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A Study of Pertuzumab in Combination With Herceptin and Chemotherapy in Participants With HER2-Positive Breast Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT00976989
Recruitment Status : Completed
First Posted : September 15, 2009
Results First Posted : June 20, 2016
Last Update Posted : February 6, 2017
Sponsor:
Information provided by (Responsible Party):
Hoffmann-La Roche

Study Description
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Brief Summary:
This 3 arm study will assess the tolerability, safety and efficacy of 3 neoadjuvant treatment regimens in participants with locally advanced, inflammatory or early stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Before surgery, participants will be randomized to receive either A) 6 cycles of pertuzumab plus trastuzumab (Herceptin), with 5-fluorouracil/epirubicin/cyclophosphamide (FEC) for cycles 1-3 and docetaxel for cycles 4-6, or B) FEC for cycles 1-3 followed by pertuzumab plus trastuzumab with docetaxel for cycles 4-6, or C) 6 cycles of pertuzumab plus trastuzumab with docetaxel and carboplatin. Pertuzumab will be administered at a loading dose of 840 mg intravenously (iv), then 420 mg iv 3-weekly, trastuzumab at a loading dose of 8 mg/kg iv, then 6 mg/kg iv 3-weekly, docetaxel at 75 mg/m^2 iv, increased to 100 mg/m^2 iv 3-weekly, and FEC and carboplatin iv 3-weekly at standard doses. Following surgery participants will receive trastuzumab 6 mg/kg iv 3-weekly for a total of 1 year, as well as adequate chemo-, radio- and hormone therapy. Anticipated time on study treatment is 4-12 months, and target sample size is 200-300.

Condition or disease Intervention/treatment Phase
Breast Cancer Drug: Pertuzumab Drug: Trastuzumab Drug: FEC Drug: Docetaxel Drug: TCH Phase 2

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 225 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Randomised, Multicentre, Multinational Phase II Study to Evaluate Pertuzumab in Combination With Trastuzumab, Given Either Concomitantly or Sequentially With Standard Anthracycline-based Chemotherapy or Concomitantly With a Non-anthracycline-based Chemotherapy Regimen, as Neoadjuvant Therapy for Patients With Locally Advanced, Inflammatory or Early Stage HER2-positive Breast Cancer
Study Start Date : November 2009
Actual Primary Completion Date : June 2011
Actual Study Completion Date : January 2016

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Breast Cancer

Arms and Interventions
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Arm Intervention/treatment
Experimental: T+P Concomitant Anthracycline-based chemotherapy
5-Fluorouracil, epirubicin with cyclophosphamide (FEC), trastuzumab (T) and pertuzumab (P) every three weeks for three cycles, followed by docetaxel, trastuzumab and pertuzumab every three weeks, for three cycles as neoadjuvant therapy. Trastuzumab every three weeks from Cycle 7 up to Cycle 17 as adjuvant therapy post-surgery.
 Drug: Pertuzumab
840 mg loading dose intravenously (IV), then 420 mg IV 3-weekly.
Other Name: Perjeta

Drug: Trastuzumab
8 mg/kg loading dose IV, then 6 mg/kg every 3 weeks.
Other Name: Herceptin

Drug: FEC
5-fluorouracil 500 mg/m^2, epirubicin 100 mg/m^2 and cyclophosphamide 600 mg/m^2.

Drug: Docetaxel
75 mg/m^2 for the first dose; 100 mg/m^2 if no dose limiting toxicity occurs.
Experimental: T+P Sequential Anthracycline-based chemotherapy
FEC every three weeks for three cycles, followed by docetaxel, trastuzumab (T) and pertuzumab (P) every three weeks, for three cycles as neoadjuvant therapy. Trastuzumab every three weeks from Cycle 7 up to Cycle 21 as adjuvant therapy post-surgery.
 Drug: Pertuzumab
840 mg loading dose intravenously (IV), then 420 mg IV 3-weekly.
Other Name: Perjeta

Drug: Trastuzumab
8 mg/kg loading dose IV, then 6 mg/kg every 3 weeks.
Other Name: Herceptin

Drug: FEC
5-fluorouracil 500 mg/m^2, epirubicin 100 mg/m^2 and cyclophosphamide 600 mg/m^2.

Drug: Docetaxel
75 mg/m^2 for the first dose; 100 mg/m^2 if no dose limiting toxicity occurs.
Experimental: T+P Concomitant Non-Anthracycline chemotherapy
Trastuzumab, carboplatin, docetaxel (TCH) and pertuzumab (P) every three weeks, for six cycles as neoadjuvant therapy. Trastuzumab every three weeks from Cycle 7 up to Cycle 17 as adjuvant therapy post-surgery.
 Drug: Pertuzumab
840 mg loading dose intravenously (IV), then 420 mg IV 3-weekly.
Other Name: Perjeta

Drug: TCH
Trastuzumab followed by carboplatin at target area under the plasma concentration-time curve (AUC) 6 and docetaxel at a starting dose of 75 mg/m^2. All treatments were given every three weeks by the IV route.


Outcome Measures
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Primary Outcome Measures :
  1. Safety: Percentage of Participants With Symptomatic Cardiac Events as Assessed by the Investigator [ Time Frame: From baseline up to approximately 3.5 years ]
    Left ventricular systolic dysfunction (LVSD) as assessed by the Investigator, including Grade 3, 4 or 5 symptomatic LVSD with symptomatic cardiac events.

  2. Safety: Percentage of Participants With Left Ventricular Ejection Fraction (LVEF) Decline During Pre-operative (Neoadjuvant) Period [ Time Frame: From baseline up to approximately 18 weeks ]
    Percentage of participants with LVEF measures decline of ≥ 10% from baseline and to a value of <50% during the pre-operative (neoadjuvant) period.


Secondary Outcome Measures :
  1. Efficacy: Percentage of Participants With Complete Pathological Response (pCR) [ Time Frame: At surgery, after 18 weeks (6 cycles) of treatment ]
    pCR is defined as the absence of invasive neoplastic cells at microscopic examination of the tumor remnants after surgery following primary systemic therapy. pCR is evaluated after 6 cycles of treatment and surgery or following withdrawal from the study whichever occurs sooner.

  2. Efficacy: Clinical Response Rate [ Time Frame: During each 3-week cycle of 6 total cycles: up to 18 weeks ]
    Tumor response is defined as complete response (CR), partial response (PR), stable disease (SD) or progressive disease (PD) and is identified as per local practice. Clinical response rate is defined as the percentage of participants who achieve a response of CR or PR at any time pre-surgery. Per Response Evaluation Criteria in Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by mammogram or magnetic resonance imaging (MRI) and clinical breast examination (CBE), CR is disappearance of all target lesions; PR is >=30% decrease in the sum of the longest diameter of target lesions.

  3. Efficacy: Time to Clinical Response [ Time Frame: Up to 18 weeks ]
    Time to clinical response is defined as the time from the date of first dose received to the first date of assessment of clinical response. Clinical response is defined as a response of CR or PR at any time pre-surgery. Per RECIST v1.0 for target lesions and assessed by mammogram or MRI and CBE, CR is disappearance of all target lesions; PR is >=30% decrease in the sum of the longest diameter of target lesions.

  4. Efficacy: Percentage of Participants Achieving Breast Conserving Surgery [ Time Frame: At approximately 18 weeks ]
    This is the percentage of participants who achieved breast conserving surgery out of the intent-to-treat population without inflammatory breast cancer, as these participants received mastectomy irrespective of their response to neoadjuvant (pre-operative) treatment.

  5. Efficacy: Percentage of Participants Without an Overall Survival (OS) Event [ Time Frame: From baseline to end of study up to 5 years ]
    Overall survival (OS) was defined as the time from randomization to the date of death from any cause. Participants who were alive or lost to follow-up were censored at the last known alive date. Participants with no post-baseline information were censored at the date of randomization plus one day.

  6. Efficacy: Percentage of Participants Without a Disease-Free Survival (DFS) Event [ Time Frame: From baseline to end of study up to 5 years ]
    The DFS was defined as the time from the first date of no disease (i.e., date of surgery) to the first documentation of progressive disease (PD) or death. PD was assessed using RECIST v1.0 and MRI and CBE. It was defined as at least a 20% increase in the sum of diameters of target lesions with an absolute increase of at least 5 mm or the appearance of one or more new lesions. Any evidence of contralateral disease in situ was not considered as PD. Participants who were withdrawn from the study without documented PD were censored at the date of the last assessment when the participant was known to be disease-free.

  7. Efficacy: Percentage of Participants Without a Progression-Free Survival (PFS) Event [ Time Frame: From baseline to end of study up to 5 years ]
    Progression-free survival was defined as the time from the date of randomization to the first documentation of PD or death from any cause, whichever occurred first. PD was assessed using RECIST v1.0 and MRI and CBE. It was defined as at least a 20% increase in the sum of diameters of target lesions with an absolute increase of at least 5 mm or the appearance of one or more new lesions. Participants who were withdrawn from the study without documented PD were censored at the date of the last assessment when the participant was known to be free from PD. Participants without post-baseline assessments but known to be alive were censored at the time of randomization plus one day.

  8. Safety: Percentage of Participants With Cardiac Symptoms Associated With Symptomatic Left Ventricular Systolic Dysfunction (LVSD) [ Time Frame: From Baseline to end of Neoadjuvant Period (up to 18 weeks), Adjuvant Period (up to 1.5 years), Follow-up Period (up to 3.5 years) ]
    Percentage of participants with signs or symptoms of cardiac events.

  9. Safety: Percentage of Participants With Asymptomatic Left Ventricular Ejection Fraction (LVEF) Events [ Time Frame: From baseline to end of Neoadjuvant Period (up to 18 weeks), Adjuvant Period (up to 1.5 years), Follow-up Period (up to 3.5 years) ]
    Percentage of participants with LVEF events without signs or symptoms of cardiac events.

  10. Safety: Maximum Decrease in Left Ventricular Ejection Fraction (LVEF) Measures [ Time Frame: From baseline up to approximately 3.5 years ]
    Maximum decrease in LVEF measures is the change from baseline at worst treatment value. LVEF is measured as percentage.


Eligibility Criteria
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Information from the National Library of Medicine

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, Learn About Clinical Studies.


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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:

  • female participants, age >/=18 years
  • advanced, inflammatory or early stage unilateral invasive breast cancer
  • HER2-positive breast cancer
  • baseline left ventricular ejection fraction (LVEF) >/=55%

Exclusion Criteria:

  • metastatic disease (Stage IV) or bilateral breast cancer
  • previous anticancer therapy or radiotherapy for any malignancy
  • other malignancy, except for carcinoma in situ of the cervix, or basal cell carcinoma
  • clinically relevant cardiovascular disease
  • current chronic treatment with corticosteroids of >10mg methylprednisolone or equivalent
Contacts and Locations
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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): NCT00976989


Locations
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Sponsors and Collaborators
Hoffmann-La Roche
Investigators
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Study Director: Clinical Trials Hoffmann-La Roche
More Information
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Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: Hoffmann-La Roche
ClinicalTrials.gov Identifier: NCT00976989    
Other Study ID Numbers: BO22280
2009-012019-17 ( EudraCT Number )
First Posted: September 15, 2009    Key Record Dates
Results First Posted: June 20, 2016
Last Update Posted: February 6, 2017
Last Verified: May 2016
Additional relevant MeSH terms:
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Breast Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Docetaxel
Trastuzumab
 Pertuzumab
Antineoplastic Agents
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents, Immunological