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Combination Chemotherapy Plus Biological Therapy in Treating Patients With Stage II or Stage III Breast Cancer

Primary Purpose

Breast Cancer

Status
Withdrawn
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
aldesleukin
filgrastim
sargramostim
therapeutic autologous lymphocytes
cyclophosphamide
doxorubicin hydrochloride
paclitaxel
Sponsored by
Roger Williams Medical Center
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring stage II breast cancer, stage IIIA breast cancer, stage IIIB breast cancer, stage IIIC breast cancer

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Histologically confirmed stage II or III adenocarcinoma of the breast High-risk disease At least 4 positive lymph nodes Fewer than 4 positive lymph nodes considered high-risk if one of the following is present: HER2/neu-positive disease Enlarged axillary nodes Extra capsular extension of tumor from lymph node Dermal lymphatic invasion Vascular invasion Bilateral disease Familial breast cancer T4 locally advanced disease Clinically chemosensitive to prior paclitaxel (or other taxane), doxorubicin, and cyclophosphamide No relapse after chemotherapy No clinical evidence of brain metastases Hormone receptor status: Estrogen and progesterone receptor status known PATIENT CHARACTERISTICS: Age: 18 and over Sex: Female Menopausal status: Not specified Performance status: Karnofsky 70-100% OR ECOG 0-2 Life expectancy: At least 3 months Hematopoietic: Granulocyte count at least 1,500/mm^3 Platelet count at least 50,000/mm^3 Hemoglobin greater than 8 g/dL Hepatic: Bilirubin less than 1.5 times normal SGOT less than 1.5 times normal Renal Creatinine less than 1.8 mg/dL Creatinine clearance at least 60 mL/min BUN less than 1.5 times normal Cardiovascular: Ejection fraction at least 45% by MUGA No uncontrolled or significant cardiovascular disease No myocardial infarction within the past year No significant congestive heart failure Pulmonary: FEV_1 at least 60% predicted DLCO at least 60% predicted FVC at least 60% predicted Other: No other malignancy except curatively treated squamous cell carcinoma in situ of the cervix or basal cell skin cancer No other serious medical or psychiatric illness that would preclude study participation HIV negative Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: See Disease Characteristics Prior standard chemotherapy with anthracyclines or combination chemotherapy involving a combination of taxanes, doxorubicin, and/or cyclophosphamide allowed Endocrine therapy: No concurrent hormonal therapy for breast cancer Concurrent hormonal therapy for nondisease-related conditions (e.g., insulin for diabetes) allowed Concurrent steroids for adrenal failure, septic shock, or pulmonary toxicity allowed Radiotherapy: Not specified Surgery: Prior complete resection of tumor allowed Other: Prior successful neoadjuvant therapy allowed

Sites / Locations

  • Roger Williams Medical Center

Outcomes

Primary Outcome Measures

Toxicity
Disease-free survival
Overall survival
Immune functions

Secondary Outcome Measures

Full Information

First Posted
August 10, 2001
Last Updated
May 4, 2015
Sponsor
Roger Williams Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT00022230
Brief Title
Combination Chemotherapy Plus Biological Therapy in Treating Patients With Stage II or Stage III Breast Cancer
Official Title
Combination of Chemotherapy With Taxol, Adriamycin, and Cytoxan (TAC), Multiple Infusions of Activated T Cells (ATC), Interleukin-2 (IL-2) and GM-CSF for High Risk Breast Cancer With and Without Her2/Neu Overexpression. (Phase I/II)
Study Type
Interventional

2. Study Status

Record Verification Date
May 2015
Overall Recruitment Status
Withdrawn
Why Stopped
PI left Institution
Study Start Date
January 2000 (undefined)
Primary Completion Date
January 2007 (Actual)
Study Completion Date
January 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Roger Williams Medical Center

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Biological therapies use different ways to stimulate the immune system and stop tumor cells from growing. Combining chemotherapy with biological therapy may kill more tumor cells. PURPOSE: This phase I/II trial is studying the side effects of giving chemotherapy together with biological therapy and to see how well they work in treating patients with stage II or stage III breast cancer.
Detailed Description
OBJECTIVES: Determine the toxic effects of sequential paclitaxel (or other taxane), doxorubicin, and cyclophosphamide followed by immunotherapy with activated T cells, interleukin-2, and sargramostim (GM-CSF) in patients with high-risk stage II or III breast cancer. Determine the disease-free survival and overall survival of patients treated with this regimen. Determine the immune function of patients treated with this regimen. OUTLINE: Patients are stratified according to number of positive lymph nodes (less than 4 nodes vs 4-9 nodes vs 10 or more nodes), type of taxane chemotherapy during study (paclitaxel vs other taxane), and prior treatment with 2 of 3 study chemotherapy agents (yes vs no). Patients receive doxorubicin IV on day 1 and filgrastim (G-CSF) on days 3-10 of 3 consecutive 14-day courses. Patients then receive paclitaxel or another taxane IV on day 1 and G-CSF on days 3-10 of 3 consecutive 14-day courses. Patients then receive cyclophosphamide IV on day 1 and G-CSF on days 3-10 of 3 consecutive 14-day courses. Patients who enroll after previously receiving 2 of these 3 chemotherapy drugs may receive the third. Treatment continues in the absence of disease progression or unacceptable toxicity. After recovery from chemotherapy, patients undergo peripheral blood mononuclear cell (PBMC) collection. The PBMC are treated ex vivo with monoclonal antibody OKT3 to form activated T cells (ATC). The ATC are expanded for up to 14 days in interleukin-2 (IL-2). At 3-4 weeks after PBMC collection, patients receive ATC IV over 15-30 minutes weekly for 8 weeks. Patients also receive IL-2 subcutaneously (SC) daily and sargramostim (GM-CSF) SC twice weekly beginning 3 days before the first ATC infusion and continuing until 7 days after completion of ATC therapy. Patients are followed every 3 months for 1 year and then annually thereafter. PROJECTED ACCRUAL: A total of 40-60 patients will be accrued for this study within 4-5 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
stage II breast cancer, stage IIIA breast cancer, stage IIIB breast cancer, stage IIIC breast cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
aldesleukin
Intervention Type
Biological
Intervention Name(s)
filgrastim
Intervention Type
Biological
Intervention Name(s)
sargramostim
Intervention Type
Biological
Intervention Name(s)
therapeutic autologous lymphocytes
Intervention Type
Drug
Intervention Name(s)
cyclophosphamide
Intervention Type
Drug
Intervention Name(s)
doxorubicin hydrochloride
Intervention Type
Drug
Intervention Name(s)
paclitaxel
Primary Outcome Measure Information:
Title
Toxicity
Title
Disease-free survival
Title
Overall survival
Title
Immune functions

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed stage II or III adenocarcinoma of the breast High-risk disease At least 4 positive lymph nodes Fewer than 4 positive lymph nodes considered high-risk if one of the following is present: HER2/neu-positive disease Enlarged axillary nodes Extra capsular extension of tumor from lymph node Dermal lymphatic invasion Vascular invasion Bilateral disease Familial breast cancer T4 locally advanced disease Clinically chemosensitive to prior paclitaxel (or other taxane), doxorubicin, and cyclophosphamide No relapse after chemotherapy No clinical evidence of brain metastases Hormone receptor status: Estrogen and progesterone receptor status known PATIENT CHARACTERISTICS: Age: 18 and over Sex: Female Menopausal status: Not specified Performance status: Karnofsky 70-100% OR ECOG 0-2 Life expectancy: At least 3 months Hematopoietic: Granulocyte count at least 1,500/mm^3 Platelet count at least 50,000/mm^3 Hemoglobin greater than 8 g/dL Hepatic: Bilirubin less than 1.5 times normal SGOT less than 1.5 times normal Renal Creatinine less than 1.8 mg/dL Creatinine clearance at least 60 mL/min BUN less than 1.5 times normal Cardiovascular: Ejection fraction at least 45% by MUGA No uncontrolled or significant cardiovascular disease No myocardial infarction within the past year No significant congestive heart failure Pulmonary: FEV_1 at least 60% predicted DLCO at least 60% predicted FVC at least 60% predicted Other: No other malignancy except curatively treated squamous cell carcinoma in situ of the cervix or basal cell skin cancer No other serious medical or psychiatric illness that would preclude study participation HIV negative Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: See Disease Characteristics Prior standard chemotherapy with anthracyclines or combination chemotherapy involving a combination of taxanes, doxorubicin, and/or cyclophosphamide allowed Endocrine therapy: No concurrent hormonal therapy for breast cancer Concurrent hormonal therapy for nondisease-related conditions (e.g., insulin for diabetes) allowed Concurrent steroids for adrenal failure, septic shock, or pulmonary toxicity allowed Radiotherapy: Not specified Surgery: Prior complete resection of tumor allowed Other: Prior successful neoadjuvant therapy allowed
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lawrence G. Lum, MD, DSc
Organizational Affiliation
Roger Williams Medical Center
Official's Role
Study Chair
Facility Information:
Facility Name
Roger Williams Medical Center
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02908-4735
Country
United States

12. IPD Sharing Statement

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Combination Chemotherapy Plus Biological Therapy in Treating Patients With Stage II or Stage III Breast Cancer

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