Trastuzumab in Treating Women With Primary Breast Cancer
Basic Trial Information
|Phase III||Treatment||Closed||18 and over||Pharmaceutical / Industry||BO16348|
BIG-01-01, EU-20216, ROCHE-B016348E, ROCHE-B016348C, EORTC-10011, CAN-NCIC-MA24, IBCSG-28-02, MA24, NCT00045032
RATIONALE: Monoclonal antibodies such as trastuzumab can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. It is not yet known whether trastuzumab is effective in treating primary breast cancer in women who have completed adjuvant chemotherapy.
PURPOSE: This randomized phase III trial is studying two different regimens of trastuzumab and observation only to compare how well they work in treating women with breast cancer.
Further Study Information
- Compare the disease-free survival of women with HER2-positive primary breast cancer treated with trastuzumab (Herceptin®) for 1 year vs trastuzumab for 2 years vs standard supportive care.
- Compare the overall survival of patients treated with these regimens.
- Compare the relapse-free survival of patients treated with these regimens.
- Compare the distant disease-free survival of patients treated with these regimens.
- Compare the incidence of cardiac dysfunction in patients treated with these regimens.
- Evaluate the safety and tolerability of these regimens in these patients.
- Compare time to recurrence in patients treated with these regimens.
- Compare time to distant recurrence in patients treated with these regimens.
- Compare outcomes, in terms of disease-free survival, overall survival, recurrence-free survival, distant disease-free survival, time to recurrence, time to distant recurrence, cardiac safety, and overall safety, in patients treated with trastuzumab for 1 year vs 2 years.
OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to nodal status (any nodal status and prior neoadjuvant chemotherapy vs no positive nodes and no prior neoadjuvant chemotherapy vs 1-3 positive nodes and no prior neoadjuvant chemotherapy vs 4 or more positive nodes and no prior neoadjuvant chemotherapy), prior adjuvant chemotherapy regimen (no anthracyclines or taxanes vs anthracyclines only vs anthracyclines and taxanes), receptor status and endocrine therapy (negative vs positive and no prior endocrine therapy vs positive and prior endocrine therapy), age (18 to 34 vs 35 to 49 vs 50 to 59 vs 60 and over), and participating center. Patients are randomized to 1 of 3 treatment arms.
- Arm I: Patients receive trastuzumab (Herceptin®) IV over 1.5 hours on day 1. Courses repeat every 3 weeks for up to 1 year in the absence of disease progression or unacceptable toxicity.
- Arm II: Patients receive trastuzumab as in arm I. Courses repeat every 3 weeks for up to 2 years in the absence of disease progression or unacceptable toxicity.
- Arm III: Patients receive no trastuzumab. Patients may later receive trastuzumab as in arm I or arm II.
Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.
PROJECTED ACCRUAL: Approximately 4,482 patients (1,494 per treatment arm) will be accrued for this study within 4 years.
- Histologically confirmed nonmetastatic primary invasive adenocarcinoma of the breast
- Adequately excised
- Axillary nodes positive or negative
- No positive or suspicious internal mammary nodes identified by sentinel node technique that have not been irradiated
- No supraclavicular lymph node involvement
- HER2-positive disease with one of the following:
- 3+ overexpression by immunohistochemistry (IHC)
- 2+ overexpression by IHC and fluorescence in situ hybridization (FISH) with c-erbB2 gene amplification
- c-erbB2 gene amplification by FISH
- Previously treated with at least 3 months or 4 courses of approved neoadjuvant or adjuvant chemotherapy with or without radiotherapy
- No synchronous bilateral or multifocal breast cancer that is not HER2-positive
- No locally advanced or inflammatory breast cancer
- No clinical T4 primary breast tumor
- Prior curatively treated ipsilateral ductal carcinoma in situ of the breast is allowed
- Hormone receptor status:
- Estrogen receptor and progesterone receptor status known OR
- Estrogen receptor status known
- 18 and over
- Not specified
- ECOG 0-1
- Not specified
- WBC at least 2,500/mm^3
- Absolute neutrophil count at least 1,500/mm^3
- Platelet count at least 100,000
- Bilirubin no greater than 2 times upper limit of normal (ULN)
- AST and ALT no greater than 2.5 times ULN
- Alkaline phosphatase no greater than 2.5 times ULN
- Creatinine no greater than 2 times ULN
- LVEF at least 55% by echocardiography or MUGA
- No serious cardiac illness
- No documented congestive heart failure
- No high-risk uncontrolled arrhythmias
- No angina pectoris requiring antianginal medication
- No clinically significant valvular heart disease
- No evidence of transmural infarction on EKG
- No poorly controlled hypertension (i.e., systolic greater than 180 mm Hg or diastolic greater than 100 mm Hg)
- No severe pulmonary disease/illness
- No other malignancy except for curatively treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or other cancer that has been curatively treated, with no evidence of disease, and has less than 15% risk of recurrence over the next 10 years
- No other concurrent serious disease that would preclude study participation
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective barrier contraception
PRIOR CONCURRENT THERAPY:
- No prior peripheral stem cell or bone marrow stem cell transplantation as part of prior neoadjuvant or adjuvant chemotherapy regimen
- No prior biologic therapy or immunotherapy for breast cancer
- No prior anti-HER2 therapy for any reason
- No concurrent immunotherapy for breast cancer
- See Disease Characteristics
- See Biologic therapy
- No prior cumulative dose of doxorubicin more than 360 mg/m^2 or epirubicin more than 720 mg/m^2
- No prior anthracyclines for another malignancy
- No more than 7 weeks since day 1 of last chemotherapy course
- No concurrent adjuvant chemotherapy
- No concurrent hormonal therapy, including aromatase inhibitors, pure antiestrogens, or progestational agents, for breast cancer
- Concurrent systemic adjuvant hormonal therapy for estrogen receptor-positive patients allowed
- Concurrent tamoxifen allowed
- See Disease Characteristics
- No more than 6 weeks since completion of prior radiotherapy
- No prior mediastinal irradiation except for internal mammary node irradiation for the present breast cancer
- See Disease Characteristics
- No more than 6 weeks since prior definitive surgery
- Concurrent ovarian ablation allowed
- No other concurrent investigational therapy for breast cancer
- Concurrent bisphosphonate therapy allowed if started prior to study
Trial Contact Information
Trial Lead Organizations/Sponsors
F. Hoffmann - La Roche, Limited
- Breast International Group
- European Organization for Research and Treatment of Cancer
- NCIC-Clinical Trials Group
- International Breast Cancer Study Group
Link to the current ClinicalTrials.gov record.
NLM Identifier NCT00045032
ClinicalTrials.gov processed this data on April 09, 2015
Note: Information about this trial is from the ClinicalTrials.gov database. The versions designated for health professionals and patients contain the same text. Minor changes may be made to the ClinicalTrials.gov record to standardize the names of study sponsors, sites, and contacts. Cancer.gov only lists sites that are recruiting patients for active trials, whereas ClinicalTrials.gov lists all sites for all trials. Questions and comments regarding the presented information should be directed to ClinicalTrials.gov.