Description:
This study investigates the effect of high-dose alkylating chemotherapy compared with
standard chemotherapy as part of a multimodality treatment approach in patients with
oligo-metastatic breast cancer harboring homologous recombination deficiency.
Title
- Brief Title: High Dose Chemotherapy in Oligo-metastatic Homologous Recombination Deficient Breast Cancer
- Official Title: High-dose Alkylating Chemotherapy in Oligo-metastatic Breast Cancer Harboring Homologous Recombination Deficiency
Clinical Trial IDs
- ORG STUDY ID:
N12OLG
- SECONDARY ID:
2012-000838-19
- NCT ID:
NCT01646034
Conditions
Interventions
Drug | Synonyms | Arms |
---|
carboplatin, thiotepa, and cyclophosphamide | | intensified alkylating chemotherapy |
chemotherapy (docetaxel, doxorubicin, cyclofosfamide, carboplatin, paclitaxel, gemcitabine) | | three cycles of chemotherapy |
Purpose
This study investigates the effect of high-dose alkylating chemotherapy compared with
standard chemotherapy as part of a multimodality treatment approach in patients with
oligo-metastatic breast cancer harboring homologous recombination deficiency.
Trial Arms
Name | Type | Description | Interventions |
---|
intensified alkylating chemotherapy | Experimental | a course chemotherapy with high dose cyclophosphamide, G-CSF and peripheral blood progenitor cell (PBPC) harvest followed by tandem intermediate-dose alkylating therapy (miniCTC, carboplatin 800 mg/m2, thiotepa 240 mg/m2, and cyclophosphamide 3000 mg/m2) with PBPC-reinfusion. | - carboplatin, thiotepa, and cyclophosphamide
|
three cycles of chemotherapy | Active Comparator | three cycles of chemotherapy depending on previously received agents
chemotherapy naïve;three cycles of docetaxel, doxorubicin, and cyclophosphamide previously received anthracyclines without taxanes;three cycles of carboplatin and paclitaxel previously received anthracyclines and taxanes;three cycles of carboplatin and gemcitabine | - chemotherapy (docetaxel, doxorubicin, cyclofosfamide, carboplatin, paclitaxel, gemcitabine)
|
Eligibility Criteria
Inclusion Criteria:
1. Histologically or cytologically confirmed infiltrating breast cancer
2. Oligometastatic disease defined as one to three distant metastatic lesions, with or
without primary tumor, local recurrence, or locoregional lymph node metastases,
including the ipsilateral axillary, parasternal, and periclavicular regions. All
lesions must be amenable to resection or radiotherapy with curative intent. Staging
examinations must have included a PET-CT-scan and a MRI of the liver in case of liver
metastases. Clustered lymph nodes that can be irradiated with curative intent in a
single field are defined as a single lesion. Histologic or cytologic confirmation of
at least one distant metastatic lesion is required.
3. No prior line of chemotherapy for metastatic disease (a maximum of 3 months of
palliative endocrine therapy is allowed).
4. The tumor must be HER2-negative (either score 0 or 1 at immunohistochemistry or
negative at in situ hybridization in case of score 2 or 3 at immunohistochemistry).
5. The tumor is deficient in homologous recombination and/or the patient has a
deleterious germline BRCA1 or BRCA2 mutation.
6. At least stable disease of all tumor lesions after three courses of induction
chemotherapy
7. Age ≥18 years
8. World Health Organisation (WHO) performance status 0 or 1
9. Adequate bone marrow function (ANC ≥1.0 x 109/l, platelets ≥100 x 109/l)
10. Adequate hepatic function (ALAT, ASAT and bilirubin ≤2.5 times upper limit of normal)
11. Adequate renal function (creatinine clearance ≥60 ml/min)
12. If clinically recommended echocardiography, MUGA, or MRI to evaluate if LVEF ≥50%;
13. Signed written informed consent
14. Able to comply with the protocol
Exclusion Criteria:
- No malignancy other than breast cancer, unless treated with curative intent without
the use of chemotherapy or radiation therapy
- No current pregnancy or breastfeeding. Women of childbearing potential must use
adequate contraceptive protection.
- No concurrent anti-cancer treatment or investigational drugs
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | Female |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Event free survival |
Time Frame: | assessed up to 120 months |
Safety Issue: | |
Description: | time from randomization to local recurrence, second primary, distant recurrence or death, whichever comes first |
Secondary Outcome Measures
Measure: | Difference in median overall survival |
Time Frame: | assessed up to 120 months |
Safety Issue: | |
Description: | time from randomization to death from any cause |
Measure: | Difference in percentage of patients with grade >2 hematologic toxicity (CTCAE v4.0) |
Time Frame: | 6 months after start of treament |
Safety Issue: | |
Description: | Difference in percentage of patients with grade >2 hematologic toxicity (CTCAE v4.0) |
Measure: | Difference in percentage of patients with grade >2 non-hematologic toxicity (CTCAE v4.0) |
Time Frame: | 6 months after start of treatment |
Safety Issue: | |
Description: | Difference in percentage of patients with grade >2 non-hematologic toxicity (CTCAE v4.0) |
Measure: | Difference in quality of life (EORTC QLQ-C30 v 3.0) |
Time Frame: | 6 and 12 months post treatment |
Safety Issue: | |
Description: | Difference in quality of life (EORTC QLQ-C30 v 3.0) |
Measure: | Difference in event free survival |
Time Frame: | assessed up to 120 months |
Safety Issue: | |
Description: | o Difference in event free survival in the subgroups based on:
Estrogen receptor status;
Origin of the oligo-metastatic lesion (lymphnodes versus bone versus visceral metastases);
Primary or recurrent oligometastatic breast cancer;
BRCA1 mutation/profile or BRCA2 mutation/profile;
HRD based on BRCA1 or BRCA2 mutation and HRD based on BRCA1-like and/or BRCA2-like profile. |
Details
Phase: | Phase 3 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | The Netherlands Cancer Institute |
Trial Keywords
- oligo metastatic
- HRD deficiency
Last Updated
January 22, 2021