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Herceptin Followed by Chemotherapy in Treating Women With Metastatic Breast Cancer That Overexpresses HER2

Primary Purpose

Breast Cancer

Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Herceptin™ (Her)
Herceptin™ (Her) + chemo
Sponsored by
Swiss Group for Clinical Cancer Research
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring stage IV breast cancer, recurrent breast cancer

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically confirmed HER2-overexpressing metastatic breast carcinoma Clinically or radiologically measurable or evaluable disease Bidimensionally or unidimensionally measurable lesions No ascitic, pleural, or pericardial effusions, osteoblastic bone metastases, or carcinomatous lymphangitis of the lung as only indicator lesion No known clinical brain or meningeal involvement Hormone receptor status: Not specified PATIENT CHARACTERISTICS: Age: 18 to 70 Sex: Female Menopausal status: Not specified Performance status: ECOG 0-1 OR SAKK 0-1 Life expectancy: At least 12 weeks Hematopoietic: Hemoglobin at least 10 g/dL Platelet count at least 100,000/mm^3 Absolute neutrophil count at least 2,000/mm^3 Hepatic: Bilirubin normal SGOT and/or SGPT no greater than 2 times upper limit of normal (ULN) (3 times ULN if proven liver metastases) OR No SGOT and/or SGPT greater than 1.5 times ULN if alkaline phosphatase greater than 2.5 times ULN Renal: Creatinine no greater than 1.25 times ULN Cardiovascular: LVEF normal No history of atrial ventricular arrhythmia, congestive heart failure, or angina pectoris, even if medically controlled No history of second or third-degree heart blocks No uncontrolled hypertension Other: Not pregnant or nursing Fertile patients must use effective contraception No pre-existing motor or sensory neuropathy grade 2 or greater No psychiatric disorder that would preclude informed consent No other prior malignancy except curatively treated nonmelanoma skin cancer or carcinoma in situ of the cervix No definite contraindications for use of corticosteroids No other concurrent serious illness or medical condition PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: Prior adjuvant or neoadjuvant chemotherapy allowed No more than 2 prior chemotherapy regimens for metastatic disease No prior cumulative dose of doxorubicin greater than 240 mg/m^2 No prior cumulative dose of epirubicin greater than 360 mg/m^2 No prior taxanes Endocrine therapy: Prior hormonal therapy as adjuvant treatment or for metastatic disease allowed No concurrent corticosteroids unless started more than 6 months prior to study and at low doses (i.e., no greater than 20 mg methylprednisolone or equivalent) Radiotherapy: Not specified Surgery: Not specified Other: No other concurrent anticancer drugs No other concurrent experimental drugs No concurrent bisphosphonates unless initiated more than 3 months prior to study Chronic use allowed provided bone metastases are not sole indicator lesions

Sites / Locations

  • European Institute of Oncology
  • Ospedale di Circolo e Fondazione Macchi
  • Kantonsspital Aarau
  • Kantonsspital Baden
  • Universitaetsspital-Basel
  • Istituto Oncologico della Svizzera Italiana - Ospedale Regionale Bellinzona e Valli
  • Inselspital Bern
  • Kantonsspital Graubuenden
  • Hopital Cantonal Universitaire de Geneve
  • Centre Hospitalier Universitaire Vaudois
  • Ospedale Regionale di Lugano
  • Praxis Dr. Beretta
  • Kantonsspital - St. Gallen
  • Regionalspital
  • Onkozentrum
  • City Hospital Triemli
  • UniversitaetsSpital Zuerich

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Herceptin™ (Her)

Herceptin™+Chemo

Arm Description

Herceptin™ (Her) loading dose 4 mg/kg iv, followed by 2 mg/kg iv weekly or loading dose 8 mg/kg iv, followed by 6 mg/kg iv every 3 weeks; at time of progression add chemotherapy

Herceptin™ (Her) loading dose 4 mg/kg iv, followed by 2 mg/kg iv weekly or loading dose 8 mg/kg iv, followed by 6 mg/kg iv every 3 weeks, and chemotherapy

Outcomes

Primary Outcome Measures

Time to progression on combined HerChemo (TTPHerChemo)

Secondary Outcome Measures

Response rate
Time to first progression
Time to treatment failure
Overall survival
Adverse events
Predictive value of serum HER2/neu ECD levels on clinical outcome
Conversion rate of estrogen receptor status
Association of immunoprofiles of erbB-1, erbB-2, erbB-3 and erbB-4 with clinical outcome

Full Information

First Posted
March 7, 2000
Last Updated
April 12, 2023
Sponsor
Swiss Group for Clinical Cancer Research
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1. Study Identification

Unique Protocol Identification Number
NCT00004935
Brief Title
Herceptin Followed by Chemotherapy in Treating Women With Metastatic Breast Cancer That Overexpresses HER2
Official Title
Randomized Phase III Trial of Herceptin® Followed by Chemotherapy Plus Herceptin® Versus the Combination of Herceptin® and Chemotherapy as Palliative Treatment in Patients With HER2- Overexpressing Advanced/Metastatic Breast Cancer.
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Terminated
Why Stopped
Trial is Life long follow-up: to reduce ressources and costs - trial terminated prematurely.
Study Start Date
August 30, 1999 (Actual)
Primary Completion Date
November 6, 2014 (Actual)
Study Completion Date
March 31, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Swiss Group for Clinical Cancer Research

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: To compare efficacy, toxicity and quality of life of the sequential administration of Her alone followed, at PD, by the combination with Chemotherapy (Arm A) vs. the upfront combination of Her and Chemotherapy (Arm B) in patients with advanced/metastatic breast cancer. PURPOSE: Trial SAKK 22/99 addresses clinically relevant and currently unresolved questions regarding the optimal use of Herceptin in the treatment of patients with advanced/metastatic breast cancer.
Detailed Description
In advanced HER2+ breast cancer the impact of combining Trastuzumab (T) and chemotherapy (chemo) versus T alone followed by the addition of chemo at disease progression has not been properly studied. The trial compared efficacy, toxicity and quality of life of sequential administration of T followed, at progression, by combination with chemo (T>TChemo) versus the upfront combination of T and chemo (TChemo) in patients with HER2+ advanced breast cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
stage IV breast cancer, recurrent breast cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Factorial Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
175 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Herceptin™ (Her)
Arm Type
Active Comparator
Arm Description
Herceptin™ (Her) loading dose 4 mg/kg iv, followed by 2 mg/kg iv weekly or loading dose 8 mg/kg iv, followed by 6 mg/kg iv every 3 weeks; at time of progression add chemotherapy
Arm Title
Herceptin™+Chemo
Arm Type
Active Comparator
Arm Description
Herceptin™ (Her) loading dose 4 mg/kg iv, followed by 2 mg/kg iv weekly or loading dose 8 mg/kg iv, followed by 6 mg/kg iv every 3 weeks, and chemotherapy
Intervention Type
Drug
Intervention Name(s)
Herceptin™ (Her)
Intervention Description
Herceptin™ (Her) loading dose 4 mg/kg iv, followed by 2 mg/kg iv weekly or loading dose 8 mg/kg iv, followed by 6 mg/kg iv every 3 weeks; at time of progression add chemotherapy
Intervention Type
Drug
Intervention Name(s)
Herceptin™ (Her) + chemo
Intervention Description
Herceptin™ (Her) loading dose 4 mg/kg iv, followed by 2 mg/kg iv weekly or loading dose 8 mg/kg iv, followed by 6 mg/kg iv every 3 weeks, and chemotherapy
Primary Outcome Measure Information:
Title
Time to progression on combined HerChemo (TTPHerChemo)
Time Frame
8 weeks
Secondary Outcome Measure Information:
Title
Response rate
Time Frame
8 weeks
Title
Time to first progression
Time Frame
8 weeks
Title
Time to treatment failure
Time Frame
8 weeks
Title
Overall survival
Time Frame
8 weeks
Title
Adverse events
Time Frame
8 weeks
Title
Predictive value of serum HER2/neu ECD levels on clinical outcome
Time Frame
8 weeks
Title
Conversion rate of estrogen receptor status
Time Frame
8 weeks
Title
Association of immunoprofiles of erbB-1, erbB-2, erbB-3 and erbB-4 with clinical outcome
Time Frame
8 weeks

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed HER2-overexpressing metastatic breast carcinoma Clinically or radiologically measurable or evaluable disease Bidimensionally or unidimensionally measurable lesions No ascitic, pleural, or pericardial effusions, osteoblastic bone metastases, or carcinomatous lymphangitis of the lung as only indicator lesion No known clinical brain or meningeal involvement Hormone receptor status: Not specified PATIENT CHARACTERISTICS: Age: 18 to 70 Sex: Female Menopausal status: Not specified Performance status: ECOG 0-1 OR SAKK 0-1 Life expectancy: At least 12 weeks Hematopoietic: Hemoglobin at least 10 g/dL Platelet count at least 100,000/mm^3 Absolute neutrophil count at least 2,000/mm^3 Hepatic: Bilirubin normal SGOT and/or SGPT no greater than 2 times upper limit of normal (ULN) (3 times ULN if proven liver metastases) OR No SGOT and/or SGPT greater than 1.5 times ULN if alkaline phosphatase greater than 2.5 times ULN Renal: Creatinine no greater than 1.25 times ULN Cardiovascular: LVEF normal No history of atrial ventricular arrhythmia, congestive heart failure, or angina pectoris, even if medically controlled No history of second or third-degree heart blocks No uncontrolled hypertension Other: Not pregnant or nursing Fertile patients must use effective contraception No pre-existing motor or sensory neuropathy grade 2 or greater No psychiatric disorder that would preclude informed consent No other prior malignancy except curatively treated nonmelanoma skin cancer or carcinoma in situ of the cervix No definite contraindications for use of corticosteroids No other concurrent serious illness or medical condition PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: Prior adjuvant or neoadjuvant chemotherapy allowed No more than 2 prior chemotherapy regimens for metastatic disease No prior cumulative dose of doxorubicin greater than 240 mg/m^2 No prior cumulative dose of epirubicin greater than 360 mg/m^2 No prior taxanes Endocrine therapy: Prior hormonal therapy as adjuvant treatment or for metastatic disease allowed No concurrent corticosteroids unless started more than 6 months prior to study and at low doses (i.e., no greater than 20 mg methylprednisolone or equivalent) Radiotherapy: Not specified Surgery: Not specified Other: No other concurrent anticancer drugs No other concurrent experimental drugs No concurrent bisphosphonates unless initiated more than 3 months prior to study Chronic use allowed provided bone metastases are not sole indicator lesions
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pagani Olivia, MD
Organizational Affiliation
Istituto Oncologico della Svizzera Italiana IOSI
Official's Role
Study Chair
Facility Information:
Facility Name
European Institute of Oncology
City
Milan
ZIP/Postal Code
20141
Country
Italy
Facility Name
Ospedale di Circolo e Fondazione Macchi
City
Varese
ZIP/Postal Code
21100
Country
Italy
Facility Name
Kantonsspital Aarau
City
Aarau
ZIP/Postal Code
CH-5001
Country
Switzerland
Facility Name
Kantonsspital Baden
City
Baden
ZIP/Postal Code
CH-5404
Country
Switzerland
Facility Name
Universitaetsspital-Basel
City
Basel
ZIP/Postal Code
CH-4031
Country
Switzerland
Facility Name
Istituto Oncologico della Svizzera Italiana - Ospedale Regionale Bellinzona e Valli
City
Bellinzona
ZIP/Postal Code
6500
Country
Switzerland
Facility Name
Inselspital Bern
City
Bern
ZIP/Postal Code
CH-3010
Country
Switzerland
Facility Name
Kantonsspital Graubuenden
City
Chur
ZIP/Postal Code
7000
Country
Switzerland
Facility Name
Hopital Cantonal Universitaire de Geneve
City
Geneva
ZIP/Postal Code
CH-1211
Country
Switzerland
Facility Name
Centre Hospitalier Universitaire Vaudois
City
Lausanne
ZIP/Postal Code
CH-1011
Country
Switzerland
Facility Name
Ospedale Regionale di Lugano
City
Lugano
ZIP/Postal Code
6900
Country
Switzerland
Facility Name
Praxis Dr. Beretta
City
Rheinfelden
ZIP/Postal Code
CH-4310
Country
Switzerland
Facility Name
Kantonsspital - St. Gallen
City
St. Gallen
ZIP/Postal Code
CH-9007
Country
Switzerland
Facility Name
Regionalspital
City
Thun
ZIP/Postal Code
3600
Country
Switzerland
Facility Name
Onkozentrum
City
Zurich
ZIP/Postal Code
8038
Country
Switzerland
Facility Name
City Hospital Triemli
City
Zurich
ZIP/Postal Code
8063
Country
Switzerland
Facility Name
UniversitaetsSpital Zuerich
City
Zurich
ZIP/Postal Code
CH-8091
Country
Switzerland

12. IPD Sharing Statement

Citations:
PubMed Identifier
32046665
Citation
Eppenberger-Castori S, Klingbiel D, Ruhstaller T, Dietrich D, Rufle DA, Rothgiesser K, Pagani O, Thurlimann B. Plasma HER2ECD a promising test for patient prognosis and prediction of response in HER2 positive breast cancer: results of a randomized study - SAKK 22/99. BMC Cancer. 2020 Feb 11;20(1):114. doi: 10.1186/s12885-020-6594-0.
Results Reference
derived
PubMed Identifier
31500588
Citation
Schmid S, Klingbiel D, Aebi S, Goldhirsch A, Mamot C, Munzone E, Nole F, Oehlschlegel C, Pagani O, Pestalozzi B, Rochlitz C, Thurlimann B, von Moos R, Weder P, Zaman K, Ruhstaller T. Long-term responders to trastuzumab monotherapy in first-line HER-2+ advanced breast cancer: characteristics and survival data. BMC Cancer. 2019 Sep 10;19(1):902. doi: 10.1186/s12885-019-6105-3.
Results Reference
derived

Learn more about this trial

Herceptin Followed by Chemotherapy in Treating Women With Metastatic Breast Cancer That Overexpresses HER2

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