Description:
The purpose of this phase II is to study the efficacy and toxicity of carboplatin and
paclitaxel with pertuzumab and trastuzumab in HER2 positive and carboplatin and paclitaxel
with bevacizumab in HER2 negative in the neoadjuvant setting for the treatment of breast
cancer.
Title
- Brief Title: Phase II Breast Ca Carboplatin + Paclitaxel With Pertuzumab + Trastuzumab or Bevacizumab
- Official Title: A Phase II Study of Breast Cancer Treatment Using Weekly Carboplatin + Paclitaxel With Pertuzumab + Trastuzumab (HER2+) or Bevacizumab (HER2-) in the Neoadjuvant Setting
Clinical Trial IDs
- ORG STUDY ID:
UCI 14-67 [HS# 2015-1888]
- SECONDARY ID:
2015-1888
- NCT ID:
NCT02436993
Conditions
Interventions
Drug | Synonyms | Arms |
---|
Carboplatin | Paraplatin | Carboplatin+Paclitaxel+Bevacizumab (HER2-) |
Paclitaxel | Taxol | Carboplatin+Paclitaxel+Bevacizumab (HER2-) |
Bevacizumab | Avastin | Carboplatin+Paclitaxel+Bevacizumab (HER2-) |
Trastuzumab | Herceptin | Carboplatin+Paclitaxel+Trastuzumab+Pertuzumab (HER2+) |
Pertuzumab | Perjeta | Carboplatin+Paclitaxel+Trastuzumab+Pertuzumab (HER2+) |
Purpose
The purpose of this phase II is to study the efficacy and toxicity of carboplatin and
paclitaxel with pertuzumab and trastuzumab in HER2 positive and carboplatin and paclitaxel
with bevacizumab in HER2 negative in the neoadjuvant setting for the treatment of breast
cancer.
Detailed Description
OBJECTIVES The study component is to evaluate the treatment response and toxicity of the
protocol.
Objectives for treatment study component:
1.1 To estimate 2-year progression-free survival in patients with breast cancer with tumor
more than 1 cm and/or with clinically detected lymph node treated with neoadjuvant weekly
Carboplatin and Paclitaxel combined with Trastuzumab + Pertuzumab in HER2-positive disease or
with Bevacizumab in HER2-negative disease.
1.2 To measure the microscopic complete pathological response (pCR) rates defined as ypT0 or
ypTis tumors in patients treated with this regimen in the neoadjuvant setting.
1.3 To assess complete clinical response (cCR) rates after treatment by physical exam and
imaging tests (ultrasonography, mammography, or magnetic resonance imaging) clinical
objective response rate (by Response Evaluation Criteria In Solid Tumors (RECIST)) 1.4 To
determine the toxicity of this regimen. 1.5 To determine treatment adherence and delivered
dose intensity of this regimen.
1.6 To assess the correlation between pCR and cCR. 1.7 To determine the rate of breast
conservation following neoadjuvant therapy. 1.8 Determine treatment efficacy according to
subgroups defined according to stage and receptor status.
Trial Arms
Name | Type | Description | Interventions |
---|
Carboplatin+Paclitaxel+Bevacizumab (HER2-) | Experimental | Carboplatin weekly 12 doses Paclitaxel weekly 12 doses Bevacizumab every other week, 5 doses | - Carboplatin
- Paclitaxel
- Bevacizumab
|
Carboplatin+Paclitaxel+Trastuzumab+Pertuzumab (HER2+) | Experimental | Carboplatin weekly 12 doses Paclitaxel weekly 12 doses Trastuzumab weekly 12 doses Pertuzumab every 3 weeks, 4 doses | - Carboplatin
- Paclitaxel
- Trastuzumab
- Pertuzumab
|
Eligibility Criteria
Inclusion Criteria:
1. Histologically proven unilateral or bilateral primary breast carcinoma. (In case of
bilateral cancer, the investigator has to decide prospectively which side will be
evaluated for the primary endpoint.)
2. Tumor size is clinically at least 1 cm in greatest diameter (palpable or by imaging)
and/or with involved lymph node. In case of inflammatory disease, the extent of
inflammation may be the measurable lesion.
3. Documentation of inflammatory breast cancer
4. Woman age > or = 18
5. Performance status of 0-2 by Eastern Cooperative Oncology Group (ECOG) criteria
6. Known HER2 status
7. Normal cardiac function must be documented within 90 days prior to registration either
via an ECHO or MUGA or per physician's review of symptoms and medical history. If an
ECHO is performed as standard of care, the ejection fraction must be above the normal
limit of the institution.. If not available in the medical chart, the ECHOs or MUGAs
are not required to be repeated for research purposes.
a. Date of Echo or multigated acquisition (MUGA) (within 90 days) if performed
8. Staging work-up prior to registration
1. Date of physical examination (within 90 days)
2. Date of bilateral mammogram (within 90 days)
3. Date of breast ultrasound (within 90 days)
4. Date of MRI breast (within 30 days)
5. Chest X-ray or CT- Chest or CT/PET Scan that includes the Chest may be done at
physician's discretion (within 90 days). If not available in the medical chart,
the Chest X-ray or CT- Chest or CT/PET Scan that includes the Chest is not
required to be repeated for research purposes.
6. Other tests as clinically indicated
9. Laboratory requirements:
1. Hematology:
- Absolute Neutrophil Count (ANC) ≥ 1,500/μl
- Platelets ≥ 100,000/μl
2. Hepatic Function
- Total Bilirubin <1x upper limit of normal (ULN)
- aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2x ULN
3. Renal Function
- Creatinine <1.5x ULN
4. Proteinuria
- Random urine total protein <100mg/dL. Urine Protein Creatinine (UPC) ratio <2g
5. Negative pregnancy test for women of childbearing potential within 14 days prior
to registration.
10. All patients must be informed of the investigational nature of this study and must
sign and give written informed consent in accordance with institutional and federal
guidelines.
Exclusion Criteria:
11. Evidence of distant metastasis. If radiographic suspicion of distant metastatic site,
a negative biopsy must be available in the medical record. If not available in the
medical record, the subject may be included and a confirmatory biopsy is not required
to be performed for research purposes.
12. Known or suspected congestive heart failure, angina pectoris requiring antianginal
medication, or other clinically significant cardiac condition.
13. Pregnant or nursing women may not participate due to the possibility of harm to fetus
or nursing infants from this treatment regimen. Women of childbearing potential may
not participate unless they have agreed to use an adequate contraceptive method
throughout study treatment and for one month after completion of treatment.
14. Male patients
15. Pre-existing peripheral neuropathy of severity grade ≥ 2 (limiting instrumental
activities of daily living).
16. Incomplete wound healing.
17. Active and significant bleeding
18. Known allergy, hypersensitivity or prior infusion reaction to one or more of the
therapies incorporated into this treatment protocol.
19. Bone marrow depression or hematologic parameters in the range that would increase the
risk for severe bleeding.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | Female |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | 2-year progression free survival in patients treated with weekly carboplatin and paclitaxel combined with either trastuzumab and pertuzumab for HER2-positive patients or bevacizumab for HER2-negative patients in the neoadjuvant setting |
Time Frame: | 2 years |
Safety Issue: | |
Description: | Progression of disease-A new lesion or a greater than or equal to 25% increase in the product of the largest perpendicular diameters of any one lesion on clinical exam or by U/S or MRI Survival-from date of registration to date of death |
Secondary Outcome Measures
Measure: | Clinical complete response rates |
Time Frame: | 2 years |
Safety Issue: | |
Description: | Clinical complete response (cCR)-Normal breast on physical exam. No mass, no thickening, no erythema, no peau d'orange |
Measure: | Pathologic complete response rates |
Time Frame: | 2 years |
Safety Issue: | |
Description: | Pathologic complete response (pCR)-No histologic evidence of microscopic invasive tumor at the primary tumor site in the surgical specimen (ypT0 or DCis) |
Measure: | Number of toxicities in Carboplatin+Paclitaxel+Bevacizumab (HER2) arm |
Time Frame: | Up to 42 days after discontinued treatment |
Safety Issue: | |
Description: | This study will utilize the Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0 for toxicity and Adverse Event reporting. |
Measure: | Number of toxicities in Carboplatin+Paclitaxel+Trastuzumab+Pertuzumab (HER2+) |
Time Frame: | Up to 42 days after discontinued treatment |
Safety Issue: | |
Description: | This study will utilize the Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0 for toxicity and Adverse Event reporting. |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | University of California, Irvine |
Trial Keywords
- Neoadjuvant Treatment
- Carboplatin
- Paclitaxel
- Pertuzumab
- Trastuzumab
- Bevacizumab
Last Updated
April 19, 2021