in the lymph nodes. For patients with a clinically negative axilla, baseline assessment of the axilla will be performed at the discretion of the treating investigator. For patients with pathologically positive axillary lymph nodes prior to preoperative therapy, a level I and II lymph node dissection at the time of definitive surgery is recommended.
  • Participants with axillary adenopathy only are not eligible for this study.
  • Patients with a prior history of contra-lateral breast cancer are eligible if they have no evidence of recurrence of their initial primary breast cancer within the last 5 years.
  • Women ≥ 18 years of age.
  • ECOG performance status ≤1 (see Appendix A).

Laboratory Evaluation

  • Absolute neutrophil count (ANC) ≥ 1,500 / mm3
  • Platelet count ≥ 100,000/ mm3
  • Bilirubin ≤ 1.5x upper limit of normal (ULN), for patients with Gilbert syndrome, direct bilirubin will be measured instead of total bilirubin ALT, AST ≤3.0 x ULN ALK Phos <2.5 x ULN
  • Creatinine ≤ 1.5 mg/dl or creatinine clearance ≥ 60 cc/min
  • Hemoglobin ≥ 9 mg/dl
  • Use of an effective means of contraception is required in subjects of childbearing potential since study agents are known to be teratogenic. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. Women of child-bearing potential and men must agree to use adequate contraception (barrier method of birth control; abstinence) prior to study entry and for the duration of study participation.
  • Ability to understand and the willingness to sign a written informed consent document
  • Individuals with a history of other malignancies are eligible if they have been disease-free for at least 5 years and are deemed by the investigator to be at low risk for recurrence of that malignancy and did not receive prior chemotherapy. Individuals with the following cancers are eligible if diagnosed and treated within the past 5 years: cervical cancer in situ, and basal cell or squamous cell carcinoma of the skin.
  • Patient must be willing to undergo mandatory research biopsy and blood draw. Prior to biopsy procedures patients must be able to be off medications that could increase the risk of bleeding

Exclusion Criteria:

  • Prior chemotherapy: Prior non-taxane or platinum containing chemotherapy will be allowed if the prior exposure was at least 5 years ago and the exposure is thought not to potentially interact with the primary outcome of the trial or put the patient at undue risk, and should be reviewed with study PI on a case by case basis.
  • Any prior treatment for the current breast cancer, including chemotherapy, hormonal therapy, radiation or experimental therapy.
  • Ipsilateral breast recurrence, unless prior treatment consisted of excision alone for DCIS or breast conserving treatment and hormonal therapy for DCIS or invasive breast cancer.
  • Ongoing use of any other investigational or study agents.
  • Peripheral neuropathy of any etiology > grade 1 (NCI CTCAE Version 4.0- Appendix B)
  • Significant hearing loss that would prevent cisplatin administration.
  • Renal dysfunction for which exposure to cisplatin would be unsafe or require cisplatin dose modification (i.e., Cre > 1.5 mg/dl or GFR < 60 cc/min).

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01982448


Locations
United States, Alabama
University of Alabama
Birmingham, Alabama, United States, 35294
United States, Indiana
Indiana University- Simon Cancer Center
Indianapolis, Indiana, United States, 46202
United States, Maryland
Johns Hopkins University
Baltimore, Maryland, United States, 21287
United States, Massachusetts
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States, 02215
Dana-Farber Cancer Institute
Boston, Massachusetts, United States, 02215
South Shore Hospital
Weymouth, Massachusetts, United States, 02190
United States, New Jersey
Memorial Sloan Kettering Cancer Center-Basking Ridge
Basking Ridge, New Jersey, United States, 07920
Memorial Sloan Kettering Cancer Center-Monmouth
Middletown, New Jersey, United States, 07748
United States, New York
Memorial Sloan Kettering Cancer Center-Commack
Commack, New York, United States, 11725
Memorial Sloan Kettering Cancer Center-West Harrison
Harrison, New York, United States, 10604
Memorial Sloan Kettering Cancer Center
New York, New York, United States, 10065
Memorial Sloan Kettering Cancer Center-Rockville Centre
Rockville Centre, New York, United States, 11570
Memorial Sloan Kettering Cancer Center-Sleepy Hollow
Sleepy Hollow, New York, United States, 10591
United States, North Carolina
University of North Carolina- Lineberger Cancer Center
Chapel Hill, North Carolina, United States, 27599
Duke University
Durham, North Carolina, United States, 27710
United States, Pennsylvania
Universtiy of Pittsburgh- Magee-Womens Hospital
Pittsburgh, Pennsylvania, United States, 15213
United States, Tennessee
Vanderbilt-Ingram Cancer Center
Nashville, Tennessee, United States, 37232
United States, Texas
Baylor College of Medicine
Houston, Texas, United States, 77030
United States, Washington
Seattle Cancer Alliance at EvergreenHealth
Kirkland, Washington, United States, 98034
University of Washignton
Seattle, Washington, United States, 98195
Sponsors and Collaborators
Dana-Farber Cancer Institute
Myriad Genetics, Inc.
Translational Breast Cancer Research Consortium
Investigators
Principal Investigator: Erica Mayer, MD Dana-Farber Cancer Institute

Responsible Party: Erica Mayer, MD, MPH, Principal Invesitigator, Dana-Farber Cancer Institute
ClinicalTrials.gov Identifier: NCT01982448     History of Changes
Other Study ID Numbers: 13-383
TBCRC030 ( Other Identifier: Translational Breast Cancer Research Consortium )
First Posted: November 13, 2013    Key Record Dates
Last Update Posted: January 30, 2018
Last Verified: January 2018

Keywords provided by Erica Mayer, MD, MPH, Dana-Farber Cancer Institute:
TRIPLE NEGATIVE BREAST CANCER WITHOUT GERMLINE BRCA MUTATIONS
CISPLATIN
PACLITAXEL

Additional relevant MeSH terms:
Breast Neoplasms
Triple Negative Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Paclitaxel
Albumin-Bound Paclitaxel
Cisplatin
Antineoplastic Agents, Phytogenic
Antineoplastic Agents
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action