Combination Chemotherapy and Trastuzumab in Treating Women With Metastatic Breast Cancer



Status:Active, not recruiting
Conditions:Breast Cancer, Cancer
Therapuetic Areas:Oncology
Healthy:No
Age Range:18 - Any
Updated:1/26/2019
Start Date:April 1999

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Randomized Phase II Trial of Paclitaxel, Carboplatin and rhuMAb Her-2 (Herceptin) as First-Line Chemotherapy in Patients With Metastatic Breast Cancer Who Overexpress Her-2

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so
they stop growing or die. Combining more than one drug may kill more tumor cells. Monoclonal
antibodies such as trastuzumab can locate tumor cells and either kill them or deliver
tumor-killing substances to them without harming normal cells.

PURPOSE: Phase II trial to study the effectiveness of combining paclitaxel, carboplatin, and
trastuzumab in treating women who have metastatic breast cancer that overexpresses HER2.

OBJECTIVES:

- Compare the response rate associated with two different treatment schedules of
paclitaxel, carboplatin, and trastuzumab (Herceptin) in women with overexpressed HER-2
growth factor receptor and metastatic breast cancer. (Schedule A closed to accrual
effective 05/16/2003).

- Compare the time to progression and median survival in patients treated with these
schedules.

- Compare the toxicity of these treatment schedules in these patients.

OUTLINE: This is a multicenter study. Patients are stratified according to prior adjuvant
therapy (none vs less than 6 months vs at least 6 months), estrogen receptor (ER) status and
progesterone receptor (PR) status at initial diagnosis (ER positive/PR positive or unknown vs
ER positive/PR negative vs ER positive or unknown/PR negative), menopausal status (pre vs
post), and performance status (0 or 1 vs 2). Patients are assigned to 1 of 2 treatment
schedules.

- Schedule A: Patients receive paclitaxel IV over 3 hours followed by carboplatin IV over
30 minutes and then trastuzumab (Herceptin) IV over 90 minutes on day 1 of week 1.
Treatment repeats every 3 weeks for up to 8 courses in the absence of disease
progression or unacceptable toxicity. Patients then receive trastuzumab IV over 30
minutes every 3 weeks until disease progression. (Schedule A closed to accrual effective
05/16/2003).

- Schedule B: Patients receive paclitaxel IV over 1 hour followed by carboplatin IV over
15 minutes on day 1 of weeks 1-3 and trastuzumab IV over 90 minutes immediately after
carboplatin on day 1. Treatment repeats every 4 weeks for up to 6 courses in the absence
of disease progression or unacceptable toxicity. Patients then receive trastuzumab IV
over 30 minutes every 3 weeks until disease progression.

Patients are followed every 3 months for 2 years and then every 6 months thereafter.

PROJECTED ACCRUAL: A total of 36-92 patients (18-46 per treatment schedule) will be accrued
for this study within 7-18.5 months. (Schedule A closed to accrual effective 05/16/2003).

DISEASE CHARACTERISTICS:

- Histologically confirmed metastatic adenocarcinoma of the breast

- Strong overexpression of HER-2 by immunohistochemistry (3+)

- 0-2+ tumors allowed if demonstrate amplification by FISH

- Bidimensionally measurable disease

- Brain metastasis must not represent sole site of disease

- No untreated brain metastasis receiving radiotherapy

- Previously treated brain metastases in continued response to radiotherapy and/or
surgery for at least 2 months allowed

- Hormone receptor status:

- Positive or negative

PATIENT CHARACTERISTICS:

Age:

- 18 and over

Sex:

- Female

Menopausal status:

- Not specified

Performance status:

- ECOG 0-2

Life expectancy:

- At least 3 months

Hematopoietic:

- Absolute neutrophil count at least 1,500/mm^3

- Platelet count at least 100,000/mm^3

Hepatic:

- Bilirubin no greater than 1.5 mg/dL

- AST no greater than 3 times upper limit of normal (ULN) (5 times ULN if liver
metastases present)

Renal:

- Creatinine no greater than 1.5 times ULN

Cardiovascular:

- No myocardial infarction within the past 6 months

- No congestive heart failure or unstable angina

- No clinically significant pericardial effusion or arrhythmia

Other:

- No other invasive malignancy within the past 5 years except curatively treated basal
cell or squamous cell skin cancer or carcinoma in situ of the cervix

- No active uncontrolled infection

- No prior allergic reaction to Cremophor EL, anesthetics, or muscle relaxants

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- No concurrent filgrastim (G-CSF)

Chemotherapy:

- Prior adjuvant chemotherapy allowed

- Prior taxane therapy allowed

- No prior cisplatin or carboplatin

- No prior chemotherapy for metastatic disease

Endocrine therapy:

- Not specified

Radiotherapy:

- See Disease Characteristics

- No prior radiotherapy to more than 25% of marrow

- At least 4 weeks since prior radiotherapy

- No concurrent radiotherapy

Surgery:

- See Disease Characteristics

- At least 4 weeks since prior surgery and recovered

Other:

- At least 7 days since prior parenteral antibiotics
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5301 East Huron River Drive
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Danville, Pennsylvania 17822
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300 East Locust St., Ste 350
Des Moines, Iowa 50309
(515) 244-7586
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400 E Third Street
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353 Fairmont Blvd
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200 First Street SW
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Saint Cloud, Minnesota 56303
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Sioux City, Iowa 51101
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Sioux Falls, South Dakota 57104
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602 W University Ave
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Carle Cancer Center Carle Cancer Center delivers comprehensive care through leading-edge technology and advanced research,...
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509 W. University Avenue
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Wichita, Kansas 67214
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